Search PubMed⌕ Search

Biomedical subjects

R Kerremans

Publications and source records attributed to R Kerremans.

104 records · Page 6Linked to original sources
PubMedDate not supplied

[Partial gastrectomy for benign stomach ulcer: early and late results].

106 patients had a partial gastrectomy for a benign gastric ulcer. 63 of them got a long-term follow-up. The mean follow-up is 127 months. The mortality rate of the emergency operation is 20%. For the elective operation the mortality rate is 0%. More than 90% of the patients have no complaints after a long time. Following a Billroth I operation most patients feel better initially but later there is no difference at all. The frequency of the ulcer recurrence following a B I is higher than following a B II, but it is lower than after another operation (resp. 5.8% and 2.2%). For these reasons we propose a partial gastrectomy for a benign gastric ulcer in elective circumstances. To prevent alkaline biliary reflux gastritis a 2/3 distal gastrectomy with selective vagotomy and Roux-in-Y anastomosis has to become a routine operation. In emergency circumstances a partial gastrectomy is not indicated because of the high mortality rate.

Adult↗
PubMedDate not supplied

[Benign stomach tumors: histology, diagnosis and surgical experience].

Benign neoplasms of the stomach lead to atypical symptoms. Radiological and endoscopic investigations are always recommended. Our surgical experience with 11 epithelial and 26 mesenchymal benign neoplasms is discussed. A local excision could be carried out in 24 patients, of whom 4 developed postoperative complications and one deceased. Ten cases required a partial and 3 cases a total gastrectomy. This was mainly due to the localisation or the extent of the lesions. One surgical complication occurred and one patient died. Relapse was never observed in the long-term (i.e. 6 years) follow-up of 29 patients. Nonetheless, a yearly radiological or endoscopical control is advocated since hyperplastic polyps can relapse as exaggerated healing of an ulcer, and because especially leiomyomas, neurilemmomas en lipomas carry a substantial risk of malignant degeneration.

Adolescent↗
PubMedDate not supplied

[Objective evaluation of anorectal function in fecal incontinence].

Evaluation of anorectal function in faecal incontinence. In cases presenting faecal incontinence, an etiological diagnosis should be based on history, clinical examination, anuscopy and rectoscopy. This diagnosis should be confirmed or contradicted by the results of objective investigations, especially manometry, myography and radiology. In the absence of anorectal anatomical defects, a functional cause of incontinence has to be found: megarectum with pseudo-incontinence, psychogenic encopresis, lesions of the nervous system, pudendal neuropathy. In the presence of obvious anatomical defects, the function of all components of the anorectal continence apparatus has to be evaluated; in this way, it will be possible to objectivate the results of conservative or surgical treatment by repetition of the technical investigations. In practice, a complete functional evaluation of the anorectum has to be performed in patients in whom the results of previous therapy remain unsatisfactory.

Anal Canal↗
PubMedDate not supplied

Hepatic hemangioma.

Explore the source record for details and available documents.

Adult↗
PubMedDate not supplied

Manometric evaluation of incontinent patients.

The relationship between symptoms and manometric data was studied in incontinent patients. Conventional anal manometry, the rectal saline infusion test and the balloon-retaining test were performed in 27 control subjects (M:8, F:19; mean age: 47 yr) and in 40 incontinent patients (M:5, F:35; mean age: 49 yr). The correlation coefficient between the clinical degree of continence/incontinence and the maximum anal basal tone, squeeze pressure and the pressure increment during squeeze was -0.74, -0.74 and -0.57, respectively. Discriminatory values of > 40 mmHg for maximum basal pressure and > 92 mmHg for squeeze pressure could identify continent patients with 96%, and incontinent patients with 88% accuracy. The uncontrollable evacuation of a balloon, progressively filled with water at 60 ml/min, before the maximum tolerable sensation level was reached, was related to the degree of clinical incontinence. Also the maximum retained volume and the interval between the first sensation volume and the maximum retained volume ("perceived rectal capacity") were related to the clinical symptoms: r = -0.72 and -0.71, respectively. The balloon-retaining test proved to be superior to the rectal saline infusion test for the determination of the severity of incontinence. The saline infusion test, however, was found to be more adequate to identify minor defects of continence. Thus, the manometric assessment of anorectal continence should consist of routine anal manometry, the rectal saline infusion test and the balloon-retaining test. Some important clinical implications are discussed.

Adult↗
PubMedDate not supplied

Paraprosthetic fistula after aortobifemoral prosthetic reconstruction: treatment by autogenous saphenous venous replacement. A case report.

Paraprosthetic fistula is a rare but dramatic complication of aortofemoral prosthetic reconstruction. Conventional treatment consisting of removal of the prosthesis and extra-anatomical revascularization results in a high morbidity and mortality rate. The authors present a patient with a paraprosthetic fistula, who was successfully treated by excision of the graft and "in situ" replacement by autogenous saphenous vein.

Arterial Occlusive Diseases↗
PubMedDate not supplied

Repeated hepatic ischemia in combination with chemotherapy for liver carcinoid metastases.

Both hepatic ischemia and chemotherapy are effective in the treatment of carcinoid liver metastases, but their effectiveness is often limited, partial and transient. It has been shown that, during intermittent occlusion of the hepatic artery with a surgically implanted occluder, no revascularisation from collaterals occurs. We studied the feasibility, the side-effects, the response to tumour measurements and hormonal excretions of a combined treatment of repeated hepatic ischemia and 5-Fluorouracil and Streptozotocin-administration in carcinoid liver metastases.

Adult↗
PubMedDate not supplied

Diagnostic accuracy of ultrasonography and surgical decision-making in patients referred for suspicion of appendicitis.

Two groups of patients referred for suspicion of acute appendicitis were compared to evaluate the accuracy of preoperative ultrasonography (US) and surgical decision-making. In one retrospective study, US was performed by trainees using a 3.5 MHz probe (219 patients). In the second prospective study, US was performed by a resident radiologist using a 5 MHz probe (144 patients). US accuracy rose from 65% to 90%, especially due to an improved negative predictive value (from 52% to 92%). The positive predictive value of US was 89%. The sonographically adjusted clinical decision to operate was correct in 85%. Thus, all patients with positive US should be operated. In contrast, clinical judgment must prevail in case of negative US findings in order to prevent surgical delay in about 11%. The negative laparotomy rate decreased by 5% only. This is probably due to the limited influence of negative US findings on surgical decision. US is to be recommended in all patients suspected for acute appendicitis when performed with an appropriate probe by an experienced ultrasonographist. However, it may not, on it self, reduce the rate of unnecessary operative procedures.

Adolescent↗
PubMedDate not supplied

Early derivation operation can restore the pancreas histology and function in chronic obstructive pancreatitis in the cat.

BACKGROUND/AIMS: Obstruction of the main pancreatic duct leads to progressive obstructive and atrophying pancreatitis in the cat. The question remains whether "early" derivative procedures can halt the destructive process or not? METHODOLOGY: Twelve cats submitted to total obstruction of the main pancreatic duct developed chronic obstructive pancreatitis as documented by histopathology. After 5 weeks, five animals underwent a caudal pancreaticojejunostomy, the others served as controls. Pancreatic histopathology and ductography was conducted in both groups, as well as tests of endocrine and exocrine functioning. RESULTS: Three of the five cats that underwent a derivation operation died 3-5 weeks following the second operation mainly due to infection, but 2 cats could be followed-up for up to 52 weeks. The histological signs of inflammation and early fibrosis gradually disappeared and the pancreas returned to normal as assessed by histology, radiology and pancreatic function tests. In contrast, cats not submitted to the derivation procedure developed an atrophic chronic pancreatitis. CONCLUSIONS: A desobstructive operation, carried out 5 weeks after total obstruction of the main pancreatic duct in cats, can halt the progression of chronic obstructive pancreatitis and leads to restitution of the pancreas as assessed by histology, radiology and function tests.

Animals↗