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Biomedical subjects

R Van Hee

Publications and source records attributed to R Van Hee.

78 records · Page 5Linked to original sources

Surgical treatment of benign tumours of the salivary glands.

In this multicentre retrospective study 30 patients with benign salivary gland tumours are reviewed. Initial operation consisted of total parotidectomy in 6 patients, superficial lobectomy in 13 and tumour enucleation in 11. There were 5 recurrences, treated by enucleation in 1, superficial lobectomy in 2 and extensive total resection in 2 patients. In 18 cases a typical facial nerve dissection was performed. The resected specimens showed a pleiomorph adenoma in 24 cases and monomorph adenoma's in 6 cases. Complications were haematoma formation, Frey syndrome and facial nerve paresis. Recurrences were related to incomplete resection or fragmentation during operation. In this study benign tumours of the salivary glands proved to have a good prognosis, provided a total tumour excision with nerve dissection is performed; the excision should consist of a superficial lobectomy or total parotidectomy depending on the location of the tumour in the lateral or medial part of the gland.

Adenoma↗

Cystadenocarcinoma of the pancreas: characteristics and surgical strategy.

When a cystic lesion of the pancreas is encountered, the first priority is to differentiate whether it is an inflammatory or neoplastic cyst. Failure to recognize the true nature of a neoplastic cyst will lead to an incorrect treatment strategy. This was dramatically proven in one of our patients. Nevertheless, because of the slow growth of this type of tumor, its tendency not to infiltrate adjacent structures and the relatively low likelihood of metastasis, operative resection should be attempted in all patients, even in more advanced stages.

Adult↗

Gastric emptying of liquid meals after anterior gastric stapling and posterior truncal vagotomy in beagle dogs: discrepancy with results for solid food.

BACKGROUND/AIMS: Since the development of highly selective vagotomy (HSV), simplified procedures such as posterior truncal vagotomy with anterior gastric wall stapling (PTV-AGS) became available to achieve parietal cell denervation. The purpose of this investigation was to detect possible gastric emptying disturbances due to complete vagotomy of the posterior gastric wall and to stapling of the anterior stomach wall. METHODOLOGY: Six female dogs, undergoing HSV, were compared with six others, in which PTV-AGS was performed. Radionuclide labeled liquid test meals were used to evaluate gastric emptying rate (GER) and results were compared with solid test meal emptying. RESULTS: A small, statistically insignificant fastening of liquid gastric emptying was seen early after HSV, as well as after PTV-AGS, and persisted one year after operation. There proved to be a striking lack of correlation between the GER-results after liquid versus solid meals. CONCLUSION: Just as after HSV, gastric emptying rates of liquid meals after PTV-AGS do not show a statistical difference as compared with preoperative values. Both operations therefore do not induce clinically important gastric motility changes. Separate test meals with liquid and solid food prove to be necessary in order to detect such changes.

Animals↗

The influence of somatostatin on postoperative outcome after elective pancreatic surgery.

A series of 34 patients with pancreatic resections was evaluated with respect to the occurrence of local and general complications. Two groups were compared, depending on whether or not treatment with somatostatin was instituted. Postoperative morbidity and mortality were less frequent when somatostatin was given (resp. 50.0 and 5.5%) than when it was omitted (resp. 68.7 and 31.2%). Less complications were observed after resections performed for chronic pancreatitis than for pancreatic cancer in the non somatostatin-treated group. It is concluded that somatostatin treatment may be beneficial in preventing complications after elective pancreatic surgery.

Adult↗

Laparoscopic splenectomy after arterial embolisation.

Laparoscopic splenectomy remains a challenging procedure, as haemorrhage causes the most complications. In order to reduce this risk, preoperative selective embolisation of the splicing artery has been performed in a series of six successful laparoscopic splenectomies in one male and five female patients with a mean age of 34.6 years (range 17-53 yrs). Indications for surgery were immune thrombocytopenic purpura (ITP)(n = 3), non-Hodgkin lymphoma with secondary haemolytic anaemia (n = 1), autoimmune haemolytic anaemia (n = 1) and congenital spherocytosis (n = 1). The mean splenic length was 12.3 cm (range 9-16 cm) and no accessory spleens were identified. Mean operative time was 96.7 min (range 90-150 min). There were no deaths nor haemorrhagic or septic complications. Recovery after surgery was excellent with a mean hospital stay of 5.2 days (range 2-10 days). We conclude that selective embolisation of the splenic artery, just prior to laparoscopic splenectomy adds to the safety, and operating time may be shortened.

Adolescent↗