Biomedical subjects

T Van Wymersch

Publications and source records attributed to T Van Wymersch.

6 recordsLinked to original sources

PubMed1994

[Anal surgery in Crohn disease].

For twenty years, opinions concerning local surgery of anal lesions in Crohn's disease have changed in practice and in the literature. We have reviewed 209 patients, usually in remission of disease, with at least 6 months' follow-up, who underwent local surgery for various anal lesions from 1974 to 1992. In this study, our indications and results are discussed and compared to the literature. Results of partial haemorrhoidectomy are successful. In anorectal stenosis, with rectal involvement, surgery improves the symptoms and can avoid or delay proctectomy. Results of surgery for simple fistulas appear to be identical in cases with or without Crohn's disease. In complex and suprasphincteric fistulas, seton management improves chronic suppuration, occasionally cures the lesion and reduces the number of tracts. After seton drainage, transanal rectal advancement flaps can be performed, but the results of this procedure have yet to be confirmed.

Anus Diseases↗

PubMed1992

Anal fissure: correlation between symptoms and manometry before and after surgery.

The study compared symptoms and manometric results in 76 patients (42 men and 34 women; median age: 45 years) before and at long-term follow-up (median time: 54 months) after fissurectomy with posterior midline sphincterotomy for anal fissure. The fissure healed in all cases. Sporadic loss of continence for flatus or for liquid stool occurred in 21 patients (27.6%) and soiling was present in 7 other patients (9.2%). Preoperative maximum resting anal pressure was significantly greater in the study group compared with 40 control subjects (p less than 0.001). Postoperative resting anal pressure fell significantly (p less than 0.001) and remained low on long-term assessment. Postoperative maximal squeeze pressure remained unchanged. No correlation could be found between preoperative and postoperative clinical symptoms (including continence) and anorectal manometry.

Adult↗

PubMedDate not supplied

[Risk of recurrence of colorectal polyps following endoscopic resection].

From 1976 to 1985, 1063 patients (614 men, 449 women, mean age: 63 years) underwent the excision of 1887 adenomatous or villous colonic or rectal polyps. Regular controls by barium enema or total colonoscopy have been proposed to these patients. A first control, performed in 715 patients (67%) after a mean of 27 months, revealed the presence of polyps in 162 of them (23%). A second control performed in 331 of the 535 controllable patients (61%), was positive (presence of polyps) in 82 of them (24%). During the follow-up period, 16 cancerous lesions were observed. Comparing the initial status of the patients with the results of the different controls, 3 risk factors for developing a new colonic or rectal polyp emerged: 1) male sex, 2) the presence of multiple lesions at the initial examination, 3) a recurrence at a previous control.

Adult↗

PubMedDate not supplied

[Villous tumors of the rectum. Endoscopic treatment using monopolar coagulation].

UNLABELLED: Many methods are used to treat villous adenomas of the rectum. The best choice between these methods is not well established. Ninety-six patients (47 men, 49 women) treated with endoscopic monopolar coagulation were studied. The mean age was 66 years (range 37-84). The lesions were located in the lower third of the rectum in 27 cases, in the middle third in 35 cases and in the upper third in 34 cases. The circumferential extent of the lesions was less than 1/3 in 70 cases (C1), greater than 1/3-less than 2/3 in 23 (C2) and greater than 2/3 in 3 cases (C3). The follow-up of 2 patients (1 C1 and 1 C2) was not sufficient. Healing was not achieved in 8 of the 94 evaluated patients. Eighty-six patients were totally healed: 68 C1, 16 C2 and 2 C3 with a follow-up of 2 to 132 months (median: 36 months). The treatment was achieved after a mean of 2.1 sessions per patient (range 1-13). CONCLUSIONS: 1) Endoscopic monopolar coagulation of villous adenoma of the rectum is a simple and efficient treatment. 2) This method is complementary to surgery for extensive lesions (C3).

Adenoma↗

PubMedDate not supplied

[Villous tumors of the rectum. Endoscopic treatment using photocoagulation].

We report the results of endoscopic photocoagulation in the treatment of villous adenomas of the rectum in 49 consecutive patients (26 males, and 23 females, mean age: 74 years). Twenty-six patients were treated with a high-power Nd-Yag laser (80 W/sec). After a mean of 3.4 laser sessions, all the small-sized adenomas (C1) and 88% of the intermediate-sized adenomas (C2) were healed. No extensive villous adenoma (C3) could be eradicated. Complications occurred in 5 patients. Recurrence was observed in 3 C2 patients who are still on maintenance laser therapy. Twenty-three patients were treated with another Nd-Yag laser (maximal power output: 45 W/sec). After a mean of 6.4 laser sessions, 85% of the C1 patients were healed, while eradication of villous tissues was obtained in 60% of C2 and C3 patients. No complications were noted. A recurrence was observed in three C1 patients with secondary healing after reinstitution of laser therapy in 2 cases. Moreover, two C3 patients also relapsed and laser eradication was again obtained in 1 patient. In conclusion, these results confirm the efficacy of laser therapy in small- and intermediate-sized villous adenomas of the rectum. The number of laser sessions required for eradicating a villous tumour was lower using a high-power Nd: Yag laser, but the risk of complications was increased.

Adenoma↗

PubMedDate not supplied

[Hemorrhoids. Review].

Correct definition of haemorrhoidal disease allows the estimation of the incidence and the therapeutic choices. The term "haemorrhoidal disease" should be used specifically for symptoms secondary to abnormalities of the intern haemorrhoidal plexus. The classification of severity is useful but difficult to apply to individual cases. The aetiopathogenesis remains unclear. Many arguments are in favour of a progressive degeneration of the fibromuscular structure of the internal haemorrhoidal plexus responsible for his prolapse in the anal canal. Most patients suffering from haemorrhoids are relieved by simple dietary advice. Moderate prolapsing haemorrhoids are significantly improved by rubber band ligation. Surgical haemorrhoidectomy remains the procedure of choice in patients with advanced prolapsing haemorrhoids.

Aged↗