[How can the Commission of Approval influence the quality of education?].
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Belgium↗
Biomedical subjects
W Allegaert
Publications and source records attributed to W Allegaert.
[Evaluation of local anesthesia in inguinal hernia operations].
The results of a group of General, Peridural and Epidural Anesthesia (162 operations) and a group of Local Anesthesia (87 operations) were compared. It was concluded that in the local anesthesia group: 1. A minimal dose of medication was needed (inclusive the anesthetics). 2. Postoperative complication rate was very low. 3. Recurrence rate was nihil after 2 years. 4. The hospitalization time was very low. 5. The acceptance rate was high (96.6%). 6. The cost of this type of anesthesia was up to half the cost of general or regional anesthesia.
Adult↗
[Considerations in the training of surgeons].
There are several reasons why this topic has been chosen by the Royal Belgian Surgical Society: the general malaise in the profession; the increased number of applicants; the interference of the government in the organization of surgical postgraduate training; the misjudgment which probably has been made in the past in the organization of surgical training programs. The many factors which have led to the present "misgrown" situation are discussed: principally there has been a fundamental oversight: general surgeons have promoted themselves as procedural specialists rather than surgical experts in specific organ systems or a well defined pathology. Finally a certain number of proposals are made to adjust the surgical training programs to the needs in this era: Junior year: in depth study of anatomy; in depth study of pathophysiology; specific training in basic surgical techniques, skills, and handcraft, all three with a test at the end of that year. 2nd-3rd-4th year: acquisition of surgical skills in a wide range of surgical interventions (elective and emergency cases). Final training years (2): acquisition of: a specific "general surgery attest" specifying the conditions where it is exclusively applicable (suburban or small town district hospitals), or an attestation of special interest in a specific organ or in a well defined pathology; formal study of management and meeting techniques; acquisition of a flexible contemporary philosophical and ethical insight.
Belgium↗
[Computer hardware for a surgical service].
While the bulk of all medical information is text, we think that the hardware needed to collect this information and to store it in a databank, must be essentially a first class work processor, working in a multi-user system with terminals where this information is gathered: the nursing stations, operating theatres, outpatient clinics and a working and archiving station centrally placed and capable to link those different terminals and those from other services as well.
Computers↗
Pilonidal sinus. Excision--marsupialization--phenolization?
Too often still this disease is called sacrococcygeal cyst, pointing into the direction of congenital etiology. With this paper (and a review of the literature) we try to proof that the theory of acquired origin of pilonidal sinus is the only one logically to be accepted. We indicate that extensive surgical procedures such as Z-plasty rotated flap or broad excision--are really unnecessary and that a simple and accurate technique--marsupialization--gives excellent results with a minimum of recurrences. The last few years phenolization of the pilonidal sinus has become a popular, and eventually a worthwhile alternative.
Adult↗
[Revascularization of the extracranial carotid-, vertebral- and subclavian arteries in a small peripheral hospital (author's transl)].
A total of 21 procedures were performed on a group of 17 patients, 13 of them more than 65 years old, for mixed intra- and extracranial vessel disease. Ten had recovered from a frank stroke. Thirteen of them underwent one procedure, three two procedures and one a total of three revascularizations. Eighteen carotid endarterectomies, without patch angioplasty were performed. The determinant factor whether or not to use an intraluminal shunt was the peroperatory encephalographic monitoring by a neurologist. The shunt was used any time significant EEG changes occurred during a test clamping period of five minutes. The other procedures included a vertebral artery endarterectomy with patch angioplasty, a subclavian- subclavian vein by-pass, as well as a common carotid artery resection for elongation and kinking of the internal carotid artery combined with marked stenosis. The mortality was nihil. Postoperatively all patients did well with an improved mental and neurological status.
Aged↗
[Iatrogene aorto-enteric fistula. Report of two cases (author's transl)].
Two cases of treated iatrogenic aorto-enteric fistula are presented: one completely successfull, the other less, with exitus after five months due to aortic wall disruption. The late occurrence, operative findings, anatomo-pathological examination of the specimens, as well as the sterile (aerobic) cultures in both cases, rather favour mechanical etiological forces associated with the healing complications of aortic synthetic grafts, with or without secundary infection. Emphasis is placed on familiarity with the symptom-complex and the fact that in general the commonly available objective diagnostic tools are not a great deal more helpful in arriving at the correct diagnosis than the history and physical examination. They may even be time-consuming and lead to the demise of the patient. The importance of prevention is stressed as well as the aspects of early aggressive surgical therapy for this dismal complication.
Aged↗
[Aneurysms of the splanchnic region].
Splanchnic artery aneurysms. The management of 16 patients, presenting with splanchnic artery aneurysms is reviewed in a retrospective study. 5 patients presented with aneurysms of the hepatic arteries, 6 patients had an aneurysm of the splenic artery and 5 patients developed aneurysms of the remaining branches of the splanchnic arteries (1 gastroduodenal, 3 pancreaticoduodenal and 1 superior mesenteric), 8 patients were treated conservatively. 8 patients had a surgical procedure performed. Two patients died from a complication of their aneurysm. Ligation of the hepatic artery, was insufficient to avoid a recurrent and fatal hemobilia in a man presenting, with a centrally located intrahepatic ruptured aneurysm. Another patient developed a fatal necrohemorrhagic pancreatitis after ligation of the splenic artery for an aneurysm that ruptured in the stomach.
Adult↗
[Plastic surgery in agenesis of the diaphragm. Status after 18 years].
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Adolescent↗