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A Gerritsen van der Hoop

Publications and source records attributed to A Gerritsen van der Hoop.

6 recordsLinked to original sources
PubMed2006

Effect of vaginal delivery on long-term pouch function.

BACKGROUND: The optimal method of childbirth for women with a restorative proctocolectomy (RP) has yet to be determined. Little is known about long-term ileal pouch function after vaginal delivery, especially when childbirth occurred before RP. The aim of this study was to evaluate the effect of vaginal delivery before or after RP on long-term pouch function. METHODS: All 267 women who underwent RP between January 1985 and November 2004 were invited to participate. Functional outcome was assessed by colorectal functional outcome questionnaire, and patients were asked about their pregnancies and risk factors for obstetric injury. Linear regression analysis was performed to study potential risk factors for poor pouch function. RESULTS: The response rate was 82.6 per cent. Median follow-up after pouch surgery was 7.2 (range 1.0-19.7) years. One hundred patients had at least one delivery. Fifty-two (60 per cent) of the 86 patients who attempted a vaginal delivery had an increased risk of obstetric injury according to predefined risk factors. In these patients ageing and longer follow-up were significant risk factors for impaired incontinence. CONCLUSION: Women who had RP and vaginal delivery with a high risk of obstetric injury had impaired continence with ageing and longer follow-up. Patients with RP should be informed about the considerable risk of vaginal delivery on long-term ileal pouch function.

Adult↗
PubMed2005

Modified technique for parastomal hernia repair in patients with intractable stoma-care problems.

OBJECTIVE: Although stoma relocation is generally the first choice of treatment for parastomal hernia, a repair using polypropylene prosthetic mesh is sometimes employed in cases of parastomal hernia recurrence. Use of this mesh, however, has been associated with a high risk of bowel erosion, adhesions formation, and fistulization. We therefore began to use expanded polytetrafluoroethylene (ePTFE) mesh to perform an onlay parastomal hernia repair. Our initial clinical experience with this procedure is described. PATIENTS AND METHODS: Sixteen patients aged 39-70 years with intractable stoma problems underwent a modified intra-abdominal onlay technique with implantation of a large (26 x 36 cm) sheet of ePTFE mesh. RESULTS: During a median follow-up of 29 months (range, 5-52 months), no mesh-related bowel erosion, fistulization, or adhesion formation were observed. Two patients had a recurrence of the hernia due to technical failure. Re-operation in one of these resulted in wound dehiscence and removal of the contaminated mesh. Another patient developed intestinal obstruction postoperatively. The mesh was removed, and a gastrointestinal stromal tumour was found. Finally, a nonmesh related small bowel erosion required removal of the mesh in one patient. All other patients had full relief of symptoms. CONCLUSION: The modified onlay technique using a large sheet of ePTFE prosthetic mesh is a feasible option for treatment of parastomal hernia recurrence. Possible advantages of the procedure include stoma preservation, strengthening of the abdominal wall, and a reduced risk of recurrence, contamination, fistulization, and bowel adhesions and erosion.

Adult↗
PubMed2004

Hand-assisted laparoscopic surgery (HALS): a report of 150 procedures.

BACKGROUND: This study was performed to evaluate the (long-term) morbidity associated with hand-assisted laparoscopic surgery (HALS) for various indications. METHODS: HALS procedures for various indications were evaluated prospectively from 1995 to 2002. The primary outcome parameters were postsurgical complications and the development of incisional hernias. RESULTS: Twenty-six splenectomies, 51 hand-assisted laparoscopic donor nephrectomies (HLDN), 34 segmental bowel resections, 29 proctocolectomies, and 10 emergency colectomies were evaluated. A Küstner or Pfannenstiel incision was used for handport placement. Minor complications (i.e., wound complications, urinary tract infection) occurred in 15%, 12%, 26%, 7%, and 33% of the patients after, respectively, splenectomy, HLDN, bowel resection, proctocolectomy, and emergency colectomy. Major complications (i.e., hemorrhage, anastomotic leakage) occurred in 15% and 12% of the patients after, respectively, bowel resection and proctocolectomy. Incisional hernias occurred in six patients (4%), all after a wound complication in the Küstner incision. CONCLUSION: HALS is fast, safe, and feasible for various indications, especially HLDN and (procto-)colectomies. Little advantage can be expected when HALS is applied in splenectomy and segmental bowel (sigmoid) resection.

Adult↗
PubMed2002

Laparoscopic surgery for colorectal carcinoma. an overnight victory?

Laparoscopic surgery became popular in the early 1990s. Cholecystectomy was the first 'victim' conquered by the new technique and laparoscopic cholecystectomy became the gold standard operation for gallbladder stones. Laparoscopic colorectal surgery was then attempted, for both benign and malignant disorders. After a short period of enthusiasm, alarming reports were published on laparoscopic surgery for malignant disease. The occurrence of so called 'port-site' metastases (PSM) led to a reduction in the use of the minimal invasive technique. In addition, the duration of the operations was criticised, as well as the limited beneficial effects (if any) and the possible violation of oncological surgical principles. The pros and cons of this new technique during its introduction are discussed, with focus on problem areas such as port-site metastases, surgical learning curve as well as beneficial effects. The current status of several comparative studies evaluating the laparoscopic technique is discussed leading to the conclusion that a basis for further research exists and therefore cautious progress is warranted.

Colorectal Neoplasms↗