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B L Langenhorst

Publications and source records attributed to B L Langenhorst.

6 recordsLinked to original sources
PubMed1993

Esophagectomy with or without thoracotomy. Is there any difference?

Two operative approaches for esophageal carcinoma were compared with respect to operative morbidity and mortality by means of multivariable analysis. From 1980 to 1986, 152 patients underwent resection by laparotomy and right-sided anterolateral thoracotomy with an intrathoracic anastomosis. From 1986 to 1989, 141 patients underwent resection by transhiatal blunt dissection with a cervical anastomosis. The stomach was the preferred organ for reconstruction. Paresis of the recurrent laryngeal nerve and leakage of the cervical anastomosis occurred significantly more often in the transhiatal group. Pulmonary complications occurred less frequently in the transhiatal group. In-hospital mortality (9% in the thoracotomy group and 5% in the transhiatal group) increased significantly with advanced age of the patients. Furthermore, it was significantly higher in case of colonic interposition as compared with reconstruction with the stomach. Long-term survival did not differ between the two groups. Especially for carcinomas in the distal part of the esophagus, transhiatal esophageal resection without thoracotomy seems to be an oncologically justifiable operation with a reduced morbidity and mortality.

Adenocarcinoma↗
PubMed1992

Adenocarcinoma of the gastric cardia. Recurrence and survival after resection.

Between January 1, 1983, and December 31, 1988, operations were performed on 112 patients with adenocarcinoma of the gastric cardia. Resection of the primary tumor was performed in 93 patients. For these 93 patients, follow-up until July 1, 1989, averaged 24 months, during which time 59 patients died. Positive resection margins carried a greater risk for the development of a local recurrence but did not correlate with survival. The cumulative overall 5-year actuarial recurrence rate was 69%. The cumulative 5-year recurrence rate for metastases was 64% and for locoregional recurrence it was 36%. The overall 5-year survival rate was 24%. Differences in survival were observed between patients with carcinomas of the various subgroups of the 1987 TNM classification system (T1-T2 versus T3-T4, N0 versus N1-N2, M0 versus M1, Stages I-II versus Stages III-IV, Grades 1-2 versus Grades 3-4). In particular, lymph node status as correlated with histopathologic grade showed remarkable differences in survival: patients with no positive lymph nodes in the resection specimen and a Grade 1 or 2 tumor had a significantly better 5-year survival rate (53%) than the other subgroups (N0/Grades 3-4: 21%; N1-N2/Grades 1-2: 12%; N1-N2/Grades 3-4: 14%).

Adenocarcinoma↗
PubMed1992

Feasibility of a predeposit autologous blood donation program in colorectal cancer patients: results from a randomized clinical study.

The hematologic and transfusion data of a multicenter randomized trial investigating the effect of blood transfusions on the 5-year survival were used to study the feasibility of an autologous blood donation program in colorectal cancer patients. Three hundred and ten patients were randomized for autologous blood transfusions (predeposition of 2 units) or homologous blood transfusions, and transfusion rules were standardized. The Hb level in the patients who donated blood decreased by 20.1 +/- 1.3 g/l (mean +/- SEM) preoperatively and 4.5 +/- 1.8 g/l postoperatively, and in controls 3.7 +/- 1.1 g/l and 16.5 +/- 1.9 g/l (significantly different between the two groups, both pre- and postoperatively: p less than 0.01). Because blood loss and number of transfusions were similar in both groups, this indicated that either preoperative or postoperative erythropoiesis is stronger in patients who had donated blood. Twenty-three percent of the autologous patients and 61% of the homologous patients were exposed to homologous blood. The effectiveness of the procedure differed per tumor localization. In patients with a right-sided colon carcinoma, 22% of the control patients needed homologous blood, compared to 10% of the autologous patients. In patients with other colon carcinomas, this was 52 and 16%, respectively, and in patients with a rectal carcinoma 85 and 41%. We conclude that predeposition of 2 units of blood for colorectal cancer surgery is feasible and useful to prevent homologous blood usage in a significant number of patients with left colon carcinoma or rectal carcinoma.

Adult↗
PubMed1990

[Esophagus resection and reconstruction without thoracotomy; initial results].

From November 1, 1986 to December 1, 1989, 100 patients with squamous cell carcinoma (n = 35), adenocarcinoma (n = 61) or 'other' carcinoma (n = 4) of the oesophagus or the gastroesophageal junction were resected and reconstructed. There were 71 men and 29 women with a mean age of 63 years (35-77 yrs). In 80 patients the tumour was localised in the distal oesophagus or the gastroesophageal junction. In 20 patients the tumour was localised more proximally. In all patients the oesophageal resection was performed transhiatally without thoracotomy with blunt dissection. Reconstruction was performed with a stomach tube (n = 84) or colonic interposition (n = 16). Postoperative pulmonary complications were seen in 25% of the patients. Leakage of the cervical anastomosis was seen in 6 patients. In-hospital mortality was 4%. Oesophageal resection without thoracotomy appears to be an operation with reduced morbidity leading to a marked decrease in postoperative mortality.

Adult↗
PubMed1988

Effect of perioperative blood loss and perioperative blood transfusions on colorectal cancer survival.

Results of various studies suggest that the perioperative administration of blood transfusions in cancer patients operated upon for cure is associated with a diminished patient survival. Furthermore, recent results from our laboratory indicate that blood loss may also be capable of promoting tumor growth. In order to elucidate these findings a retrospective study was initiated towards the survival of 164 patients with colorectal carcinoma, operated upon for cure, at the University Hospital, Rotterdam. In 117 patients who perioperatively received blood transfusions the 5-year survival was 68%, as compared to 80% in the non-transfusion group (P = 0.039; Wilcoxon). The 5-year survival in the group of patients with a perioperative blood loss exceeding 500 ml (n = 88) was 70%, as compared to 73% in the group with a blood loss of 500 ml or less (not significant). Multivariate analysis, adjusting for 11 relevant parameters, showed that only tumor stage and the administration of blood transfusions were significantly associated with a decrease in survival. It is concluded that perioperative blood transfusions adversely affect colorectal carcinoma survival in this group of patients. Perioperative blood loss was not a significant prognostic factor.

Adult↗