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C M Bruyninckx

Publications and source records attributed to C M Bruyninckx.

11 recordsLinked to original sources
PubMed1992

[Simple ligation superior to inversion of the appendiceal stump; a prospective randomized study].

OBJECTIVE: To compare two methods of treatment of the appendix stump after appendectomy for acute appendicitis. DESIGN: A prospective randomised trial of 134 consecutive appendectomies in which the appendix stump was either simply ligated or ligated and doubly invaginated. SETTING: Department of General Surgery, St Joseph Hospital, Veldhoven, the Netherlands. PATIENTS AND METHODS: During a period of 15 months all patients in whom an appendectomy for acute appendicitis was performed were allocated at random to the two groups. The following data were recorded: age, sex, histological diagnosis, hospital stay and occurrence of complications. All patients were followed until 6 months after the operation. The data were analysed statistically with the chi-square-test and the Mann-Whitney test. P less than 0.05 was considered significant. RESULTS: The appendix stump was ligated in 79 patients and invaginated in 55. Both groups were similar with respect to age, sex, degree of appendiceal inflammation, antibiotic treatment and hospital stay. There were significantly more wound infections in the 'invagination' group (p = 0.017). The other complications showed no statistical intergroup difference. CONCLUSION: Simple ligation facilitates and shortens appendectomy. It is a safe procedure, preventing deformation of the caecal wall and possibly reducing the risk of postoperative ileus due to adhesions. We therefore recommend simple ligation as the standard procedure at appendectomy.

Adolescent↗
PubMed1991

[Medium-long-term good results of vertical gastroplasty in the treatment of morbid obesity].

To determine the long-term results of the surgical treatment of patients with morbid obesity, a retrospective analysis of the patients in whom a vertical banded gastroplasty according to Mason was performed in the period 1982-1990 was carried out in the department of General Surgery, St. Joseph Hospital, Veldhoven, the Netherlands. In a series of 20 patients (4 men and 16 women) with a mean age of 32 (17-53) years who were eligible for treatment according to international criteria surgery was performed. The preoperative weight averaged 124 (94-207) kg and the mean preoperative excess weight was 60 (37-132) kg. Immediate postoperative complications occurred in 5 and late complications in 7 patients. Revision for technical complications was necessary in 2 patients. Twelve patients were followed up for more than 4 years. The mean weight loss after 4 years was 37 (18-89) kg, which was 28 (18-43) per cent of the mean preoperative weight and 62 (31-89) per cent of the mean preoperative excess weight. The 4-year results were unsatisfactory (less than 50 percent excess weight loss) in 3 of the 12 patients. It is concluded that vertical banded gastroplasty in our hands seems a relatively safe and effective surgical method of achieving sustained weight loss in most patients.

Adolescent↗
PubMed1991

[Initial experiences with laparoscopic cholecystectomy].

Laparoscopic cholecystectomy was performed in 45 patients for treatment of symptomatic gallbladder disease. The age distribution was 23 to 79 years. In four patients the procedure was not completed and a laparotomy was performed to remove the gallbladder: once because of a defective instrument, once because of bleeding of an omental adhesion and twice because of disturbed anatomy of the cystic duct region by inflammatory tissue. In four cases a laparoscopic cholecystectomy was performed because of an acute cholecystitis and in three cases a laparoscopic cholecystectomy à froid was performed. There were three postoperative complications: one case of bleeding and two cases of leakage of bile during five and ten days, respectively. In all these cases the treatment was conservative and laparotomy was not necessary. The postoperative hospital stay varied between 3 and 11 days with a mean of 4.2 days. The period of unfitness for work after leaving hospital ranged from one to three weeks. If for whatever reason the laparoscopic procedure cannot be completed, a laparotomy to remove the gallbladder should be performed in the same session. Laparoscopic cholecystectomy is a new, safe, less invasive method to remove the gallbladder with significant benefit to the patient. The morbidity is low and the hospital stay is short. A considerable reduction of costs is achieved with this treatment.

Adult↗
PubMed1991

A near fatal complication of an extra-anatomic aortic graft.

The case report is presented of a patient with a potentially lethal embolism secondary to thrombosis of a supraceliac distal thoracic aorta to femoral artery bypass. In view of this serious complication, wide use of this type of extra-anatomic bypass does not seem to be warranted.

Angiography, Digital Subtraction↗
PubMed1990

Carpometacarpal dislocation: report of three cases.

The case reports of three patients with carpometacarpal dislocations are described. The diagnosis of this condition may be difficult and is often missed. Swelling, dislocation and a palpable lump are the main clinical findings. X-ray findings, the key to the diagnosis, are loss of parallelism, interruption of the so-called M-line and overlapping of articular surfaces. Additional X-rays in different planes are to be recommended if carpometacarpal dislocation is suspected.

Adult↗
PubMed1988

The use of arm veins as peripheral vascular grafts.

Below-knee femoro-popliteal and especially femoro-distal bypass with nonautologous bypass material is met with poor patency rates. During an eight-year period, nine (composite) arm-vein grafts were done in eight patients. In only one patient, the arm-vein bypass was a primary procedure. In four patients this concerned a secondary procedure and in four a tertiary procedure. All eight patients demonstrated critical ischaemia of the affected limb. Distal anastomosis involved the below-knee popliteal artery in three cases and the tibial artery in the remainder six. In all but one case runoff was poor to extremely poor. Notwithstanding these unfavourable characteristics, eight out of nine bypasses have remained patent after a mean follow-up of 29 months (range five to 72 months). The only bypass that occluded did so without any symptoms or effect on the viability of the foot. In four patients, the arm veins were too narrow for grafting. Four to six weeks after construction of an arteriovenous fistula at the wrist their arm veins were at least partially suitable for grafting.

Aged↗
PubMed1987

Simulated hemodynamic comparison of arteriovenous fistulas.

The hemodynamic consequences of six current types of surgically constructed arteriovenous fistulas (AVFs) in the human arm are studied with the use of the model of a stationary electric resistance circuit. Variations in arterial and venous resistances and in anastomosis techniques are considered. With this model all possible AVFs can be compared in terms of risk (loss of distal perfusion pressure) and benefit (volume of fistula flow). According to our model the most efficient type of fistula is the end-to-end AVF at the wrist. In patients with abnormally high resistance of the arm arteries this fistula is inadequate for efficient hemodialysis treatment. To reduce the incidence of finger ischemia in more proximal AVFs our model indicates that the arterial anastomosis should be as proximal as possible and/or hemodynamically nonsmooth (i.e., side-to-side).

Arm↗
PubMed1986

Leiomyosarcoma of the inferior vena cava. Case report and review of the literature.

Leiomyosarcoma of the inferior vena cava is reported with increasing frequency but remains a rare lesion. In this article we report one case and review 69 cases. The disease affects mainly women approximately 50 years of age. The symptoms vary according to the location of the tumor; Budd-Chiari syndrome and leg edema occur in the more centrally located tumors and abdominal pain and swelling are seen in the more peripherally located ones. In 40% of the cases distant metastases are evident at the time of the patients' first presentation and are found most commonly in the liver and/or lungs. After resection the majority of the patients eventually die of metastatic disease with a mean survival of approximately 40 months.

Adult↗