Biomedical subjects

D Van Raemdonck

Publications and source records attributed to D Van Raemdonck.

57 records · Page 4Linked to original sources

PubMedDate not supplied

[Partial gastrectomy for benign stomach ulcer: early and late results].

106 patients had a partial gastrectomy for a benign gastric ulcer. 63 of them got a long-term follow-up. The mean follow-up is 127 months. The mortality rate of the emergency operation is 20%. For the elective operation the mortality rate is 0%. More than 90% of the patients have no complaints after a long time. Following a Billroth I operation most patients feel better initially but later there is no difference at all. The frequency of the ulcer recurrence following a B I is higher than following a B II, but it is lower than after another operation (resp. 5.8% and 2.2%). For these reasons we propose a partial gastrectomy for a benign gastric ulcer in elective circumstances. To prevent alkaline biliary reflux gastritis a 2/3 distal gastrectomy with selective vagotomy and Roux-in-Y anastomosis has to become a routine operation. In emergency circumstances a partial gastrectomy is not indicated because of the high mortality rate.

Adult↗

PubMedDate not supplied

Isolated lung transplantation; initial experience at the University Hospitals Leuven. Leuven Lung Transplant Group.

Lung transplantation nowadays has become a therapeutic modality in the treatment of patients with a variety of end-stage lung diseases. Between July 1991 and December 1992, twelve patients received an isolated lung transplant (eight single lungs and four double lungs) at the University Hospitals of Leuven. The indication for transplantation was emphysema in five patients, pulmonary fibrosis in three, cystic fibrosis in three and primary pulmonary hypertension in one. There were four early, in-hospital deaths (30%): two from sepsis and multi-organ failure, one from anoxia following a bronchial dehiscence and another patient exsanguinated following stent insertion for a partial bronchial dehiscence. Three more patients have died during follow-up: two from chronic respiratory failure secondary to the development of obliterative bronchiolitis (one at 8 months and one at 17 months), and one from a late bronchovascular fistula 4 months following transplantation. The overall actuarial one and two year-survival was 50.0% and 41.6% respectively. All patients discharged from hospital were oxygen free with an improved lung function and exercise capacity. We conclude that lung transplantation is a viable therapeutic option for selected patients with end-stage, irreversible lung disease. In our experience, the bronchial anastomosis remains an important keystone in the early success. Lung transplantation provides a good quality of life in patients free from infection and rejection. Nevertheless, chronic rejection resulting in obliterative bronchiolitis is a major problem in long-term survivors.

Adult↗

PubMedDate not supplied

Vertical axillary thoracotomy; a muscle-sparing approach for routine thoracic operations.

A standard posterolateral thoracotomy with division of the latissimus dorsi and serratus anterior muscles is associated with an important postoperative morbidity. A vertical axillary thoracotomy combining a vertical axillary skin incision with an intermuscular approach sparing both latissimus dorsi and serratus anterior muscles has the advantage of allowing full shoulder girdle motion early postoperatively as well as masking of the scar by the upper arm at rest. We report our experience with nine patients operated on with this approach for various intrathoracic lesions. All procedures were carried out without major difficulties. Wound healing was excellent in all patients. No infection nor seroma formation was seen with a submuscular suction drain. All patients had early and full shoulder girdle movement. No patient complained of late post-thoracotomy pain. We conclude that a vertical axillary thoracotomy provides an excellent cosmetic and muscle sparing incision which can be utilized for many thoracic procedures. However, we believe that, in the near future, video-assisted thoracoscopic surgery will become more popular than open thoracotomy for certain indications because of its distinct advantages of less postoperative morbidity.

Adult↗