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Biomedical subjects

E Eyskens

Publications and source records attributed to E Eyskens.

At least 19 recordsLinked to original sources

The influence of a pneumoperitoneum on the peritoneal implantation of free intraperitoneal colon cancer cells.

BACKGROUND: In order to test the influence of a pneumoperitoneum on the peritoneal implantation of free intraperitoneal colon cancer cells, 40 male syngeneic WAG rats were at random divided into four groups. METHODS: Group 1 (n = 10) animals underwent a midline laparotomy and 10(4) CC531 colon cancer cells were injected intraperitoneally (IP); in group 2 (n = 10) 10(4) CC531 cells were injected IP without further manipulation; in group 3 (n = 10) a pneumoperitoneum up to 10 mmHg was created after the IP injection of the same amount of CC531 cells. The pneumoperitoneum was maintained for 15 min. Finally in group 4 (n = 10) after the IP injection of 10(4) CC531 cells and after the creation of a pneumoperitoneum, two 14-G IV catheters simulating trocars were introduced in each flank. A follow-up period of 8 weeks was used. Tumor implantation was scored according to the peritoneal cancer index of Eggermont and the index of Chauffert. RESULTS: Tumor nodules were found varying from 60% in groups 1-3 to 50% in group 4. There was no statistical difference between the implantation rate in the four groups. A port-site recurrence was seen in group 4; all the other tumor implants were located in the mesenterium, omentum, internal genitals, or parietal peritoneum. CONCLUSIONS: The presence of a pneumoperitoneum does not enhance the implantation of free intraperitoneal malignant colon cancer cells in the rat, but the presence of a "port" may lead to abdominal-wall metastases.

Adenocarcinoma

Oesophagopleural fistula--a rare sequel of pneumonectomy.

Postpneumonectomy oesophagopleural fistula (OPF) is a devastating situation occurring in 0.2-1.0% of the patients undergoing pneumonectomy. Distinction is made between OPF appearing after pneumonectomy for chronic inflammation and suppuration, and OPF after pneumonectomy for lung cancer. Early and late fistulas (the former appearing within three months of the operation) are found in both groups. We report a case of OPF occurring almost five years after pneumonectomy for malignant lymphoma of the lung. Common signs of OPF are postpneumonectomy empyema and presence of previously ingested food particles in the empyema cavity. Treatment is extremely difficult and prolonged, and often not successful. Amelioration of the nutritional status, drainage of the postpneumonectomy space and closure of the fistula by injecting a sclerosing substance should be attempted. If this fails, the fistula should be closed by direct suture reinforced by a muscular or omental flap.

Aged

Role of thoracoscopy (VATS) in pleural and pulmonary pathology.

Although thoracoscopy is not a new procedure, there was a real revival after the introduction of laparoscopy. VATS (video-assisted thoracic surgery) has potential advantages of reduced pain due to smaller incisions and a shorter hospital stay. Main disadvantages are expensive equipment and a probably less adequate operation, especially for therapy of malignant disorders where long-term results are not known. VATS is very useful for investigation of pleural effusion and malignancy. Spontaneous pneumothorax is a very good indication for thoracoscopic treatment, as well as lung biopsy and diagnostic resection of lung metastases. Therapeutic metastasectomy, however, should not be performed by VATS. Regarding bronchogenic carcinoma, VATS is indicated for staging of lung cancer, facilitating sampling of mediastinal and hilar lymph nodes, investigation of pleural effusion, possible pleural dissemination and suspicion of intrapulmonary metastases. Wedge excision of solitary pulmonary nodules by VATS readily reveals the exact diagnosis, but its role in therapy of lung cancer is very limited at the present time.

Biopsy

Laparoscopic resection of an adenoma of the urachus in combination with a laparoscopic cholecystectomy.

In a 40-year-old male patient with symptomatic cholecystolithiasis, ultrasound examination disclosed a large cystic mass on the dome of the bladder. Laparoscopic resection of this mass was carried out in combination with a laparoscopic cholecystectomy. Histology disclosed an urachal adenoma. Postoperative recovery was uneventful. We conclude that urachal adenomas can be managed safely by laparoscopic means.

Adenoma

Pneumatosis cystoides intestinalis. Conservative approach in non surgical pneumoperitoneum: a case report and literature review.

An observation on Pneumatosis Cystoides Intestinalis (PCI) in a 66-year-old man is reported. His general condition allowed a thorough clinical and laboratory investigation which resulted in the diagnosis of the disease and the avoidance of an unnecessary laparotomy. PCI is a relatively rare condition characterized by multiple intramural pockets of gas involving any portion of the gastro intestinal tract. Various theories reflect either a mechanical or a bacterial etiology. Most of the patients are asymptomatic although some experience gastrointestinal complaints. The majority of patients require no treatment.

Aged

Nodular sclerosing Hodgkin's disease of the thymus gland.

An asymptomatic anterior mediastinal mass in a 22-year-old man proved to be nodular sclerosing Hodgkin's disease of the thymus gland. Complete excision was possible via a left posterolateral thoracotomy. Postoperative chemotherapy was given. Follow-up after 1 year showed no residual disease. Nodular sclerosing Hodgkin's disease is an uncommon tumor of the thymus gland and should be incorporated in the differential diagnosis of anterior mediastinal tumors. Multimodality treatment is advocated.

Adult

Management of digestive fistulas.

BACKGROUND: The efficacy of total parenteral nutrition and somatostatin was assessed in reducing output and promoting spontaneous closure of postoperative digestive fistulas. METHODS: In a consecutive series of 23 patients, closure was achieved in 83% of patients after a mean fistula duration of 11.0 +/- 7.9 days and a mean of 13.2 +/- 7.0 days of drug treatment, and without mortality. RESULTS: A marked first-day effect (output drop > 50%) was noted in 60% of patients and had a good prognosis. Infection of the fistula markedly prolonged fistula closure time, but did not affect total outcome. CONCLUSION: Somatostatin has been shown to be very useful in the conservative treatment of digestive fistulas because of its ability to reduce output significantly and to accelerate spontaneous closure.

Adolescent

[Viscerosynthesis: the realization of an old dream. A look at the 150-year development of surgical suture techniques].

In analogy with osteosynthesis in bone surgery, viscerosynthesis has been introduced as a term for intestinal tissue fixation by staplers. As a result of continuous research, the development of mechanical suture instruments started early in the 19th century. At that time the base of manual suture technique was described by A. Lembert (1826), which is still applicable today. Simultaneously F. Denans introduced a device for intestinal anastomosis. An impressive variety of instruments was developed since then, which resulted in 1893 in the construction of the successful J. Murphy anastomotic button. Derived from it several more elaborate instruments were constructed until recently for oesophageal and rectal anastomoses as well. Entirely new of conception was the stapler apparatus by H. Hültl in 1906, succeeded shortly after by von Petz' stapler clamp. Inspired by them the Russians developed since World War II a tremendous instrumentarium. From 1959 the Americans took over and delivered highly specialized and technologically outstanding stapler instruments which currently dominate the market. Referring to the preceding generations of surgeons, one might say that with the advent of those instruments an old dream has been realized.

Anastomosis, Surgical

Abdominal cystic lymphangioma. A case report and a review of the literature.

Authors report a case of cystic lymphangioma of the mesenterium. The embryology and the histology are important to explain the radiological findings. To make the differential diagnosis with other cystic abdominal tumors it is very important to compare the radiological findings with other clinical symptoms.

Abdominal Neoplasms

[Diaphysal pseudarthrosis of the tibia (author's transl)].

The authors analyse the etiology and treatment of 18 pseudarthroses of the tibial diaphysis occurring in a series of 320 fractures of this bone. This complication seldom appears in simple fractures treated by a plaster cast (two cases out of 144). In addition to classical and well known factors, it appears that pseudarthrosis occurs more frequently after traction-immobilization (10 cases out of 73), when the fragments had to be repositioned on many occasions under plaster cast, or in cases of open fractures. The treatment by bone grafting, principally in-lays, with or without plates and visses, yield satisfactory results.

Adolescent

[The meaning of hepatic artery ligation in surgery (author's transl)].

On the occasion of a traumatic rupture of the hepatic artery in a 10 year old boy, successfully treated by ligation of the left branch, the meaning of arterial suppression to the liver was studied. Follow-up of 58 cases reported in the literature are reviewed; so is the role of collateral arterial circulation and of portal circulation as compensatory mechanism. A number of provisions tending towards optimal oxygenization of the patient and towards upholding of portal circulation are proposed as treatments against surgical interruption of the hepatic artery.

Abdominal Injuries