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E J Spillenaar Bilgen

Publications and source records attributed to E J Spillenaar Bilgen.

9 recordsLinked to original sources
PubMed2006

Colonic explosion during endoscopic polypectomy: avoidable complication or bad luck?

We were confronted recently by an intraluminal colonic explosion during a colonic polypectomy procedure using snare loop electrocautery, probably caused by the presence of hydrogen and/or methane in combustible concentrations. Our patient needed immediate surgery, when several lacerations were found in the colon: a right hemicolectomy and a partial sigmoid resection with primary anastomoses were performed. Colonic bacteria, rests of fecal fluids, certain cleansing solutions, and oxygen insufflation are the main factors involved in cases of colonic explosion. We describe this dramatic event in our patient and discuss whether this complication might be avoidable in the future.

Adenoma↗
PubMed2004

Small but significant survival benefit in patients who undergo routine follow-up after colorectal cancer surgery.

BACKGROUND: The benefit of follow-up for patients after resection of primary colorectal cancer is unproven. The aim of this study was to evaluate the value of a standardised follow-up program considering detection of recurrent disease, eligibility for surgical treatment and survival. METHODS: Five hundred and sixty-four patients' records were evaluated. Detection of recurrent disease was distinguished in routine follow up (RF), interval visit (IV) or accidental finding (AF). RESULTS: One hundred and forty-nine patients (26%) had recurrent disease of which 68 were detected by routine follow-up. In 42 patients a resection was performed with curative intent (RF 18, IV 14, AF 10). In 26 patients radical resection (R(0)) was possible (RF 13, IV 5, AF 8), seven of them were long-term survivors. Routine follow-up itself had no significant influence on overall survival (P=0.08), although increased survival was observed if recurrent disease was detected by routine follow-up and resection was performed with curative intent (P=0.006). Median survival after resection was 4.2 years if recurrent disease was detected during routine follow-up and 0.5 years if detected during interval visits. CONCLUSIONS: Patients undergoing resection with curative intent for recurrent disease survive significantly longer if the disease is detected by routine follow-up. Routine follow-up itself did not improve overall survival.

Adult↗
PubMed2002

A coculture model mimicking the intestinal mucosa reveals a regulatory role for myofibroblasts in immune-mediated barrier disruption.

The pathogenesis of Crohn's disease involves a mucosal inflammatory response affecting the barrier function of the gut. Myofibroblasts directly underlining the intestinal epithelium may have a regulatory role in immune-mediated barrier disruption. A coculture system of T84 epithelial and CCD-18Co myofibroblasts was established in order to mimic the in situ spatial interactions between these cell types and to evaluate their role in barrier: integrity. Lamina propria mononuclear cells (LPMC) were introduced in co- and monocultures. Effects of immune cells on barrier integrity was determined by measuring resistance and permeability for macromolecules. Introduction of LPMC in both culture systems caused a time-dependent decrease in barrier integrity. This was found to be less pronounced in cocultures indicating a regulatory role for mesenchymal cells. The effects were also found to depend on the route of LPMC stimulation. Additional analyses suggested that the regulatory role of myofibroblasts in barrier integrity involves production of growth factors.

Cell Line↗
PubMed2002

Does seeding of intraluminal tumour cells cause anastomotic recurrence after oesophageal resection?

BACKGROUND: Recurrence at the cervical anastomosis of a tumour of the oesophagogastric junction after resection of the oesophagus with gastric tube reconstruction is a peculiar phenomenon in view of the distance of the primary tumour from the proximal anastomosis. It is hypothesised that contamination with tumour cells from the nasogastric tube or the gastric reconstruction tube could be responsible for this phenomenon. METHOD: Fifteen patients with a tumour of the oesophagus or gastric cardia were included. During the operation the nasogastric tube was left in the resected specimen. Debris from the tube was washed out for cytological examination. Also the gastric reconstruction tube was washed out and the debris examined for malignant cells. RESULTS: In all of the patients with a tumour extending intraluminally malignant cells were found in the nasogastric tube or the gastric reconstruction tube or both. In 92% of these patients malignant cells were found in the nasogastric tube, while 60% of the gastric reconstruction tubes were contaminated with tumour cells. CONCLUSION: The presence of intraluminal malignant cells during oesophageal resection and gastric tube reconstruction is very high, possibly leading to anastomotic recurrence. Measures should be taken to minimise local contamination with tumour cells.

Anastomosis, Surgical↗
PubMed1998

Laparoscopy and laparoscopic ultrasonography in staging of oesophageal and cardial carcinoma.

BACKGROUND: The ideal method for staging tumours of the oesophagus and gastric cardia is not known. This paper was designed to assess the value of laparoscopy and laparoscopic ultrasonography in the staging of oesophageal and cardial carcinoma. METHODS: From October 1993 to January 1996, 60 patients in whom no metastases were seen on gastroscopy, ultrasonography of the abdomen and supraclavicular region, helical computed tomography of the chest and abdomen or endosonography were scheduled for laparoscopy and laparoscopic ultrasonography. RESULTS: Some 40 patients had carcinoma of the oesophagus, in one of whom liver metastases were found at laparoscopy and proven histologically. On laparoscopic ultrasonography metastases were found in four patients but were impossible to biopsy. These lymph node metastases were confirmed at exploratory laparotomy. Twenty patients had carcinoma of the gastric cardia; distant metastases were found in four at laparoscopy. On laparoscopic ultrasonography metastases were present in four further patients, all proven by biopsy. CONCLUSION: In this study laparoscopy was not an effective staging technique for oesophageal carcinoma. The inclusion of laparoscopic ultrasonography was of little benefit. A problem that was encountered was biopsy under laparoscopic guidance. In carcinoma of the gastric cardia, laparoscopy was more effective; adding laparoscopic ultrasonography doubled the number of patients seen to have metastatic disease.

Adenocarcinoma↗