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Biomedical subjects

F van der Staak

Publications and source records attributed to F van der Staak.

7 recordsLinked to original sources
PubMed2006

Factors associated with recurrence and metastasis in sacrococcygeal teratoma.

BACKGROUND: Sacrococcygeal teratoma (SCT) is a relatively uncommon tumour, with a high risk of recurrence and metastasis. The factors associated with recurrence and metastatic disease were studied. METHODS: A retrospective review was conducted of 173 children with SCT treated between January 1970 and February 2003 at the paediatric surgical centres in the Netherlands. Risk factors were identified by univariate and multivariate analysis. RESULTS: Eight children died shortly after birth or around the time of operation. Nine children, all over 18 months old, had metastases at presentation. Four teratomas with metastasis showed mature histology of the primary tumour. Nineteen children had recurrence of SCT a median interval of 10 months (range 32 days to 35 months) after primary surgery. Risk factors for recurrence were pathologically confirmed incomplete resection (odds ratio (OR) 6.54 (95 per cent confidence interval (c.i.) 2.11 to 20.31)), immature histology (OR 5.74 (95 per cent c.i. 1.49 to 22.05)) and malignant histology (OR 12.83 (95 per cent c.i. 3.27 to 50.43)). Size, Altman classification, age and decade of diagnosis were not risk factors for recurrence. One-third of the recurrences showed a shift towards histological immaturity or malignancy, compared with the primary tumour. Seven patients died after recurrence, five with malignant disease. CONCLUSION: This national study showed that SCT recurred in 11 per cent of the children within 3 years of operation. Risk factors were immature and malignant histology, or incomplete resection. Mature teratoma has the biological capability to become malignant.

Epidemiologic Methods↗
PubMed1995

Results of splenectomy performed on a group of 91 children.

In the period 1971-1990 91 children underwent splenectomies in the University Hospital of Nijmegen. The most important indications are hereditary spherocytosis, Hodgkin's disease and very severe immune thrombocytopenic purpura (ITP). Splenectomy after a traumatic rupture of the spleen has become less frequent: from 20% in 1971-1980 to 4% in 1981-1990. Short-term complications included thrombocytosis (84%), fever without an obvious cause (46%), which is quite regularly seen in patients suffering from Hodgkin's disease (48%), and infections of the respiratory tract in 10% of the patients. The platelet count shows a steady increase in the first nine post-operative days. No thromboembolic complications were seen. Based upon the literature there seems to be no reason at this moment for anti-platelet aggregation therapy when platelet counts are below 1000 x 10(9)/l. More information about long-term complications was obtained through a questionnaire completed by general practitioners. The morbidity through overwhelming post splenectomy infection (OPSI) is 3.8% (3/79), the mortality of OPSI is 2.5% (2/79). Underlying diseases, especially those which involve the immunological system as auto immune haemolytic anemia (AIHA), seem to play an important role in the possible development of OPSI (morbidity 2/11, 18%).

Adolescent↗
PubMed1989

Rectal prolapse in children.

Rectal prolapse in children is nowadays a rare anomaly. Potty training in young children is the common cause and the resulting prolapse can be treated conservatively. In children with refractory prolapse, sclerosing injections may be used. Operative treatment by posterior rectopexy is only indicated in the very few cases of long-standing prolapse.

Adolescent↗
PubMed1986

Totally implantable systems for intravenous drug delivery. Experiences in children with cancer.

A totally implanted system for central venous access--consisting of a subcutaneous injection port, connected to a silastic catheter positioned into the superior caval vein--has been utilised in 17 children with cancer treated by aggressive chemotherapy regimens. This preliminary study over a 1 1/2-year period suggests that such devices may represent an improvement over currently available techniques of prolonged venous access, and are suitable for children as well. The device has proved to be a reliable, safe, convenient and effective method for delivering drugs, antibiotics, blood products, nutritional and other intravenous fluids. In 3881 patient days no serious complications have occurred. The complications encountered must be considered as starting problems of this device in the paediatric age group. These problems have been solved. Continuous infusion therapy lasted up to 122 consecutive days without skin problems. The system has the advantage of simplicity of positioning, use and maintenance. It facilitates ambulatory anticancer treatment.

Adolescent↗
PubMed1981

Splenopexy in a case of wandering spleen.

Wandering spleen is a rare condition, commonly treated with splenectomy. Authors report a case of wandering spleen, preoperatively diagnosed, and successfully treated with splenopexy.

Child, Preschool↗