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Biomedical subjects

J F Lange

Publications and source records attributed to J F Lange.

10 recordsLinked to original sources
PubMed1992

Hepatic resections for colorectal metastases in The Netherlands. A multiinstitutional 10-year study.

BACKGROUND AND METHODS: The records of 118 patients who had hepatic resections for colorectal liver metastases were analyzed retrospectively. RESULTS: The patient group, from 15 institutions in The Netherlands, was found to have a 5-year actuarial survival rate of 21% and a 5-year actuarial disease-free survival rate of 19%. The postoperative mortality rate was 7.6%. In the remaining group, the morbidity rate was 34.7%. A number of factors were examined that were reported to be of prospective significance in other studies. In the multivariate proportional hazard model of Cox, the number of metastases (P = 0.001) and the amount of perioperative blood loss (P = 0.002) were related significantly to disease-free survival. A factor that may be considered a contraindication to resection is the presence of extrahepatic disease (whether nodal or visceral), even if resectable. CONCLUSIONS: Although the actual benefit of resection is limited, and it is associated with considerable morbidity, surgical therapy offers some patients a chance for cure. It is a valid expectation that improvement in techniques and a proper understanding of hepatic anatomy will improve the safety and efficacy of hepatic resections in the future. Future research should focus on defining better selection criteria and on study of the value of adjuvant treatment modalities.

Adult↗
PubMed1989

Repeat hepatectomy for recurrent malignant tumors of the liver.

The results of 34 repeat hepatectomies for recurrent malignant tumors of the liver in 28 patients are reported herein. There was no operative mortality, and the morbidity rate was 15 per cent. No instances of postoperative hepatic insufficiency were observed. Only five of the repeat hepatectomies were extensive (three or more hepatic segments). Thirteen resections were performed upon 11 patients for recurrent hepatocellular carcinoma. Four of these patients are still alive, one patient with a known recurrence (a mean survival time of 33 months with a range of four to 54 months). Ten resections were performed upon nine patients for recurrent metastases from the colon and rectum. Five of these patients are alive, four without apparent recurrence (a mean survival time of 13 months and a range of one to 35 months). Eleven resections were performed upon eight patients for recurrent miscellaneous malignant tumors, and four patients are alive, of whom three have a recurrence. The results of this study demonstrate that some patients benefit from repeat hepatectomy for recurrence of malignant hepatic tumors. Repeat hepatectomy is technically highly feasible. Economic hepatic resection with a sound oncologic basis (segmentectomy) is the operation of choice.

Adolescent↗
PubMedDate not supplied

Traumatic rupture of the stomach after Heimlich maneuver.

Fatal complications following the performance of the Heimlich maneuver have been reported. A 76-year-old woman presented to the emergency department with signs of respiratory distress, abdominal pain and distension one day after airway obstruction and subsequent resuscitation. Despite successful immediate laparotomy and repair of a ruptured stomach, she later succumbed to the sequelae of aspiration of gastric contents and dehiscence of the gastric tear. This is the 4th case of stomach rupture and the 7th reported fatal complication following the Heimlich maneuver. It is recommended that persons who undergo the Heimlich maneuver be examined and observed by a physician, as soon as possible, to rule out complications.

Aged↗
PubMedDate not supplied

Mesenteric panniculitis of the mesoappendix.

A rare case of mesenteric panniculitis mimicking appendicular mass is presented. At laparotomy panniculitis localized in the mesoappendix and concomitant chronic appendicitis were found. A pathogenetical association is suggested by the Authors. The need for careful follow-up is stressed.

Aged↗
PubMedDate not supplied

The role of computed tomography in the management of acute pancreatitis.

Sixty-three patients with the clinical diagnosis of acute pancreatitis were submitted to contrast enhanced CT examination. As compared to Ranson's objective clinical parameters, CT grading according to Hill et al. as modified by Balthazar et al. was found to reflect accurately the severity of acute pancreatitis. Evaluation of serial CT examination did not reveal any significant progression in classification during the course of acute pancreatitis. The presence of hypodense areas in the pancreas as a single parameter seems to have a distinct prognostic value. In only one out of five pancreatic abscesses was the presence of gas bubbles observed on CT. It is concluded that contrast enhanced CT has a definite place in the management of acute pancreatitis.

Acute Disease↗