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Biomedical subjects

P F Verhagen

Publications and source records attributed to P F Verhagen.

14 recordsLinked to original sources
PubMed1994

[Initial results with video-controlled pulmonary lobectomy in 6 patients in The Netherlands].

In the period from May to September 1993 six patients underwent video-assisted lobectomy of the lung. Owing to the development of video optics and endoscopic devices video-assisted lobectomy is now possible; it appears to be a promising alternative to posterolateral thoracotomy. Potential advantages of this method in comparison with posterolateral thoracotomy are: less pain and improved pulmonary function in the first 24 hours postoperatively, better preservation of shoulder girdle strength and movement, shorter recovery period and hospital stay, and a better cosmetic result. Many aspects of this new technique need further prospective investigation, however.

Aged↗
PubMed1990

[Colo-anal anastomosis, a strong competitor of preternatural anus].

A colostomy after a rectum amputation has great impact on a patient's lifestyle. An alternative that can restore anal defaecation after rectum extirpation for low-seated lesions is attractive if the method does not increase mortality or morbidity, if functional results are good and if oncological principles can be maintained. In selected cases a colo-anal anastomosis after rectal excision can be an alternative to a colostomy. The technique originates from pouch-anal anastomosis techniques after total proctocolectomy for ulcerative colitis and familial polyposis coli. Based on the literature and the results of seven of our own patients the method, its complications, its functional results and the oncological consequences are discussed. The conclusion is that in selected cases of rectal carcinoma the method can prevent a colostomy without increasing morbidity or mortality, with good functional results and according to oncological principles. Especially when a lesion is located distally in the rectum, the method is often applicable when a low anterior resection is not, or technically easier than a low anterior resection.

Adolescent↗
PubMed1989

Selective embolization in the treatment of severe blunt renal injury.

About 10-15 percent of all blunt abdominal trauma is associated with blunt renal injury; 85 percent of these renal injuries are minor contusions and can successfully be treated conservatively. Injuries of the pedicle account for 5 percent and require surgical intervention. Serious lacerations and disruptions of renal parenchyma associated with bleeding, account for the remaining 10 percent. The treatment of these major injuries is more difficult and controversial. Surgical treatment is associated with few complications, but nephrectomies are indicated in 15 to 60 percent of cases. A conservative approach is associated with many early and late complications (up to 60 percent) and in 13 to 68 percent surgery is still necessary. Selective embolization of one or more bleeding segmental renal arteries is an attractive alternative. The advantages are evident. The chance that the bleeding can be successfully stopped is high (more than 90 percent). The treatment is relatively easy and can be repeated, as much as possible renal parenchyma can be saved and arteriovenous fistula can also be treated. Early complications are minor and rare and late complications e.g. hypertension, are also very rare. Two patients are presented who were successfully treated with selective embolization for severe renal bleeding after blunt trauma.

Adolescent↗
PubMed1987

Femoral artery pressure criteria in the assessment of the aorto-iliac segment obtained by means of a receiver operator characteristic curve analysis.

The hemodynamic importance of aorto-iliac arteriosclerotic obstructive disease is hard to assess when multiple level lesions are present. Therefore, direct blood pressure measurement in the femoral artery during increased blood flow is a promising technique. Criteria for aorto-iliac disease could be defined by means of a retrospective study in which preoperative blood pressure parameters were compared with the results of arterial reconstruction. These criteria were then prospectively assessed as to their value in the diagnosis of hemodynamically significant aorto-iliac disease. As in the retrospective study, results of arterial reconstructions, and not angiography, were used as the gold standard for the blood pressure criteria. The criteria appeared to be 95 percent accurate, 95 percent specific and 95 percent sensitive in the detection of significant aorto-iliac lesions when multiple level disease is present. The positive predictive value and the negative predictive value were both 95 percent. The method is described in detail and reference is made to other studies with similar good results.

Aortic Diseases↗
PubMed1984

Criteria from intra-arterial femoral artery pressure measurements combined with reactive hyperaemia to assess the aorto-iliac segment; a prospective study.

Direct femoral artery blood pressure measurements combined with reactive hyperaemia (FAP study) were performed on 50 extremities (45 patients) with multilevel arterial occlusive disease of the lower extremities. In a previous retrospective study we established criteria for detection of significant aorto-iliac occlusive disease. These criteria were used in a prospective way in this study. Twenty-seven extremities were subjected to a proximal and 23 extremities to a distal reconstruction. The half-year postoperative results were evaluated. The criteria used were 86 per cent sensitive, 100 per cent specific and 93 per cent accurate in relation to predicting the postoperative haemodynamic result. The positive predictive value was 100 per cent and the negative predictive value 89 per cent. The criteria are presented and compared with data from the literature. It is concluded that FAP studies are a simple and excellent way to assess the aorto-iliac segment and to predict the outcome of a reconstruction in multilevel arterial occlusive disease.

Aorta, Abdominal↗
PubMed1984

Indications for functional examination in patients with peripheral arteriopathy.

On the basis of personal research with the reactive hyperemia test and of a study of the literature, an attempt is made to adequately define the indications for functional examination of patients with arteriosclerosis obliterans. The question considered is how much extra information is gained by functional examination, compared with the mere determination of ankle/arm systolic blood pressure index at rest, in regard to the following problems: 1 are the symptoms indeed due to arterial insufficiency? 2 how severe is this insufficiency? 3 where are the hemodynamically important lesions situated? It is concluded that functional examination rarely yields additional information in respect of these three questions, and therefore need not be carried out routinely.

Angiography↗
PubMedDate not supplied

Primary adenocarcinoma of the appendix and pseudomyxoma peritonei.

Two cases of primary adenocarcinoma of the appendix are reported. Both patients presented with a clinical picture resembling acute appendicitis. One case was complicated by a pseudomyxoma peritonei. The other patient additionally had several colonic adenomatous polyps and a malignant neoplasm of the ascending colon. Primary adenocarcinoma of the appendix is rare and only some 250 cases have been reported. It usually presents as acute appendicitis in the 6th or the 7th decade. Prognosis and histology closely resemble that of colonic adenocarcinoma. Resection of the ileocecal segment is the first choice treatment in all stages except Dukes A. In Dukes A appendectomy alone is sufficient treatment. After ileocecal resection the 5 year survival is better than after appendectomy alone for Dukes' stages B and C. Clinical presentation and treatment of the adenocarcinoma and a remarkable complication, the pseudomyxoma peritonei, will be discussed.

Adenocarcinoma↗
PubMedDate not supplied

Direct femoral artery pressure measurement at rest and during reactive hyperemia in the evaluation of the aorto-iliac segment.

Direct femoral artery pressure (FAP) studies with reactive hyperemia (RH) were performed on 39 extremities which underwent a proximal or distal reconstruction for angiographically multilevel disease. The half-year clinical results were correlated with the FAP studies. A second group of patients underwent FAP studies and angiography and both studies were correlated. The conclusions from the studies are in the first place that FAP studies with RH are an accurate way to assess the aorto-iliac segment without giving any complications; secondly that observation of single plane angiography tends to overestimate aorto-iliac disease. Finally, criteria are proposed which can help in the clinical decision whether to perform a distal or a proximal reconstruction in multilevel atherosclerotic disease.

Arterial Occlusive Diseases↗