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Biomedical subjects

P R Schütte

Publications and source records attributed to P R Schütte.

10 recordsLinked to original sources
PubMed2006

[A 26-year-old cyclist with intermittent claudication].

A 26-year-old male amateur cyclist, with no risk factors for vascular disease or previous trauma, presented with left-calf claudication. Physical and additional examination revealed an occlusion of the external iliac artery. During the operation, the cause was found to be an endofibrotic lesion of the external iliac artery, probably due to mechanical trauma as a result of the non-physiological aerodynamic position held on the bicycle during many hours of training. An endarterectomy was performed and the tendon of the psoas-minor muscle was cut because of its strong impression on the psoas-major muscle, which resulted in kinking of the external iliac artery. There followed two episodes of re-occlusion which were treated with a venous interposition graft and a dacron interposition graft, respectively. Thereafter the patient was able to train without pain. Intermittent claudication of the legs in young athletes should not be underestimated; occlusive vascular disease caused by arterial endofibrosis should be considered.

Adult↗
PubMed2006

Poor results after surgery for bronchioloalveolar carcinoma.

BACKGROUND: Bronchioloalveolar carcinoma (BAC) is suggested to be less aggressive than other types of lung cancer. To assess the option of treatment modification, actual outcome data were studied and compared with results for other types of lung cancer. METHOD: Retrospective analysis of all consecutive patients who underwent resection for stage I lung cancer in our hospital. For 18 BAC cases, histological specimens were re-evaluated and in three cases diagnosis was revised. RESULTS: In the period 1989 through 2000, 15 patients with BAC and 260 patients with other tumour types underwent surgery in our hospital. Five-year survival rates were 24 and 53%, respectively, (p = 0.01). CONCLUSIONS: Given the poor results after standard surgery, parenchyma-sparing operations do not seem justified in patients with invasive BAC.

Adenocarcinoma↗
PubMed2002

Thoracoscopic repair of a Bochdalek hernia in an adult.

Bochdalek hernia is a rare congenital diaphragmatic hernia in adults. In most cases, there are no symptoms. Rarely, it requires surgical intervention. In cases with pain or visceral strangulation, laparatomy or laparoscopy are both possible. We present the case of an adult with a Bochdalek hernia. He was operated on via a thoracoscopic approach and had an uneventful recovery. We recommend the thoracoscopic approach as an alternative to open or laparoscopic approach in cases of noncomplicated Bochdalek's hernia.

Adult↗
PubMed1996

Resection rates and postoperative mortality in 7,899 patients with lung cancer.

Postoperative death used to be an important complication of resections for lung cancer, especially in elderly patients. To support decision making in a general situation, contemporary results and prognostic factors were evaluated. The computer records of 7899 lung cancer patients, diagnosed from 1984 until 1992 in hospitals connected to the Rotterdam Cancer Registry, were analysed to evaluate resection rates and 30 day postoperative mortality. Resections were carried out in 20% of all patients. In patients 70 yrs of age and older, the resection rate was 14%, and in younger patients 26%. The postoperative mortality was 3.1%; 3.6% for males and 0.4% for females. According to multivariate analysis, age and extent of surgery were the major determinants of operative risk. For patients aged 0-59, 60-69 and > or = 70, postoperative mortality rates were 1.4, 3.5 and 4.0%, respectively. The operative risk was 5.7% after pneumonectomy, 4.4% after bilobectomy, and 1.4% after lesser resections. Pneumonectomies were performed less often in elderly patients: 27% of operations in patients > or = 70 yrs versus 37% of operations in younger patients. Age appears to be related to treatment choice and postoperative mortality in patients with lung cancer. However, even in patients over 70 yrs of age, resections can be performed at acceptable risk, implying that chronological age should not automatically determine treatment decisions.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1995

[Good surgery results in older patients with stage 1 lung carcinoma].

OBJECTIVE: To determine the influence of age on survival of patients undergoing resection for lung cancer. DESIGN: Retrospective. SETTING: South-western part of the Netherlands. METHODS: Follow-up information was gathered on patients who had undergone resection for stage I non-small cell lung cancer from 1984 through 1990 and had been registered by the Rotterdam Cancer Registry. Operative mortality, 2-year and 5-year survival in the age groups 20-59, 60-69 and 70 years and older were compared. RESULTS: Of the 630 patients (median age of 66 years) one-third was 70 years or older. Operative mortality was mainly determined by the type of operation: 6% after pneumonectomy versus 1% after lesser resections. Five-year survival declined with age from 65% to 48% and 43% (p < 0.01). After adjustment for non-related causes of death this difference decreased: 68%, 55%, 61% (p = 0.15). The main prognostic factor was tumour size. CONCLUSION: Chronological age has a limited influence on the survival of patients with lung cancer and does not preclude surgical treatment.

Adult↗
PubMed1993

[Surgical thoracoscopy; initial results in 13 patients].

In various diagnostic and therapeutic thoracic operations the use of thoracoscopy can replace the more radical thoracotomy. On account of the development of endoscopic video systems and specialised instrumentation, this technique is increasingly being used. Our first experiences with this new development in thoracic surgery are promising. In the period July 1991-June 1992 we performed 14 thoracoscopic operations in the Merwede Hospital in Dordrecht, for the surgical treatment of spontaneous pneumothorax (8x), for open lung biopsy (5x) and for resection of a peripheral benign tumour of the lung (Ix). No major complications occurred and patient recovery was surprisingly fast. Because of the decreased operation trauma, for several procedures already established via thoracotomy, the surgical thoracoscopy can be regarded as a great improvement in thoracic surgery.

Adult↗
PubMed1986

Minimal osteosynthesis of lateral malleolar fractures.

An oblique fracture of the lateral malleolus caused by a supination-external rotation injury (Danis-Weber type B) is the most common ankle fracture and is preferably treated operatively. Interfragmentary compression and lateral plating are generally used as the method of osteosynthesis. As an alternative two posteriorly inserted lag screws in the antero-posterior direction were used in 18 patients. In all but one good to excellent results as regards pain, function and radiographic appearance were achieved. The advantages of less extensive dissection, smaller amounts of foreign material and shorter operation time tend to make this the technique of choice for this type of fracture.

Adult↗
PubMed1983

Operative repair of ruptured achilles tendon and functional after-treatment--I. Acute rupture.

The results are described of primary operative repair of acute achilles tendon rupture with a simple suture technique and functional after-treatment, followed by immobilisation after a few days in a lower leg walking plaster with the foot in right angle position. In our experience with two groups of patients (64 cases) the described method appeared simple and safe, after-treatment is convenient for the patient and the results are good.

Achilles Tendon↗