References of "Dekoster, Guy"
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See detailExtended transsternal thymectomy for myasthenia gravis: a report of 19 consecutive cases.
Durieux, Rodolphe ULg; Radermecker, Marc ULg; Dekoster, Guy ULg et al

in Acta Chirurgica Belgica (2008), 108(1), 102-6

BACKGROUND: Thymectomy is considered as an effective therapeutic option for patients with myasthenia gravis (MG). This study reports the experience of our centre's investigation into the efficacy and the ... [more ▼]

BACKGROUND: Thymectomy is considered as an effective therapeutic option for patients with myasthenia gravis (MG). This study reports the experience of our centre's investigation into the efficacy and the safety of the procedure and the influence of different pre-operative factors on the surgical outcome. METHODS: A retrospective chart review/interview was made of 19 consecutive patients who underwent extended transsternal thymectomy for MG from 1992 to 2003. The severity of the disease was determined according to the Osserman Classification. Efficacy was measured by determining the change in clinical status, the rate of remission during follow-up, and the reduction in medication requirements after thymectomy. Complete remission (CR) was defined as asymptomatic off medication for 6 months. The CR rate was calculated using the Kaplan-Meyer method. RESULTS: The mean age of the patients at surgery was 34 years (range, 9-63) and 78.9% were female. Mean length of follow up was 86 months (range, 24-163). The overall complication rate was 10.6% (1 episode of atrial fibrillation and a left recurrent laryngeal nerve palsy that resolved after the first postoperative month). There was no operative mortality. The mean hospital stay was 9.4 days (range, 5-23). The crude CR rate was 32% (n = 6). The Kaplan-Meier estimate of CR was 42% at 6 years. Age, gender, duration of symptoms, thymic histology, Osserman stage and the presence of thymoma were not identified as prognostic variables. The average daily dose of Medrol and Mestinon decreased significantly between the pre-operative period and the last follow-up (Medrol, p = 0.0081; Mestinon, p = 0.0013). CONCLUSIONS: Transsternal thymectomy for MG is safe and effective. It benefits patients with MG at all stages. Patients with thymoma are not associated with poorer remission rates. Complete responses are durable, as the CR rate remains stable over time. [less ▲]

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See detailL'image du mois. Hematome spontane du psoas
Robinet, S.; Pappalardo, Eric; Dekoster, Guy ULg et al

in Revue Médicale de Liège (2007), 62(11), 653

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See detailCatamenial Pneumothorax: A Case Report and Review of the Literature
Pappalardo, E.; LAUNGANI, Alexis ULg; DURIEUX, Rodolphe ULg et al

in Acta Chirurgica Belgica (2007), 107(6, Nov-Dec), 695-6

Catamenial pneumothorax is a rare condition that is often misdiagnosed. It is defined as spontaneous pneumothorax occuring within 72 hours before or after onset of menstruation. Etiology is unknown but ... [more ▼]

Catamenial pneumothorax is a rare condition that is often misdiagnosed. It is defined as spontaneous pneumothorax occuring within 72 hours before or after onset of menstruation. Etiology is unknown but could be linked to endometriosis. Treatment is medicosurgical: thoracoscopy for pleural abrasion and hormonotherapy to avoid recurrence. [less ▲]

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See detailEfficacy and Morbidity of a Novel Induction Treatment in Locally Advanced Non Small Cell Lung Cancer (NSCLC)
Barthelemy, Nicole ULg; Rinken, F.; Dekoster, Guy ULg et al

in International Journal of Radiation, Oncology, Biology, Physics (2006), 66(3), 476-477

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See detailEfficacy and morbidity of a novel induction treatment for locally advanced NSCLC
Bosquee, Léon ULg; Rinken, Françoise ULg; Bustin, F. et al

in Lung Cancer (2005, July), 49(Suppl. 2), 78

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See detailSma Circuits Reduce Platelet Consumption and Platelet Factor Release During Cardiac Surgery
Defraigne, Jean-Olivier ULg; Pincemail, Joël ULg; Dekoster, Guy ULg et al

in Annals of Thoracic Surgery (2000), 70(6), 2075-81

BACKGROUND: Platelet count and function are particularly damaged by cardiopulmonary bypass (CPB). This study evaluated the effects of a novel CPB circuit in terms of platelet count and activation, and ... [more ▼]

BACKGROUND: Platelet count and function are particularly damaged by cardiopulmonary bypass (CPB). This study evaluated the effects of a novel CPB circuit in terms of platelet count and activation, and postoperative need for blood products. METHODS: One hundred patients undergoing coronary grafting were randomized in two groups: control group (n = 50) and test group (n = 50, surface modifying additives circuit, SMA group). Blood samples were taken before, during, and after CPB. Postoperative blood loss, number of transfused blood products, and postoperative variables were recorded. RESULTS: The platelet count decreased less in the SMA group compared to the control group (end of CPB: respectively, 165 +/- 9 x 10(3)/mm3 vs 137 +/- 8 x 10(3)/mm3; p < 0.01). This was paralleled by a reduction in beta-thromboglobulin plasma levels in the SMA group. There was a trend to decreased blood loss in the SMA group, but the difference was significant only in patients taking aspirin preoperatively (p < 0.05). In the SMA group nearly 50% less fresh frozen plasma and platelet units were administered (p < 0.01). No operative deaths were observed. CONCLUSIONS: The use of circuits with surface additives is clinically safe, preserves platelet levels, and attenuates platelet activation. This may lead to a reduced need for blood products. [less ▲]

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See detailA propos d'un cas de chylothorax compliquant une sclérose de varices oesophagiennes
Detry, Olivier ULg; Dekoster, Guy ULg; Honoré, Pierre ULg et al

in Lyon Chirurgical (1994), 90(1), 45-47

Chylothorax is an exceptional complication of endoscopic sclerotherapy of bleeding esophageal varices. We found only three cases in the literature. We report a fourth observation. We discuss the different ... [more ▼]

Chylothorax is an exceptional complication of endoscopic sclerotherapy of bleeding esophageal varices. We found only three cases in the literature. We report a fourth observation. We discuss the different etiologies and the different therapeutic approaches of these unusual chylothorax. [less ▲]

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See detailLe chylothorax et son traitement
Detry, Olivier ULg; Dekoster, Guy ULg; Limet, Anne ULg

in Lyon Chirurgical (1994), 90(1), 38-44

Chylothorax is an unfrequent pathology defined by fistula between the thoracic duct and one of the pleura. Its spontaneous evolution is worse, with respiratory failure in the acute phase. After a few days ... [more ▼]

Chylothorax is an unfrequent pathology defined by fistula between the thoracic duct and one of the pleura. Its spontaneous evolution is worse, with respiratory failure in the acute phase. After a few days of thoracic tube drainage, hemodynamic, nutritional and immunologic disturbances appear. Since the first thoracic duct ligature by Lampson in 1948, surgical approach has obviously reduced the morbidity and mortality of chylothorax. The new development of the thoracoscopic techniques will allow earlier and less aggressive surgical treatment. However, thoracic surgeons must keep in mind that every intrathoracic operation could induce chylothorax, especially in case of posteriror mediastinal surgery. Chylothorax must be evocated if unusually profuse milky pleural effusion complicate this type of procedure. We discribe the anatomy and the physiology of chylous circulation and we discuss the etiologies and the different therapeutic approaches of chylothorax. [less ▲]

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See detailMycotic aneurysm of the upper abdominal aorta ruptured into the stomach
Van Damme, Hendrik ULg; Belachew, M.; Damas, Pierre ULg et al

in Archives of Surgery (1992), 127(4), 478-482

We report a case of primary aortogastric fistula with erosion of a mycotic aneurysm of the upper abdominal aorta into the stomach. The patient was successfully operated on with an in situ aortoaortic tube ... [more ▼]

We report a case of primary aortogastric fistula with erosion of a mycotic aneurysm of the upper abdominal aorta into the stomach. The patient was successfully operated on with an in situ aortoaortic tube graft, incorporating the splanchnic vessels, and direct suture of the gastric erosion. [less ▲]

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See detailFibromuscular dysplasia of the external iliac artery. A case report.
ADANT, JEAN-PHILIPPE; SakalihasanN, Natzi ULg; Dekoster, Guy ULg et al

in Vascular Surgery (1992), 26

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See detailTruncal Vagotomy and Pyloroplasty Combined with Valvular Replacement in Patients with Ulcer Disease
Defraigne, Jean-Olivier ULg; Innocenti, C.; DEKOSTER, Guy ULg et al

in Journal of Cardiovascular Surgery (The) (1991), 32(1), 42-5

In 1988, 5 patients (3 men and 2 women) with ulcer disease (mean age 56 +/- 8 years) underwent valvular replacement for aortic (No. = 4) or mitral disease (No. = 1). All patients had had gastroduodenal ... [more ▼]

In 1988, 5 patients (3 men and 2 women) with ulcer disease (mean age 56 +/- 8 years) underwent valvular replacement for aortic (No. = 4) or mitral disease (No. = 1). All patients had had gastroduodenal ulcers. Preoperative gastroscopy demonstrated active ulcers (No. = 4) and a healed pyloric ulcer with pyloric stenosis (No. = 1). Despite the presence of ulcers, a non-biologic prosthesis was preferred in each patient because of their young age (No. = 3), chronic atrial fibrillation requiring anticoagulant therapy (No. = 1), and refusal of the eventuality of subsequent reoperation (No. = 1). In each patient, a truncal vagotomy with pyloroplasty was performed simultaneously with the valvular procedures by the same incision. The postoperative courses were uneventful. With a mean follow-up of 15 +/- 3 months, no gastrointestinal bleeding was observed during anticoagulant therapy. With anticoagulant drugs, bleeding may occur with a frequency of 4% per patient treatment-year, half of which are gastrointestinal in origin. Nevertheless, in selected patients with gastroduodenal ulcers, performing a vagotomy-pyloroplasty simultaneously with valvular replacement allows implantation of a non-biologic prosthesis, with greater durability than bioprosthesis. [less ▲]

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See detailPrimary Pulmonary Hemangiopericytoma: Early Local Recurrence after Perioperative Rupture of the Giant Tumor Mass (Two Cases)
VAN DAMME, Hendrik ULg; DEKOSTER, Guy ULg; CREEMERS, Etienne ULg et al

in Surgery (1990), 108(1), 105-9

We report two recent observations of giant hemangiopericytoma of the lung, one in a 4-year-old child and another in a 65-year-old man. There were no specific clinical signs, but the radiologic appearance ... [more ▼]

We report two recent observations of giant hemangiopericytoma of the lung, one in a 4-year-old child and another in a 65-year-old man. There were no specific clinical signs, but the radiologic appearance was rather characteristic in both cases, as were the histologic findings. Pneumonectomy was carried out, complicated in each case by rupture of the fragile, incomplete pseudocapsule and diffuse dissemination of necrotic tumor tissue in the operative field and opposite bronchial tree. Outcome was fatal in both cases within a few months, with extensive, rapidly growing metastases in the subcutaneous scar tissue of the thoracotomy and in the other lung and in one case with diffuse diaphragmatic and intraabdominal metastases. These two observations will offer some guidelines for better understanding of this rare localization of hemangiopericytoma, its natural history, and its optimal treatment, with special reference to the malignant potential and local recurrence rate. [less ▲]

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See detailLe remplacement valvulaire mitral pour rupture de pilier mitral post-infarctus. A propos de 13 cas opérés à la phase aigue de l'infarctus
Defraigne, Jean-Olivier ULg; LAVIGNE, Jean-Paul ULg; Remy, D. et al

in Archives des Maladies du Coeur et des Vaisseaux (1990), 83(3), 377-82

Between 1983 and 1988, thirteen patients (12 men and 1 women, average age 63 years) were operated in the acute phase of myocardial infarction for papillary muscle rupture (PMR). The rupture involved the ... [more ▼]

Between 1983 and 1988, thirteen patients (12 men and 1 women, average age 63 years) were operated in the acute phase of myocardial infarction for papillary muscle rupture (PMR). The rupture involved the posterior papillary muscle in 12 cases. The average left ventricular ejection fraction was 47 +/- 9 per cent (range 34 to 63%). Pulmonary capillary pressures ranged from 76 to 41 mmHg (average 35 mmHg). Eleven patients presented with acute pulmonary oedema and 7 had cardiogenic shock. Coronary arteriography showed triple vessel disease in 3 cases, double vessel disease in 7 cases and single vessel disease in 3 cases. Surgery was carried out on average 2.7 days after the rupture and 10 days after the initial infarct. In addition to mitral valve replacement (N = 13), 11 patients underwent a myocardial revascularisation procedure. The operative mortality was 15 per cent (N = 2). Papillary muscle rupture in the acute phase of myocardial infarction causes cardiac failure which is related more to the mechanical abnormality than to an alteration of left ventricular function. Considering the operative mortality and the natural history of PMR treated medically, the authors recommend early surgery as the only management which can improve the precarious haemodynamic status of patients with this complication. [less ▲]

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See detailChirurgie coronarienne et carotidienne en simultané: à propos de 73 cas
VAN DAMME, Hendrik ULg; CREEMERS, Etienne ULg; Defraigne, Jean-Olivier ULg et al

in Acta Chirurgica Belgica (1990), 90(4), 185-96

A series of 73 simultaneous carotid and coronary revascularizations (Group I) is presented (January 1980-December 1988). Age, sex, risk factors, severity of angina, coronarography, neurological symptoms ... [more ▼]

A series of 73 simultaneous carotid and coronary revascularizations (Group I) is presented (January 1980-December 1988). Age, sex, risk factors, severity of angina, coronarography, neurological symptoms, angiographic carotid lesions and operative outcome of these 73 patients are compared with the aspects of 3544 coronary bypass patients (Group II) and 1001 carotid endarterectomized patients (Group III) during the same period. The angina in Group I is more severe, with 22% belonging to NYHA class IV and 26% having a stenosis of the left main coronary artery, vs 14% and 13% in Group II. Seventy percent of the carotid lesions in Group I are asymptomatic vs 33% in Group III. Group I patients had more problems in the perioperative period, with 16.4% needing prolonged high-doses analeptics and 5.4% intraaortic counterpulsation balloon. Operative mortality is higher (7%) in Group I compared with Group II (2.3%) and Group III (1.7%). These results permit to define a population of polyvascular patients with concomitant coronary and carotid disease, characterized by a more diffuse atherosclerosis and a higher operative risk. Operative morbidity and mortality after combined myocardial and cerebral revascularization remains nevertheless inferior to the cumulated surgical risk of the sequential procedures (74 patients with coexistant coronary and carotid lesions operated in two sessions before 1986). [less ▲]

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See detailCoronary Artery Reoperations
VAN DAMME, Hendrik ULg; CREEMERS, Etienne ULg; DEKOSTER, Guy ULg et al

in Journal of Cardiovascular Surgery (The) (1990), 31(3), 255-62

From June 1976 to June 1989, 138 previously revascularized coronary patients were reoperated upon. This represents 3.28% of all aortocoronary bypass procedures performed during the same period in our ... [more ▼]

From June 1976 to June 1989, 138 previously revascularized coronary patients were reoperated upon. This represents 3.28% of all aortocoronary bypass procedures performed during the same period in our institution. Characteristics of this group, risk factors, coronarographic data, perioperative morbidity and mortality are analyzed and compared to the data of the general population undergoing bypass surgery. The mean age of individuals requiring reoperation was 59 years. The mean interval between the two operations reached 73 months (5 to 180 months). Angiographic lesions were more extensive with three-vessel disease in 65% of the reoperated patients. The mean ejection fraction was 55%. A mean of 2.1 bypass grafts per patient were inserted with 60% of cases having an internal mammary artery graft. Perioperative infarction occurred in 8.0% of the reoperations and an intraaortic balloon counterpulsation was necessary in 4.3% at the end of the procedure. Operative mortality was 5%. Symptomatic improvement was obtained in 85% of the cases. In recent years, cardiac transplantation has been performed for 11 previously bypassed patients with severely impaired ventricular function. There were no postoperative deaths. Cardiac transplantation can be considered as a more valuable alternative to repeat coronary artery bypass grafting in such cases. [less ▲]

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See detailLes réopérations pour pontages aorto-coronaires
Van Damme, Hendrik ULg; Creemers, Etienne ULg; Dekoster, Guy ULg et al

in Acta Chirurgica Belgica (1989), 89(5), 237-45

Iterative aorto-coronary bypass. From 1978 to 1988, 106 previously revascularized coronary patients were reoperated. This represents 3.01% of all aorta-coronary bypass procedures performed in the same ... [more ▼]

Iterative aorto-coronary bypass. From 1978 to 1988, 106 previously revascularized coronary patients were reoperated. This represents 3.01% of all aorta-coronary bypass procedures performed in the same period. Characteristics of this group, risk factors, coronary anatomical data, perioperative morbidity and mortality are analyzed and compared to the data of primary revascularization. The progression of atherosclerotic disease, with an annual 2% attrition rate of bypass grafts after the first year, is evidenced by this study. The success rate of coronary reoperations approaches the results of primary bypass surgery. The causes of recurrent angina and graft failure are discussed. The mean age of individuals requiring reoperation is 58.5 years. The mean interval between the two operations reaches 66 months (5 to 168 months). Angiographic lesions are more extensive, with a three vessel disease in 75% of the reoperated patients and an ejection fraction lowered at 55%. A mean of 2.7 bypass grafts per patient is realized, with in 60% of cases an internal mammary artery graft. Perioperative infarction occurs in 10.5% of the reoperations and in 4.5%, an intraaortic counterpulsation balloon is necessary at the end of the procedure. Symptomatic improvement is obtained in 85% of cases. Operative mortality is 5.7%. These findings suggest that coronary reoperation can be accomplished with low morbidity, low mortality and a therapeutic benefit in the majority of cases. In recent years, cardiac transplantation has been considered for some patients with impaired ventricular function. This procedure is only limited by the insufficient number of donors. [less ▲]

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See detailNon Small Cell Lung Carcinoma (Nsclc) at Stage 3. A Fourteen Years Retrospective Study of 449 Patients. Indications of Surgery in a Multidisciplinary Management
RADERMECKER, Marc ULg; Dekoster, Guy ULg; Minet, P. et al

in Acta Chirurgica Belgica (1989), 89(3, May-Jun), 153-8

Through a fourteen years retrospective study of all the patients treated at the State University of Liege, we have focused on the survival of 449 patients with, at least, a clinical stage 3 NSCLC disease ... [more ▼]

Through a fourteen years retrospective study of all the patients treated at the State University of Liege, we have focused on the survival of 449 patients with, at least, a clinical stage 3 NSCLC disease (NORMS UICC). The whole study was divided in two periods (1972-1978, period 1, and 1979-1985, period 2) because, everything remaining nearly equal as far as the clinical material was concerned, period 2 was characterized by a different therapeutic attitude. Since 1979, the NSCLC stage 3's surgical indications have been widely extended. We have performed surgical resections in patients with NSCLC N2 disease because of positive homolateral mediastinal lymph nodes or with T3 disease. This led the NSCLC stage 3 resection rate to move from 26% in period 1 to 47% in period 2. We report here the effects of such a management on the short and long term survival and the stage 3 NSCLC global prognosis. We noted a modest significant increase in the NSCLC stage 3 global prognosis with a five year survival of 4% and 6% (period 1 and 2 respectively; P = 0.03). The 172 resected patients' outcome did not change (five year survival 11% (P1) and 12% (P2]. Although patients were not randomized, our results suggest that adjuvant therapy should not be added whenever the patient underwent a complete resection. On the other hand, it seems very useful indeed whenever the resection was partial. NSCLC patient at stage 3 who underwent a complete resection achieved a 37% five years survival. [less ▲]

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See detailLe patient polyvasculaire. Etude rétrospective de 4200 patients vasculaires opérés entre 1980 et 1986
Van Damme, Hendrik ULg; Creemers, Etienne ULg; Dekoster, Guy ULg et al

in Acta Chirurgica Belgica (1988), 88(2, Mar-Apr), 111-9

Polyvascular patients. Among a consecutive series of 4200 patients submitted to vascular surgery, a group of 292 people operated on, in at least two anatomically and physiologically different sites, is ... [more ▼]

Polyvascular patients. Among a consecutive series of 4200 patients submitted to vascular surgery, a group of 292 people operated on, in at least two anatomically and physiologically different sites, is individualized as polyvascular patients. A subgroup is characterized by simultaneous procedures in two separated fields; 32 have benefited in the same time from carotid and coronary procedures, i.e., 0.6% of all coronary patients and 2% of all carotid patients. The carotid-coronary group exhibited a more severe anatomical disease both in the carotid and the coronary vasculatures. Apart from simultaneously operated patients, others were sequentially treated over a 7 years period: people with carotid (25%) or visceral (40%) arterial disease were more prone to become polyvascular. Polyvascular patients differ from monovascular patients in that hypertension is more frequent and more severe, mean cholesterol level higher and incidence of severe hypercholesterolemia more frequent. [less ▲]

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See detailRupture intrapéricardique d'un anévrysme du sinus de Valsalva antéro-droit: cas clinique et revue de la littérature
Defraigne, Jean-Olivier ULg; DEKOSTER, Guy ULg; Demoulin, J. C. et al

in Acta Chirurgica Belgica (1988), 88(6), 369-74

Intrapericardial ruptured aneurysm of the right anterior sinus of Valsalva. A intrapericardial ruptured aneurysm of the right anterior sinus of Valsalva is presented. An infectious origin was suspected ... [more ▼]

Intrapericardial ruptured aneurysm of the right anterior sinus of Valsalva. A intrapericardial ruptured aneurysm of the right anterior sinus of Valsalva is presented. An infectious origin was suspected. The aneurysm was treated by plication, which allowed to correct the preoperative insufficiency. Aneurysms of the Valsalva sinus can remain asymptomatic. When they are small, a conservative treatment is conceivable. Many complications can occur: rupture (more often in right cavities), aortic insufficiency, coronary insufficiency, cardiac failure, rhythm disturbances. This complications necessitate a surgical treatment. Aortic valvular replacement is indicated only when the structure of the valve is altered. [less ▲]

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