References of "Acta Chirurgica Belgica"
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See detailEffects of large pore hemofiltration in a swine model of fulminant hepatic failure
Detry, Olivier ULg; Janssen, Nathalie ULg; Cheramy-Bien, Jean-Paul ULg et al

in Acta Chirurgica Belgica (2010, April), 110

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See detailTraumatic Abdominal Wall Hernia : Case Report and Review of the Literature
Henrotay, J.; Honore, Charles ULg; Meurisse, Michel ULg

in Acta Chirurgica Belgica (2010), 110

Traumatic abdominal wall hernia (TAWH) is a rare type of hernia that occurs after an impact of the abdominal wall against a blunt object. The first case described was reported in 1906 and ever since, 46 ... [more ▼]

Traumatic abdominal wall hernia (TAWH) is a rare type of hernia that occurs after an impact of the abdominal wall against a blunt object. The first case described was reported in 1906 and ever since, 46 cases have been reported. CT scan is mandatory in the diagnosis of TAWH but also because of a frequent association with significant intra-abdominal injuries. We report here the case of a 61-year-old man with a TAWH developed after impact against a bicycle handlebar. Hemodynamically stable and without associated injuries, the patient was monitored for 24 hours before hospital discharge. A successful elective hernia repair with a prosthetic mesh was performed 6 weeks later once cicatrisation was achieved. [less ▲]

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See detailErectile Dysfonction, a Sentinel of Cardiovascular Disease...
Andrianne, Robert ULg; Legros, Jean-Jacques ULg

in Acta Chirurgica Belgica (2010), 110

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See detailPenile Prosthesis in the Age of the Blue Pill
Andrianne, Robert ULg

in Acta Chirurgica Belgica (2010), (110), 149-152

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See detailDo we need a new carotid artery stenting trial?
Van Damme, Hendrik ULg; Defraigne, Jean ULg

in Acta Chirurgica Belgica (2010), 110(4), 432-44

Four well-conducted carotid artery trials comparing carotid artery stenting with carotid artery endarterectomy (EVA-3S, SPACE, ICSS and CREST) could not demonstrate the superiority of carotid artery ... [more ▼]

Four well-conducted carotid artery trials comparing carotid artery stenting with carotid artery endarterectomy (EVA-3S, SPACE, ICSS and CREST) could not demonstrate the superiority of carotid artery stenting (CAS) over carotid artery endarterectomy (CEA). There is at the moment no level-I evidence to support widespread use of endovascular management of carotid artery disease in routine practice. In order to shead some light on the continuing debate on the role of carotid artery stenting, the authors conducted a search in contemporary published literature concerning carotid artery stenting. This extensive literature review reveals a higher peri-procedural stroke-death rate after CAS and a higher cost. Two other events hamper the value of CAS: a higher late restenosis rate and a higher risk of micro-embolisation during the procedure, compared with CEA. The authors conclude that the prevailing overenthusiasm of interventionalists (vascular surgeons, radiologists, cardiologists) for carotid artery stenting is not justified. [less ▲]

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See detailWord usage in scientific writing.
Van Damme, Hendrik ULg

in Acta Chirurgica Belgica (2010), 110(2), 137

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See detailThrombolysis of occluded infra-inguinal bypass grafts: is it worthwhile?
Bonhomme, Stéphanie ULg; Trotteur, Geneviève ULg; Van Damme, Hendrik ULg et al

in Acta Chirurgica Belgica (2010), 110(4), 445-50

BACKGROUND: Thrombosis of an infra-inguinal bypass graft often results in a limb-threatening ischemia. There is no consensus on the optimal management strategy. AIM OF THE STUDY: To analyse safety and ... [more ▼]

BACKGROUND: Thrombosis of an infra-inguinal bypass graft often results in a limb-threatening ischemia. There is no consensus on the optimal management strategy. AIM OF THE STUDY: To analyse safety and efficacy of catheter-guided intra-arterial thrombolysis to re-open thrombosed infra-inguinal bypass grafts and to identify factors that influence graft patency and limb salvage rate after thrombolytic procedures. METHODS: A continuous cohort-study of 106 thrombolytic procedures between 1993 to 2008. RESULTS: Despite a high initial success rate (76%), the mid-term results are less convincing, with a 58% re-occlusion rate at 45 months follow-up. Thrombosed vein grafts, old (2 weeks or more) occlusions, poor run-off and failure to identify or rectify an underlying causative stenosis are determinant for a poor long-term outcome of thrombolytic procedures. COMMENTS : The outcome results of author's experience are consistent with literature reports. Thrombolysis of occluded infra-inguinal bypass grafts should be limited to selective cases (recent occlusion, prosthetic or vein graft in place since 1 year or more, critical limb ischemia). Despite its obvious advantages, the long-term outcome of thrombolytic procedures is deceiving. The inherent risk of hemorrhagic complications should also be taken in account at the decision making of treatment strategy. The question whether, in general, catheter-guided selective intra-arterial thrombolysis offers a significant advantage over operative revascularisation (thrombectomy or new bypass) remains unanswered. A more selective approach seems to favour thrombolysis as most appropriate strategy in the management of recent (< 2 weeks) thromboses of grafts in place since at least 1 year. [less ▲]

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See detailThe society for Internet-based Scientific Studies : a new platform to promote multicentric studies in the Royal Belgian Society for Surgery
Bertrand, C. L.; Squifflet, Jean-Paul ULg; Gys, T. et al

in Acta Chirurgica Belgica (2010), 110

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See detail14 steps to writing clearly
Van Damme, Hendrik ULg; Ceelen, W.; Detry, Olivier ULg et al

in Acta Chirurgica Belgica (2009), 109

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See detailEndovascular aneurysm repair (EVAR): does it fulfil all its promises?
Van Damme, Hendrik ULg; Creemers, Etienne ULg; Defraigne, Jean-Olivier ULg

in Acta Chirurgica Belgica (2009), 109(4), 436-43

In the trend of the endovascular revolution for occlusive arterial disease, management of aneurysmal disease has known an analogous change in the nineties. Elective endo-aneurysmal stentgrafting (EVAR or ... [more ▼]

In the trend of the endovascular revolution for occlusive arterial disease, management of aneurysmal disease has known an analogous change in the nineties. Elective endo-aneurysmal stentgrafting (EVAR or endovascular aneurysm repair) is nowadays of widespread application in contemporary practice all over the world, sometimes by over-enthusiast proponents. There is a burden of recent publications on that topic. Critical analysis of relevant data reveal compelling evidence that elective EVAR is a safe procedure with a threefold reduced 30-day morbidity-mortality, when compared to conventional open aneurysm repair. EVAR also deemed efficace in terms of AAA rupture prevention. At the other hand, mid-term follow-up revealed that EVAR does not endure at the long-term in any late survival benefit, compared to open AAA repair. The major concern and drawback of EVAR is its higher cost and the need for indefinite, life-long surveillance, with a 20% reintervention rate (almost catheter-based endovascularly) at 5-year follow-up. In this review-paper, short-term gains of EVAR are balanced against the inherent disadvantages and long-term losses. According best available evidence, EVAR should not longer be the first choice for high-risk patients, judged unfit for open aneurysm repair. There also exist doubt on the use of EVAR in young fit patients with an anticipated long life expectancy. In approximately half of the AAA patients, EVAR can be considered as the appropriate treatment option. [less ▲]

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See detailSpinal cord stimulation. New regulation of national health insurance.
Van Damme, Hendrik ULg; Suy, R.; Van den Brande, P. et al

in Acta Chirurgica Belgica (2008), 108(1), 139-41

Since January 1, 2008, the Belgian national health insurance (INAMI/RIZIV) edited a new agreement for the prolongation of the pilot-study on spinal cord stimulation for chronic critical unreconstructable ... [more ▼]

Since January 1, 2008, the Belgian national health insurance (INAMI/RIZIV) edited a new agreement for the prolongation of the pilot-study on spinal cord stimulation for chronic critical unreconstructable lower limb ischemia. After a short introduction and a summary of the results of the initial Belgian pilot study (2000-2005) on spinal cord stimulation, the official new text is now published in both languages. [less ▲]

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See detailBilateral humeral artery aneurysm as a cause of digital ischaemia.
Marival, T.; Vandaele, S.; Van Damme, Hendrik ULg et al

in Acta Chirurgica Belgica (2008), 108(6), 750-2

Bilateral humeral artery aneurysm is a very rare condition. Simultaneous bilateral complication of these aneurysms makes it even more unusual. We present a case of a 44-year-old man with bilateral digital ... [more ▼]

Bilateral humeral artery aneurysm is a very rare condition. Simultaneous bilateral complication of these aneurysms makes it even more unusual. We present a case of a 44-year-old man with bilateral digital ischaemia as a complication of a bilateral humeral artery aneurysm. Anamnestic, clinical and per-operative findings led to several hypotheses. A venous bypass graft was done to exclude both aneurysms and to arrest the embolisation into the digital arteries. [less ▲]

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See detailThe history of Pancreas Transplantation: Past, Present and Future
Squifflet, Jean-Paul ULg; Gruessner, R.; Sutherland, D.

in Acta Chirurgica Belgica (2008), 108

Abstract. The first attempt to cure type 1 diabetes by pancreas transplantation was done at the University of Minnesota, in Minneapolis, on December 17, 1966, followed by a series of whole pancreas ... [more ▼]

Abstract. The first attempt to cure type 1 diabetes by pancreas transplantation was done at the University of Minnesota, in Minneapolis, on December 17, 1966, followed by a series of whole pancreas transplantation. Due to the lack of potent immunosuppressive drugs, rejections and infections, it was concluded that pancreas was less antigenic than the kidney which was less antigenic than the duodenum. It opened the door to a period, between the mid 70’s to mid 80’s where only segmental pancreatic grafts were used in the recipient. Numerous techniques for diverting or dealing with the pancreas juice secretion were described, none of them being satisfactory. In the late 70’s – early 80’s, three major events happened and boosted the development of pancreas transplantation : firstly the introduction of Cyclosporine A in the clinical field, secondly the organization on March 1980, of the first international meeting on Pancreas Transplantation with the first report of the International Pancreas Transplantation Registry (IPTR) and finally in 1982, the organization of the first informal so-called Spitzingsee meetings where pancreas transplantation successes but mainly failures were discussed which precluded the onset of IPITA (International Pancreas and Islet Transplantation Association), EuroSPK (European Study Group for simultaneous Pancreas and Kidney Transplantation) and EPITA (European Pancreas and Islet Transplantation Association). During one of the Spitzingsee meetings, participants had the idea to renew the urinary drainage technique of the exocrine secretion of the pancreatic graft with segmental graft and eventually with whole pancreaticoduodenal transplant. That was clinically achieved during the mid 80’s and remained the mainstay technique during the next decade. In parallel, the Swedish group developed the whole pancreas transplantation technique with enteric diversion. It was the onset of the whole pancreas reign. The enthusiasm for the technique was rather moderated in its early phase due to the rapid development of liver transplantation and the need for sharing vascular structures between both organs, liver and pancreas. During the modern era of immunosuppression, the whole pancreas transplantation technique with enteric diversion became the gold standard for simultaneous pancreas and kidney transplantation (SPK), with portal drainage of the venous effluent of the pancreas, even for pancreas after kidney (PAK) or pancreas transplantation alone (PTA). Today, there remains room for improvement : safety of using the duodeno-duodenal anastomosis technique must be confirmed by prospective analysis while preventing ischemic reperfusion injuries, using specific drugs ; that must be assessed in new trials. [less ▲]

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See detailThe history of the EuroSPK - Study Group
Squifflet, Jean-Paul ULg; Malaise, J.; Van Ophem, D. et al

in Acta Chirurgica Belgica (2008), 108

The EuroSPK Study group was created during the 4th Spitzingsee 1997 workshop in Kühtai, Austria. Thanks to W. Land for the incentive to gather European Centres – with Switzerland and Israel – and propose ... [more ▼]

The EuroSPK Study group was created during the 4th Spitzingsee 1997 workshop in Kühtai, Austria. Thanks to W. Land for the incentive to gather European Centres – with Switzerland and Israel – and propose them to joint efforts and share data in the field of pancreas transplantation. Today, two prospective randomized studies have been already performed ; a lot of data and results have been generated and worldwide spread. The spirit of the group will continue with a new interest in innate immunity and prevention of the ischemic reperfusion injury in pancreas transplantation. [less ▲]

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See detailMilestones in Pancreas Transplantation in Belgium
De Roover, Arnaud ULg; Squifflet, Jean-Paul ULg

in Acta Chirurgica Belgica (2008), 108

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See detailGuidelines for quality improvement in cardiac surgery. The College of Cardiac Surgery : results of the 2007 survey.
De Smet, J. M.; Kolh, Philippe ULg; Van Kerrebroeck, Chr et al

in Acta Chirurgica Belgica (2008), 108(6), 638-44

Optimal delivery of health care is a common goal of individual physicians, professional organizations, hospital structures and governmental authorities. A growing concern has emerged from the public ... [more ▼]

Optimal delivery of health care is a common goal of individual physicians, professional organizations, hospital structures and governmental authorities. A growing concern has emerged from the public, media and third payer organizations concerning the quality of care and the amount of resources spending. In the United States, large databases, guidelines and performance evaluation have been elaborated by medical societies, particularly in the area of cardiac surgery. These tools are useful for improvement of patients' care, resources distribution, pay for performance and public and practitioners' awareness. The evaluation of quality is based on composite models combining structure, process and outcome indices. However, pitfalls such as patients' selection, and risk avoidance in order to improve results must been prevented by adjustment of the treated populations' risk factors by specific scores. The Belgian Health authorities have built a structure directed at delivery of care improvement based on "Care Programs", monitored by Colleges formed by delegates of professional organizations. The College of Cardiac Surgery has promoted several studies aimed at data collection and evaluation. In 2007, a survey was addressed to all the Belgian Cardiac surgeons to define their opinion as to the best indicators of care in their specialty. These results will serve to define further avenues of research. By maintaining the responsibility of care evaluation in the hands of the involved professionals, this kind of cooperation between governmental and physicians' organizations seems to serve the best interests of the public and the practitioners. [less ▲]

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See detailHealth care cost containment.
Van Damme, Hendrik ULg; Michel, L.

in Acta Chirurgica Belgica (2008), 108(1), 2-3

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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 detailImmunosuppression in Pancreas Transplantation The Euro SPK Trials and Beyond
Malaise, J.; De Roover, Arnaud ULg; Squifflet, Jean-Paul ULg et al

in Acta Chirurgica Belgica (2008), 108

The Immunosuppression in Pancreas Transplantation was historically based on the fact that the pancreas is an extremely immunogenic organ. Quadruple drug therapy with polyclonal or monoclonal antibodies ... [more ▼]

The Immunosuppression in Pancreas Transplantation was historically based on the fact that the pancreas is an extremely immunogenic organ. Quadruple drug therapy with polyclonal or monoclonal antibodies induction was the mainstay therapy since the introduction of Cyclosporine A. In the modern era of Immunosuppression, Mycophenolate Mofetil replaced Azathioprine while Tacrolimus-another potent calcineurin inhibitor-had-and still has-a difficult challenge to replaced Cyclosporine A, due to its potential diabetogenic effect. Thanks to the first two EuroSPK studies which prospectively tried to answer several questions in that field. But, the future challenge will be in understanding the impact of innate immunity and ischemic reperfusion injuries on the long term graft function. Hopefully, new drugs will be available and tested to block unspecific deleterious reactions to attenuate the proinflammatory response. It will be the aim of the third Euro SPK Stud [less ▲]

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See detailCurrent concepts in breast reconstruction
Preud'homme, L.; LEMAIRE, Vincent ULg; Nizet, Jean-Luc ULg

in Acta Chirurgica Belgica (2008), 108(3), 298-303

As the incidence of breast cancer increases, breast reconstruction is more and more often proposed and its indications are viewed in terms of quality of life. In the past, delayed reconstruction was the ... [more ▼]

As the incidence of breast cancer increases, breast reconstruction is more and more often proposed and its indications are viewed in terms of quality of life. In the past, delayed reconstruction was the rule. Progress in reconstructive techniques currently allows performing immediate reconstruction in selected cases, even when the operative field has to be irradiated. These new techniques generally improve the result of breast reconstruction. Moreover, expansion of screening techniques allows detection of small tumors for which a conservative excision is sufficient. Nevertheless, this kind of less aggressive surgery may require a reconstructive procedure in order to maximise the aesthetic result. [less ▲]

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