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Acta Chir Belg 2022 May 22:1-4. Epub 2022 May 22.

Department of Abdominal Surgery, Grand Hôpital de Charleroi, Gilly, Belgium.

Background: Pheochromocytoma is a rare catecholamine-secreting tumor of neuroendocrine origin. It has a prevalence of <1% in adults with hypertension. In some cases, hypertension is associated with the classical triad of headache, sweating, and tachycardia. Read More

Acta Chir Belg 2022 May 23:1-8. Epub 2022 May 23.

Inonu University, Liver Transplantation Institute, Malatya, Turkey.

Background: Current standard treatment for perihilar cholangiocarcinoma (pCCA) is surgical resection. Bismuth-Corlette (BC) type IV pCCA is accepted as an unresectable disease. In the present study, the results of non-transplant surgical approaches in patients with BC type IV pCCA were examined. Read More

Acta Chir Belg 2022 May 20:1-8. Epub 2022 May 20.

CHU Charleroi, Lodelinsart, Belgium.

Background: Minimally invasive procedures for coronary revascularization have been performed for over 20 years; however, their technical complexity, steep learning curves and absence of training programs explain the weak acceptance of these techniques. The aim of this study is to describe the step-by-step learning process on how to establish a minimally invasive coronary artery revascularization program. The short-term outcomes of our first 30 patients were compared to our left internal mammary artery (LIMA) to left anterior descending (LAD) artery off pump coronary artery bypass (OPCAB) cohort as a quality control baseline. Read More

Acta Chir Belg 2022 May 22:1-7. Epub 2022 May 22.

Department of Plastic, Reconstructive and Aesthetic Surgery, Ghent University Hospital, Ghent, Belgium.

Introduction: To report a case of radiation necrosis after reirradiation for breast cancer and the difficulties encountered when treating these complex cases.

Patients And Methods: We present an 86-year-old woman with a history of right-sided intraductal breast cancer treated with a right mastectomy followed by local adjuvant radiotherapy (50 Gray). Twelve years later, she was diagnosed with a local recurrence in the mastectomy scar which was treated with local resection (including resection of rib four) and adjuvant radiotherapy up to 32 Gray. Read More

Acta Chir Belg 2022 May 9:1-8. Epub 2022 May 9.

Department of Plastic and Reconstructive Surgery, Ghent University Hospital, Ghent, Belgium.

Background: Surgical site infection (SSI) is a common complication following head and neck surgery. Dead space at the excision site can increase the risk of infection, abscess formation, and mortality. Herein, we evaluated the performance of the chimeric anterolateral thigh (ALT) flap in addressing these concerns. Read More

Acta Chir Belg 2022 Jun 2;122(3):215-221. Epub 2022 May 2.

Plastic and Reconstructive Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China.

Background: Pedicle length deficiency in microsurgical procedure is a challenging issue. The aim of this report is to present a case series of a flap-splitting technique for pedicle lengthening of large multiple perforator-based (MPB) free flaps.

Methods: In this retrospective case series, we reviewed the medical records of patients who underwent free flap repair with "split flap" pedicle-lengthening technique between August 2017 and December 2021. Read More

Acta Chir Belg 2022 May 10:1-10. Epub 2022 May 10.

Department of Vascular Surgery, AZ Sint-Maarten, Mechelen, Belgium.

Purpose: The excellent performance of the Supera Peripheral Stent System by Abbott Vascular in femoropopliteal interventions has already been proven through several trials. This retrospective study aims to evaluate the durability and long-term patency of the Supera stent for the treatment of severe femoropopliteal lesions in a real-world population.

Methods: A retrospective analysis was conducted of 136 consecutive limbs from 128 patients with atherosclerotic disease in the femoropopliteal region, treated with Supera stents between September 2010 and September 2017. Read More

Acta Chir Belg 2022 May 4:1-7. Epub 2022 May 4.

Department of Surgery, University of Eastern Finland and Mikkeli Central Hospital, Mikkeli, Finland.

Background: Laparoscopic ventral hernia repair (LVHR) may be associated with chronic pain, seroma formation, bulging and failure to restore abdominal wall function. These outcomes are risk factors for hernia recurrence and poor quality of life (QoL). Our study evaluates whether robotic-assisted ventral hernia repair (rVHR) diminishes these complications compared to LVHR with primary closure of the defect (hybrid). Read More

Acta Chir Belg 2022 May 4:1-17. Epub 2022 May 4.

Burn Center, Ghent University Hospital, Ghent, Belgium.

Introduction: Early surgical debridement of the deep second and third-degree burns is still the standard of care (SOC) to prepare the wound bed for skin grafting. However, this technique has some drawbacks that explain the growing interest in enzymatic debridement as an alternative. In this article, we provide a historic overview as well as the current state-of-the-art and future prospective of this type of non-surgical debridement. Read More

Acta Chir Belg 2022 May 16:1-3. Epub 2022 May 16.

Department of Cardiac Surgery and Cardiovascular Anaestesia, Ospedale Mauriziano "Umberto I", Torino, Italy.

Background And Aim: Papillary fibroelastoma (PFE) represents only 16% of the benign cardiac tumor and approximately 15% of these are located on the tricuspid valve.

Materials And Methods: Over a period of 22 years (1999-2021) we observed 75 pts with cardiac tumors at our Center over 9650 pts operated on but only one case of a tricuspid valve PFE in a 69-year-old patient. Trans-thoracic echocardiography demonstrated a mobile mass (20 × 10 mm), adhering to the atrial side of the septal leaflet of the tricuspid valve of unknown origin. Read More

Acta Chir Belg 2022 Apr 8:1-4. Epub 2022 Apr 8.

Department of Surgery, Zuyderland Medical Center, Heerlen, The Netherlands.

Background: Manubriosternal dislocations are a rare entity and frequently associated with thoracic spine fractures and, in minority of cases, with cervical or thoracolumbar fractures.

Methods: Our case represents a 38-year-old male who fell from a height resulting in multiple fractures, amongst others of the first lumbar vertebra. At primary survey and computed tomography scan no manubriosternal injury was apparent. Read More

Acta Chir Belg 2022 Apr 8:1-6. Epub 2022 Apr 8.

Department of Surgery, Health Sciences University, Haydarpasa Numune Teaching Hospital, Istanbul, Turkey.

Introduction: Safe thyroid surgery depends on a deep knowledge of human neck anatomy, including the recurrent laryngeal nerve (RLN). Anatomic variations such as extra-laryngeal terminal branching (ETB) are common.

Patients And Methods: We studied the ETB pattern of 1001 RLNs at risk in 596 patients. Read More

Acta Chir Belg 2022 Mar 28:1-4. Epub 2022 Mar 28.

Department of Urology, St. Lucas Hospital, Ghent, Belgium.

Well differentiated papillary mesothelioma (WDPM) is a rare entity making up 0.3-5% of all mesothelioma cases, while manifestations of the tunica vaginalis are even more uncommon. Literature on WDPM is scarce and our understanding is rather limited. Read More

Acta Chir Belg 2022 Apr 5:1-12. Epub 2022 Apr 5.

Department of Surgery A, University Hospital Duesseldorf, Duesseldorf, Germany.

Introduction: Cholangiocellular carcinoma (CCA) has a poor prognosis and the goldstandard even in locally advanced cases remains radical surgical resection. This approach however is limited by the future liver remnant volume (FLRV) after extensive parenchymal dissection leading to post-operative liver failure and high mortality rates. The aim of this study was to compare the outcome of in situ liver transection with portal vein ligation (ISLT) procedure and conventional two-stage hepatectomy with portal vein embolization (PVE/TSH) in patients with CCA. Read More

Acta Chir Belg 2022 Mar 31:1-9. Epub 2022 Mar 31.

Department of Emergency Medicine, Tunceli Government Hospital, Tunceli, Turkey.

Introduction: This study aimed to investigate the specific effects of subcutaneous adipose tissue thickness (SATT) on trauma-related injury (TRI) development in patients with low-energy isolated blunt thoracic trauma.

Patients And Methods: This prospective observational study was performed between March 2018-March 2019. Patients admitted to our hospital because of blunt thoracic trauma were enrolled. Read More

Acta Chir Belg 2022 Apr 10;122(2):144-149. Epub 2022 Mar 10.

Cardiothoracic Surgery, Hasselt, Belgium.

Introduction: Partial upper sternotomy is an established technique for aortic valve surgery in numerous centers. Based on the favorable results, this access can be extended for more complex procedures. We assessed the outcomes of aortic root and arch surgery through partial versus full sternotomy. Read More

Acta Chir Belg 2022 Mar 11:1-6. Epub 2022 Mar 11.

General Surgery Department, Centro Hospitalar de Vila Nova de Gaia Espinho, EPE, Vila Nova de Gaia, Portugal.

Background: Bronchobiliary fistula is a rare and complex entity defined by an abnormal communication between the biliary and bronchial systems. The etiopathogenesis is not completely understood, but the most common factors implicated are hepatobiliary tumors, biliary obstruction, iatrogenic damage or trauma.

Methods: Here we present a case of a 69-year-old man that developed a bronchobiliary fistula and a pulmonary abscess after migration of a bile duct stent placed as part of the treatment of an iatrogenic bile duct injury that occurred during elective cholecystectomy. Read More

Acta Chir Belg 2022 Mar 17:1-5. Epub 2022 Mar 17.

Department of Gastroenterology, AZ Groeninge, Kortrijk, Belgium.

Background: Lymphoepithelial cysts (LECs) of the pancreas are a rare type of true pancreatic cysts and represent an estimated 0.5% of all pancreatic cystic lesions . They are benign lesions and have no malignant potential. Read More

Acta Chir Belg 2022 Mar 12:1-9. Epub 2022 Mar 12.

Department of Pathology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.

Background: Alveolar soft-part sarcoma (ASPS) is a rare soft tissue sarcoma subtype, occurring mainly in young people, with poor prognosis.

Materials And Methods: We conducted a retrospective analysis of localized or metastatic ASPS patients admitted to the First Affiliated Hospital of Zhengzhou University (China) from 2012 to 2020, focusing on treatment and prognosis.

Results: The median age at diagnosis was 24 years (range: 1. Read More

Acta Chir Belg 2022 Feb 17:1-4. Epub 2022 Feb 17.

Department of Endocrinology, Université Catholique de Louvain, CHU UCL Namur (Site Godinne), Yvoir, Belgium.

Background: Adrenocortical carcinoma is a rare and aggressive tumour. The only curative treatment is surgery with negative margins. In most series, the average lesion size ranges from 5. Read More

Acta Chir Belg 2022 Feb 16:1-6. Epub 2022 Feb 16.

The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Background: Peutz-Jeghers syndrome (PJS) is a rare autosomal dominant disorder characterized by a predisposition to the development of multiple neoplasms. Gastric-type mucinous adenocarcinoma (GAS), a new variant of carcinoma of the cervix according to 2014 WHO classification, is less common compared with squamous cell carcinoma, is more aggressive and has a lower 5-year survival rate compared with the usual-type endocervical adenocarcinoma, and is also unrelated to human papillomavirus (HPV) infection.

Case Summary: We herein present the case of a 32-year-old patient with PJS who was diagnosed with GAS of the cervix. Read More

Acta Chir Belg 2022 Feb 2:1-4. Epub 2022 Feb 2.

Department of General Surgery, Maria Middelares Hospital, Gent, Belgium.

Introduction: We report on a case of congenital unilateral atresia of the vas deferens encountered during a robotic-assisted transabdominal preperitoneal (TAPP) inguinal hernia repair.

Case Report: Our 65-years-old male patient was scheduled for a bilateral robotic-assisted TAPP inguinal hernia repair because of bilateral symptomatic groin hernia. Standard intraoperative dissection obtaining a critical view of the myopectineal orifice did not allow for an identification of the vas deferens (VD) on the left side. Read More

Acta Chir Belg 2022 Feb 2:1-8. Epub 2022 Feb 2.

Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures Romania.

The continuous-flow left ventricular assist device (CF-LVAD) is used to save the lives of patients in the final stage of congestive heart failure, replacing the pump function of the left ventricle. Although quality of life increases significantly, CF-LVAD-related complications might prove fatal, as in the case presented in this paper. A 20-year-old female, during her second pregnancy, presented with signs of heart failure. Read More

Acta Chir Belg 2022 Jun 27;122(3):151-159. Epub 2022 Jan 27.

Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.

Introduction: The aim of this systematic review and meta-analysis was to evaluate whether the benefits of prophylactic inferior vena cava filters (IVCF) outweigh the risks thereof.

Patients And Methods: PubMed, EMBASE, and Cochrane Library were systematically searched for records published from 1980 to 2018 by two independent researchers (MG, GG). The endpoints of interest were pulmonary embolism (PE) and deep vein thrombosis (DVT) rates. Read More

Acta Chir Belg 2022 Jan 23:1-6. Epub 2022 Jan 23.

Department of Vascular and Thoracic Surgery, ZNA Middelheim Hospital, Antwerp, Belgium.

Background: Mycotic aortic aneurysms (MAA) arise due to infection of a pre-existent aneurysm or aneurysmal degeneration of an infected vascular wall. MAA of the thoracic aorta are relatively rare. Treatment is mainly guided by clinical experience as there are no large randomized trials available. Read More

Acta Chir Belg 2022 Jan 19:1-3. Epub 2022 Jan 19.

Department of Radiology, University Hospitals Leuven, Leuven, Belgium.

Background: Outcome of minimally invasive treatment of posttraumatic, hemorrhagic bladder rupture is unknown.

Methods: A 41-year-old male presented at the emergency department with pelvic and scrotal pain and macroscopic hematuria after a motor vehicle accident. Contrast-enhanced computed tomography revealed an open book fracture and an arterial phase contrast media extravasation posterior to the symphysis pubis and anterior to the urethra-vesical junction. Read More

Acta Chir Belg 2022 Jan 19:1-6. Epub 2022 Jan 19.

Department of Surgery, Zuyderland Medical Center, Heerlen, Sittard, The Netherlands.

Background: Spontaneous esophageal perforation or Boerhaave syndrome is a life-threatening emergency, associated with significant morbidity and mortality. In this retrospective series we describe our single-center experience with a hybrid minimally invasive treatment approach for the treatment of Boerhaave syndrome.

Methods: Clinical data of all patients who presented with spontaneous esophageal rupture between January 2009 and December 2019 were analyzed. Read More

Acta Chir Belg 2022 Jun 19;122(3):222-224. Epub 2022 Jan 19.

Department of Surgical Oncology, VieCuri Medical Centre for North-Limburg, Venlo, Netherlands.

Introduction: Metastasis of basal cell carcinoma (BCC) is a very rare finding because the disease is mostly discovered early in development and treated immediately. Moreover, the metastasis percentage is less than 0.5%. Read More

Acta Chir Belg 2022 Jan 12:1-7. Epub 2022 Jan 12.

Urology Clinic, Euromedic General Hospital, Belgrade, Serbia.

Objective: To assess the feasibility and functional outcomes of mini-laparotomy radical cystectomy (RC) in association with limited bowel externalization during ileal conduit urinary diversion.

Methods: Between January 2018 and March 2020, 53 patients underwent RC plus pelvic lymph node dissection (PLND) for invasive carcinoma of the urinary bladder. This group of patients was intentionally treated utilizing the mini-laparotomy approach, with the addition of limited bowel externalization during conduit preparation and match-paired with 46 examinees from a historical series of patients who underwent conventional open RC plus PLND and ileal conduit diversion. Read More

Acta Chir Belg 2022 Jan 17:1-8. Epub 2022 Jan 17.

Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Objectives: To analyse the mineral content of tap water in Flanders and assess if the region one lives in could prevent or precipitate stone formation due to a difference in mineral content.

Methods: Data from six water companies providing tap water to nine regions in Flanders regarding calcium, magnesium, potassium, sodium and sulphate content in tap water was retrieved. Minimum and maximum values were collected and compared between the different geographical regions. Read More