Jan J van Lanschot

..The individualized operative approach for patients with potentially curable oesophageal cancer is based on tumour location, positive high-thoracic lymph nodes and preoperative physical condition...

..Suggestions have been made that a further decrease in hospital mortality may be achieved by centralization of esophagectomies in high volume centers...

..Barrett epithelium of the esophagus in a 63-year-old man with early carcinoma, detected at regular endoscopy...

..Zenker's diverticulum; diverticula of the small intestine; Meckel's diverticulum...

..In a 67-year-old woman with recurrent vomiting the gastric folds did not disappear after air insufflation. Linitis plastica was diagnosed and stomach resection was carried out...

..This study aimed to analyse the current outcome after palliative surgical drainage of malignant biliary obstruction...

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..With the development of new diagnostic tools more/smaller peritruncal nodes may be found positive preoperatively. We evaluate whether it is justified to exclude all patients with positive peri-truncal nodes from curative surgery...

..Therefore, this technique has the potential to refine the staging system for esophageal cancer and to help identify patients who will not be cured by surgery alone...

..The validity of this nomogram was externally tested in patients treated in another country at a different high-volume institution...

..a long period...

..CONCLUSIONS: Preoperative biopsies have a poor diagnostic accuracy. Local resection is an adequate surgical treatment for adenomas. In experienced hands, PD is the preferred treatment for patients with adenocarcinoma...

..CONCLUSIONS: Preoperative biliary drainage did not influence the incidence of postoperative complications, and although it can be performed safely in jaundiced patients it should not be used routinely...

..To provide a qualitative ranking of clinical variables by surgeons that influence their decision for reoperation and to evaluate whether these variables are related to positive findings at relaparotomy...

..The aim of this study was to assess the diagnostic impact of extended en bloc lymphadenectomy in staging (adeno)carcinoma of the mid/distal oesophagus or gastric cardia...

..Survival after surgical bypass procedures for tumour recurrence was limited, particularly when ascites was present. Patients readmitted for complications of surgery had a good prognosis...

..CONCLUSIONS: Resection margins, lymph-node status and tumour differentiation are independent prognostic factors. Survival after standard pancreaticoduodenectomy for periampullary tumours has not improved...

..Prolonged drainage is a sign of adequate dissection on the site of the primary tumor, probably due to the more extensive trauma to the lymphatic vessels in the mediastinum...

..The aim of this study was to investigate the feasibility of laparoscopic mobilization of the stomach and gastric tube formation in patients undergoing an open transthoracic esophagectomy for cancer...

..Solid-pseudopapillary neoplasms (SPNs) of the pancreas are increasingly diagnosed, but the exact surgical management in terms of extent of the resection is not well defined...

..To perform a two-part study of pancreaticoduodenectomy in the Netherlands, focusing on the effects of risk factors on outcomes in a single high-volume hospital and the effect of hospital volume on outcomes...

..The objective of this study was to gain insight into the incidence and sequelae of injury to the major airways during subtotal esophagectomy...

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..Considering the fact that the detection rate of diagnostic laparoscopy is lower than 100%, the use of staging laparotomy is too limited to justify it as a routine procedure...

..The relatively long plateau phase after recovery supports the argument for surgical treatment, including surgical palliation in selected patients...

..It remains unclear whether these relatively distant metastases have an effect on long-term survival. The aim of this study was to identify the incidence of such positive nodes and evaluate their prognostic significance...

..Endoscopic biopsy surveillance of Barrett's oesophagus is generally recommended. However, optimal patient selection and frequency of follow-up are subject to ongoing discussion...

..Although transthoracic resections had significantly higher early (pulmonary) morbidity and mortality rates, 5-year survival was approximately 20% after both transthoracic and transhiatal resections...

..The aims of the present study were to validate the Physiological and Operative Severity Score for the enUmeration of Mortality adjusted for oesophagogastric surgery (O-POSSUM)...

..Benign tracheo-neo-esophageal fistulas after esophagectomy are rare and treatment can be challenging. They can result from perioperative tracheal injury or various postoperative complications...

..CONCLUSIONS: Despite the excellent functional outcome after repair, the occurrence of a BDI has a great impact on the patient's physical and mental QOL, even at long-term follow-up...

..In this study it was determined whether internal drainage is feasible with acceptable postoperative morbidity and recurrence rates...

..For any lesion suspicious of PAC an aggressive surgical approach is justified lest a potentially curable lesion is missed. As a consequence, there is at least a 5% chance of resecting a lesion based on CP, mimicking PAC...

..Local resection of even limited ampullary carcinomas is not advisable because of lymphatic dissemination of the tumor and consequently, inadequate clearance...

..There was a slight overall preference towards the ROD strategy despite the considerable variability per case vignette...

..For colorectal liver metastasis, more liberal resection criteria, a high failure rate due to adhesions from previous surgery, and better preoperative imaging probably resulted in a lower efficacy...

..To assess 3 years of quality of life in patients with esophageal cancer in a randomized trial comparing limited transhiatal resection with extended transthoracic resection...

..In this study we evaluated the management and survival of patients with positive CLN findings on endoscopic ultrasonography (EUS) and compared the outcome in surgically treated patients with that of nonsurgically treated patients...

..To determine to what extent patients who have survived abdominal sepsis suffer from symptoms of posttraumatic stress disorder (PTSD) and depression, and to identify potential risk factors for PTSD symptoms...

..We have reviewed the results of our trial after follow-up of more than 10 years...

..CONCLUSION: The incidence of pancreatic leakage did not change over the study interval. Preservation of a small pancreatic tail was associated with higher morbidity and mortality rates than those of completion pancreatectomy...

..We investigated whether tumour cells of an oesophageal carcinoma could be detected in the thoracic duct during operative manipulation...

..The independent prognostic factors for survival of patients who underwent surgical treatment for pancreatic adenocarcinoma are tumour-related...

..Choice of treatment strategy was an independent predictor of survival...

..Pancreatectomies, oesophagectomies and high-risk vascular surgery should be concentrated in dedicated centres with a sufficient volume to obtain a good outcome of surgical care...

..To evaluate the short-term and long-term clinical outcome of transhiatal oesophagectomy without thoracotomy for cancer...

..Planned relaparotomy and relaparotomy on demand are two frequently employed surgical treatment strategies for patients with abdominal sepsis...

..The aim of this study was to evaluate the efficacy of endoscopic stent placement in patients with PD presenting with chronic pancreatitis...

..Unusual pathologic variants are encountered in only 1% to 7% of patients, and therefore data evaluating the treatment and survival in this group of esophageal neoplasms are sparse...

..Surgical treatment of hilar cholangiocarcinoma (Klatskin tumours) is difficult because of its central location in the liver hilum. Recent developments in surgical techniques have improved the outcome after resection...

..Each patient requires an individual, multidisciplinary approach, thereby obtaining optimal treatment-outcome...

..Over a period of 8 weeks, the long mediastinal fistula track obliterated, and after removal of the T-drain the (neo-)esophagocutaneous fistula closed rapidly...

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..CONCLUSIONS: Anorectal function after rectal surgery with or without RT is greatly hampered because of a decreased rectal compliance. After 12 months, partial improvement is shown, especially in the absence of RT...

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..This may be useful in clinical settings to monitor the viability of the esophagus after surgical interventions. Distal transsection substantially reduces esophageal perfusion without apparent short-term histological damage...

..The extra-anatomical position of a cervical oesophagogastrostomy is a reason for impaired anastomotic healing, but transposition of the omentum that is covered with mesothelial cells may be a way to improve that...

..Spiral CT was used minimally and ERCP was frequently performed without subsequent biliary drainage. The mean duration of diagnostic work-up was relatively long...

..The primary aim of this study was to examine the influence of using different methodologies on SUV-survival correlation...

..To determine the inter-rater agreement of expert witness testimonies in bile duct injury malpractice litigation...

..Acceptance and implementation of the results from surgical RCTs through evidence-based guidelines depends heavily on local opinion leaders and the training of surgical residents...

..If the cause of the abdominal pain is still unclear following a CT-scan, then diagnostic laparoscopy may be considered for fertile women of childbearing age and for men aged less than 50 years with signs of appendicitis...