8 results on '"Vincent Lens"'
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2. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic vertical banded gastroplasty: results of a 2-year follow-up study
- Author
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M. Schiltz, A. Limgba, Juan Santiago Azagra, Vincent Lens, K Arapis, and Martine Goergen
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Adult ,Male ,medicine.medical_specialty ,Gastroplasty ,Luxembourg ,Gastric Bypass ,Risk Assessment ,Severity of Illness Index ,Body Mass Index ,Cohort Studies ,Postoperative Complications ,Weight loss ,Weight Loss ,Severity of illness ,medicine ,Humans ,Laparoscopy ,Aged ,Probability ,Retrospective Studies ,Chi-Square Distribution ,medicine.diagnostic_test ,business.industry ,Mortality rate ,Anastomosis, Roux-en-Y ,Retrospective cohort study ,Middle Aged ,Roux-en-Y anastomosis ,Obesity, Morbid ,Surgery ,Treatment Outcome ,Female ,medicine.symptom ,business ,Body mass index ,Follow-Up Studies ,Abdominal surgery - Abstract
The world’s epidemic of obesity is responsible for the development of bariatric surgery in recent decades. The number of gastrointestinal surgeries performed annually for severe obesity (BMI > 40 kg/m2) in the United States has increased from about 16,000 in the early 1990s to about 103,000 in 2003. The surgical techniques can be classified as restrictive, malabsorptive, or mixed procedures. This article presents the results for 2 years of bariatric surgery in the authors’ minimally invasive center and analyzes the results of the most used surgical techniques with regard to eating habits. Between January 2002 and January 2004, the authors attempted operations for morbid obesity in 110 consecutive patients adequately selected by a multidisciplinary obesity unit. This represented 43% of all consultations for morbidly obese patients. The patients were classified as sweet eaters or non–sweet eaters. All sweet eaters underwent gastric bypass. The procedures included 70 Roux-en-Y gastric bypasses, 39 Mason’s vertical banded gastroplasties, and 1 combination of vertical gastroplasty with an antireflux procedure. Revision procedures were excluded. The mean age of the patients was 41.36 years (range, 23–67 years), and 72.3% were female. The mean preoperative body mass index was 44.78 kg/m2 (range, 34.75–70.16 kg/m2). The mean operating time was longer for gastric bypass than for the Mason procedure. Three patients required conversion to an open procedure (2.7%). The two operative techniques had the same efficacy in weight reduction. Early complications developed in 11 patients (10%), and late complications occurred in 9 patients (8.1%). The postoperative length of hospital stay averaged 4.4 days (range, 1–47 days; median, 4 days), and was longer in the gastric bypass group. The mortality rate was zero. Data were available 2 years after surgery for 101 of the 110 patients (91%). Most comorbid conditions resolved by 1 year after surgery regardless of the type of operation used. With zero mortality and low morbidity, bariatric surgery performed for adequately selected patients is the most effective therapeutic intervention for weight loss and subsequent amelioration or resolution of comorbidities. The patient’s eating habits before surgery play an important role in the choice of the operative technique used.
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- 2006
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3. Minimally invasive management of postoperative esophagojejunal anastomotic leak
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Vincent Lens, Martine Goergen, Virginie Poulain, Frank Heieck, J.S. Azagra, and O. Facy
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Male ,medicine.medical_specialty ,Fistula ,medicine.medical_treatment ,Anastomotic Leak ,Anastomosis ,Dehiscence ,Esophageal Fistula ,Postoperative Complications ,Gastrectomy ,Stomach Neoplasms ,medicine ,Intestinal Fistula ,Humans ,Minimally Invasive Surgical Procedures ,Laparoscopy ,Aged ,medicine.diagnostic_test ,business.industry ,Stent ,Jejunal Diseases ,medicine.disease ,Dysphagia ,Surgery ,Endoscopy ,Treatment Outcome ,medicine.symptom ,business - Abstract
Purpose Postoperative esophagojejunal fistula induces morbidity and mortality after total gastrectomy and affects the long-term survival rate. Methods Between 2003 and 2011, 38 patients underwent laparoscopic total gastrectomy and 2 developed an esophagojejunal fistula. Results The diagnosis was established by a computed tomography scan with contrast ingestion. The absence of complete dehiscence and the vitality of the alimentary loop were checked during laparoscopic exploration, associated with effective drainage. During the endoscopy, dehiscence was assessed and a covered stent and nasojejunal tube were inserted for enteral feeding. The leaks healed progressively, oral feeding was resumed and the drains removed within 3 weeks. The stent was removed 6 weeks. Three months later, the patients were able to eat without dysphagia. Conclusions Early diagnosis allows successful conservative management. The objectives are effective drainage, covering by an endoscopic stent and renutrition. Management by a multidisciplinary team is essential.
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- 2014
4. Two staged minimally invasive treatment for acute cholecystitis in high risk patients
- Author
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Antonio, Vázquez Tarragón, Juan Santiago, Azagra Soria, Vincent, Lens, Daniel, Manzoni, Paolo, Fabiano, and Martine, Goergen
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Adult ,Aged, 80 and over ,Cholangiopancreatography, Endoscopic Retrograde ,Male ,Luxembourg ,Cholecystitis, Acute ,Comorbidity ,Middle Aged ,Radiography, Interventional ,Risk Assessment ,Severity of Illness Index ,Treatment Outcome ,Cholecystectomy, Laparoscopic ,Risk Factors ,Humans ,Cholecystectomy ,Female ,Prospective Studies ,Tomography, X-Ray Computed ,Aged - Abstract
The most optimal treatment for acute cholecystitis in high risk patients and severe acute cholecystitis remains still controversial. We review the outcomes of a two step treatment with percutaneous cholecystostomy and delayed laparoscopic cholecystectomy (DLC).We collected data prospectively from January 2004 to April 2010 from 26 patients that underwent percutaneous transhepatic CT-guided cholecystostomy and DLC.Percutaneous transhepatic CT-guided cholecystostomy was achieved in all cases with no complications. There was just one catheter dislodgement. Most of patients, 92%, improved after drainage. There was one case of mortality. Laparoscopic cholecystectomy was achieved in 88% of patients with no mortality, and a low rate of morbidity (7.6%) and of conversion to open surgery. Pre-operative percutaneous cholangiogram showed additional and useful information in 55.5% of patients.Two-step minimally invasive treatment combining percutaneous transhepatic CT-guided cholecystostomy and DLC is safe and feasible and report low morbi-mortality rates.
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- 2013
5. Right coronary artery originating in the left ventricle
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Jean Beissel, Daniel R. Wagner, Vincent Lens, and Agnieszka Ciarka
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Coronary angiography ,Adult ,Male ,medicine.medical_specialty ,business.industry ,Coronary Vessel Anomalies ,Heart Ventricles ,Coronary Angiography ,medicine.anatomical_structure ,Left coronary artery ,Parasternal line ,Ventricle ,Right coronary artery ,medicine.artery ,Internal medicine ,Circulatory system ,Cardiology ,Medicine ,Ventricular outflow tract ,Humans ,Ultrasonography ,business ,Cardiology and Cardiovascular Medicine - Abstract
[Figure][1] ![Figure][1] [Video 1][2] Coronary Angiography The left coronary artery connected to the right coronary artery. ![Figure][1] [Video 2][3] Abnormal Flow in the Left Ventricular Outflow Tract Transthoracic echocardiography, parasternal long-axis view. In blue
- Published
- 2010
6. The Vena Cava Syndrome
- Author
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Vincent Lens and Mario Dicato
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Chemotherapy ,medicine.medical_specialty ,Superior vena cava syndrome ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Vena cava syndrome ,Malignancy ,medicine.disease ,Radiation therapy ,Biopsy ,medicine ,Radiology ,Azygos vein ,medicine.symptom ,Lung cancer ,business - Abstract
The superior vena cava syndrome in malignancy is most often secondary to lung cancer where up to 10% of patients with small cell lung cancer and 2% with non-small cell lung cancer will have this syndrome. Classically, steroids, chemotherapy, and radiotherapy have been the standards of therapy. However, over the past few years, stenting has mostly replaced these standards as its advantages are rapid efficacy and giving at least equal results for the clinical syndrome in addition to allowing the securing of a biopsy tissue for diagnosis, and the clinical relief of symptoms is almost immediate.
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- 2010
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7. CONTRIBUTORS
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Judith A. Aberg, Amy P. Abernethy, Janet L. Abrahm, Michael Adolph, Michael Aherne, K. Allsopp, Rogelio Altisent, Carmen Fernandez Alvarez, Pablo Amigo, Wendy G. Anderson, Sik Kim Ang, Tiziana Antonelli, John Armstrong, Wendy S. Armstrong, Robert M. Arnold, Pilar Arranz, Koen Augustyns, Isabel Barreiro-Meiro Sáenz-Diez, Pilar Barreto, Debra Barton, Ursula Bates, Maria B. Fernandez-Creuchet Santos, Jacinto Bátiz, Costantino Benedetti, Nabila Bennani-Baiti, Michael I. Bennett, Kevin Berger, Mamta Bhatnagar, Lesley Bicanovsky, Lynda Blue, Barton Bobb, Jean-Jacques Body, Gian Domenico Borasio, Claudia Borreani, Federico Bozzetti, Valentina Bozzetti, Jason Braybrooke, William Breitbart, Barry Bresnihan, Bert Broeckaert, Eduardo Bruera, Kay Brune, Bradley Buckhout, Phyllis N. Butow, Ira Byock, Anthony Byrne, Clare Byrne, Beryl E. Cable-Williams, Sarah E. Callin, David Casarett, David Casper, Eric J. Cassell, Barrie Cassileth, Emanuele Castagno, Carlos Centeno, Walter Ceranski, Lucas Ceulemans, Meghna Chadha, Bruce H. Chamberlain, Eric L. Chang, Victor T. Chang, Harvey Max Chochinov, Edward Chow, Grace Christ, Katherine Clark, Stephen Clarke, Josephine M. Clayton, James F. Cleary, Lawrence J. Clein, Katri Elina Clemens, Libby Clemens, Robert Colebunders, Steven R. Connor, Viviane Conraads, Colm Cooney, Massimo Costantini, Azucena Couceiro, Holly Covington, John D. Cowan, Patrick Coyne, Garnet Crawford, Brian Creedon, Hilary Cronin, Garret Cullen, Jennifer E. Cummings, David C. Currow, Paul J. Daeninck, Pamela Dalinis, Prajnan Das, Mellar P. Davis, Sara N. Davison, Catherine Deamant, Liliana de Lima, Conor P. Delany, Peter Demeulenaere, Lena Dergham, Noël Derycke, Rajeev Dhupar, Mario Dicato, Edwin D. Dickerson, Andrew Dickman, Maria Dietrich, Pamela Dixon, Philip C. Dodd, James T. D'Olimpio, Per Dombernowsky, Michael Dooley, Deborah Dudgeon, Geoffrey P. Dunn, David Dunwoodie, Jane Eades, Badi El Osta, Katja Elbert-Avila, John Ellershaw, Bassam Estfan, Louise Exton, Alysa Fairchild, Matthew Farrelly, Konrad Fassbender, Jason Faulhaber, Kenneth C.H. Fearon, Lynda E. Fenelon, Peter F. Ferson, Petra Feyer, Marilene Filbet, Pam Firth, Susan F. FitzGerald, Hugh D. Flood, Francesca Crippa Floriani, Paul J. Ford, Barry Fortner, Darlene Foth, Bridget Fowler, Karen Frame, Thomas G. Fraser, Fred Frost, Michael J. Fulham, Pierre R. Gagnon, Lisa M. Gallagher, Maureen Gambles, Subhasis K. Giri, Paul Glare, Cynthia R. Goh, Xavier Gómez-Batiste, Leah Gramlich, Luigi Grassi, Phyllis A. Grauer, Claire Green, Gareth Griffiths, Yvona Griffo, Hunter Groninger, David A. Gruenewald, Jyothirmai Gubili, Terence L. Gutgsell, Elizabeth Gwyther, Paul S. Haber, Achiel Haemers, Mindi C. Haley, Mazen A. Hanna, Janet R. Hardy, Jodie Haselkorn, Katherine Hauser, Cathy Heaven, Michael Herman, Jørn Herrstedt, Stephen Higgins, Irene J. Higginson, Joanne M. Hilden, Kathryn L. Hillenbrand, Burkhard Hinz, Jade Homsi, Kerry Hood, Juliet Y. Hou, Guy Hubens, Peter Hudson, John G. Hughes, John Hunt, Craig A. Hurwitz, James Ibinson, Nora Janjan, Birgit Jaspers, Thomas Jehser, A. Mark Joffe, Laurence John, Jennie Johnstone, J. Stephen Jones, Javier R. Kane, Matthew T. Karafa, Andrew P. Keaveny, Dorothy M.K. Keefe, Catherine McVearry Kelso, Rose Anne Kenny, Martina Kern, Dilara Seyidova Khoshknabi, Jordanka Kirkova, Kenneth L. Kirsh, David W. Kissane, Eberhard Klaschik, Seref Komurcu, Kandice Kottke-Marchant, Kathryn M. Kozell, Sunil Krishnan, Deborah Kuban, Damian A. Laber, Ruth L. Lagman, Rajesh V. Lalla, Deforia Lane, Philip J. Larkin, Wael Lasheen, Peter Lawlor, Susan B. LeGrand, Vincent Lens, Dona Leskuski, Pamela Levack, Marcia Levetown, Jeanne G. Lewandowski, William R. Lewis, S. Lawrence Librach, Wendy G. Lichtenthal, J. Norelle Lickiss, Stefano Lijoi, Edward Lin, Arthur G. Lipman, Jean-Michel Livrozet, Mari Lloyd-Williams, Richard M. Logan, Francisco López-Lara Martín, Charles L. Loprinzi, John Loughnane, Michael Lucey, Laurie Lyckholm, Carol Macmillan, Frances Mair, Stephen N. Makoni, Bushra Malik, Kevin Malone, Marco Maltoni, Aruna Mani, Lucille R. Marchand, Darren P. Mareiniss, Anna L. Marsland, Joan Marston, Julia Romero Martinez, Isabel Martínez de Ubago, Lina M. Martins, Timothy S. Maughan, Catriona Mayland, Susan E. McClement, Ian McCutcheon, Michael F. McGee, Neil McGill, Stephen McNamara, Mary Lynn McPherson, Henry McQuay, Regina McQuillan, Robert E. McQuown, Michelle Meiring, Sebastiano Mercadante, Elaine C. Meyer, Randy D. Miller, Yvonne Millerick, Roberto Miniero, Armin Mohamed, Busi Mooka, Helen M. Morrison, J. Cameron Muir, Fiona Mulcahy, Hugh E. Mulcahy, Monica Muller, H. Christof Müller-Busch, Scott A. Murray, Friedemann Nauck, Katherine Neasham, Busisiwe Nkosi, Simon Noble, Antonio Noguera, Anna K. Nowak, Juan Nuñez-Olarte, Eugenie A.M.T. Obbens, Tony O'Brien, Megan Olden, Norma O'Leary, David Oliver, David Oliviere, Aurelius G. Omlin, Kaci Osenga, Diarmuid O'Shea, Christophe Ostgathe, Faith D. Ottery, Michel Ouellette, Edgar Turner Overton, Moné Palacios, Robert Palmer, Teresa Palmer, Carmen Paradis, Armida G. Parala, Antonio Pascual-López, Steven D. Passik, Timothy M. Pawlik, Malcolm Payne, Sheila Payne, Silvia Paz, José Pereira, George Perkins, Karin Peschardt, Hayley Pessin, Douglas E. Peterson, Vinod K. Podichetty, Robin Pollens, Eliza Pontifex, Susan Poole, Josep Porta-Sales, Graeme Poston, Ruth D. Powazki, William Powderly, Leopoldo Pozuelo, Eric Prommer, Christina M. Puchalski, Lukas Radbruch, David F.J. Raes, Jane Read, Anantha Reddy, Steven I. Reger, Susan J. Rehm, Stephen G. Reich, Javier Rocafort, Adam Rosenblatt, Cynda Hylton Rushton, K. Mitchell Russell, Karen Ryan, Lisa A. Rybicki, Paola Sacerdote, Vinod Sahgal, Mary Ann Sammon, Dirk Sandrock, Mark Sands, Denise L. Schilling, Valerie Nocent Schulz, Lisa N. Schum, Peter Selwyn, Joshua Shadd, Charles L. Shapiro, Aktham Sharif, Helen M. Sharp, Kirk V. Shepard, J. Timothy Sherwood, Nabin K. Shrestha, Richard J.E. Skipworth, Howard S. Smith, Mildred Z. Solomon, Diego Soto de Prado Otero, Denise Wells Spencer, Ron Spice, David Spiegel, Manish Srivastava, John N. Staffurth, Randall Starling, Grant D. Stewart, Jan Stjernswärd, Florian Strasser, Edna Strauss, Imke Strohscheer, Brett Taylor Summey, Graham Sutton, Nigel P. Sykes, Alan J. Taege, Marcello Tamburini, Yoko Tarumi, Davide Tassinari, Martin H.N. Tattersall, Karl S. Theil, Keri Thomas, Adrian Tookman, María P. Torrubia, Anna Towers, Daphne Tsoi, Rodney O. Tucker, James A. Tulsky, Rachel A. Tunick, Claire Turner, Martha L. Twaddle, Marie Twomey, Christina Ullrich, Catherine E. Urch, Mary L.S. Vachon, Bart Van den Eynden, Antonio Vigano, Erika Vlieghe, Angelo E. Volandes, Raymond Voltz, Paul W. Walker, Sharon Watanabe, Michael A. Weber, Elizabeth Weinstein, Sharon M. Weinstein, Kathryn L. Weise, Sherri Weisenfluh, John Welsh, Clare White, Donna M. Wilson, Joanne Wolfe, Tugba Yavuzsen, Albert J.M. Yee, Lisa M. Yerian, and Elena Zucchetti
- Published
- 2009
- Full Text
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8. Use of upper gastrointestinal studies after gastric bypass
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Martine Goergen, Elias Rodriguez-Cuellar, Juan Santiago Azagra, and Vincent Lens
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medicine.medical_specialty ,Leak ,medicine.diagnostic_test ,business.industry ,Gastric bypass ,Computed tomography ,Signs and symptoms ,Hepatology ,Internal medicine ,Isotonic ,Medicine ,Upper gastrointestinal ,Surgery ,Radiology ,business ,Abdominal surgery - Abstract
After reading the interesting article ‘‘Predictive value of upper gastrointestinal studies versus clinical signs for gastrointestinal leaks after laparoscopic gastric bypass’’ by Madan [1] et al., we want to contribute our opinion about the use of routine imaging tests (RIT) after laparoscopic Roux-en-Y gastric bypass (LRYGB). The efficiency of upper gastrointestinal (UGI) studies relies mainly on radiologist experience; besides, it is well known that computed tomography (CT) scanning has a better sensitivity and specificity [2] than UGI studies for detection of leaks. Therefore we consider that in the case of clinical suspicions of any complications after LRYGB, a CT scan with isotonic oral contrast must be requested and UGI studies should be limited only to patients with a weight over the CT scanner limit (most frequently 180 kg). In the last few years, surgeons have acquired great experience in bariatric surgery, which has been translated into a significant decrease in leak rates [3], such that the most experienced bariatric surgeons show leak rates under 1%. For this reason, we do not support the routine use of any RIT after LRYGB, but to perform them when patient’s clinical signs and symptoms require us to do so.
- Published
- 2007
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