G Coremans

Universitair Ziekenhuis Leuven, Louvain, Flanders, Belgium

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Publications (87)490.85 Total impact

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    ABSTRACT: Background Endoscopic resection (ER) with or without ablation is the first choice treatment for early Barrett’s neoplasia. Adequate staging is important to assure a good oncological outcome.
    Preview · Article · Jan 2016 · United European Gastroenterology Journal

  • No preview · Article · Sep 2012 · International Urogynecology Journal
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    ABSTRACT: Laparoscopy offers great exposure and surgical detail, reduces blood loss and the need for excessive abdominal packing and bowel manipulation making it an excellent modality to perform pelvic floor surgery. Laparoscopic repair of level I or apical vaginal prolapse may be challenging, due to the need for extensive dissection and advanced suturing skills. However it offers the efficacy of open abdominal sacrocolpopexy, such as lower recurrence rates and less dyspareunia than sacrospinous fixation, as well as the reduced morbidity of a laparoscopic approach.
    No preview · Article · Dec 2011 · Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne
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    ABSTRACT: Laparoscopy offers great exposure and surgical detail, reduces blood loss and the need for excessive abdominal packing-- and bowel manipulation making it an excellent modality to perform pelvic floor surgery. Laparoscopic repair of level I or apical vaginal prolapse may be challenging, due to the need for extensive dissection and advanced suturing skills. However, it offers the efficacy of open abdominal sacrocolpopexy, such as lower recurrence rates and less dyspareunia-- than sacrospinous fixation, as well as the reduced morbidity of a laparoscopic approach.
    Full-text · Article · Mar 2011
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    ABSTRACT: This study examined the outcome of surgery for symptomatic Crohn's rectovaginal fistula (RVF) and assessed the effect of therapy with antibody against tumour necrosis factor (TNF) on healing. Fifty-six patients with Crohn's disease underwent surgery for a RVF between January 1993 and December 2006. Outcome analysis was performed in February 2008 in relation to the surgical procedures used and the effect of anti-TNF treatment. Four patients with a healed fistula still had a stoma at final follow-up for other reasons and were excluded from the analysis. Fistula closure was achieved in 81 per cent of the remaining 52 patients. Primary and secondary surgical success rates were 56 and 57 per cent respectively. The primary healing rate was similar in patients who received anti-TNF treatment before the first operation (12 of 18 patients) and those who did not (19 of 34). In univariable analysis, duration of Crohn's disease (P = 0.037) and previous extended colonic resection (P < 0.001) were significantly related to failure of primary surgery, but only the latter remained significant in multivariable analysis (P < 0.001). Late recurrence developed in four patients. Fistula closure was achieved in most patients, but more than one operation was often required.
    Full-text · Article · Oct 2009 · British Journal of Surgery
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    ABSTRACT: Endoscopic dilatation of Crohn's disease-related strictures is an alternative to surgical resection in selected patients. The influence of disease activity and concomitant medical therapy on long-term outcomes is largely unknown. To study the long-term safety and efficacy of stricture dilatation in a single centre cohort. Between 1995 and 2006, 237 dilatations where performed in 138 patients (mean age 50.6+/-13.4, 56% female) for a clinically obstructive stricture (<5 cm, 84% anastomotic). Immediate success of a first dilatation was 97% with a 5% serious complication rate. After a median follow-up of 5.8 years (IQR 3.0-8.4), recurrent obstructive symptoms led to a new dilatation in 46% or surgery in 24%. Niether elevated levels of C-reactive protein nor endoscopic disease activity predicted the need for new intervention. None of the concomitant therapies influenced the outcome. This largest series ever reported confirms that long term efficacy of endoscopic dilatation of Crohn's disease outweighs the complication risk. Neither active disease at the time of dilatation nor medical therapy afterwards predict recurrent dilatation or surgery.
    Full-text · Article · Oct 2009 · Gut
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    ABSTRACT: There are several clinical problems that frequently present to general practice which are not of sufficient severity to warrant further investigation. These disorders are usually managed effectively by the general practitioner (GP) with routine examination and simple advice or treatment. Patients who repeatedly visit their GPs because of failure to respond to such measures are those most likely to be referred to specialists for a further opinion and possibly more extensive evaluation. As much research is still conducted in specialist centres, it is usually undertaken on this unrepresentative sample of patients. Conclusions and guidelines derived from this type of work are then transferred back to primary care where they may not be entirely applicable. Irritable bowel syndrome (IBS) is a typical example of such a disorder and since research in general practice is becoming much more widespread, now is a good time for this condition to be more fully evaluated in the prmary care setting. It was against this background that representatives of European general practice and gastroenterology met in London to discuss the feasibility of undertaking primary care therapeutic trials in IBS. This paper will discuss some of the differences between GP and hospital IBS patients, the need for research in primary care and the problems associated with undrtaking such studies.
    No preview · Article · Jul 2009

  • No preview · Article · Jul 2008 · Colorectal Disease
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    ABSTRACT: Primary perianal actinomycosis is rare. Sporadic cases, with lesions varying in extent have been reported. The infection is caused by the bacterium Actinomyces, which often is a saprophyte. Male gender and diabetes are risk factors, but the exact pathogenic mechanism remains speculative. The diagnosis is a challenge and often delayed, with a protracted history of masses and sinuses extending into the gluteal and genital region. The treatment, a combination of surgery and antibiotics, is poorly standardized. We report three cases and compare their characteristics to those of published cases, found by a computerized literature search (1968-2002). The lesions, a simple fistula-in-ano or a mass, were diagnosed in an early stage in all three patients. The infection always spread into the scrotum. There were no risk factors other than gender, except in one patient. The diagnosis was suspected by the observation of draining sulfur granules and promptly confirmed by histology in the three cases. All patients healed with antibiotics in addition to simple surgical procedures. Treatment consisted of amoxicillin for two weeks in two cases and more extended antimicrobial treatment in the third. These findings are contrasting with the classic picture of perianal actinomycosis. It is concluded that perianal actinomycosis can occur in the absence of risk factors and that early diagnosis requires a high degree of suspicion. An infection with Actinomyces should be suspected in the presence of lesions containing watery purulent material with sulfur granules. The indication for extended antibiotherapy combined with sphincter damaging surgery may need to be revised in the presence of early detection.
    No preview · Article · Apr 2005 · Diseases of the Colon & Rectum
  • G Coremans · R Vos · V Margaritis · Y Ghoos · J Janssens
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    ABSTRACT: Polyethylene glycol 3350 increases stool frequency and accelerates colonic transit. Used as a laxative, it proved effective in patients with normal and slow transit. Although free of severe side effects, it may cause nausea and vomiting. The effect of this substance on upper gut transit has not been studied. To investigate the effect of polyethylene glycol 3350 on gastric emptying and oro-caecal transit in 12 healthy subjects. In a randomised controlled study, isosmotic polyethylene glycol 3350 electrolyte balanced solution, in the maximal recommended dose or isosmotic electrolyte solution, was administered after breakfast and lunch on separate days. Gastric half-emptying time and oro-caecal transit time were measured using [13C]-octanoate and lactose-[13C] ureide breath tests. Isosmotic polyethylene glycol 3350 electrolyte solution, as compared to isosmotic electrolyte solution, decreased oro-caecal transit time from 424+/-28 to 314+/-17 min (P = 0.001). Gastric half-emptying time was significantly increased (84+/-6 min versus 127+/-14 min; P = 0.006). Polyethylene glycol 3350 accelerate oro-caecal transit in healthy subjects, but also cause an important delay in gastric emptying. The delay in gastric emptying may be of clinical significance in patients who have associated gastroparesis.
    No preview · Article · Mar 2005 · Digestive and Liver Disease
  • S. Dockx · G. Coremans · J. Wyndaele · A. Hendrickx
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    ABSTRACT: The complexity of anal fistulas is different in Crohn and non-Crohn patients, as well as in males and females. Among other means, Goodsall's rule is a popular help in predicting the course of the track and the internal orifice of a fistula starting from the external orifice. The incidences of radial and horseshoe fistulas with a ventral or dorsal internal opening are different in Crohn and non-Crohn patients. Ventral horseshoe fistulas are more frequent in Crohn patients, especially in women. Frequently these fistulas have an extension to the vagina. The diagnostic accuracy of Goodsall's rule is significantly lower in females than in males. The rule holds as good in Crohn and in non-Crohn patients, independently of the first clinical sign, a draining sinus or an abscess. The accuracy of Goodsall's rule is excellent for fistulas with an external orifice on the ventral or dorsal midline. The accuracy is also good for fistulas with a dorsal external opening. This is not the case for fistulas with a ventral external opening, especially in women. It should be kept in mind that many fistulas defy Goodsall's rule, particularly in females with an external orifice located ventral to the transverse anal line. Goodsall's rule alone can not be used to guide the surgical treatment. Blindly applying the rule carries a high risk of creating a false passage and recurrence.
    No preview · Article · Jun 2004
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    G Coremans · B Geypens · R Vos · J Tack · V Margaritis · Y Ghoos · J Janssens
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    ABSTRACT: Patients with slow transit constipation frequently have delayed gastric emptying. In animals rectal distensions inhibit gastrointestinal motility. In healthy volunteers isovolumetric rectal distensions delay upper gut transit. The purpose of this study was to determine the effect of continuous isobaric rectal distension on gastric emptying and oro-cecal transit in young females. Using validated 13C octanoic and lactose-[13C] ureide breath tests gastric half-emptying time and oro-cecal transit time for a meal were measured in 12 volunteers. The tests were repeated in randomized order: during isobaric balloon distension and during sham distension. Isobaric rectal distension was applied using a polyethylene bag connected to a barostat. Intraballoon pressure was kept just below the threshold for the urge sensation. Mean gastric half-emptying time during rectal distension (92.3 +/-5.1 min) was significantly higher than during sham distension (78.8 +/- 4 min; P = 0.015). Mean oro-cecal transit time during rectal distension (391.3 +/-29.1 min) and sham distension (328.8 +/- 38.4 min) were not significantly different. In conclusion, these findings indicate that isobaric rectal distension inhibits gastric emptying, but not small bowel transit in young healthy women. Studies in patients with constipation are indicated.
    Full-text · Article · Mar 2004 · Neurogastroenterology and Motility
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    ABSTRACT: During a meeting in The Hague, The Netherlands, the IBiS Club evaluated the most important techniques that can be used in the investigation of irritable bowel syndrome, either in the context of scientific research or as a clinical diagnostic tool. In each of these, the relevance of findings made in irritable bowel syndrome was balanced against the applicability of the technique. The discussion of the group is summarized in this paper.
    Full-text · Article · Feb 2004 · Digestion
  • DOCKX S · COREMANS G · WYNDAELE JJ · HENDRICKX A

    No preview · Article · Jan 2004 · Tijdschrift voor Geneeskunde
  • Coremans G · Deprest J · Wyndaele Jj · Dockx S

    No preview · Article · Jan 2004 · Tijdschrift voor Geneeskunde
  • G Coremans · S Dockx · J Wyndaele · A Hendrickx
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    ABSTRACT: The complexity of anal fistulas is different in patients with and without Crohn's disease and in men and women. This may affect the localization of the internal orifice. We compared the characteristics of anal fistulas and the accuracy of Goodsall's rule in predicting the position of the internal orifice in male and female Crohn's and non-Crohn's patients. A total of 191 fistula tracks in 182 consecutive patients (110 men and 72 women) were analyzed prospectively. Of the patients, 63 were diagnosed with Crohn's disease. The positions of the orifices were recorded and the accuracy of Goodsall's rule determined. The distribution of fistula subtypes among Crohn's and non-Crohn's patients differed significantly (p = 0.0471). Fistulas with an anterior external opening occurred more frequently in Crohn's patients (p = 0.0350) and in women (p = 0.0030). Fistulas with a posterior external orifice were observed more frequently in non-Crohn's patients (p = 0.0350) and in men (p = 0.0028). Overall, Goodsall's rule performed less well in women compared with men (p = 0.0633). The accuracy of Goodsall's rule overall was not affected by Crohn's disease. In female non-Crohn's patients, the positive predictive value of a posterior external orifice was lower than in men (p = 0.0406). The distribution of fistula subtypes and the ratio of anterior and posterior external openings among Crohn's and non-Crohn's patients differ significantly. Many fistulas defy Goodsall's rule, particularly in women and when applied to fistulas with anterior external orifices. The popular rule, however, falls equally short in Crohn's and non-Crohn's fistulas.
    No preview · Article · Jan 2004 · The American Journal of Gastroenterology
  • G Coremans
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    ABSTRACT: The complexity of anal fistulas is different in patients with and without Crohn's disease and in men and women. This may affect the localization of the internal orifice. We compared the characteristics of anal fistulas and the accuracy of Goodsall's rule in predicting the position of the internal orifice in male and female Crohn's and non-Crohn's patients.MethodsA total of 191 fistula tracks in 182 consecutive patients (110 men and 72 women) were analyzed prospectively. Of the patients, 63 were diagnosed with Crohn's disease. The positions of the orifices were recorded and the accuracy of Goodsall's rule determined.ResultsThe distribution of fistula subtypes among Crohn's and non-Crohn's patients differed signficantly (p = 0.0471). Fistulas with an anterior external opening occurred more frequently in Crohn's patients (p = 0.0350) and in women (p = 0.0030). Fistulas with a posterior external orifice were observed more frequently in non-Crohn's patients (p = 0.0350) and in men (p = 0.0028). Overall, Goodsall's rule performed less well in women compared with men (p = 0.0633). The accuracy of Goodsall's rule overall was not affected by Crohn's disease. In female non-Crohn's patients, the positive predictive value of a posterior external orifice was lower than in men (p = 0.0406).Conclusions The distribution of fistula subtypes and the ratio of anterior and posterior external openings among Crohn's and non-Crohn's patients differ significantly. Many fistulas defy Goodsall's rule, particularly in women and when applied to fistulas with anterior external orifices. The popular rule, however, falls equally short in Crohn's and non-Crohn's fistulas.
    No preview · Article · Dec 2003 · The American Journal of Gastroenterology
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    ABSTRACT: Human papilloma virus infections of the anogenital region are very common and cause condylomata acuminata; cervical, penile, vulvar, or perianal intraepithelial neoplasia; and more rarely, invasive cancer. The currently available therapies often result in painful, extensive, slow-healing ulcerations and frequent early relapses. This study was aimed at determining the efficacy of topical application of the antiviral agent cidofovir at 1 percent. Twenty patients treated with coagulations were compared with 27 patients treated with cidofovir. Lesions refractory to cidofovir were cleared up with additional coagulations. The number of patients previously treated for condylomata did not differ between the two groups. Significantly more patients treated with cidofovir, however, had an impaired immune status (37 percent) compared with the patients treated with coagulations (5 percent). Cidofovir alone cured the lesions in 32 percent of the patients and induced partial regression in 60 percent. However, in smokers, complete resolution of the condylomata occurred only in 16.6 percent compared with 66 percent of nonsmokers (P = 0.03). The number of coagulation sessions was much lower (P < 0.0005) in the cidofovir treated group (1 +/- 0.8 vs. 2.9 +/- 2). Furthermore, the relapse rate was significantly lower in the cidofovir group (3.7 vs. 55). All recurrences in the electrocoagulation group occurred within four months of confirmed lesion clearance. Topical applications of cidofovir 1 percent were well tolerated. Thirty-three percent of the patients reported only mild pain caused by erosive dermatitis. In contrast, coagulations caused painful ulcerations that necessitated the use of analgesics in all patients treated this way. Topical applications of cidofovir, an antiviral compound with activity against human papilloma virus, is effective in the majority of patients with perianal condylomata and is a valuable adjuvant to surgical treatment of these lesions.
    No preview · Article · Aug 2003 · Diseases of the Colon & Rectum
  • M. Hiele · G. Coremans · L. Marchal
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    ABSTRACT: Treatment of small bowel obstruction caused by adhesions is based on intravenous administration of fluids and reversion of intestinal distension. According to the literature conservative treatment with intestinal decompression using either nasogastric or nasointestinal tubes has a succesrate of more than 50%. The advantage of long endoscopically placed tubes as compared to nasogastric tubes is not established. Conservative treatment includes the risk of unrecognized strangulation for which no reliable diagnostic criteria are available. However the risk of urgent operation for intestinal obstruction may well be in the same range as that of unrecognized strangulation, but exact data are not available. Succesrate of conservative treatment with suction tubes is higher in patients with partial obstruction as compared to complete obstruction, but also here the criteria are not completely reliable. In our series of 115 patients, conservative treatment was succesful in 63%. The mortality rate was 2.6%. Of the 56 patients treated with a nasogastric tube 21 (38%) were ultimately operated. One in 3 of the operated patients needed segmental resection for strangulation. In the group of 14 patients treated with a nasogastric tube 3 patients (21%) were finally operated. Only in 1 of the 14 patients (7%) a small bowel resection was inevitable. Of the 19 patients who were urgently operated upon admission 5 (26%) showed a strangulated bowel segment requiring resection.
    No preview · Article · Apr 2003
  • V Moons · G Coremans · J Tack

    No preview · Article · Apr 2003 · Acta gastro-enterologica Belgica

Publication Stats

2k Citations
490.85 Total Impact Points

Institutions

  • 1982-2009
    • Universitair Ziekenhuis Leuven
      • Department of Gastroenterology
      Louvain, Flanders, Belgium
  • 1986-2008
    • University of Leuven
      • Department of Microbiology and Immunology
      Louvain, Flanders, Belgium
  • 1995
    • Ospedale Luigi Sacco
      Milano, Lombardy, Italy
  • 1991-1995
    • Catholic University of Louvain
      • Department of Internal Medicine - MINT
      Лувен-ла-Нев, Walloon, Belgium