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Biomedical subjects

A Benchekroun

Publications and source records attributed to A Benchekroun.

At least 19 recordsLinked to original sources

[Ureteral replacement with ileal graft with anti-reflux valve].

The authors describe an ureteroileoplasty with a new anti-refluxing technique. A subtotal ureteroplasty is carried out, anti-refluxing proceeding is made. This one is based on Benchekroun's hydraulic valve principle. A transversal ileostomy is carried out 8 cm below the uretero-ileal anastomosis, which is invaginated and fixed to the proximal layer of the ileostomy with Dexon 3/0, the ileostomy is then closed using Dexon 2/0. The hydraulic valve may then ensure anti-reflux.

Adult

Hydraulic valve for continence and antireflux. A 17-year experience of 210 cases.

The hydraulic ileal valve ensures urinary continence and can be employed in many different reservoirs. The valve is constructed by isolating a 14 cm long intestinal loop with its mesentery. The isolated ileal segment is then folded inward on itself throughout its length. This hydraulic valve was used in the construction of 210 continent urostomies--ileocaecal reservoir in 184 cases (including 8 detubularized), ileal reservoir in 15, sigmoid in three, rectum and transverse colon one each, and bladder (continent cystostomy) in six cases. The indications for continent urostomy included bladder tumour (45.5% of cases), complex vesicovaginal fistula (31%), neurogenic bladder (11%) and bladder exstrophy (7%). Continence was immediately achieved in 155 patients (75%), rising to 91.5% after valve repair. The mean postoperative follow-up was 56 (range 3-205) months.

Adult

[Continent urinary diversions].

A series of 200 continent Benchekroun pouchs are presented. This original technique, with a hydraulic continence valve, provided a 91.5% continent rate. A review of the literature puts this technique into perspective.

Adolescent

[Boerhaave's syndrome].

Spontaneous esophageal perforation (Boerhaave syndrome) is a life-threatening emergency. It usually has misleading clinical manifestations and causes severe complications. In the presence of the clinical manifestations: vomiting, pain, emphysema, this diagnosis must be considered and confirmed by radiological evaluation of the chest and the esophagus. We report two cases and we describe the severity of this syndrome, its cause, its pathogenesis, and its characteristic clinical features and radiological signs.

Emergencies

Continent urostomy with hydraulic ileal valve in 136 patients: 13 years of experience.

The hydraulic ileal valve, which we developed in 1975, ensures continence by adapting to 5 different urinary reservoirs. The valve is made by isolating a 14 cm. long intestinal loop with the mesentery. The isolated ileal segment then is folded inward on itself throughout its entire length. We performed 136 continent urostomies with this hydraulic valve. An ileocecal reservoir was used in 122 patients, ileum in 8, sigmoid in 1, rectum in 1 and bladder (continent cystostomy) in 4. Indications for continent urostomy were bladder tumor in 55 patients, complex vesicovaginal fistulas in 5, neurogenic bladder in 13, vesical exstrophy in 12 and miscellaneous reasons in 5. Of the patients 103 (75 per cent) were continent immediately. Continence was obtained after repair of the valve in 24 patients (17.6 per cent). Therefore, 127 patients over-all were continent. Mean followup of our patients was 38 months (range 3 to 154 months). Continence remained excellent with self-catheterization performed easily in 88.3 per cent of the patients. Over-all, all of our continent urostomies were well tolerated biologically and radiologically.

Cecum

[Continent urostomy using a hydraulic ileal valve. Apropos of 160 cases].

We report our experience of continent urostomy about 160 cases. This study described the continence mechanism by the hydraulic valve. This one is made by isolating of 14 cm long ileal loop which is invaginated. It was adapted to six reservoirs: 142 ileocecums, 9 ileal pouchs, 4 bladders, 3 sigmoids, 1 rectum and 1 colonic transverse segment. The follow-up was few months to 14 years. 145 patients are continent, the continent urostomy was well tolerated by the upper urinary tract. The complications of the valve and their management are analysed.

Cecum

[The continent urostomy. 12 years' experience with the continent ileocecal bladder].

The ileo-caecal continent urostomy was first described in 1975. It is a combination between an ileo-caecal reservoir and an ileal hydraulic valve. From 1973 to 1986 we performed 107 such operations (41 for vesicovaginal fistula, 40 for bladder tumor, 26 for bladder exstrophy, neurogenic bladder and miscellaneous). Continence was obtained in 100 patients (80 at the first operation and 20 after operation). The follow up was 3 to 146 months (average 37) in 82 patients 74 of whom had conserved good continence. In cases with failure of continence, repair was obtained by reinvagination of the same valve or by creating a new valve. Only 2 cases of metabolic disorders in the form of acute pyelonephritis are reported. The continent urostomy provides a better quality of life for patients requiring a urinary diversion. The psychosocial and economic impact is very important.

Adolescent

Continent caecal bladder.

A new method of urinary diversion using the terminal ileum and the caecum as a reservoir, and an invaginated and sutured ileal segment interposed as a lid for the caecal portion has been experimented in 5 patients. Four of them are now completely continent and use a continence-enxuring device at regular intervals.

Adult