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Biomedical subjects

B Debesse

Publications and source records attributed to B Debesse.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Prognostic factors of survival in resected N2 bronchial cancer].

This study was based on 206 patients with non small cell lung cancer and N2 nodal disease submitted to curative surgery: pneumonectomy 163, lobectomy 39 and segmentectomy 4. All accessible mediastinal lymph nodes were removed and classified according to their anatomical location in lymph node chains; "skip" metastases were present in 24.8% of cases. N2 disease would have been missed in 20% of cases if routine removal of mediastinal nodes had not been performed. There was solitary nodal chain involvement by metastasis in 126 cases (61.2%). Overall 5-year survival was 18.3% +/- 3. Survival was not influenced by site, size or extension (T) of tumor, adjuvant radiotherapy, tumor histology or presence of vascular invasion. The prognosis was significantly worsened by the presence of microscopic residual disease (22 cases) and of satellite nodules (18 cases). Survival was significantly improved when metastases involved a single node chain (25% versus 8.5%). The location and number of involved nodes in the chain, "skip" metastasis and presence of extracapsular spread of carcinoma did not influence prognosis. Routine mediastinal lymph node dissection is necessary to improve survival and for classification of lung cancer. Anatomical description allows better understanding of N2 disease which is not a contraindication to surgery when a complete gross resection can be achieved.

Adult↗
PubMed1993

Near-haploid karyotype in a squamous cell lung carcinoma.

Cytogenetic analysis of a squamous cell lung carcinoma revealed a near-haploid karyotype with 27 chromosomes, in both primary cultures and an established cell line. The only chromosomes with two homologs present were chromosomes X, 5, 7, and 22. The two X chromosomes were early and late replicating, respectively. No structural rearrangements could be detected. In vitro, the clone evolved by duplication towards hyperdiploidy with 54 chromosomes.

Carcinoma, Squamous Cell↗
PubMed1993

[Chylomediastinum after mediastinoscopy. Apropos of a case].

A mediastinal chylous effusion occurred in a young woman after a mediastinoscopy. This effusion healed rapidly with medical treatment. An understanding of the anatomy of these intra-thoracic/lymphatic channels explains that intra-thoracic chylous effusions may occur in case of incontinence of the lymphatic vessels which connect the tracheo-bronchial nodes to the thoracic duct in the mediastinum. This is very important following the surgical excision of a node because incontinent lymphatic vessels are directly sectioned. When the lymph nodes are biopsied in an enclosed cavity such as the mediastinum, the quantity of lymphoid tissue acts as an obstacle to reflux of the lymph which is thus less significant and more easily controlled.

Adolescent↗
PubMed1993

[Excision of mediastinal nodes using video-thoracoscopy].

A man of seventy-one years with gross respiratory failure was suspected of having a cancer of the right upper lobe with metastases to the right pretracheal and intertracheobronchial nodes. A diagnostic mediastinoscopy did not achieve a diagnosis, and a right sub-bronchial node biopsy was performed, using videothoracoscopy and this revealed the presence of tuberculosis without any further delay.

Aged↗
PubMed1992

[Radiation-induced sternal tumors: value of myocutaneous flap of the latissimus dorsi].

Two patients treated by radiotherapy, one 13 years previously for Hodgkin's thymoma and the other 10 years previously for breast cancer, presented with a radiation-induced sternal tumour. The first case had undergone manubriectomy for fibrosarcoma complicated by dehiscence of the skin wound one year prior to referral to our unit: she presented with a haemorrhagic ulcerated recurrence. The lesions were widely excised (skin defect: 13 x 13 cm). The second patient underwent "en bloc" cutaneo-osteomyopericardectomy with omentoplasty onto the pericardium and sternal prosthesis (skin defect: 12 x 7 cm). These tumours are rare, but the radiation-induced skin damage requires wide excision. In both cases, the skin defect was easily repaired by means of a latissimus dorsi myocutaneous flap.

Adult↗
PubMed1992

[The bronchial arteries and their anastomoses with the coronary arteries].

We studied bronchial arteries (BA) and their anastomoses with coronary arteries in 53 adult subjects (30 female and 23 male, mean age 82) and one 2 month old child. Each subject had 1 to 4 BAs, born from an area on the anterior side of the descending aorta measuring less than 2 cm in diameter in 62 percent of the cases and never exceeding 4 cm in the other cases. In 6 cases BAs vascularize the left auricle; more than half of all cases had an anastomose with the coronary arteries: 11 with the right coronary artery and 9 with the left one. These anastomoses preserve the vascularization of the carina after a cardio-pulmonary transplantation. The may have a function of vascular supply in some coronarian patients and the study of associated coronary pathology gives confirmation of it in one fourth of the cases.

Aged↗
PubMed1992

[Lymphatic drainage of the heart].

The study was carried out on 91 adult cadavers to point out clearly the lymphatic drainages of the heart into the blood circulation. 45 right and 63 left ventricles and 9 right and 5 left atria were injected by means of a green modified gerota medium. A right collecting trunk received its afferents from 29 right and 5 left ventricles, ran upwards in front of the ascending aorta, involved the left brachiocephalic nodes and opened into the left subclavicular veins but also in 1 case in 5 into thoracic duct. A left collecting trunk received its afferents from 59 left and 23 right ventricles, ascended along the pulmonary trunk, involved the right paratracheal nodes and opened into the right subclavicular veins. From the right paratracheal nodes were also injected the left tracheobronchial nodes in 14 cases, and then the left brachiocephalic nodes twice, the left paratracheal nodes in 3 cases until the thoracic duct once and directly the thoracic duct in the mediastinum in one case. Afferents from the right atria ran upwards the superior vena cava and involved the right brachiocephalic nodes but connected also with the right paratracheal nodes as did the afferents of the left atria too. The connections with the thoracic duct must be emphasized.

Adult↗
PubMed1992

[Pericardial fatty fringes: preoperative anatomo-radiographic value of their use in the protection of bronchial sutures].

Bronchial sutures grafts by epiplooplasty is a method used to allow a better vascularisation of the bronchial sutures. The authors purpose an other method using the pericardial fatty fringes (P.F.F.). The vascularisation of P.F.F. was studied on 30 fresh cadavers and 8 patients before surgery. Angiography of the internal thoracic artery was done in the first group and M.R.I. in the second group. M.R.I. is better than angiography because numerous parietal vessels project in the angiogram, and they overlap pericardial fat fringes vessels.

Aged↗
PubMed1992

[Mesothelial cyst of pleuro-parietal origin].

This is a case report of two mesothelial cysts, both with liquid contents. They had developed in the thoracic wall; in spite of their perfectly benign character, both were eroding the ribs at the point of contact. These ectopic cysts are probably of coelomic origin.

Adult↗
PubMed1992

[Lobectomies enlarged to the main bronchus in the conservative treatment of lung carcinoma. Apropos of 75 cases].

From february 1965 to march 1990, 70 squamous cell carcinomas, 3 adenocarcinomas and 2 undifferentiated lung cancer were operated by lobectomy extended to the main bronchus: 44 right upper lobectomies, 22 left upper lobectomies, 5 left lower lobectomies, 2 right lower lobectomies, 1 middle lobectomy and one lower and middle bilobectomy. Respiratory function prevented pneumonectomy in 1 out of 3 patients. The postoperative mortality related to surgery (2.7%) has been eliminated since the introduction of systematic protection of the pulmonary artery from the bronchial suture (1976). The sutures are performed with very fine suture material. Endoscopic follow-up is essential: 11 cases of suture granuloma (1 laser) and 4 cases of fibrotic stenoses, including 1 post-irradiation stenosis (2 lasers). Fifty-three patients were N0 (28 T1, 22 T2, 3 T3) and 22 were T+ (including 4 N2). The actuarial survival for the N0 was 91% at 1 year and 60% at 5 years and decreased to 63% and 40% for N+. Eighty-three percent of the late cancer-related deaths had metastatic disease. Lobectomies extended to the main bronchus do not appear to compromise the oncological value of the resection and they offer the possibility of resection in some respiratory failure patients.

Adenocarcinoma↗
PubMed1991

[Percutaneous parietal pleurectomy using video-endoscopy. Modern treatment of spontaneous recurrent pneumothorax].

The best prevention of recurrent spontaneous pneumothorax is obtained with a parietal pleurectomy, the recurrence rate being below 0.5%. The sequelae on the muscles and the aesthetic result of a thoracotomy favour a pleurodesis using a closed chest technique. Video-endoscopy enables us to perform 16 percutaneous parietal pleurectomies (PPP) without thoracotomy in 14 patients. 11 cases were idiopathic spontaneous recurrent pneumothoraces and in 3 cases the recurrent pneumothorax occurred in patients suffering from AIDS with progressive pulmonary lesions. PPP was performed under general anaesthetic with selective intubation. The posterior incision of 2-3 cm did not involve any muscular section and the dissection was performed throughout using video-endoscopy which enabled perfect control of haemostasis. PPP achieves a sub-total pleurectomy. The hospital stay was on average for five days. Those operated on did not suffer from immediate post operative pain and shoulder mobility was excellent from the moment at which the patient awoke. The advantages of PPP are: perfect haemostasis and the absence of muscular sequelae or unpleasant aesthetic sequelae. These benefits now make us consider that percutaneous parietal pleurectomy may be the treatment of choice in spontaneous recurrent pneumothoraces.

Adult↗
PubMed1991

[6 para-esophageal cysts. Discussion on their origins].

Para-oesophageal cyst is a rare lesion which can be classified, by its origin, as a gastrointestinal duplication. It is mostly encountered in children. Since 1977, we have observed 6 cases in adults, and 5 out of 6 presented as postero-inferior mediastinal tumors. Pre-operative diagnosis is difficult: when the lesion is intramural, the only other diagnosis is leiomyoma; in other cases, a bronchogenic cyst or a posterior mediastinal enteric formation can be discussed. Surgical findings and histological criteria allow a precise definition of these cysts, which lie at least partially in the wall of the oesophagus. There was a histological association of respiratory mucosa and musculosa, either of type or associated with cartilaginous islets. The definition of the clinical classification is easier with a good knowledge of the histogenesis.

Adolescent↗