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B Debesse

Publications and source records attributed to B Debesse.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Postoperative pain after thoracotomy. A study of 116 patients].

We have studied post-operative pain in 116 patients who underwent a thoracotomy. The pains were assessed using a visual analogue scale and were significant and identical whatever type of operation was used and irrespective of sex or diagnostic disease category. On the operative day only the surgeon seemed to have any influence. On the first post-operative day the pain was influenced by age and on the eighth day by socio-professional category. The insertion of drains had no influence on the pain. Massage and physiotherapy decreased the pain in a significant fashion. The importance of taking account of post-operative pain is underlined.

Adolescent↗
PubMed1990

[Surgical treatment of associated bronchial, upper respiratory and digestive tract cancers].

Between 1980 and 1987, 63 lung cancers associated with upper aero-digestive tract carcinomas were operated on 50% of the primary malignancies of the upper aero-digestive system were laryngeal. These tumors developed synchronously in 13% and metachronously in 87%. The operative mortality rate was 3%. The five years survival rate was 30%. Our results were found identical to those observed in a single lung cancer series. Coin lesion of the lung should be therefore considered as a second primary cancer. Thus, the best treatment is surgical resection. When the option exist, the lung cancer should be treated before the upper airway cancer to avoid the impact of previous irradiation and/or surgical treatment of the upper airway cancer upon the post-thoracotomy management.

Adult↗
PubMed1990

[Esophago-bronchial fistula in adults].

The authors report five cases of benign oesophago-bronchial fistula in adults. These chronic bronchitic patients presented with recurrent episodes of secondary lung infections (or even haemoptysis). Questioning of the patients revealed a history of coughing when swallowing liquids in three cases. Two women concealed this symptom, which was only revealed retrospectively. The fistula was detected by upper GI series in three cases and by oesophageal fibroscopy in one case. In the remaining case, it was discovered at operating for severe haemoptysis. In four of the five cases, the fistula was situated on the right and was of post-tuberculous origin. In one case of post-traumatic fistula, it involved the left main bronchus. All of the patients were operated: a resection-suture of the fistula was performed via the oesophageal approach and, via the bronchial approach, simple suture of the fistula was possible in two cases, while resection of the destroyed pulmonary parenchyma was necessary in three cases (one right lower lobectomy, two bilobectomies). Demonstration of the oesophago-bronchial fistula, definition of its site and assessment of the condition of the pulmonary parenchyma are essential steps to be performed prior to surgery.

Adult↗
PubMed1990

[Lymphatic afferents and efferents of lymph nodes of the Barety's space. Anatomic review in adults].

Lymph nodes of the Barety's space (LNLB) often involved in lung diseases are known under various names for a long time ago by pathologists. Our study involves 360 cadavers of adult subjects. The injection of a dye was performed by direct catheterization of a pulmonary segment. L.N.L.B. were directly or indirectly coloured (inter connected ganglionary network) more often from the lobes of the right lung, but from the lobes of the left lung too. From L.N.L.B. the lymphatic flow discharges in the venous confluent of the neck in the right side; in 1/4 of the cases a mediastinal efferent joints the left venous confluent too. From the lower lymph nodes of the space efferents can go to lymph nodes which are located right along the arch of the azygos vein (and then to the thoracic duct) and in the left side the group of left suprabronchial lymph nodes (then either to the thoracic duct in the mediastinum, or to the recurrent chain to the neck). At last, it seems that inside the lymph nodes themselves, lymphatic flows exist, the topography and the nature of which change according to the area interested by the injection.

Adult↗
PubMed1989

[Apropos of 6 para-esophageal cysts. A discussion about 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. They are a histological association of respiratory mucosa and muscular, either of type or associated with cartilaginous islets. The definition of the clinical classification is easier with a good knowledge of the histogenesis.

Adolescent↗
PubMed1989

[The destroyed lung. Apropos of 46 surgical patients].

The authors report the results of a retrospective study of 46 patients operated upon for lung destruction of various origins. The main points that emerged were: (1) this type of pathology is regressing in France but persists in North Africa and Black Africa; (2) tuberculosis is the predominant cause of lung destruction; (3) superinfection with aspergillosis is frequent and must always be looked for; (4) surgery is difficult, especially pleuropneumonectomy for tuberculosis or its sequelae which has numerous complications (e.g. haemorrhage and pyothorax) responsible for a high mortality rate in this and other published series. However, in all patients operated upon for complications of lung destruction, when cure was obtained it was complete and permanent.

Adolescent↗
PubMed1989

[Thoracic duct collaterals of lymphatic and pulmonary origin. Anatomy and chylothorax after pulmonary surgery].

Dye injection of lung segments reveals the existence of lymphatic drainage of the lungs generally into cervical venous confluents and more rarely into the arch of the thoracic duct in the neck and also occasionally into the thoracic duct in the mediastinum. Direct drainage of the lymph into the thoracic duct was observed in 10 cases out of a series of 589 injections of lung segments in adult cadavers. In one half of cases, the thoracic duct was injected from the left suprabronchial lymph node chain, the origin of the left recurrent chain, and in one quarter of cases from the lateral anteroposterior right major azygos and left azygo-aortic lymph node chains, not recognised by the classical authors. More rarely, direct lymphatic collaterals drained certain segments of the lower lobes into the thoracic duct via the triangular ligament. Analysis of cases of chylothorax occurring after lung resection and observed in the authors' department or in the literature reveals that most of them can be attributed to a chyle leak from one of these pulmonary lymph collaterals. These pathways are probably also involved in the development of medical or idiopathic chylothorax.

Adult↗
PubMed1989

[Pseudotumoral lambda chain pulmonary amyloidosis].

A case is described of primary multi-nodular pulmonary amyloidosis which was "pseudotumoral" and its progress had been under observation for eight years. Protein analysis revealed that it was a monoclonal light chain and there was no evidence of myeloma. It appears to be of a local pathology and is of the same type as amyloid tumors of the bronchi.

Amyloidosis↗
PubMed1989

[Bronchial cancer associated with upper respiratory and digestive tract cancers].

The authors report a series of 63 cases, all operated, of bronchial cancer associated with upper airway cancer. The laryngeal portion of the upper airways was the site of cancer in 50% of cases. The two cancers occurred synchronously in 13% and at different times in 87% of cases. Operative mortality was 3%. Post-operative complications were dominated by bronchopulmonary congestion. Long-term survival was similar to that in series of operated bronchial cancer alone and was 70% at one year and 30% at five years. These results should lead to all isolated pulmonary lesions being considered as second primary cancers with early surgical resection being proposed.

Adult↗
PubMed1989

Direct lymphatic drainage of lung segments to the mediastinal nodes. An anatomic study on 260 adults.

The subpleural lymphatics of 483 lung segments were injected in cadavers of 260 adult subjects. The injected lymph vessels corresponded to the pulmonary segmentation in 91% of the cases and remained close by in the other cases. Direct passages to the mediastinal nodes were observed in 54 of 243 right lung segments injected (22.2%) and 60 of 240 left lung segments (25%). Among a total of 114 direct passages observed, 99 remained superficial in the pleura, half of them composed of a single vessel. These passages have been observed more frequently in the segments of the upper lobes. Injections of basal segments in the right and left lower lobes showed fewer of these direct passages to the mediastinal lymph nodes and also demonstrated direct lymph vessels to lymph nodes located at the origin of the upper lobar bronchi. In two dissections of the right upper lobe, the drainage went directly to the right venous jugular-subclavian junction, and in three dissections from three right terminal basal segments the lymph vessel went directly to the thoracic duct in its mediastinal passage. Direct contralateral lymph pathways were observed five times, four of them from basal segments of lower lobes.

Adult↗