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B Descottes

Publications and source records attributed to B Descottes.

96 records · Page 6Linked to original sources
PubMedDate not supplied

[Voluminous retroperitoneal liposarcoma. Apropos of a case and review of the literature].

The authors report a case of bulky retroperitoneal liposarcoma (6 kg) in a 42-year-old woman. This observation of liposarcoma is interesting in that diagnosis was incidental during check up for recent hypertension. The diagnosis was suggested by ultrasonography, essentially computed tomography and suspected by multiple subcutaneous lipomas. Treatment was exclusively surgical with complete tumor resection including the left adrenal gland. The authors review literature data of retroperitoneal liposarcoma. Because of frequent recurrency, follow-up of tumor resection must be made by CT scanning every six months. An aggressive surgical approach including adjacent organs if necessary and total excision of local recurrencies can improve long-term prognosis. Postoperative adjuvant radio- and/or chemotherapy does not effect survival.

Adult↗
PubMedDate not supplied

[Total gastrectomy and viscerosynthesis].

A retrospective study of 134 total gastrectomies performed between 1982 and 1992 was conducted with regular follow-up. There were 96 males and 38 women (mean age 66.66 years, range 27-82). The indication for total gastrectomy was malignant tumour (n = 115), mostly adenocarcinoma (79.1%, 91/115) with 7 cases of stump degeneration after partial gastrectomy (5.2%) and benign lesions (n = 19), mostly gastric ulcers. Gastrectomy was associated with node dissection in 53 cancer cases (47.8% 53/115) and dissection of neighbouring organs in 16 patients. Y anastomosis with circular mechanical suture was performed in 78 cases (62.9%) with pre-stapling in 30 (38.5%). Operative mortality was 8.2% (11/134). The oesophagealjejunal disunion occurred in 7/133 patients (5.3%) including two fatal cases. Early reoperation was necessary in 10.5%. Long-term follow-up for 2 to 12 years in 119 patients gave the following data. For malignant tumours: 5-year survival rate 10.1% (n = 8), recurrence an anastomosis 6.3% (n = 5), distant recurrence 28.2% (n = 21). For all patients sequellae were: reflux oesophagitis 8.1% (n = 10), stenosis of the anastomosis 7.3% (n = 9) requiring late reoperation in 2. The quality of life was considered satisfactory by 28.57% (n = 8) and good in 39.29% (n = 11). These results were compared with those reported in the literature and led to the conclusion that the general view as to the gravity of gastrectomy should be reconsidered in light of the progress in viscerostapling.

Adenocarcinoma↗
PubMedDate not supplied

Major liver resections without vascular clamping: retrospective study of 84 cases.

BACKGROUND/AIMS: The question as to whether vascular clamping aggravates mortality and morbidity of major liver resection was investigated in this study. Major liver resection with vascular clamping for parenchyma transection has mortality between 0 and 5%, and higher morbidity reaching 47% with healthy liver in recent report. METHODOLOGY: Eighty-four major liver resection without vascular clamping were carried out between January 1986 to December 1996 were reviewed. There were 57 men and 27 women with average age of 58.2 (12.2) years old. Indications of resection were adenoma (4.8%) angioma (11.9%) focal nodular hyperplasia (1.2%) hematoma (1.2%) metastases (60.7%) hepatocellular carcinoma (14.3%) and cholangiocarcinoma (5.9%). Resections used ultrasonic dissector (Sonoca) with intraoperative ultrasonography were right hepatectomy in 56 cases extended right hepatectomy in 10 cases left hepatectomy in 17 cases and middle hepatectomy in 1 case. Remnant liver was cirrhotic in 3 cases. RESULTS: Three patients died (3.5%) and the rate of major complications were 11.2%. 46 patients (54.8%) had no blood transfusion. The mean of blood transfusion was 1.5 (2.7) units. The mean of operative length was 286.23 (63.3) minutes and the mean hospital stay was 15.8 (8.1) days. Liver function tests are same with the others authors at day 1, 4 and 7 after operation with return to normal value after 1 week. CONCLUSION: In major liver resection, vascular clamping is not always necessary.

Blood Loss, Surgical↗