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B Detroz

Publications and source records attributed to B Detroz.

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

[Intraperitoneal hyperthermic chemotherapy (IPHC), a promising treatment of peritoneal carcinomatosis].

Intraperitoneal hyperthermic chemotherapy (IPHC) appears to be a promising treatment of peritoneal carcinomatosis. This paper reports the physio-pathological background of IPHC and the various studies which have been published in the literature. It points out the heterogeneity of these series and discuss the most critical points as surgical indications, choice of the antineoplastic drugs, their doses, temperatures of the IPHC, extend of the cytoreductive surgery, morbidity and mortality. Finally, several options are proposed for those points which are not yet standardized.

Animals↗
PubMed1994

Treatment of peritoneal carcinomatosis by intraperitoneal chemo-hyperthermia: reliable and unreliable concepts.

Intraoperative peritoneal chemo-hyperthermia (IPCH) is a promising treatment of peritoneal carcinomatosis arising from digestive tumors. After presenting the rationale for the use of IPCH, this review reports the results published to date by different groups. Unfortunately, data with respect to technical aspects, indications and results are unclear, inhomogeneous and questionable. The discussion presents reliable and unreliable points, mainly concerning the technical aspects of IPCH: what is the maximal desirable tumor thickness before initiating treatment? What is the ideal temperature? Is central hyperthermia beneficial? What is the ideal duration? What is the most effective antimitotic drug? A new classification of peritoneal seeding before cytoreductive surgery and before the initiation of IPCH, is proposed, and a suggestion concerning the reporting of drug concentrations made. Numerous prospective studies need to be conducted to test different technical modalities and to evaluate the results of IPCH.

Animals↗
PubMed1994

[Surgical interventions for erroneous diagnoses of liver metastases].

Among 635 laparotomies carried out for liver metastases (LM) between June 1983 and December 1992, twenty three operations (with 6 hepatectomies) were performed for a false positive diagnosis of LM. They represented 3.6% of the whole population, but only 2.8% if the 5 patients operated for persistent diagnostic doubt are excluded. The 6 hepatectomies represented 2.2% of the 276 hepatectomies carried out for LM. The 23 false positive diagnosis of LM could be classified as follows: 14 complete errors (operation for the diagnosis of LM), 4 partial errors (the operation was also indicated for a concomitant disease), and 5 cases of real diagnostic doubt. Two groups of patients were differentiated according to the survey: one group had a regular survey and had a modification of their initial morphologic examinations of the liver, and one group had no reference morphologic examinations of the liver. The errors were more frequent in the first group. Atypical angiomas were the most frequent lesion (n = 10), followed by atypical cysts (n = 4), and nodular focal hyperplasia (n = 4): they represented 78% of all false positive diagnosis of LM. These false positive lesions were mainly detected in three carcinomas: colorectal carcinomas (n = 10), breast cancers (n = 5) and melanomas (n = 3): they represented 78% of the incorrect diagnosis. The relative frequency was high for melanomas (36%) and breast cancers (14%), but low for colorectal cancers (2%). The retrospective study of these cases shows that some errors could be eliminated by a more extensive imaging and systematic radio-clinical confrontation.(ABSTRACT TRUNCATED AT 250 WORDS)

Breast Neoplasms↗
PubMed1993

Misdiagnosed malignancy in transplanted organs.

The case reports of three patients who received cancer-bearing organs at this institution are presented. A fourth recipient, who was to be transplanted with a cancerous kidney, was spared this disastrous complication. The relevant data regarding the donors is also alluded to, with special reference to the type and site of the primary malignancy. Following these case reports, the implications of these issues, their possible prevention, and further management are discussed.

Adult↗
PubMed1991

[Sternal osteitis and mediastinitis after coronary artery bypass graft surgery].

Between 1980 and 1987, 31 cases of osteitis (n = 9) and/or mediastinitis (n = 22) were observed after 2,801 consecutive aorto-coronary bypasses (1.1%). Three types of treatment were used: 1) sternal debridement with osteosynthesis and continuous mediastinal irrigation (n = 25); 2) sternal and mediastinal debridement with open drainage without osteosynthesis (n = 2); 3) incision and debridement of sternal abscesses (n = 4). The overall mortality was 26% (8/31), i.e. 11% (1/9) for isolated osteitis and 32% (7/22) for mediastinitis. Four factors were statistically associated with infection: reoperation for hemorrhage (19.4%, p less than 0.001); preoperative diabetes (25%, p less than 0.001), postoperative low cardiac output (55%, p less than 0.001), postoperative respiratory insufficiency (45%, p less than 0.001).

Aged↗
PubMed1987

Plasmacytoma of the thyroid: a case report, a study with use of the immunoperoxidase technique, and a review of the literature.

A case of solitary plasmacytoma of the thyroid is reported. A monoclonal component (IgG lambda) was identified in the serum of the patient and disappeared after total thyroidectomy and radiotherapy. The use of the immunoperoxidase technique on thyroid, bone marrow, and lymph node specimens allowed us to demonstrate the production of IgG lambda by the tumor, and to rule out the possibility of multiple myeloma. Previously reported cases are reviewed (15 cases). The diagnostic criteria, the association with thyroiditis, and the treatment of this rare disorder are discussed.

Bone Marrow↗
PubMedDate not supplied

Adjuvant hyperthermic intraperitoneal peroperative chemotherapy (HIPEC) associated with curative surgery for locally advanced gastric carcinoma. An initial experience.

AIM OF THE STUDY: After macroscopic radical (R0) surgery for advanced gastric carcinoma, 40 to 50% of the tumors recur in the abdomen as locoregional or peritoneal disease. We initiated a protocol in which patients with suspicion of macroscopic serosal, lymphatic or peritoneal invasion, treated with R0 resection, underwent adjuvant HIPEC. METHODS: Between June 1998 and January 2003, 16 patients with locally advanced adenocarcinoma of the stomach were included in the study. Surgery consisted of a total gastrectomy with a D2 lymphadenectomy. Splenectomy (n = 1), splenopancreatectomy (n = 4), transverse colectomy (n = 3), left hepatectomy (n = 1), localized peritonectomy (n = 3) were associated to obtain a R0 resection. HIPEC protocol consisted of heated (42.5 degrees C) intraperitoneal mitomycin C (15 mg/m2) for a planned duration of 90 minutes. RESULTS: HIPEC median duration was limited to 73(20-90) min because of central hyperthermia recognition in half of the cases. One patient died in the postoperative period of sepsis secondary to a duodenal fistula. Postoperative morbidity included pancreatic fistula (n = 2), pulmonary oedema (n = 1), pulmonary embolus (n = 1) and transient renal failure (n = 1). UICC staging was IB (n = 2), II (n = 2), IIIA (n = 5), IIIB (n = 1), IV (n = 6). Nine of the 16 patients are alive without recurrence with a median follow-up of 52 months. Four patients developed a recurrence, intraperitoneal (n = 2), systemic (n = 1), or combined (n = 1). Two patients were lost to follow-up. CONCLUSIONS: Aggressive surgical therapy and HIPEC might represent the standard of care in a selected population with locoregional disease and for whom a R0 resection can be achieved. This protocol was associated in this study with a 75% 5-year survival with a low peritoneal recurrence rate and an acceptable morbidity.

Adenocarcinoma↗