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B Sastre

Publications and source records attributed to B Sastre.

At least 91 records · Page 5Linked to original sources
PubMed1989

Mucinous pancreatic duct ectasia in the body of the pancreas.

The authors describe one case of mucinous pancreatic duct cancer (ductectatic cystadenocarcinoma). This disease is characterized by dilatation, with mucoid secretion, in side branches of the main pancreatic duct. Unlike in other reported cases in which mean age of the patients is over 57 years, this case involved a young woman (aged 30 years), and the lesion was located in the body of the pancreas rather than in the uncinate process. Malignant transformation was noted.

Adult↗
PubMed1989

[Cancers of the sigmoid and upper rectum extending to the bladder or ureter, treated by monobloc resection. Apropos of 13 cases].

The aim of this retrospective study is to assess the operative and functional risks and the results of "en bloc resection" performed for tumors of the sigmoid colon or of the rectum extending to the bladder. Thirteen patients required this resection, the sigmoid was involved in ten cases, the rectum in three. The urinary tract involvement was an operative finding in ten cases, while recurrent cystitis was observed in three cases. This extension reached the dome of the bladder in 11 cases, and the terminal portion of the ureter in 2 cases. All the patients underwent curative "en bloc resection" including colectomy and partial cystectomy or cysto-ureterectomy: operative mortality was 7.6%. Precise histological staging of lymph node and bladder involvement was only obtained in 11 cases; all were Astler Coller's stage B2. In 9 cases the malignant tissue involved the urinary tract; in 2 cases there were only inflammatory adhesions. In all cases the functional urinary results were good. The 5 year direct survival rate was 50%; following Kaplan Meier's actuarial method this rate was 68%. Bladder involvement by a colonic or rectal adenocarcinoma does not seem to have any "en bloc resection" is worthwhile for this kind of extensive prognostic valve.

Adenocarcinoma↗
PubMed1987

[Malignant tumors of the ampulla of Vater treated by cephalic duodenopancreatectomy. Apropos of 20 case reports].

Between 1966 and 1986, 27 tumors of the ampulla of Vater were operated on and 20 patients underwent potentially curative pancreatico-duodenal resection (PDR) (74% of resecability). The retrospective study of those 20 cases (13 men, 7 women, mean age: 59.9 +/- 9.8 years old) was done to evaluate the risks and the results of this type of wide resection. 15 patients (75%) had jaundice and gallbladder was palpable among 20 p. cent (4 cases) of the patients without cholecystectomy. Endoscopy was performed in 13 cases; endoscopic biopsies, done in 12 cases, were positive in 5 cases (45.4%), uncertain in three (25%) and falsely negative in four (33.3%). All the patients underwent Child's procedure. Histological analysis pointed out 15 adenocarcinomas and 5 malignant villous tumors; lymph node involvement was present in 11.1 p. cent; the staging following Martin's classification listed 6 stage 1, 3 stage II, 10 stage III and 1 stage IV. Operative mortality was of 5 p. cent; one patient died after an emergency procedure performed for massive bleeding but no death was observed in the group of patients treated out of emergency. Post-operative complications occurred in 5 patients (26.3%); none of the patient had pancreatico-jejunal or hepatico-jejunal anastomotic leakage. Hospitalisation had a mean duration of 22.8 +/- 6.4 days. The age over 65 years old, preoperative jaundice and preoperative endoscopic or surgical biliary drainage done to improve jaundice had no statistical influence upon post-operative morbidity. The 5 years survival rate following Kaplan Meier's method reached 44.5 p. cent.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1986

[Splanchnicectomy using the Dubois transhiatal approach. Current technical modifications].

Technical modifications were applied during 47 splanchnicectomies using Dubois' trans-hiatal approach, with major simplification of the method, mainly by the absence of freeing of the abdominal esophagus. The approach to the right and left greater splanchnic nerves involved displacement of the esophagus to the left, avoiding the need to perform a gastro-esophageal antireflux procedure at the end of the operation. Furthermore, the most effective plane for pleural detachment is situated in fact in contact with the aortic adventitia. The simplicity and safety of this modified surgical method makes it an indication of choice for the treatment of intractable supramesocolic pain.

Abdomen↗
PubMed1986

[Intra-epithelial carcinoma of the pancreas. Study of a case and review of the literature].

The authors report the case of a 74 year-old woman who was hospitalized for severe abdominal pain. The patient had epigastralgia for many years. Biology revealed hyperamylasemia and computerized tomodensitometry showed that the pancreas head was enlarged. At retrograde wirsungography a short stenosis was visible in the pancreatic duct, 2 cm from the papilla. This was considered to be a tumor and surgery was performed. Histological sections of the pancreatic head showed strictly intraductal carcinoma "de novo" or associated with ductal epithelial hyperplasia. Although very rare, in situ carcinoma should be considered when clinical features are unexplained in order to perform radical surgery.

Aged↗
PubMed1984

[Localized Caroli's disease associated with mucosecreting papillary adenocarcinoma. Value of hepatic resection].

A new case of carcinoma arising in Caroli's disease in a 48-year old male patient is reported. Since dilatation of the bile ducts was localized to the left lobe, left hepatectomy was performed. Histological examination showed that the tumour was a papillary mucoid adenocarcinoma. There was no recurrence of cholangitis while the patient survived. This case and a review of the literature shows that left hepatectomy suppresses repeated attacks of cholangitis in patients with Caroli's disease restricted to the left lobe, and that the incidence of carcinoma in Caroli's disease is higher than was formerly believed, which should encourage early surgical treatment when the disease is localized in the left lobe.

Adenocarcinoma, Mucinous↗
PubMed1984

Reconstructive operations for esophagogastric corrosive lesions.

Corrosive esophagogastric lesions are common in Algeria and France. Within the past 14 years, our overall mortality has decreased to 6% as compared to 12% in the best results from elsewhere. This report describes our operative experience with 68 patients from 1974 to 1982. According to a prospective interdisciplinary program, lesions in 351 patients were staged by emergency esophagoscopic findings: Stage I, ulceration; Stage II, hemorrhage and ulceration; Stage III, mucosal necrosis, hemorrhage, and ulceration. Total parenteral nutrition or jejunal feeding was given to patients with Stage II lesions for 3 weeks and to those with Stage III lesions for 3 months before repeat esophagoscopy. Operations were required by 68 patients who had Stage III lesions and severe stenosis. Procedures done included 39 retrosternal colon interpositions, 11 partial or total gastrectomies, nine esophagogastrectomies, four esophagoenteral colonic bypasses, six esophagogastric colonic interpositions following partial gastric resection, and one gastrojejunostomy. Eleven of the cervical anastomoses were to the pharynx. There were no operative deaths and no anastomotic leaks. All patients have satisfactory nutrition and rehabilitation. Our operative experience in the preceding 5 years included an 11% mortality; improved results in the past 8 years are attributed to early and accurate staging, planned multidisciplinary management, good nutritional support, and better timing of operations. Stage III esophagogastric corrosive lesions may be treated within 4 to 5 months of injury with low mortality and good functional outcome.

Adolescent↗
PubMed1984

[Role of formalin in the occurrence of sclerosing lesions of the bile ducts. Experimental approach in dogs. Apropos of 3 clinical cases].

The authors experimentally reproduced in dogs, sclerosing lesions of biliary tract similar to those that they noticed in clinical practice, after the use of a formalin solution for sterilization of the hydatid cysts of the liver. These lesions have been found with formalin solutions more concentrated than those used in surgical treatment of liver echinococcosis. Nevertheless, even with the use of lower concentrated solution in every case, inflammatory scars are produced in the liver and the biliary tract with persist several months after the formalin injection consequently, the authors recommend to forsake the abandonment of this product for surgical treatment of hydatid cyst.

Adult↗
PubMed1983

[Leak-proof intrathoracic esophagogastric anastomosis].

The procedure described is intended for lesions of the middle or lower third of the oesophagus, when 5 cm at least of proximal thoracic oesophagus can be preserved. It involves the use of a gastric tube and is facilitated by mechanical sutures. A new fundus is created, together with a sleeve that protects the anastomosis against leakage.

Esophagus↗
PubMed1983

[Prognostic nutritional index in digestive surgery].

It is difficult to select and combine the nutritional parameters most useful in predicting the outcome of major gastrointestinal surgery. The aim of this study was to define retrospectively a multifactorial prognostic nutritional index adapted to this purpose. Seventy-eight patients on whom one or more total or partial visceral resection were performed in nonemergency conditions were included in this study. Statistical analysis was carried out to determine correlations between the preoperative nutritional parameters and the postoperative complications such as: a) wound rupture and anastomotic leakage; b) severe sepsis; c) death. Delayed hypersensitivity, assessed as normal or abnormal, together with plasmatic albumin and transferrin levels, the thresholds of which were respectively determined at 35 g/l and 2.2 g/l, were selected as the factors with the greatest predictive value. For the prognosis of postoperative severe complications and death, the sensitivity and specificity of an index using the association of these three parameters were respectively 82.7 p. 100 and 51 p. 100 with positive and negative predictive values of 50 p. 100 and 83.3 p. 100.

Adolescent↗
PubMed1981

[Fistula-type pararectal mucinous carcinoma. A case report (author's transl)].

A case of the exceptionally rare fistula type of pararectal mucinous carcinoma is reported, the patient presenting with clinical signs of a chronic abscess in the ischiorectal hollow. The unusual gelatinous secretion suggested the need for a biopsy of the fistula cavity. Pathological examination confirmed the diagnosis, where as a barium enema and rectoscopy gave negative results, eliminating the possibility of a digestive tract origin for the tumour. Local recurrence occurred two and a half years after an abdominoperineal resection, and was treated by local excision. Aetiopathogenic hypotheses and current therapeutic procedures are discussed.

Adenocarcinoma, Mucinous↗