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C Duvillard

Publications and source records attributed to C Duvillard.

12 recordsLinked to original sources
PubMed2003

[Pharyngeal stenosis: treatment by resection-end to end anastomosis].

OBJECTIVES: Pharyngeal stenosis occurs frequently after laryngectomy or total laryngectomy extended to the pharynx. Oral feeding might become impossible or is limited to liquids. In such cases, dilations can be performed, but surgery becomes necessary when they are unsuccessful. The objective of this report is to show that pharyngeal resection anastomosis is one of the existing techniques which can be helpful in such cases. METHODS: A 67-year-old woman had been operated on a laryngeal cancer 18 years earlier when she presented with a 2 cm height pharyngeal stenosis responsible for a chronical dysphagia to solids. The multiple dilations performed were unsuccessful and she underwent a pharyngeal resection and end to end anastomosis by lateral cervicotomy. RESULTS: The outcome was uneventful. Normal pharyngeal permeability and swallowing were restored and are still maintained with a 18 months follow-up. CONCLUSION: Rehabilitation technics using flaps--pectoralis myocutaneous, lingual, platysma or jejunum flaps--is not always mandatory in patients presenting with pharyngeal stenosis. A pharyngeal resection end to end stenosis, pharynx anastomosis can also be successfully performed in stenosis of limited height.

Aged↗
PubMed2001

Pre-clinical study of the epinephrine-cisplatin association for the treatment of intraperitoneal carcinomatosis.

We have previously shown that intraperitoneal (i.p.) epinephrine enhances tumour penetration and anti-cancer activity of i.p.-administered cisplatin in rats with peritoneal carcinomatosis. Here, we show a direct correlation between the i.p. epinephrine concentration and cisplatin accumulation in rat peritoneal tumour nodules up to a concentration of 5 mg/l. This concentration leads to a maximal 3.7-fold increase of tumour platinum content and a maximal vasoconstriction of the peritoneal and tumour superficial microcirculation when registered by a laser doppler probe. Further, epinephrine half-life was 20.8+/-3.6 min in the peritoneal cavity of two laparotomized pigs. In these animals, epinephrine plasma concentration, heart rate and systolic blood pressure were dependent on the intraperitoneal dose of epinephrine, and life-threatening signs were not observed in either animal. In conclusion, a 5 mg/l concentration of epinephrine could be safely maintained in peritoneal fluid by regular replacement. This concentration is sufficient to maintain a constant vasoconstriction of the peritoneal and tumoral microvascular bed, and enhance the slow diffusion of cisplatin into peritoneal tumour nodules in the course of per-operative intraperitoneal chemotherapy.

Animals↗
PubMed2001

[Labyrinthine fistulae and cholesteatoma].

Labyrinthine fistula is a potentially serious complication of cholesteatoma. During or after surgery, cholesteatoma can induce partial or total destruction of cochleovestibular functions. We operated 38 patients from 1983 to 1996. The site of the fistula was the external semi-circular canal in 90% of the cases. The facial nerve canal was eroded in 66% of the cases. We performed 11 CT scans; only 7 evidenced the fistula. We removed the matrix of the cholesteatoma during the initial surgery in 35 cases and in 3 left the fistula in situ for subsequent excision at a second operation. Postoperative hearing loss compared with the preoperative situation was observed in 66% of the patients. Deafness was observed in 4 ears (11%). Hearing improved after surgery in 23% of the patients. We consider that a closed technique with immediate removal of the cholesteatoma matrix is indicated for most fistulae but that second-intention resection (combined approach tympanoplasty) is the better choice when the fistula is wide and the ear is infected. In some cases (old patient, one functional ear, better ear) an open technique may be preferred without risk for the cochleovestibular functions.

Adolescent↗
PubMed2000

[Intraperitoneal cisplatin plus epinephrine and surgical debulking for the treatment of advanced peritoneal carcinomatosis in the rat].

OBJECTIVE: To evaluate and compare the effects of cytoreductive surgery with intraperitoneal cisplatin and epinephrine on peritoneal carcinomatosis in the rat. MATERIAL AND METHODS: Twenty-day old peritoneal carcinomatosis was obtained after intraperitoneal injection of 1 x 10(6) DHD/K12/PROb cells into BDIX rats. The surgical treatment included electric fulguration of the peritoneal tumors with spleen and omentum removal while intraperitoneal chemotherapy included platinum (3 mg/kg) associated with epinephrine (2 mg/kg). RESULTS: Surgery did not increase rat survival unlike cisplatin or cisplatin/epinephrine chemotherapy. Intraperitoneal chemotherapy alone with cisplatin +/- epinephrine increased survival but did not provide cure. Surgery followed by intraperitoneal cisplatin and epinephrine cured four out of five twenty-day old peritoneal carcinomatosis. CONCLUSION: Surgery combined with intraperitoneal cisplatin and epinephrine could be an efficient treatment for peritoneal carcinomatosis in man.

Animals↗
PubMed2000

[Mastoid cortical bone grafts in ossiculoplasty].

Ossicular homografts have been left for safety reasons with regard to viral transmission diseases. Several means are usable to reconstruct ossicular chain: synthetic prosthesis and autologous bone. On grounds of disponibility, biocompatibility, cost and use easiness we have been using mastoid cortical bone since 1995. We have studied hearing results and tolerance of 45 ossiculoplasties performed with cortical bone. Two years after, we have been obtaining as good or even better functional results with cortical bone graft than with auto or homologous ossicular bones (air bone gap inferior or equal to 20 DB in 89 % of the cases) and no extrusion. Thus, cortical bone seems to be, the better material when autologous ossicular bones are not available.

Adolescent↗
PubMed1999

Epinephrine enhances penetration and anti-cancer activity of local cisplatin on rat sub-cutaneous and peritoneal tumors.

Despite the theoretical advantages of a high local concentration of anti-cancer drugs, local chemotherapy often fails to produce complete and lasting responses in experimental and human solid tumors. Experiments using Patent Blue dye showed that fluids diffused poorly into tumor mass when injected inside or around s.c. rat tumors in rats. In the same way, Patent Blue dye distributed poorly from the peritoneal cavity into the tumor nodules of rats with peritoneal carcinomatosis. The potent vasoconstrictor, epinephrine (1 mg/kg of body weight) was shown to facilitate the penetration of Patent Blue dye into s.c. and peritoneal rat tumors. Platinum concentration evaluated by micro-PIXE in s.c. DHD/K12/ PROb colon tumors or by atomic absorption spectrometry in DHD/K12/PROb peritoneal tumors was 4- to 12-fold higher when epinephrine was added to local cisplatin. Peri-tumoral or intra-tumoral injection of cisplatin (2 mg/kg) alone does not cure s.c. DHD/K12/PROb colon tumors or GV1A1 glioma tumors in BD IX rats. By contrast, a complete and lasting cure of s.c. tumors was achieved regularly and without skin necrosis when epinephrine was added to intra-tumoral or peri-tumoral cisplatin. Rats with peritoneal-tumor nodules 1 to 2 mm in diameter, and insensitive to i.p. cisplatin alone, were cured when the anti-cancer drug was combined with epinephrine. These experimental results could justify clinical trials using a combination of cisplatin and epinephrine in the treatment of locally growing solid tumors.

Animals↗
PubMed1999

[Intratumoral chemotherapy in an experimental animal model: another therapeutic possibility in cancerology].

OBJECTIVE: Assess the efficacy of intratumoral chemotherapy in a colonic tumor model implanted subcutaneously in the BD IX rat. METHOD: In order to determine their antitumoral effect, 5 anticancer drugs were administered via intravenous and direct intratumoral routes 2 or 10 days after subcutaneous inoculation of tumoral cells. Intratumoral diffusion was evaluated using Patent blue injected directly into the tumoral tissue. Cisplatinum was administered via intratumoral, intravenous and intra-arterial routes to determine the intratumoral and intrarenal concentrations achieved with each of these administration routes. Cisplatinum was also administered via intravenous and intratumoral infusion for 30 minutes to determine the antitumoral effect of each of these routes. RESULTS: Mitomycin and cisplatinum inhibited growth of tumors which had not yet become established and caused advanced stage tumors to regress. For early stage tumors, the intratumoral route was always more effective than the intravenous route. Patent blue diffusion demonstrated a nonhomogeneous intratumoral distribution. Compared with intravenous or intra-arterial infusion, intratumoral infusion gave much higher concentrations of cisplatinum within the tumors and reduced systemic diffusion. At 7 weeks, the antitumoral effect was equivalent for the 2 administration routes while at 13 weeks, the intratumoral treatment was more effective than the intravenous treatment. CONCLUSION: These findings in an experimental animal model demonstrate that intratumoral chemotherapy is more effective than intravenous chemotherapy. It is however still impossible to consistently cure tumors induced in animals.

Amiodarone↗
PubMed1999

[The effect of intra-abdominal temperature on the tissue and tumor diffusion of intraperitoneal cisplatin in a model of peritoneal carcinomatosis in rats].

OBJECTIVE: To evaluate the effects of hyperthermia and hypothermia on the peritoneal and on tumor penetration by intraperitoneal cisplatin. MATERIAL AND METHODS: Twenty day old peritoneal carcinomatosis was obtained after intraperitoneal injection of 1 x 10(6) DHD/K12/PROb cells into BD IX rats. Animals were treated by intraperitoneal infusion of cisplatin (25 micrograms/mL) using hyperthermic (16.6 degrees C), normothermic (37.6 degrees C) or hyperthermic (41.8 degrees C) intraperitoneal chemotherapy. RESULTS: Hyperthermia increased cisplatin concentration in tumoral and diaphragmatic tissues compared to normothermic treatment, while renal concentrations were lower. Hypothermia produced lower cisplatin concentrations in both cancer and peritoneal tissues compared to normothermic treatment. CONCLUSION: These experiments confirmed the pharmacological advantage produced by hyperthermia in cisplatin intraperitoneal chemotherapy.

Abdomen↗