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C Rebuffat

Publications and source records attributed to C Rebuffat.

44 records · Page 3Linked to original sources
PubMedDate not supplied

Anastomotic healing in dogs under cortisone treatment. A pilot study comparing compression and stapled anastomosis.

Colonic anastomoses made both by a new Compression Anastomotic Device (CAD) and by a traditional stapler (Autosuture CDEEA) were evaluated in impaired anastomotic healing induced by systemic cortisone in the dog. Twenty dogs were given daily i.m. hydrocortisone (25 mg/kg) starting one month before surgery and then until sacrifice. Eight untreated dogs served as controls. Surgery consisted of colonic transection and anastomosis done with CAD-25 in half the cases and with CDEEA-25 in the remaining half. The dogs were sacrificed six and 13 days after surgery. Macroscopic assessment, bursting pressure test, and histology were performed on the anastomosis. One dog died from peritonitis due to anastomotic dehiscence. No other clinical complications were observed. Although the number of observations was too small to attain statistical significance, CAD anastomoses appeared better than stapled ones as regards peri-anastomotic adhesions, anastomotic index, and histology. This preliminary study suggests that compression is as reliable as the stapler in the construction of colon anastomosis even in such situations of delayed anastomotic healing. Further experience is required to substantiate this conclusion.

Anastomosis, Surgical↗
PubMedDate not supplied

[Acute pseudo-obstruction of the colon (Ogilvie syndrome). Apropos of a case].

An additional case of acute colonic pseudo-obstruction (Ogilvie's syndrome) is reported. Conservative management was successful. Etiology of this syndrome is still uncertain. The aim of the treatment is to stop natural evolution to ischemia or perforation. Medical therapy, colonoscopic decompression and surgery are employed following prognostic criteria (age, cecal diameter, therapeutical delay). Mortality rate remains high, especially if complications occur. Colonoscopic decompression is a safe and efficacious first line of treatment when cecum is less than diameter 12 cm. Surgery is mandatory when perforation or ischemia are suspected and colonoscopy failed or is contraindicated.

Acute Disease↗
PubMedDate not supplied

Major videothoracoscopic pulmonary resections.

Major pulmonary resections are generally performed through long thoracotomies which cause important functional and cosmetic sequelae. The progress in videoendoscopic surgery has allowed the authors to perform 31 pulmonary resections (28 lobectomies, 1 segmentectomy and 2 pneumonectomies) by thoracoscopic approach. Seven patients had benign pulmonary disease, 3 patients had pulmonary metastases and 21 cases suffered from a primary lung cancer TNM stage I. In all cases of malignancy hilar lymphadenectomy was performed. No major postoperative complications were observed. Functional and cosmetic results were always excellent.

Adolescent↗
PubMedDate not supplied

Videoendoscopic thoracic surgery.

Personal experience of 42 videothoracoscopic operations is reported. From September 91 to May 92 we performed 10 major lung resections (1 pneumonectomy, 8 lobectomies, 1 segmentectomy) 9 wedge lung resections, 4 excisions of pulmonary bullae, 12 pleurectomies with or without apicectomy, 6 excisions of mediastinal masses (3 thymomas, 2 mediastinal cysts, 1 thoracic disembryoma), 1 removal of esophageal leiomyoma. No major complications occurred. Except for one patient submitted to bullectomy with pleurectomy who required a second thoracoscopy due to postoperative bleeding, all patients had excellent p.o. course. We describe technical details employed in different videothoracoscopic operations and discuss personal results and principles of videothoracoscopic approach. Different fields of videoendoscopic chest surgery are examined. Present data seem to advocate videothoracoscopic treatment for many thoracic diseases and also for major lung resections, due to its minimal trauma and little functional impairment. Nevertheless this still remains avant-garde surgery. Further improvement in endoscopic instrumentation is necessary and may lead to future extensions of videothoracoscopic surgical possibilities.

Female↗
PubMedDate not supplied

Videothoracoscopic operative staging for lung cancer.

The authors describe their experience in performing Videothoracoscopy as the first step of the operation in patients affected by lung cancer: they refer to this procedure as Videothoracoscopic Operative Staging (VOS). In 286 patients, already proposed for curative surgical resection on the basis of conventional staging, VOS was carried out in order to reach a conclusive judgement of resectability. VOS discovered unsuspected causes of inoperability in 17 patients (5.7%), while 269 patients underwent surgical operation but in 9 of them this consisted in an exploratory thoracotomy (ET). Furthermore, VOS allowed us to assess the operability of 11 patients in whom preoperative computed tomography (CT) had suggested unresectability but without providing a definitive judgement. Based on their experience the Authors conclude that VOS should be performed in every patient affected by lung cancer in order to obtain a more detailed staging and to reduce to a minimum the number of ETs. By using VOS it was possible to decrease the rate of exploratory thoracotomies to less than 4%.

Biopsy↗
PubMedDate not supplied

Major thoracoscopic operations: pulmonary resection and mediastinal mass excision.

After the great success of laparoscopy in the field of abdominal surgery, the mini-invasive approach has opened interesting new possibilities in the field of thoracic surgery too. At present, in many centres, thoracoscopy is the surgical approach of choice for the treatment of recurrent pneumothorax, giant bullous lung disease, peripheral benign lesions. In very few centres a new phase is now starting, having the objective of verifying the validity of more complex thoracoscopic surgical operations. The authors describe their experience in performing major thoracoscopic operations such as excision of mediastinal masses and major pulmonary resections. The series includes 36 patients submitted to thoracoscopic excision of mediastinal masses and 113 patients submitted to video-thoracoscopic major pulmonary resections. Every kind of mediastinal lesion as well as every kind of major pulmonary resection was performed; the evidence of no intra-operative deaths confirms the possibility of a useful employment of the mini-invasive approach in this kind of surgery.

Adenocarcinoma↗