PubMed Health⌕ Search

Biomedical subjects

D Beurton

Publications and source records attributed to D Beurton.

At least 91 records · Page 5Linked to original sources
PubMed1984

[Uselessness of systematic bone scintigraphy in the assessment of the spread of bladder cancer, before excision surgery].

The authors reviewed bone scans in 55 patients with carcinoma of the bladder. Only 3 patients had a pathological bone scan. In two, an ordinary X-ray of the spine (visible on IVP) showed the existence of bone metastases. Thus amongst the total of 55 cases, bone scan was of specific value only once (1,9%). The authors mention the frequency of bone metastases at autopsy (24 to 37%) and the superiority of bone scan over an ordinary radiological skeletal survey. In the literature, false negative results for bone scan do not exceed 5% whilst the false negative rate for ordinary X-ray is 19%. Despite this reliability, bone scan alone is of basic importance in only a small number of cases. The present series is in line with those in the literature. Thus, other than where there is a special indication, the authors no longer request a bone scan in the assessment of spread of carcinoma of the bladder.

Bone Neoplasms↗
PubMed1983

[Pathology of the umbilical cord].

The pathology of the umbilical cord is an important factor in placental pathology, and may be the cause of acute fetal distress or antenatal death, though many unknown factors still remain.

Cysts↗
PubMed1983

[Results of reconstructive surgery of renal artery stenosis in children].

The authors report their experience of 20 cases of renal artery stenosis in children, seen over the last ten years. The stenosis was latent in 8 of the 20 cases and was usually discovered during investigation for headaches or a complication of hypertension. The search for a renal cause involved the use of urography (which shows the classical signs of asymmetrical kidney size, delayed excretion, very sharp image, asymmetry on the fluid load test) (19 of the 20 cases) and arteriography which, in 5 cases, showed a bilateral lesion. Almost all of the anatomical lesions were situated in the arterial trunk (20 out of 25), 4 lesions were at the bifurcation of the trunk and only one lesion involved a branch. The most common lesions were dysplasia and hyperplasia of the arterial wall. These lesions were treated by aorto-renal by-pass grafting (without any synthetic prosthesis) in 8 cases, by direct re-implantation into the aorta in 5 cases, by spleno-renal anastomosis in 5 cases, by resection and anastomosis in 4 cases, by enlargement venous angioplasty in 1 case and by auto-transplantation in 1 case. The following results were obtained: 9 cures (45%), 3 moderate results (15%) and 8 failures (40%), including 7 cases of early thrombosis and 1 delayed stenosis. The cases treated by direct aorto-renal re-implantation or by resection and end-to-end anastomosis were always successful. The failures occurred in children operated by one of the other techniques of arterial repair. Surgery provided these authors with excellent or satisfactory results in 60% of cases.

Adolescent↗
PubMed1983

[Lymphography and lymph node excision in bladder cancer. Apropos of a series].

The authors reviewed a series of 100 consecutive total cystectomies for carcinoma of the bladder, 78 with bilateral pelvic lymph node dissection and 43 with preoperative lymphography, attempting to determine the reliability of lymphography, to quantify the risk of lymphadenectomy and to assess the usefulness of lymphadenectomy when the nodes are involved. Routine reading of lymphography was associated with a level of accuracy of 68.7% an error rate of 10.8% and a level of uncertainty of 20.5%. Evaluating the results by number of patients rather than by the number of sides opacified by lymphography, the score was even lower: accuracy 60.5%, error 13.2%, doubt 26.3%. Strictly reviewing those cases where all necessary information was present in the record, initial routine reading of lymphographies gave 58% accuracy, 14% error, and 28% doubtful. Retrospective reading by one radiologist only gave much better results, but these did not correspond with the results obtained in everyday routine work. The number of complications related to lymphadenectomy appeared slight: amongst 78 operations, one lymphocoele, two cases of prolonged lymphatic discharge and three cases of oedema of the lower limbs. Of 14 patients with involved nodes, only three are living without recurrence and with follow-up periods which are as yet too short. All patients with involvement extending above the common iliac bifurcation died within a short time, as did all those with prostatic involvement. Comparing the data from their own series and the literature, the authors came to the following conclusions.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1983

[Bladder accommodation disorders in children with posterior urethral valves].

On the basis of 8 special cases, the authors draw attention to the role of pathology of the bladder itself in the aetiogenesis of residual dilatations of the upper urinary tract after endoscopic treatment of posterior urethral valves. This pathology is dominated by impaired accommodation of the bladder with hypertonicity during filling. It is a second bladder disease, residual after section of the valve. The diagnosis may be made on the basis of two arguments: --narrowing of the upper tract when the bladder is kept permanently drained (in the absence of any vesico-ureteral reflux); --data from urodynamic examination (confirming the absence of any residual obstructive pathology in the cervico-urethral canal). The effects upon the upper urinary tract of this impaired vesical accommodation may be demonstrated by simultaneous urodynamic studies of the upper and lower urinary tract, but in practice urography findings (comparison between full bladder and empty bladder) and those of urodynamics are sufficient to make the diagnosis. It is thus possible to avoid an erroneous diagnosis of primary obstruction of the terminal ureter or of residual cervico-urethral obstructive pathology. This in turn avoids useless and dangerous ureterovesical reimplantations, endoscopic procedures involving the bladder neck or so-called residual valve tissue which no longer exists. Therapeutic approaches are reviewed. The respective roles of urinary bypass and of enterocystoplasty have not yet been clearly defined.

Adolescent↗
PubMed1983

[Obstructive posterior urethral valves. A series of 82 cases].

The authors report their experience gained from a series of 82 cases of severe posterior urethral valves with distension of the upper urinary tract. From analysis of their own series and from a study of the literature, they propose a therapeutic approach to these severe forms. Vesico-ureteral reflux was present in 45% of cases. Once the patency of the bladder neck and urethra was restored, 41% of these cases of reflux disappeared spontaneously and 25% persisted but were well tolerated. Only 13 ureters (29.5%) had to be re-implanted. The cases of ureteral distension without reflux had a similar favourable course after removal of the obstruction of the lower urinary tract. 57% of the dilated ureters resolved or were greatly improved and 11% persisted but were well tolerated. Simple treatment of the valves meant that ureterovesical re-implantation was avoided in 68% of cases. The overall results of uretero-vesical re-implantation were mediocre: out of 32 re-implanted ureters, there were only 15 successes (46.9%), 13 cases (40.6%) were unchanged and there were 4 failures (12.5%). The authors recommend the simple treatment of the posterior valves and suggest careful consideration of the indications for ureterovesical re-implantations in children with abnormal bladder and ureters proximal to the posterior urethral valves.

Adolescent↗
PubMed1983

[Role of radiotherapy in the treatment of bladder cancer. Comments apropos of 178 cases].

In the light of their experience involving 178 patients suffering from carcinoma of the bladder and a study of the literature, the authors attempt to determine the role of radiotherapy in the treatment of carcinoma of the bladder. A number of points emerge: --the possibility of stopping the progression of a recurrent multifocal superficial malignant tumour by 2 flashes of 6.5 Gy; --the efficacy of curative doses of radiotherapy associated with transurethral resection of the tumour in 20% of cases. These figures rise to 50% in anaplastic carcinomas. 20% efficacy of radiotherapy alone without surgery is a high figure. It tends to restore the radiotherapy sensitivity test suggested by R. Couvelaire to its true value; --when combined with excision surgery (partial cystectomy or total prostato-cystectomy), high doses of radiation do not give a better result than limited radiation. In view of the gravity of radiotherapy complications which may occur in up to 20% of cases where high doses of radiation have been administered, the authors would be inclined to limit radiotherapy when treatment of the tumour must be mixed, with surgery. A preoperative flash of 6.5 Gy followed by postoperative radiotherapy up to a total of 45 Gy when partial cystectomy is used. When a decision is made to perform cutaneous implantation of the ureters, the technique should consist of concentrated radiotherapy of 20 Gy in one week followed by excision by total prostato-cystectomy the next week. When urinary bypass is to involve uretero-colonic implantation or bladder replacement, flash radiotherapy of 6.5 Gy once or twice. No additional postoperative radiotherapy. Sandwich radiotherapy is too dangerous.

Aged↗
PubMed1982

[Transurethral resection of the prostate (author's transl)].

The authors report a retrospective study of 320 primary resections for benign prostatic hypertrophy yielding a mean weight of 30 grams, only 5% exceeding 50 grams. Routine internal urethrotomy of the penible urethra carried out in 62 patients did not prevent urethral stenosis in 2 of them. There were no cases of fluid absorption syndrome, but the relatively frequent nature of the immediate (5 cases) or early (10 cases) abundant bleeding should be noted. Only one third of the patients required a transfusion. Seventeen developed a septicaemia and six epididymitis. Septicaemia (2 cases), pulmonary embolism (1 case) and cardiac insufficiency (1 case), were the causes of the 4 deaths (1.25%). There were 14 cases of urethral stenosis, 19 of incomplete resection, 1 fibrosis of the prostatic bed and 6 fibrosis of the bladder neck. There were 3 cases of complete incontinence (0.9%). In this retrospective series, spread over 7 years and involving 16 different surgeons, 80% of the patients undergoing resection had a perfect result, to which could be added 7%, following minor endoscopic re-operation for urethral stenosis or incomplete prostatic resection. The experience of the surgeon and the improvements in equipment appeared to be the two essential factors in the improvement of results of endoscopic resection for benign prostatic hypertrophy.

Humans↗
PubMed1982

[Comparative experimental study of the renal consequences of vesico-ureteric reflux and of ureteric obstruction in the sheep foetus (author's transl)].

The authors sought to determine what links existed between foetal vesico-ureteric reflux and renal dysplasia. Using sheep with operation upon the foetuses in utero, at a fairly early stage of gestation, the following were obtained: 1) Foetal vesico-ureteric reflux by unilateral excision of a ureteric meatus. 2) Stenosis of the foetal ureter by ligation. In the first case, no renal dysplasia occurred. In the second case, dysplasia-type parenchymatous lesions were found. This led them to conclude that the direct relationship between isolated foetal vesico ureteric reflux created experimentally in a normal ureter (without any additional functional or organic obstructive factor) and renal dysplasia could not be demonstrated in the sheep foetus.

Animals↗
PubMed1982

[The role of foetal surgery in urology (author's transl)].

The authors report a brief experimental study showing that cystostomy performed in utero perfectly prevents, at least in the animal, deterioration of the urinary tract after urethral ligation. In the light of this experimental finding, the authors raised the question as to whether there is not a place for such bypass urinary surgery in utero in the humans. Indications would be highly obstructive forms of valves of the posterior urethra, treated in utero by cystostomy and, secondly, severe obstructions of the excretory system which could be temporarily bypassed by pyelostomy. This risks are described, but the possibility of such surgery is not excluded.

Animals↗