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D Beurton

Publications and source records attributed to D Beurton.

At least 109 records · Page 6Linked to original sources
PubMed1982

[Adjuvant chemotherapy in the treatment of infiltrating cancers of the bladder. Preliminary results in 25 cases].

Twenty-five cases of invasive carcinoma of the bladder treated by surgery, radiotherapy and chemotherapy are discussed. Cis-diammine dichloroplatinum (CDDP) was used in 8 cases, bleomycin in perfusion in 6 cases and a combination of CDDP and adriamycin in 11 cases. Of 8 cases with lymph node invasion, 4 are alive 5 to 21 months after the start of treatment. Of 12 who were followed up and has no nodal involvement, 9 are alive 5 to 52 months from the start of treatment. The tolerance to treatment is poor, but the results are encouraging. Therefore, we suggest a program of treatment consisting of intense preoperative radiotherapy, partial or radical cystectomy, followed by an combination of 100 mg of CDDP and 60 mg of adriamycin monthly for 9 months.

Aged↗
PubMed1981

[Experimental study in the urinary tract of a new smooth surface absorbable synthetic monofilament (author's transl)].

The authors used 27 dogs to test the behaviour in the urinary tract of a new synthetic monofilament and absorbable suture material. Polydioxanone (PDS). The experiment was aimed at assessing the strength, ease of use, rate of absorption and lithogenic power of this material, in comparison with chromic catgut. Four loops of each material studied were inserted in the bladder, floating freely in the lumen. Absorption was evaluated by periodic cystoscopies. In the kidneys, one suture of each type was inserted into the excretory cavities by the transparenchymatous route. Development of a possible calculus was sought by urography and repeated plain X-rays of the abdomen. All the animals were killed at 6 months and routine pathological study made of the kidneys and bladder. Certain dogs were infected with proteus and subjected to fluid restriction. The lithogenic power of PDS and chromic catgut appeared to be identical. In contrast with urine, the absorption of chromic catgut by enzyme digestion was more rapid than that of polydioxanone by hydrolysis. By contrast, within the thickness of the tissues, absorption of the latter was more constant and more complete than that of chromic catgut. Polydioxanone caused a less marked tissue inflammatory reaction than the former. Scars were of equal strength. Finally, PDS suture material appears to be remarkably strong and very much easier to use than woven absorbable synthetic materials currently in use.

Animals↗
PubMed1981

[Assessment of the renal consequences as related to operative technique in surgery for 190 staghorn or calyceal calculi. Comparative value of renal scintigraphy and intravenous urography (author's transl)].

The authors have studied 86 patients with staghorn calculi who underwent preoperative quantitative renal scintigraphy. 50 of them (63 kidneys) had one or two follow-up scans between 1 and 9 years after the operation. These scintigraphic data were compared with those of I.V.U. These 50 patients had undergone surgery on 60 kidneys (12 pyelotomies only, 26 pyelotomies associated with limited nephrotomies, 18 extended nephrotomies and finally 4 bi-value nephrotomies). In 46 of these patients, the urine became definitively sterile and there was no recurrence of lithiasis in any of them. These quite exceptional conditions were such that it is possible to bear in mind only the operative technique in assessing the possible harmful consequences of each type of operation. The authors clearly show that the threat to function of the kidney which has been operated upon is more threatened when there has been a nephrotomy and when such a nephrotomy has been more extensive. A limited nephrotomy is associated with a mean loss of (% of renal function. Extended nephrotomies or more than 3 cm result in a loss of function of approximately 22%. Large bi-value nephrotomies result in a 36% loss of function. Simultaneous study of scintigraphic scans and I.V.U. revealed that a loss of 1 cm in height of the renal parenchyma corresponds to a functional loss of 10% as determined by scintigraphy. Of basic importance is the fact that the impairment caused by nephrotomies remains stable and does not worsen with the passage of time.

Adult↗
PubMed1981

[Extrasinusal ureterocaliceal anastomoses. Review of 27 cases (author's transl)].

Extrasinusal ureterocaliceal anastomoses have been conducted in 27 patients, 21 adults and 6 children, in the Urological Clinic of the Hôpital Necker over the last 10 years. Principal indications, of much greater importance than tuberculosis, are pyelocaliceal lithiasis and certain anomalies of the pyeloureteral junction. In 15 cases, the operation was first choice therapy, while in the other 12 patients it was employed to treat a postoperative cicatriceal stenosis of the subpyelic portion of the ureter. "Peripheral" ureterocaliceal anastomosis (the ureter is sutured to a section of a calyx opened by partial nephrectomy) was carried out in 21 cases, and a "central" anastomosis, suturing the ureter to the base of a calyx after partial nephrectomy, in the 6 others. The most effective drainage method, employed in 14 patients without secretion leak, was nephrostomy at the side of a ureteral sound intubating the anastomosis. The two main postoperative complications were early anastomosis stenosis (6 cases), requiring a repeat operation, and fistulae necessitating prolonged ureteral drainage. Results have remained constant, and of the 25 cases followed up for an average of 2 years, 19 are still perfectly satisfactory (3 of these patients had had repeated ureterocaliceal anastomoses). Results were better after first than second choice ureterocaliceal anastomoses. It should logically be performed as the initial operation, therefore, when required because of the existing pathological condition: destroyed or inaccessible renal pelvis, inability to use the subpyelic portion of the ureter, or very marked pyelocaliceal distension requiring dependent drainage.

Adolescent↗
PubMed1980

[Therapeutic trials in inoperable carcinoma of the bladder (author's transl)].

The authors report the preliminary results of attempts at treatment using radiotherapy and chemotherapy for inoperable carcinoma of the bladder. Chemotherapy alone (cis diamine dichloropalatinum : CDDP) used twice for metastases gave 1 regression of more than 50 % and 1 failure, used twice for non-irradiated pelvic tumours gave 1 regression of more than 50 % and finally was associated with no improvement in 7 patients already irradiated. Chemotherapy (CDDP) associated with a series of flash doses of radiotherapy was used in 6 cases and gave one regression of more than 50 % and one of less than 50 %. Bleomycin in continuous infusion associated with flash radiotherapy was used in 3 cases and gave a regression of more than 50 % of pelvic tumours in two. These poor though not completely nil results have lead the authors to develop a cooperative treatment programme involving the urologist, radiotherapist and chemotherapist.

Adult↗
PubMed1980

[Haematuria as the presentation of a vascular abnormality of the kidney or its excretory system (author's transl)].

The authors report 18 cases of a vascular pathology of the kidney or of its excretory system presenting with heavy and recurrent haematuria. In contrast to data in the literature, their series includes a majority of capillary angiomas (8 cases), as against 6 aneurysms, 2 arteriovenous fistulae and 2 peripyelo-ureteric varices. Of the six arterial aneurysms, all recognised by arteriography, 4 underwent surgery: 2 endo-aneurysmorrhaphies with success, 1 nephrectomy for rupture of the aneurysm and 1 nephrectomy made necessary by the multiplicity of aneurysms inaccessible in situ. Both cases of arteriovenous fistula were recognised by arteriography. One was treated by polar nephrectomy (success) whilst the other underwent nephrectomy after failure of an attempt at embolisation. Of the two cases of peri-uretero-pelvic varices identified by selective phlebography under cover of an intra-renal-artery injection of angiotensin, only one was treated successfully by excision of the varicosities. The eight cases of capillary angioma were divided into two groups: one, of 4 cases where the diagnosis was made by selective renal phlebography without angiotensin and renal arteriography; and another of 4 cases not identified by these vascular investigations. In these 4 cases, after elimination of Berger's disease by a surgical renal biopsy, the authors exposed the kidney, performed a pyelocalyscopy during a period of haematuria, localised the haemorrhagic segment of the kidney and treated the lesion by partial nephrectomy in the presence of a pathologist to immediately identify the haemorrhagic lesion and examine it histologically. Amongst the 7 angiomas treated, 5 partial nephrectomies gave successful results whilst two nephrectomies were necessary: one because of a diagnostic error and the other following failure of an attempt at hyperselective arterial embolisation.

Adolescent↗
PubMed1979

[Replacement of the lower third of the ureter via the bladder (author's transl)].

The author suggests a special incision in the bladder permitting the formation of a tube using a strip of bladder long enough to permit an anti-reflux vesico ureteral reimplantation. The method is a combination of the Boari and the transverse bipartition described by Turner Warwick. Extraperitonealization of the hemi-bladder opposite to the diseased ureter and section of the umbilical artery. Transverse anterior cystostomy at mid height of the bladder. The mobilized dome of the bladder is stitched up to the psoas muscle above the iliac vessels. Creation of a rectangular flat, the anterior limit of which is the superior margin of the transverse cystostomy, of which the upper part is a split which cuts the dome of the bladder from front to back, of which the posterior limit is a split on the posterior wall of the bladder, parallel to the anterior incision. The length must not be larger than one and one half the width of the flap. Reimplantation of the ureter, creation of the tube and closure of the bladder is done without difficulty. Drawings illustrate the technic. Four cases are reported with three successes.

Adult↗
PubMed1979

[Cutaneous urine shunts in adults (author's transl)].

The authors review 123 cases of cutaneous urine shunts in adults. - 93 cutaneous ureterostomies in 63 patients (58 malignant and 5 tuberculous lesions). There were 5 postoperative deaths (8%) and in the 36 operated cases followed-up for varying periods there was 1 death only from progressive renal insufficiency (2.7%), 10 minor incidents (27.8%) and 2 cases with kidney stones (5.5%). Not one of these patients had to be operated on again - 3 cutaneous uretero-ureterostomies with 2 excellent results and necrosis of the foot of the Y in the other case. - 45 transintestinal cutaneous ureterostomies (38 ileal loops and 7 colon grafts) for fistula of the lower urinary tract (2 cases), malignant tumors (35 cases), tuberculosis (1 case), bladder extrophia (1 case), neurological bladder (6 cases). There were 4 early postoperative deaths (8.9%) and 5 severe complications (2 eviscerations, 2 occlusions, 1 digestive tract hemorrhage). Of the 37 operated cases followed-up for varying periods, 5 (13.5%) had diminished renal function, 23 (62%) had late complications requiring further operations in 17 cases (45.9%). These complications were 7 cases of stenosis of the ureter, 1 case of fistual of the ureter, 1 ileal fistula, 4 cases of stenosis of the graft opening, 3 prolapses of the graft, 1 skin lesion, 5 kidney stones and 1 case in which reflux was poorly tolerated. - 12 transprosthetic cutaneous ureterostomies with only 2 good results. No cutaneous shunt operation is exempt from complication. Transprosthetic cutaneous ureterostomies are probably the least affected. Direct cutaneous ureterostomies are statistically better tolerated than transintestinal cutaneous ureterostomies, which appear to have the major inconvenience of deteriorating at a later stage, requiring repeated further operations.

Adult↗