PubMed Health⌕ Search

Biomedical subjects

E Pelissier

Publications and source records attributed to E Pelissier.

At least 19 recordsLinked to original sources
PubMed1992

Conventional external irradiation alone as adjuvant treatment in resectable pancreatic cancer: results of a prospective study.

Between 1/85 and 1/90, 14 consecutive patients were entered into a prospective study of conventional adjuvant post-operative external beam radiotherapy after complete resection for a pancreatic adenocarcinoma. The surgical procedure was a Whipple resection in nine patients, a distal pancreatectomy in four patients and a total pancreatectomy in one patient. There were three T1b, eight T2 and three T3 tumours (UICC 1987); nodal involvement was present in five cases. The radiotherapy was delivered using a four-field box technique with a 23 x MV photon beam. All patients received a total dose of 54 Gy to the tumour bed. The mean treated volume was 900 cm3. Acute toxicities consisted mainly of weight loss (mean: 2 kg). Two patients had a grade 2 diarrhoea and two patients a grade 2 gastritis. Late effects were minimal and only observed in two patients. The overall locoregional recurrence (LR) rate was 50%. The median disease-free survival was 12 months, and the median survival was 23 months. This post-operative conventional radiotherapy treatment gives results that are comparable to the results of the GITSG-adjuvant study using a combination of split-course radiotherapy and 5-fluorouracil (5-FU).

Carcinoma, Intraductal, Noninfiltrating↗
PubMed1991

[Advantages and limits of programmed autologous transfusion in cardiovascular surgery. Apropos of 524 patients].

Between October 1987 and July 1989, 544 patients, candidates for cardiovascular surgery, were included in a trial of programmed autologous autotransfusion. Five hundred and twenty four patients underwent one or several (maximum 4) blood donation sessions in the 3 weeks before surgery with no complications. Overall, 57% of patients benefited from homologous blood transfusion, thereby avoiding all risk of contamination. It was in the group of patients able to undergo 3 or 4 preoperative blood donations that we observed the smallest number of homologous transfusions (30%). Programmed autologous transfusion would seem to be a very useful technique for cardiac surgery, allowing a reduction in health care costs without additional patient risk. In order to improve on this method, it may be useful to associate a peroperative technique of blood recuperation in patients in whom the transfusion needs are likely to exceed the possibilities of preoperative blood donation alone.

Blood Transfusion, Autologous↗
PubMed1990

[Tolerance and efficacy of delayed autologous transfusion in cardiovascular surgery].

Over a period of 18 months, 313 patients (mean age 52 years) undergoing elective cardiovascular surgery were included in the autologous transfusion program involving two different Transfusion Centres. A further 10 patients were excluded because of anaemia (haemoglobin levels less than 11 g.dl-1) (n = 3), angina pectoris less than 8 days before (n = 3), patient refusal (n = 2), pneumonia (n = 1), and severe aortic insufficiency (n = 1). A maximum of 5 ml.kg-1 of blood was obtained during the 3 to 4 weeks prior to surgery, one donation being taken a week. In one Transfusion Centre, the blood was taken without tourniquet, and without any fluid replacement. Diuretics and converting enzyme inhibitors were stopped. In the opposite, in the other Centre, blood was taken using a tourniquet, and replaced by a gelatin solution (Plasmion). All the patients were given iron. The blood units were kept by the Transfusion Centres under the same conditions as homologous blood, but in a separate circuit. The 313 patients predeposited a mean of 2.71 units of blood: 4 units where obtained in 59 patients, 3 in 113, 2 in 133 and only 1 in 8. Mean haemoglobin level on starting the program was 14.49 g.dl-1. Neither homologous red cells nor plasma was administered in 176 patients (56.23%); among the 172 patients who predeposited 3 or 4 units, 123 (71.5%) were given their own blood only. Intraoperative blood salvage was used in 189 out of 313 patients (60.4%), and intraoperative haemodilution with albumin was used in 173 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Primary carcinoma of the gallbladder. Adjuvant postoperative external irradiation.

Seven patients received the same postoperative (Postop) external-beam irradiation (NRT) after apparent complete removal of gallbladder carcinoma between August 1983 to February 1988. A dosage of 4600 cGy were delivered on a first volume (average treated volume 0.87 liters) corresponding to this of potentially locoregional disease, completed by a boost dose of 900 cGy on the gallbladder bed. Moderate acute side effects were seen in five patients; regressive dyspepsia in three and mean weight loss of 1.5 kg in three. The minimum follow-up is 5 months and the maximum is 58 months. Five patients are alive with no evidence of disease (NED) after 5, 9, 11, 31, and 58 months, respectively. One died at 12 months with local recurrence, liver metastasis, and peritoneal implants. Another one died at 26 months of abdominal recurrence. With regard to the natural history of this tumor, the dismal results obtained by surgery alone, and our preliminary data, we advocate Postop adjuvant XRT as a safe treatment.

Aged↗
PubMed1989

[Effect of proximal gastric vagotomy on the competence of the lower sphincter of the esophagus].

The aim of this prospective study was to assess the effects of highly selective vagotomy on lower esophageal sphincter pressure, and to determine whether or not it leads to increased gastroesophageal reflux. Fifteen patients (4 females, 11 males), mean age 43 years (22-63) suffering from duodenal ulcer without any clinical or pH evidence of gastroesophageal reflux were treated by highly selective vagotomy. All of them were studied before and 3-6 months after operation by history taking, pH reflux, manometric, and acid secretory pentagastrin tests. After operation none of the 15 patients had clinical evidence of duodenal ulcer or gastroesophageal reflux. The basal and stimulated acid outputs were decreased after vagotomy; pre and postoperative values were 6.8 +/- 8.9 mmol/h and 0.9 +/- 1.6 mmol/h; 42.2 +/- 10.3 mmol/h and 21.4 +/- 6.4 mmol/h, for BAO and PAO respectively (p less than 0.001). The lower esophageal sphincter pressure was 22.5 +/- 5.6 cm H20 before and 21.1 +/- 4.9 cm H20 after surgery (p less than 0.01). None of the values were lower than normal. There was no significant difference in pH reflux tests; the total duration of pH less than 5 reflux was 1.2 +/- 2.1 p. 100 before, and 1.9 +/- 2.8 p. 100 after vagotomy. These results suggest that an efficient highly selective vagotomy does not impair lower esophageal sphincter efficiency in patients-without gastroesophageal reflux, and that the routine addition of an antireflux procedure is not well advised.

Adult↗
PubMed1986

[A safe trans-gallbladder drain].

The new transcystic drain described is provided with 3 wings which ensure that it remains in the common bile duct even after the ligature is absorbed, with a series of bosses which ensure good adherence to the skin and avoid all traction on the intraluminal end of the drain, and with a bile collection system which prevents contamination at counter-current.

Common Bile Duct↗
PubMed1986

Partial reversal of low molecular weight heparin (PK 10169) anti-Xa activity by protamine sulfate: in vitro and in vivo study during cardiac surgery with extracorporeal circulation.

Neutralization of a low molecular weight (LMW) heparin fraction by protamine sulfate was evaluated in vitro and in vivo. Anti-Xa and anti-IIa activities were measured by amidolytic and coagulation methods (activated partial thromboplastin time, APTT). Fifteen patients (4 males and 11 females) underwent surgery with extracorporeal circulation. In vitro, anti-Xa and anti-IIa activities and APTT of unfractionated heparin were neutralized with a protamine/heparin (P/H) gravimetric ratio of 1.6, 1.33 and about 2, respectively. Anti-IIa activity and APTT induced by PK 10169 were completely corrected at a P/H ratio of 1 and 2, respectively, while anti-Xa activity was incompletely neutralized at a ratio of 5. In vivo, in 9 patients who did not receive intravenous protamine sulfate, a good correlation was found between doses of PK 10169 infused, anti-IIa plasma level and blood loss. In 3 patients who were treated prophylactically with protamine, bleeding was normal or only slightly increased. In 3 patients who received protamine because of hemorrhage, mean anti-Xa and anti-IIa were 2.3 and 0.54 U before and 1.32-0.06 U after neutralization. Bleeding was stopped by a second dose of protamine in 1 patient, but blood loss was abnormal in the other patients. However, a correlation between bleeding and anti-Xa or anti-IIa activities was not clearly evident.

Adolescent↗
PubMed1986

[Anatomo-pathological factors in the prognosis of rectal cancers. A mono- and multifactorial study].

Pathological prognostic factors of rectal adenocarcinoma were studied retrospectively in 173 patients who underwent curative resection between 1970 and 1980. Analysis was mono- and multifactorial. Minimal and median follow-up were 24 and 66 months respectively. Three factors had a favorable influence on the local failure (LF) and distant metastasis (DM) risks: length of the tumor less than 2 cm; polypoid aspect; Astler-Coller's stage A. Four factors increased the LF risks: perineural invasion (LF = 57 p. 100); poorly differentiated or colloid tumors (LF = 50 p. 100); lymph node metastasis (LF: 43 p. 100); lymphatic invasion (LF = 36 p. 100). Two factors increased the DM risks: perineural invasion (DM = 43 p. 100); lymph node metastasis (DM = 37 p. 100). The multifactorial analysis showed that the risk factors were the same for LF as for DM. Perineural invasion (p less than 0.001), lymph node metastasis (p less than 0.002), level of extension of the tumor in the rectal wall (p = 0.005) were the most important factors for local recurrences. Lymph node metastasis (p less than 0.001), perineural invasion (p = 0.03) and level of extension in the wall (p = 0.05) were the most important factors for DM. These data suggest that a failure risks scale may be established and can be of help in stratifying patients in adjuvant treatment studies.

Adenocarcinoma↗
PubMed1985

[Pseudotumoral form of hepatic tuberculosis. Apropos of a case report].

Concerning one case of autonomous hepatic tuberculosis in a pseudo-tumoral aspect, the difficulties of making the diagnosis are brought to light. Liver biopsy is the best examination to clarify things, either performed under ultrasonic control or during surgery. This biopsy permits pathologic examination and culture of a liver fragment in Lowenstein medium. But in fact, only isolation of the tubercle bacillus at the liver level confirms presence of tuberculosis.

Aged↗