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Biomedical subjects

E Reboud

Publications and source records attributed to E Reboud.

At least 19 recordsLinked to original sources
PubMed1992

[Bronchial cancer associated with atheromatous arteriopathy. Prognostic and therapeutic consequences in pulmonary excision].

Between January 1980 and January 1985, 462 consecutive patients underwent lung resection for bronchogenic carcinoma. Eighty of these patients (17.3 percent) had atherosclerosis involving mainly the coronary arteries (40 percent). The mortality rate was significantly higher in patients with atherosclerosis (10 percent) than in those without it (4.7 percent), but the long-term survival was not affected with the presence of atherosclerosis. The lung carcinoma-atherosclerosis association raises two problems: what investigations should be carried out in this group of patients at risk, and what treatment should be given priority when vascular lesions are present and likely to become complicated by pulmonary surgery? However, the presence of atherosclerosis should not lead to a re-evaluation of the need for lung resection.

Adult↗
PubMed1992

[Results of surgery of non-small cell primary bronchial cancers. Retrospective analysis of 452 resections].

Data from 452 patients who underwent pulmonary resection for a non small cell bronchogenic carcinoma from 1980 to 1985 were analysed retrospectively. The operative mortality rate was 5.5%. Mortality was significantly increased in patients who underwent enlarged resections for T4 tumors (20%; p < or = 0.05), and in patients who were 70 years and older (12.8%; p < or = 0.05). The overall 5-years survival rate was 32.7% at 5 years. Prognosis in patients who were 70 years and older was similar to that in younger patients. No difference in survival was observed in patients with lymph node metastases with regard to the operative procedure (pneumonectomy versus lobectomy). Survival in patients without lymph node metastases who underwent a lobectomy was similar to those who underwent a conservative resection. Prognostic significance of the histologic cell type and the tumor formula (pTNM) was assessed by multivariable analysis. There were statistically significant differences between squamous cell carcinoma and both adenocarcinoma (p < or = 10(-5)) and undifferentiated carcinoma (p < or = 0.01). This study confirmed the validity of the TNM classification (4th ed) for the accurate prognosis evaluation. Lymph node involvement appeared to be the most pejorative factor (p < or = 10(-5)).

Adult↗
PubMed1990

[Gastric esophagoplasty in the treatment of cancer of the esophagus].

Between March 1982 and December 1987, 112 patients with oesophageal cancer were treated by gastroplasty following oesophagectomy to restore gastrointestinal continuity. This technique was used in all oesophageal cancers regardless of their site, with the exception of paryngo-oesophageal and oesophago-cardio-fundal cancers. The overall mortality of 12.5% fell to below 6% during the last two years. The postoperative course was straightforward in 54.5% of cases. The most frequent complications were respiratory tract complications (19 cases of ARDS out of 112 patients, i.e. 17%) and fistulae at the oesophago-gastric anastomosis (9 cases out of 112, i.e. 8%). The secondary complications were dominated by anastomotic stenoses (19/98, i.e. 19.3%).

Adult↗
PubMed1990

[Gastroesophageal reflux and respiratory manifestations: diagnostic approach, therapeutic indications and results].

The authors report a study of 140 patients presenting with a non-allergic respiratory tract disease (121 cases of asthma--19 cases of spasmodic cough). Gastro-oesophageal reflux was detected by 24-hour pHmetry in 86 of these patients. In 34 of them (i.e. 40% of cases), the gastro-oesophageal reflux appeared to be responsible for the initial respiratory tract symptoms. These 34 patients were submitted to a therapeutic trial of high dose anti-H2 therapy for at least two months. Only those patients in whom a marked improvement or even complete resolution of the respiratory tracts symptoms was observed underwent anti-reflux surgery. Out of the 13 patients undergoing surgery, there were two failures and 11 good results after a follow-up of more than 18 months.

Asthma↗
PubMed1990

[Preoperative staging of central bronchopulmonary cancer. X-ray CT-MRI-pulmonary digital subtraction angiography and surgery].

In order to evaluate the reliability of medical imaging methods in the assessment of mediastinal invasion by lung cancers, a prospective study was conducted in 30 patients undergoing preoperative computed tomography (CT), magnetic resonance imaging (MRI) and pulmonary digital subtraction angiography. MRI improved the sensitivity of detection of surgically confirmed mediastinal lymphadenopathy, but its specificity in relation to histological results was poor and identical to that of CT. In terms of extension to vascular structures, MRI and CT gave comparable results for the pulmonary artery and vein with two false positives for the pulmonary veins and left atrium with the two methods. MRI was found to be superior to CT for the detection of invasion of the aortic arch. Digital subtraction angiography is not as reliable as the other two modalities, particularly for extension to the pulmonary vein for which it was found to be technically inappropriate. By means of sagittal and frontal scans, MRI was therefore found to be more effective than CT for examination of the subcarinal region and aorto-pulmonary window. In contrast, the persistence of false positives with the two methods and the impossibility of distinguishing between inflammatory lymph nodes and neoplastic lymph nodes means that thoracotomy can never be contraindicated on the basis of the results of imaging alone.

Aged↗
PubMed1989

[Surgical treatment of benign laryngotracheal stenosis. Apropos of 12 cases].

The authors report a series of twelve benign laryngotracheal strictures. In almost every case, these lesions were secondary to tracheal intubation and consisted of extensive, circumferential and almost complete stenosis. All were treated surgically. The authors obtained enlargement of the airway be means of an interposed cartilaginous graft and an intraluminal prosthesis which was left in place. In nine cases, this procedure was combined with posterior cricotomy. One eight month old infant died during the postoperative period. Ten patients had an uneventful postoperative course with a satisfactory anatomical and functional result.

Adolescent↗
PubMed1988

[Inoperable cancer of the esophagus: preliminary results of combined chemotherapy (5-fluorouracil-cisplatin) and radiotherapy].

The aim of this study was to appreciate the tolerance and efficacy of a new nonoperative therapy for inoperable esophageal squamous cell carcinoma based on chemotherapy (5FU-cisplatinum) and concomitant splitcourse radiation therapy. Twenty five symptomatic patients (24 males, 1 female, mean age: 59 yrs, range: 41-72 yrs) were included. Five had 2 esophageal carcinoma, 5 an associated upper respiratory tract tumor and 2, relapse after surgery. Nine patients had a tumor limited to the esophagus (stage I or II) but were considered at high surgical risk. Sixteen had stage III disease with mediastinal involvement in 13 cases, nodal involvement in 4 and distant metastasis in 7. Treatment consisted of 2 cycles of chemotherapy with 5-FU (1 g/m2/24 h by continuous infusion for 5 days, D1-D5 and D29-D33) and cisplatinum (70 mg/m2 IV bolus on D2 and D30). Radiation therapy was concomitant in 2 courses delivering 20 grays in 5 days (D1-D5 and D29-D33). On the first day of the treatment, peroral endoscopic dilation or Nd-YAG laser therapy was applied. At the end of treatment all the patients could eat. Histoendoscopic control was performed 8 weeks after the beginning of therapy. Seventeen of the 24 patients had a complete response with negative biopsies. Of the 7 patients with metastatic disease, only 4 were evaluable for response to chemotherapy: one with hepatic metastasis had a complete response for 12 months, 2 had stable disease and one progressive disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1977

[Surgery for carcinoma of the esophagus. Methods and techniques].

Given the poor prognosis in carcinoma of the oesophagus, and with the aid of advances in anaesthesia and postoperative care, surgery has progressively evolved towards wider excision and a reduction in the number of operative stages. Partial oesophagectomy, with gastrolysis and gastro-oesophageal anastomosis, via a left thoracotomy, is favoured by large number of authors. However, it involves a certain number of disadvantages: by definition a limited excision, unsuitable for carcinomas in the cervical region and a marked risk of postoperative gastro-oesophageal reflux. Total oesophagectomy offers a hope of better results from an oncological standpoint, the more so since excision may be extended superiorly (laryngectomy) or inferiorly (total gastrectomy with lymph node excision). Continuity is re-established using a colonic transplant. The operation may be performed in two stages, though a single stage procedure with two teams would appear to be preferable, overall mortality and morbidity being reduced. Finally, colonic oesophagoplasty may be used alone, as a simply palliative measure, without associated tumour excision. By short-circuiting the oesophageal stenosis, it permits continued alimentation per os and the patient's period of survival is more comfortable.

Colon↗
PubMed1977

[Postoperative complications in esophageal surgery].

Apart from certain complications which may follow any surgical procedure, the authors sought to emphasise in particular the problems posed by fistulae occurring after oesophageal surgery. They draw a clear distinction between cervical fistulae which, draining adequately, do not affect the vital prognosis, merely prolonging the period of hospitalisation, and intrathoracic or sub-diaphragmatic fistulae, with a grave prognosis and which pose delicate problems of re-operation, drainage and intensive care. They feel that the possibility of prevention of these digestive fistulae must be stressed, combining the most meticulous surgical technique with appropriate pre- and postoperative care.

Diaphragm↗