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Emmanuel Barranger

Publications and source records attributed to Emmanuel Barranger.

32 records · Page 2Linked to original sources
PubMed2004

Metastasis on a Schuchardt incision after Schauta-Amreich operation for cervical carcinoma.

BACKGROUND: Laparoscopic pelvic lymph node dissection in combination with a vaginal radical Schauta-Amreich operation has become an alternative for women with early-stage cervical cancer. CASE: We described the first case of metastasis on Schuchardt's incision after Schauta-Amreich operation for neuroendocrine cervical cancer. CONCLUSION: Metastasis on Schuchardt's incision after Schauta-Amreich operation can rarely be the metastatic localization of the cervical carcinoma.

Female↗
PubMed2004

Value of intraoperative imprint cytology of sentinel nodes in patients with cervical cancer.

OBJECTIVE: The purpose of this study was to evaluate intraoperative imprint cytology (IC) for the detection of sentinel node (SN) involvement in patients with cervical cancer. METHODS: Thirty-six consecutive patients with cervical cancer underwent a laparoscopic SN procedure with intraoperative IC, followed by complete laparoscopic pelvic lymphadenectomy, with or without laparoscopic para-aortic lymphadenectomy. The SN was bisected and both cut surfaces were applied to the surface of glass slides. Permanent sections were stained with H&E and immunohistochemical methods. The IC results were compared with the final histological results. RESULTS: At least one SN (mean: 2 SN per patient, range: 1-5) was detected in 34 of the 36 patients. Eight patients (22.2%) had a total of 12 metastatic SNs (four macrometastatic, five micrometastatic, and three with isolated tumor cells). No false-negative results of SN biopsy were obtained. Only one metastasis was identified by IC. No false-positive findings were obtained with IC. The overall sensitivity, specificity, accuracy, and positive and negative predictive values of IC were 8.3%, 100%, 85.7%, 100%, and 85.5%, respectively. CONCLUSION: These results suggest that intraoperative imprint cytology of sentinel nodes is unreliable in patients with cervical cancer.

Adult↗
PubMed2004

Lymphatic mapping for gynecologic malignancies.

In gynecologic malignancies, regional lymph node status is a major prognostic factor and a decision criterion for adjuvant therapy. This is the basis for lymphadenectomy. The sentinel node (SN) procedure has emerged as an alternative to systematic lymphadenectomy in various cancers, reducing treatment-related morbidity. In melanoma and breast cancer, SN biopsy is the standard procedure for determining nodal stage. Use of the SN procedure is also well established in vulvar cancer. In small series, combined SN detection based on blue dye and radiocolloid was suitable for the evaluation of lymph node status in cervical cancer. Although some investigators have reported the feasibility of the SN procedure in endometrial cancer, further studies and standardization are required before its routine use can be recommended.

Endometrial Neoplasms↗
PubMed2004

Laparoscopic sentinel node procedure using a combination of patent blue and radiocolloid in women with endometrial cancer.

BACKGROUND: We assessed the feasibility of a laparoscopic sentinel node (SN) procedure based on the combined use of radiocolloid and patent blue labeling in patients with endometrial cancer. METHODS: Seventeen patients (median age, 69 years) with endometrial cancer of stage I (16 patients) or stage II (1 patient) underwent a laparoscopic SN procedure based on combined radiocolloid and patent blue injected pericervically. After the SN procedure, all patients underwent complete laparoscopic pelvic lymphadenectomy and either laparoscopically assisted vaginal hysterectomy (16 patients) or laparoscopic radical hysterectomy (1 patient). RESULTS: SNs (mean number per patient, 2.6; range, 1-4) were identified in 16 (94.1%) of the 17 patients. Macrometastases were detected in three SNs from two patients by hematoxylin and eosin staining. In three other patients, immunohistochemical analysis identified six micrometastatic SNs and one SN containing isolated tumor cells. No false-negative SN results were observed. CONCLUSIONS: An SN procedure based on a combination of radiocolloid and patent blue is feasible in patients with early endometrial cancer. Combined use of laparoscopy and this SN procedure permits minimally invasive management of endometrial cancer.

Aged↗
PubMed2004

Laparoscopic sentinel node procedure for cervical cancer: impact of neoadjuvant chemoradiotherapy.

BACKGROUND: SN detection based on combined blue dye and radiocolloid labeling can reliably show lymph node status in cervical cancer, but the influence of prior neoadjuvant chemoradiotherapy has not yet been reported. The aim of this study was to evaluate the effect of neoadjuvant chemoradiotherapy on the accuracy of a dual-labeling laparoscopic sentinel node (SN) procedure in patients with cervical cancer. METHODS: Between July 2001 and June 2003, 26 patients (mean age, 50.3 years) with cervical cancer underwent a laparoscopic SN procedure based on dual labeling with patent blue and radiocolloid. After the SN procedure, all the patients underwent complete laparoscopic pelvic lymphadenectomy and laparoscopic radical hysterectomy (n=19), the Schauta-Amreich operation (n=5), or trachelectomy (n=2). The results of the SN procedure were compared between 11 patients who received neoadjuvant chemoradiotherapy and 15 patients who did not receive neoadjuvant treatment. RESULTS: The SN identification rates were 100% in the 11 patients who underwent neoadjuvant chemoradiotherapy and 93.3% in the 15 patients who did not receive adjuvant therapy. A total of 59 SNs were removed. Eight SNs (13.6%) from five patients (19.2%) were found to be metastatic at the final histological assessment. Three SN involvements were detected by hematoxylin and eosin staining of the SN. Immunohistochemical studies identified five metastatic SNs in three patients. There were no false-negative SN results. CONCLUSIONS: This study suggests that SN detection with a combination of radiocolloid and patent blue is feasible and accurate in patients with cervical cancer undergoing neoadjuvant chemoradiotherapy or primary surgery. The combination of laparoscopy and the SN procedure permits minimally invasive management of cervical cancer.

Chi-Square Distribution↗
PubMed2004

Epithelioid angiomyolipoma of the uterus: a case report.

BACKGROUND: Epithelioid angiomyolipoma is a recently recognized pathologic entity. The occurrence of epithelioid angiomyolipoma in thefemale genital tract is rare. CASE: A case of uterine epithelioid angiomyolipoma occurred in a young woman without tuberous sclerosis and underwent an early recurrence with lymph node metastasis. CONCLUSION: Uterine epithelioid angiomyolipoma should be considered in young women with a tumor exhibiting high intratumoral linear vascularity and aneurysmal dilation.

Adolescent↗
PubMed2003

Sentinel lymph nodes.

Explore the source record for details and available documents.

False Negative Reactions↗
PubMed2003

Laparoscopic sentinel lymph node procedure using a combination of patent blue and radioisotope in women with cervical carcinoma.

BACKGROUND: The authors evaluated the feasibility of a laparoscopic sentinel lymph node (SN) procedure with combined radioisotopic and patent blue labeling in patients with cervical carcinoma. METHODS: Thirteen women (median age, 52.5 years) with cervical carcinoma (Stage Ia2 in 1 patient, Stage Ib1 in 10 patients, Stage Ib2 in 1 patient, and Stage IIa in 1 patient) underwent a laparoscopic SN procedure using an endoscopic gamma probe after both radioactive isotope and patent blue injections. After the procedure, all patients underwent complete laparoscopic pelvic lymphadenectomy and either laparoscopic radical hysterectomy (eight patients) or the Schauta-Amreich operation (five patients). RESULTS: SNs (mean, 1.7 SNs per patient; range, 1-3 SNs per patient) were identified in 12 of 13 patients. A median of 10.5 pelvic lymph nodes per patient (range, 4-17 pelvic lymph nodes per patient) were removed. No lymph node involvement was detected in SNs with hematoxylin and eosin staining. Immunohistochemical studies identified four metastatic SNs in two patients, with micrometastases in two SNs from the first patient and isolated tumor cells in two SNs from the second patient. No false-negative SN results were obtained. CONCLUSIONS: The results of this study suggest that SN detection with a combination of radiocolloid and patent blue is feasible in patients with cervical carcinoma. The combination of laparoscopy and the SN procedure permitted minimally invasive management of early-stage disease.

Adult↗
PubMed2003

Abdominal sacrohysteropexy in young women with uterovaginal prolapse: long-term follow-up.

OBJECTIVE: The purpose of this study was to evaluate the long-term efficiency after abdominal sacrohysteropexy in women with uterovaginal prolapse. STUDY DESIGN: We conducted a retrospective chart review at our tertiary referral urogynecology unit. Thirty women of childbearing age with uterovaginal prolapse who wanted uterine preservation underwent abdominal sacrohysteropexy between 1987 and 1999. RESULTS: The mean age of the women was 35.7 years (range, 29-43 years). All women were parous. Thirteen women had grade 2 uterovaginal prolapse, and 17 women had grade 3 prolapse. In all women, the Burch procedure and posterior colporrhaphy were performed at the same time. Intraoperative and postoperative complications occurred in 2 patients (6.6%) and 4 patients (13.3%), respectively. The mean objective and subjective follow-up periods were 44.5 months (range, 2-156 months) and 94.6 months (range, 8-160 months), respectively. At the time of the last physical examination, there were two cases of recurrent uterovaginal prolapse (6.6%), which was symptomatic in 1 patient and required repeat surgical treatment. At the time of the last questionnaire, apart from the patient who underwent repeat surgery, no patients had any uterovaginal prolapse symptoms. Three women had pregnancies that were conceived spontaneously, which led to three early legal abortions. CONCLUSION: The abdominal sacrohysteropexy is effective and safe in the treatment of uterovaginal prolapse in women of childbearing age. This procedure has a high success rate in correcting prolapse without a time-dependent decrease in efficiency.

Adult↗
PubMed2003

Evaluation of fluorodeoxyglucose positron emission tomography in the detection of axillary lymph node metastases in patients with early-stage breast cancer.

BACKGROUND: The aim of this study was to assess the capacity of positron emission tomography (PET) with fluorodeoxyglucose (FDG) to determine axillary lymph node status in patients with breast cancer undergoing sentinel node (SN) biopsy. METHODS: Thirty-two patients with breast cancer and clinically negative axillary nodes were recruited. All patients underwent FDG-PET before SN biopsy. After SN biopsy, all patients underwent complete axillary lymph node (ALN) dissection. RESULTS: The SNs were identified in all patients. Fourteen patients (43.8%) had metastatic SNs (macrometastatic in seven, micrometastatic in six, and isolated tumor cells in one). The false-negative rate of SN biopsy was 6.6% (1 in 15). FDG-PET identified lymph node metastases in 3 of the 14 patients with positive SNs. The overall sensitivity, specificity, and positive and negative predictive values of FDG-PET in the diagnosis of axillary metastasis were 20%, 100%, 100%, and 58.6%, respectively. No false-positive findings were obtained with FDG-PET. CONCLUSIONS: This study demonstrates the limitations of FDG-PET in the detection of ALN metastases in patients with early breast cancer. In contrast, FDG-PET seems to be a specific method for staging the axilla in breast cancer. SN biopsy can be avoided in patients with positive FDG-PET, in whom complete ALN dissection should be the primary procedure.

Adult↗
PubMed2002

Reproductive performance after hysteroscopic metroplasty in the hypoplastic uterus: a study of 29 cases.

OBJECTIVE: To evaluate the reproductive performance after hysteroscopic metroplasty performed for hypoplastic uterus. DESIGN: Crossover study (15 patients) and descriptive analysis (14 patients). SETTING: Tertiary care university hospital. POPULATION: Twenty-nine women (mean age: 31.4 years; range: 27-38.5 years) with a hypoplastic malformed uterus and a history of primary infertility and/or recurrent abortion and/or preterm delivery were included in this study. Fourteen women suffered from primary infertility and 15 women had previous pregnancies. Twenty-three women had been exposed to diethylstilboestrol in utero. METHODS: Women underwent hysteroscopic metroplasty between January 1996 and May 1999. MAIN OUTCOME MEASURES: Rate of pregnancies and live births, anatomical results. RESULTS: The mean follow up was 40 months (range: 13-67 months). Twenty-one women (72.4%) experienced 30 pregnancies. Thirteen women gave birth to 16 live infants. At the time of the follow up, four women were pregnant in the second trimester. Compared with previous pregnancies, the rate of deliveries increased from 3.8% to 63.2%. No complications occurred during metroplasty. The hysteroscopic anatomical results were good in all cases. CONCLUSIONS: Our results suggest that hysteroscopic metroplasty, with its simplicity and minimal post-operative sequelae, seems to be an operation of choice in women with a hypoplastic malformed uterus and a history of severe infertility and/or recurrent pregnancy loss.

Abortion, Habitual↗