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F Ghesquiere

Publications and source records attributed to F Ghesquiere.

9 recordsLinked to original sources
PubMed1985

[Corticotherapy and surgery. Apropos of 73 cases].

The authors reviewed the outcome of 73 operations performed on 60 patients on long-term steroid therapy: Eighteen operations were carried out for gastro-intestinal perforation but the causal role of steroid therapy was only established in 6 cases (4 gastric and 2 colonic perforations). In the other 12 cases there was intercurrent pathology or a recrudescence of the underlying disease process. More selective indications for steroid therapy and the protective action of new drugs on the gastro-intestinal mucosa are probably responsible for the low incidence of iatrogenic complications compared with previously published series. However, steroid therapy did affect the postoperative course: the risk of infection was 20 to 30 p. 100 higher than normal, very common after emergency surgery (75 p. 100) and a major cause of mortality (60 p. 100); the risk seems to be high when the steroid dose exceeds 0.5 mg/kg/day, the disunion of an anastomosis was observed in 6 cases, including 5 "dirty" operations with a mortality of 60 p. 100, healing was slow: 2 cases of evisceration and 2 of abdominal hernia were observed. It was not possible to assess the threshold dose of steroids with regards to this complication, metabolic complications, especially adrenal failure were much less common. Of the diseases requiring steroid therapy the problem of angiitis seemed particularly prominent. Although the prognosis of the intercurrent surgical condition was not aggravated; mortality from a relapse of the angiitis was nearly 100 p. 100. Therefore, medical control of the relapse would seem to be the first priority and should be taken into account when assessing the surgical indications.

Adult↗
PubMed1984

Respiratory effects of intrathecal morphine after upper abdominal surgery.

The effects of intrathecal (IT) administration of two doses of morphine (Group 1: 2 mg, n = 9; Group 2: 5 mg, n = 10) were studied in 19 patients after upper abdominal surgery. The ventilatory variables and occlusion pressure (P0.1) were recorded during room air breathing and during CO2 rebreathing tests prior to surgery, 24 h after surgery before IT morphine (n = 12), and 3, 5, 7, 11, and 24 h after injection. During room air breathing, minute ventilation (VE) did not change significantly in Group 1 and decreased significantly 3, 5, 7, and 11 h after injection in Group 2. During the rebreathing tests, there was a significant shift to the right of the ventilatory response to CO2 in both groups. The peak of the ventilatory depression was delayed, occurring 7 h and 11 h postinjection in Groups 1 and 2, respectively. Two patients in Group 2 developed clinically significant ventilatory depression. The shallow breathing observed after surgery was not changed after analgesia. In group 2, 5, mg IT morphine was responsible for a significant decrease in f60 (respiratory frequency for a PETCO2 of 60 mmHg). P0.1 increased markedly after surgery during both room air breathing and the rebreathing tests. After IT morphine, compared with the postoperative preanalgesic values, P0.1(60) (P0.1 at a PETCO2 of 60 mmHg) did not change in Group 1 and decreased significantly in Group 2. It is concluded that IT morphine is responsible for a ventilatory depression that is delayed and seems to be dose related and that analgesia does not abolish the shallow breathing observed after upper abdominal surgery.

Abdomen↗
PubMedDate not supplied

[Diagnosis and treatment of a hydatid cyst of the liver. Report of 52 cases (author's transl)].

A series of 52 hydatid cysts of the liver is reported. It is emphasized that diagnosis should be easily done with simple explorations as liver scan, echography, immunologic tests. As far as treatment is concerned the possibility of anaphylactic accidents during operation must be kept in mind. To avoid as much as possible postoperative complications special attention must be taken in the choice of the operative technic. In young, unilocular cysts hydatidectomy should be performed. In old cysts complete resection of both cyst and adjacent hepatic parenchyma (pericystectomy) gives the best results.

Biliary Fistula↗
PubMedDate not supplied

[Parietal complications of cholecystectomy : results of prophylactic antibiotic therapy with cefazoline (author's transl)].

Patients undergoing cholecystectomy were randomly divided into two groups. The effects of a single injection of one gram of cefazoline given thirty minutes before operation to 30 patients were compared with those obtained in a second group of 29 untreated cases. The efficiency of the second generation cephalosporins in preventing postoperative complications of this type was confirmed. Prophylactic administration of this antibiotic therapy before uncomplicated biliary tract surgery can significantly reduce the incidence of postoperative parietal infections and therefore the duration of hospitalization.

Adult↗
PubMedDate not supplied

[Value of duodenostomy in cases where duodenal stump closure is difficult following gastrectomy for ulcer (author's transl)].

The authors report 3 cases of gastrectomy with terminal duodenostomy in patients which were operated on in emergency for large duodenal ulcers. They outline the history of this method, which seems to be seldom used in France. Technic and results are presented. This procedure is advised when closure of the duodenal stump is difficult and may lead to postoperative leakage : it is therefore advocated in large perforated ulcers involving the anterior wall of the duodenum.

Adult↗