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Biomedical subjects

F Hakami

Publications and source records attributed to F Hakami.

At least 19 recordsLinked to original sources
PubMed2001

[Renal transitional carcinoma and caval tumor thrombus].

Transitional cell carcinoma of the kidney with caval tumour thrombus is extremely rare. The authors describe the radiological signs suggesting the preoperative diagnosis and guiding the therapeutic approach. They present the case of a 51-year-old patient with excluded caliceal stones, and review 17 cases published over a period of 24 years during which considerable progress has been made in radiological investigations. Only CT appears to be able to indicate this aetiology and allows retrograde ureteropyelography looking for a tumour of the urinary tract. MRI provides the best assessment of tumour involvement of the inferior vena cava. Nephroureterectomy with excision of a perimeatal bladder cuff and cavotomy is the only oncological surgical procedure, despite the extremely poor prognosis.

Carcinoma, Transitional Cell↗
PubMed2001

[Report of 2 cases of arterio-ureteral fistula].

Uretero-arterial fistulas are exceptional complications: only about forty cases have been reported in the literature. The authors report new two cases of fistula between the common iliac artery and the ureter. One fistula occurred in a context of prolonged ureteric stenting after radiotherapy and pelvic surgery for cancer of the uterus, and the other occurred after an aorto-bifemoral allograft. These fistulas generally occur in a particular clinical context, associating several aetiological factors. The clinical presentation is dominated by often massive and intermittent haematuria. The most useful diagnostic examinations are retrograde ureteropyelography and arteriography. The proposed treatment options (nephrectomy, vascular bypass graft and even embolization) depend on the urgency of the situation and involve both the blood vessel and the urinary tract. The prognosis depends on early diagnosis, but preventive measures can be envisaged to decrease the risk of appearance of these fistulas in high-risk patients.

Female↗
PubMed1994

[Stenosis of the vesico-urethral anastomosis. Our experience with 114 radical prostatectomies].

The authors report a retrospective series of 114 radical prostatectomies performed over a ten-year period. This study was designed to investigate the factors likely to cause complications in order to prevent them. Stenosis of the vesicourethral anastomosis was observed in 22 patients and represented the commonest complication (19.2%). It generally occurred before the 12th month, while late stenoses. An anastomotic leak after removal of the bladder catheter appears to be the most significant factor. The decreasing incidence of these stenoses over the ten-year study period illustrates the role of operator experience. The most effective treatment for these stenoses is mono-incision which, completed by dilatation sessions, prevents recurrence without compromising continence.

Aged↗
PubMed1994

[Late renal and hypertensive complications of extracorporeal lithotripsy. Myth or reality?].

Extracorporeal shock wave lithotripsy (ESWL) has produced dramatic advances in the surgical management of urinary calculi. However this new procedure could induce deleterious effects as loss of renal function and hypertension. Animal studies show that ESWL induces focal areas of necrosis and subsequent fibrosis in renal tissue. In humans, imaging technics demonstrate renal alterations in 80% of the patients. Acute renal hemodynamic and functional changes is frequent but transient in most of the cases. Some studies have shown a tendancy to an increase in blood pressure related to a decrease in renal plasma flow in one study. However most of these results are based on retrospective surveys of blood pressure and renal function. Therefore prospective clinical trials are needed to investigate the important questions of ESWL-induced hypertension and decrease renal function.

Animals↗
PubMed1989

[Etiology of urethral stenosis. I. After transurethral resection of the prostate. Apropos of 2 comparative series. Review of the literature].

The authors study the incidence of urethral strictures after transurethral resection of prostate. A retrospective study of 135 patients and a prospective study of 187 patients found respectively 74% and 3.2% of urethral stenosis. Two important data are seen in this study, the duration of urethral catheter of 24 hours post operatively and the internal urethrotomy when they found a pathologic urethra pre operatively reduce the incidence of urethral strictures. With a normal urethra pre operatively and 24 hours of urethral catheter post operatively, any stenosis occurred, equally when an internal urethrotomy is done with a pathologic urethra pre operatively.

Cystoscopy↗
PubMed1989

[Intra-diverticular tumors of the bladder. Natural history and management perspectives].

The review of the literature and our study of 15 tumors in bladder diverticula (IDT) show us that these tumors are rare and mainly observed in elderly adult males. Bleeding is the major symptom. Diagnosis is difficult and treatment is not well defined. Prognosis is good for low stage tumors and catastrophic in the short term for high stage tumors. Nearly half of IDT were primary tumors, and one third of them stay primary until death of the patients. Most of the high stage tumors contained a squamous cell differentiation and all the tumors with these features were deeply invasive. The bad prognosis is mainly related to the difficult and delayed diagnosis, with a long symptomatic period, regardless of treatment. This emphasizes the need for further investigations (biopsies, sonography, computer tomography) when the diagnosis is not evident. The treatment of these tumors depends on the general status of patients and the volume and stage of tumors. Low stage tumors (Ta) and diverticula could be treated either by transurethral resection or by open surgery with good results. In (T1) tumors, only open surgery is recommended to avoid loco-regional relapse. High stage tumors (greater than or equal to P T3) were treated by either TUR or open palliative surgery with the same bad prognosis. No radical treatment was indicated since patients have a bad performance status and most of the tumors extended beyond the diverticulum. Adjuvant treatments were not helpful. While preventive diverticulectomy is to be discussed case by case, we think that an important step in improving the prognosis of these tumors is to make the diagnosis at an earlier stage.

Aged↗
PubMed1989

[Intracystic tumors of the kidney. Apropos of 3 cases].

The authors report three cases of cystic tumors of the kidney: one benign papillary tumor and two renal cell carcinomas. Although the clinical features were atypical, the authors emphasize the role of computer tomography which make easier the diagnosis of these scarce tumors. When the diagnosis is doubtful a guided needle biopsy is recommended.

Aged↗
PubMed1989

[Internal urethrotomy in the treatment of stenosis of the urethra. Late results and a review of the literature].

The authors report their experience with 37 patients treated by internal urethrotomy for urethral strictures. The results were appreciated on urethral calibration and flow rate after a median follow-up of 33,5 months and a minimal follow-up of one year. The rate of satisfying results was 78,3%. The authors emphasize the need of dilatations associated to low-doses of cortico-steroids in the post-operative period during the first three months, to improve the results.

Adult↗
PubMed1985

[Surgical resection of hepatocellular carcinoma. Retrospective study of 42 cases].

We studied the results 42 liver resections performed for hepatocellular carcinoma. Thirty-three patients underwent major liver resections. Hepatocellular carcinomas were associated with cirrhosis in 30.9 p. 100 of cases. The overall operative mortality was 24.3 p. 100: 60 p. 100 in patients with cirrhosis who underwent major liver resections and 12.5 p. 100 in patients with cirrhosis undergoing limited resections. The overall 5-year survival rate was 14.8 p. 100; the 5-year survival rate in patients with hepatocellular carcinoma without cirrhosis was 20 p. 100 whereas no patient with associated cirrhosis of the liver survived at 3 years. We conclude that surgical resection of hepatocellular carcinoma must be performed whenever possible: a limited resection should be done if the tumor is small, especially in patients with cirrhosis; a major liver resection must be proposed when the tumor is large and if the remaining liver parenchyma is normal.

Carcinoma, Hepatocellular↗
PubMed1985

[Leiomyosarcoma of the small intestine. Apropos of 3 cases].

The authors report three cases of leiomyosarcomas of the small intestine and review the literature on this subject. Leiomyosarcomas of the small intestine are rare tumours, representing 0.2% of all malignant tumours of the gastrointestinal tract. These large, round, hypervascular tumours are derived from smooth muscle cells in the intestinal wall and often develop extra-luminally. The malignant nature is often difficult to confirm on the histological examination. The clinical signs often only appear when the tumour has reached a large volume. It is rare to make the diagnosis pre-operatively, despite the use of a number of investigations. Arteriography is the most reliable examination. Spread of the disease is essentially haematogenous. The malignant tumour invades adjacent organs, causes hepatic metastases and peritoneal seedlings and tends to recur locally. The treatment is essentially surgical and the prognosis varies according to the size of the tumour, its grade, its activity and its degree of extension. The 5-year survival of all forms of the disease varies between 20 and 50%, according to the series.

Aged↗
PubMed1982

[Palliative treatment of carcinoma of the hepatic duct junction. Intra-hepatic derivation or trans-tumoral intubation? (author's transl)].

Intra-hepatic cholangiojejunostomy (group I patients) and simple trans-tumoral intubation (group II patients) were retrospectively compared in a series of 44 patients with primary carcinoma of the hepatic duct junction. Hospital mortality was 30% in the 13 group I patients and 9.5% in the 21 group II patients. Jaundice and pruritus were equally relieved in both groups. The mean survival time (hospital deaths excluded) was 16 months in group I and 12 months in group II patients. It is concluded that the decision as to which of these two palliative surgical procedures should be performed must rest on the degree of biliary duct distension as well as on the patient's age and general condition.

Adult↗