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Biomedical subjects

F Michot

Publications and source records attributed to F Michot.

122 records · Page 7Linked to original sources
PubMedDate not supplied

Anal endosonography after sphincter repair: specific patterns related to clinical outcome.

BACKGROUND: This study evaluates the endosonographic patterns of the anal sphincter after sphincteroplasty to define specific postoperative findings and to identify factors related to clinical outcome after sphincter repair. METHODS: Thirty-one incontinent patients (29 women, two men; mean age = 57 years) who underwent surgical repair for an external sphincter defect were studied postoperatively by endosonography. Twenty patients were found to improve after surgery. RESULTS: Postoperative endosonograms showed specific images: direct visualization of the surgical process was represented by the "overlapping sign" in 17 cases and the "end-to-end suture" in four cases. These echographically favorable cases were associated with improvement after surgery in 18 of 21 patients (p < 0.005). Persistent defects were reduced in five patients and unchanged in five other patients and were associated with poor outcome in eight of 10 patients (p < 0.005). CONCLUSIONS: Postoperative endosonography of the external anal sphincter presented some specific endosonographic aspects. The association between anal endosonographic findings and clinical outcome suggests the use of this procedure to assess patients following sphincteroplasty.

Adult↗
PubMedDate not supplied

[Long-term results of surgical treatment for achalasia of the esophagus].

25 patients were operated with Heller's procedure for achalasia of the esophagus. A study of their clinical, radiological, manopetric and pH-metric evolution was carried out over an average period of 75 months. While the long-term results were satisfactory in 80% of these patients, the poor results were essentially caused by the occurrence of gastroesophageal reflux. An objective study performed by manometry and pH-metry allowed evidencing true asymptomatic acid reflux. It is necessary to devise an anti-reflux valve if the myotomy reaches as far as the cardia.

Adolescent↗
PubMedDate not supplied

[Neuroma of the common bile duct: a rare cause of jaundice].

We report a case of neuroma of the main bile duct arising twenty years after cholecystectomy. The patient, a 82-year-old woman, was admitted for jaundice. Endoscopic retrograde cholangiography showed a regular stenosis of the main bile duct. Histologic examination demonstrated neuroma. Based on the analysis of this and 15 other previously published cases, the following features of bile duct neuroma were outlined: a) variable interval between cholecystectomy and the onset of jaundice (6 months to 35 years); b) the generally complicated postoperative course, c) the various localizations on the biliary tree (cystic, main bile duct, intrahepatic bile duct) and, d) the circumstances of onset.

Adult↗
PubMedDate not supplied

[Appendicular endometriosis. Report of one case (author's transl)].

The authors studied, in one case, the signs of appendicular endometriosis. This endometriosis is discovered either through the symptoms occuring in the right iliac fossa, or during a surgical opération, usually gynecological. They emphasize the easy treatment by appendicectomy.

Adult↗
PubMedDate not supplied

[Superficial gastric cancer. A review of 30 cases].

Thirty cases of superficial cancer of the stomach were treated over a ten-year period from 1984 to 1993. Actuarial survival rate at 5 years was 73%. The depth of cancer invasion has a predominant effect on two prognosis factors: mucosal and submucosal involvement. Invasion of the lymph nodes is more frequent in cases with submucosal invasion. Treatment is based on gastric surgery. Nevertheless, if the diagnosis of superficial cancer is certain before operation and deep extension is clearly identified by histology and especially by echoendoscopy, more selective surgery could be justified: R1 type exeresis for cancers involving the mucosa only and R2 type exeresis for submucosal involvement.

Aged↗
PubMedDate not supplied

[Appendiceal mucoceles. Pathophysiology and therapeutic indications].

Appendiceal mucoceles (AM) are rare lesions of the appendix, characterized by an accumulation of mucus. Two main pathogenic mechanisms may be invoked to explain their development. Firstly, AM are secondary to an obstruction of the appendiceal lumen for a wide variety of reasons. Secondly, they may be due to tumours of the appendix, whether malignant (cystadenocarcinomas) or benign (cystadenomas), responsible for a hypersecretion of mucus. Intraperitoneal mucinous effusion (IME) develops when appendiceal perforation occurs, especially with malignant AM. We found 13 retention AM and in most a definite obstructive lesion was present. There were 3 malignant AM, all associated with a neoplastic IME. While they are frequently described in the literature, no cystadenoma was observed in these series. Clinical symptoms are often confusing, but paraclinical investigations may lead to preoperative diagnosis. Appendectomy is the treatment of retention AM and cystadenoma. Their prognosis is related to other associated diseases, namely ovarian and colorectal tumours, but is otherwise good. Cystadenocarcinomas require a right hemicolectomy with evacuation of IME but their prognosis is poor.

Adenocarcinoma, Mucinous↗
PubMedDate not supplied

[Practical approach to tumoral perforations of cancers of the colon. Apropos of 7 cases].

In 4 to 5% of cases, the cancer of large bowel is presented with a perforation in situ. The mortality rate in these conditions is high, and it is evaluated in the literature between 40 to 50% of cases. The authors present their experience with 7 consecutive patients, operated for this complication. In all cases, the tumour is excised: in 6 patients, terminal colostomy is realised while one patient only had a direct resection anastomosis. No per-operative mortality, was noted, and in four patients retauration of intestinal tract is realised, within 3 to 6 months latter. In our experience, the perforated tumour does not appear as a factor of immediate gravity.

Adenocarcinoma↗
PubMedDate not supplied

Ileoanal anastomosis for ulcerative colitis: results of an evolutionary surgical procedure.

BACKGROUND/AIMS: Proctocolectomy with ileoanal anastomosis (IAA) has proved to be the most suitable surgical treatment for ulcerative colitis. The aim of this study was to compare the results of IAA according to the evolution of surgical procedures and particularly to compare the results of stapled versus hand-sewn anastomosis. METHODOLOGY: From 1984 to 1996, 37 men and 31 women were operated on in our centre for ulcerative colitis. The anastomosis between the J pouch and the dentate line was handsewn in 35 patients (group 1) and stapled in 33 patients (group 2). RESULTS: The mean operative time was significantly shorter in group 2 as compared with group 1 (265+/-59 vs. 323+/-53, p<0.01, respectively), whereas morbidity and functional results were comparable in both groups. In 10 patients with stapled IAA, a diverting ileostomy was not performed and the morbidity in this group did not increase. CONCLUSIONS: These results suggest that stapled IAA anastomosis is a safe procedure. The stapling technique of IAA simplifies total excision of the rectum and could mean that a diverting ileostomy is not necessary.

Adult↗
PubMedDate not supplied

Squamous cell carcinoma of the thoracic esophagus following radiation therapy for breast cancer.

Between 1981 and 1995, 4 patients (3 females, 1 male; aged 48-80) were diagnosed with squamous cell carcinoma of the esophagus, following mediastinal irradiation for breast cancer. The interval between irradiation and the presentation of esophageal cancer was 10.75 years on average (7-19). The treatment consisted of: radiotherapy only; a partial esophagectomy with proximal gastrectomy without post-operative radiotherapy; laser photocoagulation for a superficial tumor; and, palliative treatment including gastrostomy, tracheal photocoagulation and chemotherapy for 1 patient suffering from advanced stage cancer with tracheal invasion, respectively. Radiotherapy of the esophageal cancer (exclusive or adjuvant) should take into account previous esophageal radiation therapy. The indications of curative excision surgery are the same as for other types of esophageal cancer, but the anastomoses should be performed in a non-irradiated area. Excision by esophageal stripping without thoracotomy is contraindicated because of the presence of peri-esophageal sclerosis. Preventive measures in radiation therapy for breast cancer are suggested.

Aged↗