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Biomedical subjects

F R Pruvot

Publications and source records attributed to F R Pruvot.

84 records · Page 5Linked to original sources
PubMed1986

[Perforations of the esophagus].

The prognosis of esophageal perforations remains poor. In this study 80 cases (26 cervical, 45 thoracic and 9 abdominal) are reported. Pain was the most frequent symptom, present in 56/80 cases. Signs of perforation were detected on standard X-ray films in 85% of the cases, and oesophagography with Hytrast showed a leak in 88%. Treatment was delayed for more than 24 hours in 41 patients. Direct intervention on the esophageal wound (suture, fistulization, drainage, double exclusion, resection) was carried out in 54 patients, whereas 26 were fed parenterally or by tube or through jejunostomy and were given antibiotics with or without drainage of a fluid collection. The overall mortality rate was 35%, death being caused by infection or toxic shock. Treatment and prognosis were dependent upon the course of the infection. No other single prognostic factor was significant, with the exception of age over 60.

Esophageal Perforation↗
PubMed1986

[Barotraumatic rupture of the esophagus. 4 cases. Review of the literature].

Oesophageal barotraumatism is a rare lesion and only 19 cases have been reported in the literature. Four new cases are described, the mechanism involved being either a jet of gas into the oesophagus or an explosion close to the face producing rupture of the oesophagus by increased endoluminal pressure. Four characteristic clinical signs are noted: wounds or burns to the face or mouth, chest or epigastric pain, subcutaneous emphysema and respiratory distress. A pneumomediastinum or pleural effusion is a constant finding, and a perforation is identified regularly by an oesophageal water soluble opacification. Of the 19 cases reported in the literature, 4 were detected at autopsy, one patient died after surgery and 14 recovered after operation. The mediastinal infection was either subacute requiring external thoracic drainage after oesophageal exclusion, or acute, necessitating emergency direct oesophageal repair. Only one of the 4 patients reported in this paper survived the accident.

Accidents, Occupational↗
PubMed1986

[Chest wounds].

Explore the source record for details and available documents.

Humans↗
PubMed1986

[Surgical treatment of chronic pancreatitis. Retrospective study of 221 cases].

221 patients have been operated for chronic pancreatitis, secondary to alcoholic intoxication in 92% of cases. Surgery was performed for a complication of the disease (69%), for intractable pain (30%), or for a false diagnostic of cancer; 265 operations were done, among which 41% of resections, 18.5% of internal derivations, and 14.3% of external derivations. Post-operative morbidity was 23.4% and hospital mortality was 6.4%. Late mortality was 35.5%, pancreatitis being responsible for more than half of those deaths during the first three post-operative years. Iterative surgery was necessary in 37 cases. The risk of diabetes was multiplied by 3.2 after resection. Results were good in 50% of cases after 5 years. An important factor was the arrest of alcoholic intoxication. There was no significant difference between resection and derivation. Internal drainage should be preferred when possible. Surgery must be reserved to grave or invalidating complications of chronic pancreatitis.

Adult↗
PubMed1985

[Surgery of perforated duodenal ulcer. Treatment of the perforation or the ulcer?].

Treatment of duodenal ulcer disease with an anti-acid preparation significantly reduces early postoperative complications after simple suture of a perforation, in relation to the course of the disease. Future prognosis of the latter is unpredictable even when those parameters, normally considered as being important, are allowed for. Percentage recovery is comparable with or without cimetidine. Treatment proposed is a two-stage operative procedure: 1) treat the peritonitis; 2) conduct recovery surgery at a later stage for recurrent lesions or those resistant to medical treatment. This therapy is based on the belief that emergency conditions do not require a complicated procedure and that the latter is useless in 45% of cases, which cannot be predetermined. This attitude is reinforced by the working conditions and the increased postoperative safety after simple suture as a result of the use of cimetidine.

Cimetidine↗
PubMedDate not supplied

[Leiomyoma of the esophagus and pulmonary metastasis].

An important and symptomatic esophageal leiomyoma is treated by enucleation. A secondary metastasis, also important and symptomatic, is resected 3 years later. The follow-up is now 2 years, without any sign of relapse. This case allows for discussion of the malignancy of leiomyoma and of its microscopic criteria.

Adult↗
PubMedDate not supplied

[Anatomo-clinical and therapeutic study of esophageal resection for cancer of the thoracic esophagus].

272 cancers of the thoracic esophagus were resected on 664 cases observed from 1975 to 1985 (resection rate: 41 p.c.): 8.1 p.c. were on the upper third, 71.3 p.c. on the middle third, 20.6 p.c. on the lower third of the esophagus. Tumors were classified as stage I (12: 4.5 p.c.), II (40: 15.2 p.c.), III (100: 37.9 p.c.), IV (112: 42.2 p.c.); 8 cases were not classified. Post-operative radiotherapy was administered to 90 patients. Hospital mortality was 50 (18.4 p.c.). Respiratory complications were the main lethal cause. After a post-operative survival of 81.6 p.c., survival at 1 year was 58.3 p.c., at 3 years 23.3 p.c., at 5 years 9.8 p.c. Actuarial survival at 5 years is 11.1 p.c. +/- 3, 17.2 p.c. for T1 and T2, 8 p.c. for T3. No advantage was noted comparing neck or intrathoracic anastomosis. Post-operative irradiation was beneficial. Factors influencing survival are staging, curative or no curative resection and post-operative irradiation for T3 N+. Nodes invasion is more important than invasion of the site of anastomosis. Palliative resections are the majority. They have no more severity than curative resections and give a 10 p.c. 5 years survival. The main effort must bear on a decrease of post-operative pulmonary complications and mortality.

Adult↗