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Biomedical subjects

G Benhamou

Publications and source records attributed to G Benhamou.

At least 19 recordsLinked to original sources
PubMed1992

[Tubular gastrostomy using celioscopy].

Surgical feeding gastrostomy is attended by a significant morbidity and mortality. Today, the percutaneous endoscopic route is regarded as the best method, but it is not feasible in case of pharyngo-oesophageal stenosis and has its own drawbacks. A new method using laparoscopy to perform a Depage-Janeway gastrostomy is presented here. The theoretical advantages of this method are clear: the limited parietal damage should avoid cicatricial complications, and the limited ventilatory aggression should reduce the amplitude of respiratory complications. Moreover, in surgical practice this is a simple, rapid and efficient operation.

Aged↗
PubMed1992

[The aorto-esophageal fistula. A rare cause of digestive hemorrhage].

The authors report a new case of aortoesophageal fistula caused by a giant ulcer of the esophagus. Success of the surgical treatment during the bleeding period couldn't occult the seriousness of this fistula which is almost fatal. Only an early diagnosis permitting a surgical treatment in better conditions could improve the prognosis of this condition.

Aortic Diseases↗
PubMed1992

[Laparotomy in HIV-infected patients. Indications, results apropos of 104 operated patients].

From May 1st 1983 to March 1st 1991, 126 laparotomies were performed on 104 patients infected by human immunodeficiency virus (HIV). We report the operative indications, macroscopic findings, anatomopathologic and microbiological results, and hospital mortality in this population. In 12.5% of cases, infection by HIV was established after operation. Sixty-eight percent of patients presented criteria for AIDS. The population was divided into 4 groups of indications: Group I: 30 patients had an emergency exploratory laparotomy. Laparotomy provided a diagnosis in 80% of cases, with a hospital mortality in 66%. Group II: 45 patients had an emergency laparotomy with a preoperative diagnosis. Hospital mortality was 24.4%. Group III: 29 patients had a non-urgent laparotomy with no mortality. Group IV: 14 patients were reoperated (22 laparotomies). For the entire population, hospital mortality was 9.3% for seropositive patients and 38.8% for AIDS patients.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Intestinal ascariasis. A rare cause of obstruction of the small intestine].

Ascariasis is a benign and common disease in tropical areas. Due to its endemicity and high prevalence, serious abdominal complications requiring urgent and versatile surgical therapy do occur. An observation of intestinal obstruction by ascaris bundle, diagnosed during operation, is reported. The postoperative course was uneventful.

Adult↗
PubMed1991

[Causes for surgical interventions in HIV seropositive patients. 226 interventions].

Between January 1, 1983 and October 1, 1990, we performed 266 surgical operations in 255 patients with human immunodeficiency virus (HIV) infection. We report the reasons for these operations and compare them with those recorded in all patients operated upon in our department between January 1, 1988 and December 31, 1989 (4,960 operations in 4,498 patients). During the 1988-89 period, 2.4 percent of these patients had HIV infection, which suggests that the proportion of patients operated upon is the same in an HIV-infected population as in the general population. The proportion of HIV-infected patients who underwent surgery for diagnostic purposes or as adjuvant treatment was 42.7 percent as compared with 37.3 percent in the general population. Among laparotomies, 37.3 percent were exploratory in the HIV group versus 7.3 percent in the control group. The emergency surgery rate was the same in both groups. In gastrointestinal surgery, proctological operations were performed in 33.5 percent of the HIV group versus 7.4 percent of the control group. Among other types of surgery, only splenectomies were more frequent in HIV-infected patients than in the general population (6.3 versus 1.7 percent).

HIV Seropositivity↗
PubMed1991

[Appendicitis and acquired immunodeficiency syndrome. Apropos of 19 cases].

Appendectomy is the most current digestive surgical procedure in France. Ascending prevalence of infection by HIV, invites us to report 19 documented cases of appendicular syndroma in a population infected by HIV, within 13 cases who required criteria for AIDS. In 31.5% of cases, operation discovered infection by HIV or AIDS. 10 patients had an abscess or gangrenous appendicitis. Furthermore, a tumoral, inflammatory of infectious associated disease which required a treatment was found in 5 others patients. 2 patients died. In all cases, histologic, bacteriologic, virologic and parasitologic samps are warranted to discover current associated diseases.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Implantable devices for permanent venous access. A single-center prospective study comparing an AIDS population with a control population (80 cases)].

Although the tolerance of indwelling catheters in AIDS patients has been evaluated, the complications of implanted devices in this population are unknown. This encouraged us to compare in a prospective unicenter trial, dealing with 80 consecutive implanted devices, the complications of this kind of system in 20 AIDS patients, versus a control population. The follow-up was 10,658 days. No patient was excluded or lost to follow-up. In the control population, the infection rate was 5% (0.036 per 100 catheter days). We observed 3 thromboses (5%). In the AIDS group, the infection rate was 25% (0.21 per 100 catheter days). We observed 1 thrombosis (5%). This trial shows that implanted devices are more frequently infected in AIDS patients (p less than 0.05) than in a control population; it suggests that the infection rate in AIDS patients is not superior to the indwelling catheter rate, as reported in the literature. The precision of bacteriological tests and use of antibiotic therapy adapted to the clinical context should help to determine, in the presence of suspected infection, whether the implanted device can be maintained or should be removed in this high risk population.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Emergency treatment of sigmoid volvulus. One-stage resection with mechanical staplers].

In sigmoid volvulus, most authors recommend an emergency detorsion with transrectal intubation and delayed resection. In 25% of cases, detorsion in unsuccessful, necessitating multi-stage laparotomy. However, this approach can be harmful in these patients who are often elderly or with multiple diseases. When detorsion is impossible, we now use a one-stage resection with staplers. Using a median laparotomy, detorsion is performed and viability of the colon is confirmed; a Faucher tube placed freely in the rectum, is pushed by the nurse into the dilated colon; the colon is then deflated by applying gentle suction. After removing the tube, we perform a side-to-side anastomosis at the lower ends of both limbs with mechanical staplers, after economic resection of the mesosigmoid. We have used this procedure in five patients with a median age of 82 years; the mean operating time was 92 minutes. There was no mortality, no fistulae, or stenosis with a median follow-up of 16 months. The patients stayed in hospital for 12 to 18 days. In volvulus cases which cannot be reduced immediately, this procedure obviates multi-stage operations, often the cause of mortality, morbidity or loss of autonomy in patients who are often elderly or with multiple disease.

Aged↗