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Biomedical subjects

G Grosdidier

Publications and source records attributed to G Grosdidier.

At least 19 recordsLinked to original sources
PubMed1992

[Value of limited resections in the surgical treatment of lung cancers].

From 1969 to 1990, 88 limited lung resections were performed for the treatment of malignant lung tumours. These operations consisted of 73 typical resections (29 segmentectomies, 15 bisegmentectomies, 23 middle lobectomies, 6 lingulectomies) and 15 atypical resections. In 15 cases, they were completed by lymph node dissection. These operations were performed in patients with a mean age of 55.8 years (range: 24 to 76). The ventilatory functional status contraindicated wider resection in only 7 cases. The immediate postoperative mortality (7 cases, i.e. 8%) and the postoperative complications observed in 29.6% of cases were higher than those observed after wide resections, but do not constitute a specific argument in the indication for partial resection. Histological examination of the operative specimens revealed 80 primary lung cancers (42 squamous carcinomas, 28 adenocarcinomas, 8 anaplastic and unclassifiable tumours, 1 bronchiolo-alveolar tumour and 1 malignant carcinoid tumour). The primary nature of the tumour could not be definitely confirmed in the other 8 patients (history of head and neck neoplasm in 7 cases and bladder carcinoma in 1 case). The survival according to TNM stage, histological nature of the tumour, positivity of the resection margins and intraoperative tumour effraction was identical to that associated with lobectomies.

Adenocarcinoma↗
PubMed1992

[Resection of lung neoplasm in patients aged 70 years and over. Apropos of a series of 193 resections].

Lung cancer in the elderly is an active cancer. Due to the poor tolerance of radiotherapy and chemotherapy, and the ever increasing life expectancy of patients over the age of 70 years, surgery remains the treatment of choice for these lesions. We report a series of 193 patients over the age of 70 years, the high postoperative mortality of 19% during the first month was counterbalanced by a 5-year survival of more than 20%. The criteria of operability must be rigorous and based on objective elements, especially lung function and the patient's good psychological state.

Adenocarcinoma↗
PubMed1991

Anatomical basis of the anterior vertebral graft using a pediculated rib.

The rib is frequently used as a bone graft in the surgery of the anterior spine. The advantage of the rib is that it is easily used as a pediculated vascularized graft when it is transferred to the anterior vertebrae. The average length of the pedicle is over 5 cm for the ribs number 3 to 10. Their useful length of bone is 12 cm. With this technique fusion of 4 to 6 lumbar or thoracic vertebrae is possible.

Cadaver↗
PubMed1991

[Contribution of a 3% solution of boric acid in the treatment of deep wounds with loss of substance].

The correct application of antiseptics to major surgical wounds must comply with appropriate protocols. Compliance with the protocol established by the CHRU of Nancy was evaluated by means of a questionnaire assessing the understanding of the protocol by the nursing staff and by a survey in the wards in which it was applied. The defects observed cannot be explained by a lack of efficacy for superficial wounds and deep wounds, as a randomised study of 42 wounds demonstrated the superiority of the protocol in relation to the use of another product which is widely used in the wards. In contrast, for deep wounds with loss of substance, the proposed protocol does not always achieve therapeutic success. This finding has led the authors to propose the use of a 3% boric acid solution based on a case-control study which demonstrated a significantly superior efficacy. All of the epidemiological and clinical elements are summarised in order to demonstrate the solid basis for compliance with antiseptic protocols of surgical wounds which can only be beneficial in terms of therapeutic success, length of hospital stay and cost savings.

Anti-Infective Agents, Local↗
PubMed1991

[Pulmonary metastasis of a dermatofibrosarcoma].

Progressive and recurrent dermatofibrosarcoma, described by Darier and Ferrand in 1924, is a fibrous skin tumour with essentially local malignancy. The authors report a case with pulmonary metastasis, a rare event as only 13 cases of visceral metastases have been reported in the literature. The clinical course of this case was favourable (follow-up of 5 years), in contrast with the usually pejorative nature of metastatic disease (death after several months to one year following the discovery of the first metastasis).

Fibrosarcoma↗
PubMed1990

[Plastic surgery of the thoracic wall (malformations and tumors) using a sliding splint-stapler].

Chest wall instability, created surgically by correction of a chest deformity (funnel chest or, more rarely, pigeon chest) or by resection of a tumour of the chest wall, is serious as it can jeopardize the immediate vital prognosis because of paradoxical respiration and, in the long term, the functional and aesthetic prognosis due to progressive impaction of the unstable segment of the wall. The polyvalent and adaptable material which we have developed (sliding splint-staple) and which we also use in thoracic traumatology (thoracic flaps), has allowed us to perform audacious corrections for deformities or wide resections for tumours since 1980. We have used this material on 13 occasions for contention after sternochrondroplasty, with an excellent result in each case both in terms of the immediate stability and in terms of the aesthetic result. The sliding splint-staples, generally two, are placed in staggered positions behind the sternum (11 cases--funnel chest) or in front of the sternum (2 cases--pigeon chest). The material is left in place for at least one year. We have used this material on 8 occasions after various tumour resections: 3 times after subtotal resection of the sternochrondral breastplate and 5 times after lateral or anterolateral resection removing at least 2 ribs.

Adult↗
PubMed1989

Anatomical basis of pelvic growth in bladder exstrophy.

Pelvic growth in bladder exstrophy was studied in 10 patients. Growth of their pelves in length as well as in width was similar to that found by Tanner. Meanwhile, the speed at which the diastasis of the pubic symphysis increases is variable. Before 5 years of age and during the end of growth it is fast, whereas it is slow between 5 and 10 years of age. There are no radiological abnormalities of hip joint orientation, and the acetabular angles are normal.

Acetabulum↗
PubMed1989

[In vivo study of human tumor cell proliferation, by histo-immunodetection of 5-iododeoxyuridine incorporated into DNA].

5 Iododeoxyuridine (IDU) was administered, (2.4 g by continuous infusion for 24 hrs.) without adverse effect, to 18 patients bearing thoracic tumours. 5 microns tissue sections were incubated with a monoclonal anti-IDU antibody. Cells that had incorporated IDU were identified immunohistochemically. The labelled cells number and situation vary from one tumor cell type to an other, from patient to patient and from territory to territory. The stroma components cells (inflammatory reaction, fibrosis...) were seldom labelled except for neovascularization. Normal tissues have different labelling indexes with their origin.

Adult↗
PubMed1989

[Metachronous bronchial neoplasm. 20 cases surgically treated].

The authors present a series of twenty metachronous lung carcinomas operated upon in the Thoracic Surgery Unit of Nancy between 1975 and 1987. These lesions occur after a first lung tumor resected for stade 1 TNM in 19 cases, with a 59 month's mean free interval and they are surgically treated by 14 controlateral lobectomies and 6 completion pneumonectomies. In spite of 4 post-operative deaths, the survival rates reach 51% at 3 years and 32% at 5 years. This study with a review of the literature emphasize the relatively high incidence of metachronous lung carcinomas in the patient resected for a tumor of good pronostic factors, their occurrence after a prolonged interval, the difficulty to prove their primary nature and the justification of a surgical approach because the long-term results are comparable with that of patients operated upon for a single carcinoma.

Adult↗
PubMed1988

Anatomic basis for the orthopedic treatment of bladder exstrophy: anatomic study of the sacrosciatic ligaments in the newborn.

Anatomic study of the pelvis of 30 fetuses and newborn children, yielded a precise relationship between the sacrotuberous ligaments and size of the gluteal region. At birth, the distance between the posterior superior iliac spine and the ischium is 40 mm. Closure of the anterior defect in bladder exstrophy sometimes requires an orthopedic surgical procedure. Bilateral posterior iliac osteotomy and section of these ligaments can be easily done by a single medial posterior approach herein described.

Bladder Exstrophy↗
PubMed1988

[Anatomic characteristics of the pelvis in children].

Growth characterizes the pelvic modifications until adult maturity is reached. Recollection of pelvic ossification is done insisting upon the primary ossification points, the triradiate cotyloid cartilage and the secondary ossification points. The socket's neonatal particular morphology with it's cartilaginous roof and it's fibrocartilaginous acetabular labrum finds it's application in ultrasonography. Bone modifications which occur permanently during growth result in increase of pelvic volume and in modifications of the physical mechanical resistance characteristics so that there are differences between children and adult fractures. Ligamental hyperlaxity and numerous cartilaginous structures are also accountable for these differences. About visceral concern, the main characteristic apart from genital modifications is the apparent migration of the bladder from the neonatal abdominal position down to the adult backward pubic position. Bladder capacity variations have been studied. The male urethra anatomy is recalled from which the different surgical procedures are deduced. The main vasculo nervous axes orientations are described allowing the comprehension of CT scan images. In fact the horizontal plan given by the modern imagery is sometimes difficult to study. An apprentice ship schedule is given following the bone, vasculo-nervous and visceral identification.

Adolescent↗
PubMed1985

Anatomical basis for study of acetabular migration of the prosthetic cup used in arthroplasty of the hip: a new technique for measurement of migration.

A retrospective study was carried out on 96 partial hip prostheses. Results of this study led us to define new radiological criteria for evaluation of the anatomical position of the prosthetic cup in the acetabulum. A method of measurement of the migration of the prosthetic cup in the acetabulum is proposed based on the results of roentgenological and anatomical study. The anatomical landmarks, geometric constructions and methods of computation of such measurement are described. The application of this technique to radiological/anatomical study was found to be reliable and allowed the determination of prognostic factors indicative of poor acetabular tolerance of the prosthetic cup.

Acetabulum↗
PubMed1985

[Surgical treatment of flail chest by sliding staples].

The authors have compared the results obtained in two series of patients with flail chests treated by internal fixation. In the first series of 36 patients, Judet rib staples were used. The average time of artificial ventilation was 5.8 days. In the second series of 43 patients, gliding staples were used. The average time of artificial ventilation was only 2.6 days, a significant reduction. Thanks to this new technique, the indications for artificial ventilation in the treatment of flail chests have been reduced from 47 per cent to 33 per cent. The technique of fixation has also been used in seven cases of operative treatment of funnel chests. In five other cases it has been used to reinforce plastic mesh inserted after extensive resection for malignant tumour.

Adolescent↗