PubMed Health⌕ Search

Biomedical subjects

G Portier

Publications and source records attributed to G Portier.

9 recordsLinked to original sources
PubMed1988

Surgical treatment of Graves' disease.

Seven men and 81 women were operated on for Graves' disease. Their median age was 33 years. Eleven patients underwent a bilateral subtotal lobectomy; 77 patients underwent a complete lobectomy with contralateral partial lobectomy. Forty-seven patients were treated before 1981. In these patients, the weight of the thyroid remnant was estimated empirically between 5 and 12 g. In the 41 patients treated since 1981, the remnant weight was estimated at 5 g by comparative weighing. There were no postoperative deaths. Functional results were established in 83 patients with an average follow-up of 50 months (range 12 to 156 months), with control of vocal cord mobility demonstrated by indirect laryngoscopy in 66 patients. Hormonal determinations were carried out in 74 patients. There were no cases of permanent hypoparathyroidism. Three patients (4.5 percent) had unilateral vocal cord dysfunction. Twelve patients (14.5 percent) had clinical and biologic hypothyroidism, which occurred within 1 year postoperatively in 11 cases. Seven patients (8.3 percent) had latent hypothyroidism only discovered by hormonal determinations. Fifteen patients (17.8 percent) had recurrent hyperthyroidism, 6 of whom were diagnosed by hormonal determinations. The actuarial recurrence rate increased progressively up to the sixth postoperative year. The only predictive factor for recurrence was the type of operation. Patients who underwent a bilateral subtotal lobectomy had more recurrences than patients who underwent a complete lobectomy with partial contralateral lobectomy (p less than 0.01). These results suggest that patients should be followed closely for many years and should undergo hormonal determinations regularly, as some recurrences can occur 5 years or more after operation with very few symptoms.

Adolescent↗
PubMed1988

Carcinoma of the cardia and proximal third of the stomach. Results of surgical treatment in 91 consecutive patients.

In the present retrospective study, 79 percent of the patients were men with a median age of 65.5 years. Of 91 patients, 84 were surgically explored. Excision of the tumor was carried out in 57 patients (63 percent) and was curative in 28 cases and palliative in 29 cases. Curative resection included proximal gastrectomy in 5 patients and total gastrectomy in 23 patients, which was extended to the spleen and distal pancreas in 18 patients. Lymph node metastases were found in 67 percent of the patients treated by resection. According to the TNM classification, 18 percent of the patients undergoing resection had stage I tumor, 28 percent had stage II tumor, 40 percent had stage III tumor, and 14 percent had stage IV tumor. The postoperative mortality rate was 16 percent for the entire series, 21 percent for patients undergoing palliative resection, and only 4 percent for patients undergoing curative resection. Three patients had an obvious anastomotic leak, one of whom died. Median survival time was 5 months for patients who had exploration only, 6 months for patients who had palliative resection, and 36 months for patients who had potentially curative resection. The 5 year actuarial survival rate was 20 percent for patients having resection and 40 percent for patients having curative resection. Survival was closely related to tumor stage. These results indicate that total gastrectomy with complete abdominal lymph node dissection can give comparatively good long-term results when performed for cure. Nevertheless, only one of three patients in this series could have a potentially curative resection. The only way to increase the curative resection rate and to improve survival is to detect the cancer at an early stage.

Adult↗
PubMed1985

[Spontaneous rupture of the liver in pregnancy. Case study and review of the literature].

The authors report a case of "spontaneous" rupture of the liver in a woman of 35 years of age. This occurred immediately after post-partum eclampsia. It was not possible to obtain complete haemostasis using absorbable haemostatic compresses along the convexity of the liver. Complete cessation of bleeding only occurred after the operation when posterior pituitary abstracts had been transfused. The patient died 53 days after the initial procedure from a high gastro-intestinal haemorrhage. A study of the literature shows that this rare condition is most probably a complication of toxaemia of pregnancy but the physio-pathology of these liver lesions is ill-understood. The clinical picture is in two phases--the first corresponds to the formation of a sub-capsular haematoma and the second to the intra-peritoneal rupture of this haematoma. The prognosis for this condition is poor, the maternal mortality ranging from 56%-75%. The prognosis is linked to the speed with which the diagnosis is made and surgical intervention is carried out. This should be done before the capsule of the liver ruptures. Haemostasis is nearly always best obtained by using haemostatic compression with packs but haemostasis is not always adequate, particularly if there are several lesions in both lobes of the liver. This case history shows that using posterior pituitary abstracts in transfusion can be helpful.

Adult↗
PubMedDate not supplied

[Anterior sacral meningocele. Report on 2 cases treated by the abdominal approach].

Anterior sacral meningocele is a rare affection (150 cases published) that is frequently misdiagnosed with resulting inappropriate, always dangerous treatment. Diagnosis should however be simple to establish on the finding of a fluid hypogastric mass attached to the sacrum with associated radiologic anomalies of the sacrum. Two cases are reviewed and diagnostic and surgical therapy features discussed.

Abdomen↗