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J B Flament

Publications and source records attributed to J B Flament.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Morbidity of laparoscopic fundoplication for gastroesophageal reflux: a retrospective study about 1470 patients.

BACKGROUND/AIMS: The aim of this retrospective study was to report and quantify the immediate and 3-year complications after laparoscopic anti-reflux surgery in order to understand the mechanism. METHODOLOGY: From 1992 to 1996, 1470 laparoscopic fundoplications were performed for symptomatic gastroesophageal reflux disease. Preoperative checkup included upper gastrointestinal tract endoscopy in 1437 patients (97.7%), esophageal manometry in 934 patients (63.5%), and 24-hour pHmetry in 799 patients (54.3%). Three procedures were performed: Nissen (n = 655), Nissen-Rossetti (n = 423), and Toupet (n = 392). The results were estimated at 1 and 3 months; thereafter they were evaluated at 3 years. Patients unable to return to the hospital center were contacted by telephone. RESULTS: Mean length of hospital stay was 4.6 days (range: 2-48 days). The preoperative complication rate was 2.1% (n = 31). The postoperative morbidity and mortality rates were 2.9% (43 patients) and 0.07% (1 patient), respectively. Conversion rate to laparotomy was 6.5% (96 patients). At 3 months, 87 patients (5.9%) had invalid dysphagia but there was no difference between the 3 procedures. Twelve patients have been reoperated (0.8%). At 3 years, 78 patients (5.6%) presented a clinical recurrence. The rate of dysphagia was 0.35%, and 38 patients were reoperated. CONCLUSIONS: Laparoscopic fundoplication is safe and effective with a low morbidity and mortality rate if junior surgeons commenced this procedure under the direct supervision of an experienced surgeon. Despite the advantage of this technique, we believe that indications for surgical management remain unchanged in the laparoscopic era.

Adolescent↗
PubMedDate not supplied

[Perforation of rectal with peritonitis during a barium enema administration. Report of a case (author's transl)].

The authors report one case of perforation of rectal with peritonitis during a barium enema administration in a patient suffering from an adeno-carcinome of colon, and died after 48 hours with collapsus. After a brief review of the literature, the authors expose pathogeny and clinical signs of this relatively rare accidients. The conclusions repose on watchful precautions according to indications and technical way of barium enema examination in patients specially exposed to perforation accidents.

Adenocarcinoma↗
PubMedDate not supplied

[Arterial vascularization and innervation of the lacrimal gland. Apropos of 100 dissections].

The authors report the different types of arterial vascularization and lacrimal gland innervation, noticed in 100 human orbits with arterial latex injected. The lacrimal artery may be unique, arising either from the ophtalmic artery, the most frequent case (vascularization of type I) or from the external carotid system (vascularization of type II): it is possible that 2 lacrimal arteries are simultaneously present, originating from the 2 carotid system (vascularization of type III). The lacrimal gland is innerved by the lacrimal nerve and by one or several nervous branches, originated from the maxillary nerve. 3 possibilities can be found: a zigomatic branch from the maxillary nerve makes a preglandular anastomosis with the lacrimal nerve; a real lacrimal loop, which may form either an intraglandular anastomosis or be completely independant of the lacrimal nerve. Sometimes, several zigomatic rami do exist. These different variations and their frequency are analyzed and referred to the literature.

Arteries↗
PubMedDate not supplied

[Macroscopic aspects of arterial vascularization of the orbit].

The authors report the result of 80 orbital dissections, after injection with latex of the arterial system. They insist upon the course of the ophthalmic artery, usually found, upon his possible variations: specially under-crossing of the optic nerve, absence of an extra-conical passage. After all, the authors describe the principal branches of the artery.

Arteries↗
PubMedDate not supplied

[Exteriorized suture of injuries of the colon].

When the use of an intraperitoneal suture of a colon wound does not appear reasonable due to a delay in treatment or the marked peritoneal contamination, temporary exteriorization of the sutured colon can constitute a valuable alternative to pure and simple exteriorization of the colon wound. Cicatrization of the colon suture can be obtained outside the abdominal cavity in more than half the cases. The colon can then be integrated simply at about the 15th day, avoiding in this way the disagreeable need for prolonged colostomy and the potential risks of a construction of a secondary circuit. This process was used in 6 injured patients and healing was obtained in 3.

Adolescent↗
PubMedDate not supplied

[Increase in the size of an hepatic amebic abscess treated with metronidazole: value of immunologic surveillance with the ELIFA method].

The authors report a case of amoebic liver abscess regularly increasing in size for a period of 20 days (iterative controls by echography), in spite of a metronidazole treatment. Immunological studies by the ELIFA method, on the successive sera of the patient, show IgG, IgM, IgE and IgA antibodies within one particular precipitating system; the specific IgA disappeared after surgical drainage of the abscess.

Humans↗
PubMedDate not supplied

[Value of parathyroid scintigraphy in preoperative localization of parathyroid adenoma. Study apropos of 138 tests].

The authors have studied, about a total of 138 exams, the value of parathyroid nuclide scan. All the patients, who had primary hyper parathyroidism, have been operated upon. The results of parathyroid scintigraphy have been compared to the results of surgical exploration. Overall sensibility of the exam has been 80%, better with the MIBI (89%) than with the Thallium (78%). The specificity has also been better with the MIBI (95%) than with the Thallium (87%) with a global result of 88%). Computerized treatment of images with automatized subtraction especially studied in Institut Jean-Godinot, Rheims, explain the quality of these results.

Adenoma↗
PubMedDate not supplied

[Thoughts on the treatment of diverticular sigmoiditis. Apropos of 191 cases].

Between January 1, 1984 and December 31, 1993, we treated 191 patients with diverticular sigmoiditis. Three groups of patients were distinguished in this retrospective study. In group 1, there were 108 patients (56.5%) who were referred by gastroenterologists after one or two episodes of sigmoiditis and who underwent planned exeresis. In group 2, there were 42 patients (21.9%) in whom the sigmoiditis was revealed by a complication and who underwent and emergency procedure. In group 3, there were 41 patients (21.6%) over 70 years of age with major risk for anesthesia and/or surgery who were treated medically. Mortality, morbidity and duration of hospital stay were analyzed by group. Operative mortality was 0.92, 19 and 7.3% respectively. Operative morbidity among the survivors was 21 and 35% in groups 1 and 2 respectively. Mean hospital stay varied from 15 days for planned procedures up to 20 days for emergency surgery. It was 9 days in group III. These findings recall the need for radical preventive exeresis for diverticular sigmoiditis.

Aged↗
PubMedDate not supplied

[Late and multiple endocrine metastases of an adenocarcinoma of the kidney].

Ten years after nephrectomy a renal cell carcinoma of the felt kidney, the patient presented successively pancreatic, adrenal gland, thyroid gland and contralateral renal metastases. Surgical exeresis was performed for the different metastases with a survival period of 7 years. No similar observation (non-necropsic discovery, surgical treatment, prolonged survival) of multiple metastasis of renal cell carcinoma to endocrine glands was found in the literature. The important role of modern imaging techniques are emphasized together with the need for long-term follow-up of operated renal cell cancer since the clinical course can be unpredictable. Long-term remission has been reported and surgical exeresis of metastasis should always be proposed when possible.

Adenocarcinoma↗