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Biomedical subjects

J Baulieux

Publications and source records attributed to J Baulieux.

At least 19 recordsLinked to original sources
PubMed1991

[Massive small bowel resection. Apropos of 27 cases].

27 patients were admitted in the Digestive intensive care unit of Croix-Rousse Hospital after a massive bowel resection (residual bowel 120 cm). The etiology was of vascular origin in 15 cases. The length of intestine was nil in 4 cases, between 20 and 50 cm in 12 cases, and between 50 and 120 cm in 11 cases. A colon resection was performed in 20 cases. For 5 patients, a "double temporary intestinal stoma" for ischemic bowel was made. A "second look laparotomy" was performed in 11 cases. The definitive intestinal continuity restauration was made in 23 cases (7 immediately, 16 later) with 3 duodenocolic anastomoses. 8 patients were able to find back a oral alimentation. 19 patients (with 4 total bowel resections) received a home parenteral nutrition. Actually, 11 are alive.

Adolescent↗
PubMed1991

[Cystic lymphangioma of the mediastinum. 2 personal cases and a review of the literature].

Two mediastinal lymphangiomas (KLM) are described, in 36 and 41 year-old women. They presented as an incidental finding on chest radiograph. The mediastinal mass was anterior or posterior, compressing the adjacent vital structures, and cystic on computed tomography. The complete surgical removal was possible, but complicated by the size (12 x 7 x 4 cm and 10 x 7 x 5 cm), the hypervascularization and the infiltrative tendency of the lesions. The patients are well 36 and 30 months after removal. We compare these cases with 109 previously reported. They account for 1 p. 100 of the whole lymphangiomas and for 0.5 to 4.5% of all mediastinal tumours. The congenital or infantile cervico-mediastinal lymphangiomas are more frequent (10%). The general signs, symptoms, pathological findings, treatment and pathogenetic theories are discussed.

Adult↗
PubMed1990

[Surgical treatment of diverticula of the thoracic esophagus].

Pathogeny of thoracic esophageal diverticuli, divided into parabronchial and epiphrenic, appears to have been modified by development of functional esophageal motility measurement. We present 23 patients with epiphrenic diverticuli and 3 with parabronchial diverticuli (15 male and 11 female with a mean age of 61 years). Twenty-four underwent surgery: 4 isolated diverticulectomy, 7 diverticulectomy and associated myotomy, 5 myotomy alone, 3 antireflux procedure alone. Three patients required esophagectomy for carcinoma in a diverticulum, for a huge diverticulum adherent to the inferior pulmonary vein. One patient presenting with perforation of a carcinomatous diverticulum in the pleura was treated with pleurotomy and has died. No fistula has been notified. Long term results had been analysed with a mean follow up of 4 years. Special attention has been reported on development of gastro-esophageal-reflux. The finding of a thoracic diverticulum requires evaluation by barium swallow, fibroscopy and functional test which should indicate the operation required. Long term analysis should include functional manometric evaluation and a pHanalysis as long term results are reduced by the appearance of gastro-esophageal-reflux.

Aged↗
PubMed1990

[Surgical treatment of peptic stenosis of the esophagus].

36 patients with peptic strictures were operated between 1981 and 1987. 40 operations performed because 4 recurrences after a first intervention obliged to a re-operation. The conservative procedure was used in 29 cases (72.5%). A resection had to be done in 11 cases (27.5%), with 3 re-operations after a first conservative treatment. 1 patient died in hospital. The follow up concerns all patient after a minimum of 2 years. 31 patients (88%) remained symptom free, but 4 patients required further surgery. No mortality and a low morbidity with conservative surgical method were observed. The rate of success was 76% with 24% of recurrence. For us, the best conservative method is total fundoplicatio if possible (sometimes on a gastric cone in case of reflux stricture with shortening of the esophagus). The duodenal diversion is recommended if approach of hiatus is too difficult (re-operation) and in case of alkaline reflux.

Adult↗
PubMed1990

[Contribution of endo-sonography in the evaluation of cancer of the esophagus].

Images of endoscopic ultrasonography are compared with data of surgery and histology. As to tomodensitometry, endoscopic ultrasonography has proved to be more accurate in study of penetration into the esophageal layers, of extension to surrounding structures, specially peri-esophageal lymph nodes. In contrast, endoscopic ultrasonography is helpless searching distant lymph nodes involvement and metastases. These new imaging techniques, together with tracheo-bronchoscopy, enable high degree of precision in determination of the extent of the tumor. Despite better accuracy of the staging, surgical indications remain controversial.

Esophageal Neoplasms↗
PubMed1989

[The contribution of echo-endoscopy in the evaluation of cancer of the esophagus].

Images of endoscopic ultrasonography are compared with data of surgery and histology. As to tomodensitometry, endoscopic ultrasonography has proved to be more accurate in study of penetration into the esophageal layers, of extension to surrounding structures, specially peri-esophageal lymph nodes. In contrast, endoscopic ultrasonography is helpless searching distant lymph nodes involvement and metastases. These new imaging techniques, together with tracheo-bronchoscopy, enable high degree of precision in determination of the extent of the tumor. Despite better accuracy of the staging, surgical indications remain controversial.

Esophageal Neoplasms↗
PubMed1989

[Excision of cancer of the upper thoracic esophagus by initial right thoracotomy].

The authors present their experience with right thoracic first approach in resection of upper thoracic esophageal carcinoma followed by gastro-esophageal anastomosis. This technique has got many advantages: any degree of tumoral extension can be managed by an adapted strategy for the situation; and the technique is particularly suitable for resection of upper thoracic esophageal lesions which usually present many hazard for their removal. Thirty three patients have been operated according to this technique. A satisfactory rate of complete resection was obtained. Mortality rate one month after the operation was of 6%, an although the extensive character of the lesions encountered in this survey of patients, long-life survival rate was satisfactory and seems that it could be ameliorated by the application of a preoperative radio-chemotherapy protocol.

Actuarial Analysis↗
PubMed1989

[Fulminant and subfulminant hepatitis treated by orthotopic transplantation of the liver. Apropos of 10 cases].

In the period between 15/12/1987 and 15/08/1989, ten patients with either fulminating or subfulminating hepatitis have been treated by orthotopic liver transplantation (O.L.T.). Six patients are doing well in the post-operative period with a mean follow-up of 12 months (7-23 months). No evidence of neurological sequelae has been observed and recurrence of HB virus infection was absent from the three cases who survived hepatitis B transplantation. Four out these ten patients died after initial successful O.L.T... One patient succumbed 7 days after O.L.T. from sepsis or early super-acute rejection, the second 21 days after O.L.T. from neuromeningeal listeria, the third 43 days post O.L.T. from acute rejection, while the fourth developed cytomegalovirus pneumonia and died 61 days after O.L.T. Orthotopic liver transplantation has become the treatment of fulminating hepatitis. It is an emergency which is usually accompanied by successive difficulties in decision making: indication criteria, then acceptance or refusal of ABO incompatible grafts (5/10) and of suboptimal donors. Orthotopic liver transplantation for fulminating hepatitis is technically easy to perform, but usually requires the use of extra-corporal veno-venous circulation. Accompanying intensive medical care is essential and usually includes one or multiple plasmaphereses to correct existing coagulopathy without any fluid or sodium overload to the circulation.

Acute Disease↗
PubMed1988

[Excisional surgery of hepatic metastases of colorectal adenocarcinoma].

Between 1981 and 1985, 39 patients had hepatic resection for colorectal cancer liver metastases 44 operations (5 iteratives resections) were performed with 33 major hepatectomy. There was no mortality. Long term results showed: a one year 53% survival, a two years 23% survival, a three years 11% survival. 28 patients had recurrences; 15 of these 28 had hepatic recurrences. According to recent literature the high level of hepatic recurrence suggest that surgical resection should be accompanied with regional chemotherapy.

Actuarial Analysis↗
PubMed1986

[A case of hepatic and splenic peliosis occurring in the puerperium after normal pregnancy].

The authors report a case of Peliosis of the liver and of the spleen that occurred at term after a normal pregnancy that lasted 38 weeks. The delivery was complicated by amniotic infection with hemorrhagic shock and uterine inertia that gave rise to the need for a sub-total hysterectomy in order to stop the bleeding. The progress of the case was made worse by the development of the disseminated intra-vascular coagulation syndrome with septicaemia and pulmonary oedema. When the operation was carried out to stop the bleeding it was noted that the liver was enlarged, hard, smooth and dark in colour and the histological specimen showed a major degree of Peliosis hepatis. The same lesions were found in the region of the spleen and a lymph node. The patient died 14 days after delivery of acute renal failure together with cerebral oedema and septic shock. The authors consider that the aetiology of the Peliosis could be due to hormone changes of pregnancy associated with septicaemia. The anatomical evolution of Peliosis hepatis to widespread necrosis of the parenchyma makes it possible to understand that the condition of diffuse intra-vascular coagulation will not improve in the presence of hepato-cellular insufficiency.

Adult↗
PubMed1985

[Which hiatal hernias require surgery?].

Several clinical situations may justify surgery for hiatal hernia. The approach varies depending on whether the problem is a mechanical complication or a gastro-oesophageal reflux responsible for oesophagitis, peptic stenosis, chest pain, respiratory disorders or Barrett's oesophagus. Recurrence of reflux after surgery raises even more complex problems. Evaluation by modern exploratory techniques helps in establishing precise indications for the operation which must, be reserved to selected cases.

Esophageal Neoplasms↗