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Biomedical subjects

J F Bosset

Publications and source records attributed to J F Bosset.

13 recordsLinked to original sources

Functional results of coloanal anastomosis with reservoir.

Functional results in 33 patients who underwent a coloanal anastomosis with reservoir were prospectively evaluated three months after colostomy closure and later (16.2 +/- 5.7 months) and were compared with those of 36 healthy controls. We were unable to demonstrate any significant difference between patients and controls concerning frequency of stools, feeling of the need to defecate, continence of stools and flatus, differentiation between flatus and feces, urgency, and need to wear a protective pad. There was a statistically significant difference concerning the ability to evacuate, which was better in the control group (score = 1.03) than in the patients (score = 1.63) (P less than 0.001). These results suggest that coloanal anastomosis with reservoir provides nearly normal function except for the ability to evacuate.

Adult

Stapled coloanal anastomosis with reservoir procedure.

A closed-lumen procedure of coloanal anastomosis with a reservoir, performed exclusively with staplers to reduce spillage, is described. This stapling procedure provides three advantages: simplicity, reduction of spillage, and the preservation of sphincteric structures. In 33 procedures performed, 2 (6%) anastomotic leakages and 5 (15%) dilatable stenoses occurred.

Adult

Conventional external irradiation alone as adjuvant treatment in resectable pancreatic cancer: results of a prospective study.

Between 1/85 and 1/90, 14 consecutive patients were entered into a prospective study of conventional adjuvant post-operative external beam radiotherapy after complete resection for a pancreatic adenocarcinoma. The surgical procedure was a Whipple resection in nine patients, a distal pancreatectomy in four patients and a total pancreatectomy in one patient. There were three T1b, eight T2 and three T3 tumours (UICC 1987); nodal involvement was present in five cases. The radiotherapy was delivered using a four-field box technique with a 23 x MV photon beam. All patients received a total dose of 54 Gy to the tumour bed. The mean treated volume was 900 cm3. Acute toxicities consisted mainly of weight loss (mean: 2 kg). Two patients had a grade 2 diarrhoea and two patients a grade 2 gastritis. Late effects were minimal and only observed in two patients. The overall locoregional recurrence (LR) rate was 50%. The median disease-free survival was 12 months, and the median survival was 23 months. This post-operative conventional radiotherapy treatment gives results that are comparable to the results of the GITSG-adjuvant study using a combination of split-course radiotherapy and 5-fluorouracil (5-FU).

Carcinoma, Intraductal, Noninfiltrating

[Recognition of predictive prognostic factors in recurrent colonic cancer. Apropos of a retrospective series of 178 cases].

Prognostic factors influencing the outcome of colon cancer were studied retrospectively in 178 patients who underwent curative resection between 1975 and 1985. Monovariate and multivariate analysis have been performed. Median follow-up was 8.7 years. Three factors increased the risk of recurrences: age when equal or greater than 70, poorly differentiated tumor and advanced Duke's stage. Two factors increased the risk of intra-abdominal recurrence: age when equal or greater than 70 and advanced Duke's stage. Two factors increased the risk of metastasis (including the liver): poorly differentiated tumor and advanced Duke's stage. Multivariate analysis showed that the risk of recurrences was correlated to Duke's stage, age and histological differentiation. Patterns of failure and prognostic factors reported in the literature are reviewed and implications of these prognostic factors on adjuvant treatment indications are discussed.

Adult

[Rectal cancer: need for radiotherapy in determining the treatment plan].

Postoperative radiotherapy is highly effective in the prevention of local recurrence in rectal cancer. Nevertheless, the results remain disappointing for Locally Advanced Rectal Cancer. New approaches include introduction of chemotherapy to postoperative radiotherapy or combined radiotherapeutic treatment with preoperative irradiation, surgery and intraoperative irradiation, along with elective postoperative treatment in function of surgical and pathological data. Based on recent advances in radiobiology we are able to modify treatment parameters to enhance efficacy without increasing the toxicity. The reduction of dose per fraction, the application of radiosensitizers, the optimal protection of healthy tissue will increase the therapeutic ratio while keeping results constant or even reduce the incidence of local failure.

Combined Modality Therapy

[Breast cancer following breast prosthesis and irradiation in childhood].

The authors report a case of breast cancer developing 7 years after insertion of a breast prosthesis. This patient was 45 years old at the time of this discovery and had received low dose radiation during childhood for a haemolymphangioma of the homolateral axillary region. The possible factors predisposing development of cancer are discussed: haemolymphangioma, low dose axillary irradiation during childhood, peri-prosthetic fibrous capsule. These various points are examined in the light of data from the literature. The conclusions recall the necessity for clinical and radiological follow-up of breast prostheses, preferably performed by a plastic surgeon.

Axilla