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J F Cuttat

Publications and source records attributed to J F Cuttat.

33 records · Page 2Linked to original sources
PubMed1991

Squamous cell carcinoma of the lung in a nonsmoking, nonirradiated patient with juvenile laryngotracheal papillomatosis. Evidence of human papillomavirus-11 DNA in both carcinoma and papillomas.

Malignant transformation of laryngeal juvenile papillomatosis most often occurs in patients with previous radiation therapy or smoking histories. We report the case of a 35-year-old, nonsmoking, nonirradiated man who developed squamous cell carcinoma of the lung with a 33-year history of laryngotracheal juvenile papillomatosis. Postmortem examination showed pulmonary cavitating papillomatosis and chest wall, vertebrae, and peribronchial lymph node involvement by tumor. Molecular studies (Southern blot, polymerase chain reaction) showed extrachromosomal human papillomavirus-11 (HPV11) DNA in both carcinoma and two laryngotracheal squamous cell papillomas, including one excised 20 years previously. Our observation is analogous to the previously reported cases of spontaneous (not related to irradiation or smoking) malignant transformation of juvenile laryngotracheal papillomatosis. Although HPV11 viral infection likely played a role in the malignant transformation, other less likely factors, such as drugs given for treatment and radiography performed throughout the illness, should be considered. Repeated pulmonary infections and the host immune response are additional considerations.

Adult↗
PubMed1990

[Dieulafoy's simple stomach ulcer: apropos of 5 cases].

Dieulafoy's ulcer is a probably congenital arterial malformation which may produce severe upper gastrointestinal haemorrhage. It represents about 1% of all cases of acute upper gastrointestinal haemorrhage (3/249 in our department during 1989). We report 5 cases in whom haemostatic endoscopic treatment was successful and propose therefore that this therapy should be the initial treatment of choice. Surgical intervention should be considered only if endoscopic therapy fails.

Adult↗
PubMed1990

[Therapeutic choice in primary costal tumors].

Primary rib tumors constitute a rare entity and have only seldom been studied separately. In a retrospective study based on 21 cases, with the help of the literature, we try to specify the specific problems encountered with rib tumors and the therapeutic consequences that follow. Our series comprises 10 benign tumors, 3 malignant tumors and 8 cartilaginous tumors. The benign tumors were resected and all the patients recovered uneventfully. One of the patients died of a plasmocytoma 92 months after resection. Among the cartilaginous tumors, we observed two recurrences after 9 and 24 months from which the patient died eventually at 20 and 72 months after resection. The histologic diagnosis of a rib tumor must be made through an excisional biopsy. Cartilaginous tumors are potentially malignant. They must be treated as malignant tumors by radical resection and primary reconstruction. The long-term follow-up of every patient carrying a rib tumor is mandatory because of the risk of late recurrence.

Adult↗
PubMed1989

[Gastroduodenal ulcer disease: what surgical indications are left?].

Between 1976, date of the introduction of anti-H2, and 1987, 716 patients were hospitalized and operated on for ulcer disease in the surgical department of this hospital. The present study shows that 1. the annual number of operations has regressed by some 30%, 2. while the number of gastric ulcers remains constant on the whole, cases of acute duodenal ulcer have diminished by half, 3. cases of chronic, recurrent, or therapy-resistent duodenal ulcer have increased some tenfold (2 out of 78 in 1976 and 14 out of 45 in 1987), 4. the same is true of perforated ulcers (12 out of 78 in 1976 and 10 out of 45 in 1987) and hemorrhages (12 out of 78 and 10 out of 45), 5. surgery for stenosis has remained constant. -Proximal selective vagotomy has been the treatment of choice since 1981 in over 80% of duodenal ulcers. Operative mortality affects only elderly patients undergoing emergency surgery for complicated ulcer (two thirds perforations, one third hemorrhages). It is 2.6%. We thus confirm the reduced role of surgery in the treatment of gastric ulcer, while redefining the present surgical indications.

Aged↗
PubMed1989

[Pseudocyst and pancreatitis. Which factors are predictive of development?].

Pseudocysts complicating the evolution of pancreatitis are being recognized with increasing frequency at the subclinical stage. The authors' retrospective study covering 55 cases of pseudocyst brings out 5 criteria for prediction of the evolution of the disease, which should facilitate decision-making with regard to therapy.

Acute Disease↗
PubMed1989

[Synchronous hepatic metastases of colorectal adenocarcinoma: what is the course? Apropos of 36 cases].

The discovery of synchronous hepatic metastases from colorectal cancer poses a tactical problem ticklish to resolve. What are favourable circumstances for curative excision of hepatic metastases? When and how to operate them? To try to respond, we analysed a collective of 36 patients between 10. 1. 1985 and 30. 12. 1986. Of the patients staged Dukes B presenting synchronous hepatic metastases (less than 4, less than 50% of hepatic involvement by the tumour) without systemic involvement, excision at the first attempt is realizable and will be a benefit for the patient. For the others, excision is to be considered in the near future after having analysed (tumour grading and staging, CEA, ploidy of primary tumour). Patients presenting extrahepatic metastases will not benefit from hepatic resection. Surgery, associated or not to regional infusion chemotherapy is discussed.

Adenocarcinoma↗
PubMed1989

Diagnosis and treatment of malignant oddian tumors.

Between 1959 and 1987 we operated on 18 patients for malignant oddian tumor. Eleven had a Whipple resection, 3 a bilio-enteric anastomosis, 4 a local excision with or without bilio-enteric anastomosis. The overall operative mortality was 11% and the median survival was 13.8 months. Three patients are living and without evidence of disease 12, 29 and 30 months, respectively, after a Whipple resection. Because of their anatomy and favourable behaviour, malignant oddian tumors must be separated from the other periampullary tumors. Echography and endoscopic retrograde cholangiopancreatography with deep biopsies are the most efficient diagnostic modalities. With the aim of cure, the treatment is always surgical and relies mainly on duodenopancreatectomy. Those patients with unresectable tumors or unfit for a major procedure should benefit from internal or external biliary drainage. By coexisting duodenal obstruction, a surgical double derivation should be done.

Adenocarcinoma↗
PubMed1989

[Invasive adenocarcinoma of the stomach: prognostic factors and surgical technics].

Between 1976 and 1987, 183 patients with an invasive adenocarcinoma of the stomach were treated in the Department of Surgery of the CHUV in Lausanne. This study allows us to conclude: 1. The localisation, age, sex and the association with atrophic gastritis have no prognostic significance. 2. Histologic subtype does not influence prognosis. Eighty percent of patients with isolated cell carcinomas survived less than 2 years, as did 68% of those with intestinal cell carcinomas. 3. No patients with distant metastasis survived over 2 years: mean survival for these patients was 4.1 months. 4. Patients without distant metastasis had a survival of 24 months regardless of the type of operation and degree of stomach wall invasion. 5. Wide gastric resection seems wise to avoid local recurrence but in itself did not improve survival. 6. Wide lymph node resection should be offered to patients who can withstand the procedure by medicosurgical teams with low predictable morbidity and mortality. The improved survival seems clear for patients with stage T1N1 and T1N2 tumors. 7. These results need to be confirmed by a prospective study.

Adenocarcinoma↗
PubMed1989

[Esophageal perforation: prognostic factors].

Esophageal ruptures are amongst the severest of the digestive tract. We report a retrospective study of 30 cases (15 men and 15 women) aged 17 to 85, collected between 1976 and 1987. The group of risk is constituted by patients aged 60 and up, presenting an underlying esophageal illness. The endoscopic etiology of the perforation is as severe as the one of surgical or spontaneous origins. Medical treatment is considered only if the perforation is inferior to 2 cm, extra-thoracic, without an associated pleural effusion and without an associated esophageal illness. When surgical treatment of a primary suture is done, it is the most important factor to protect the suture by a patch.

Adolescent↗
PubMed1989

[Adenocarcinoma of the cardia].

The extensed total gastrectomy of principle represents a new hope in the surgical treatment of the cardial adenocarcinoma. On the basis of a retrospective study of 38 patients (30 men and 8 women) we think that for patients in good general condition and for stades I and II, the enlarged total gastrectomy represents the only treatment with curative aiming. As for stade III and a fortiori stade IV, there is no advantage to use the enlarged total gastrectomy. For stade III, survival is inferior to 10 months, whatever the type of operation used, and for stade IV survival is inferior to 3 months, whatever the treatment.

Adenocarcinoma↗
PubMed1985

Spontaneous pneumothorax. A complication of lung cancer?

Among 338 adults (258 men and 80 women) presenting with spontaneous pneumothorax, there were six men with lung cancer: five squamous cell carcinoma and one oat cell carcinoma. Pneumothorax led to the diagnosis in five cases and the remaining occurred as a complication of known neoplastic disease. The average age was 67 years. We analyze these six cases, along with 46 others from the literature. In patients less than 40 years old with normal chest x-ray film findings after lung expansion, further investigation for neoplastic disease is not justified. However, heavy smoking, chronic bronchitis, bullous emphysema and incomplete lung expansion after chest drainage in patients over 40 years old are indications for cancer screening through sputum cytologic study, bronchoscopic examination and surgical exploration. The occurrence of a pneumothorax neither alters the treatment of the underlying disease nor modifies the one-year prognosis. Five-year survival is nil, suggesting that lung cancers present as pneumothorax at an advanced stage of disease.

Aged↗