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J F Gigot

Publications and source records attributed to J F Gigot.

60 records · Page 4Linked to original sources
PubMedDate not supplied

[Value of automatic sutures in total gastrectomy for cancer: apropos of 81 patients].

We reviewed the results of stapled circular (EEA) and linear (TA 30 or 55) anastomoses in a prospective study of 40 total gastrectomies for cancer, using an interposed jejunal limb (Henley technique). There were 63 circular anastomoses: 40 esophago-jejunal, 20 jejuno-duodenal and 3 jejuno-jejunal anastomoses. Forty patients were submitted to 41 linear stapled closures of the jejunal stump. Technical failure rate with stapled anastomoses was 5% (3 out of 63). Incidence of anastomotic leak was 6.3% for all the circular stapled anastomoses tried and 5% if the 3 technical failures were excluded. Anastomotic leakage is more often associated to splenopancreatectomy. One patient (1% of all the anastomoses) presented gastro-intestinal bleeding, related to the suture line. A conservative treatment was carried out successfully. The mean follow-up time of the surviving patients was 27 +/- 20 months: there was a 5.5% rate of late anastomotic stenosis; all the patients were cured by esophageal dilations. Late anastomotic stenosis is directly related to associated cobalt therapy. Analysis of an older retrospective series of 41 hand-sutured total gastrectomies allowed a comparison to be made between stapled and sutured anastomoses in total gastrectomy for cancer.

Adult↗
PubMedDate not supplied

[Preoperative localization of parathyroid adenomas: significance, indications and results].

Preoperative localizing technics of a parathyroid tumour. The authors present a limited experience about preoperative localizing technics of a parathyroid tumour. Oesophagography and selenomethionine 75 scintigraphy were not useful. Ultrasonography and computed tomography localised 50% of the tumours. Selective thyroïd venous catheterization and radioimmunoassay are correctly predictive in 87,5% of the studied cases. The interest, morbidity and results of these different technics are discussed.

Adenoma↗
PubMedDate not supplied

Benign hepatocellular tumors: MRI after superparamagnetic iron oxide administration.

OBJECTIVE: Our goal was to describe the features of benign hepatocellular tumors on superparamagnetic iron oxide (SPIO)-enhanced MR images and to evaluate the potential role of SPIO administration in the diagnosis of these tumors. MATERIALS AND METHODS: The T1- and T2-weighted SE images were performed before and after SPIO administration in 19 patients with focal nodular hyperplasia (FNH) or adenomas. The lesions were counted and qualitatively assessed. In 32 tumors with a diameter of > 10 mm, the contrast-to-noise ratio (CNR) and the liver and tumor enhancement were calculated. RESULTS: Thirty-seven tumors were detected on MR images: 29 before and 36 after SPIO administration (p < 0.05). The SPIO-enhanced T1-weighted images provided the highest detection rate and CNR. The central scar was most conspicuous on SPIO-enhanced T2-weighted images. Most FNHs and adenomas lost less signal than the liver, three tumors did not lose signal, and four FNHs showed a signal loss equal to or greater than that of the liver. CONCLUSION: The SPIO-enhanced T1-weighted images increased the CNR and the detection rate of benign hepatocellular tumors. On T2-weighted images, most benign hepatocellular tumors showed a signal decrease after SPIO administration. No significant difference in signal loss was observed between FNH and adenomas.

Adenoma↗
PubMedDate not supplied

Is laparoscopic splenectomy a justified approach in hematologic disorders? Preliminary results of a prospective multicenter study. Belgian Group for Endoscopic Surgery.

The feasibility and safety of laparoscopic splenectomy were evaluated in a prospective multicenter study of 50 patients operated on for idiopathic thrombocytopenic purpura (ITP) (n = 31), hereditary spherocytosis (n = 6), hemolytic anemia (n = 4), Hodgkin's disease or lymphoma staging (n = 5), benign splenic tumors (n = 3), and wandering spleen (n = 1). Conversion to laparotomy was required in 10%. An accessory spleen was routinely searched for, although the lesser sac was opened during surgery in only 10%; the overall incidence was 14%. Hospital mortality was 2% and postoperative morbidity 22%. Postoperative hospital stay and home rehabilitation were improved when exclusively laparoscopic splenectomy was performed. In ITP patients, at a mean follow-up of 8.2 months, 8 patients (27%) had recurrence of thrombocytopenia, which was transient in 7% and permanent in 20%. Laparoscopic splenectomy is feasible and safe when performed in selected patients by expert laparoscopic surgeons. Adequate selection of patients and routine, careful search for accessory spleen are critical. The recurrence rate (20%) for ITP was high at 8.2 months, and this factor is the major limitation of laparoscopic splenectomy at present.

Adolescent↗