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Biomedical subjects

J F Rodier

Publications and source records attributed to J F Rodier.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Latissimus dorsi myocutaneous flap closure in mastectomies after chemotherapy of advanced and progressive breast cancers].

A latissimus dorsi myocutaneous flap now appears to be the best solution to closing large carcinological exeresis of the breast. After an analysis of a series of 14 cases of advanced cancer (T3 or T4) or of progressive cancers (PeV3) of the breast treated by inductive chemotherapy and which underwent surgery at the Strasbourg CRLCC (France), the authors stress the simplicity and reliability of the method, which can make it possible to carry out an extensive and complete exeresis, which is of primordial importance in the control of the local tumor. Its excellent trophic quality made it possible to start radiochemotherapeutic adjuvant treatments rapidly. The other methods (myocutaneous flap of the rectus abdominis, Kiricuta's epiploic flap, neighboring autoplasties) now persist only in cases of advanced breast tumor in which the greater dorsal flap is contraindicated.

Adult↗
PubMed1991

Prevention of radiation enteritis by an absorbable polyglycolic acid mesh sling. A 60-case multicentric study.

Radiation-induced small bowel injury is a limiting factor to postoperative tumoricidal pelvic doses exceeding 4500 to 5000 cGy. Data from a review of the literature showed the inadequacy of medical measures and the bad reproducibility of radiation therapeutic attempts to decrease small intestine damage. Recent studies cited the benefit of a polyglycolic acid mesh to create an absorbable intestinal sling and suspend the loops above the pelvic radiation field. In 60 cases of gynecologic and rectal malignancies with a surgical intestinal morbidity of 8.3% (5 cases), the rate of radiation enteritis was 7% (4 cases) with an average follow-up of 17.8 months (range, 1 to 57 months). The quality of small intestinal elevation and the absence of loop herniation were demonstrated by the barium index. Magnetic resonance imaging was used for checking the polymer polyglycolic acid mesh position and its complete resorption at the third to fifth postoperative month. The authors conclude that this new procedure is safe in selected patients with high pelvic recurrence risk after optimal surgery, in residual disease after debulking surgery, or at the time of exploration for unresectable pelvic tumors. Clinical studies are ongoing to evaluate the long-term efficacy of this surgical technique to prevent chronic radiation enteropathy and improve locoregional control in advanced pelvic carcinomas.

Adult↗
PubMed1991

[Role of total thyroidectomy in the treatment of multinodular goiter].

Although it may seem to be excessive, total thyroidectomy has recently been advocated by several authors for the treatment of diffuse multiheteronodular goiters. As a complement to a recent study on the thyroid function following thyroidectomy for benign goiters, the authors specify the role of this surgical technique, which had been reserved for the sole thyroid neoplasms for a long time. On the occasion of the presentation of a series of 75 cases gathered from 1989 to 1990, the justification of glandular resection is based on the publication of new pathogenetic data and on the absence of any increase in morbidity, subject to precise indications and to a strict technique aimed at preserving recurrents and locating the parathyroid glands while maintaining their vasculature. When aimed at reducing the frequency of recurrence of euthyroid and toxic diffuse multinodular goiters, total thyroidectomy might also contribute in reducing the morbidity of second surgery, at the expense of a permanent substitution therapy. While the choice of its indications must remain eclecty, thelong-term consequences of initial surgery with too restricted glandular exeresis must be recognized.

Adult↗
PubMed1991

[The value of peritoneal cytology in invasive uterine cancers. Analysis of 80 cases].

When they analysed 80 cancers of the uterus, the authors showed how valuable it was both for diagnosis and prognosis to carry out cytological lavage of the peritoneum, particularly in cases of endometrial adenocarcinoma. The results of this study are compared with recent extracts appearing in the international literature. This technique makes it possible to identify groups of patients of high risk for recurrences in the pelvis and abdomen who would benefit from adjuvant therapies, demonstrating that this technique is applicable to the diagnosis of gynaecological cancers with intraperitoneal spread which have long been failed to be recognised. The procedure is innocuous and simple and therefore should be carried out widely in the management of uterine cancers.

Adenocarcinoma↗
PubMed1991

[Surgical removal of diaphragmatic metastasis of advanced ovarian cancer. Review of the literature].

Many studies have established the close relationship between the survival and the residual tumoral volume after a first maximal cyto-reducing surgery. In that light, the surgical exeresis of the metastatic lesions should facilitate the response to chemotherapy. In this respect, the diaphragm metastases of ovarian cancers prove to be worthy of the highest interest due to the difficulty of their surgical approach. Several techniques for the exeresis of these secondary peritoneal localizations have been reported, using various processes (electrocoagulation, laser vaporization, classic surgical exeresis) and more recently, the ultrasound dissector. After a review of the literature on 43 cases, the authors draw the attention on the approach and surgical exeresis methods for these metastases. If these techniques prove to be quite feasible, with an acceptable morbidity rate, only a great hindsight, together with more observations, will enable the assessment of the benefit in terms of survival.

Diaphragm↗
PubMed1990

[Tamoxifen and endometrial adenocarcinoma].

The authors report a case of endometrial carcinoma treated with tamoxifen introduced after normal initial uterine curettage. Based on recent experimental and clinical data, the importance of a gynecological follow-up in anti-estrogen therapy is emphasized.

Adenocarcinoma↗
PubMed1990

[Functional cervical lymph node excision with section of the sternocleidomastoid muscle].

Based on 7 cases, the authors update the low section and subsequent suture technique of the sternocleidomastoid muscle in conservative cervical lymphadenectomy, principally for differentiated thyroid cancer. Due to the good exposure obtained, this technique permits functional clearance with excellent visualisation of the structures to be preserved and is associated with very minor functional sequelae. A review of the literature confirms the perfect feasability and reproducibility of this technique and justifies its use from a cosmetic viewpoint.

Adult↗
PubMed1990

[Thyroid function after thyroidectomy for benign goiter. 200 cases explored by ultrasensitive TSH].

Based on a retrospective study of a series of 200 thyroidectomies for benign goitre and a mean follow up period of 12 Months, the authors analysed post-operative thyroid function and correlated it with the degree of surgical excision (47 unilateral lobectomies, 91 classical subtotal bilateral lobectomies and 62 extended bilateral subtotal lobectomies). After a presentation of the results in comparison with data from the literature, the timing and threshold for the institution of replacement therapy are examined and the need for prolonged clinical and laboratory monitoring is also stressed. In terms of changes in laboratory criteria only monitoring of spontaneous changes in US TSH allows opotherapy to be avoided or conversely to accurately define the conditions for institution of definitive replacement therapy. The justification of total thyroidectomy in the treatment of multihetoronodular goitres almost totally involving the glandular parenchyma is acknowledged.

Adolescent↗
PubMed1990

[Significance of the non-peritonization technic in extended lymphadenocolpohysterectomies in uterine cancer. Analysis and results in a series cases].

The gravity of the pelvic lymphocysts after extended lymphadeno-colpo-hysterectomies for uterine cancers has been outlined in many studies and only a preventive strategy can reduce the morbidity, which is mainly of urinary order. The present technique is in line with this approach and breaches the peritonization dogma in gynaecology. After the presentation of 60 cases of extended colpo-hysterectomies with iliac lymphadenectomy and without reperitonization, the authors study the post-operative lymphorrhea and evaluate the morbidity proper to the technique by comparing their results with the literature data. The safety , the feasibility of the technique and its preventive role in the development of lymphocysts should favour its expansion in pelvic cancer surgery.

Adult↗
PubMed1989

[Prevention of radiation injuries of the small intestine with pelvic exclusion by polyglactin 910 mesh. Contribution to gynecologic and digestive cancer surgery].

Used in 13 cases of advanced gynecological and gastrointestinal carcinoma, pelvic exclusion using a suspension of the small intestine above the pelvis using absorbable material. The low-level of morbidity, value in dosimetric estimation, perfect feasibility and low cost of this technique should lead to its more widespread use whilst strictly respecting its indications. Nuclear magnetic resonance has been found to be a particularity novel and valuable method of post-operative investigation in visualisation and assessment of resorption of the polyglactine 910 trellis. Results in this series are analyzed at the end of a 5 to 14 month follow-up period and compared with data from experimental and clinical studies in the recent world literature.

Adult↗
PubMed1989

[Gastric metastases of cancer of the breast. Apropos of a case. Review of the literature].

Since they are rare and often latent, gastric metastases from breast cancer, principally lobular, are difficult to diagnose particularly at the isolated stage. The primitive and non specific nature of their symptomatology and the negativity of endoscopic biopsies should lead to early explorative laparotomy. Surgery is often palliative to reduce tumor load and seldom involves complete excision, and can only hope to obtain prolonged survival if followed by chemotherapy, hormone therapy or indeed radiotherapy. Following a recent personal case a review of the worldwide literature was carried out and the principal pathogenic hypotheses were analysed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Hürthle cell tumor of the thyroid gland. Analysis of a series of 33 cases].

Hurthle cell or oxyphil cell tumours of the thyroid, which consist of large cells with eosinophilic granular cytoplasm, rich in mitochondria, have given rise to much controversy in recent years. Difficulty in histological diagnosis (benign or malignant), unexpected evolution, and the possibility of very late recurrence and metastasis occurring in cases which were previously labelled benign, characterise these ambiguous tumours. Their malignant forms are most often classified with vesicular cancers of the thyroid. They differ from the latter by the frequent presence of lymphatic metastases, the lack of effect of I 131 on distant metastases and their poorer prognosis. The experience of the authors is based upon a series of 33 cases of Hurthle cell tumours of the thyroid treated surgically (27 benign, 6 malignant), with a mean age of 44 years for benign lesions and 50 years for cancers (range 17 to 69 years) showing a clear female predominance (66% of cases). They most often presented clinically as a cold thyroid nodule which tended to be larger in the case of cancers (5 out of 6 cases had a diameter of more than 5 cm). The limits of resection were most often dictated by the results of per-operative frozen section: total lobectomy + isthmectomy for benign tumours and total thyroidectomy if macroscopic or histological signs of malignancy were present (spread beyond the capsule, vascular invasion, lymphatic metastases), with cervical node clearance if N+. The 27 cases who underwent surgery for benign tumours have survived (1 single local recurrence after 7 years, without any malignant progression and a median survival of 7 years). No deaths have occurred among the 6 cases of malignant tumours (follow-up ranging from 1 to 9 years, median 5.4 years) but a present metastases. A study of the series published in the literature confirms the difficulty with diagnosis in terms of the benign or malignant nature of the tumours. It also stresses the justification for relatively aggressive surgery on the thyroid parenchyma and the need for a very long period of locoregional and general surveillance in order to assess the results of treatment. Survival rates for malignant forms range from 60 to 65% at 10 years and from 25 to 47% at 15 years.

Adenoma↗
PubMed1989

[Primary or secondary malignant tumors of tonsillar cysts. Apropos of a case of occult papillary cancer of the thyroid disclosed by intracystic metastasis].

The development of a malignant process within a tonsillar cyst is controversial. This phenomenon is exceptionally rare, at present only three cases which have been compatible with anatomo-clinical diagnostic criteria have been clearly established. Based on an original case showing a secondary papillary thyroid cancer in a tonsillar cyst, the authors analyse, in the light of recent data from worldwide literature, the various stages in the diagnostic process in both primary and secondary malignant tumours. The therapeutic and prognostic aspects of the two tumour varieties are also discussed.

Adult↗