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Biomedical subjects

J F Rodier

Publications and source records attributed to J F Rodier.

At least 73 records · Page 4Linked to original sources
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↗
PubMed1989

[Current role of pre-scalene biopsy in the pretherapeutic evaluation of invasive cancer of the uterine cervix].

Despite coded staging of localization studies in cancer of the uterine cervix, numerous authors have attempted to improve knowledge concerning certain prognostic factors, of which the most important in lymph node status. It is with this in view that pre-scalene biopsies are performed. Their adjunction to pretreatment investigations appears to be determining, especially in advanced-stage forms when aggressive surgical (pelvic exenteration), radiation (lomboaortic irradiation) or even chemotherapeutic treatments are being considered. Because of the wide variation in the results in the literature and the lack of precision of the indications of this low-morbidity surgical procedure, the authors decided to define the place of this supraclavicular lymph node investigation for staging. While it need not be systematic in the early stages of the disease, this does not seem to be the case in advanced stages and recurrences which call for a more moderate attitude.

Biopsy↗
PubMed1988

[Spontaneous regression of pulmonary metastasis of cancer of the kidney. Apropos of a case occurring after the irradiation of a pelvic metastasis. Review of the literature].

Spontaneous regression of metastases from cancer of kidney is an exceptional event, original but non-specific to this neoplasm. Observed principally in secondary pulmonary localizations this phenomenon occurs most frequently after nephrectomy. A personal case is presented of regression of pulmonary images considered as being metastatic after irradiation of a pelvic metastasis from renal adenocarcinoma, and a literature review carried out. The various pathogenic hypotheses are discussed and the place of nephrectomy for metastatic renal cancer (Robson's stage IV) debated.

Adenocarcinoma↗
PubMed1988

[190 cancers of the thyroid with a follow-up of more than 5 years].

Outcome in 190 patients operated upon by first intention for thyroid cancer is analyzed after follow up over more than 5 years. No deaths due to cancer occurred in 57 cases of papillary cancer, but 7 cases presented pulmonary metastases, while the global-5-year survival rate in 63 cases of vesicular cancer (including 25% with preoperative metastases) was 60%. In the absence of preoperative metastases, ans if well differentiated forms are separated from moderately differentiated forms, the respective 5-year survivals were 88 and 45%. The 1-year survival rate for the 42 cases of anaplastic cancer was 15%, while the 5-year rate for 15 cases of medullary cancer was 80%.

Adult↗
PubMed1987

[Trophoblastic tumor of placental location or trophoblastic pseudotumor. Apropos of 2 cases. Review of the literature].

Two cases of trophoblastic tumor of placental site are reported, less than 30 such lesions being listed in the published literature. Identification of this tumor from among other trophoblastic lesions is facilitated by immunohistochemical and electron microscopy technics, and demonstration of histoprognostic and biologic criteria improves assessment of evolutory potential of this type of tumor and allows adaptation of therapy. Treatment at the localized stage requires early diagnosis and wide surgical excision, results of chemotherapy in metastatic forms being, inversely than with choriocarcinoma, very deceiving.

Adult↗
PubMed1987

[Complications of abdominal hysterectomy for benign gynecologic lesions. Apropos of 1,000 cases].

The authors present a retrospective study of 1,000 total abdominal hysterectomies performed between 1969 and 1975, and they report the main complications. Early complications are dominated by: rare thrombo-embolic accidents (2.2%) since the advent of prophylactic heparin therapy; infectious complications, dominated by the abscess of the abdominal wall and asymptomatic urinary infections, and for which simple measures prevent resorting to prophylactic antibiotherapy. The role of the hysterectomy seems minimal in the occurrence of a prolapse or a stress-related urinary incontinence: prolapses after hysterectomy (1.4%) seem more related to tissue aging than to the procedure which modifies very little the supporting system of the pelvis. A post-operative urinary incontinence is, most of the time, the result of an incomplete pre-operative work-up: failure to recognize a potential stress-related incontinence, or an incontinence secondary to an unstable bladder. Prolapse and incontinence must always be treated independently. In the psychological and sexual repercussion, age, ovariectomy and the distress related to the procedure, involving the heart of womanhood, seem to be the most important factors.

Adult↗
PubMed1987

[Ureteral dosimetry during gynecological curietherapy. Possible effects on the occurrence of postoperative ureteral complications].

The dosage of radiations delivered during gynaecological brachytherapy is usually calculated for the bladder and the rectum. A new technical approach is described in order to known the dose of radiation received by the terminal portion of the ureter. During placement of the Fletcher suit one of the ureters is catheterized by a special stent which appears on the X-rays control used for dosimetry. Data of 16 pre-operative brachytherapies for carcinoma of the cervix were studied. In half of the cases, the dose debit was higher on the ureter than on the bladder and the rectum. In 7 cases, the dose delivered was also higher on the ureter rather than on the bladder and the rectum. And in 3 cases this dose was higher than 50 grays. It is concluded that the ureter is frequently the most irradiated organ in the pelvis during brachytherapy for carcinoma of the cervix. This may be a physiopathologic explanation for some ureterovaginal fistulas occurring after radical hysterectomy.

Brachytherapy↗
PubMed1986

[Value of lumbo-aortic curettage in stage I and IIA tubal cancers].

Results of a 7-year follow-up review of a patient with intratubal cancer and lumbo-aortic glands invasion are reported. The highly lympholytic character of these tumors and the existence of elective lumbo-aortic lymph node metastases suggest that surgery should include routine bilateral lumbo-aortic curettage in tubal cancer, particularly stages I and IIA. As well as providing improved assessment of degree of extension of the disease it can also avoid the frequently poorly tolerated abdominopelvic radiotherapy.

Adult↗
PubMed1986

[Surgical treatment of recurrence of uterine cervix cancer].

Surgery for recurrence of malpighian epithelioma of uterine cervix was performed in 14 patients, exenteration being necessary in 10 cases (5 anterior, 4 total and 1 posterior). Possibilities of surgical excision of recurrences are limited (10 to 20% of cases) and should not be considered except after a careful general, local and regional investigation including, if necessary, and exploratory laparotomy. This recovery surgery must be preceded by high-dose irradiation. This partly explains the high incidence of exenterations, with the need for cutaneous bypass of urine and/or fecal matter, but also the high prevalence of postoperative complications and mortality. Long-term results are deceiving and a 5-year survival rate of 20% appears to be maximum obtainable. However, this surgery remains the only solution capable of providing the patients with a chance, and it very often relieves them of the painful course of a pelvic tumor.

Adult↗
PubMed1986

[Injuries of the thoracic duct during neck surgery].

Although rarely published, operative injuries to thoracic duct in neck are by no means exceptional, and can occur during all types of surgery to lower cervical and supraclavicular regions. A case is reported and used as a basis for an analysis of diagnostic means and therapeutic possibilities of injuries detected during operation or those developing manifestations at a later stage. In the case reported, long-term medical treatment resulted in arrest of lymphorrhea within 37 days.

Adult↗
PubMedDate not supplied

Lobular carcinoma in situ of the breast: results of a radiosurgical conservative treatment.

From 1980 to 1992, 17 women underwent lumpectomy (13) or quadrantectomy (4) and whole breast irradiation (median dose: 52 Gy) for pure lobular carcinoma in situ (LCIS). Three cases correspond to palpable lesions and 14 were discovered only by mammography. Twelve women also received tamoxifen at 20 mg/day for two years. With a median follow-up of 88 months, no local or regional recurrences have been recorded. The global rate of bilateral carcinoma was 17.6% (2 synchronous and one metachronous). In the literature, only eight other cases of LCIS were treated by lumpectomy and radiation therapy, but without details and data on long-term results. After biopsy alone for LCIS subsequent infiltrating carcinoma occurred in about 15% of the cases. Thus, the classical radiosurgical association should represent an interesting alternative both for biopsy alone and radical surgery until now only proposed to treat LCIS.

Aged↗