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J L Pouly

Publications and source records attributed to J L Pouly.

At least 109 records · Page 6Linked to original sources
PubMed1991

[Acute salpingitis. Celioscopy before and after treatment: 110 cases].

The authors report their experience concerning 110 cases of acute salpingitis that were diagnosed and controlled laparoscopically one month after antibiotic treatment had been achieved. During the second look laparoscopy three parameters were appreciated: pelvic adhesions, tubal patency, and residual inflammation. Laparoscopic findings at the time of early second look have shown relationship between the occurrence of tubal sequelae and the seriousness of initial PID: the relation was statistically significant regarding pelvic adhesions and tubal patency. Chlamydia trachomatis infections were associated with a poorer reproductive potential outcome. Second look laparoscopy seems particularly indicated after severe form of PID (pyosalpinx, tubo-ovarian abscess), in the presence of Chlamydia trachomatis, among young nulliparous woman wishing to conceive.

Acute Disease↗
PubMed1991

[Contribution of celioscopy in the early diagnosis of ovarian cancers].

Four hundred and eighty-one patients with an ovarian cyst considered to be benign on the basis of clinical and ultrasonographic findings underwent diagnostic laparoscopy. All malignant tumours (9 cases) were recognized by diagnostic laparoscopy and were treated immediately via laparotomy. When a cyst was identified as being benign on laparoscopy, the diagnosis was always confirmed by histological examination. Sixty one patients (64 cysts) were treated via laparotomy immediately after laparoscopy for the following reasons: malignant or suspicious lesions (19 cases) dense adhesions or anatomical conditions making laparoscopic surgery difficult (42 cases). 420 patients (444 cysts) were treated by laparoscopic surgery with either intraperitoneal cystectomy or transparietal cystectomy. The postoperative course following laparoscopic surgery for annexal cysts was uneventful in 417 cases (3 patients developed a complication).

Cysts↗
PubMed1991

[Conservative celioscopic treatment of isthmic ectopic pregnancies].

Twenty-six ectopic pregnancies located strictly within the isthmus were treated surgically using conservative laparoscopic techniques. In each and every case the Triton's monopolar electrode was used to perform salpingostomy which was followed by the aspiration of the trophoblast. This therapeutic approach is very reliable since only one failure was observed (3.9%), requiring a further operation during which salpingectomy was carried out by laparoscopy. It was possible to evaluate subsequent fertility for 11 patients. 7 of whom (63.6%) obtained an intra-uterine pregnancy and only one patient (9.1%) had a recurrence. This highly satisfactory prognosis is perfectly comparable with that obtained with treatment via laparotomy with segmental resection of the isthmic portion of the tube and immediate or delayed anastomosis. These very encouraging results mean that laparoscopic treatment presents a very advantageous alternative to classic surgical treatment for isthmic ectopic pregnancies, in that the patients are spared a laparotomy.

Adult↗
PubMed1991

[The role of anti-inflammatory agents in the treatment of acute salpingitis. A randomized study of 40 patients with celioscopic control].

In a randomised second look laparoscopic study, concomitant antibiotic--anti-inflammatory therapy for the treatment of pelvic inflammatory disease (P.I.D.) was studied. Six weeks after medical treatment results were evaluated during second look laparoscopy based on three parameters: residual inflammation, pelvic adhesions and tubal patency. The combination treatment resulted in decreased pelvic adhesion and tubal occlusion in severe forms of P.I.D. Anti-inflammatory agents combined with anti-biotics are not more beneficial than anti-biotics alone in mild and moderate forms of P.I.D. so combination therapy must be reserved for severe forms of P.I.D.

Administration, Oral↗
PubMed1991

[Ectopic pregnancies with intrauterine devices. Characteristics and subsequent fertility].

Out of the 503 ectopic pregnancies (EP) dealt with surgically using conservative laparoscopic techniques, 153 (30.42%) occurred in patients with an intrauterine device (IUD) in situ. Examination of the characteristics of the EP reveals that there is a significantly higher proportion located in the isthmus in the group of patients without an IUD, whereas the fimbrial location is more frequent among patients with an IUD. Whereas tube wall condition does not differ according to the presence or absence of an IUD, adhesions and obstructed or not existent contralateral tubes are significantly less frequent among patients with an IUD in situ. 223 patients desired pregnancy, 30 of which had an IUD in situ when the EP was diagnosed. The subsequent fertility for these 30 patients with an IUD resulted in rates for intrauterine pregnancy (IUP), recurrent EP an infertility of 96.7%, 3.3%, and 0% respectively. These results are significantly better than those for women who had no IUD, the figures for their group being 59%, 13.4%, and 27.4% respectively. The favorable prognosis is due solely to the fact that women with an IUD have far less negative antecedents and that the EP probably occurred due to impaired ciliary action, reversible when the IUD is removed.

Female↗
PubMed1991

[Laparoscopic treatment of ovarian cysts. Indications, techniques, results. Apropos of 650 cases].

Laparoscopic management of annexes is now accepted as alternative to classical management by laparotomy. However, a careful pre-operative evaluation, including clinical and ultrasonographic examination is of ut most importance in order to exclude malignant lesion which should be treated by laparotomy. The laparoscopic treatment includes several procedures: intra-peritoneal cystectomy, extra-abdominal cystectomy, oaphorectomy and adnexectomy. These procedures and used according to the laparoscopic diagnosis. About 652 cases managed by laparoscopy, we can concluded: laparoscopic diagnosis of benign lesion is reliable (positive predictive value 100%); most of benign ovarian cysts can be treated by laparoscopy, from 89 to 97% of the benign adnexal cysts; complications are uncommon (8 cases out of 616 patients); the recurrence risk appears to be low (only 2.7% in patients treated for a non endometriotic adnexal cysts).

Biopsy, Needle↗
PubMed1990

Laparoscopic management of adnexal cystic masses.

Four hundred twenty of 481 patients with adnexal cystic masses (508 cysts) confirmed by laparoscopy were treated by translaparoscopic surgery only. The remaining 61 patients were treated by laparotomy for one of the following reasons: malignancy or suspicion of malignancy (19 cases) and dense adhesions or large cysts (42 cases).

Adolescent↗
PubMed1990

Laparoscopic management of unicornuate uterus with rudimentary horn and unilateral extensive endometriosis: case report.

One case of unicornuate uterus with a cavitary rudimentary horn and unilateral extensive endometriosis was treated by laparoscopy, after three months of treatment with GnRH analogues. The rudimentary horn and the corresponding tube were removed. The post-operative course was uneventful. Laparoscopic radical management of this malformation reduces both peritoneal damage and economic cost.

Adult↗
PubMed1990

[CO2 laser in operative laparoscopy. Techniques. Indications. Results].

The authors share their experience in the use of the CO2 laser, over 10 years. Three main indications for the CO2 laser in operative laparoscopy are examined: adhesiolysis, neosalpingostomy and endometriosis. The CO2 laser presents a number of advantages for each of these indications. For adhesiolysis it is possible to eliminate type C adhesions without any major damage to the peritoneum, and to remove adhesions on the surface of the ovary by vaporization. For neostomy, the tube can be sectioned without any bleeding, and the surgeon can work both quickly and accurately. Finally, for endometriosis the CO2 laser proves an ideal tool, being suitable for treating all aspects of this pathology. Thus, the CO2 laser is particularly well-suited for use in operative laparoscopy as it enables results to be obtained comparable to those of traditional surgical techniques, avoiding laparotomy for the patient.

Endometriosis↗
PubMed1990

[Acute bacterial salpingitis. The importance of residual inflammation. A comparative study with celioscopic control of 2 antibiotic protocols: sulbactam-ampicillin versus cefoxitin].

The combination of sulbactam-ampicillin was compared to cefoxitin for the treatment of acute salpingitis in 40 women divided into two groups of 20 women each. There were 11 patients in each group who were given doxycycline because of evidence of chlamydial infection. All patients were diagnosed by laparoscopic examination and evaluated by the same procedure 7-12 weeks later: At the second laparoscopy, only 1 of the 20 patients (5%) treated with sulbactam/ampicillin had severe adhesions, while 6 of the 20 patients (40%) treated with cefoxitin had severe adhesions. Tubal patency was without obstruction in 14 patients (70%) given the combination treatment and in 12 patients (60%) given cefoxitin. Side effects were essentially absent in both groups.

Adult↗
PubMed1990

[Illustration and defense of endoscopic surgery in gynecology. A 20 years' experience].

A 20-year experience has enabled the authors to perform mutilating or conservative coelioscopic surgery for 87.4% of all benign ovarian cysts and 95% of all tubal pregnancies. The help obtained from CO2 laser allows performing salpingoneostomies successfully in 35% of cases, and destroying implants of endometriosis and their adhesions with results similar to those of the medical treatment or of microsurgery, according to the stage of diffusion. Some types of myomectomies, hysterectomies and iliopelvic lymphadenectomies can also be performed by coelioscopy.

Female↗
PubMed1989

Treatment of acute salpingitis with sulbactam/ampicillin.

The combination of sulbactam/ampicillin was compared to cefoxitin for the treatment of acute salpingitis in 40 women divided into two groups of 20 women each. There were 11 patients in each group who were given doxycycline because of evidence of chlamydial infection. All patients were diagnosed by laparoscopic examination and evaluated by the same procedure 7-12 weeks later. At the second laparoscopy, only 1 of the 20 patients (5%) treated with sulbactam/ampicillin had severe adhesions, while 6 of the 20 patients (40%) treated with cefoxitin had severe adhesions. Tubal patency was without obstruction in 14 patients (70%) given the combination treatment and in 12 patients (60%) given cefoxitin. Side effects were essentially absent in both groups.

Acute Disease↗
PubMed1989

Gamete intrafallopian transfer: benefits of programmed stimulation.

Fifty-six cycles of gamete intrafallopian transfer (GIFT) were performed after programming by administration of norethisterone in the previous cycle. Ovarian hyperstimulation was achieved with clomifene citrate and human menopausal gonadotropins. Only one GIFT was performed during a weekend (1.8%). The implantation rate was 41.1% and the evolutive pregnancy rate 30.4%. The endocrinological influence of these regimens are discussed by comparison of those observed in an in vitro fertilization program. The main influence is a decreased serum luteinizing hormone (LH) level in the preovulatory phase.

Estradiol↗