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J Lauroy

Publications and source records attributed to J Lauroy.

At least 19 recordsLinked to original sources
PubMed1996

[What are abdominal painful syndromes of unexplained origin? Prospective study: 99 patients followed for three years].

99 patients, 67 of whom were female, with a mean age of 25.5 years, were admitted as emergencies between 1991 and 1992 for acute abdominal pain of unknown aetiology. The follow-up, carried out prospectively, was 100% at 1 month, 98% at 6 months, 95% at 1 year, 84% at 2 years. The patients were divided into 3 groups: group I: 42 patients only underwent investigations; group II: 31 underwent laparoscopy, and the appendix was left in place after being considered to be normal by the surgeon; group III: 26 underwent laparoscopic appendicectomy for a histologically normal appendix. For 90% of patients, the painful episode never returned. In the other cases the pain returned within one year, but there was no difference between the three groups (11.2%, 9.6%, 11.5%) (ns). The causes found at the second admission were largely genital, or rare diseases (Crohn, Spiegel hernia). 2 patients were operated for acute appendicitis, not recognized in Group I. In those who had a laparoscopy (Group II and III), the incidence of persistent pain was identical whether the appendix was considered to be normal by the operating surgeon or found to be normal histopathologically. This study suggests that: after admission for acute abdominal pain of unknown cause, the incidence of recurrence of pains is of the order of 10% within one year; the investigations carried out during the patient's admission, allowed the exclusion of serious diseases for three years; the risk of missing a true appendicitis is small (2.5%) and has no prognostic significance; the finding of a normal appendix during laparoscopy should not necessarily lead to its removal; one year follow-up is sufficient to assess the outcome of abdominal pain of unknown cause.

Abdominal Pain↗
PubMed1995

[Common bile duct lithiasis. Analysis of surgical treatment of 130 consecutive cases].

OBJECTIVES: Common bile duct lithiasis can be treated either surgically or endoscopically. Generally, morbidity and mortality is thought to be greater for surgery. The aim of this work was to evaluate the results of surgical cure in 130 consecutive patients treated from 1983 to 1993. METHODS: Transcytic extraction was performed in 16 cases, ideal choledocotomy in 25, choledocotomy with external biliary drainage in 45, choledocojuodenal anastomosis in 14 and transduodenal sphincterotomy in 32. RESULTS: There were 3 deaths. Morbidity was 11.5%. The postoperative hospitalization time was 9.86 +/- 8.9 days for patients without drainage and 15.13 +/- 3.09 days with drainage. Stone extraction was unsuccessful in 2 cases. CONCLUSIONS: Morbidity and mortality for surgical cure of common duct lithiasis are comparable or lower than for endoscopic sphincterotomy. It is much more adapted for stone desobstruction via the choledoscopy. Supra-duodenal choledocotomy without external drainage was performed in most cases with a small incision and without touching the Oddi sphincter thus allowing a hospital stay equivalent to that for endoscopic sphincterotomy. Associating surgery with laparoscopic cholecystectomy would allow simple benign treatment in most cases of common bile duct lithiasis.

Adult↗
PubMed1995

[Does laparoscopic treatment of abdominal infections generate bacteremias? Prospective study: 75 cases].

Laparoscopy is increasingly used in conditions complicated by peritonitis. A theoretical concern is that carbon dioxide pneumoperitoneum may increase bacteraemia. In a prospective study 90 patients were treated by laparoscopic appendicectomy. 30 of them had no histological abnormality; 30 had an acute appendicitis and 30 an acute peritonitis. 75 patients were eligible for the study. The treatment protocol (surgery-antibiotherapy) was the same for the 3 groups. All patients had blood cultures before, during and after insufflation of CO2 in the peritoneum, and bacterial examination of the operative site. Septic morbidity was evaluated for each patients. Positive bacterial culture from abdominal site are correlated with the pathologic findings. There were no positive blood cultures in the groups studied and no incidence in term of septic morbidity. This study suggests that laparoscopic treatment of septic abdominal diseases does not facilitate bacteriemias and does no affect septic morbidity.

Acute Disease↗
PubMed1994

[Inguinal hernias in adults. Laparoscopic surgery versus the Shouldice method. Controlled randomized study: 181 patients. Preliminary results].

181 patients have been included in a controlled randomized prospective study to compare two hernia repair technics: Classic al Shouldice herniography vs totally pre-peritoneal video-surgery. There was no mortality and no difference concerning morbidity, operating time and hospital stay. Videosurgery allows detection and treatment of some bilateral hernias not diagnosed by clinical exam, ensures better post-operative comfort and has a significant effect on the time to return to work (12.5 vs 24.3 days). There was no recurrence in either group with a 12-month follow-up. These patients must be followed for a long time to compare their late results with those of conventional technics.

Adult↗
PubMed1994

[Under what conditions is laparoscopic treatment of inguinal hernia financially profitable?].

A randomized controlled study between Shouldice technic (119 cases) and laparoscopic totally pre-peritoneal hernia repair (122 cases) was performed to evaluate the different costs. Only with reusable devices, and if the Prolene Mesh is not fixed by stapple, laparoscopic repair, even a specific increasing expenses (700 FF) allow a little benefit (1100 FF per patient). Laparoscopic hernia repair is really benefit for active workers, specially in liberal practice. These conclusion suggest to correlate the technic with professional activity.

Adult↗
PubMed1993

[Right iliac fossa pain in women. Conventional diagnostic approach versus primary laparoscopy. A controlled study (65 cases)].

In a series of 187 patients with acute abdominal pain syndrome, 65 young women reported non specific pain in right iliac or pelvic area. A controlled study compared 33 patients with immediate laparoscopy and 32 explored with a laboratory contrast or imaging approach. In the laparoscopic group, an exact diagnosis was made in 97% of the patients, allowing in 2/3 of cases the endoscopic treatment. Only 28% in the second group had an exact diagnosis. Hospital stay was shorter in the laparoscopic group (4.18 vs 6.16 days; p = 0.01) decreasing the hospital cost. The authors suggest that immediate laparoscopy should be performed in young women presenting with non-specific abdominal pain.

Abdominal Pain↗
PubMed1993

[Appendectomies. Mac Burney or laparoscopy? (100 cases)].

The authors have compared their early (50 cases) experience on laparoscopic appendectomy for acute appendicitis with a control group treated by open approach. A teaching period is necessary to reduce the converting rate to an open procedure from 22% to 6% p = 0.05 and to obtain an equal median anesthesia time (39 vs 40 mn+/-16) ns). The mean post operative stay for open operation was 5-8 (range 3-23) days and for the laparoscopic route 3.3 (range 1-8) days (p < 0.005). The wound infection rate was 16% (n = 8) for open/ and 0% for laparoscopic appendectomy p = 0.001. The results suggest that emergency laparoscopic appendectomy should be explored further as an alternative to open surgery for acute appendicitis.

Adolescent↗
PubMedDate not supplied

[Idiopathic segmental infarct of the omentum. Differential diagnosis in an obese patient].

OBJECTIVE: Infarction of the greater omentum is a rare etiology of acute abdominal pain. The differential diagnosis, especially with appendicitis, is difficult to establish. CASE REPORT: A 29 years-old male presented with acute abdominal pain. He underwent a laparoscopic resection on the 5th hospital day because of persistant pain despite conservative management. Histopathological examination confirmed the diagnosis of omental infarction. DISCUSSION: Primary segmental necrosis of the omentum is a rare entity. Obesity and cardiovascular diseases are considered predisposing conditions. The infarctions tend to occur in the right side of the omentum. Abdominal pain is predominant in opposition to the patient's good general condition. Laboratory results are usually nonspecific. Abdominal ultrasound may show a solid, ovoid, hyperechoic lesion. CT-scan may depict a fatty oval-shaped mass below the right anterolateral parietal wall associated with a thickening of the anterior parietal peritoneum. CONCLUSION: The correct diagnosis of omental infarction is important to establish preoperatively in acute abdominal pain, as in uneventful courses surgery can be avoided.

Abdomen, Acute↗