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Biomedical subjects

J M Gil-Vernet

Publications and source records attributed to J M Gil-Vernet.

At least 19 recordsLinked to original sources

Invasive bladder cancer in women.

A total of 84 radical cystectomies were performed for invasive bladder cancer in 67 men (79.8%) and 17 women (20.2%). The present study investigated the possible sex-dependent differences in the pattern of invasive bladder cancer. More than 40% of the women presented lower urinary tract syndrome alone or with haematuria, giving a clinical picture similar to acute cystitis. This caused an average time-lag in diagnosis of 18.5 months in the women and 8 months in the men. There was a higher frequency of non-transitional cell carcinoma in the women (17.6%) than in the men (2.9%). We found statistically significant differences (p < 0.005) in tumor grade: 35.2% of the women had low grade tumors, compared to 7.4% of the men. However, no significant differences in staging or survival rate were found when comparing the two sexes. This leads us to believe that bladder cancer is less aggressive in women.

Adult

Alpha-interferon and oral fluorouracil in the treatment of unremovable and/or metastatic renal cancer.

We present the results obtained in a study of the pharmacological action (phase II) of alpha-interferon and oral fluorouracyl administered in our 2-year study (Feb. 1988-Feb. 1990) in 10 patients suffering from surgically unremovable or metastatic renal cancer. Our results were: 1 patient with complete regression of lung metastasis; 5 with progressive disease within 3-4 months from beginning of treatment and 2 deaths with stable disease after 4-5 months. Two patients abandoned treatment and their disease progressed within 4-5 months.

Adult

[Total parenteral nutrition. A 1-year experience with 96 patients].

In 1987, ninety-six surgical patients, of whom 44 were premature or newborn babies and 52 were infants or older children, received total parenteral nutrition (T.P.N.) at our hospital. A peripheral venous line was utilized on forty patients in the first group and only on 9 in the second group. The excellent results yielded by T.P.N. are self-evident from the low mortality showed by these patients. Thirty-three out of the 44 neonates and premature infants with serious surgical problems survived, being noteworthy the occurrence of just 3 deaths within a series of 13 necrotizing enterocolitis. In the series of 52 infants and older children, composed of 13 digestive patients (with 5 liver transplants), 6 tumoral, 9 neurologic, 4 renal (2 transplantations), 18 cardiac, 1 thoracic and 1 burnt, only 9 patients died. The average duration of T.P.N. was 10 days in the group of premature and newborn infants and 6 days for the nursing infants and older children, save for the 8 patients in whom the treatment had to be prolonged for a few months. We conclude that T.P.N., when applied in time and of short duration should entail no risk at all. In neonate and premature infant a peripheral vein shall be the route of choice. In the nursing infant and older child a central venous line is preferable, if possible the superior vena cava or its major tributary veins.

Humans

[Oncocytoma and calcification. A rare association].

The oncocytoma constitutes 3-6% of the kidney neoplasiae. The authors report one case of calcified kidney tumor, Its presentation as a calcified kidney mass is exceptional and is not present in the largest series of calcified kidney tumors. The calcification prognosis is much debated, even more in the case of oncocytoma due to the very limited series available. For calcified kidney tumor, the oncocytoma should be included as one of the differential diagnosis, even if it is not very frequent.

Adenoma

Orthotopic renal transplant and results in 139 consecutive cases.

Although a commonly performed technique, heterotopic renal transplantation may be a cause of late graft failure owing to ureteral stenosis, urinary fistula and vesicoureteral reflux secondary to the immune response. The new retroperitoneal lumbar approach to the splenic vessels has allowed the orthotopic technique to be developed using the splenic artery or aorta, the renal vein and a pyelo-pyelic anastomosis. In this manner the renal graft is located in an anatomical position that is well protected, and with the recipient urinary tract the normal physiology is preserved with comparatively low complication and mortality rates. A third transplant attempt also is simplified. This method is the only alternative in some cases. Transplant ureter pathology symptoms are not observed. The results of 139 consecutive cases are presented.

Adult

New surgical approach for treatment of complex vesicovaginal fistula.

Complex vesicovaginal fistulas still represent a management problem, since most of the cases have been operated on previously and because of the lack of a completely successful surgical technique. A new procedure for vesical autoplasty is presented. A flap is obtained from the posterosuperior bladder wall that slides down to cover large lesions, even in low capacity reservoirs. The technique has shown excellent long-term results in 42 consecutive complicated cases.

Adult

Urogenital diaphragm raising maneuver.

The urogenital diaphragm raising maneuver, a procedure to facilitate membranous urethral surgery, is described. The technique shortens operating time by permitting easy identification and exposure of the severed urethral ends, thus, allowing for precise re-establishment of urinary tract continuity. Selective membranous urethral surgery can be performed with ease, preserving external sphincter integrity. This maneuver represents an advance over any other technique by almost eliminating the risk of stenosis, urinary fistula and incontinence owing to failure of precise reapproximation of the membranous urethra.

Humans

Ileal conduit and orthotopic renal transplantation. An alternative in pathology of the nonviable lower urinary tract.

The technique of orthotopic renal transplantation with urinary shunt, using the ileal conduit as an alternative in cases of pathologically nonviable lower urinary tract, is described. Various techniques for heterotopic renal transplantation using the ileal conduit have been used. We feel that orthotopic renal transplantation accompanied by the ileal conduit results in a more anatomical and physiological unit than the previously proposed alternatives.

Adult

Descent of the right renal vein.

A new operation is described, in which the right renal vein outlet is moved to a lower level on the vena cava, helping to decrease the distance between the kidney and the bladder. This procedure permits treatment of extensive obstructive wounds of the pyeloureteral junction or lumbar ureteral junction, caused by lithiasis and ureteral and renal operations, that cannot be treated with conventional operations. Renal circulation is not altered with this procedure. The operation is simple, does not cause complications and provides excellent results.

Constriction, Pathologic

New approach to the splenic vessels.

The transperitoneal approach is used systematically for an arterial or a venous splenorenal anastomosis. However, this approach is associated with high morbidity and mortality rates. Because of our anatomical and surgical findings we have used the retroperitoneal approach to the splenic hilus by means of the lumbar region. The first splenorenal arterial anastomosis with this approach was done in 1972. The approach has proved to be less aggressive since it avoids the danger of damaging the pancreas, it is a more direct approach to the splenic vessels and it provides better exposure and facilitates the anastomosis. In addition, the loss or infection of ascitic fluid in cirrhotic patients is avoided with this approach, as well as intraoperative hemorrhaging caused by the great surplus circulation. There has been neither mortality nor complications in the 13 cases of arterial and venous splenorenal anastomoses that we have done with this method.

Humans