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J R Delpero

Publications and source records attributed to J R Delpero.

At least 91 records · Page 5Linked to original sources
PubMed1991

[Pancreatic conservation after autotransplantation in dogs. Value of histologic surface analysis].

A study of an artificial conservation fluid (hyperosmolar, pH = 8, rich in lactobionate and raffinose) was carried out by means of an experimental procedure involving segmental pancreatic autotransplants in dogs. The study covers 14 transplants, seven carried out without conservation and seven with 24-hour conservation at 4 degrees C. The caudal pancreas was removed after splenectomy and either transfused with 250 ml of 4 degrees C Euro-Collins before immediate transplant or with 250 ml of 4 degrees C conservation fluid for 24 hours before the transplant. The caudal pancreas was transplanted onto the right iliac vessels, while an arterio-venous fistula was created on the distal splenic vessels and the pancreatic duct was injected with modified tissucol. At the same time as the transplant, a cephalic pancreatectomy was performed. Laboratory tests included an intra venous glucose tolerance test monitored on days 0 and 28 and blood glucose and serum amylase measured every three days from days 1 to 28. The histological study of the pancreatic tissues 28 days after the transplants involved the light microscopic evaluation of the degree of fibrosis, inflammation of the pancreas, cystosteatonecrosis and peripancreatic inflammation. We used a computerized method to measure the surface area of the islets of Langerhans, as revealed by immunocytochemistry, and the surface area of fibrosis. The blood glucose and the serum amylase analyses from days 1 to 28, and the blood glucose variations during the intra venous glucose tolerance test, showed no differences between the two groups. Standard laboratory parameters were similar in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Amylases↗
PubMed1991

[Locoregional extension of advanced cancer of the uterine cervix:prospective evaluation of results of clinical examination, endocavitary ultrasonography, TDM, MRI and histology].

Between January 1988 and January 1991, 37 advanced cervical cancer patients were operated and explorated by: clinical examination and endoluminal ultrasonography under general anesthesia (endovesical, endovaginal and endorectal US); tomodensitometry (26 cases); MR imaging (14 cases) and cytoscopy (33 cases). Results of these explorations have been compared with post-operative histopathology. Sensitivity, specificity, predictive values and accuracy of each exploration were calculated for several anatomical structures. Vesical posterior wall has been analysed in about 37 cases, vesico-vaginal structure in about 36 cases, rectal anterior wall and recto-vaginal structure in about 36 cases, parametrium and pelvic sides walls in about 35 cases. Accuracy for clinical examination, endoluminal US, TDM and IRM were respectively: 76, 85, 73, 86%, and respectively 85% by cytoscopy for vesical posterior wall; 72, 88, 65, 78% for vesico-vaginal structure; 92, 97, 83, 64% for rectal anterior wall; 78, 94, 74, 57% for recto-vaginal structure; 84, 89, 69, 73% for vagina; 81, 78, 81, 81% for parametrium; 94%, 93% and 87.5% by TDM and IRM for pelvic side wall. Contribution of endoluminal US is effective for advanced cervical cancer loco-regional staging. Endoluminal US have a good accuracy, are realised under general anesthesia without any discomfort for patients and are little expensive.

Female↗
PubMed1991

[Cancer of the rectum. Results of a prospective study comparing preoperative rectal touch and transrectal ultrasonography with postoperative histopathology before and after preoperative radiotherapy].

Between January 1988 and December 1990, 23 patients with rectal cancer were evaluated by clinical staging (23) and transrectal sonography before (22, one complete stenosis) and after radiotherapy (21). Two criteria were correlated with histological findings: a) the confinement to the rectal wall or spread beyond and b) the presence of meso-rectal lymph node involvement. The 22 patients who underwent transrectal sonography before radiotherapy were staged as uT2: 3 cases, uT3: 17 cases and uT4:2 cases. Fifteen days after irradiation, transrectal sonography showed a regression on the tumor in all cases; the uT stage was different in 9 patients but there was no change in the uN stage. The comparison of the preoperative clinical and sonographic assessment of local invasion beyond the rectal wall with postoperative histopathology revealed a correlation: a) with digital examination in 13 of the 21 patients with palpable tumors, b) with transrectal sonography before irradiation in 12 of the 22 staged tumors, c) with transrectal sonography after irradiation in 17 of the 21 staged tumors. The presence of meso-rectal lymph node involvement determined by histologic examination was correlated with the results of transrectal sonography for 14 of the 21 staged tumors. Transrectal sonography provides a good assessment of the tumor stage before irradiation. This stage should be considered for the study of survival.

Adenocarcinoma↗
PubMed1991

[Prognostic value of the cellular expression of carcinoembryonic antigen (CEA) in gastric adenocarcinoma].

Fifty resected gastric adenocarcinomas were studied retrospectively to evaluate survival factors. Eleven different criteria were assessed using multivariate analysis. Only two criteria were significant: 1--cellular expression of carcinoembryonic antigen (p less than 0.0001 - CCR = 1.48) 2--intravascular or lymphatic tumor emboli (p less than 0.006 - CCR = 2.06). Thus, it is suggested that in addition to the various prognostic factors available to the surgical pathologist, the presence of cellular expression of carcinoembryonic antigen in tumor tissue will aid in predicting the prognosis of patients with gastric carcinoma.

Adenocarcinoma↗
PubMed1990

Splenectomy for hypersplenism in chronic lymphocytic leukaemia and malignant non-Hodgkin's lymphoma.

Between 1 January 1980 and 31 July 1988, 62 patients with chronic lymphocytic leukaemia (CLL) or malignant non-Hodgkin's lymphoma (NHL) were splenectomized for splenomegaly and presumed hypersplenism. All patients except one had splenomegaly (mean (s.d.) weight 1585(872) g, range 150-4300 g) and 34 had massive splenomegaly (greater than 1500 g). Forty-nine patients had platelet counts less than 100 x 10(9)/l and 16 patients had anaemia with haemoglobin levels less than 10 g/dl. White cell counts were less than 3 x 10(9)/l in six NHL patients. Fifteen patients had bicytopenia, and three NHL patients had tricytopenia. The selected group of 62 patients underwent splenectomy largely because of failure to respond to medical therapy (39 patients) or inability to tolerate or start adequate chemotherapy because of very low blood counts (11 patients). There was one postoperative death, and a 29 per cent morbidity rate. The response rate was 89 per cent in the first month after splenectomy and 39 patients (63 per cent) had a continuing complete response with a median follow-up of 26 months (range 3-96 months). Twelve patients (10 with CLL) received no further therapy after splenectomy. Seven patients failed to respond and 15 relapsed after splenectomy. These 22 patients could be distinguished on the basis of: (1) lower average preoperative platelet counts (P less than 0.007), postoperative platelet counts (P less than 0.001), and postoperative rise in platelets (P less than 0.004); (2) lower average spleen weight (P less than 0.052); (3) preoperative chemotherapy (P less than 0.044). However preoperative and postoperative platelet counts were the only two variables selected by stepwise regression analysis (P less than 0.05 and P less than 0.01, respectively). Bone marrow failure did not preclude complete response after splenectomy. Long-term survivors emerged from the group of patients with continuing complete response. Of the seven patients who failed to respond, five died with a median survival of 4 months, and of the 15 patients who relapsed after splenectomy, 13 died, with a median survival of 6 months after relapse and 18 months after splenectomy. Thus, splenectomy may be an effective palliation for both CLL and NHL patients with splenomegaly and hypersplenism.

Adult↗
PubMed1990

[Adenomyoma of the distal common bile duct. An uncommon cause of stenosis of the extrahepatic bile duct].

We report the case of a 68-year-old man with adenomyoma of the distal common bile duct, fortuitously discovered on a surgical specimen of a Whipple procedure. To our knowledge, three similar cases have been reported; all patients were operated on with the diagnosis of malignancy: adenomyoma was always discovered on the surgical specimen. Adenomyomas are rare tumors and their origin is discussed. Adenomyoma of the distal common hile duct should be considered as enteropancreatic heterotopia.

Aged↗
PubMed1990

[Mucinous cystadenocarcinoma of the appendix. A rare tumor of the right iliac fossa].

An observation of a mucinous cystadenocarcinoma of the appendix, in the tumor form, revealed by a painful syndrome of the right iliac fossa in a 62-year man is reported. It is a rare malignant tumor as less than 0.5% of the appendicectomy parts present a malignant mucosecreting tumor. In our observation, the diagnosis was allowed by pre-operation imaging. An increase of the serous amount in the tumor markers (carcinoembryonic antigen) (CEA) and CA 19-9 was found before the intervention and the immunodetections performed on the operation part were positive for CEA and CA 19-9. The serous amounts of these markers were normalized after operation. To the author's knowledge, the interest of dosing the serous tumor markers in the observation of such a type of tumor is not mentioned in the literature. The recurrences are frequent and sometimes late even when the initial excision has been macroscopically satisfactory. A new increase of the serous amount of the markers could allow for an earlier detection of a recurrence during the patient follow-up. At present, the prognosis of these malignant forms remains very poor as the 5-year survival does not exceed 25%.

Appendiceal Neoplasms↗
PubMed1990

[Uterine cervix cancers: staging by magnetic resonance imaging].

The accuracy of Magnetic Resonance Imaging in cervical carcinoma staging for clinical stages superior to IB was studied retrospectively in 27 patients. The MRI results were then correlated with operative findings in 12 cases and with examination carried out under general anesthesia in 15 cases for myometrial, bladder, rectal, parametrial, parietal and vaginal extension. The accuracy of MRI was 81.5% for bladder, 92.5% for rectal, 87% for parametrial and 73% for vaginal extension. The accuracy of staging by MRI was 59%. The contribution of MRI in pre-operative studies for cervical carcinomas has not been properly defined until now. Nevertheless it is a particularly valuable technique due to its non invasive nature.

Adult↗
PubMed1990

Vascular reconstruction after extended resection of a retroperitoneal fibromatosis.

We report the case of a 25-year-old man who underwent successful en-bloc resection of a retroperitoneal fibromatosis, extended to the right kidney and testis, with excision of the right iliac arteries and veins. Arterial replacement was done by means of a right iliofemoral prosthetic graft. A right femorocaval prosthetic graft with a temporary arteriovenous fistula was used for venous replacement. The patient is still alive and after 3 years shows no sign of recurrence on successive computed tomographic scans. He has preserved patency of the right arterial and venous iliac grafts. To our knowledge, this is the first documented case of simultaneous arterial and venous iliac replacement successfully performed after excision of a retroperitoneal tumor.

Adult↗
PubMed1989

[Gastrocolonic excision of cancer. Retrospective analysis of the immediate postoperative course and long-term survival in 18 patients].

Eighteen patients underwent gastrocolic resection for cancer. Thirteen had primary gastric cancer and 5 had primary colon cancer (two of these 5 patients had local-regional recurrence after right hemicolectomy). Twelve resections were curative and 6 palliative. Twelve patients had more than 2 organs resected. Involvement of adjacent tissues or organs was present in 15 patients (11/13 gastric cancer and 4/5 colon cancer: 83%). All patients had immediate colonic anastomosis. The mean duration of postoperative stay was 22 +/- 8 days (SD). Mortality was 5.6% (1/18). Seven patients had post-operative complications (41%; 7/17); 3 of these 7 patients had anastomotic leakage (one colonic and two pancreatic fistulae; 3/17: 17.6%); the mean duration of postoperative stay for these three patients was 27 +/- 4 jours, (p less than 0.004). One colonic fistula complicated the 18 colonic anastomoses (5.5%). There was no reoperation in this series. The estimated 2-year survival for the entire group was 20%. The median survival was 9.5 mois; the median survival was 13.5 months after curative resections and 5 months after palliative procedure (p less than 0.01). The median survival was 8 months for gastric adenocarcinoma and 36 months for colon adenocarcinoma (p less than 0.05). Despite the poor results in gastric cancer extending to adjacent organs, complete excision is still recommended whenever feasible. Complete excision of advanced colon cancer may lead to prolonged disease-free survival depending on the lymph node status. With an acceptably low mortality, resection remains a better procedure than palliative diversion or exclusion for these advanced tumours.

Adult↗
PubMed1989

[Early adjuvant intraportal chemotherapy with 5-fluorouracil after hepatic resection of colorectal metastasis: a preliminary clinical and pharmacokinetic study].

Intraportal continuous infusion of 5-FU (600 mg/m2/24 h during 7 days) was administered in the immediate postoperative course of 6 consecutive patients with colorectal metastases resected for cure (one segmentectomy and 5 nonanatomical local resections). One month later, a systemic continuous infusion of 5-FU was delivered at the same dose. The tolerance of intraportal chemotherapy was good despite 2 patients with mild digestive toxicity. The plasma concentrations of both unchanged 5-FU and 5,6-dihydro-5-FU (the primary metabolite of 5-FU), were determined in 2 patients using Gas Chromatography--Mass Spectrometry. The 5-FU clearance was higher after intraportal infusion than after systemic infusion (x 1.5 to 3). Hepatic extraction was variable (0.32-0.70) and lower than in reported experimental data on dogs (0.90-0.99). 5,6-dihydro-5-FU concentrations were constantly higher than 5-FU concentrations in plasma. The patient with lower hepatic extraction had the higher 5,6-dihydro-5-FU plasma concentrations. These findings suggest a predominant extrahepatic formation of plasmatic 5,6-dihydro-5-FU.

Adult↗