Biomedical subjects

J-L Peix

Publications and source records attributed to J-L Peix.

6 recordsLinked to original sources

PubMed2006

[Anaplastic thyroid carcinoma: aggressive radical resection and cervical reconstruction. A case report].

STUDY AIM: Anaplastic carcinoma of the thyroid is a rare but highly malignant tumor. The goal of this study was to present the case of a patient who underwent a multimodal treatment and to analyze prognosis factors. PATIENT AND METHODS: We present the case of a patient treated in 1996 for an anaplasic thyroid carcinoma with cervical cutaneous invasion. The initial surgical procedure was a total thyroidectomy extended to the anterior cervical skin associated to bilateral neck dissection. The patient underwent a differed reconstruction with musculocutaneous latissimus dorsi flap. Management was then supplemented by radiotherapy and chemotherapy. RESULTS: This patient is free of tumor 9 years after this multimodal management. She does not present any functionary sequela and plastic results of the reconstruction is considered as very satisfactory. CONCLUSION: Anaplastic carcinoma is one of more aggressive neoplasm affecting humans. This case report suggests that multimodality therapy, including surgery, chemotherapy and radiotherapy may offer hope for long-term survival. A musculocutaneous latissimus dorsi flap is a reliable solution to cover this large cervical defect.

Carcinoma↗

PubMed2006

[Rectal amputation by pure perineal approach with laparoscopic colostomy: a palliative therapeutic option for low rectal or anal cancers for elderly patients with multiple comorbidities].

Rectal syndrome caused by locoregional evolution of low rectal cancers and anal cancers is prevented and treated by surgical resection. But, for old patients with multiple tares, carcinologic surgical resection as abdominoperineal amputation can not be considered. Management of rectal syndrome becomes a therapeutic challenge. We reported a prospective serie of 5 patients more than 80 years old with multiple tares, treated by rectal amputation by pure perineal approach with laparoscopic colostomy. This surgery avoided for all patients trying rectal symptoms and maintained acceptable quality of life with fast coming back at home. The palliative treatment of low rectal cancers or anal cancers combining rectal amputation by pure perineal approach with laparoscopic colostomy may be an interesting therapeutic option for patients who cannot undergoing aggressive carcinologic surgical treatment.

Aged↗

PubMed2006

[Gastropleural fistula presenting with a pyopneumothorax in pregnancy].

INTRODUCTION: Gastropleural fistula has only rarely been described in the literature, typically presenting with evidence of left-sided pleural infection. CASE REPORT: The diagnosis may be suggested by the occurrence of chest pain and repeated vomiting with the diagnosis confirmed by microbiological examination of the pleural fluid and appropriate radiological investigations. The fistula occurs most frequently after abdominal or anterior thoracic surgery. Generally, surgical repair should be performed urgently but in the case that we describe occurring during pregnancy, surgery was delayed for 10 weeks until a caesarean section could be performed. CONCLUSION: In the presence of left-sided basal pleuritic chest pain in the context of a possible gap in the diaphragm the diagnosis of gastropleural fistula should be considered. Treatment is usually a medico-surgical emergency.

Adult↗

PubMed2003

[Laparoscopic pancreatic resections].

The feasibility of laparoscopic pancreatic resection has been demonstrated. However, the real clinical benefit for the patients remains questioned. The best indication for a laparoscopic approach appears to be the resection of benign or neuro-endocrine tumors without a need for pancreato-enteric reconstruction (i.e enucleation or distal pancreatectomy). The use of the laparoscopic approach for malignant tumors still remains controversial. The benefits of minimally invasive surgery are clearly correlated with the successful management of the pancreatic stump. Pancreatic related complication rate (fistula and collection) is 15% when using pancreatic transection with a laparoscopic endostappler.

Humans↗

PubMed2003

[Cervical lymph node dissection and thyroid carcinoma].

After an anatomic recall of the cervical lymph node compartments we describe the surgical technique of the lymph node dissection in patients with differentiated thyroid carcinoma. These lymphadenectomies should be associated with total thyroidectomy. Cervical lymph node dissection always concerns central compartment and is sometimes extended to the cervico lateral compartments. Lymphadenectomy of a compartment should be complete, reoperations leading to an important morbidity. The two main complications of cervical lymph node dissection are inferior laryngeal nerve palsy and hypoparathyroidism.

Carcinoma↗

PubMedDate not supplied

[Differentiated thyroid carcinoma in children and adolescents: therapeutic strategy according to clinic presentation].

AIM OF THE STUDY: The aim of this retrospective study was to propose a therapeutic strategy according to clinic and pathologic presentations, in differentiated thyroid carcinoma in patients less than 20 years of age. PATIENTS AND METHODS: From 1995 to 2002, 74 patients less than 20 years of age were operated on for a differentiated thyroid carcinoma. Patients were divided in two groups according to the presence of lymph node (LN) detected before operation (19 "with LN" and 55 "without LN"). RESULTS: Surgery consisted of total thyroidectomy and lymph node dissection in the group "with LN". In the second group "without LN", total thyroidectomy was performed in 19 patients (associated with lymph node dissection in seven) and loboisthmectomy in 29 patients. Post operative radio iodine ablation was performed in 25 patients (16 "with LN" and nine "without LN"). During the follow up (median 71 months), 9/19 patients "with LN" underwent surgery for lymph node recurrence. Four patients of the "without LN" group were reoperated for recurrence in the controlateral thyroid lobe after initial loboisthmectomy. Initial presence of lymph nodes was a risk factor for reoperation. Survival without reoperation at 5 and 10 years was 58% and 38% for the "with LN" group and 96% and 91% for the "without LN" group respectively (P < 0.001). At the time of analysis, all patients were alive. Ninety percent of patients were in remission (68% of "with LN" and 98% of "without LN" patients). CONCLUSION: The risk of reoperation for lymph node recurrence during first post operative year is important in the "with LN" group. Therapeutic strategy consists of total thyroidectomy, complete lymph node dissection, radio iodine administration and l-thyroxine treatment. In "without LN" patients risk of lymph node recurrence is low. Treatment consist of total thyroidectomy, lymph node dissection and radio iodine administration are not systematic.

Adolescent↗