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Jean Deslauriers

Publications and source records attributed to Jean Deslauriers.

7 recordsLinked to original sources
PubMed2006

Bleeding "downhill" varices: a rare complication of intrathoracic goiter.

We report a case of a 68-year-old woman with a 16-year history of a benign goiter. The patient presented with hematemesis and a clinically evident superior vena cava syndrome. Preoperative evaluation demonstrated upper esophageal varices and large posterior mediastinal goiter. The patient underwent successful resection of the mass with complete resolution of both the superior vena cava syndrome and "downhill" varices.

Aged↗
PubMed2006

Surgical anatomy of the bronchial tree and pulmonary artery.

Sleeve lobectomy is an excellent procedure in the surgical management of non-small-cell lung cancer located in proximal lobal bronchi. The surgeon undertaking these procedures has, however, the responsibility of understanding the particular anatomy applicable to the technique. Good knowledge of the topographic anatomy of the tracheobronchial tree and of its blood supply is necessary to reduce the operative morbidity, whereas that of the oncological anatomy of lung cancer forms the theoretical basis for the operation and improves the potential for better long-term results.

Anastomosis, Surgical↗
PubMed2004

Sleeve lobectomy versus pneumonectomy for lung cancer: a comparative analysis of survival and sites or recurrences.

BACKGROUND: Sleeve lobectomy (SL) in a lung-saving procedure indicated for central tumors for which the alternative is pneumonectomy (PN). Although it has been suggested that it may provide as good if not better survival results than pneumonectomy in the treatment of lung cancer, there are very few reports of clinical series comparing operative mortality, survival, and sites of recurrences between these procedures. METHODS: Survival and sites of recurrences were analyzed and compared in 1,230 consecutive patients who underwent PN (n = 1,046) or SL (n = 184) in a single institution. Sleeve lobectomy was always done when technically possible. Thus PN was reserved for lesions that could not be removed by a bronchoplastic procedure. Pathologic staging was accomplished by nodal sampling except for N2 and selected N1 patients who underwent mediastinal lymphadenectomy. Ultimately, all patients were staged according to the 1997 TNM nomenclature. RESULTS: There were 3 operative deaths of the 184 SL patients (operative mortality of 1.6%) and 55 operative deaths of the 1,046 PN patients (operative mortality of 5.3%, p = 0.036). Follow-up was complete for all 1,230 patients. For the entire group, survival at 5 years was 52% after SL and 31% after PN (p < 0.0001). These rates for patients with complete resection were 58% for SL and 33% for PN (p = 0.021). There was also a significant difference in survival favoring SL for patients with pathologic stage I (p = 0.018) and stage II (p = 0.005) disease. When recurrences occurred (n = 577), the site of first recurrence was local in 22% of patients with SL and in 35% of patients with PN. CONCLUSIONS: Sleeve lobectomy can be done with a much lower risk of operative mortality than PN. Although it is recognized that stage for stage, PN patients likely have more advanced disease, long-term survival and local control are significantly better when complete resection can be achieved by SL.

Carcinoma, Non-Small-Cell Lung↗
PubMed2004

Sleeve pneumonectomy.

Lung cancer involving the carina can be treated by surgery, but patients must be carefully selected before the operation. Because pneumonectomy is required in addition to carinal resection, patients must be able to withstand the procedure, and they must be told that the operative mortality is 2 to 4 times higher than what is expected after standard pneumonectomy. Patients who have mediastinal nodal disease documented preoperatively by mediastinoscopy should not have this operation. In general, it is possible to perform a safe operation if the surgeon adheres to the principles of healthy bronchial suturing and restricts airway resection to a maximum distance of 4 cm. Surgeons must always remember, however, that it is better and safer to accept a positive resection margin than to have to deal with a bronchopleural fistula caused by anastomotic separation. Finally, reported long-term survival rates of 25% to 40% justify the use of this procedure.

Carcinoma, Bronchogenic↗
PubMed2003

Late complication of bovine pericardium patches used for lung volume reduction surgery.

Lung volume reduction surgery has recently become an option for the management of patients with severe emphysema. The procedure consist of resecting non-functional lung in order to improve respiratory mechanics. Because postoperative prolonged air leakage is a serious complication of the operation, most surgeons now use staplers reinforced with bovine pericardial strips to seal the lung. We report a patient where the migration of an intact pericardium patch caused an obstructive pneumonia and recurrent hemoptysis over several years.

Animals↗
PubMed2002

Role of Eloesser flap and thoracoplasty in the third millennium.

In the modern era of thoracic surgery, few indications remain for thoracoplasty. Indeed, many surgeons believe that the resulting deformity outweighs the usefulness of collapse therapy. Rather than trying to obliterate chronic spaces, these surgeons advocate myoplasty techniques to fill the space. Unfortunately, these techniques are not minor procedures and two to three operations are often necessary to solve the problem. This is the reason why thoracoplasty remains the best option in selected patients. In some cases, it should be a first-line procedure rather than as a last resort when everything else has failed. In their discussion of the article by Horrigan and Snow [31], Pairolero and Trastek [44] summarized well the current attitudes toward these different concepts: "Although management of the chronically infected pleural space has changed over the years, the goals of therapy remain the same to conserve the patient's life with a healed chest wall without evidence of infection. Determination of which techniques are necessary to achieve these goals must be tailored to the individual patients."

Bandages↗