PubMed Health⌕ Search

Biomedical subjects

L Corbel

Publications and source records attributed to L Corbel.

At least 19 recordsLinked to original sources
PubMed1994

Erythrocyte polyamines and prognosis in stage D2 prostatic carcinoma patients.

We studied 43 patients with newly diagnosed, untreated, stage D2 prostatic carcinoma, and correlated the initial performance status, hemoglobin, prostate specific antigen levels, tumor Gleason grade, extent of disease on the bone scan, and erythrocyte spermidine and spermine levels with progression. Three patients died of unrelated causes and were excluded from the study, 16 remained in remission with a mean 28 +/- 11 months of followup and 24 had progression (18, or 75%, of whom died of the cancer) with a mean 12 +/- 9 months of followup (p < 0.05 for followup) after initiation of hormonal therapy. Pretreatment performance status, hemoglobin, and erythrocyte spermidine and spermine levels were correlated with progression, hemoglobin and spermine being the most significant independent variables (p = 0.006 and p = 0.001, respectively). Concerning cause-specific survival, only hemoglobin and spermine erythrocyte levels were significant independent variables (p = 0.02 and p = 0.0025, respectively). If confirmed, polyamine erythrocyte levels obtained by a simple blood sample could discriminate at diagnosis patients with a high risk of rapid hormonal relapse who may benefit from a more aggressive primary management.

Aged↗
PubMed1994

[Synchronous bladder metastasis of a clear-cell adenocarcinoma of the kidney].

Urinary bladder synchronous metastases from renal cell carcinoma are rare, three cases were reported in the literature and we present the fourth. In these four published cases, the bladder metastases followed a left kidney tumor and in three, a brain metastases was also found. A possible retrograde metastatic dissemination through the left genital and vertebral veins has to be taken in consideration. The short survival after the extirpation of the tumor and the bladder metastases implies a less aggressive approach in the presence of a bladder metastases.

Adenocarcinoma, Clear Cell↗
PubMed1994

[Extracorporeal lithotripsy for urinary calculi: a non invasive technique? Report of 150 patients treated with the Nova lithotriptor].

The NOVA apparatus is an electrohydraulic lithotriptor not yet available in France. The authors present an evaluation of the first 150 patients treated with this machine. 92.2% of the 185 stones treated were fragmented. 141 patients were reviewed at 1 month and, if necessary, 3 months after the first session; 4/24 patients and 1/3 patients were not reviewed after their second and third treatment session, respectively. Evaluation of the 177 sessions performed (16% of second sessions and 2% of third sessions), 69.11% of patients did not have any residual stones. The success rate was 52% for renal stones; 96% for stones of the lumbar ureter and 50% for pelvic stones. The morbidity was low (10% of renal colic, 5% of obstructive stone) but in combination with second treatment sessions, it generated a risk of being rehospitalised after the first session of 26%. When the procedures performed under anaesthesia before and after ECL (apart from repeated sessions) are added, the risk of this supplementary anaesthetic for a given patient is 18.66%. Lastly, the risk of undergoing another anaesthetic after the 1st ECL was 33%. These data indicate the limits of the "noninvasive" nature of a modern and effective lithotriptor.

Adolescent↗
PubMed1994

[How to control the Santorini's plexus easily].

Control of Santorini's plexus is one of the main difficulties of prostatectomy and total cystectomy. Two procedures allow easy control of this plexus: Perform a running haemostatic suture in the bladder neck, from one edge of the pelvic aponeurosis to the other. Apart from ensuring haemostatis by bringing Santorini's plexus together in the midline, this suture also provides excellent exposure of the prostate. Prepare the passage of the dissector at the prostatic apex by disrupting the fibrous tissue with a finger. The urethra is easily identified as it is intubated by the bladder catheter. The avascular plane between the urethra and Santorini's plexus is open to the finger and the dissector can be easily introduced into the correct plane. Section of the venous plexus is performed precisely to reveal the urethroprostatic junction.

Humans↗
PubMed1994

[Acquired experience in anesthesia and perioperative intensive care in percutaneous nephrolithotomy. Current approach in the endoscopic treatment of lithiasis and pyelo-ureteral junction anomalies].

Percutaneous endoscopic treatment of the kidney retains a place in the treatment of renal stones (percutaneous nephrolithotomy--PCNL) and ureteropelvic junction abnormalities (endopyeloplasty). It requires anaesthesia ensuring surgical comfort and safety for the patients despite changes in position and the prolonged ventral supine position. The operation carries certain iatrogenic risks related to caliceal irrigation in patients with more or less documented episodes of infection and carries risks of haemorrhage and effraction of adjacent organs. 282 patients treated by PCNL between 1984 and 1991 were reviewed in order to define the respective indications for general anaesthesia and peridural anaesthesia and to determine the modalities, to evaluate the risk and severity of absorption of irrigation fluid and to assess the risk of infection by defining the indications for prophylactic antibiotics. General anaesthesia, using etomidate and propofol via an infusion pump, ensures surgical comfort, anaesthetic safety and better control of intraoperative complications. The renewed interest in this technique must be counterbalanced by the growing incidence of anaphylactic reactions related to anaesthetic drugs. Operations lasting more than 2 hours, raised intracaliceal pressure, the initially exclusive use of glycine for irrigation induce haemodilution complications, possibly aggravated by glycine intoxication. Repeated surgery is preferable with the use of an Amplatz tube as often as possible and physiological saline, except when required by the operation. Patients with a history of urinary tract infection or infected stones should receive prolonged and effective antibiotics before, during and after the operation. Prophylactic antibiotics are reserved for those patients with no history of infection. These principles equally apply to percutaneous nephrolithotomy and endopyeloplasty.

Adolescent↗
PubMed1993

Accuracy of ultrasound diagnosis after blunt testicular trauma.

The aim of this study is to determine the value of ultrasound evaluation for the diagnosis of testis rupture due to blunt scrotal trauma. We reviewed 16 operated cases of blunt scrotal trauma with hematocele, which were evaluated by ultrasound preoperatively. In 2 cases a tunica albuginea rupture was correctly diagnosed by ultrasonography but there were 2 false-positive and 5 false-negative diagnoses of rupture. Systematic exploration of the 16 cases revealed testicular rupture in 7, simple hematocele in 7 and hematocele associated with spermatic cord injury in 2. In 2 cases orchiectomy was necessary. From our experience the accuracy rate of ultrasound evaluation of blunt scrotal trauma was 56%, with a 58% negative predictive value. Considering these results, ultrasound examination of blunt scrotal trauma with hematocele is not sufficiently accurate to eliminate surgical exploration and, therefore, we recommended early surgical exploration as primary therapy in these cases.

Adult↗
PubMed1993

Resection of anatomical segments of the liver.

The aim of this report is to review recent experience of removal of anatomical segments of the liver. Resection of one or more segments of the liver was undertaken in 49 patients; in 32 patients, the resection was for malignant disease and in the remainder it was for benign disease. Operating time was 130 (60-600) min and the median transfusion requirement was 0 (0-15) units, with 31 patients having a resection without the need for a blood transfusion. There was no postoperative or in-hospital mortality. The removal of anatomical segments of the liver is a very useful technique for the safe removal of benign and malignant lesions.

Blood Loss, Surgical↗
PubMed1993

Polyamines and prostatic carcinoma: clinical and therapeutic implications.

The erythrocyte polyamines, spermidine and spermine, are known proliferation markers. The authors present their experience with polyamines and prostatic carcinoma. 229 patients with prostatic carcinoma had polyamine erythrocyte determination at diagnosis. Previous results confirmed a tendency to spermidine increase with tumor stage and a significant increase in spermine in metastatic and hormonal escape patients. No correlation was found between polyamine erythrocyte levels and hemoglobin, prostate-specific antigen or tumor grade. 148 prostatic carcinoma patients were followed up. Their pretreatment erythrocyte polyamine levels were correlated to progression. Patients (whatever stage) with rapid progression present significantly enhanced pretreatment erythrocyte spermine levels compared to patients with a favorable outcome. Polyamines are not only proliferation markers but are also necessary for cell division. The authors present their results on polyamine deprivation, combining a polyamine-free diet, polyamine synthesis inhibitors and intestinal tract decontamination, on in vivo tumor growth inhibition of the murine prostatic carcinoma Dunning Mat LyLu tumor model.

Adult↗
PubMed1993

[Can we do better than surgery in the treatment of benign prostatic hypertrophy? Results after 10 years in endoscopic resection and adenomectomy in urination and sexual disorders].

Surgery is considered to be the reference treatment for obstructive benign prostatic hypertrophy (NPH). Transurethral resection of the prostate (TURP) and suprapubic prostatectomy are the operations most frequently performed by urologists. However, little information is available concerning the long-term results of this surgery. In order to assess the long-term efficacy, we recalled 618 consecutive patients operated for benign prostatic hypertrophy between 1979 and 1982 (390 by TURP and 228 by suprapubic prostatectomy (SP). 167 patients were reviewed and investigated, 150 had died and 301 were lost to follow-up. Ten years after the operation, 85% of the patients reviewed had good or satisfactory micturition and 72% of them were satisfied, regardless of the technique used. In 80% of patients, no complementary procedure was required to ensure urinary comfort. However, the effects of this surgery on sexual function were considerable, as one half of patients reporting sexual intercourse before the operation reported a deterioration of sexual function after the operation. Lastly, long-term morbidity affected 10 to 41% of patients and 9 to 12% of them were reoperated. Although, overall, surgery gave excellent results at 10 years, 15% of patients did not derive any benefit from the procedure. It is therefore important, in the future, to more clearly define the indications for surgery and the place of noninvasive treatments. At the present time, young subjects wishing to preserve their sex life may benefit from noninvasive first-line treatments, provided their quality of life is sufficiently altered by the severity of the urinary symptoms.

Aged↗
PubMed1993

Does detubularization improve continence in bladder replacement?

Camey in the seventies promoted bladder replacement. In 1987, the French Association of Urology gave us the opportunity to review 729 Tubularized Ileocystoplasty (Camey operation) [1]. The day time continence was excellent or acceptable (mild stress incontinence) on 91% of the patients, the night time continence was excellent (no pads, no leakage) or acceptable (one pad or less than 3 wakes at night) for 44% of the patients (56% had to use a device). Since 1985, the detubularization attempted to improve the continence rate. Today, the review of the literature shows that day time continence has not changed and the night time continence improved less than 20% arising from 44% to 60%. Bladder replacement after prostatocystectomy has been proved to be superior to continent urinary diversion in patients whose urethral and external sphincter can be preserved. Day time continence is excellent in tubularized and detubularized bowel reservoirs. Night time continence, in 30 to 50% of patients, remains an unresolved problem also in detubularized low pressure reservoirs, even if they are of great capacity. The literature is therefore too optimistic when describing night time continence in 85% of the patients. These results are stated in spite of the absence of sensitivity in the neobladder, the loss of reflexic increase in sphincteric activity during bladder filling, and the low sphincteric tonus during sleeping. These optimistic results are due to lack of unanimous criteria for evaluating continence after bladder replacement and not taking into consideration as continence failure the abundant although not frequent nighttime incontinence. In order to improve continence, muscle reeducation and artificial sphincter implantation are the most adequate solutions.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1992

Complications of enterocystoplasty.

Bladder reconstruction, either by augmentation or substitution enterocystoplasty, is a safe alternative to supravesical urinary diversion providing careful attention to preoperative selection, surgical technique, and postoperative review is observed. However, under the most optimal conditions an untoward outcome may occur. We reviewed our series of 100 intestinocystoplasties to categorize the types of complications encountered, and to identify preoperative risk factors that could potentially develop into an unfavorable sequela. Twenty-seven patients required either early or late surgical intervention, while 30 were managed nonoperatively. In our review we identified two groups, those with myelodysplasia and those with a solitary functioning kidney, who are at a higher risk for an unfavorable outcome to develop.

Adult↗
PubMed1992

[Desmoid tumor of the mesentery. An uncommon cause of ureteral obstruction].

Desmoid tumors are rare lesions with a local invasive potential and a risk of recurrence considered as benign due to the absence of metastases. They are included in fibromatoses and may be associated with Gardner's syndrome. The authors report an unusual case, in a 26 year old man, of a desmoid tumor invading ileon, right colon, appendix and the right ureter and responsible of a ureteral obstruction. Etiologic factors (traumatic, hormonal, auto-immune...) are discussed. The treatment of choice to lower the risk of recurrence is the complete surgical removal of the tumor.

Adult↗
PubMed1992

Major liver resection without a blood transfusion: is it a realistic objective?

BACKGROUND: Observations from 75 patients undergoing resection of the liver during a recent period have been analyzed with respect to the use of perioperative blood transfusions and operative outcome. METHODS: Twenty-six patients were operated on for benign disease and 49 patients for malignant disease. Twenty-one patients underwent a right or left hepatectomy, 49 patients underwent removal of one or more anatomic segments of the liver, and five patients underwent wedge resection of a lesion in the liver. There was one postoperative death. RESULTS: The median blood loss was 0 units (range, 0 to 15 units). Sixty-three percent of the patients underwent operation without the need for a blood transfusion. The median postoperative stay was 10 days (range, 4 to 88 days). In the group of patients who did not undergo a blood transfusion the median postoperative stay was 9 days (range, 4 to 28 days), and in the patients who had a blood transfusion it was 14 days (range, 6 to 84 days) (p less than 0.0003). CONCLUSIONS: The performance of major liver resection without a blood transfusion is a realistic objective.

Aged↗
PubMed1991

[Desmoid tumor of the mesentery. An uncommon cause of ureteral obstruction].

Desmoid tumors are rare lesions with a local invasive potential and a risk of recurrence considered as benign due to the absence of metastases. They are included in fibromatoses and may be associated with Gardner's syndrome. The authors report an unusual case, in a 26 year old man, of a desmoid tumor invading ileon, right colon, appendix and the right ureter and responsible of a ureteral obstruction. Etiologic factors (traumatic, hormonal, auto-immune, ... ) are discussed. The treatment of choice to lower the risk of recurrence is the complete surgical removal of the tumor.

Adult↗
PubMed1991

[Conservative surgery of kidney cancer. Ex vivo surgery with immediate magnetic resonance imaging].

In addition to the technical difficulties arising when the tumor is located in the centre of the kidney, one of the stumbling blocks of conservative partial surgery of the parenchyma is the risk of leaving a second tumoral focus in place. In these cases, we propose an ex vivo operation associated with an intraoperative examination of the isolated kidney with nuclear magnetic resonance.

Anastomosis, Surgical↗
PubMed1990

[Severe and late complications after Nissen's procedure].

Eleven severe complications have been observed in 8 patients operated on with Nissen's procedure. The average time of occurrence of these lesions is of 4 years and 7 months +/- 3 years and 10 months (extreme values 9 months-11 years and 3 months). These patients were 3 women and 5 men of a mean age of 42 +/- 11 years (extreme ages 25-61 years). The complications are of two different types. In 5 cases they consist in the perforation of a gastric ulcer into the pericardium, the mediastinum, the pleura or one of the crura of the diaphragm. The diagnosis is established by Christ Ray and esogastroduodenal gastrograffin follow-through. A quite different picture is that of hemorrhagic ulcer occurring abruptly without any warning signs in 6 cases, causing cataclysmal bleeding in three. The etiological diagnosis is based on fibroscopy. Two patients had multiple complications. In three cases there were in addition obvious signs of disorders of gastric emptying and in one case alkaline reflux. The perforated ulcers were all treated by suture, but for the bleeding ulcers total or upper partial gastrectomy was required in 2 of 6 cases. No hospital mortality or morbidity was noted. The pathogenesis of these complications is controversial, but they seem to be caused by disorders of gastric emptying or alkaline reflux. The occurrence of these complications leads to call into question the indications of Nissen's procedure in the treatment of gastroesophageal reflux. The treatment must be medical at first.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Percutaneous surgery for lithiasis: results and perspectives. Apropos of 390 operations].

Percutaneous nephrolithotomy (PCNL) has radically changed the treatment of renal stones. The indications for this technique have been modified by the development and refinement of extracorporeal lithotripsy (ECL). The authors present their experience of 390 PCNL performed between 1984 and 1991, for solitary stones in 75% of cases. There were only 11 cases of failed puncture (3.8%). The overall morbidity was 18% with only 4.4% of major complications, i.e. life threatening or requiring reoperation. There were two deaths (0.5%). Stones were completely eliminated in 80.25% of patients, after a second operation (PCNL or other technique) in 32 cases (11%). 45 staghorn calculi were treated with 11% of complications and a 51% complete cure rate. The mean hospital stay was 6 days (2 to 30). PCNL is a safe and reliable technique. Its indications have decreased (6.5% of our patients treated for renal stones), but it still retains a place in the therapeutic approach to patients with renal stones.

Adolescent↗