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Biomedical subjects

L De Calan

Publications and source records attributed to L De Calan.

9 recordsLinked to original sources

[Obligatory surgery after endoscopic sphincterotomy for the treatment of stones in the common bile duct].

Endoscopic sphincterotomy is the treatment of choice for stones in the common bile duct in patients with a high operative risk. However, when this modality is insufficient or fails, these patients need to be operated. The authors have operated 14 patients under these conditions. In addition to the cholecystectomy performed in 9 patients who still retained their gallbladder, the common bile duct was cleared in 3 cases and drained by means of choledochoduodenal anastomoses in 10 cases. Three patients developed complications and one of them died. Endoscopy and surgery appear to be complementary in this indication. Sphincterotomy should be proposed as first-line treatment as, even in the case of incomplete disobstruction, it enables high-risk patients to be operated under better conditions.

Aged

[Thyroid ectopia and Basedow's disease].

Graves' disease was diagnosed in a 35-year old woman with a history of myxoedema in childhood. Clinical data, ultrasonography and radioisotope scanning showed that the disease had developed in an ectopic subhyoid thyroid gland. Although numerous thyroid diseases associated with an ectopic thyroid have been described, Graves' disease does not seem to be frequent since only one case has been published so far.

Adult

[A case of sacrococcygeal chordoma].

The authors describe a case of sacrococcygeal chordoma which was detected in a 49-year old male subject in the course of a clinical examination. Bone X-rays and CT-scans confirmed the diagnosis of sacral tumor, and radical excision was performed via combined abdominal and sacral approach. The chief characteristics of these rare tumors are further discussed, with particular focus on the therapeutical problems arising in relation with the fact that surgical removal, alone, can prevent tumor recurrences.

Bone Neoplasms

[Basedow's disease: recurrence after surgical treatment. Study of a series of 88 patients].

A homogeneous series of 88 patients with a history of surgery for Basedow's disease was studied retrospectively to evaluate long term recurrences. A total of 88 cases were reviewed after a follow up of a median of 50 months (range 1 to 13 years), and hormone assays were carried out in 74 cases. Surgical complications were minor: no mortality, no definitive hypoparathyroidism, 45% unilateral recurrent nerve palsies and 14.3% definitive hypothyroidism occurring during the first year. Fifteen patients had one or several recurrences of hyperthyroidism. The actuarial recurrence rate at 5 years was 17%, the risk increasing progressively up to the sixth year. The type of operation was the only predictive factor of recurrence surveillance of these patients should be prolonged and involve regular hormone assays, since 6 of the 15 recurrences were poorly symptomatic.

Adolescent