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L Goncette

Publications and source records attributed to L Goncette.

At least 19 recordsLinked to original sources
PubMed2004

Whole stomach with antro-pyloric nerve preservation as an esophageal substitute: an original technique.

The paper describes an original technique of gastric tailoring in which the two-thirds of the lesser curvature proximal to the crow's foot are denuded flush with the gastric wall, leaving both nerves of Latarjet and the hepatic branches of the left vagus nerve intact. Maintenance of the vagal supply to the antro-pyloric segment in two patients resulted in the presence of peristaltic contractions sweeping over the antrum on simple observation of the antral wall at the end of the procedure and on both upper G-I series and intragastric manometry tracings 6 weeks postoperatively. Gastric exposure to bile on 24-h gastric bile monitoring was normal 6 weeks after the operation. Neither patient had any gastrointestinal symptoms with the exception of early sensations of postprandial fullness when overeating.

Esophageal Diseases↗
PubMed1998

Terminalized semimechanical side-to-side suture technique for cervical esophagogastrostomy.

BACKGROUND: The classic manual end-to-side technique of esophagogastrostomy after gastric pull-up to the neck carries a rather high risk of fistula and stricture. METHODS: A terminalized semimechanical side-to-side technique of cervical esophagogastrostomy was performed in 16 patients by the application of an Endo-GIA stapler across the gastric and esophageal walls placed side by side, so as to create a V-shaped posterior opening between the two lumina. The anterior aspect of the anastomosis was hand-sewn using a classic running suture. The cross-sectional area of the semimechanical anastomoses was estimated by barium swallow study 2 months after operation and compared with that of 24 manual end-to-side esophagogastrostomies. RESULTS: The cross-sectional area was 225 +/- 15.7 mm2 (mean +/- standard error of the mean) for the 16 semimechanical anastomoses versus 136 +/- 15 mm2 for the 24 manual anastomoses (p = 0.0001). The anastomotic area decreased from 206.6 +/- 13.5 mm2 in 29 patients without dysphagia to 107.5 +/- 4.7 mm2 in 7 patients with moderate dysphagia for solids that did not require endoscopic dilation and to 55.7 +/- 16 mm2 in 4 patients with severe dysphagia that required dilation (p = 0). The anastomotic area in 6 of the 7 patients with initial moderate dysphagia for solids increased spontaneously with time from 107.3 +/- 5.5 mm2 to 174.6 +/- 8.1 mm2, with concomitant symptomatic relief (p = 0.0277). CONCLUSIONS: The terminalized semimechanical side-to-side suture technique produces a larger anastomosis than the classic end-to-side esophagogastrostomy technique. Inflammatory changes related to the operation may cause transient narrowing of a cervical esophagogastrostomy.

Anastomosis, Surgical↗
PubMed1998

Tracheal laceration and tension pneumomediastinum of spontaneous favorable outcome.

The case of a 75-year-old women with probable tracheal laceration and tension pneumomediastinum after intubation is reported. A dramatic reduction of tracheal caliber was observed during fiberoptic bronchoscopy. Despite severe dyspnea, the patient healed with conservative measures. We conclude that aggressive surgical treatment for tracheal laceration is not always necessary.

Aged↗
PubMed1998

[Spiral CT in pulmonary embolism].

Pulmonary embolism is a leading cause of morbidity and mortality that can occur in many clinical situations. For several years, spiral CT has represented a relatively non invasive modality for diagnosing this common disease. The present article is reviewing the CT features of acute and chronic pulmonary embolism, the technical aspects of spiral CT acquisition, the diagnostic accuracy and major limitations and pitfalls of the technique.

Acute Disease↗
PubMed1997

Solitary fibrous tumor of the pleura: a report of five cases diagnosed by transthoracic cutting needle biopsy.

Five patients had a solitary fibrous tumor of the pleura; a well-known but rare entity. In all cases, biopsy by a transthoracic cutting needle (Tru-Cut; Travenol; Deerfield, IL) yielded specimens adequate for histologic analysis and gave the clue to the diagnosis. In four patients, surgical resection confirmed the diagnosis. The opportunity for and interest in diagnosing these tumors by transthoracic cutting needle biopsy before surgery are discussed. An accurate diagnosis of solitary fibrous tumors of the pleura can be made by a minimally invasive procedure; this allows for a more informed allocation of surgical resources.

Aged↗
PubMed1997

Laparoscopic treatment of gallbladder duplication. A plea for removal of both gallbladders.

BACKGROUND: Gallbladder duplication is a rare congenital condition, which can now be detected preoperatively by imaging studies. METHODS: We report a case of duplicated gallbladder with symptomatic unilobar gallstones. Appropriate biliary workup (ultrasound, oral cholecystography, and intravenous cholangiography) allowed a correct preoperative diagnosis. RESULTS: Laparoscopic treatment included selective removal of the diseased accessory gallbladder. However, postoperative acute cholecystitis and symptomatic gallstone occurred in the remaining main gallbladder, and laparoscopic reintervention was required 27 months later. CONCLUSIONS: This case illustrates the need for complete removal of both gallbladders during initial surgery. Precise intraoperative recognition of vascular and biliary anatomy-including abnormalities-is highlighted to avoid mistakes during surgery.

Adult↗
PubMed1996

Bronchioloalveolar carcinoma: computed tomography findings.

The aim of the present study was to investigate the appearance of bronchioloalveolar lung carcinoma on computed tomography (CT) scans, and to determine the frequency of signs suggestive of this diagnosis. CT features of 42 cases with pathologically proven bronchioloalveolar carcinoma were retrospectively analysed for pattern, size, location and secondary signs suggesting the diagnosis. Bronchioloalveolar carcinoma had one of the following patterns: solitary nodule or mass (16), lobar consolidation (10), multilobar consolidations (13) and diffuse nodules (3). The 16 solitary nodules or masses ranged in size from 2.0 to 9.4 cm (mean +/- SD 3.75 +/- 1.7 cm). Eleven of the 16 nodules or masses were peripheral and five were central: Eight of the 16 tumours had pleural tags, seven had spiculated margins, and three had bubblelike lucencies. The consolidations were peripherally distributed in 13 out of 23 cases; cystic airspaces were observed in 19 out of 23 consolidations; bulging of interlobar fissures in 8 out of 23; and the angiogram sign in 7 out of 23. In conclusion, computed tomography findings of bronchioloalveolar carcinoma have a wide spectrum, showing typically a peripheral nodule or consolidation. Computed tomography has a role in the diagnosis of nodular localized versus other forms, with subsequent therapeutic and prognostic implications.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1996

[Value of echography in the diagnosis of acute intestinal occlusion].

OBJECTIVE: The aim of our study was to assess the value of sonography in the diagnosis of acute intestinal occlusion. MATERIAL AND METHODS: Sonographic findings were reviewed in 50 cases of intestinal occlusion (39 small bowel and 11 colonic occlusions). The final diagnosis was based on surgical findings (n = 40) or clinical course and further imaging findings (n = 10). RESULTS: Occlusion was correctly detected with sonography in 48 cases (96%). The location was correctly established with sonography in 43 cases (86%). The precise cause was suggested with sonography in 21 cases (42%). COMMENTARY: These results confirm the value of sonography for the diagnosis of intestinal occlusion and the identification of its level and its cause.

Acute Disease↗
PubMed1995

Pulmonary sequestration. Visualization of an enlarged azygos system by CT.

The purpose of this study was to determine the prevalence of enlargement of the azygos system in the case of lung sequestration and its potential usefulness in the differential diagnosis of lower lobe opacities. Seven consecutive adult cases of pulmonary sequestrations were retrospectively enrolled; 4 sequestrations were proved surgically and all 7 angiographically. A group of 50 consecutive patients with a normal chest CT were used as controls. Another group consisted of 25 consecutive patients identified on the basis of an opacity in a posterobasal location on chest CT. For the 3 groups, the maximum diameter of the azygos and hemiazygos veins was measured, the level of measurement located between the upper poles of the kidneys and the confluence of inferior pulmonary veins into the left atrium. The diameter of the azygos veins (mean 10.4 +/- 5.1 mm) and of the hemiazygos veins (mean 7.1 +/- 3.0 mm) in the sequestration group was significantly larger than the diameter of the azygos and hemiazygos veins in the control group (mean 5.7 +/- 2.5 mm, and 3.4 +/- 2.4 mm, respectively), as well as in the study group (mean 5.9 +/- 2.6 mm and 3.3 +/- 2.6 mm, respectively). Our results suggest that enlargement of the azygos system in association with a posterobasal chest opacity, although nonspecific, may be a useful additional CT sign of sequestration.

Adolescent↗
PubMed1994

Radiologic findings of normal and compromised thoracic venous catheters.

We review the radiologic findings of normal positioning, malpositioning, and complications related to the more commonly used thoracic venous catheters. These include central venous catheters, long-term central venous access catheters, and pulmonary artery catheters. The radiologist plays an important role in the early recognition of the complications of these catheters. The daily practice of chest radiology is intimately related to the evaluation of the integrity and correct placement of thoracic venous catheters. The purpose of this pictorial essay is to review radiologic findings of normal positioning, malpositioning, and complications related to the more common devices used, including central venous catheters, long-term central venous access catheters, and pulmonary artery catheters. Many of the complications described are serious and may remain unrecognized for a long time; this may cause incorrect diagnosis and delayed treatment. The radiologist plays an important role in the early recognition of these complications. Malpositioning and complications often are more easily diagnosed with contrast-enhanced studies and computed tomography.

Catheterization, Central Venous↗
PubMed1994

[Recurrent lithiasis following cholecystectomy imaged with ultrasonography, tomodensitometry and cholangiography].

It is generally admitted, that after cholecystectomy, the cystic duct and the gallbladder remnant may cause symptoms, by being the site of inflammation. Recurrence of stones in a reformed gallbladder is avoided when cholecystectomy is complete. We report the case of a 43-year-old woman, presenting 19 years after cholecystectomy with a reformed gallbladder containing stones demonstrated by US, CT and cholangiography.

Adult↗
PubMed1991

Spontaneous favorable outcome of tracheal laceration.

We present the case of a 57-year-old woman with a huge tracheal laceration after intubation. With simple supportive therapy, the laceration healed in ten days, and the patient made an uneventful recovery. At the three-month follow-up, no sequelae were observed.

Female↗
PubMed1990

[Plasma cell granuloma of the lung. Apropos of a case and review of the literature].

A case of plasma cell granuloma of the lung is presented, and the clinical, radiological, histological, diagnostic and therapeutic data obtained from 97 published cases are reviewed. Since the disease is usually peripheral, the diagnosis rests on surgical biopsy and histological examination. In the case presented here, it was established on intrabronchial biopsy obtained by fibroscopy.

Adult↗