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Biomedical subjects

L K Lacquet

Publications and source records attributed to L K Lacquet.

8 recordsLinked to original sources
PubMed1977

Intrathoracic chemodectoma with multiple localisations.

In 1958 a mediastinal tumour was discovered in an asymptomatic woman with a history of vomiting and an oesophageal anomaly which had not been treated. A tumour of the anterosuperior mediastinum in relation to the aortic arch was extirpated and proved to be a chemodectoma or non-chromaffin paraganglioma. At subsequent follow-ups the mediastinum was never normal and the heart size progressively increased, the oesophageal anomaly remaining unchanged. A small opacity appeared in the left lung in 1974. An operation performed in 1975 revealed an osteochondroma in the lung, pericarditis, and an intrapericardial chemodectoma. The oesophagus was not explored. An intrathoracic chemodectoma is rare. The importance of angiography in its diagnosis is emphasised. Malignant degeneration is seldom observed. Therapy is surgical, the tumour being radioresistant. The possibility to be considered in our patient was either relapse of the tumour with degeneration or multiple localisations of the tumour.

Adult↗
PubMed1976

[Mediastinal chemodectoma (author's transl)].

In 1958 a mediastinal tumor was discovered in an asymptomatic patient. She had previously complained of vomiting and an oesophageal abnormality had been discovered though not treated. The mediastinal tumor was resected and diagnosed as a non chromaffine chemodectoma. In the follow-up the mediastinal image never appeared normal and the heart shadow was enlarged. In 1974 an infiltrate appeared in the left lung. In 1975 the patient was operated : a pulmonary osteochondroma, a pericarditis and an intrapericardial aortopulmonary chemodectoma were discovered. The mediastinal chemodectoma is a rare tumor and its frequency, location and signs are discussed. The importance of angiography for diagnosis is stressed. The authors consider malignant degenerescence to be rare, and the treatment is surgical as the tumor is radioresistant. In the present case there was either a malignant recurrence or multiple focuses with a possible oesophageal location.

Bone Neoplasms↗
PubMed1976

[Mediastinoscopy and bronchial carcinoma. Experience with 600 mediastinoscopies (author's transl)].

Of 600 mediastinoscopies carried out from 1966 to 1973, 479 were performed to assess the operability of a pulmonary carcinoma. Of these, (43%) were positive and (57%) negative. Of the 161 patients found positive during an initial period, 14 were considered candidates for operation. The tumour was irresectable in one patient, who died after 3.5 months; curative resection was possible in one and palliative resection in 12 patients. These 12 patients all died within a year. Of the 184 patients found negative during an initial period, 149 were treated by operation. The tumour proved irresectable in 5%, while curative resection was possible in 76% and palliative resection in 19%. Comparison with the period 1957-1963, when in the same hospital resection was performed after a negative Daniels biopsy, shows that the tumour was irresectable in 20%, while curative resection was possible in 35% and palliative resection in 45%. During a second period, patients with a positive mediastinoscopy were refused operation. Of 89 negative patients, 81 were treated by operation. No tumour was found to be irresectable; curative resection was possible in 78% and palliative resection in 22%. A survival study was made of 100 operated patients with a follow-up from a minimum of two years and four months to a maximum of four years and four months. The early mortality averaged 10%. The late mortality was 31% after curative lobectomy, 43% after curative pneumonectomy, and 100% after palliative resection. The survival was 49%

Bronchial Neoplasms↗
PubMed1975

Mediastinoscopy and bronchial carcinoma: experience with 600 mediastinoscopies.

Of 600 mediastinoscopies carried out from 1966 to 1973, 479 were performed to assess the operability of a pulmonary carcinoma. Of these, 206 (43%) were positive and 273 (57%) were negative. Of the 161 patients found positive during an initial period, 147 were refused operation; the remaining 14 were considered suitable candidates for operation, either because only one homolateral lymph node site was involved or because there was a concomitant osteoarthropathy. The tumour was irresectable in one of these 14 patients who died after 3-5 months; curative resection was possible in one and palliative resection in 12 patients. These 12 patients all died within a year. Of the 184 patients found negative during an initial period, 149 were treated by operation. The tumour proved irresectable in seven (5%), while curative resection was possible in 113 (76%) and palliative resection in 29 (19%) patients. Comparison with the period 1957-63, when in the same hospital resection was performed after a negative Daniels' (scalene node) biopsy, shows that the tumour was irresectable in 25 (20%) of the 124 patients with a negative biopsy, while curative resection was possible in 43 (35%) and palliative resection in 56 (45%) patients. During a second period, patients with a positive mediastinoscopy were in principle refused operation. Of 89 negative patients, 81 were treated by operation. No tumour was found to be irresectable; curative resection was possible in 63 (78%) and palliative resection in 18 (22%) patients. An operation for bronchial carcinoma was performed on 167 patients between September 1970 and September 1973 after a negative mediastinoscopy in 95, and without mediastinoscopy in 71 patients, either because of a peripheral tumour (70) or because of a tumour relapse after two years (1). The resection was palliative in 11% of the 71 cases, but in only one patient with a peripheral tumour could a mediastinoscopy have been positive. Finally, an operation was performed on one patient with a positive mediastinoscopy and a tumour relapse after six years. A survival study was made of the first 100 patients with pulmonary carcinoma, operated on between September 1970 and March 1972 and with a follow-up from a minumum of two years to a maximum of 3-5 years. The early mortality averaged 10% and was higher after pneumonectomy than after lobectomy. The late mortality was 16% after curative lobectomy, 38% after curative pneumonectomy, and 83% after palliative pneumonectomy. The survival after 2 to 3-5 years was 63%.

Bronchial Neoplasms↗
PubMedDate not supplied

[Surgical treatment of pulmonary metastases (author's transl)].

From April 1954 till February 1976, pulmonary resections for metastases of primary extrapulmonary malignancies have been done on 35 patients, 21 men and 14 women with average age of 49 years 7 months. In about half of the cases the lung opacities were discovered occasionally. Three patients have undergone a second thoracotomy for a recurrent metastasis. Of the 48 resected metastatic lesions, 31 were located in the right and 17 in the left lung. Thirty were on resection unilateral and solitary. There was no operative mortality and the postoperative morbidity was neglectable. The cumulative 3- and 5-years survival percentages as obtained by the life-table method were 44.6 and 31.2. Better survival rates were found in the age group of 0-40 years and in the group of the sarcomas. Worse results were obtained when the primary tumor was invasive or associated with regional metastases. Resection of metastatic lung lesions larger than 5 cm diameter and especially the resection of multiple lesions gave poorer results. The time-interval between the primary operation and the pulmonary resection had no clear prognostic value. The factors determinating the palliative character of the pulmonary resection had a negative influence on the survival. None of the 9 patients with pulmonary metastasis and secondary intrathoracic lymphatic metastases did survive longer than 3 years. All these patients had a primary carcinoma. Out of this study no conclusions can be made as to the extension of the pulmonary resection.

Adolescent↗
PubMedDate not supplied

[Blunt and open trauma of the heart and thoracic aorta in 26 patients (author's transl)].

Twenty-six patients with blunt or open trauma to the heart and thoracic aorta were admitted and 23 were operated on. Among 19 blunt trauma there were 15 ruptures of the aorta among which 12 were operated and 3 were not, 2 lesions of the ventricular septum, 1 coronary thrombosis and 1 rupture of the right atrium. In 7 open wounds there were 3 ventricular lesions; 3 cases of pericarditis and 1 aortic lesion. Among operated patients 1 died of a rupture of the aortic isthmus and another of a rupture of the aortic arch and left carotid artery. The 3 patients that were not operated died of a rupture of the aortic isthmus. In these cases the diagnosis must be set early and the aortography must be followed by an operation. In cases of an open wound early thoracotomy is recommended.

Adolescent↗
PubMedDate not supplied

The value of mediastinoscopy in the assessment of the operability of bronchial carcinoma respective five years survival after resection.

Of 740 mediastinoscopies carried out from january 1966 to january 1976, 581 were performed to assess the operability of a pulmonary carcinoma. Of these, 42% were positive and 58% were negative. The remaining 159 mediastinoscopies were performed as aids in the diagnosis of affections of the lungs and mediastinum. Of these, 63% were positive and 37% were negative. Patients with bronchial carcinoma and a negative mediastinoscopy were regarded as operable; patients with a positive mediastinoscopy were regarded as inoperable because of mediastinal metastases (Nohl, 1956; Reynders, 1964; Carlens, 1965). Nevertheless a small number of patients with a positive mediastinoscopy were operated during an initial period.

Bronchial Neoplasms↗