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Biomedical subjects

M A Bruhat

Publications and source records attributed to M A Bruhat.

161 records · Page 9Linked to original sources
PubMed1982

[Intraepithelial cervical neoplasia: incidence of associated condylomatous lesions. Results of CO2 laser treatment].

The present study reports our results using the CO2 Laser destruction of cervical intra-epithelial neoplasia (CIN) and points out the relationship with condylomatous lesions. 97 patients were selected and evaluated by cytology, colposcopy and directed punch biopsy. The cytologic criteria used for identification of virus infection are now well recognized. 12 CIN were overdiagnosed and lesions reclassified as condyloma. 85 CIN were studied. Epithelial changes suggestive of a condylomatous lesion were found in 27 cases (31.7%) and respectively 11.5% of CIN I, 37.8% of CIN II and 45.5% of CIN III. Further studies are required to evaluate the significance of condylomatous-CIN association. 70 women were treated by CO2 Laser including 24 CIN I, 32 CIN II and 14 CIN III. The primary failure rate for CIN I was 9.1%, CIN II 12.2%, CIN III 30.7%. However after a second treatment the total success rate was 93.8%. These data may give impetus for active management of precancerous lesions of the cervix.

Biopsy↗
PubMed1980

Treatment of ectopic pregnancy by means of laparoscopy.

Sixty cases of ectopic pregnancy were treated by laparoscopy without laparotomy. In each case, one of two techniques was used-tubal aspiration or salpingotomy-in conjunction with aspiration of the conceptus and peritoneal rinsing. Of these 60 cases, only 3 were failures. Twenty-five women later desired pregnancy, and 18 conceived. The operated fallopian tube was checked in 18 cases and in 13 of these was found to be patent. A laparoscopic film has been made to illustrate this new technique.

Female↗
PubMed1979

[Carbon dioxide laser and gynaecological surgery (author's transl)].

The authors describe their one year's experience with a CO2 Laser in gynaecology. They emphasise the ease of use of the equipment. Three major divisions of gynaecology can benefit from the CO2 Laser: benign or precancerous lesions of the vulva and of the vagina, dysplasia of the cervix, surgery of the fallopian tubes. In the future, technical progress will enable the CO2 Laser to be used in laparoscopy and its indications will certainly be extended to laparoscopic surgery.

Carbon Dioxide↗
PubMedDate not supplied

Management of adnexal masses: role and risk of laparoscopy.

Laparoscopic surgery has become the gold standard in the treatment of benign adnexal masses, whereas laparotomy remains the standard for the treatment of malignant tumors. The laparoscopic management of adnexal masses remains controversial because of the potential risks of cancer dissemination suggested by many case reports and national surveys. Experimental data show potential advantages and disadvantages for the laparoscopic treatment of gynecologic cancer. Since the risk of dissemination appears high when a large number of malignant cells are present, adnexal tumors with external growths and bulky lymph nodes may be considered contra-indications to CO(2) laparoscopy. Surgical diagnosis is the key to adequate management of adnexal masses. In our experience, laparoscopic diagnosis of malignancy is reliable after a careful pre-operative evaluation has been performed. Moreover, national surveys have revealed that despite suspicious laparoscopic findings, many malignant masses were considered benign at the outset. Using strict guidelines, laparoscopic diagnosis can be proposed for both non-suspicious and complex masses, thus avoiding many unnecessary laparotomies for benign masses suspicious at ultrasound. The more controversial limits of laparoscopic treatment are discussed. If a laparotomy was performed for all masses suspicious at surgery, 80% of the cases would be treated by laparoscopy. The role of laparoscopy for restaging and second-look operations for ovarian cancer requires further evaluation.

Adnexal Diseases↗
PubMedDate not supplied

Laparoscopic hysterectomy. A preliminary study.

Thirty-three patients were selected for laparoscopic hysterectomy and operated on in the Department of Obstetrics, Gynecology and Reproductive Medicine of Clermont-Ferrand University Hospital. Surgical techniques included blunt dissection with scissors and bipolar coagulation to achieve hemostasis. A case was considered successful when all the uterine vessels were treated by laparoscopy. Twenty-four cases were completed laparoscopically (72.7%). None of these patients had postoperative bleeding; 22 had an uneventful postoperative recovery. Nine procedures were converted to laparotomy (27.3%), five because of a difficult or unsatisfactory hemostasis. We conclude that in selected cases, a total hysterectomy can be performed safely by experienced laparoscopists. Further technological progress is necessary to make this procedure more acceptable. Its value as compared to the others will have to be demonstrated.

Adult↗
PubMedDate not supplied

[Pelvic pain of venous origin].

Although the causes of chronic unrecognized pelvic pain are multifactorial, most investigators observe circulatory disturbance as being a main etiological factor, in particular if the patient has a retroverted uterus. We examined 50 patients who were diagnosed to have this condition, comparing data obtained by hysterophlebography and laparoscopy, with complementary but sometimes differing results, which, in any event, are not sufficient to establish the diagnosis, thereby leading us to offer a method to measure uterine blood flow using a radioisotope of Xe 133. It is certain that better understanding of the pathophysiology of this disorder would provide an improved therapeutic approach. Here too, the value of laparoscopy must be emphasized, because of its contribution both to positive as well as differential diagnosis.

Diagnostic Imaging↗
PubMedDate not supplied

Laparoscopy procedures to promote fertility ovariolysis and salpingolysis. Results of 93 selected cases.

In 93 selected infertile patients removal of periadnexal adhesions was attempted by laparoscopic procedure. Adhesiolysis was assessed according to Palmer's classification reviewed in Madrid (July 1980). Success was defined in terms of pregnancies, therefore patients with tubal obstruction were excluded. The rate of intra-uterine pregnancies was high (51,6%) and appeared to correlate with the quality of adhesiolysis. The present data strongly suggest that laparoscopic procedures represent a satisfactory method of adhesiolysis and emphasize the critical importance of case selection.

Adult↗