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Biomedical subjects

M Belas

Publications and source records attributed to M Belas.

At least 19 recordsLinked to original sources
PubMed1993

[Urodynamic study of the behavior of detubulated ileocystoplasties according to feeding].

Twenty-three patients having undergone enterocystoplasty with a detubulated graft has an urodynamic study on an empty stomach and after a standardized meal. All patients (average age 62.9 years) had been operated more than 6 months earlier, and 30% still presented with urine leakages at night. The urodynamic study included a cystomanometric measurement with rapid water filling, an urethral profile and a micturating cystography. It was repeated 60 to 90 minutes after a meal composed of glucids, lipids and protids. Feeding had variable effects on the intestinal graft: increase in peristaltic intensity and/or earlier onset of contractions (10/23); apparently paradoxical decrease in contractions (6/23); sometimes no modification (7/23). This short work without any obvious physiopathological explanation has led us to advocating breaking up feeding for patients who were improved by the meals.

Aged↗
PubMed1992

[Treatment of urinary stress incontinence in women by percutaneous cervico-cystopexy. Gitte's operation: contribution of intraoperative ultrasonography. Apropos of 47 patients].

Between March 1988 and February 1991, 47 patients with urinary stress incontinence (USI) were treated by Gittes' operation, suspension thread traction being determined by perioperative ultrasonography in 31 of these cases. All patients were re-examined on February 1992 after a mean follow-up of 26 months (range 12 to 24 mths). The global success rate (recovery and improvement) was assessed as 72% at 3 months and 56% at follow-up. Rated as a function of closure pressure (CP), the success rate at evaluation was 62% with normal CP, 42% with CP low for age, and 33% with CP < 30 cm H20. For the 31 patients with perioperative ultrasonography examination the success rate was 80% at 3 months and 70% at follow up. As a function of CP the rate was 83% at follow up with a normal CP, 50% with a CP low for age, 37.5% with a CP < 30 cm H20. Although Gittes' operation is a simple, fairly non-aggressive intervention, results diverge widely from those obtained with "classical" techniques. Optimization of indications is essential, therefore, only patients with pure USI without hypotonia of the sphincter obtaining maximum benefit from the intervention, carried out preferably under perioperative by control ultrasonography.

Adult↗
PubMed1990

Clinical experience with a new pulsed dye laser for ureteral stone lithotripsy.

We treated 45 patients (46 ureteral stones) with a new pulsed dye laser. A 250 mu. fiber was used through a rigid (40 stones) or flexible (6) ureteroscope. Stones were in the upper (5 cases), middle (5) or lower (36) third of the ureter. Stone composition was calcium oxalate dihydrate (34 patients) or monohydrate (7), struvite (2) or uric acid (2). Of the calculi 36 (78%) were fragmented, including 14 that also required simultaneous basket removal of fragments. Ten stones were not fragmented: 6 because of the pure monohydrate composition and 4 due to malfunction of the laser. No damage to the ureteral wall was noted. Retrograde rigid ureteroscopy with laser lithotripsy was effective for lower and middle third ureteral stones. Flexible ureteroscopy with laser lithotripsy was effective (impacted stones) but difficult for upper third ureteral stones.

Endoscopy↗
PubMed1990

Clinical experience with a new pulsed dye laser for ureteral stone lithotripsy.

Forty-five patients with 46 ureteral stones were treated using a new pulsed dye laser (Pulsolith, TMI). A fiber of 250 micrometers was used through rigid (40 cases) or flexible (6 cases) ureteroscopes. Stones were located in the upper third (5 cases), middle third (5 cases), or lower third (36 cases) of the ureter. Stone composition was calcium oxalate dihydrate or monohydrate, struvite, or uric acid in 34, 7, 2, and 2 patients, respectively. Thirty-six stones (78%) were fragmented, including 14 cases that required basket removal of fragments at the same time. Ten stones were not fragmented, 6 because of the pure monohydrate composition and 4 due to a laser breakdown. No damage to the ureteral wall was noted. Retrograde rigid ureteroscopy with laser lithotripsy was effective for lower and middle third ureteral stones. Flexible ureteroscopy with laser lithotripsy was effective (impacted stones) but difficult for upper third ureteral stones. Laser lithotripsy was not effective for pure calcium oxalate monohydrate stones.

Calcium Oxalate↗
PubMed1990

Laser lithotripsy of ureteral calculi: initial experience with a new pulsed dye laser.

Thirty-two patients with ureteral calculi ranging in size from 5 x 5 to 12 x 18 mm underwent lithotripsy with a new pulsed dye laser (Pulsolith, TMI). In 24 cases, the patients were entirely free of stones following laser lithotripsy alone, or with adjunctive stone basket removal. There were three instances of equipment failure and five calcium oxalate monohydrate stones that did not respond to laser energy.

Calcium Oxalate↗
PubMed1989

Bladder tumors invading the lamina propria (stage A/T1): influence of endovesical bacillus Calmette-Guérin therapy on recurrence and progression.

47 patients with transitional cell bladder carcinoma invading the lamina propria (stage A/T1) were treated from 1984 to 1986 by complete transurethral resection followed by 1-3 cycles of endovesical bacillus Calmette-Guérin instillations, and followed 14-64 months by cytology, endoscopy and bladder biopsies, 64% achieved a complete response, 36% recurred (recurrence rate/100 months/patient 2.2), 21% progressed to muscle invasion. Duration of treatment, tumor size or type (solid vs. papillary), presence of carcinoma in situ bore no relation to the final result. The preceding history of T1 bladder tumor appeared associated with a higher risk of progression although not reaching statistical significance. The results were compared to those obtained by transurethral resection in a similar group of 50 patients treated from 1982 to 1984 and followed up 12-100 months, 90% recurred and 34% progressed to muscle invasion with a recurrence rate/100 months/patient of 9.22. Keeping in mind the limits of a nonrandomized historical comparison, it appears that endovesical bacillus Calmette-Guérin therapy alters favorably the recurrence pattern of T1 bladder cancer.

Adult↗
PubMed1989

[Urethral fistula following reconstructive surgery of hypospadias. Apropos of 34 cases].

Thirty-four children, ten of them coming from another Surgical Center, underwent repair for urethral fistula after hypospadias reconstructive surgery, over a period of three years (1985-1987). After the first operation, there was no recurrence in 59% (20 cases). Currently, all fistulas have been closed, except in 3 cases. Closure by direct suture was used in 30 cases (88%). The best results were observed with suture in three planes and without diversion, on an outpatient basis (91% of success for 12 cases). The Leveuf method is a safe operation for complex penile fistulas after repeated surgery.

Adolescent↗
PubMed1989

Bladder tumors invading the lamina propria (stage T1): influence of endovesical BCG therapy on recurrence and progression.

We treated 47 patients with transitional cell bladder carcinoma invading the lamina propria (stage T1) from 1984 to 1986 with complete transurethral resection followed by one to three courses of endovesical BCG instillation and followed them for 14-64 months with cystoscopic and endoscopic tests and bladder biopsy. Complete response was achieved in 64%, and 36% had recurrences (recurrence rate per 100 month/patient, 2.2); 21% progressed to muscle invasion. Duration of treatment, tumor size or type (solid versus papillary), and presence of carcinoma in situ bore no relation to the final result. A history of previous T1 bladder tumor appeared associated with a higher risk of progression, although not statistically significantly. The results were compared with those obtained by transurethral resection alone in a similar group of 50 patients treated from 1982 to 1984 and followed for 12 to 100 months. Of these 90%, had recurrence, and 34% progressed to muscle invasion, with a recurrence rate per 100 month/patient of, 9.2. In light of the limits of a non-randomized historical comparison, it appears that endovesical BCG therapy favorably alters the recurrence pattern of T1 bladder cancer.

Administration, Intravesical↗
PubMed1988

[Ureteropelvic junction syndromes: antenatal diagnosis].

Seventy-four hydronephrosis by uretero-pelvic obstruction, discovered by antenatal real-time ultrasound, have been managed on sixty-one children. Three groups, with a specific management, are distinguished. The minimal forms have been only watched over (15 cases). The average forms have been operated (49 cases); considering the results (3 immediate complications and 2 early stenoses), it seems better to wait for 4 months to operate and to place a drain in renal cavities. In major forms (silent kidney on IVP), the diagnosis and therapeutic management use the percutaneous nephrostomy (10 cases). The interest of antenatal diagnosis of uretero-pelvic obstructions is to allow to operate, not only before the renal deterioration emphasizes, but principally before septic complications.

Age Factors↗
PubMed1987

[Polycystic renal dysplasia in children].

Ultrasonography has profoundly modified the diagnostic conditions of polycystic renal dysplasia in children. Non-palpable forms, which were previously most frequently missed, can now be detected during the antenatal period. In infants, ultrasonography generally provides a definite diagnosis, which can be confirmed by aspiration-opacification of the cysts. On the basis of a series of 40 cases and a review of the literature, the authors discuss the therapeutic implications of these new data. Surgery remains essential in cases of palpable polycystic renal dysplasia, especially when it is complicated. However, in the sub-clinical forms, as the risks of malignant degeneration and the incidence of post-operative complications are minimal in the one case and undefinable in the other, surgical excision is possible but not essential.

Child↗
PubMed1987

[Partial splenectomy for epidermoid cysts of the spleen in children. Apropos of 3 cases].

Three cases of epidermoid cyst of the spleen treated by partial splenectomy are reported on children. The diagnosis rests now on the ultrasonography. The operative indication is systematic because of the risks of complication. The polar localisation of the cysts permits one to make a conservative surgery. The partial splenectomy is a technique of choice in this benign tumoral pathology. Postoperative digital intravenous subtraction angiography demonstrated the good vascularization of the remaining part of the spleen.

Adolescent↗
PubMed1987

[Treatment,in girls, of ectopic ureters, due to duplication, using reimplantation of the single pathological ureter into the bladder].

Mostly the ectopic ureter belongs to the upper pole in urinary tract duplications. In the pelvis, the two ureters are clearly separated. The only dissection of the ectopic ureter is in no case dangerous for the ureter of the lower pole. Therefore the reimplantation of the ectopic ureter can be performed separately. This only reimplantation of the ectopic ureter has been performed 9 times, without any mortality nor morbidity. The scar is almost invisible and the child is cured without any risk for the upper pole and saving the whole of the renal parenchyma. If the upper pole is functional, which happened in 1/4 of the cases, this technique is the best way and the less dangerous to recovery.

Adolescent↗
PubMed1987

[Value of the Goebbel-Stoeckel operation in the treatment of neurogenic bladder in girls].

Repeated catheterisation and drugs with a pharmacodynamic action are not always able to ensure perfect continence in children with meningomyeloceles. To treat uncontrollable incontinence, the authors propose an aponeurotic suspension of the bladder neck as described by Goebbel-Stoeckel in order to increase the peripheral resistance. At the same time, sufficient bladder compliance can also be obtained either by means of pharmacodynamic treatment or by enlargement enterocystoplasty. The aim is to obtain catheterisation every 4 to 6 hours without any incontinence. Young girls constitute the ideal indication for this programme as catheterisation is safe and easily accepted. Ten girls underwent Goebbel-Stoeckel operation, associated with sigmoido-cystoplasty in 6 cases. Eight of these girls are now perfectly continent with a normal social life, including one case with a follow-up of 12 years and a pregnancy. The authors stress the need, in cases of enterocystoplasty, to resect almost all of the pathological detrusor and to use the caecum rather than the hypertonic sigmoid.

Adolescent↗
PubMed1987

[Post-anastomotic stenosis in atresia of the esophagus. Study apropos of 23 cases].

Between 1977 and 1984, a total of 23 patients with post-anastomotic stenosis after surgery for esophageal atresia were treated conjointly by the ORL and digestive surgery departments of Hôpital Trousseau, France. Most cases were type III atresias treated by direct anastomosis, favoring factors for stenosis being gastro-esophageal reflux, post-anastomotic fistula and the surgical act. Stenosis usually develops early, provokes only moderately severe symptomatology and requires treatment by dilatation mainly, in association with anti-reflux medication. Prognosis was usually good in the 23 cases reported, 21 being able to take food normally. Surgery should be reserved for cases with severe reflux and for those with persistent stenosis.

Dilatation↗