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M Canis

Publications and source records attributed to M Canis.

At least 19 recordsLinked to original sources
PubMed1995

[Treatment of endometrial clinical stage I adenocarcinoma by laparoscopic surgery. Seventeen cases].

AIM: Study and follow-up of laparoscopic surgical treatment of endometrial cancer, clinical stage I. METHOD AND MATERIALS: This retrospective study covering the period 01 February 1990 to 31 January 1994 on 17 patients presenting with endometrial cancer, clinical stage I, that is, 35.4% of endometrial cancers operated in our department during that period, and for which laparoscopy was the first step in surgical treatment. RESULTS: Of the 17 cancers assessed by laparoscopy, 12 were also operated by laparoscopy. Conversion to laparotomy concerned 5 cases (29.4%): one case of postoperative adhesions, 2 cases of laparoscopic complications (cardiac rhythm problems, sub cutaneous emphysema), 2 cases of peritoneal granulations giving rise to suspicious of stage III. The mean age of the patients operated via laparoscopy was 59.9 years (extremes: 34-74). Their weight varied from 52 to 94 kg with a mean of 68.1 kg. Two endoscopic surgical complications arose (one bladder injury and one cervico-vaginal bleeding), but did not require conversion to laparotomy. No postoperative complications were noted. The average follow-up for these patients treated by endoscopy is 22.3 months. There was regrettably one early recurrence of the disease 7 months postoperatively. CONCLUSION: Laparoscopic surgery can be used to treat clinical stage I cases of endometrial cancer. This surgical approach must be used only for favourable cases and is reserved for teams trained in endoscopic and cancer surgery.

Adenocarcinoma↗
PubMed1994

[Hepatic confluence tumors: results and quality of life according to the type of treatment].

We analyzed survival rate and quality of life according to the treatment modality in 52 patients with hilar tumors. Six of them underwent resection (11.5%); 4 without hepatectomy, one left hepatectomy and one trisegmentectomy. The remaining 46 patients were treated by: radiologic external-internal drainage (12), placement of percutaneous endoprostheses (14), surgical intubation (18), and cholangioanastomoses to segment III in 2. Prognostic factors (PITT and A.P.A.C.H.E. II), survival time and quality of life were analyzed. Survival and comfort index were significantly better (p < 0.001) in the resection group than in the palliation one. Among palliative procedures percutaneous endoprostheses and surgical intubation offered better quality of life (p < 0.001) than radiologic external-internal drainage. We conclude that resection improves survival and offers better quality of life than palliative procedures. Our results suggest that resection during laparotomy should be attempted in order to improve results in the treatment of hepatic confluence tumors.

Adult↗
PubMed1994

[Self-expanding metallic endoprostheses in the palliative treatment of biliary obstructions in nonresectable carcinoma of the head of the pancreas].

OBJECTIVE: A study of immediate and long-term results with the self-expandable metallic stent (Wallstent), in the treatment of biliary obstruction in 25 patients with non resectable carcinoma of the head of the pancreas was carried out. Stent placement was successful in all patients. RESULTS: Complication rate was 4% (n = 1); one patient had venous bleeding after percutaneous catheter placement. There was no procedure related mortality (30-day mortality); hospital stay was 6, 7 days (2-12). Average survival was 6 months (+/- 2.97). Average patency of the initial stent lasted 5 months (+/- 2.01); comfort index was 83%. Five patients required re-admission. Late complications were cholangitis in 2 and stent occlusion in 4. Disimpaction in one patient and placement of additional stent (PAL-MAZ) in the remaining 3 patients were performed. One patient required surgical treatment; hepaticojejunostomy was performed. Elapse time between prostheses placement and stent occlusion was 3.4 months (2-4.5). CONCLUSIONS: We conclude that metallic stent placement has low morbidity without mortality and provide good quality of live. The most frequent late complication was prostheses obstruction.

Cholestasis↗
PubMed1992

Second-look laparoscopy after laparoscopic cystectomy of large ovarian endometriomas.

Forty-two patients who underwent a second-look laparoscopy after a unilateral or bilateral intraperitoneal cystectomy for treatment of an ovarian endometrioma of greater than 3 cm were included. At second-look laparoscopy, 92.4% of the adnexae treated for a large endometrioma had no deep ovarian endometriosis. Adhesion de novo formation occurred in 21% of the treated adnexae and in 17% of the contralateral adnexae. Complete or partial recurrence of dense adhesions occurred in 82% of the cases. Laparoscopic cystectomy is effective in treating large endometriomas. However, operative difficulties may be encountered, explaining persistent endometriomas and postoperative adhesions.

Adnexa Uteri↗
PubMed1992

Results of conservative laparoscopic treatment of isthmic ectopic pregnancies: a 26 case study.

Twenty-six ectopic pregnancies located strictly within the isthmus were treated surgically using conservative laparoscopic techniques. In each and every case, the Triton monopolar electrode was used to perform salpingostomy which was followed by aspiration of the trophoblast. This therapeutic approach is very reliable since only one failure was observed (3.9%), requiring a further operation during which salpingectomy was carried out by laparoscopy. It was possible to evaluate subsequent fertility for 11 patients, seven of whom (63.6%) obtained an intrauterine pregnancy and only one patient (9.1%) had a recurrence. This highly satisfactory prognosis is perfectly comparable with that obtained with treatment via laparotomy with segmental resection of the isthmic portion of the tube and immediate or delayed anastomosis. These very encouraging results mean that conservative laparoscopic treatment presents an advantageous alternative to classic surgical treatment for isthmic ectopic pregnancies, in that the patients are spared a laparotomy.

Female↗
PubMed1992

Fertility following laparoscopic management of benign adnexal cysts.

Fertility following laparoscopic treatment of benign adnexal cysts without ovarian suture was studied retrospectively. Patients with endometriomas or who were previously infertile were excluded. Thirty-eight patients treated conservatively were included, 10 after partial resection of functional cysts, 23 after an ovarian cystectomy and six after treatment of a paraovarian cyst. One patient had two cysts. The overall intrauterine pregnancy rate was 92%; one patient had an ectopic pregnancy (2.6%). From these results, we conclude that fertility following laparoscopic treatment of adnexal cysts appears to be normal. Technical guidelines to improve laparoscopic cystectomy are proposed.

Adnexal Diseases↗
PubMed1992

[The palliative treatment of pancreatic cancer: percutaneous drainage versus surgical diversion].

In a retrospective study, the outcome of 56 patients with unresectable carcinoma of the exocrine pancreas undergoing two palliative operations (bypass surgery vs percutaneous transhepatic biliary drainage with endoprosthesis) for the management of biliary obstruction was evaluated. Morbidity and mortality were similar in the two groups. Postop hospital stay was 8 days for the intubated, and 15 days for operated patients (p less than 0.01). Although the symptom-free period was similar in both groups, intubated patients had a shorter period of poor-quality life.

Biliary Tract↗
PubMed1992

[Laparoscopic hysterectomy. Results in 44 cases].

Laparoscopic hysterectomy is a recent procedure. We present our preliminary results about 44 patients. In 77.3% of cases (34 patients) the operation was carried out completely by laparoscopy and 10 patients (22.7%) required conversion of the laparoscopy to a standard laparotomy. The indications for laparotomy were: hemostasis difficulties (6 cases); bladder injury (1 case); inability to expose the uterine pedicles and or the ureter (3 cases). Three post-operative complications occurred: one small bowel occlusion which was explored by laparoscopy, and two infection treated by antibiotics only. These preliminary results enable us: to affirm that laparoscopic hysterectomy is feasibility without an important risk of per and or post-operative complications. to specify the four situations in which laparoscopic surgery is particularly advantageous for hysterectomy: absence of genital prolapse; when uni or bilateral adnexectomy is required; previous past-history of abdomino-pelvic surgery, salpingitis, endometriosis ...; neoplastic pathologies (lymphadenectomy); to propose a laparoscopic hysterectomy classification.

Adult↗
PubMed1992

[Technique and preliminary results in second-look laparoscopy in epithelial malignant ovarian tumors].

Second-look laparotomy is the usual mean of intraperitoneal evaluation in patients treated for ovarian carcinoma. We present a preliminary study of 33 second-look. Thirteen of these procedures were performed by laparoscopy. Because of previous surgical history a specific technique is necessary including safety tests, cytologic evaluation after peritoneal washing, and biopsies of any abnormal peritoneal areas, original tumors sites and normal appearing peritoneum. In order to achieve the evaluation of the entire peritoneal cavity a complete bowel adhesiolysis is required. For trained laparoscopists the surgical complication rate is low. In this preliminary study we found that prognosis following negative second-look laparoscopy and second-look laparotomy are similar, suggesting that laparoscopy is a valuable alternative to laparotomy for second-look evaluation in ovarian cancer.

Carcinoma↗
PubMed1992

[Recurrence after conservative celioscopic treatment of a first ectopic pregnancy].

Conservative laparoscopic treatment by salpingotomy was performed on 192 patients who presented with a first ectopic pregnancy (EP). The overall fertility results show that 139 patients (72.4%) obtained an Intra Uterine Pregnancy (IUP), whereas only 18 patients (9.4%) suffered a recurrence. The risk of ipsilateral recurrence is 66.7% (12 cases). For the 14 patients presented with two patent tubes after conservative laparoscopic treatment of a first EP, the ipsilateral recurrence rate is 57.1% (8 cases). The side of the recurrence is directly influenced by the patient's previous history. While 88.9% (8 cases) of recurrence are ipsilateral for patients presenting previous tubal history, this rate is only 44.4% (4 cases) when tubal factors are absent (p less than 0.05). This prompts us to recommend laparoscopic salpingectomy for patients with a serious past tubal history. In these patients recurrence is ipsilateral in more than three out of four cases. On the other hand, for patients with no or few tubal factors the treatment has to be conservative.

Evaluation Studies as Topic↗
PubMed1992

Role of gonadotrophin-releasing hormone agonists in the treatment of external genital endometriosis: review of 77 cases.

Peritoneal and ovarian endometriosis are anatomically highly polymorphous and can give rise to pain and sterility. Endometriosis can be recognized and evaluated by means of laparoscopy and an appropriate therapeutic strategy determined. Surgical laparoscopy using lasers (CO2, KTP and argon) produces excellent results. More than 80% of cases can be treated by coelioscopy, bearing in mind that severe endometriosis can require classic surgery and remains difficult to perform. However, one basic idea should not be forgotten, ie, that endometriosis is a progressive disease. Restoration of anatomic pelvic integrity (with free pouch of Douglas, mobility of appendages and functional ovaries) is the only guarantee of good fertility, achievable by interruption of progression of the disease. Following therapeutic trials with danazol, norsteroidal progestagens, gonadotrophin-releasing hormone agonists have opened up wide perspectives for use and we use them in combination with coeliac surgery. Our experience has paralleled that of Donnez and Bruhat, with almost identical results.

Combined Modality Therapy↗
PubMed1991

[Ectopic pregnancy. Techniques and results of celioscopic treatment].

As in laparotomy the laparoscopic treatment of ectopic (EP) can be either conservative or radical. After conservative laparoscopic treatment, the risk of failure is comparable to what has been observed after the same treatment by laparotomy and the post-EP fertility results are better than those observed after treatment by laparotomy. These results, associated with the advantages of endoscopy over laparotomy, enable us to say that the laparoscopic treatment is nowdays the best surgical treatment of EP. The post-EP fertility is determined by previous patient's history, whereas the characteristics of the EP do not affect or only slightly affect fertility. A multifactorial analysis enabled us to quantify the pejorative impact on fertility of each of the factors which significantly affect the fertility results. We thus propose a therapeutic scoring system of EP designed to choose the treatment which will better preserve the fertility of the patients who wish to become pregnant.

Female↗
PubMed1991

[Celioscopic treatment of ovarian cysts. Indications, techniques, results].

Benign ovarian cysts can be diagnosed and treated by surgical laparoscopy which, like laparotomy, permits a histological examination. Ovarian cysts that are, or are suspected of being malignant must be removed by laparotomy after evaluation by ultrasounds and diagnostic laparoscopy. Several techniques are used in laparotomic surgery, such as transparietal or intraperitoneal cystectomy ovariectomy, etc. Their indications vary according to the histology of the cyst and the operator's experience. From a series of more than 650 ovarian cysts treated by this method, we draw the following conclusions: the positive predictive value of this method concerning the benignity of the cyst was 100%; 89 to 97% of the cysts treated by laparoscopy were benign; complications occurred in only 3 out of 652 patients; except when endometriosis was present, the risk of recurrence was low: a second treatment was necessary in 2.7% of the cases.

Female↗
PubMed1991

Present day endoscopic surgery in gynecology.

The last ten years have been characterized by a tremendous change in laparoscopy. Initially used exclusively for diagnosis, laparoscopy is now a surgical method in its own right and plays a strategic role. Long-term evaluation of results for various pathologies (such as ectopic pregnancy and tubo-peritoneal sterility) means that just one laparoscopic procedure can be used for diagnosis, selection of the best therapeutic approach and also for treatment in those cases where laparoscopy is the optimum choice. Other more recent indications (including hysterectomy, lymphadenectomy etc.) which are now possible thanks to recent technological developments (such as clips and mechanical sutures) need long-term analysis of their results.

Endometriosis↗