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Biomedical subjects

M Chazal

Publications and source records attributed to M Chazal.

26 records · Page 2Linked to original sources
PubMed1994

[Video-assisted thoracic surgery: indications and limitations].

From November 1990 to September 1992, 72 patients underwent a video-assisted thoracic surgery (VATS), 47 men and 25 women, of mean age 49 years. Video-assisted thoracic surgery was indicated for the following: 44 spontaneous pneumothorax, 6 benign tumors of the lung or the mediastinum, 4 pleural effusions, one broncho-pleural fistula and one sympathectomy; 17 diagnostic procedures (lung or mediastinal lymph-nodes biopsies). In one patient, it was necessary to associate a mini-thoracotomy and 5 patients went on to a formal thoracotomy. There was no mortality and the morbidity rate was 5.5%. Some conditions are required: one-lung ventilation, ability to convert to a formal thoracotomy at any moment. It is contra-indicated in cases of single lung or complete obliteration of the pleural space due to dense adhesions. The place of VATS is now well defined for the treatment of spontaneous pneumothorax. It is discussed for resection of pulmonary diseases depending on their size, location and histologic type.

Adolescent↗
PubMed1993

[Traumas of the duodenum].

The aim of this study is to present current management of duodenal trauma. Duodenal lesions following penetrating injuries are rare, but more serious, than those following blunt injuries. the severity is mostly due to delay in the diagnosis and associated intraabdominal injuries. Diagnosis is based on abdominal plain film, gastroduodenography, and more recently US scan and CT-scan. Surgical procedures depend on the type of lesion. In patients operated early, a duodenal wound can be treated by suture-closure with duodenal decompression tube. If suture-closure is not available, with a wound affecting proximal or distal duodenum, resection with anastomosis can be performed. In the second portion of the duodenum, the best treatment is a jejunal plasty with a Roux-en-Y loop. When there is an associated pancreatic injury, treatment depends on whether biliary or pancreatic ducts are injured, and a pancreatico-duodenectomy could be necessary. In patients operated on later, closure with duodenal exclusion by diverticulization is associated due to the high risk of leaking.

Duodenal Diseases↗
PubMed1991

[Bronchogenic cysts of the esophagus. Classical surgery or video-surgery?].

Two cases of bronchogenic cysts involving esophagus are reported. The first case concerns a 30 year-old man, who admitted for dysphagia, regurgitation and abdominal pain. Barium esophagography, esophagoscopy and CT scan showed a cystic mass involving the lower third of the esophageal wall. Treatment consisted in the resection of the cyst by left thoracic approach. The second case concerns a 26 year-old woman, admitted for dysphagia. MRI and endoscopic ultrasonography had contributed to define the exact nature, internal composition and location of the cyst: upper and posterior mediastinum, close to the esophagus but respecting all the esophageal layers. Treatment consisted in the resection by video-thoracoscopy. Histologically, these two cysts were typical bronchogenic cysts. These two cases allowed us to discuss the benefits of new imaging methods (CT scan, MRI, endoscopic US) in the diagnosis of cystic masses of the mediastinum, and to emphasize video-surgery in their treatment.

Adult↗
PubMed1990

Melanin in a dentigerous cyst and associated adenomatoid odontogenic tumor.

The authors report on a case of dentigerous cyst associated with odontogenic adenomatoid tumor in an 8-year-old black Nigerian boy. Both the cyst and the tumor contained melanocytes and melanin-laden epithelial cells. To their knowledge this is the first reported case of melanotic follicular cyst and adenomatoid tumor. A review of the literature revealed that melanin is rarely found in odontogenic lesions. Since the neural crest influence on the development of odontogenic tissues is well established, the occurrence of melanocytes in these tissues is not surprising. A racial predisposition may be present; black patients predominated in the 15 reported cases of melanotic odontogenic lesions.

Child↗
PubMedDate not supplied

Infectious complications of endoscopic retrograde cholangio-pancreatography managed in a surgical unit.

The immediate infectious pancreato-biliary complications of endoscopic retrograde cholangiopancreatography (ERCP) warranting transfer to a surgical unit are analyzed, in order to evaluate their frequency and severity as well as means of treatment and prevention. Thirty complications of this type were observed in a series of 3226 ERCP performed with or without endoscopic sphincterotomy (ES) over a six year period (0.9%). ES had been performed in 12 of 30 cases, but the complication could not be attributed to the procedure. Post-ERCP complications included: acute cholangitis: 16 cases (53%); acute cholecystitis: 8 cases (26%); acute pancreatitis: 4 cases (13%); infected pancreatic pseudocyst: 2 cases (6%). The global mortality rate was 16.6% (five patients): Four of the deaths were due to septic complications. Twenty-seven of the 30 patients underwent surgery, and three of them died (11%). Acute cholangitis was responsible for most of the deaths (four of five) and the mortality appeared related to the long interval before surgery (three of four deaths). Strict adherence to good endoscopic procedures (aseptic conditions, injection without excessive pressure, antibiotic prophylaxis) and decompression of the biliary tract (nasobiliary drain or transhepatic catheter) should help reduce the frequency of post-ERCP complications, and especially cholangitis, which appears to benefit from early surgical treatment.

Acute Disease↗
PubMedDate not supplied

[Tumor markers in the follow-up of colorectal cancers].

The aim of this work was to review the usefulness of tumour markers in the follow-up of colo-rectal cancers after operation. The carcinoembryonic antigen (CAE) is the most sensitive marker for early detection of relapse. It can be combined with CA 19-9 assay, increasing the sensitivity and specificity of the tests. These assays are useful because one half of the relapsing tumours can be resected leading to a survival rate of 40%. CAE and CA 19-9 must be assayed within 2 months to 2 years after surgery to be effective screening tests. Presently, the widespread use of labelled monoclonal antibodies can, in certain tests, localize recurrent tumours before a second look operations.

Antibodies, Monoclonal↗