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Biomedical subjects

M Ribet

Publications and source records attributed to M Ribet.

At least 19 recordsLinked to original sources
PubMed1997

[Reoperations for persistent or recurrent gastroesophageal reflux after surgical treatment].

Thirty one cases of failed antireflux surgery were analyzed. The first operation had been performed on 24 patients with uncomplicated reflux and 7 patients with complicated reflux. There was an abnormality of the cardia in all cases. Twenty eight patients had been operated through an abdominal approach and 3 through a thoracic approach. The failure was diagnosed during the first year in 12 patients. The reflux became complicated in 17 cases. Oesophageal stenosis was the most common complication. Twenty four patients were reoperated through an abdominal approach and 7 through a thoracic approach. In 29 cases out of 31, an anatomical cause of the failure was found and rectified. Mortality was nil. The results of iterative surgery were good in 80 p. cent of cases after a mean follow up of 6 years.

Adolescent↗
PubMed1995

Multiple primary lung cancers.

Seventy-five cases of multiple primary lung cancers, representing 3.78% of a series of 1980 consecutively resected tumors, were divided into 24 synchronous and 51 metachronous cancers, according to the criteria of Martini and Melamed. They all concerned tobacco-smoking men. The synchronous tumors were symptomatic in 66% of the cases, the metachronous tumors in 37%. Nine synchronous locations were unilateral and 15 were bilateral; 20 metachronous locations were ipsilateral and 31 were contralateral. There were three third metachronous cancers. The resection of both tumours was performed for 15 synchronous cancers and for 19 metachronous cancers, including two third metachronous tumors. There were two deaths related to metachronous cancers. No patient with resected synchronous cancers survived 5 years, while 20% of patients with resected metachronous cancers survived this period. Synchronous cancers appear to represent an advanced stage. Metachronous cancers are often diagnosed too late.

Actuarial Analysis↗
PubMed1995

[Open thoracic surgery of giant bullous pulmonary emphysema in adults].

Ninety-two adult patients underwent open surgery for unilateral (60) or bilateral (32) emphysematous bullae filling at least one third of an hemithorax: 56 were apical, 34 were basal and 2 were apical on one side and basal on the other side. A first group of 18 patients were admitted in critical care medicine, after an acute complication, in a state of respiratory distress which was not controlled by oxygen therapy and/or drainage, 17 of them being mechanically ventilated at time of operation. In this group 9 patients died, 8 of them with bilateral bullae and 5 with cor pulmonale. A second group of 74 patients underwent surgery after a delay during which symptoms appeared or worsened, complications were observed or a radiological opacity was discovered. In this group 5 patients died. During a mean 4.8 year follow-up, 55 patients among the 71 survivors with no associated cancer were in a better functional state and remained clinically stable. The patients history and the results of surgery suggest that: 1) giant bullae should be resected when they increase in volume, when they are bilateral and when symptoms progress; 2) criteria for surgery are not limited to patients having compression of lower lobes from apical bullae; 3) it is necessary to operate on both sides for bilateral disease in elective surgery; 4) when there is a state of respiratory distress after a complication of bilateral bullae, the mortality is prohibitive; 5) cor pulmonale is of poor prognosis; 6) diffuse lung disease and associated diseases add to mortality and morbidity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

[Colonic esophagoplasty for benign lesions].

68 patients underwent oesophageal replacement for benign disease: atresia (12), reflux oesophagitis (16), caustic stenosis (37), internal fistula (3). The transplant was the ileocolon (27), the transverse (5) or left colon (36). It was substernal (55) or posterior mediastinal (13). A by-pass was performed without oesophagectomy (51) or an interposition accompanied oesophagectomy (17). The superior anastomosis was cervical (52) or thoracic (16). The inferior anastomosis was on the stomach (46), duodenum (10) or jejunum (12). Hospital mortality was 8.8%, morbidity was 57.3%. Among the 62 survivors, 18 had another operation. At the end of the survey, 68% had near normal function.

Adult↗
PubMed1995

[Thoracic tumors after treatment for Hodgkin disease].

Twenty-one patients were admitted to the surgical unit for management of an intra-thoracic mass following treatment of Hodgkin's disease (HD). They consisted of 14 males and 7 females, with a mean age of 34 years (range: 17-62). Seven had recurrent HD, 14 had a non-Hodgkin solid tumour. HD recurrences were treated with repeated chemotherapy with 4 prolonged survivals including 1 relapse (40 to 84 months follow-up). Non-Hodgkin tumours were 13 lung carcinomas, which were resected in 4 cases, with only 1 prolonged survival (54 months) and malignant schwannoma. HD recurrences are observed equally in both young males and females and are subsequent to a mediastinal location of the disease, after an average 3.2 years. They are located on the borders or irradiation fields. Repeated chemotherapy is effective. Carcinomas more often appear in males, at an older age, in a favorable clinical context, after an average 10.2 years. Their prognosis is very poor. Irradiation and chemotherapy contribute to their development. Long-term risks of HD treatment must be considered.

Adolescent↗
PubMed1994

[Familial thymoma and translocation t (14;20) (q24;p13)].

A familial lympho-epithelial thymoma with constitutional chromosomal translocation t (14;20) (q24;p13) is presented: the thymoma and its particular translocation are present in the mother and the two sons of her offspring. The small number of cases do not allow establishing any relation between thymoma and this particular translocation. Concerning genetic counseling, an annual thoracic radiography is necessary for all the other family members, carriers or not of the translocation.

Adult↗
PubMed1994

Pulmonary hamartoma and malignancy.

Sixty-five patients, aged 15 to 65 years, including 48 men (73.8%), were operated on for pulmonary (60) or endobronchial (5) hamartoma: there were 36 enucleations, 17 lobectomies (1 sleeve resection), 7 wedge resections, 4 segmentectomies, and 1 pneumonectomy. The average tumor diameter was between 2 and 4 cm; 15 were calcified. All were benign. Two were parts of an incomplete Carney's triad. Eight were associated with carcinomas, and three of these were bronchial carcinomas. Concerning these latter three tumors, a study of the incidence tables for northern France and of the standardized mortality ratio showed that the risk of bronchial cancer developing in patients with hamartoma, after a sufficient follow-up (61 patients), was multiplied by 6.66, and the chi 2 test showed a significant difference of incidence compared with that in the general population (p < 0.001). It is concluded that patients with hamartoma should be submitted to a complete evaluation and to a regular follow-up.

Adolescent↗
PubMed1993

Bronchial carcinoids.

Seventy-four bronchial carcinoids were observed over a period of 20 years, representing 69.7% of so-called "benign" tumors and 3.8% of all bronchial tumors resected during the same period of time. The tumors were centrally located in 59 cases and peripheral in 14 cases. From 54 biopsies, the preoperative diagnosis was accurate for 27, presumed for 15, doubtful for 15 and erroneous for 7 patients. Surgery was performed on 73 patients: 7 bronchotomies, 3 enucleations, 2 wedge resections, 5 segmentectomies, 35 lobectomies, 4 lobectomies with sleeve resections, 11 bilobectomies and 6 pneumonectomies. One patient died postoperatively. All the tumors were considered as carcinoids on initial microscopical examination. There were 4 cases of associated tumors. Six patients developed recurrence and 9 patients died from another cause. A pathology review changed the diagnosis into neuroendocrine carcinoma in 2 cases. Carcinoids should be considered and resected as carcinomas in the majority of cases, because of possible errors in diagnosis, of the effect of obstruction, of tumoral associations and of lymphatic involvement. Recurrences are possible.

Adolescent↗
PubMed1993

[Late portal vein thrombosis caused by hematoma after liver transplantation].

Late portal vein thrombosis of liver grafts is uncommon and is usually revealed by variceal bleeding. We herein report a case of thrombosis discovered in an adult 10 months after liver transplantation, due to stenosis of the portal vein by extrinsic compression, probably secondary to a biopsy-induced hematoma. Development of venous collateral circulation allowed for normal function of the liver graft.

Adult↗