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M Soulie

Publications and source records attributed to M Soulie.

15 recordsLinked to original sources
PubMed2002

Effect of nonsteroidal anti-inflammatory agents and finasteride on prostate cancer risk.

PURPOSE: We examine the relationship of nonsteroidal anti-inflammatory drugs and finasteride on the risk of prostate cancer. MATERIALS AND METHODS: Participants in this case control study using a prospective collection of data were drawn from consecutive patients who underwent prostate biopsy at 12 different departments of urology from January 1999 to June 2000. Medication use was assessed by self-questionnaire as well as questions about dietary and lifestyle factors that might be relevant for prostate cancer risk. RESULTS: The study included 639 patients with prostate cancer and 659 cancer-free controls. Univariate analysis showed no significant impact of aspirin and finasteride on prostate cancer risk while the nonaspirin nonsteroidal anti-inflammatory drug users had a lower risk (OR 0.80, 95% CI 0.64-0.99). After adjusting for potential confounders, the protective effect of nonaspirin nonsteroidal anti-inflammatory drugs was no longer significant (OR, 0.84, 95% CI 0.66-1.07), while finasteride showed a significant protective effect (OR 0.58, 95% CI 0.37-0.92). CONCLUSIONS: The results suggest that finasteride could have a chemopreventive role in prostate cancer. While aspirin did not show any impact on prostate cancer risk, the role of nonaspirin nonsteroidal anti-inflammatory drugs warrants further studies.

Aged↗
PubMed2001

Experience with retroperitoneal laparoscopic adrenalectomy for pheochromocytoma.

PURPOSE: Although laparoscopic adrenalectomy has become the preferred surgical treatment of benign adrenal masses, for pheochromocytoma it is limited by concerns over hypertensive events related to early access to the adrenal vein. We report our experience with retroperitoneal laparoscopic adrenalectomy for pheochromocytoma. MATERIALS AND METHODS: From January 1995 to December 1999, 21 retroperitoneal laparoscopic adrenalectomies (left 12 and right 9) were performed for symptomatic pheochromocytoma in 11 men and 9 women 17 to 68 years old (mean age 46). To our knowledge pheochromocytoma was always diagnosed by increased urinary catecholamine, computerized tomography, magnetic resonance imaging and 131iodine iobenguane scintigraphy. RESULTS: There were no conversions to open surgery. The operating time ranged from 100 to 150 minutes (mean 116). Mean blood loss was 140 ml. (minimum 550), and none of the patients required transfusion. Hemorrhage due to adrenal vein injury occurred in 1 patient and was controlled intraoperatively. Average postoperative hospital stay was 3.4 days (range 1 to 12). The mean diameter of the excised masses was 38 mm. (range 15 to 70). Postoperative complications occurred in 4 cases, including hematoma in 1, trocar wound infections in 2 and eventration in 1 after 1 year. With a mean followup of 21.6 months (range 6 to 46), all patients had normal urinary catecholamine levels and 18 had normal blood pressure without treatment. CONCLUSIONS: Retroperitoneal laparoscopic adrenalectomy can be safely performed for small (less than 5 cm. diameter) pheochromocytoma. Retroperitoneal laparoscopy is a direct approach that allows the surgeon to control the adrenal vein first, thereby avoiding hypertensive events.

Adolescent↗
PubMed2001

Urological complications of laparoscopic surgery: experience with 350 procedures at a single center.

PURPOSE: We assessed our experience with urological complications of laparoscopic surgery in regard to incidence, etiology, treatment and possible prevention. MATERIALS AND METHODS: A total of 350 laparoscopic procedures were performed at our institution between June 1993 and December 1999 in 206 men and 139 women. These procedures included pelvic lymph node dissection in 102, bladder neck suspension in 99, adrenalectomy in 54, varicocelectomy in 23, pyeloplasty in 22, nephrectomy in 20, treatment of benign renal pathologies, including cyst, diverticula and calculi, in 13, genitourinary prolapse repair in 11 and miscellaneous procedures in 6 patients. Complications were evaluated according to the procedure attempted and were listed by incidence and etiology. RESULTS: A total of 19 (5.4%) complications occurred in our series. The associated mortality rate was 0.3% and conversion rate was 1.1%. Most intraoperative complications (2.6%) were vascular (4) and visceral injuries (5), while postoperative complications (2.8%) were predominantly thromboembolism (3) and wound infection (2) at trocar sites. The complication rate decreased from 9% for the first 100 to 4% for the subsequent 250 procedures. CONCLUSIONS: Critical documentation of complications of laparoscopic surgery is important for further development of the technique and information for urologists in training. Most of our serious complications should be preventable with better mastery of the different procedural steps. However, laparoscopy must be regarded as major surgery with a significant learning curve.

Adolescent↗
PubMed2001

[Leiomyosarcoma of the renal vein].

The authors report a new case of leiomyosarcoma of the right renal vein, marked by a rapidly fatal course within 9 months, despite the initial absence of metastasis. This exceptional vascular tumour (only about thirty cases have been published) must be distinguished from primary renal leiomyosarcoma and retroperitoneal leiomyosarcomas involving adjacent structures. This difficult diagnosis was suggested by preoperative CT and angiography. Leiomyosarcomas of the renal vein generally have an unfavourable outcome in the medium term. The prognosis is related to the localized nature of the tumour and the risk of local and distant recurrence. Limited tumour resection is rarely sufficient and radical nephrectomy is usually necessary, possibly associated with a vascular procedure on the inferior vena cava in the case of contiguous extension.

Adult↗
PubMed1999

[Value of free PSA/total PSA ratio in therapeutic decisions in the case of a single positive biopsy of the prostate].

OBJECTIVES: Study of the value of the free PSA/total PSA ratio in the therapeutic decision concerning prostatic adenocarcinoma, in the case of a single positive biopsy. MATERIAL AND METHODS: The free PSA/total PAS ratio was calculated on serum samples derived from 37 patients with clinically localized prostatic carcinoma and only one positive biopsy, in whom radical prostatectomy was performed. RESULTS: The free PSA/total PSA ratio appeared to be independent of pathological stage and histological prognostic criteria (grade and score, degree of capsular effraction). CONCLUSION: In the case of a single positive biopsy, calculation of the free PSA/total PSA ratio does not appear to provide any decisional criteria in favour of radical prostatectomy.

Adenocarcinoma↗
PubMed1998

[Screening of cancer of the prostate (IV). Economic approach: the costs of screening tests and treatment. Members of the Sub-Committee of the Prostate of CCAFU].

OBJECTIVES: To estimate the unit and global costs of prostatic cancer screening and the resulting treatments, based on a theoretical screening protocol and the epidemiological data available in France. METHODS: The screening protocol consisted of digital rectal examination (DRE) performed by the general practitioner and serum prostate specific antigen (PSA) assay, with confirmation of the diagnosis by systematized ultrasound-guided biopsies performed by a specialist. Costs were calculated on the basis of the French National Health rating. Treatment costs were estimated on the basis of real public and private establishment case files. Extrapolations to the general population were based on two estimations of the screening yield. RESULTS: The theoretical cost of screening was estimated to be 501 French Francs (FF) per person screened and 16,700 or 91,000 FF per cancer detected, depending on the detection rate adopted. The mean cost of curative treatment was estimated to be 44,000 FF per cancer. The theoretical global cost of screening and treatment was estimated to be between 4 and more than 10 billion French Francs. CONCLUSION: Unit costs per individual of screening and treatment of prostatic cancer may appear acceptable. The biases of economic calculations related to extrapolations to the general population and uncertainties concerning the public health benefits of organized screening compared to the current situation of individual screening explain the current predominant attitude of non-recommendation of organized screening.

Aged↗
PubMed1997

[Renal oncocytoma. Report of 13 cases].

We report 13 cases of renal oncocytoma. Urinary symptoms occurred in only 3 cases. The patient's age ranged from 41 to 74 years with an average of 62.3 years. The mean tumor diameter was 5.6 cm (range: 1.5-14). Diagnostic features of ultrasonography, CT scan and, in some instances, angiography were suggestive of renal oncocytoma in 2 patients, but never affirmative, 4 patients were treated by partial nephrectomy. No local or metastatic recurrence was observed with a mean follow-up of 30.8 months, ranging from 6 to 96 months. We assume that the term renal oncocytoma should be restricted to tumors exclusively composed of regular oncocytic cells with an eosinophilic granular mitochondria-rich cytoplasm and an absence of malignant potential. Diagnostic imaging characteristics may sometimes suggest the diagnosis of renal oncocytoma, but cannot eliminate the main differential diagnosis, i.e. granular renal cell adenocarcinoma. When the tumor is small and unifocal, nephron sparing surgery may be considered. Whether or not the diagnosis has been confirmed by fine needle aspiration, conservative surgery must be controlled by intraoperative frozen sections of the tumor and surgical margins.

Adenoma, Oxyphilic↗
PubMed1996

Micrometastatic adrenal invasion by renal carcinoma in patients undergoing nephrectomy.

OBJECTIVE: To examine adrenal invasion by renal cell carcinoma (RCC), particularly by adrenal micrometastasis, to determine whether adrenalectomy should be performed during radical nephrectomy. PATIENTS AND METHODS: From 1987 to 1994, 129 patients with RCC (90 men and 39 women, mean age 61.4 years, range 22-81) underwent radical nephrectomy with associated adrenalectomy because they had risk factors for adrenal invasion (tumour size > 5 cm. or tumour of the superior pole). Pathological examinations were carried out systematically and records of these examinations reviewed. The tumour size was recorded and the frequency of invasion calculated. RESULTS: There were 10 cases where the gland was invaded: one was a synchronous contralateral metastasis and nine (7%) were ipsilateral invasions of which two were tumours in the superior pole that invaded the gland by direct extension and the other seven invaded the gland by distant metastasis, six being micrometastatic (4.7%). A single micrometastasis was found in two cases (1.5%). There was no adrenal invasion by tumours of < 5 cm in diameter from the superior pole. When only tumours > 5 cm in diameter were considered, the ipsilateral invasion rate was 11% (9/80) and the micrometastatic rate was 7.5% (6/80). CONCLUSION: Adrenalectomy need not be performed routinely in small tumours which are detected early, but the possibility of adrenal micrometastasis from larger tumours (> 5 cm) should be considered.

Adrenal Gland Neoplasms↗
PubMed1994

[Percutaneous endopyelotomies. Preliminary results (a series of 16 patients)].

Percutaneous endopyelotomy was performed in 16 patients with ureteropelvic junction obstruction. The procedure was always completed with no intra-operative complication. After a mean follow-up of 18 months (6-30 mos), we report 12 good results (75%), 2 patients with no clinical symptoms but remaining partial radiological obstruction, and 2 failures (12.5%) which required early open surgery. Much care must be given to the ureteral stenting: one of our failures was due to extra-pelvic migration of the stent. Endopyelotomy may be considered as an efficient procedure, but long-term evaluation is still required.

Adolescent↗
PubMed1987

[Ureteral triplication].

Two cases of ureteral triplication are reported, on in a child of 4 years the other in a 2-week-old baby. In both cases the triplication was associated with one or two ureteroceles. A literature review is used as a basis for describing the characteristics of this rare malformation.

Child, Preschool↗