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Biomedical subjects

P Ballanger

Publications and source records attributed to P Ballanger.

At least 55 records · Page 3Linked to original sources
PubMed1986

[Diagnostic and therapeutic approach to the extension of kidney cancer to the vena cava].

In the light of their experience with 16 cases seen over 5 years, the authors analyze the diagnostic and therapeutic tools for assessment of the vena cava thrombi that complicate 5 to 10% of renal carcinomas. Cavography still plays a central part in the detection of vena cava lesions. Localization of the upper extremity of the thrombus is needed to decide upon the operative technique and can be achieved by free flow inferior cavography for free floating thrombi; for complete thrombi, the two most informative procedures appear to be echocardiography (to evaluate the right atrium and intrathoracic inferior vena cava) and inferior cavography by the superior route; it seems that computed tomography provides no additional information in the assessment of extensive spread to the inferior vena cava. 14 patients were treated surgically: the surgical approach is dictated by the location of the thrombus and should allow control of the vena cava proximal to the thrombi. Two patients with a thrombus that extended into the right atrium had surgery using extracorporeal circulation; because this method is especially safe, extension of its indications to retrohepatic thrombi may be justified. The absence of operative mortality and comparison of results to those previously reported in the literature confirm the value of surgical treatment of vena cava lesions, especially if there is no lymph node involvement.

Aged↗
PubMed1985

[Prostatic osteocondensing metastases. The value of examining for osteomalacia].

Bone pains observed in patients undergoing estrogen therapy, and presenting with osteoblastic metastases from prostatic cancer are usually related to unsuccessful treatment. In some patients, these pains may result from osteomalacia--ie incomplete mineralization of the new bone--because of the drainage of calcium by the osteoblastic metastases. A clinical, biological and histomorphometric study of bone specimens without decalcification was conducted in ten patients with osteoblastic disease secondary to prostatic carcinoma, who were under estrogen therapy, and for whom a change of therapy was contemplated. The study reports three cases of osteomalacia. Their bone pains were more intense, more diffuse and more permanent than those registered by patients without osteomalacia. All three had had previous fractures of the neck of the femur and a low urinary and serum calcium and phosphorus content. The discovery of osteomalacia by histomorphometric study is important because it allows effective, etiological treatment of the bone pains in these patients.

Aged↗
PubMed1984

[Cutaneous transuretero-ureterostomy or cutaneous Y-ureterostomy. Apropos of 14 cases].

Cutaneous transureterostomy was performed in 14 patients, this bypass procedure being necessary in 9 cases for neoplasm (7 after total cystectomy) and in 5 patients for non-neoplastic lesions. The simplicity of this method is emphasized, particularly when compared with Bricker's operation, beneficial effects with respect to the comfort of the patient being similar. However, at least one ureter must be dilated: one failure of treatment was due to narrow ureters and a repeat operation was necessary to exteriorize each ureter on to the skin. The essential problem concerns the skin stoma, if an apparatus is to be fitted without a catheter. In 8 of 12 patients the cutaneous ureterostomy remained patent without artificial assistance. Two operated cases required ureteral catheters, while two others had prosthetic replacement of the foot of the ureterostomy in Y. One patient died after cystectomy for cancer. A new cutaneous and aponeurotic reconstructive mode appears capable of guaranteeing more consistent results.

Adult↗
PubMed1984

[Endometriosis and obstruction of the upper excretory pathway. Apropos of 2 cases].

The authors report two new cases of endometriosis of the ureter, one affecting the pelvic ureter as part of a locoregional disorder, and the other, more unusual, affecting the lumbar ureter and apparently isolated. Both patients were treated surgically: one with ureterovesical reimplantation in a psoic ureter, and the other by resection and anastomosis after ureterolysis, because the diagnosis was only made postoperatively on the basis of the anatomicopathological images. Details concerning this rare localization of endometriosis are given on the basis of a review of the literature. Diagnosis is difficult. Space is given to a discussion of the recent possibilities of medical treatment; the results, however, are dependent on the anatomicopathological characteristics of the lesion. The patient must therefore be followed closely to avoid functional loss of the kidney, which can be avoided by appropriate surgical means.

Adult↗
PubMed1983

[Prevention of post-operative infections in urologic surgery. Comparative study of cotrimoxazole and cefazolin].

The main point of this study resides in comparing the efficiency and the disadvantages of using cefazoline and cotrimoxazole in the prevention of post-surgery infections of the low urinary tract. 91 patients who were about to undergo urologic surgery were divided in three groups for randomisation. 31 patients received 500 mg of intramuscular cefazoline every eight hours, the day before surgery, the day of surgery and five days following surgery. 30 others received 800 mg of intramuscular sulfametoxazole and 160 mg of trimetoprime every 12 hours during the same lapse of time. The third group of 30 patients did not receive any antibiotics. Age, sex, clinical pathology needing surgery and indwelling catheter were the same in the three groups. The group treated by cefazoline, presented 5 post surgery infections among which 3 transitory fevers and 2 isolated bacteriurias. In the group treated by cotrimoxazole, there were 7 post surgery infections among which 3 fevers and 4 isolated bacteriurias. Tolerance in both cases was similar. In the control group, there were 19 post-surgery infections with 2 cases of sepsis, 14 transitory fevers and 3 isolated bacteriurias. These results show the importance of antibiotic prophylaxy in urologic surgery of the low genital tract whether the patient has a urethral catheter or not and whatever the type of urologic surgery. But, there is no significant difference between cefazoline and cotrimoxazole.

Aged↗
PubMed1983

[Results of endoscopic urethrotomy in the treatment of urethral stricture. Apropos of 72 cases].

Seventy-two patients with strictures of the urethra were treated by endoscopic urethrotomy over a period of 2 years, the strictures being of iatrogenic origin in 37.5% and of undetermined etiology in 22% Important features of this series were the advanced age of the patients (57% between 60 and 80 years) and the iatrogenic nature of the lesion in many cases. Strictures were perineobulbar in 36 cases, of the anterior urethra in 13, multiple or extending in 6, and of the membranous urethra in 17 cases. Retromeatal and cervical strictures were not included. Urethrotomy (at 12 o'clock) was followed by insertion of a urethral catheter retained for 5 days. Complications included one case of severe infection and 2 cases of epididymo-orchitis. Follow-up has been for from 6 to 36 months. Good results were obtained in 41 cases (57%), with absence of dysuria and lack of the need for dilatation. Results were moderate in 9 cases (12.5%), with functional improvement but altered flow and the need for less than 2 dilatations per year. Treatment was a failure in 23 cases (32%), the condition remaining unaltered and requiring either multiple dilatations or a repeat urethrotomy. Overall therapeutic efficacy was 70%, the poorest results being observed in extensive or membranous urethra strictures.

Adult↗
PubMed1980

The significance of lymphadenectomy in prostatic cancer. Early stage therapy.

The results of systematic pelvic lymphadenectomy in 25 cases of early stage prostatic cancer treated by radiotherapy are presented. The relationship between the frequency of the metastatic lymph nodes and the staging and grading of the primary tumor is stressed; the prognostic interest of lymphadenectomy is underlined. From a therapeutic point of view, local radium therapy is associated with external cobalt therapy allowing the administration of 7,000--8,000 rad without severe complication. The results are satisfactory after a 36-month follow-up.

Aged↗
PubMed1980

[Replacement of the ureter by the appendix in the treatment of a tumour of the excretory tract of a single kidney (author's transl)].

The authors report a case of appendiculoplasty of the right ureter within the context of the course of a bilateral tumour of the excretory tract necessitating conservative surgery with a single remaining kidney. The result is good at three years. The literature is reviewed, there being 13 published cases. Of the 10 cases with a follow-up of more than 1 year, there were only 5 good results and stenosis may develop several years after the reconstructive procedure.

Aged↗
PubMed1979

Renal adenomas.

In presenting five new cases of renal adenomas the authors describe the general nature of these rare tumours. If the small adenoma corresponding to microscopic forms is frequent, the large adenoma is rare and always solitary. Haematuria and pain are the most common signs. The classic criterion of non-malignancy in a solid tumour measuring less than 3 cm has no diagnostic value. From a review of the lieterature on the subject, the authors demonstrate the angio-architecture corresponding to the different types of adenoma: the tubular adenoma which is hypervascularised and well circumscribed; the papillary adenoma, often cortical, hypovascular or avascular with bordering arcade; the alveolar adenoma; the mixed forms. They stress the difficulty of radiological diagnosis and the frequency of transitional forms with cancer. The place of angiography is in the pre-operative diagnostic assessment and in defining localised anomalies in angio-architecture which can guide histological examination in the search for neoplastic foci.

Adenoma↗