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Biomedical subjects

P Cubertafond

Publications and source records attributed to P Cubertafond.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Effect of age on the results of surgical treatment of cancer of the gallbladder].

The aim of the study was to define the influence of age on the surgical treatment of cancer of the gall bladder. From a population of 731 patients: 104 were over 80 years (14%) and 230 were between 70 ant 80 years (32%). The histological stages T1, T2, T3, T4 were also distributed throughout the various age groups. There were however significantly more in situ lesions before the age of 70 years than after. The incidence of resection was similar in the various age groups but extended right hepatectomy was only carried out in patients under 70 years. The mortality rate was low for patients who underwent surgery for lesions graded Tis, T1 and T2. High survival rates were only obtained in the Tis and T1 patient groups. T2 grade cancers had a significantly improved prognosis when resection was carried out. Duration of survival after bilio-intestinal anastomosis was very short regardless of the age of the patient. In summary, age did not appear to constitute a contraindication to resection for early lesions, but it did have an effect for the lesions graded T1, T2, on the degree of hepatic resection around the gall bladder. Lesions graded Tis were all treated by simple cholecystectomy regardless of age. Patients with T3 or T4 lesions did not benefit from resection, regardless of age, and in these cases the value of bilio-intestinal anastomosis is debatable.

Actuarial Analysis↗
PubMed1989

[Treatment of splenic injuries. Retrospective study of 101 cases].

101 patients with splenic trauma were treated during the period 1978 to 1988. They included 76 men and 25 women aged between 16 and 85 years, with a mean age of 38 years 6 months. Exclusively splenic lesions were present in 33 cases (32.67%) and bony or visceral lesions were also present in 68 cases (67.33%). 61 cases (60.39%) suffered from multiple trauma. 97 patients underwent laparotomy, 86 (85.1%) subsequently underwent total splenectomy and 11 (10.8%) conservative surgical treatment (10 partial splenectomies and 1 splenorrhaphy). Four patients did not undergo surgery and were kept under surveillance in a surgical ward for 3 weeks. The majority of partial splenectomies were carried out after 1985 though the first was performed in 1981. There was no operative mortality and post-operative mortality was 9.9% (10 deaths). The overall mean duration of hospitalisation was 20.2 days: 15.6 days for patients who underwent partial splenectomy, 19.6 days for patients who underwent total splenectomy and 21 days for cases involving simple surveillance. Operative complications occurred in 28 patients who underwent laparotomy. Complications did not occur in the 4 patients who received simple surveillance. The most frequent complications were sepsis, pneumonia, thrombo-embolic complications and four patients required reoperation for hemoperitoneum. Conservative surgical treatment is increasingly being used in splenic trauma. The criteria for avoidance of surgical intervention remain difficult to define at the present time.

Accidents↗
PubMed1989

[Results of surgical treatment of cancer of the common bile duct as a function of age].

The aim of this study was to determine whether an age greater than 70 years constitutes a risk factor in subjects who undergo surgery for cancer of the common bile duct. From a total population of 758 cases, 216 patients belonged to this age group. Tumour lesions did not appear to be more progressive in patients over 70 years, however there was a significantly higher incidence of visceral involvement in the latter group. The rate of palliative procedures was comparable in the under 70 and over 70 years groups. However, hepatectomy and hepatic transplantation were only carried out in patients under 70 years. Mortality increased with age both for palliative and curative surgery. The mortality rates were respectively 10% and 10.1% under 70 years and 41% and 49.1% over 70 years. These results should therefore lead to the choice of endoscopic drainage procedures in more elderly patients. However, in the absence of a contraindication to anaesthesia, surgery remains indicated when curative resection is envisaged, in cases of distal stenosis of the bile duct or for failure of other methods.

Adult↗
PubMed1989

[Cancer of the extrahepatic biliary tracts and abnormality of the biliopancreatic junction].

This retrospective study was undertaken to evaluate the incidence of an abnormal pancreaticobiliary ductal union (long common duct) in biliary tract carcinoma. Of 86 patients presenting with such a cancer, 67 had a pre- or intra-operative radiologic examination. An abnormal pancreaticobiliary ductal union was found in only one 60 year old woman having stones associated with invasive gallbladder carcinoma. Operative cholangiogram revealed an early and marked Wirsung opacification with a 1.5 cm long common duct. This low incidence in our study contrasts deeply with Japanese data and raises several questions about the correct evaluation of pancreaticobiliary ductal union, the true consequences of such an anomaly and possible interracial variations in incidence.

Biliary Tract Neoplasms↗
PubMed1989

[Surgical treatment of postoperative eventration with a prosthetic grid. 62 cases].

The treatment of post-operative eventration with major loss of parietal substance often justifies the use of prosthetic material. 62 post-operative patients from a series of 345 benefited from such a procedure. In the majority of cases they were patients who had undergone multiple surgery and also one or many attempts to cure the eventration (55%). The eventrations were of large volume and complex and one or more operative risk factors were present (81%). A Mersilene grid, implanted retromuscularly in all but one case, was the prosthetic material used in 96% of cases. Operative mortality in this series was zero, but unfortunately post-operative hematomas occurred in 27% of cases and one half of these became infected. Recurrent eventration (11%) was seen in all but one case where post-operative infection occurred. In five out of six cases under these circumstances this became apparent during the first post-operative year. The authors stress the fundamental importance of peri-operative care during such interventions; the quality of post-operative results depends, to a large extent, on this care and on the respect of the peroperative technical principles defined by the authors.

Adult↗
PubMed1989

[Treatment of inguinal hernia by Shouldice type herniorrhaphy. Analysis of a series of 403 cases surgically treated].

The authors report a statistical analysis of 403 patients operated on between 1981 and 1987 for inguinal hernias using the Shouldice kelorraphy procedure. The majority of patients were men and 62% of them were under 50 years. The early operative results were assessed in all patients; recurrences were assessed at one and six years in patients who were either reviewed or who had replied to a questionnaire. Post-operative mortality was 0.5% and the recurrence rate was 1.6%. In 94.2% of patients the course was uncomplicated. A morbidity study demonstrated parietal hematoma formation in 2.5% and sepsis in 1.7%. These results are compared with those in the literature. A comparison was also made with an already published study of 399 keloplasties with reinforcement of the peritoneal sac using the technique proposed by R. Stoppa. It would appear in fact that the two groups of patients were completely different and that the two forms of treatment were not in opposition but rather were complementary.

Adult↗
PubMed1989

[Colorectal anastomoses with a Steichen-type rectoplasty adapted by Dubois. Analysis of a series of 46 patients].

The authors report the results of a latero-lateral colorectal anastomotic technique which includes a wide rectoplasty. Analysis is based on 46 patients with a post-operative follow-up of between 2 and 8 years. 1 patient suffered from congenital mega-colon and 45 from adenocarcinoma of the upper half of the rectum. 4 of the anastomoses followed colostomy for obstruction and 4 others were followed by a protective colostomy. Two post-operative deaths occurred and there were 3 anastomotic fistulae, one of which was asymptomatic. Hepatic metastases occurred in 10 cases and were associated with loco-regional recurrence in 5 cases. The functional results were excellent. In survivors with no evidence of local recurrence there were no cases of stenosis of the anastomosis.

Adenocarcinoma↗
PubMed1986

[Results of preoperative irradiation in the treatment of rectal adenocarcinoma].

The goal of this retrospective study was to assess the tolerance and the efficacy of preoperative irradiation in the treatment of rectal carcinoma. From 1980 to 1983, 81 patients with potentially operable rectal carcinoma underwent abdominoperineal resection. Fourty-one were treated with surgery alone; 40 had a preoperative pelvic irradiation. They received 30 Gy in 15 fractions during three weeks. Surgery followed within four weeks after the last irradiation. In one third of the irradiated patients, the size of the tumor decreased by at least 50 p. 100. Postoperative morbidity and mortality were not increased following irradiation and there was no delay in perineal healing. Five year survival was improved by irradiation (78 p. 100 versus 28 p. 100) with statistical significance (p less than 0.05). In patients with stage C tumors according to Astler-Coller's modification of Dukes staging, 5 year survival was higher in patients who received preoperative irradiation (68 p. 100 versus 23 p. 100) with a statistically significant difference (p less than 0.05). Pelvic recurrence occurred in 8 p. 100 of the patients irradiated and in 45 p. 100 of the patients treated with surgery alone respectively. This difference was also statistically significant (p less than 0.05). Survival of patients who underwent abdominoperineal resection for rectal carcinoma appeared to be improved with preoperative irradiation.

Adenocarcinoma↗
PubMed1985

[Effect of restoring duodenal continuity after total gastrectomy in the rat].

An experimental study in the rat compared efficacy of re-establishment or not of duodenal continuity during digestive reconstruction by Y loop after total gastrectomy. Results were evaluated as a function of growth rate in the two groups. Nutrition following gastrectomy in rats treated by this technique was significantly better than in the other rats. Similar findings have been reported in humans, suggesting that this procedure be used more frequently after total gastrectomy.

Animals↗