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P Testas

Publications and source records attributed to P Testas.

At least 19 recordsLinked to original sources
PubMed1992

[Complications of cholecystectomy by laparoscopic approach. Apropos of 6512 cases].

6,512 laparoscopic cholecystectomies have been performed by 141 surgeons. The lithiasis was uncomplicated in 80% of cases. Conversion from laparoscopy to laparotomy was necessary in 350 cases (5.37%), for technical problems (22 cases), complications (87 cases) or surgical difficulties (241 cases): 107 cholecystitis, 68 adhesions, 14 difficulties in finding the cystic duct and 25 common bile duct stones were the principle surgical difficulties. Among the 304 complications, we have observed 35 general and 251 local complications: 58 haemorrhages, 12 common bile duct lesions (10 cases of iatrogenic trauma and 2 accidental ligations), 4 cystic duct problems and 3 cases of intestinal trauma were the principle per-laparoscopic complications. Among the 164 post-laparoscopies cholecystectomy's complications, we have observed 50 biliary fistulae with 32 requiring further surgery (damage to the common bile duct in 14 cases), 3 common bile duct strictures, 20 haemorrhages (7 requiring further surgery), 31 deep or sub-phrenic abscesses (16 requiring further surgery) and 2 peritonitis after intestinal trauma. We have had 7 deaths (0.10%). Prognostic factors are: 1) The degree of surgeon's experience; the first 50 laparoscopies cholecystectomies performed are more likely to require further surgery (P < 0.05). 2) Cholecystitis with an significantly higher rate of conversion to laparotomy (P < 0.001) and morbidity (P < 0.01). For an experienced surgeon the biliary morbidity is near to that observed in classical cholecystectomy.

Adolescent↗
PubMed1991

Evaluation by women consulting in a family planning centre of their risk of HIV infection.

In order to assess women's self-perception of their risk of infection by HIV, research was performed among 654 women who had consulted in a family planning centre in the Paris region. Of the 452 (69%) women who took part in this research, 77% considered themselves as 'not at risk of carrying the AIDS virus', 11% as 'at risk' and 12% did not give a specific answer. The most important risk factors noted by the patient and the doctor were found to be the number of partners, the use of syringes and the non- or faulty use of condoms. Estimates of the risk of infection by physicians had a high correlation with those of the women, although there were wide differences between the opinions of the six doctors involved. In one case out of three the doctors were unable to decide whether or not their patient was at risk. The evident difficulties experienced by these physicians show an urgent need for the development of specific medical training programmes. The seroprevalence of 2.4% of HIV infection among the women studied, and 1.1% of those who consulted during the study period, confirm the importance of carrying out specific studies on women consulting in family planning centres.

Adult↗
PubMed1990

[A trial of evaluation of cholecystectomy by celioscopic approach. Apropos of 2266 patients].

Facing enthusiasm and critics it is necessary to evaluate new surgical techniques. The aim of our study is to try to evaluate cholecystectomy by laparoscopy. 2266 patients operated on by laparoscopy in France are compared with 3390 patients operated on by laparotomy which were published in 1990 in American surgical revues. Both groups are comparable concerning age of patients and surgical indications. Even if 10% of the patients operated on by laparoscopy needed a laparotomy, the morbidity and the mortality were not significantly different in both techniques. This study allows to conclude that cholecystectomy done by laparoscopy offers the same security to patients than using laparotomy, with in addition a faster and better recovery and a much lower economic cost. However, some problems are not yet resolved, especially the one concerning main bile duct stones and the one concerning the necessity of a special training for these surgical laparoscopic technics.

Adolescent↗
PubMed1978

Comparative study of two models for experimental cirrhosis in the dog.

Two canine models of cirrhosis induced by administration of dimethyl-nitrosamine (DMNA) alone or in combination with hepatic vein ligation, were studied. The criteria used for development of cirrhosis were not only the appearance of portal hypertension, ascites, biochemical disorders or retention of BSP but also the formation of histological lesions such as sclerotic transformation of the liver lobules together with nodular regeneration. According to these criteria, the experimental protocol consisting in hepatic vein ligation and prolonged administration of DMNA was successful in inducing in animals liver cirrhosis similar to human conditions.

Acute Disease↗
PubMed1977

Vascular exclusion in surgery of the liver: experimental basis, technic, and clinical results.

Because liver exeresis and surgery for liver trauma still carry a great mortality by hemorrhage or air embolism due to suprahepatic or vena cava injuries, temporary vascular exclusion of the liver is considered. Based on hemodynamic, biologic, and anatomopathologic experimental and clinical data, a catheter was designed that allows isolation of the retro-and suprahepatic portions of the inferior vena cava and consequently vascular exclusion of the liver for 30 minutes. We report on seven patients in whom this technic was utilized (4 requiring hepatectomy and 3 traumatized), confirming the utility, ease, and efficacy of this method.

Adult↗
PubMed1976

[Intestinal lesions induced by radiotherapy of malignant pelvic tumors. Apropos of 2 cases].

Intestinal lesions after radiotherapy for pelvic malignant tumours are of two types: ulcerative colitis with stenosis and hemorrhage sometimes sevre and repeated, and ileal involvement with focal ischemic lesions and malabsorption responsible for nutritional disorders. It is difficult to distinguish them from a recurrence of the tumour in spite of endoscopy, arteriography and biopsy. The course in 3 stages is of great value in diagnosis. A reduction in the frequency of such complications may be hoped for by assessment and exclusion of predisposing factors, by strict observance of therapeutic rules. They are serious owing to the marked irreversible conjunctivo-vascular changes and the fragility of the irradiated tissues during operation.

Adult↗
PubMed1976

[Hepatic surgery with vascular exclusion. Experimental bases. Technic and preliminary results].

Hepatic surgery has a high mortality due to hemorrhage or gas embolism due to tears of the hepatic veins or vena cava, hence the idea of temporary vascular exclusion. Based on clinical, hemodynamic, laboratory and pathological findings, we have designed a catheter which permits one to isolate the retro and suprahepatic segment of the vena cana and obtain hepatic vascular exclusion within 30 minutes. We report here six cases where this technic was used, 3 hepatectomies, 2 liver injuries, and one case of disobstruction of an iliac vein which confirm the use, ease and harmlessness of this method.

Adult↗