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Biomedical subjects

R Stoppa

Publications and source records attributed to R Stoppa.

At least 73 records · Page 4Linked to original sources
PubMed1983

[Conservative treatment of esophagus ruptures and perforations. Esophageal diversion by minimal pharyngostomy].

In ruptures or perforation of the oesophagus, the difficult choice between conservative methods (suture or drainage) and total exclusion of the organ can be avoided by minimal pharyngostomy. This procedure, which supersedes lateral oesophagostomy and makes use of an aspiration silicone-lined catheter to divert the oesophageal contents, is simple, rapid, effective and reversible. It is carried out in a region devoid of dangerous anatomical variants, in the avascular space below the greater cornu of the hyoid bone (a palpable landmark), the incision being made on the convexity of a curved clamp which pushes back the pharyngeal wall at the level of the sinus pyriformis. This technique has been used in 13 patients with satisfactory results.

Esophageal Diseases↗
PubMed1983

[Colonic occlusions. Retrospective cooperative study of 497 cases].

A retrospective multicenter study involving 12 digestive surgery centers was conducted on 497 cases of colon obstruction. The most frequent cause of colon obstruction was colo-rectal cancer (71 p. cent of cases), but many other etiologies were involved, including 61 cases of torsion and 37 patients with occlusive sigmoiditis. Differential clinical and radiological features in each etiological group are discussed, the results of therapy undertaken analyzed, and a reasonable line of conduct proposed, adapted to each situation, with the objective of attempting to reduce mortality which still affects 25 p. cent of cases operated upon.

Adult↗
PubMed1982

[Agenesis of the gallbladder. Comments on physiopathology and diagnosis. Apropos of 2 cases].

Initially a simple anatomical curiosity discovered at operation or autopsy, agenesis of the ball bladder has now, and despite its rarity, become of the greatest interest from a pathogenic, physiopathological and diagnostic standpoint. Embryogenesis explains that this a developmental abnormality affecting the hepatic diverticulum which is probably of genetic origin, hence its frequent association with other malformations and the hereditary nature of the condition. The usual finding of a syndrome of blockage of the sphincter of Oddi with dilatation of the common bile duct raises the problem of synergism between the sphincter of Oddi and the gall bladder. The discovery of lithiasis of the hepatic and common bile ducts in agenesis of the gall bladder leads to discussion of the reality of organ lithiasis or the role of the distended wall of the common duct. Cholecystography and echotomography would appear to be the two techniques of investigation to be recommended preoperatively in order to increase support for the presumptive diagnosis once disorders affecting neighbouring structures have been eliminated. The definite diagnosis is made peroperatively by manual exploration, peroperative cholangiography or even coeliac arteriography during the operation. The indication for surgery is based upon clinical symptomatology. This does not treat the agenesis but the associated lesions which are its complications, in particular: lithiasis the common duct, sphincter of Oddi block syndrome and dilatation of the common duct.

Abnormalities, Multiple↗
PubMed1981

[Pre-operative preparation of the colon: a controlled prospective multicentre study in 215 patients (author's transl)].

Three procedures for pre-operative preparation of the colon were compared during a controlled multicentre study in 215 patients. Though mechanical irrigation with a 10 p. cent mannitol solution is definitely superior as far as the degree of intestinal emptying obtained, no significant difference was noted in the frequency or severity os postoperative infections after conventional preparations by digestive tract irrigation with or without intestinal antibiotics. This method is limited by its tolerance (67 p. cent), its advantages are its rapidity and cost, elective indications being ascending colon lesions with little or no stenosis in young subjects. In other circumstances it has to be compared with the conventional methods of preparation, which should still be employed before operation in subjects who are elderly and/or have moderate to severe stenosis. The addition of antibiotics (neomycin, metronidazole by mouth) reduces the incidence of postoperative sepsis to a marked but non-significant degree, independently of the lesion (cancer, sigmoiditis) and its site. A recent study by F. Lazorthes has led him to prefer an association of antibiotics active against aerobic and anaerobic flora: orally preoperatively, and systemically during surgery.

Adult↗
PubMed1981

[The calibrating drainage of the common bile duct (C.B.D.). Value of "axial exit" drainage (author's transl)].

The authors believe that utilisation of calibrating drainage is justified in case of difficult restauration of the C.B.D. of normal caliber, either throughout its length or in one segment. They underline that "axial exit" has not the disadvantages of the "lateral exit" of T-tubes. They recall the various modalities of "axial exit" (transcystic, transpapillary, transhepatic, "en seton") and their own contribution to the improvement of the transpapillary drainage by the association of a systematic sphincterotomy. Abstract of their clinical series, technics, postoperative mortality and morbidity, calibrating drainage duration and results (in connection with etiology) are reported. Main advantages of the "axial exit" are the absence of any risk of stenosis on a non dilated C.B.D. (as for the "lateral exit") and the facility for long time calibration up to several years. No hemorrhage, no bile leakage have been observed. The one only risk of this sort of drainage is the premature fall of transcystic or transpapillary drains ; but this disadvantage does not exist for "en seton" drainage. Shortly : "axial exit" calibrating drainage is recommandable when a very long time calibration after restauration of non dilated C.B.D. is necessary.

Adult↗
PubMed1980

[Dacron tulle prosthesis and biological glue in the surgical treatment of incisional hernias (author's transl)].

In repair of incisional hernias the authors use Dacron tulle material for less than peritoneal sac reinforcement prosthesis greater than (PSRP)--a method which prevents recurrences whether or not the abdominal wall is badly damaged. A biological glue (n-butyl-cyanoacrylate monomer) in many cases avoids direct or indirect suture of the patch). In practice, there are two types of PSRP. In one type, the gap in the abdominal wall is small and can be sutured, and the peritoneal Dacron tulle patch is a mere adjunct to parietal synthesis. In the other type, the medial, lateral or peripheral eventration is extensive or recurrent, and parietal synthesis is impossible. A piece of Dacron tulle of very large size is then inserted without any glue or transfixing sutures to help solve mechanical and pathophysiological problems.

Adhesives↗
PubMed1980

[Answers to ten questions often asked by colostomized patients (author's transl)].

Wishing to help practitioners, who often are slightly puzzled by the technicalities of intestinal surgery, the authors offer short answers to the ten questions most frequently asked by colostomized patients, i.e.: where is my colostomy located? How was it made? Is there any possibility of passing motions through by natural anus? What does continent colostomy mean? What are the basic rules for the maintenance of colostomy? How to choose the colostomy bag? What to do in case of intolerance to the bag? Must I follow a restrictive diet? When can my colostomy be suppressed? Can I resume work with a colostomy? No effort should be spared to prevent a colostomized patient from becoming an invalid and to help him lead a normal life.

Colostomy↗
PubMed1980

[Circular mechanical colorectal anastomoses (author's transl)].

When they are terminoterminal, circular lower colorectal mechanical anastomoses involve certain risks due to the incongruence of the intestinal ends, to the difficulties encountered in reconstructing the rectal pouch and to ischaemia resulting from stripping of the rectal section. Terminolateral anastomoses between the colon and the anterior surface of the rectal stump are easier and safer.

Colon↗