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R Villet

Publications and source records attributed to R Villet.

At least 19 recordsLinked to original sources
PubMed2006

[Identification and management of hereditary breast-ovarian cancers (2004 update)].

BACKGROUND: Since the last recommendations, up to 2500 new references had been published on that topic. METHODOLOGY: On the behalf of the health Minister, the Ad Hoc Committee consisted of 13 experts carried out a first version revisited by five additional experts who critically analyzed the first version of the report. MAIN UPDATING: Breast and ovarian cancer seem to be associated with fewer deleterious mutations of BRCA1 and BRCA2 than previously thought. The screening of ovarian cancer is still not an attractive option while in contrast MRI may be soon for these young women with dense breast, the recommended option for breast cancer screening. The effectiveness of prophylactic surgeries is now well established. French position is to favor such surgeries with regard to a quality of life in line with the expected benefit, and providing precise and standardized process described in the recommendation. CONCLUSIONS: Due to methodological flaws, the low power and a short follow-up of the surveys, this statement cannot however aspire to a high stability.

Breast Neoplasms↗
PubMed2005

[Endometrial choriocarcinoma in peri-menopausal women].

We report a case of a primary uterine choriocarcinoma associated with adenocarcinoma occurring during peri-menopausal age, and review the literature. The clinical course and the histopathology of the case were reviewed and a Medline literature search for other cases was performed. BHCG and analysis of uterine curettage provided the diagnosis of choriocarcinoma. Polychemotherapy, started immediately after the patient's clinical condition deteriorated, was successful. Colpohysterectomy and pelvic lymphadenectomy were performed 5 months later. Treatment was completed by vaginal curietherapy. Histopathologic examination of the surgical specimen revealed only adenocarcinoma. The patient was followed for 18 months without evidence of recurrence. The literature search revealed that primary forms are exceptional; the etiology is unknown. Treatment is based on polychemotherapy. Primary choriocarcinomas are rare tumours, associated with other histopathological forms. We document a case occurring during the peri-menopausal period and review the literature on this pathology. The very poor prognosis in the past has changed with early polychemotherapy.

Choriocarcinoma↗
PubMed2004

[Changing attitudes on the surgical treatment of urogenital prolapse: birth of the tension-free vaginal mesh].

OBJECTIVES: To describe, in view of the new standardization, the technique for urogenital prolapse repair using a one-piece synthetic mesh. MATERIALS AND METHODS: The history and development steps through which the Tension free Vaginal Mesh (TVM) technique emerged are described. The use of a mesh was prompted by the 20-30% recurrence rate associated with conventional repair techniques. Selection of the type of mesh is discussed. Non-absorbable synthetic meshes have shown their usefulness in visceral surgery. A list of materials along with their respective advantages and inconveniences is reviewed and particular emphasis is put on both the tolerance and erosion issues, the latter being specific to the vaginal route. The TVM Group selected a one-thread polypropylene mesh, Prolene Soft, which seemed the most appropriate for the transvaginal approach of prolapse surgical repair. The prosthesis and its design rationale are described. Full details are given on the consecutive intervention steps and underlying concepts. RESULTS: The relevant literature is scarce and there is a lack of methodologically sound studies validating the materials and techniques used. After completion of a first step of technique refinement and feasibility assessment involving about 300 surgical interventions, the authors initiated a prospective multicenter study. Clinical outcome assessments using feasibility, complications, and efficacy endpoints will be published after twelve months, three years, and five years of follow-up. CONCLUSION: Fruitful reasoning led to the development of the TVM technique of complete surgical repair of genital prolapse, which uses a synthetic materiel carefully selected after several tests. All surgeons can apply this technique after a short training period.

Female↗
PubMed2003

Classical and nerve-sparing radical hysterectomy: an evaluation of the risk of injury to the autonomous pelvic nerves.

Radical hysterectomy represents the treatment of choice for FIGO stage IA2-IIA cervical cancer. It is associated with several serious complications such as urinary and anorectal dysfunction due to surgical trauma to the autonomous nervous system. In order to determine those surgical steps involving the risk of nerve injury during both classical and nerve-sparing radical hysterectomy, we investigated the relationships between pelvic fascial, vascular and nervous structures in a large series of embalmed and fresh female cadavers. We showed that the extent of potential denervation after classical radical hysterectomy is directly correlated with the radicality of the operation. The surgical steps that carry a high risk of nerve injury are the resection of the uterosacral and vesicouterine ligaments and of the paracervix. A nerve-sparing approach to radical hysterectomy for cervical cancer is feasible if specific resection limits, such as the deep uterine vein, are carefully identified and respected. However, a nerve-sparing surgical effort should be balanced with the oncological priorities of removal of disease and all its potential routes of local spread.

Aged↗
PubMed2003

[Clinical management of non palpable breast lesions: experience about a series of 176 consecutive cases].

OBJECTIVE: To propose a rational attitude to treat infraclinic breast lesions about a 176-case retrospective analysis. PATIENTS AND METHODS: Between January and December 2000, 176 patients were addressed for an infraclinic breast lesion. The epidemiologic and mammographic data, diagnostic management and histological results were collected. RESULTS: Patients were addressed for an ACR 2 lesion in 0.8% of cases, ACR 3: 34.8%, ACR 4: 43.2% and ACR 5: 21.2%. One hundred and sixteen patients underwent a stereotactic macrobiopsy: 55 Advanced Breast Biopsy Instrumentation (ABBI), 61 Minimal Invasive Breast Biopsy (MIBB). Histologically, 59.5% were benign, 33.6% malignant, 2.6% borderline and 4.3% suspicious or non contributive. Forty-two patients underwent an open surgical biopsy. Histologically 56.1% were benign, 41.5% malignant and 2.4% borderline. Eighteen patients were controlled by mammography. Among ACR 3s there were 90% of benign lesions and 46% of malignancy in ACR 4s. Patients with malignant, borderline or suspicious result in stereotactic biopsy, underwent one-time surgery in 97% vs 55% in surgical biopsy (P < 0.0001). DISCUSSION AND CONCLUSION: Infraclinic breast lesions must be radiologically classified with the ACR classification. Stereotactic macrobiopsies are reserved for ACR 4 and ACR 5 lesions. Because of their reliability, practice of macrobiopsies avoids surgery in about 50% of ACR 4 lesions which correspond to benign lesions. When the result is malignant, it allows most of times surgical procedure one-time.

Adult↗
PubMed2003

[Perineal incisional hernia following rectal resection. Diagnostic and management].

Postoperative perineal hernia is a rare complication following abdominoperineal excision of the rectum. We report four cases illustrating its clinical presentation and modern management. Surgical technique for rectal excision and perineal closure, making of an epiplooplasty, postoperative infection may contribute to the occurrence of this complication. Mesh repair through an anterior open or laparoscopic abdominal approach is one of the surgical options if not contraindicated by age and/or general condition. Perineal or combined approaches can also be selected to solve this difficult problem.

Aged↗
PubMed2002

Comparison of anterior colporrhaphy versus Bologna procedure in women with genuine stress incontinence.

The aim of the study was to compare the anterior colporrhaphy and the Bologna operation for the treatment of anterior vaginal wall prolapse associated with genuine urinary incontinence (GSI). Sixty-two women undergoing surgery for GSI and concurrent grade 2-3 cystocele were the subjects of the study. Anterior colporraphy was performed on 31 women (group A) and the Bologna operation on another 31 (group B). The mean follow-up was 3 years (range 2-7). Perioperative complications, including urinary tract infections, occurred in 16% of group A versus 42% of group B (P<0.001). Anatomic success regarding the prolapse was, respectively, 92.9% (26/28) and 84.6% (22/26) (P = 0.25). Subjective cure rates of GSI (patient history) were 57.1% in group A (16/28) and 87% in group B (23/26) (P<0.05). Objective cure rates of GSI (negative stress test result) were 53.6% in group A (15/28) and 84.6% in group B (22/26) (P<0.02). We concluded that the Bologna operation was more effective for treating GSI associated with anterior vaginal prolapse than was anterior colporraphy, with an increased rate of morbidity and postoperative urinary retention.

Aged↗
PubMed2000

MetaHox gene clusters.

Homeobox genes encode important developmental control proteins. The Drosophila fruit fly HOM complex genes are clustered in region 84-89 of chromosome 3. Probably due to large-scale genome duplication events, their human HOX orthologs belong to four paralogous regions. A series of 13 other homeobox genes are also clustered in region 88-94, on the same chromosome of Drosophila. We suggest that they also duplicated during vertebrate evolution and belong to paralogous regions in humans. These regions are on chromosome arms 4p, 5q, 10q, and 2p or 8p. We coined the term "paralogon" to designate paralogous regions in general. We propose to call these genes "meta Hox" genes. Like Hox genes, metaHox genes are present in one cluster in Drosophila and four clusters (metaHox A-D) in humans on the 4p/5q/10q paralogon.

Animals↗
PubMed2000

[Stereotactic excisional nonpalpable breast lesions using the advanced breast biopsy instrumentation].

UNLABELLED: Today, the widespead use of mammography has increased the detection of suspected nonpalpable lesions. Accordingly, the number of surgical biopsies is higher. PURPOSE: Evaluation of Advanced Breast Biopsy Instrumentation (ABBI) system as a promising alternative to conventional surgical biopsy in stereotactic excisional breast biopsies less than 20 mm. METHODS: From October 1998 and May 1999, 33 women have had: stereotactic excisional breast biopsies less than 20mm using ABBI. Epidemiologic, mammographic and histologic datas were collected. RESULTS: Mammographic finding were 23 microcalcifications and 10 nonpalpable solid nodular densities. In 25 cases, pathology were benign (79%), 7 cases (21%) were cancer. In these cases, the cancer could be treated later, with a single surgical procedure. No complication occurred and tolerance was excellent in most cases. CONCLUSION: Stereotactic excisional breast biopsies less than 20 mm using ABBI is a very good alternative (reliable, reproducible, ambulatory, very weak morbidity) to surgical biopsy.

Anesthesia, Local↗
PubMed2000

[Prolapse of neovagina after anterior pelvic exenteration for urethral cancer].

The authors report the case of a patient undergoing anterior pelvic exenteration for cancer of the urethra with sigmoid colon urinary diversion and vaginal reconstruction using a colonic segment. The postoperative course was marked by prolapse of the neovagina requiring reoperation via a transvaginal approach. The modalities of this prolapse repair are described and the various possibilities for urinary diversion and vaginal reconstruction after pelvic exenteration in women are then discussed.

Female↗
PubMed2000

[Schistosomiasis: an unusual cause of breast microcalcifications].

We report a unusual case of mammary schistosomiasis revealed by breast microcalcifications. This localisation of schistosomiasis is exceptional but should be suspected in women who come from endemic areas. Other cases previously reported in the literature are also described.

Adult↗
PubMed1999

[Genital actinomycosis. Diagnostic and therapeutic difficulties. Report of three cases].

Genital actinomycosis is a rare bacterial infection affecting women of child-bearing age, which is sometimes related to the use of an IUD or an intra-vaginal pessary. Nevertheless, this relationship is at best tenous and actinomycosis is not the only bacterial infection caused by IUD use. Genital actinomycosis often occurs as a pelvic tumour which is sometimes difficult to correctly diagnose and consequently treat accordingly. Rapid diagnosis is essential in order to avoid any irreparable tissue damage. Treatment of this condition consists of a combination of antibiotics and surgery to achieve complete recovery. Three cases are described.

Actinomycosis↗