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Biomedical subjects

S Donnadieu

Publications and source records attributed to S Donnadieu.

33 records · Page 2Linked to original sources

[Epidemiology of postoperative infections in cervicofacial surgery].

Post-operative infections are studied about 150 patients distributed in five groups according to type of surgery (total pharyngolaryngectomy, hemilaryngectomy, bucco-pharyngectomy, cordectomy, cervicotomy). An antibiotic prophylaxis by penicillin G and metronidazole was prescribed for all groups excepted the last. Only sixteen patients (seven of whom in bucco-pharyngectomy group) developed a local infection, therefore these antibiotics are indicated until mucosa cicatrisation. Systematic bacteriologic study of cervical drains is useless because they are frequently positive with non-pathogenic germs and in case of local infection the responsible germ is different of the germ obtained by culture of drain.

Anti-Bacterial Agents↗

[Induction chemotherapy in cancer of the upper respiratory and digestive tract. Preliminary results of the protocol combining cisplatin, 5-fluorouracil and bleomycin (CFB)].

Prognosis in cancer of the upper respiratory-digestive tract (URDT) is dominated by the importance of local and regional spread, of second localizations or metastases and of any underlying clinical condition. Stable results are obtained using local and regional treatment (surgery and/or chemotherapy) alone, and the use of chemotherapy has been evaluated since 1965, neo-adjuvant cancer chemotherapy being adapted in 1970 for cancer of URDT. From november 1982 to december 1983, 184 patients with epidermoid cancer of URDT were treated by combined therapy with Cisplatin, 5 Fluoro-uracil, Bleomycin as a continuous infusion. Results are presented of the different tumoral responses as a function of localization and stage, excluding any glandular responses.

Antineoplastic Combined Chemotherapy Protocols↗

[Use of the CO2 laser in the emergency treatment of dyspnea in laryngeal cancer].

Occlusion of the larynx of neoplastic origin was treated by CO2 laser in seven patients between Marc 1982 and April 1983. Temporary tracheotomy was avoided in all 7 cases but treatment had to be repeated in two patients. Specific anesthetic techniques necessary when using the laser in hypercapneic patients are described, and the advantages, limitations and complications of this therapy are discussed.

Carcinoma, Squamous Cell↗

[Criteria for choice of an anesthetic technic for laryngeal laser microsurgery using the laser in adults].

Laryngeal microsurgery by means of the laser involves anesthetic constraints regarding mainly the mode of ventilation during operation. The principal techniques and different anesthetic protocols are discussed. The two main criteria for the choice of method appear to be the permeability of the laryngeal passage and the patient's general condition and history. The two principal methods proposed are high frequency jet ventilation and ventilation controlled by a protected intubation tube.

Adult↗

[High frequency injection ventilation in laryngeal surgery. Methods and indications].

High frequency injection ventilation was employed in 150 patients during endoscopy or laryngeal surgery. Lower mean intratracheal pressures are obtained that by conventional injection ventilation, and the respiratory pathways are protected to a greater degree. The reduced diameter of the tracheal approach provided by the use of a small transglottic catheter or a small intercricothyroidal tube enables the operative zone to be well exposed. For optimal efficacy, the method requires a frequency, equal to or less than 150 per minute, a short insufflation period, and sufficient exposure of the respiratory tract. General anesthesia is required.

Humans↗

[Tracheotomy in the surgical treatment of carcinomas of the pharyngo-larynx (author's transl)].

The authors studied the local postoperative course and period of hospitalisation after 890 total and partial pharyngo-laryngectomies according to whether the operation was started under general anaesthesia by intubation or after tracheotomy under local anaesthesia. The authors show the improvement in postoperative course as well as the decrease in the period of hospitalisation when intubation was used first.

Anesthesia↗

[Partial vertical surgery of the larynx : results as a function of anesthesia and the employ of tracheotomy (author's transl)].

Postoperative course and complications were studied as a function of the type of anesthesia, and the employ of a tracheotomy tube and gauze drainage of the laryngeal cavity, following partial vertical surgery on the larynx of 238 patients. Findings demonstrated that a general anesthetic by intubation with total skin closure without tracheotomy and gauze drainage of the laryngeal cavity, reduced the incidence of local infections complications and the duration of hospitalization. Without insisting on the advantages of this type of anesthesia and the value of immediate suturing, the authors note that these simple techniques markedly reduce the hospitalization period at a time when emphasis is being placed on the economic impact of the duration of this period.

Anesthesia↗

[Comparative use of thiopental and methohexital in patients anesthesized for E.N.T. endoscopy. Apropos of 60 cases].

The clinical effects of methohexital versus thiopental are studied in 60 randomized patients anaesthetized for E.N.T. endoscopy or laser surgery of the larynx. Thiopental is injected by I.V. bolus (5 mg/kg) and methohexital is administered by continuous infusion (0.1 mg/kg/min). Fentanyl is the analgesic and succinyl-choline is used for curarisation. All patients are ventilated by a conventional ventilator or by high frequency ventilation. Side-effects, extubation time, and recovery estimated by the Newman-test modified by Weber are studied. The only difference between methohexital and thiopental is a better recovery-score at 30 minutes for the methohexital group.

Adult↗