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Biomedical subjects

T Anné

Publications and source records attributed to T Anné.

8 recordsLinked to original sources
PubMed1999

Laparoscopic repositioning of an adjustable silicone gastric band for pouch dilatation and stoma obstruction.

Pouch dilatation with stoma obstruction is a well-known late complication after adjustable gastric banding operations for morbid obesity. Surgical treatment of this problem usually results in removal of the band, with or without replacement by another, or in repositioning of the band via laparotomy. We present the case of a patient with late pouch dilatation and stoma obstruction after placement of a Laparoscopic Adjustable Gastric Banding system (LAGB-Bioenterics) and in whom the adjustable band was laparoscopically opened, disconnected from the access port, and repositioned more proximally on the stomach. The postoperative course was uneventful. A postoperative radiographic contrast examination showed a correct repositioning of the band. The case demonstrates that the LAGB can be successfully opened and repositioned by a minimal invasive procedure. This is the first time to our knowledge that such a procedure has been reported.

Barium Sulfate↗
PubMedDate not supplied

[The treatment of gastroesophageal reflux using the Kaunitz technic].

The Kaunitz' procedure in the surgical treatment of gastroesophageal reflux associated with a hiatal hernia. In patients with pathological gastroesophageal reflux associated with a hiatal hernia, simple repositioning of the lower esophageal sphincter (L.E.S.) without fundoplication can restore the competence of the L.E.S., provided there is adequate mobilisation of the esophagus and fixation to strong tissues. The procedure proposed by Kaunitz consists of a left thoracotomy, with fixation of the gastroesophageal junction to the diaphragm. In the period May 74-May 83 we performed the procedure on 85 patients. There was no operative mortality and a low early complication rate. All but one patient showed a good repositioning on the postoperative barium swallow and improved dramatically, with complete cessation of reflux symptoms. Seventy-eight patients (92,8%) are followed up regularly by means of a standard questionnaire, barium swallow and esophagoscopy. At this stage of the study, with follow-up periods ranging from 6 months to 9 years, 65 patients (83,3%) show an excellent result, six (7,7%) are greatly improved, with disappearance of the preoperatively existing esophagitis, but keep some mild residual reflux symptoms. In one patient repositioning was impossible. Six recurrences were noted, four of them in patients operated during the early period of our experience with the Kaunitz technique. This simple and effective procedure is a valuable alternative in the surgical treatment of pathological gastroesophageal reflux.

Adolescent↗
PubMedDate not supplied

Two-stage orchiopexy.

A number of well known complications and disorders force operative correction of cryptorchism, once the diagnosis of true cryptorchism is certain. In order to perform a successful orchiopexy, an extensive mobilization of the testis, up to the kidney, is sometimes needed. However, one can not always bring the testis down to the bottom of the scrotum. In this case it seems reasonable to bring the testis as low as possible. A second exploration can be planned, a few years later and, in most cases, the testis will then easily be brought down to the bottom of the scrotum. In our series (76 patients with unilateral or bilateral cryptorchism, between January 1967 and December 1978), 7 patients have been treated according to this procedure: four underwent a successful two-stage orchiopexy, two patients are waiting for the second intervention and one had a bilateral orchiectomy. A review of the literature reveals only a small number of attempts to staged orchiopexies. These small series are completely comparable to our series.

Adolescent↗
PubMedDate not supplied

[Parenteral nutrition "à la carte" in major abdominal surgery with mixtures of Totamine concentrate and Vintène. A clinical study based on nitrogen balance].

The authors present a series of thirty patients who underwent major abdominal surgery. Each patient received preoperative total parenteral nutrition (TPN) during bowel preparation. After the operation the TPN was continued immediately, even if reanimation was necessary. The dosages of nitrogen and calories were individually adapted in function of the daily calculated nitrogen-balances. So the authors were able to administer a TPN "à la carte" using eight solutions mixed in a single bag, containing amino-acids (varying between 6 and 20 g of nitrogen), glucose (ad 150 Kcal/gN) lipids (constituting 40% of the calorie-intake), ions, vitamins and oligoelements. With a follow-up of minimum 10 days, the study proves the possibility of creating positive nitrogen-balances in 87% of the cases and an acceptable deviation in the daily measured glycemia and plasma-ionograms.

Abdomen↗
PubMedDate not supplied

Portal derivation surgery in children. A long-term follow-up report.

Eight children and two adults with portal hypertension were treated by portal diversion surgery. In all cases recurrent gastro-intestinal bleeding from esophageal varices was the indication for shunt-operation. Still in early childhood, three of these patients had had a splenectomy in other hospitals: one emergency splenectomy for hemoperitoneum and two elective splenectomies for hypersplenism. Three operative techniques were used: 5 spleno-renal shunts, 3 meso-caval shunts and 2 porto-caval shunts. All, but one, were followed over a period from 2 to 13 years after shunt-surgery. There was no mortality in this series. After shunting all children remained free of esophageal bleeding. We did not find any complication directly related to the shunt procedure.

Adolescent↗
PubMedDate not supplied

[Intraoperative identification of parathyroid glands with methylene blue (author's transl)].

Identification of parathyroid glands during surgery for treatment of hyperparathyroidism remains difficult. The staining with methylene blue was first described by Dudley. Twenty-one patients were explored. Thirty to sixty minutes before surgical incision, an intravenous perfusion of methylene blue was started. The dose varied between 5 to 10 mg per kg. Thirty-seven enlarged glands were found of which 33 were obviously stained; 13 showed some color that could not be attributed with certainty to the dye; 1 adenome was not stained at all. In 89.2% of the cases the staining had the favorable effect of shortening the operation. Only 4 normal glands showed the blue stain. The affinity for methylene blue is thus mainly found in pathological parathyroid glands.

Adenoma↗
PubMedDate not supplied

[Surgical therapy of pheochromocytoma (author's transl)].

Between 1958-1978 a total of 19 patients, 11 men and 8 women, were treated for pheochromocytoma. Their age varied between 9 and 67 years (overage 39 years). In all cases with unilateral tumor located in the adrenal gland a lateral approach was preferred. When not certain of the tumor location or when presumed outside the adrenals a laparotomy was deemed necessary. Fourteen thoraco-abdominal lateral approaches and 5 laparotomies were performed. Due to minimal manipulation, especially with the lateral approach, peroperatory hypertensive crises could be reduced to a minimum. Sofar no recurrence has been seen. There was no operative mortality.

Adolescent↗