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T Billebaud

Publications and source records attributed to T Billebaud.

At least 37 records · Page 2Linked to original sources
PubMed1990

[The value of ultrasound-guided multiple systematic biopsies in the early diagnosis of cancer of the prostate].

Endorectal ultrasonography using a 7 mHZ probe was performed in 99 patients with a negative history for surgery of the prostate and either findings on rectal examination suggestive of cancer (T3 stage excluded) or a serum level of prostate-specific antigen of 2.5 mg/ml or more. A biopsy gun was used to harvest 1.5 centimetre long specimens. Ultrasound-guided biopsies were performed in peripheral hypoechogeneic areas; in addition, regardless of the result of the endorectal ultrasonography, routine multiple ultrasound-guided biopsies were performed in both lobes of the prostate (3 per lobe). Morbidity consisted in two cases of prostatitis (2%). Among the 99 patients, ultrasound guided biopsies found 16 carcinomas (16.1%), and routine multiple ultrasound-guided biopsies found 32 (32.3%) carcinomas. Four patients with normal results upon rectal examination and endorectal ultrasonography were found to have carcinoma of the prostate. These findings suggest that the morbidity of routine multiple ultrasound-guided biopsies is low; that routine multiple ultrasound-guided biopsies is more sensitive than ultrasound guided biopsies, with 16/99 (16%) additional carcinomas detected in this study and 56% of carcinomas among those patients with findings upon the rectal examination suggestive of malignant disease; and that routine multiple ultrasound-guided biopsies can allow the detection of carcinomas responsible for isolated elevation of prostate-specific antigen levels without anomalies of the rectal examination or endorectal ultrasonography (8% of the carcinomas in this study).

Antigens, Neoplasm↗
PubMed1990

[Treatment using an endo-urologic approach of stenoses following uretero-intestinal anastomosis].

Twenty-one strictures following uretero-digestive anastomoses were treated by percutaneous transrenal dilatation. In 20 cases, an Olbert type angioplasty balloon on a guidewire was used. Rigid coaxial dilators were used in one patient after failure of the preceding technique and an electroincision was performed prior to dilatation in the remaining case. Overall, percutaneous transrenal dilatation was successful in nine patients, whereas ten dilatations failed and two patients are undergoing continued modeling with a mean follow-up of 16 months (range 1-42 months). Success rates by type of anastomosis were as follows: Bricker 5/12; Coffey 1/4; enterocystoplasty 2/4 and ureteroileovesical anastomosis 1/1. The date of development of the stricture, duration of modeling, and caliber of the indwelling catheter were apparently without influence on results. Because morbidity is low with percutaneous transrenal dilatation, this technique is advocated as first-line treatment, with surgery being reserved to failures.

Adult↗
PubMed1989

Prevention of the transient adverse effects of a gonadotropin-releasing hormone analogue (buserelin) in metastatic prostatic carcinoma by administration of an antiandrogen (nilutamide).

Gonadotropin-releasing hormone (GnRH) analogues administered for the treatment of advanced prostatic cancer induce a transient increase in plasma testosterone levels during the first week of treatment, often with a secondary rise in plasma levels of prostatic acid phosphatase and a flareup of disease. To determine whether the antiandrogen nilutamide (Anandron) blocks these effects, we carried out a multicenter, placebo-controlled study of nilutamide in men with prostatic cancer treated with the GnRH analogue buserelin. Thirty-six men with disseminated prostatic cancer and elevated plasma levels of prostatic acid phosphatase were randomly assigned to two groups. Group 1 included 17 men who received buserelin (500 micrograms daily subcutaneously) and nilutamide (300 mg daily by mouth); group 2 included 19 men treated with buserelin and placebo. Symptoms were assessed, and plasma was collected before treatment, daily for 14 days, and on days 18, 22, and 29 after the initiation of treatment. Bone pain appeared or worsened in 5 of the 17 men in group 1 and in 12 of the 19 men in group 2 (P less than 0.05). Acute urinary obstruction occurred in one man in group 2. Despite similar changes in the plasma testosterone levels in both groups, the median concentration of plasma prostatic acid phosphatase decreased almost immediately in group 1, but increased transiently, then decreased on day 14 in group 2. Median levels of prostate-specific antigen decreased immediately in group 1 and decreased on day 8 in group 2. We conclude that nilutamide can prevent the adverse consequences of the buserelin-induced transient rise in plasma testosterone levels in men with advanced prostate cancer treated with a GnRH analogue.

Acid Phosphatase↗
PubMed1989

[Treatment of urethral stenosis using Olbert's balloon dilatation angioplasty. Re-evaluation of the results].

Twenty-eight patients with an urethral stricture underwent Olbert's angioplasty balloon dilatation under local anaesthesia and fluoroscopic control. Four dilatations failed. Six were performed palliatively after failure of classical urethral catheterisation. Sixteen dilatations were performed curatively: thirteen patients developed a recurrent stricture after periods of between 3 days and 12 months. Three patients were cured. Our results suggest that angioplasty balloon dilatation is ineffective as a curative procedure and should be reserved for inoperable patients requiring and indwelling catheter, in whom classical catheterisation has failed.

Angioplasty, Balloon↗
PubMed1989

[Leiomyoma of the urinary excretory tract].

Four cases of leiomyoma of the urinary tract are presented: 3 locations in the bladder and one location in the ureter. Leiomyomas of the urinary tract are rare. These benign mesothelial tumors require conservative resection. Small lesions can be managed with endoscopic techniques.

Female↗
PubMed1989

[Endoscopically "impassable" urethral stenosis. Catheterization under fluoroscopic guidance. Apropos of 11 cases].

In eleven patients with impassable urethral stenoses, we attempted retrograde catheterisation with an angiographic guide under fluoroscopic control. The stenosis was able to be negotiated with the guide in 10 cases (91% success). After dilatation by dilators (coaxial or rigid) or by Olbert's angioplasty balloon, we were able to introduce a Foley catheter into the bladder. The only failure was caused by a very marked separation of the two ends of the urethra due to trauma. This simple and effective method constitutes an alternative to immediate surgical treatment of endoscopically impassable urethral stenoses.

Fluoroscopy↗
PubMed1989

[Technical problems raised by renal puncture in the percutaneous extraction of coralliform calculi].

Initial puncture and dilation of nephrostomy track(s) remain difficult procedures in percutaneous extraction of staghorn calculi. Technical s adjuvants are necessary and are exposed in detail. The choice of the needle, of the wires and of the catheters for initial puncture and ureteral catheterization is explained. Techniques of "Y" tract and double puncture are exposed. Severe complications (3 cases) are reported. Extraction of up to 90% of the stone can be expected if these technical adjuvants are optimally used.

Humans↗
PubMed1989

[Early endoscopic treatment of a complete traumatic rupture of the membranous urethra].

A man presenting complete traumatic disruption of the membranous urethra, with a 1 cm gap between the proximal and distal urethra, underwent successful endoscopic reconstruction ten days after the injury. When the urethral catheter was removed after fifteen days, peak flow rate was 25 cc per second. One internal urethrotomy was necessary 8 months later. Twenty months after the injury, cystography and retrograde urethrography revealed satisfactory restoration of urethral continuity. We suggest that this treatment be considered in complete traumatic disruption without hematoma and with less than a 1 cm gap between the proximal and distal urethra.

Cystoscopy↗
PubMed1988

[Transrenal percutaneous treatment of urinary fistula. Apropos of 19 cases].

Percutaneous nephrostomy (PCN) was used to treat 16 ureteral fistulas, two ileal fistulas following ileo-cystoplasty, and one pelvic fistula. Discharge resolved in all cases. PCN alone achieved complete recovery of the ileal and pelvic fistulas. Insertion of a wire-guide through the fistula into the bladder and stenting of the ureter for 5 to 20 days with a 8 to 10 F multi-side-hole catheter was possible in 12 of the ureteral fistulas and ensured complete recovery in every case. Because of complete stenosis, this procedure failed in the four other cases of ureteral fistula, and surgery was therefore required. Transrenal percutaneous treatment of urinary fistulas is a simple, effective procedure requiring only local anesthesia, and can be recommended in recently operated patients, and when retrograde catheterization is inadvisable (ileo-cystoplasty).

Humans↗
PubMed1987

[Idiopathic spontaneous adrenal hematoma in adults: echography and x-ray computed tomography. Apropos of 5 cases].

The five patients presented with sudden lumbar pain, transient collapse, and a right hypochondrium palpable mass. The location and the type of the mass could be determined by ultrasonography which showed a septated heterogenous mass displacing the retroperitoneal fat anteriorly. Computed tomography showed in two cases tiny parietal calcifications and a spontaneous hyperdensity in one case. All the patients underwent surgery and no tumoral tissue could be found.

Adrenal Gland Diseases↗
PubMed1987

[Percutaneous treatment of fistulas and stenoses after anastomosis of the uretero-digestive tract].

14 ureteral stenoses and 5 fistulae following an uro-intestinal anastomosis (UIA) were managed by a transrenal percutaneous approach. The stenoses (12 uretero-ileal and 1 uretero-colic anastomoses) were dilated with an angioplasty balloon and stented for several weeks. After withdrawal of the stent, performed on 12 out of 14 patients, the dilatation was successful in 8/12 cases (66%), with a follow up of 3 to 36 months. All the fistulae were dried. In 2 cases, complete recovery was achieved after placement of a bilateral nephrostomy tube. In 2 other cases, the ureter was stented at the site of the fistula which dried without sequelae after withdrawal of the stent. In the last case (uretero-colic diversion) surgery was performed after the fistula dried for the cure of a complete stenosis associated with the fistulae. The use of percutaneous nephrostomy is highly recommended for the management of post-operative stenoses and fistulae before considering surgical correction.

Colon↗
PubMed1986

[Benign ureteral stenoses. Dilatation with an angioplasty balloon].

An angioplasty balloon was used to dilate 23 benign ureteral stenoses in 21 patients. The anterograde approach through percutaneous puncture of the kidney was used in 19 cases. Following dilatation, an 8 F to 24 F catheter was left in the ureter. Dilatation was successful in 13 out of 23 cases (56%) followed up for 1 month to 2 years. It failed in 8 cases, and 2 patients are undergoing ureteral remodelling. Thus, dilatation of benign ureteral stenoses after percutaneous renal puncture was effective in about 60% of the cases. The follow-up period is still too short for us to determine the indications of this technique according to the cause and duration of the stenosis.

Adolescent↗
PubMed1986

[Real-time echography in the evaluation of the venous extension of cancer of the kidney. Prospective study of 50 cases].

Fifty patients with renal carcinoma were evaluated with real time ultrasonography: 15 tumors involved the renal vein (group Ia), 12 of them presented with caval tumor extension (group Ib); 35 tumors did not involve the renal veins (group II). In 3 cases, the renal vein could not be visualized. If the renal veins could be adequately delineated, evaluation of venous extension could be achieved in 100% cases (groups Ia and II). Nevertheless, caval tumor extension could be detected in only 70% cases (group Ib). This prospective study suggests that in the case of renal vein free of thrombus on ultrasonography, further investigations are not necessary to evaluate the venous extension of renal carcinoma. In case of inadequate delineation, or tumor involvement of the renal vein on ultrasonography, evaluation of inferior vena cava is mandatory, either by computed tomography, or inferior cavography.

Humans↗