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T Yandza

Publications and source records attributed to T Yandza.

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

[Liver transplantation in children. New experience in a Pediatric Surgery unit. Evaluation of the first 18 months' experience].

The authors report an eighteen month experience with orthotopic liver transplantation (OLT) in children in the Pediatric Department of Hospital Bicêtre in Paris, from January 1988 until July 1989. Thirty-eight OLTs including 4 retransplant operations, were performed in 34 children, aged from 7 months to 13 years, 20 of them under the age of 3 years. Biliary atresia was the indication for 22 children. Twenty-eight donors were children. A reduced-size liver was used in 17 cases. The technique for OLT was based on the description by TE Starzl. Surgical complications led to reoperation in 15 cases, mostly in relation to hepatic artery thrombosis (HAT), which occurred in 7 cases: small donor liver was considered to be one of the causative factors. In all but one case of HAT a retransplant was considered; to date it is has been performed in 3 of these children. Thirty-one children have survived, with a mean follow-up of 8 months, all are at home, except for one child at the time of this report. Liver function tests are normal for 22, and moderately altered for 5. For the four remaining children, retransplant is planned for 3 cases and one child has just been retransplanted. The authors emphasise the fact that OLT in small children requires a specialised pediatric environment, particularly as regards intensive care and nursing.

Adolescent↗
PubMed1989

[Rapid liver perfusion in multiple organ procurement in children. For liver transplantation].

We report our experience of the rapid liver flush technique in multiple organ harvesting from donor children. Between January 1988 and May 1989, out of 33 liver transplantations in 30 children, 24 were performed using livers obtained from children. The donors' mean age was 75 months. In every case several organs were removed (24 kidneys, 9 heart-lung blocks, 9 hearts, 1 pancreas). The mean duration of the procedure was 153 minutes. Supernumerary hepatic vessels (6 left and 2 right hepatic arteries) were left intact. Twenty-two hepatic grafts were classified as functional. Two grafts classified as non-functional were responsible for 2 deaths in this series. The rapid liver flush technique seems to be satisfactory in donor children when the following characteristics are taken into account: tendency to haemodynamic instability, small caliber of the vessels and fragility of tissues.

Adolescent↗
PubMed1988

Hepatic artery thrombosis in pediatric liver transplantation.

The incidence of hepatic artery thrombosis was analyzed in a series of 59 consecutive liver transplants performed in 52 children less than 15 years of age at the University of Louvain Medical School, Brussels, from March 1984 to March 1987. This incidence was 17% for the whole series; it was increased in small recipients less than 3 years of age and less than 15 kg (23%) in weight, as well as when the liver was harvested from a small donor less than 15 kg in weight (38%). It was also increased when the donor liver was supplied by more than one artery. This incidence was markedly reduced by arterial revascularization from the aorta, either directly or by interposition of an iliac segment; the reduced-size livers had a much lower incidence of arterial thrombosis (5%) than the whole livers (23%). In the present series, we did not find any argument to support the view that poorly controlled rejection could be implicated in the pathogenesis of arterial thrombosis.

Adolescent↗
PubMed1988

Pediatric liver transplantation: report on 52 patients with a 2-year survival of 86%.

Between March 1984 and March 1987, 59 orthotopic liver transplantations have been performed in 52 children at the Catholic University of Louvain in Brussels. The actuarial survival was 86% +/- 5 up to 3 years of evolution. The most frequent indication has been chronic hepatic insufficiency (43 patients) mainly because of biliary atresia; seven patients were transplanted for acute hepatic insufficiency and only two for liver tumor. Because of important donor/recipient weight discrepancy, a reduced-size liver was used in 20 occasions either for first or second transplant. No difference in the incidence of major complications were seen between whole liver and reduced size liver transplanted children, with the exception of more frequent subhepatic collections in the first and more hepatic artery thrombosis in the second group. Liver tests, clinical rehabilitation, and survival appear to be equal in the two groups.

Child↗
PubMed1988

Liver transplantation for biliary atresia: indications and results.

This report reviews the results of some paediatric surgical departments and points out the unsolved problems in biliary atresia disease. The authors conclude that a 5-year survival rate of 60% may be achieved in long-term follow-up, but a complete cure is observed only in 30%. Children who develop a cirrhosis and portal hypertension without or in spite of bile flow can benefit only by liver transplantation. As a result of long-term clinical experience conditions are defined that should be taken in consideration in the surgical treatment of bile duct atresia. In respect of liver transplantation the disadvantages of an external bile draining fistula to prevent cholangitis, an extensive mobilisation of the liver for HPE procedure, and the disadvantages of reoperation are discussed. By avoiding these disadvantages liver transplantation procedure will be facilitated and a 1-2 year survival rate of 80% may be achieved.

Biliary Atresia↗
PubMed1987

[Total esophagectomy by stripping without thoracotomy in cancer of the pharynx, esophagus and cardia. 34 cases].

Total oesophagectomy by stripping without thoracotomy was performed in 34 cancer patients to reduce operative mortality and morbidity in those with impaired respiratory function. The carcinoma was located in the pharynx in 20 cases, on the cardia in 9 cases and on the lower oesophagus in 5 cases. Reconstruction in the posterior mediastinum was effected with the descending colon in 32 patients. The operative mortality rate was 11.8% and fistulization developed in 20.6% of the cases. Eight patients (26.5%) required post-operative endoscopic dilatation. Ninety per 100 of the patients who survived surgery resumed satisfactory feeding. Thus, these patients with high operative risk who underwent oesophagectomy by stripping without thoracotomy benefited from tumoral excision and normal feeding with results comparable to those of other types of oesophagectomy.

Adult↗
PubMed1987

[Post-traumatic hemobilia. Is selective hepatic artery ligation dangerous?].

Selective hepatic artery ligation has traditionally been considered dangerous by some authors in the treatment of traumatic haemobilia. Having observed one case in which this technique was successful in controlling liver haemorrhage, the authors have reviewed the literature. Conditions in which selective hepatic artery ligation can be dangerous are discussed. The safety and effectiveness of this treatment of traumatic haemobilia in normovolemic patients is emphasized.

Adolescent↗
PubMed1987

Surgical approach to the superior mesenteric artery by the Kocher Maneuver: anatomy study and clinical applications.

The Kocher maneuver allows approaching the origin of the superior mesenteric artery. This affords adequate exposure for procedures such as embolectomy or mesenteric arterial reimplantation into the aorta. Because of its simplicity, this technique may be better than the classical interpancreaticoduodenal or splenopancreatic methods. The results of 11 cadaveric dissections and two surgical operations for mesenteric ischemia using this technique are reported.

Aged↗
PubMed1986

Benign tumors of the liver in children: analysis of a series of 20 cases.

Twenty children were treated for a benign hepatic tumor during a 17-year period. One child was not operated upon but followed since birth for 2 years by ultrasonogram. Mesenchymal hamartoma was found in 8 cases, a solitary cyst in 4, and 3 other cases of hamartomas were without cystic components. Two girls had lesions corresponding to focal nodular hyperplasia; two children had a solitary adenoma. Radical surgical treatment was possible in all 19 operated cases, except one case of focal nodular hyperplasia where a right lobectomy would have been necessary. Ultrasonography and angiography are the main explorations to be undertaken before treatment; preoperative embolization of the main arteries to the tumor was done in five cases, with unquestionable advantage in four of them. No mortality was recorded and results were good with a mean follow-up of 19 months.

Adenoma↗