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Results for “PERITONEOSCOPY”

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At least 397 records · Page 22Linked to original sources

PubMed1986

Prognostic factors in small cell lung cancer: multivariate model based on 778 patients treated with chemotherapy with or without irradiation.

The relationships between prognostic factors and duration of survival in small cell lung cancer were investigated in a consecutive series of 874 patients treated with combination chemotherapy with or without irradiation. The series included 443 patients with limited and 431 patients with extensive stage disease based on staging including bone marrow examination and peritoneoscopy with liver biopsy but no routine scans. The median durations of survival for the two disease categories were 48 and 30 weeks, respectively. The influence on survival of various pretreatment factors was investigated by use of univariate methods and Cox's multivariate regression model. Patients in each stage were treated according to one of three controlled trials. Variations among the applied treatment regimens did not result in significant differences in duration of survival among patients with limited disease. An alternating regimen was superior to continuous therapy in patients with extensive disease and raised serum lactate dehydrogenase. Prognosis was correlated with disease extent. Surgical resection as well as limited stage disease thus both contributed to survival. Poor performance status, reduced hemoglobin concentration, and raised values for serum lactate dehydrogenase were significantly associated with a reduced duration of survival in both stages. Females with limited disease lived significantly longer than males while advanced age was a negative prognostic factor in extensive disease. Plasma sodium and serum urate were both predictive of survival in limited disease. Proved metastatic disease affecting specific sites or total number of metastatic sites did not carry significant prognostic information in a model including a general variable characterizing stage of disease. Fifty of the 778 patients, on whom the multiple regression model was based, were alive and disease free 2 years after the start of the treatment. Two-year survival rates were strongly correlated to groupings based on prognostic factors, and information about disease extent was not mandatory for predicting the probability of long term disease-free survival.

Adult↗

PubMed1988

Cholestatic liver disease in a 20-yr-old woman with histiocytosis X.

A 20-yr-old woman with known diabetes insipidus complained of high fever and jaundice. Liver specimens biopsied under peritoneoscopy showed proliferating histiocytic or foamy cells in periportal areas. Immunocytochemical investigation demonstrated the presence of S-100 protein, but the absence of lysozyme in their histiocytic cells, and ultrastructural study revealed Birbeck granules in them. Vinblastine therapy reduced jaundice and high fever, and diabetes insipidus was controlled. Clinical, immunohistological, and cytological features suggested Letter-Siwe disease with jaundice, which responded well to treatment.

Adult↗

PubMedDate not supplied

Hepatic fibrosis in alcoholic steatosis. Morphologic aspects and evolutive tendencies.

Alcoholic hepatic steatosis, considered for a long time as a reversible "harmless" disease, is now re-evaluated according to the concept of cirrhosis without cell necrosis and inflammation. The study of 166 biopsies from alcoholic hepatic steatosis has demonstrated the presence of fibrotic process in 25 (15%) of the cases. Histologic and electron microscopic examination have supplied data on the distribution of this fibrosis (perivenous, perisinusoidal and extensive) as well as on the cells involved in collagen synthesis; myofibroblasts, fat storing cells (Ito cells) and the hepatocyte itself. Peritoneoscopy revealed aspects of incipient portal hypertension in some of the cases. Follow-up in time with reiteration of morphologic exploration at intervals of 2 to 3 years has shown the possible evolution toward cirrhosis in cases of steatosis with fibrosis when ethanol consumption is continued. Detection of early fibrosis, in patients with alcoholic steatosis, by means of morphologic or biochemical methods would be necessary for its therapeutic implication: possible reversibility by abstinence from alcohol and antifibrogenic therapy.

Biopsy↗

PubMed1988

Hepatic circulation and hepatic oxygen consumption in alcoholic and nonalcoholic fatty liver.

The purpose of this study was to determine the differences in hepatic circulation and oxygen consumption in two groups: those with nonalcoholic obesity-related fatty live and those with alcoholic fatty liver. Although the histological degree of fatty infiltration was equal in the two groups, the delta Er569-650, as an index of the regional liver blood flow estimated by spectrophotometric method, was significantly lower in alcoholic fatty liver than in nonalcoholic fatty liver, and the in vivo hepatic oxygen consumption (VO2), also determined by hepatic reflectance spectrophotometry during peritoneoscopy, tended to be lower in alcoholic fatty liver than in nonalcoholic fatty liver. The oxygen saturation of hemoglobin in local liver blood (SO2) was, however, significantly higher in alcoholic fatty liver than in nonalcoholic fatty liver. These results suggest that an increase in oxygen extraction to maintain oxygen consumption, which was indicated by the lowering of the SO2, was not found in alcoholic fatty liver, in spite of a reduction of oxygen supply to the liver. It is concluded that the impairment of hepatic circulation and hepatic oxygen consumption was more serious in alcoholic fatty liver than in nonalcoholic fatty liver, possibly contributing to a different prognosis for the two forms of fatty liver.

Fatty Liver, Alcoholic↗

PubMed1979

Observations on hepatic superficial lymph flow.

Hepatic superficial lymph flow was studied by injecting patent blue V solution into the liver under peritoneoscopy. This procedure enabled detailed observations of the direction of hepatic lymph flow in superificial lymphatic vessels and migration of lymph from these lymphatic vessels to lymphatic vessels of the gallbladder. Increase in this flow was observed in patients with increased liver fibrosis and lobular distortion.

Adult↗

PubMed1979

[The liver in a case of protoporphyria (author's transl)].

A 18 year old man with protoporphyria had discrete, sunlight-induced skin changes at the nose and the back of his hands, and liver disease. The transaminases ranged from 30 to 200 U/1, uro- and coproporphyrins in the urine were in the normal range. There was no evidence of a progression of the liver disease during 4 years. At peritoneoscopy the liver was yellow-brown with a granular surface. Microscopically fibrosis was present and globular pigment was distributed mostly in hepatocytes. These findings had been misinterpreted as "chronic active hepatitis with choletasis and fibrosis". This observation shows that liver disease in protoporphyria may be present with a normal urinary excretion of uro- and coproporphyrins and suggests that in cases of chronic liver disease of unknown origin the gastroenterologist ought to pay attention to sunlight intolerance and the pathologist to the yellow-brownish pigment of protoporphyrin.

Adolescent↗

PubMed1979

Mitochondrial glutamic oxaloacetic transaminase and its clinical significance.

The m-GOT were studied in 57 patients with liver diseases, diagnosed by peritoneoscopy and biopsy. In acute hepatitis, the m-GOT rose to 100 units or there-about. But in chronic hepatitis, even in hepatitis B with sublobular necrosis, the m-GOT were low and 20--30 units. On the other hand, in alcoholic hepatitis, the m-GOT were 50--60 units which may be considered to be higher than expected for comparable their histological necrotic findings. These values were higher than OCT, which were measured at the same time. This results showed that there might be m-GOT induction by alcohol. In liver cirrhosis lower values were obtained. Generally m-GOT was liable to be lower as the lobular distortion was getting severer.

Adult↗

PubMed1979

[Metastasis and special explorations in the study of the spread of bronchogenic carcinoma (author's transl)].

The results of a prospective study on bronchogenic carcinoma are analyzed. The most frequent metastatic localization being the bone (24 percent), followed by the brain (21 percent) and the pleura (20 percent). The type which most frequently metastatized to the brain is the epidermoid carcinoma. The as yet unresolved difficulties in the diagnosis of metastasis to the adrenal glands as well as to the liver are pointed out, conducting a comparative study with data from necropsies in order to corroborate such defficiencies. We systematically practiced radioisotope bone scanning, eliminating the bone radiography and carrying it out only in areas with pathologic isotopic uptake. Biopsy of the iliac crest should be performed in all cases of undifferentiated small-cell type, although this is not necessary with the other histopathologic types. Finally, the criteria for the identification of liver metastasis, in the absence of more proper pilot studies, should be the same as those established in 1974; physical examination and determination of hepatic enzymes; if the results are abnormal, a liver scanning should be indicated, and if it is normal, it will be necessary to perform a liver biopsy by peritoneoscopy.

Carcinoma, Bronchogenic↗

PubMed1983

Hepatic hemodynamics in patients with chronic hepatitis or cirrhosis as assessed by organ-reflectance spectrophotometry.

Hepatic hemodynamics in patients with chronic liver disease has been studied by reflectance spectrophotometry of the liver in situ during peritoneoscopy. An organ-reflectance spectrophotometer used in this study was equipped with a branched optic fiber bundle, which coupled the liver surface with the spectrophotometer. The spectrophotometry could measure qualitatively and quantitatively the absorption of hemoglobin in the liver in situ, thus estimating the regional hepatic tissue blood hemoglobin concentration and the saturation level of hemoglobin in the regional tissue blood. The analysis of 42 cases has shown that the estimated regional hepatic tissue blood hemoglobin concentration and saturation level of hemoglobin decreased in most cirrhotic livers, suggesting that even in cirrhotic livers the hepatic oxygen extraction increased, concomitant with a decrease in the regional hepatic tissue blood hemoglobin concentration. The hepatic blood hemoglobin concentration estimated on the surface layer of the liver was positively correlated with the regional hepatic blood flow measured by radioisotope clearance technique. The estimated hepatic blood hemoglobin concentration was also correlated positively with serum albumin level and prothrombin time, and negatively correlated with plasma retention of indocyanine green at 15 min. It is concluded that the hepatic tissue blood hemoglobin concentration decreases significantly with progress of chronic hepatitis to cirrhosis. This decrease in hepatic blood hemoglobin concentration and flow is concomitant with a decrease in metabolic functions, which is not compensated by an increased hepatic oxygen extraction.

Adult↗

PubMedDate not supplied

[Recent aspects of tuberculous peritonitis (22 cases in the adult) (author's transl)].

The authors show in this work the principal features of 22 tuberculous peritonitis cases seen between 1967 and 1977 affecting 17 Black Africans, 2 West Indians and 3 French (metropolitan) Caucasians cirrhotic or alcoholic. The 9 ascitic forms are not in the majority but it is worthwhile to consider a laparoscopy with peritoneal and/or hépatic biopsy where there is abdominal pain or unexplained fever. In most cases there exists one or several other tuberculous sites particularly pleural, pulmonary, hepatic, or in the cases of the Africans mediastinal lymphadénopathy. The means of diagnosis are commented upon with stress on the importance of peritoneoscopy and biopsies. The prognosis is good provided that antituberculous treatment is employed over a period of one year, with or without the temporary conjunction of corticosteroids.

Adult↗

PubMed1980

Long-term survival in small cell carcinoma of the lung.

From June 1973 to August 1977, three hundred thirty-seven patients with small cell carcinoma of the lung were included in randomized therapeutic trials. By February 1979, fifty-one patients (15%) had survived for 18 months, including 29 (9%) in clinical complete remission. Of the latter patients, readmitted for restaging, including bone marrow examination, peritoneoscopy, and bronchomediastinoscopy, residual tumor was found in four. Treatment was discontinued in the remaining patients; six subsequently had relapses, while three patients died, free of disease, of other causes. Sixteen patients are still alive and free of disease more than 19 to 50 months after the primary diagnosis; seven were treated with combination chemotherapy alone, including four who initially had distant metastatic disease. The remaining nine patients had regional disease and were treated with both chemotherapy and radiotherapy, including prophylactic brain irradiation in four patients. Long-term survival can be achieved in a small number of patients in all stages of small cell carcinoma with intensive combination chemotherapy.

Carcinoma↗

PubMedDate not supplied

[Encapsulating perihepatitis. Report of four cases (author's transl)].

The authors report 4 cases of encapsulating perihepatitis, the macroscopic appearance of which corresponded to the morphological definition of the condition. The circumstances surrounding the diagnosis were very variable: association of ascites and porial hypertension, sub-obstructive syndrome due to associated encapsulating peritonitis, chance discovery at laparotomy or an unexpected finding at autopsy. The diagnosis was made pre-operatively in 2 cases by peritoneoscopy. All the patients had portal hypertension with, in particular, evidence of oesophageal varices. Three patients were treated surgically: hepatic decortication in all cases, combined in one another with umbilico-caval anastomosis. In all cases, the underlying perihepatic matrix produced epiglissonian fibrosis. However the inderlying hepatic lesions varied, ranging from definite cirrhosis to mild fibrosis. In one case, cirrhosis was associated with a hepato-cholangioma with nodular metastatic spread. The prognosis depended essentially upon the effects of general condition and the severity of hepatic lesions. In the light of cases reported over the past twenty years, the authors review the various clinical, pathogenic and therapeutic aspects of encapsulating perihepatitis.

Aged↗

PubMed1982

An autopsy case of primary hepatoma associated with an oral contraceptive.

Primary hepatoma was found in a 38-year-old female who had been using an oral contraceptive for 28 months. Histologically the hepatoma was a well-differentiated hepatocellular carcinoma. Alpha-fetoprotein was not increased and tests for HBS antigen was negative. Carcinoembryonic antigen was elevated remarkably before death. The findings of hepatic arteriography and peritoneoscopy suggested metastatic tumors of the liver rather than primary hepatoma. During the course of the disease, phlebothrombosis occurred and spread widely in the lower left limb. The observation of erythrocytosis indicated the presence of a tumor producing erythropoietin or an erythropoietin-like substance.

Adult↗

PubMed1983

[Significance of laparoscopy in the diagnosis of hepatocellular carcinoma in siderocirrhosis].

A case report is given of a patient with liver cirrhosis caused by hemosiderosis, who developed liver carcinoma. In such patients liver carcinoma can only be excluded by means of peritoneoscopy. Sonography, computer tomography and laboratory findings will not allow to make the correct diagnosis, because of the particular nature of liver changes in hemosiderosis of the liver, as can be seen in our case. Thus none of the non-invasive procedures mentioned above are suited for early diagnosis of malignant liver disease because of the special morphological features in hemosiderosis of the liver.

Carcinoma, Hepatocellular↗

PubMed1978

[Pseudomyxoma of the peritoneum (author's transl)].

A case report is given of a peritoneal pseudomyxoma originating from pseudomucineous cystadenomata of both ovaries. The diagnosis was established by peritoneoscopy and histological examination. Both ovaries were removed surgically and cytostatic treatment initiated thereafter; hyperthermic peritoneal perfusion was done as well. The patient lives after surgery now for more than a year without recurrence of the disease.

Ascites↗

PubMed1983

Staging laparotomy in early ovarian cancer.

Systematic restaging was performed prospectively in 100 patients referred to the Ovarian Cancer Study Group institutions with a diagnosis of "early" (stage Ia-IIb) ovarian cancer. Before referral, only 25% of patients had an initial surgical incision that was adequate to allow complete examination of the pelvis and abdominal cavity. In patients referred to member institutions, 31 (31%) of 100 were found to have a more advanced stage and 23 (77%) of 31 of these actually had stage III disease. Sixty-one percent of the patients had their advanced stage detected by procedures other than a second laparotomy-nine (29%) of 31 by peritoneoscopy, six (19%) of 31 by peritoneal washings, and six (19%) of 31 by lymphangiography. Sites of unsuspected disease are most likely to be pelvic peritoneum, ascites fluid, other pelvic tissue, para-aortic nodes, and the diaphragms. Based on these data, we conclude that the initial staging approaches traditionally used in clinical evaluation of patients with early ovarian cancer are often incomplete and inadequate.

Adolescent↗

PubMed1984

Staging and surgical evaluation of ovarian cancer.

Ovarian carcinoma is the only female genital malignancy surgically staged. Appropriate preoperative roentgenographic, isotopic, and endoscopic studies can help define the spread of disease and the extent of surgery required. At surgery, the common sites of metastases--pelvic and para-aortic lymph nodes, diaphragm, serosal surfaces and omentum--should be examined and biopsied or excised. Total hysterectomy, bilateral salpingo-oophorectomy, and appendectomy should also be performed in patients with epithelial ovarian tumors. Evidence suggests that patients who have had optimal cytoreduction of the tumor (less than 1.5 cm) have a better outcome following chemotherapy. Patients who have no clinical or CT evidence of disease after a full course of chemotherapy should be explored to confirm disease status. Peritoneoscopy can be used as an interval procedure to assess response to treatment.

Female↗

PubMed1980

The prognostic value of peritoneoscopic findings in patients with liver cirrhosis.

This study was conducted on 139 patients with liver cirrhosis with diffuse formation of the nodules on the liver surface demonstrated by peritoneoscopic examination. In all of these patients, the diagnosis had been established more than 5 years ago, and the cumulative survival rates were calculated by the life table method. The relationship between the survival rate and macroscopic findings on the surface of the liver was studied and the following conclusions were drawn. 1) The 5 and 10 year survival rates in patients with cirrhosis with swelling of the right lobe were as high as 71.2 and 53.4% respectively and were significantly higher than the corresponding figures of 30.0 and 12.7% in patients with cirrhosis with right lobe atrophy (pless than0.001). 2) The 5 year survival rate in patients with cirrhosis of the small nodular type with a predominance of nodules with diameters less than 3mm was a high as 70.6%. This was significantly higher than that in patients with cirrhosis of the medium and large nodular type with nodules measuring more than 3mm in diameter where the 5 year survival rate was 36.0% (pless than0.001). 3) The 5 year survival rate in patients with cirrhosis of the narrow stromal type was as high as 61.4%, being significantly higher than that in patients with cirrhosis of the broad and mixed stromal type where the 5 year survival rate was 43.2% (pless than0.05). The observation of the surface pattern of the liver by peritoneoscopy appears to be of great predictive value for the prognosis of liver cirrhosis.

Atrophy↗