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Biomedical subjects

A Cortot

Publications and source records attributed to A Cortot.

At least 145 records · Page 8Linked to original sources
PubMed1990

[Laser treatment of rectosigmoid villous tumors. Study of a series of 313 patients].

Endoscopic laser treatment is reported in 313 patients with benign rectosigmoid villous adenomas. Total tumor destruction was achieved in 92% of them, without any major complications. The circumferential extension of the tumor base was the only factor affecting this result. During the average 37-month follow-up period of the patients with total tumor destruction, 14% had a tumor recurrence. The recurrence rate after initial treatment was higher a) in patients treated for a recurrence after a previous non laser treatment, b) when the initial histology was low-grade dysplasia and c) when the tumor was located in the lower or middle rectum. Because treatment is long and difficult with a high cancer rate, laser treatment for patients with a circumferential villous adenoma should be limited to nonsurgical candidates. In the other cases, laser is well adapted to old and fragile patients, when transanal resection seems difficult or in case of recurrence after a previous non-laser treatment.

Actuarial Analysis↗
PubMed1990

[Blue rubber bleb nevus syndrome. 3 cases treated with a Nd:YAG laser and bipolar electrocoagulation].

This report concerns three patients with "blue rubber bleb nevus syndrome" presenting with recurrent digestive tract hemorrhage. Tuberous angiomas of the digestive tract associated with typical skin lesions as described by Bean led to diagnosis. Endoscopic coagulation with Nd:YAG laser and bipolar electrocoagulation "Bicap" of gastric and colonic angiomas was performed successfully without complication but did not avoid hemorrhagic recurrence originating from lesions located in the small bowel, as demonstrated during laparotomy in one case.

Adult↗
PubMed1989

[Diarrhea and functional digestive pathology].

Functional bowel disorders are the most frequent cause of chronic diarrhoea. Functional disorders may present as typical "diarrhée motrice" (colonic hypermotility) or as watery diarrhoea. The diagnosis cannot be made unless an organic cause has been ruled out. Although colonic motor abnormalities have been described in some patients, its physiopathology remains obscure. Treatment is the same as for functional bowel disorders, i.e. fibres and antidiarrhoeal drugs.

Chronic Disease↗
PubMed1989

Parameters affecting laser palliation in patients with advanced digestive cancers.

Ninety-nine nonsurgical patients (group I) with esophagogastric cancer were referred to the laser center for palliation of dysphagia, and another 142 nonsurgical patients (group II) with a rectosigmoid cancer were referred for palliation of abnormal rectal discharge (125 patients) or occlusion (17 patients). The immediate success rate was 83% in group I and 90% in group II. Patients were retreated monthly. The average duration of palliation was 4.3 months +/- 0.5 (+/- standard error) in group I and 9.3 months +/- 0.95 in group II. Complication rate was 4% in group I and 3.4% in group II. Parameters affecting results were found only in group I. Factors that could negatively affect the immediate success rate included annular size of the tumor basis more than two thirds of the circumference, tumor localization at the upper third of the esophagus, and recurrence after a nonlaser treatment. The average duration of improvement after initial success was affected only by the circumferential extension.

Aged↗
PubMed1989

Laser palliation for rectosigmoid cancers.

Lasers are now used in the rectum an colon for treatment of vascular telangiectasia [1], and benign and malignant sessile tumours [2,3]. This paper will describe the results of a 7 years experience with treatment of sessile rectosigmoid cancers.

Adult↗
PubMed1989

Endoscopic laser treatment for rectosigmoid villous adenoma: factors affecting the results.

Endoscopic laser treatment is reported in 264 patients with benign rectosigmoid villous adenomas revealed by biopsy. Patients include 100 who had contraindications to surgery, 60 who had a tumor recurrence after a nonlaser treatment, 101 for whom surgical resection appeared to be too drastic for a tumor found benign on biopsy, and 3 who refused surgery. Two types of lasers were used: the Nd:YAG and the argon laser. In some patients, both lasers were used. Treatment was completed in 226 patients. Total tumor destruction was attained in 92% of them, a carcinoma was detected in 7% on biopsy specimens obtained during laser treatment, and benign villous tissue persisted in 1%. During the average 25.9-mo follow-up period of the patients with total tumor destruction, 13% had a tumor recurrence. Treatment was well-tolerated with no major complications. The circumferential extension of the tumor base was the only factor affecting the duration of treatment, and the rate of complications. The recurrence rate after initial treatment was higher in patients treated for a recurrence after a previous nonlaser treatment than in patients treated only by laser (p = 0.04). It was also higher when the initial histology was low-grade dysplasia than if it was high-grade dysplasia (p = 0.017) and when the tumor was located in the lower or middle rectum as opposed to the upper rectum or sigmoid (p = 0.04). We estimated that the direct cost of laser treatments was 28%-40% of the surgery charges for lesions of identical size in our hospital and 31%-69% at UCLA Center for the Health Sciences. Because treatment is long and difficult and the cancer rate is high, endoscopic laser for patients with a circumferential villous adenoma should be limited to nonsurgical candidates. The risk of a fatal complication after surgery has to be balanced against the risk of undetected carcinoma in the other patients and the indication for endoscopic laser treatment should be discussed case by case.

Adenoma↗
PubMed1989

Impaired bacterial flora in human excluded colon.

We compared the rectal microflora of 16 patients with surgically excluded colorectum with 16 healthy controls. The cause of diversion was inflammatory bowel disease (n = 10), colon cancer (n = 3), miscellaneous (n = 3). Six patients had a diversion colitis. In the excluded colorectum, the total bacterial count was only slightly lower than controls but the variety of the flora was significantly reduced. This reduction was confined to strict anaerobes, mainly the genus Eubacterium and Bifidobacterium. Among aerobes, enterobacteria were more often isolated than in controls. This altered microflora of excluded colorectum could be involved in the mucosal damage observed in some cases.

Adult↗
PubMed1989

Sweet's syndrome associated with Crohn's disease.

The first known case involving an association of Sweet's syndrome with Crohn's disease is described. A 36-year-old woman developed a diarrhea, fever, and infiltrated erythematous cutaneous plaques on neck and limbs, consistent with a presumptive diagnosis of Sweet's syndrome. This was confirmed by a skin biopsy showing a dense dermal infiltrate of polymorphonuclear leukocytes. Crohn's disease, extending from the anus to the terminal ileum, was diagnosed as well. Prednisolone treatment resulted in the improvement of both the bowel disease and skin lesions.

Adult↗