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A Gainant

Publications and source records attributed to A Gainant.

51 records · Page 3Linked to original sources
PubMed1989

[Colorectal anastomoses with a Steichen-type rectoplasty adapted by Dubois. Analysis of a series of 46 patients].

The authors report the results of a latero-lateral colorectal anastomotic technique which includes a wide rectoplasty. Analysis is based on 46 patients with a post-operative follow-up of between 2 and 8 years. 1 patient suffered from congenital mega-colon and 45 from adenocarcinoma of the upper half of the rectum. 4 of the anastomoses followed colostomy for obstruction and 4 others were followed by a protective colostomy. Two post-operative deaths occurred and there were 3 anastomotic fistulae, one of which was asymptomatic. Hepatic metastases occurred in 10 cases and were associated with loco-regional recurrence in 5 cases. The functional results were excellent. In survivors with no evidence of local recurrence there were no cases of stenosis of the anastomosis.

Adenocarcinoma↗
PubMed1988

[Glaphenine biliary lithiasis. Identification by infrared spectrophotometry].

The authors report the case of a woman, presenting with choledocholithiasis essentially composed of glafenic acid. Identification of the drug and its metabolites was demonstrated using infrared spectrophotometry and thin layer chromatography. To our knowledge, this is the first publication of drug choledocholithiasis.

Aged↗
PubMed1986

[Carbohydrate antigen CA 19-9: value in pancreatic pathology].

In order to determine the diagnostic usefulness of the dosage of carbohydrate antigen (CA 19-9) serum levels in pancreatic diseases, 38 patients with pancreatic lesions proved at laparotomy were studied. Pancreatic lesions were classified into two groups: a) group I: pancreatic adenocarcinoma (17 cases) b) group II: benign pancreatic diseases (21 cases). CA 19-9 serum levels were statistically higher in patients of the first group (p less than 0.001). All patients except one with CA 19-9 higher than 60 U/ml had pancreatic carcinoma. All patients except two with CA 19-9 less than 60 U/ml had a benign lesion. The sensitivity and specificity of CA 19-9 were 88 and 95 p. 100 respectively. These results show that CA 19-9 dosage is useful in distinguishing between benign and malign lesions of the pancreas.

Adenocarcinoma↗
PubMed1986

[Results of preoperative irradiation in the treatment of rectal adenocarcinoma].

The goal of this retrospective study was to assess the tolerance and the efficacy of preoperative irradiation in the treatment of rectal carcinoma. From 1980 to 1983, 81 patients with potentially operable rectal carcinoma underwent abdominoperineal resection. Fourty-one were treated with surgery alone; 40 had a preoperative pelvic irradiation. They received 30 Gy in 15 fractions during three weeks. Surgery followed within four weeks after the last irradiation. In one third of the irradiated patients, the size of the tumor decreased by at least 50 p. 100. Postoperative morbidity and mortality were not increased following irradiation and there was no delay in perineal healing. Five year survival was improved by irradiation (78 p. 100 versus 28 p. 100) with statistical significance (p less than 0.05). In patients with stage C tumors according to Astler-Coller's modification of Dukes staging, 5 year survival was higher in patients who received preoperative irradiation (68 p. 100 versus 23 p. 100) with a statistically significant difference (p less than 0.05). Pelvic recurrence occurred in 8 p. 100 of the patients irradiated and in 45 p. 100 of the patients treated with surgery alone respectively. This difference was also statistically significant (p less than 0.05). Survival of patients who underwent abdominoperineal resection for rectal carcinoma appeared to be improved with preoperative irradiation.

Adenocarcinoma↗
PubMed1985

[Effect of restoring duodenal continuity after total gastrectomy in the rat].

An experimental study in the rat compared efficacy of re-establishment or not of duodenal continuity during digestive reconstruction by Y loop after total gastrectomy. Results were evaluated as a function of growth rate in the two groups. Nutrition following gastrectomy in rats treated by this technique was significantly better than in the other rats. Similar findings have been reported in humans, suggesting that this procedure be used more frequently after total gastrectomy.

Animals↗
PubMedDate not supplied

Radical surgery for gallbladder cancer. Results of the French Surgical Association Survey.

BACKGROUND/AIMS: Gallbladder carcinoma is a highly lethal disease. The advantages of radical surgery remain controversial. The authors' objective was to evaluate the effectiveness of an aggressive approach to gallbladder carcinoma on long-term survival. METHODOLOGY: A questionnaire was sent to 73 institutions in France, Europe, and overseas. Data, from 724 patients treated between 1980 and 1989, were analyzed for patient sex and age, associated hepatobiliary diseases, symptoms and signs, diagnostic tests, operative management, pathology reports and survival. Seventy-eight percent of the patients were women, and 22% were men. Gallstones were present in 86% of the cases. Four percent of the patients had Tis lesions, 11% had T1 to T2 lesions, and 85% had T3 to T4 lesions. RESULTS: Twenty-three percent of the patients underwent curative operations, and 77% had a palliative treatment (25% of the patients underwent exploratory laparotomy). Exploratory laparotomy was followed by the highest mortality rate (66%), and older patients (>70 years) had a higher operative risk. The overall median survival was 3 months, and long-term survival correlated with cancer stage: Tis >60 months, T1 to T2 >22 months, and T3 to T4 2 to 8 months. Projected five-year survival for cancers limited to the gallbladder and treated by simple cholecystectomy was 93%, 18% and 10% for Tis, T1 and T2 respectively. For T3 to T4, no difference was observed among the different surgical procedures adopted--hepatic resection, trans-tumoral stenting or biliary-enteric anastomosis. CONCLUSIONS: In conclusion, a simple cholecystectomy is effective only for Tis cancer. An extended cholecystectomy for invasive cancer should be performed, but only if there is limited involvement of the immediately adjacent hepatic parenchyma. There is now a need to evaluate more effective adjuvant therapy in the form of radiotherapy or newer chemotherapeutic agents.

Adult↗
PubMedDate not supplied

Prevention of postoperative wound dehiscence in high risk patients. A randomized comparison of internally applied resorbable polyglactin 910 mesh and externally applied polyamide fiber mesh.

This randomized prospective study was undertaken to compare the effectiveness of two methods used to prevent post-operative wound dehiscence in 100 high risk patients. Fifty patients were treated with a polyamide fiber mesh applied externally to the skin using a topical glue, while the other 50 patients were treated with a resorbable intraperitoneal mesh of polyglactin 910. Each patient had at least one of the following risk factors for wound dehiscence: undernutrition, malignancy, ascites, peritoneal infection, immunodepression, abdominal irradiation, repetitive surgical procedures through the same incision, or pulmonary disease. Judging criteria consisted of the development or absence of dehiscence and the frequency of abdominal wall complications. The percentage of wound dehiscence was significantly increased in patients with externally applied polyamide fiber mesh as compared to those with intraperitoneal polyglactin 910 mesh (p less than 0.01). Abdominal wall complications and the duration of healing did not vary significantly in frequency between the two groups. The intraperitoneal placement of a polyglactin mesh was more effective and better tolerated than external application of a polyamide fiber mesh.

Adult↗
PubMedDate not supplied

[Lymph node involvement and prognosis in medullary cancers of the thyroid gland].

Involvement of regional lymph nodes is extremely common in medullary carcinoma of the thyroid gland (MTC). The aim of the present study was to determinate the prognostic of MTC correlated with the regional lymph node involvement. From 1975 to 1994, 23 MTC patients were treated. The surgical protocol included a total thyroidectomy with bilateral dissection of the jugulocarotid chain and of the paratracheal groove. We have distinguished two groups: group N+ (histological lymph nodes involvement) and group N- (absence of histological lymph nodes involvement). In each group we have evaluated the prognostic significance of age, sex, palpable lymph nodes, histological capsular effraction and presence of distant metastasis. The data were analyzed with the exact Fisher test and comparisons by Student t test. Significance was defined as p > 0.05. Survical curves were based on the method of Kaplan Meier. In Group N+ (n = 15), 9/15 patients died: they had palpable lymph nodes, histological capsular effraction and distant synchronous or metachronous metastasis. The median survival was 8 months, when patients have distant metastasis. Six patients are alive, 2 with an elevated thyrocalcitonin level without metastasis, and 3 with resection of metastatic MCT to regional lymph nodes. In groupe N- (n = 8), all patients are alive: 2/8 patients had palpable lymph nodes, 1/8 had histological capsular effraction, but none had distant metastasis. 2 patients underwent resection of regional lymph metastasis and one of pulmonary metachronous metastasis. Gender did not appear to affect the lymph involvement. Factors significantly associated in the group N+ included the following: age (p = 0.003), palpable lymph nodes (p = 0.015), capsular effraction (p > 0.00025), distant synchronous metastasis (p < 0.013). The regional lymph node metastasis had significant influence on the 5-year survival, 48% vs 100% (p = 0.006), and on disease free survival, 16.6% vs 62.5% (p = 0.018). The median time from resection of the primary tumor to the development of metastasis disease was 37 months for patients N+ vs 169 months for patients N-. Involvement lymph node did not affect the metastasis disease, regional involvement or distant metastasis (p > 0.05).

Adult↗