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Biomedical subjects

A Le Duc

Publications and source records attributed to A Le Duc.

At least 127 records · Page 7Linked to original sources

An original antireflux ureteroileal implantation technique: long-term followup.

An original ureteroileal reimplantation technique in which the ureter is placed in a sulcus created in the ileal mucosa was performed on 51 patients (97 ureters). Followup ranged from 3 to 8 years. As determined by excretory urography, retrograde ileography and urine bacteriology studies the method was effective in 85 per cent of the patients, with a low rate of stenosis (1.5 per cent). The use of this technique, initially limited to patients with the U-shaped continent ileal bladder, has been broadened to include those who undergo various reconstructive or urinary diversion procedures that require ureteroileal reimplantation.

Adult↗

[Unilateral bladder neck incision: endoscopic treatment of bladder neck obstruction. Results in 100 patients].

Endoscopic diathermy unilateral incision of the bladder neck was carried out in 100 consecutive male patients. This procedure was performed for bladder neck obstruction and small benign prostate. The operative details of this technique are given. Follow-up after 2 months revealed excellent symptomatic and urodynamic results. Morbidity was low. Results remain stable after 13 +/- 9 months. One patient needed a transurethral resection of the prostate. Retrograde ejaculation occurred in 5% of the patients. Unilateral bladder neck incision is a simple procedure safe, and easy to learn, with a low risk of retrograde ejaculation. It is the operation of choice for small benign prostate, bladder neck obstruction and young patients.

Adult↗

[Bladder tumors].

Explore the source record for details and available documents.

Carcinoma in Situ↗

[Endoscopic nephrotomy].

A procedure of small endoscopic nephrolithotomy during open surgery for staghorn calculi is described. This procedure is based on the principle of percutaneous nephrolithotomy. Same instruments are used. These endoscopic nephrostomies are less traumatic.

Endoscopy↗

[Antireflux uretero-ileal implantation via a mucosal sulcus].

The authors present an original antireflux uretero-ileal implantation. This procedure is based on the insertion of the ureter in a mucosal sulcus. The ileal mucosa progressively grows over the ureter. 260 ureters have been reimplanted according to this procedure. The antireflux system is effective in 85% of cases. The incidence of stenosis seems to be low: less than 2%.

Humans↗

[Percutaneous urinary drainage. Technic, results and indications].

The various nephrostomy sets are described and the characteristics of a nephrostomy set adapted for urological practice are defined. The basic technique of percutaneous nephrostomy is described. The possible complications are reviewed together with the methods for their prevention and treatment. The current indications of percutaneous nephrostomy are also defined.

Humans↗

[Monoclonal anti-prostatic acid phosphatase antibodies (production and characterization)].

5 monoclonal antibodies have been produced by Köhler and Milstein. The production and the characteristics of the monoclonal antibodies are presented. They are all IgG1 and have high specificity against prostatic cells producing prostatic acid phosphatase. These monoclonal antibodies can be used to perform immunoscintigraphies and immunolymphoscintigraphies to titrate prostatic acid phosphatase serum levels and to identify the prostatic origin of a tumor.

Alkaline Phosphatase↗

[Acquired stenosis of the upper urinary tract after percutaneous nephrolithotomy].

The authors present two well documented cases of extensive acquired stenosis of the infra-pelvic upper urinary tract following percutaneous nephrolithotomy. This type of complication appears to be exceptional as, by combining the series of two centres, it represents only two cases out of more than five hundred cases treated. The delay in appearance is of the order of six months. The more or less complex nature of the procedure does not appear to be responsible. It is difficult to determine the exact mechanism fo this complication: several hypotheses are proposed. A few rare cases have been reported in the literature without raising any particular attention. These complications required difficult reconstructive surgery with a good result in both cases. Although these complications seem to be difficult to prevent, they should be systematically detected by ultrasonography at two months and at six months to avoid delay in the diagnosis of functional renal exclusion.

Adult↗

[Vesico-urethral fibroscopy. Reflections after 4 years' practice].

The visualisation of the lower urinary tract by the mean of a fiberscope makes an advance when compared to rigid endoscopy mainly in male patient. Technical features of the fiberscopes suitable for urology thus basic technique of the examination are described. Main advantages are painfree and total visual scanning of the mucosa. Disadvantages are very low.

Cystoscopy↗

[Percutaneous nephrolithotomy: perspectives for the future. Analysis of 250 cases in 3 years' experience].

The authors report their experience of percutaneous nephrolithotomy over a period of three years. The analysis of the first 250 cases performed reveals a low morbidity, with serious complications in 1% of cases, and an acceptable complete success rate of 83%. The indications for percutaneous nephrolithotomy have been modified since the opening of an extracorporeal lithotripsy unit. The choice between the two techniques depends on their efficacy and their expected morbidity based on four criteria: the volume, chemical composition and site of the stone and the morphology of the upper urinary tract. Percutaneous nephrolithotomy is the treatment of choice for large stones (greater than 2.5 cm), hard stones or those formed proximally to a stenotic lesion of the urinary tract, which can then be dilated at the same procedure. A combination of the two methods is sometimes uses to treat staghorn calculi with a success rate of 80%. On the other hand, very large staghorn calculi with caliceal branches are best treated by open surgery.

Adolescent↗

[Treatment of renal cancer extending supradiaphragmatically with fibrinolytics following surgery under extracorporeal circulation, hypothermia and circulatory arrest].

The authors report a case of right renal carcinoma with a supradiaphragmatic vena cava thrombus. The patient presented to the emergency ward with a severe pulmonary embolus managed by fibrinolytic treatment. After alcohol embolization of the tumor, the patient underwent a right radical nephrectomy with cavectomy. A large tumor extending to the heart was removed by cardiopulmonary bypass combined with hypothermia and cardiac arrest. The immediate postoperative course was satisfactory. Eighteen months later, a CT scan revealed a suprarenal growth. A cytological study was performed on a specimen obtained by percutaneous fine needle aspiration under CT guidance and revealed local a recurrence of the renal cell carcinoma. This was removed without any problems. Two years later, no pulmonary metastases have been noted despite, the fibrinolytic therapy.

Carcinoma, Renal Cell↗

[Role of chemotherapy in the treatment of cancer of the testis in adults].

Owing to its considerable effectiveness, modern multiple chemotherapy ranks first in the treatment of non-seminoma metastatic tumours of the testis. Its side-effects in short-term treatment are recognized and acceptable in view of the results obtained, but they remain imperfectly known in long-term treatments. Fort this reason, the present tendency in clinical stage I non-seminoma tumours is to reserve chemotherapy for patients who relapsed after orchidectomy. Advanced seminomas with or without high levels of human chorionic gonadotrophin (subunit beta) already benefit from chemotherapy, and this treatment is likely to be extended to less disseminated forms of cancer. Pure or predominant choriocarcinomas still respond poorly to the cytotoxic drugs at present available.

Adult↗

Correlations between radiography, ultrasonography, computed tomography and pathologic findings in prostatic disease.

A total of 20 macroscopically normal or hypertropic prostates were taken from cadavers of men older than fifty, who died of causes other than urologic ones. The samples were studied in vitro by nonscreen x-ray films, ultrasonography, computed tomography, and then by a pathologist. There were 4 normal prostates, 12 with benign prostatic hypertrophy, 3 with carcinoma, and 1 with prostatitis. Conventional radiography which showed only prostatic calcifications was of no pathologic interest. Computed tomography is by no means of diagnostic use in distinguishing between benign prostatic hypertrophy and carcinoma, and should be used only as an alternative in the evaluation of regional extension of prostatic carcinoma. On the other hand, ultrasonography appears to be sensitive to detection of very small nonpalpable nodules. However, its specificity is poor and its use should be restricted as a guide in obtaining biopsy specimens or as a means of evaluating tumor volume.

Aged↗