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Biomedical subjects

A Pans

Publications and source records attributed to A Pans.

7 recordsLinked to original sources
PubMed1995

The impact of renal revascularisation on renal dysfunction.

AIM: To determine the value of kidney revascularisation in patients with impaired renal function and correctable renal artery stenosis, the authors reviewed their surgical experience from 1978 to 1990. PATIENTS AND METHODS: The study population included 23 patients with ischaemic nephropathy whose preoperative baseline creatinine level exceeded 20 mg/l (range 21-65 mg/l). This represents 20% of all patients operated on for renal artery disease during the same time interval. Preoperative risk profile, operative mortality, impact on hypertension and on renal function, and late survival were analysed. Renal function response to kidney revascularisation was defined as favourable (20% or more reduction of serum creatinine), moderate (stabilised serum creatinine values) or bad (further deterioration of renal function). All patients had atherosclerotic renal artery disease, involving a solitary kidney in five, both kidneys in 15 and one of the two kidneys in three patients. Hypertension was present in 74%. Revascularisation was unilateral in 10, bilateral in nine and associated with controlateral nephrectomy in four patients. RESULTS: Four patients died postoperatively (three myocardial infarctions, one stroke). Four patients needed postoperative short-term dialysis. After operation, renal function improved in 13, stabilised in six and deteriorated in four patients (of whom two died). Follow-up among the survivors averaged 46 months. The mean serum creatinine value at last follow-up visit was 26.2 mg/l, a decrease of 7.7 mg/l compared to preoperative values (p < 0.05). Overall, 69% of azotemic patients submitted to renal revascularisation manifested a favourable response (45% improved and 24% stabilised). Three patients required long-term dialysis. The 5-year survival rate was 48%. CONCLUSION: These data suggest that kidney revascularisation in patients with ischaemic nephropathy can restore or stabilise renal function, preventing evolution and end-stage renal disease and dialysis dependency.

Chronic Disease↗
PubMed1992

A comparison of intraperitoneal prostheses for the repair of abdominal muscular wall defects in rats.

We compared the tissue response to the intraperitoneal implantation of three different prostheses (Gore-Tex, Mersilène, Vicryl-Mersilène) used to repair abdominal wall defects in rats. Vicryl-Mersilène is a new experimental prosthesis made of Dacron (Mersilène) coated with absorbable polyglactin (Vicryl). The least amount of adhesions to omentum and gut was found with Mersilène. Gore-Tex was responsible for the accumulation of neutrophils rather than macrophages mostly collected in close contact with Mersilène and Vicryl-Mersilène. Fibrosis, evaluated by histology and computerized morphometry, was mostly found with Vicryl-Mersilène. This should allow a better incorporation of Mersilène and a tighter anchorage to the abdominal wall, after Vicryl resorption.

Abdominal Muscles↗
PubMed1992

[Acquired diverticulosis of the small bowel].

The authors report about their surgical experience? On the basis of one case of pneumascos and one case of gastrointestinal hemorrhage with collapse, for which no origin was found preoperatively and which was attributed to the presence of diverticula in the small bowel. The analysis of the literature shows that this rare condition (0.1% of the population) is mainly expressed as acute complications: diverticulitis, perforation, hemorrhage, obstruction. The treatment is surgical as a rule, but it can be medical if the condition is included in the scope of a malabsorption syndrome.

Aged↗
PubMedDate not supplied

[Transsection of the cervical trachea secondary to a closed injury. Apropos of a case].

The successful surgical management of a case of complete blunt traumatic transection of the cervical trachea is reported. The management of this rare pathology is a real challenge for the surgeon with regard to early recognition of the lesion and proper therapeutic strategy. Except in case of respiratory distress and/or major laryngotracheal lesions, where urgent tracheotomy is recommended, diagnostic fiberoptic bronchoscopy should be performed to assess the lesions. Guided intubation can also be contemplated. It seems however more prudent to explore the trachea surgically under mask or IV (Ketalar) anesthesia with maintenance of spontaneous breathing. During this exploration intubation can be guided by the surgeon and general anesthesia be initiated. In cases of complete transection, end-to-end anastomosis using absorbable sutures, avoidance of protective tracheotomy and postoperative low-dose steroids seems to be the treatment of choice to avoid stenotic sequelae. If a postoperative stenosis occurs, it should be treated by laser before contemplating surgical correction.

Adult↗
PubMedDate not supplied

[Surgical treatment of incarcerated inguino-crural hernia with interposition of a preperitoneal prosthesis].

For the last four years, 17 inguinal and femoral strangulated hernias have been treated at our institution by a median subumbilical incision. In all cases, a prosthesis has been placed by preperitoneal approach. An intestinal resection for irreversible necrosis has been performed in five patients. This procedure gives good control of the herniated organs, allows easy intestinal resection and good management of unforeseeable situations. The surgical exploration of the other hernial orifices and, if needed, their simultaneous treatment can be performed. Intestinal resection does not represent, in our opinion, an absolute contra-indication to the implantation of a prosthesis. In our study, the morbidity does not seem to be increased.

Adult↗
PubMedDate not supplied

[Gallbladder volvulus].

We report two new cases of gallbladder volvulus. This rare condition principally affects elderly patients but is due to a congenital malformation related to the presence of a long mesocyst. Various factors such as kyphoscoliosis, multiparity and peristalsis of neighbouring organs favorise the occurrence of volvulus, the role of lithiasis is debatable. The diagnosis may be suggested on ultrasound but is most often confirmed at laparotomy. Diagnosis should be made rapidly in order to avoid progression towards a potentially fatal secondary peritonitis. Certain clinical elements such as the presence of a "floating mass" on palpation may suggest the diagnosis.

Aged↗