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Biomedical subjects

B Dufour

Publications and source records attributed to B Dufour.

At least 73 records · Page 4Linked to original sources
PubMed1991

[Preoperative radiotherapy with concomitant chemotherapy in the treatment of infiltrating cancers of the bladder].

The ratio of disappearance of bladder tumors after conventional irradiation (i.e. 45 Gy) is about 30-40%. At least this is the percentage resulting from the study of specimens obtained with total cystectomy, a procedure that remains the usual treatment of these infiltrating cancers. For 30 patients (29 T3 and 1 T2), we have implemented a radio-chemotherapeutic procedure associating 24-Gy radiation to a sensitizing chemotherapy from D1 to D3 and from D15 to D17. Complete response was obtained in 75% of all patients. In one half of the cases in which the response was total, we abstained from removing the bladder, and have noted no signs of recurrence so far.

Adult↗
PubMed1991

[Long-term results of angioplasty balloon dilatation of stenosed uretero-digestive anastomoses. Effect of prolonged pattern with large caliber prosthesis].

UNLABELLED: 16 strictured uretero enteric anastomoses were dilated and stented for 4 months with a large size stent (18F in fifteen cases and 14F in one case). All the patients had undergone a radical cystoprostactectomy, had received radiotherapy prior to surgery. The length of the stenosis did not exceed 3 cm in all cases. All the stenoses occurred within 2 years following the removal all of the stent. RESULTS: 6 cases (37%), have a patent anastomosis, 18 to 36 months following removal of the stent. Most of the recurrences occurred within six months following removal of the stent. We recommend a long term stenting with a large size stent to obtain long term patency of dilated anastomotic strictures.

Anastomosis, Surgical↗
PubMed1991

[Accidental diagnosis of cancer of the renal parenchyma in adults].

We have reviewed the files of 145 patients who had presented with cancer of the renal parenchyma between March, 1985, and May, 1990. In 30.4% of cases, these cancers were discovered incidentally, ie. before the occurrence of any suggestive symptoms. In 66.7% of cases, the credit for this early detection was due to the ultrasound study prescribed by the attending physician within a general health assessment or the follow-up of some other disease. The early diagnosis allowed treating cancers at a less advanced stage, with a significant difference (p less than 0.05), which will probably improve their prognosis.

Adenocarcinoma↗
PubMed1991

[Magnetic resonance imaging and preoperative evaluation of cancer of the kidney. The results apropos of 60 cases].

Sixty renal carcinomas confirmed at surgery or autopsy were studied. Capsular effraction, present in 17 cases, was well assessed in 8 cases, under staged in 8 cases and over staged in 5 cases (sensitivity 47%, specificity 88%). Renal vein involvement was present in 11 cases. In 8 of these 11 cases, a thrombus was present in the inferior vena cava. MRI detected a thrombus in the renal veins in 10/11 cases and in 7/8 cases of caval invasion. The false negative case was due to a huge right upper pole tumor laminating the inferior vena cava. The false positive case was due to an enlarged lymph node compressing the inferior vena cava. Cranial extension of the thrombus was well assessed in 6 of the 7 cases. One thrombus in the right atrium was missed. Lymph node involvement was present in 10 cases and correctly diagnosed by MRI in 7 cases. Three false negative cases were noted, because of microscopic invasion in non enlarged lymph nodes. Adjacent organ invasion, present in 2 cases, was detected in 1 case of liver invasion. Initial results of MRI seem very promising and at present, the best indications of MRI in pre-operative evaluation of a renal carcinoma are assessment of caval extension and spread to adjacent organs in patients with large tumors.

Adult↗
PubMed1991

[Use of papillotome for antegrade treatment of ureteral stenoses and uretero-ileal anastomotic strictures under radioscopic control. Experimental study in dogs and clinical application].

A new technique of electro-incision of ureteral stenoses and strictured uretero-enteric anastomoses is presented. Incision is performed with a papillotome, routinely used to achieve endoscopic retrograde sphincterotomy of the duodenal papilla. Group I: 7 ureteral stenoses were performed, on a dog model after surgical ligation of the lumbar ureter. Ten days later, through a percutaneous approach, the papillotome was placed through the stenosis, deflected, and cutting current was applied to incise the stenosis. The IVP performed one month later showed disappearance of the stenosis in 4 cases, a residual stenosis without obstacle in 2 cases and a residual stenosis with obstacle in one case. Group II: 7 strictured uretero-enteric anastomoses on 6 patients. After placement of a percutaneous nephrostomy, a wire guided papillotome was placed into the stenosis. Cutting current was then applied to cut the stenosis. A 18 F ureteral stent was subsequently placed for 8 weeks. Two patients have a patent anastomosis, 7 and 10 months after removal of the stent. One patient died from metastases of bladder tumor. The three remaining patients are still stented. An urinoma occurred in one patient the day following removal of the stent, and was surgically drained. This new technique which combines electro-incision and stenting with a large caliber stent may be proposed as an alternative to surgery or balloon dilatation for the treatment of strictured uretero-digestive anastomoses.

Anastomosis, Surgical↗
PubMed1990

[Cancer of the kidney: venous staging using magnetic resonance imaging].

Venous tumor invasion in 42 renal cell carcinomas was evaluated by MRI. A correct diagnosis of renal vein and inferior vena cava (IVC) involvement was made in 14 of 17 tumors: 1 false negative diagnosis of right renal vein invasion was due to a double renal vein in which the inferior vein (identified by MRI) was not involved; 2 cases of IVC involvement were understaged (1 case of suprahepatic extension) or not identified (the false negative of renal vein invasion previously described). One false positive (among 31 tumors without venous invasion) was reported in a case of a large tumor in which the compressed but free right renal vein was overevaluated by MRI.

Carcinoma, Renal Cell↗
PubMed1989

[Initial resistance to streptomycin, isoniazid, thiacetazone, rifampicin and ethambutol in bacilliferous tuberculosis in Maniema, Zaire].

Initial resistance to streptomycin, isoniazid, thiacetazone, rifampicin and ethambutol was tested in 102 patients with bacilliferous tuberculosis in Kalima, a rural area in eastern Zaïre. The initial resistance for at least one of these tuberculostatics was 43%. The highest resistance recorded was for streptomycin (31%). No resistance to rifampicin or ethambutol was found. The practical interest of these findings is discussed.

Antitubercular Agents↗
PubMed1989

[Percutaneous treatment of abscess of the kidney and retroperitoneum].

Twenty eight abscesses or infected liquid collections located in the kidney or in the retroperitoneum were drained percutaneously. The abscesses were located in the renal parenchyma in most cases (14 cases), in the anterior pararenal space in 3 cases and in the iliopsoas muscle in 9 cases. In all cases, the drain was inserted under TV monitoring after needle puncture, which was most often guided by ultrasound. The percutaneous treatment was successful in 82% of all cases. Among the 5 unsuccessful attempts, 1 case of duodenal fistula required surgical treatment while the anterior pararenal abscess was effectively evacuated by the inserted drain, and 1 case of infected hydatid cyst was treated surgically immediately after the percutaneous needle puncture. Drainage is the first-line method for the treatment of abscesse of the kidney and retroperitoneum. It requires an appropriate technique and strict follow-up, which allow healing the lesion in most cases.

Abscess↗
PubMed1988

[Endoscopic transvesicoparietal exteriorization of ureteral catheters].

Endoscopic introduction of catheter into the ureter for drainage has long been a common procedure, and recent advances in endoscopic urology have widened its indications. The ureteral catheter is usually exteriorized through the urethra and attached to the urethral catheter, but with this technique it tends to descend spontaneously and to create infections which are a possible cause of ureteral stenosis. A technique of endoscopic transvesicoparietal exteriorization of ureteral catheters without incision has been developed in 1982. The problems encountered in exteriorizing the ureteral catheter through the lumen of a suprapubic trocar have now been solved by using a bipodal forceps introduced into the trocar.

Endoscopes↗
PubMed1988

[Tumor grafts in the upper urinary tract secondary to tumors of the bladder epithelium].

A retrospective study of cases seen between 1975 and 1985 showed 24 tumors of upper urinary tract secondary to primary bladder localizations. These secondary localizations developed during evolution of multi-resected recurring bladder tumors, within a mean period of 15 months after discovery of a secondary vesicorenal reflux. This reflux is acquired constantly during the course of these tumors and it is undoubtedly responsible for the onset of these upper tract tumoral grafts. These findings suggest the need for urographic surveillance combined with regular endoscopic examinations of patients with bladder tumors, for prevention of reflux during endoscopic resections and for treatment of any reflux detected.

Humans↗
PubMed1988

[[Neoadjuvant chemotherapy (cisplatin, doxorubicin, cyclophosphamide) in the treatment of invasive urothelial tumors of the bladder. Preliminary results of a prospective study concerning 22 patients].

Twenty two patients with transitional cell bladder carcinoma (T greater than or equal to 2 Mo) received 2 or 3 courses of systemic chemotherapy (cyclophosphamide 600 mg/m2, doxorubicin 60 mg/m2, cisplatinum 100 mg/m2) prior to total (18) or partial (18) cystectomy. Response rate was appreciated on the pathologic findings of the surgically removed bladders (pTNM): 5 tumor progression (23%); 8 tumor stability (36%); 3 partial remission (14%); 4 complete remission (18%), 2 pTo after complete transurethral resection (9%). These results lead us to conclude that: the rate of tumor progression and stability was too high. Further experience will require a more effective preoperative treatment; clinical staging dramatically underestimates tumor spread; prognosis of non responders is quite poor: 7 deaths with a maximum follow-up of 6 months.

Adult↗
PubMed1987

[Benign prostatic hypertrophy. Surgical treatment. Value of surgery by a high approach].

Transurethral resection of the prostate is not a new procedure for the treatment of adenoma of the prostate but is being increasingly used. This fact is incontrovertible and all urologists perform transurethral resection for small adenomas. For large adenomas we still believe surgical removal is the best method. The results of resections of the prostate reported in the literature are not good enough to cause us to change our mind (80% good results after one or several procedures with an 8% incontinence rate!). To allow a more accurate evaluation we compared our personal results with surgical removal to the results of resections performed in our unit and reported in the literature.

Aged↗
PubMed1987

[Treatment and course of advanced bladder cancers. Retrospective study of 29 cases].

A retrospective study of 29 patients with extensive but non metastatic bladder cancer (T234N+ M0) demonstrated once more the dreadful prognosis of advanced bladder cancer. Only 4 patients are alive without evidence of recurrence with a follow up of 12 to 64 months. The 11 patients whose tumor was too extended for radical cystectomy had a similar survival rate and better quality of survival than the 18 patients who underwent total cystectomy. Recurrence appears quickly (mean time : 11 months) and is mostly metastatic. This study led us to change our therapeutic attitude. We now use systemic preoperative polychemotherapy and we no longer perform radical cystectomy in bulky nodal metastasis.

Adult↗
PubMed1986

[Extensive nephrectomy in severe forms of cancer of the kidney in the adult].

Resection of renal tumours may be useless when the staging procedures reveal that the disease is too far advanced. A retrospective study of 100 radical nephrectomies for renal cell carcinoma distinguished the following groups: advanced cancers in young patients; cancers in patients over the age of 70 years. Despite the limited follow-up of this series, the study of survival demonstrates the following points: the difficulty of predicting the degree of lymph node involvement on pre-operative staging, the value of an anterior sub-costal and abdominal approach which facilitates radical nephrectomy in elderly and fragile patients, the poor prognosis of lymph node invasion and metastases, although some patients have survived for 12 months after resection of metastatic tumours.

Adult↗