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Biomedical subjects

B Gattegno

Publications and source records attributed to B Gattegno.

At least 19 recordsLinked to original sources
PubMed1992

Urinary tract infection prophylaxis in transurethral surgery: oral lomefloxacin versus parenteral cefuroxime.

The purpose of this study was to compare the efficacy and safety of single-dose oral lomefloxacin and single-dose parenteral cefuroxime for the prevention of urinary tract infection following transurethral surgery. A total of 63 patients were enrolled in this prospective, randomized open-label study, which was conducted at two medical centers in France. Patients were randomized to receive either 400 mg of oral lomefloxacin 2-6 hours before surgery or 1.5 g parenteral cefuroxime 30-90 minutes before surgery. Postoperative clinical evaluation was performed daily, and bacteriologic evaluation included urine cultures performed 24 hours after surgery, just before and 1 day after removal of the indwelling catheter, and 3-5 days after surgery. Another urine culture was optionally performed 1-3 months after surgery. Infection was defined as a urinary bacteria count greater than or equal to 10(5) colony-forming units (CFU)/mL of urine. Of the 63 patients enrolled, 54 were evaluable for efficacy, 27 in each group. The success rate of prophylaxis was 88.9% in the lomefloxacin group and 88.5% in the cefuroxime group (p = nonsignificant). None of the 16 lomefloxacin-treated patients who were re-cultured at 1-3 months was found to be infected. Adverse events were minor in both groups. A single oral dose of lomefloxacin was as efficacious and as safe as a single intravenous dose of cefuroxime for prevention of postoperative urinary tract infection in patients undergoing transurethral surgery.

Administration, Oral↗
PubMed1992

[Sub-venous iliac lymphatic dissection with celioscopy for the staging of prostatic cancer (16 patients)].

Subvenous external iliac lymph node dissection is an essential element for the staging of prostatic cancer. 7 to 30% of patients with intracapsular prostatic cancer have lymph node metastases despite normal imaging examinations. Laparoscopic surgery allows lymph node dissection through a limited incision. Sixteen patients underwent laparoscopic lymph node dissection (LLND) for prostatic cancer. The mean duration of the operation was 100 +/- 50 minutes (35-180 min: 130 minutes for the first nine operations, then 60 minutes for the last seven operations). One patient died on the second day from a cerebral vascular accident. There was one technical failure (pneumoperitoneum leak), one vascular injury, one ureteric injury, one transient paresis of the obturator nerves and one case of perineal lymphoedema. The mean number of lymph nodes removed in bilateral lymph node dissection was 7.5 +/- 2 (14-20) per patient. Three patients had lymph node metastases. The mean hospital stay related to laparoscopy was 4 +/- 2 days with a median of 2 days. Laparoscopic surgery, like any conventional or innovative surgical technique, requires specific training to become safe and effective. It allows complete histological examination of the lymph nodes removed and planning of prostatectomy, which may be subsequently performed through a perineal approach.

Abdomen↗
PubMed1992

[Vesico-ureteral reimplantation on psoas bladder in lesions of the pelvic ureter. Review of 50 patients].

Between 1979 and 1991, the authors performed 50 psoas bladder ureterovesical reimplantations for lesions of the pelvic ureter. 90% of very good results were obtained with this technique at the cost of a low morbidity. This series confirms the influence of previous pelvic radiotherapy on the postoperative complication rate. On the basis of the excellent results in this series, confirmed by those reported in the literature, this technique can be proposed as treatment of choice for lesions of the pelvic ureter when suture-resection or simple reimplantation cannot be performed after failure of endoluminal dilatation in patients with a life expectancy greater than 6 months to one year.

Adolescent↗
PubMed1992

Bladder reconstruction with ileum after cystoprostatectomy for bladder cancer: analysis of the micturition and continence of 44 consecutive patients.

From October, 1987, to August, 1990, 47 patients underwent an ileal low pressure bladder replacement using the Hautmann procedure after radical cystoprostatectomy for bladder cancer. The qualities of micturition and continence were evaluated from a questionnaire mailed to the patients and by urodynamic examinations in 44 consecutive patients over a follow-up period of more than 3 (mean 10.7) months. The 44 patients (100%) were perfectly dry during the daytime and voided every 4 (2-6) h with a micturitional volume of 357 (200-500) ml. Forty-two of the 44 patients had no residual urine. Thirty-three of the 44 patients (75%) were perfectly dry at night with a voiding frequency of 1.5 (0-3). Seven of the 44 patients (16%) were occasionally incontinent (spotting less than 2/week). Four of the 44 patients (9%) had night incontinence and used as external device. Only two patients showed high pressure waves of greater than 50 cm H2O. The maximum urethral pressure was 59.07 +/- 13.6 (30-80) cm H2O. The maximum flow rate was 17.2 +/- 9.7 (4.5-35) ml/sec. The different factors responsible for the new micturitional balance were discussed. With its very good functional results and its ease of performance, the ileal neobladder is, for us, the procedure of choice for bladder reconstruction after cystectomy.

Adult↗
PubMed1991

[Pulmonary carcinomatous lymphangitis of prostatic origin, disclosed by acute respiratory insufficiency, regressing by treatment with an LH-RH agonist].

Carcinomatous lymphangitis of prostatic origin is infrequent and usually carries a poor prognosis. The authors report a case of pulmonary carcinomatous lymphangitis related to a prostatic carcinoma. This case was remarkable for its acute mode of revelation and for its favourable outcome under treatment with LH-RH agonists.

Follow-Up Studies↗
PubMed1991

[Adrenal myelolipoma. Review of the literature and case report].

Adrenal myelolipoma is a rare, benign tumour composed of adipose and haematopoietic cells. It is usually an incidental finding or may present in the form of a complication, the most severe being spontaneous retroperitoneal rupture. Computed tomography is the best examination, providing a preoperative diagnosis in 90% of cases. Adrenal aspiration cytology is useful in the case of a persistent doubt concerning the diagnosis. The principal differential diagnosis consists of an angiomyolipoma of the upper pole of the kidney. The indications for surgical resection are limited to symptomatic tumours, tumours larger than 5 cm in diameter and in the case of a doubtful diagnosis.

Adrenal Gland Neoplasms↗
PubMed1991

[Should adrenalectomy be performed systematically as part of radical nephrectomy for renal cancer? Review of 119 cases].

Systematic histological examination of 119 operative specimens of radical nephrectomies performed for renal cell carcinoma revealed adrenal invasion in 6 cases (5.04%). Preoperative computed tomography visualised the adrenal lesions with a sensitivity of 100%. Adrenal involvement was due to either contiguous invasion (3 cases) or metastatic spread (3 cases). Other visceral or lymph node metastases were detected in every case. The mean survival of patients with an adrenal lesion was 16.5 months. These data and those reported in the literature suggest the value of systematic adrenalectomy as part of radical nephrectomy.

Adrenalectomy↗
PubMed1991

[Functional analysis of micturition and continence after a Hautmann type enterocystoplasty (27 patients)].

Twenty seven patients treated by Hautmann enterocystoplasty completed a detailed questionnaire concerning the quality of their micturition and continence. The mean capacity of the neobladder was 250 cc with a diurnal interval between micturitions of about 3 hours. 79% of patients experienced an urge to micturate. The mean frequency of nocturnal micturition was 1.6. Diurnal continence was perfect in 100% of patients, while nocturnal continence was excellent in 78% of cases and good in 18% of cases, while one patient (4%) suffered from nocturnal incontinence. Hautmann enterocystoplasty is therefore an excellent technique for bladder replacement, ensuring diurnal and nocturnal continence for the great majority of patients.

Aged↗
PubMed1990

[Chemotherapy in cancer of the prostate].

The most classical treatment of metastatic prostatic adenocarcinoma is hormone therapy. Most often, chemotherapy is proposed only when the tumor becomes hormonally unresponsive. But evaluation of its efficacy is impaired by the diversity of inclusion criteria used and by the different criteria of response assessment. Results of randomized, comparative studies show that all cytotoxic agents currently available have a similar response rate (about 30 to 40%). Use of combined chemotherapy does not seem to significantly improve these results. Several others ways have been proposed which attempt to improve the efficacy of chemotherapy (androgen stimulation, priming chemotherapy, adjuvant or neo-adjuvant chemotherapy...) but, most probably, progress will come from the discovery of more effective and selective cytotoxic agents, and not from the increase of clinical trials with the same agents.

Antineoplastic Agents↗
PubMed1990

[Treatment of hemorrhagic cystitis caused by cyclophosphamide using intravesical instillation of potassium alum. Apropos of 5 cases].

Five patients with malignant hemopathies, including four treated by bone marrow transplantation, developed cyclophosphamide-induced hemorrhagic cystitis that failed to respond to the usual treatments. Each was treated by continuous irrigation of the bladder with potassium alum. Hematuria ceased in three patients followed up for 5 to 10 months. A review of the literature confirmed the 75% success rate of this treatment. No local side effects were recorded, but one patient had a single seizure.

Administration, Intravesical↗
PubMed1990

[Hautmann enterocystoplasty. Clinical and urodynamic study in 24 patients].

Twenty-four patients with invasive bladder cancer underwent Hautmann enterocystoplasty. A study of the urinary continence revealed 100 per cent of good results during the day and 87.5 per cent of good results at night. Urodynamic investigation after 3 months revealed that only one patient presented with peristaltic waves and that the postmicturating residual urine volume was always less than 100 cc. There was no mortality in this series. The only uncertainty concerns the long-term outcome of these patients because of the risk of incomplete emptying and distension of the neobladder.

Aged↗
PubMed1990

[Report of a case of malignant vesical pheochromocytoma. Diagnosis and therapy].

Bladder pheochromocytoma is a rare, usually benign bladder tumor. An exceptionally malignant bladder pheochromocytoma is reported with more than 5 years follow-up. The study of our case, and the review of 15 other cases reported in the literature show that surgery is the only effective therapy. Partial cystectomy with regional lymphadenectomy, when feasible is the treatment of choice. Because metastatic occurrence may be late, we emphasize the importance of long term follow-up.

Adrenal Gland Neoplasms↗
PubMed1990

[Treatment of urethral stenosis using a pedicled flap of the scrotal skin. Long-term results in 16 patients].

The scrotal skin is vascularized in part by means of the superficial perineal branch of the internal pudendal artery. This nutrient pedicle, together with the scrotal skin dependent on it, can be isolated. The urethra is approached via the perineum. The stricture is incised longitudinally right down to the healthy area. The scrotal flap and pedicle are mobilized, and then anastomosed along the edges of the urethra. From March 1983 through April 1987, sixteen patients have been operated. Postoperative results: the mean follow-up for the 16 patients is 60 months with extremes of 24 and 66 months. 13/16 patients show good results (81%). 3/16 patients show poor results with recurrence of the stricture localized at the junction of the flap and healthy urethra. Such recurrences have yielded to treatment, in two cases, by optical urethrotomy and, in the other case, by means of a new scrotal flap.

Follow-Up Studies↗
PubMed1990

[Low-pressure enterocystoplasty after prostato-cystectomy for cancer. Apropos of 13 cases].

Thirteen patients were operated for bladder carcinoma, from November 1987 to September 1988, using a Camey type II low pressure ileal bladder replacement. Clinical, radiological and urodynamic findings were studied. Diurnal continence was always acquired at three months. In terms of nocturnal continence, only 75 percent of the patients are comfortable, while two patients require oxybutinin to remain continent. Urodynamic exploration showed a low pressure in 8 patients, but a high pressure peak in 4 patients. Radiological study showed integrity of the urinary tract. This work confirmed the improvement obtained with the Camey II procedure. Nevertheless, it also shows the failure of the method with occasional high pressure peaks. We think that a more anatomical bladder reconstruction, such as Hautmann Pouch, may improve the results for nocturnal continence. This needs to be confirmed by a comparative study.

Aged↗
PubMed1989

[Accidental discovery of renal cancer by ultrasonography].

A retrospective study of 152 consecutive patients admitted for renal carcinoma between January, 1969 and August, 1987 showed that these patients could be divided into two groups, the dividing line being 1980, date of the advent of ultrasonography. Compared with the 68 patients treated between 1969 and 1980, the 84 patients treated between 1981 and 1987 had a significantly greater number of asymptomatic renal carcinomas. The asymptomatic tumours discovered incidentally by ultrasounds were less advanced than the symptomatic tumours, the difference between the 2 groups being highly significant. The diagnosis of asymptomatic renal carcinoma at an early stage suggests that these tumours might have a better prognosis. These data underline the usefulness of a systematic study of the kidney during all abdominal or vesicoprostatic ultrasonographic explorations.

Female↗