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Biomedical subjects

D Gossot

Publications and source records attributed to D Gossot.

At least 91 records · Page 5Linked to original sources
PubMed1989

[Immediate oesojejunal anastomosis after total gastrectomy in caustic necrosis].

Eight patients underwent total gastrectomy for caustic ingestion. Oesophago-jejunostomy was performed in the same surgical session. One patient died from hemorrhage. Only one of the 7 survivors had a benign anastomotic fistula. Five healed without any sequelae, 2 underwent colonoplasty 3 months later, because of a secondary oesophageal stenosis. We conclude that it is feasible, in certain unusual cases, to restore gastrointestinal continuity after total gastrectomy for caustic necrosis: moderate oesophageal lesions (stage I or II) and ingestion of a caustic product that cause few oesophageal damage (acids, liquid chlorine bleach, ...).

Adolescent↗
PubMed1989

[Role of surgery in burns of the upper digestive tract in adults. Apropos of 679 cases].

Surgery is mandatory in severe caustic burns of the upper digestive tract, either as an emergency, or later because of secondary complications. Then, the patients who develop oesophageal stenosis require oesophagoplasty or oesophagopharyngoplasty. The first clinical survey must be performed in a surgery department with an intensive case unit. All patients undergo an oesophageal examination with a fiberoptic endoscope when admitted. Some of them need a fiberoptic bronchoscopy. The authors describe their experience over the 18 years up to now. Over 700 patients were admitted in the same department. The different surgical procedures are given, as well as guidelines for management.

Adult↗
PubMed1987

[Esogastric lesions caused by ingestion of liquid chlorine bleach in adults].

A retrospective study of 193 adult patients who ingested liquid chlorine bleach is reported. This figure represents 37 p. 100 of caustic product ingestions treated in the authors' hospital unit, these being attempted suicides in 85 p. 100 of the cases. All patients had oesophagogastric fibroscopy on the day of the ingestion: serious, grade 2 or 3 lesions were present in 38 p. 100 of the cases. Emergency surgery was necessary in 10 patients for a complication that occurred within the first 3 weeks, and after 2 months in 6 patients to treat a digestive tract stenosis. Compared with the other caustic products, liquid chlorine bleach predominantly creates gastric lesions and may produce digestive tract perforations by secondary necrosis which occurs after a free interval ranging from 2 to 26 days.

Adolescent↗
PubMed1987

Management of caustic ingestion in adults.

The treatment of 484 adults with caustic ingestion injury is discussed. Signs and symptoms are an unreliable guide to injury and a chest X-ray and fibreoptic endoscopy should be performed as soon as possible. All of the 250 patients who developed superficial lesions of the oesophagus, stomach or duodenum experienced healing without sequelae. Forty-four patients required emergency surgery of whom twenty-four died and oesophagectomy without thoracotomy is now advocated for this group, followed by interval surgery to restore continuity. The remaining 190 patients suffered gastric or oesophageal ulceration without necrosis: 92 recovered without complication, 3 succumbed to aorto-oesophageal fistula, 12 survived following delayed surgery for complications and 83 developed oesophageal and/or gastric stenosis which subsequently required endoscopic or surgical treatment.

Adolescent↗
PubMed1987

[Parathyroid microadenomas].

Ten out of 329 cases of hyperparathyroidism operated over a 4 year period had lesions which conformed to the diagnostic criteria of microadenoma. Although small and light weight these lesions all gave rise to complete laboratory work ups and 7 out of the 10 patients had clinical signs. The microadenomas were not easily identified at surgery and the diagnosis could only be confirmed after a thorough histological examination. After resection, all patients seemed to be permanently cured.

Adenoma↗
PubMed1987

[Parathyroid adenoma at an atypical site, ectopic or not].

Of 800 patients undergoing operation for primary hyperparathyroidism between 1960 and 1985, 163 presented parathyroid adenomas located in other than typical sites in normal parathyroid glands. A retrospective study of case-reports is used to demonstrate the value of complementary investigations in the localization of these lesions, and to emphasize certain operative factors indispensable for their detection.

Adenoma↗
PubMed1987

[Is the palliative treatment of cancer of the esophagus by retrosternal bypass justified?].

We report a retrospective study of 52 patients with unresectable carcinomas of the esophagus treated with substernal bypass without resection. There were 49 squamous-cell carcinomas and 3 adenocarcinomas. The site of the tumor was the middle third of the esophagus in 32 patients, the upper third in 9, and the lower third in 11. The diagnosis of inextirpability was made preoperatively in 34 patients and at laparotomy in 18. Thoracotomy was never performed. The bypass procedure was ileocolic in 22 cases and gastric in 30 cases. No patient had postoperative chemotherapy or radiation therapy. The operative mortality rate was 9.6 p. 100 (5 cases) and the hospital mortality was 19.2 p. 100 (10 cases). Morbidity was 46 p. 100. Twenty-two cervical fistulas occurred; 19 closed spontaneously. Eighteen endoscopic dilatations and four reoperations were performed for 22 secondary stenoses of the cervical anastomosis. Median survival rate was 6.2 months. We conclude that substernal bypass is a valuable alternative for palliation of esophageal cancer but that its indications should be limited.

Adenocarcinoma↗
PubMed1987

Early blunt esophagectomy in severe caustic burns of the upper digestive tract. Report of 29 cases.

Caustic ingestion may cause severe necrosis of the upper digestive tract. Of 520 patients admitted in our department for caustic ingestion, 29 (5.5%) underwent emergency esophagogastrectomy because of transmural necrosis. We used a stripping procedure, which was performed through a cervicotomy and a laparotomy. This method allowed 18 patients (62%) to survive. Thus it appears to be a safer technique than open thoracic esophagectomy, which we used in our earlier experience.

Adolescent↗