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Biomedical subjects

D Gossot

Publications and source records attributed to D Gossot.

At least 109 records · Page 6Linked to original sources
PubMed1986

[Retrosternal esophagoplasties by gastric upturn. Functional value].

The functional results in 13 cases of retrosternal oesophagoplasty by gastric upturn were compared with those obtained in 20 retrosternal oesophagoplasties by interposed colon and with published data concerning intrathoracic isoperistaltic reconstructions. Nine patients were examined by radiocinematography and 6 by radioisotope scanning to evaluate the speed of passage through the neo-oesophagus and the quality of gastric emptying. It appeared that gastric emptying took place within normal delays. Signs of reflux were observed in 9 of the 13 patients, but the problem did not seem to be worse than with isoperistaltic reconstructions.

Esophagoplasty↗
PubMed1986

[Perforations of the thoracic esophagus. Apropos of 14 surgical cases].

The authors report the datas of 14 patients with perforation of the esophagus who underwent surgical treatments. Three patients died (21%). Various technics have been used, but a new personal one consisting in stappling the cervical esophagus--and sometimes the lower end in the chest-is brought forward. The last six patients who underwent this technic healed. Five out five have got a spontaneous repermeation of the esophagus. The sixth healed after fiberendoscopic dilatation.

Adolescent↗
PubMed1986

[Gastropericardial fistula. Late complication of the treatment of hiatal hernia].

An exceptional case of gastropericardial fistula is reported, the lesion developing from a gastric ulcer on an antireflux valve instituted ten years previously. A literature review showed 31 similar cases: 14 gastropericardial fistulae, 16 esophagopericardial fistulae and one jejunopericardial fistula. Three features common to all these fistulae were determined: the frequency of hiatus hernia in the genesis of these lesions, either from an ulcer on esophagitis or herniated stomach or from surgical complication; the extremely high mortality of these fistulae (68% mortality); the need for aggressive treatment.

Aged↗
PubMed1985

[Fatal hematemesis due to erosion of a retro-esophageal right subclavian artery by an esophagogastric tube].

A case of fatal haematemesis due to erosion of a retro-oesophageal right subclavian artery by a nasogastric tube is reported. In view of this exceptional but extremely serious complication, no oesophageal tube should be used in patients known to have this abnormal anatomical arrangement. Systematic treatment of aberrant subclavian arteries should perhaps be considered when it can be performed during thoracic surgery.

Aged↗
PubMed1985

[Vascular malformations of the digestive tract: a cause of severe digestive hemorrhage. Apropos of 2 cases].

We report on two cases of angiodysplasia of the digestive tract complicated by serious acute bleeding. The preoperative diagnoses were made by angiography. One case concerned a voluminous jejunal lesion which was macroscopically visible; the other concerned a punctiform lesion detected only by angiography and not found on the pathology specimen. The authors insist on the potential gravity of these angiodysplastic lesions, the necessity to perform an emergency celio-mesenteric angiogram when confronted with a serious digestive tract hemorrhage non-explained by conventional methods of exploration when they can be performed.

Adult↗
PubMed1984

[Cystic teratoma of the diaphragm. Apropos of a case, review of the literature].

Benign tumors of the diaphragm are rare lesions. The cystic teratoma of this muscle is an internal axial tumor, a benign dysembryoma, and only 4 cases could be found in the published literature. The cystic teratoma reported was discovered fortuitously during investigation of hypertension. It was located in the diaphragm above the psoas arch.

Adult↗
PubMedDate not supplied

Thoracoscopic dissection of the esophagus: an experimental study.

In order to reduce the respiratory morbidity of thoracotomy in esophageal surgery, several methods have been used, such as blunt dissection and endoscopic dissection through mediastinoscopy. It seems that the latter reduces drastically the morbidity but does not allow full visualization of the esophageal wall, a disadvantage in some circumstances. We describe a thoracoscopic dissection of the esophagus which gives a large and magnified view of the pleural cavity, of the mediastinum, and of the esophagus.

Animals↗
PubMedDate not supplied

[Vicissitudes of the surgery of primary hyperparathyroidism].

The difficult and disappointing cases encountered in patients who were operated upon for hyperparathyroidism between 1960 and 1987 have been studied. Ninety two patients underwent negative cervicotomy. Among the 12 patients who underwent a second operation, 4 were found to have cervical adenomas and in 6 others mediastinal adenomas were discovered by sternotomy. Most of the other cases were diagnostic errors. The present frequency of negative surgical operations is very low: 2 to 3 per cent of the cases; errors of diagnosis are exceptional, and the unusual sites of adenomas are better known. Seventeen patients were reoperated upon for persistent or recurrent hypercalcaemia despite excision of a 1st parathyroid lesion; 3 cancers which had been mistaken for adenomas at the 1st operation; 6 had a 2nd adenoma which had passed unnoticed during an exploration that was probably too limited and as hypercalcaemia persisted all 6 were reoperated upon with success at different intervals; finally, 8 patients had undiagnosed primary hyperplasia (as part of polyadenomatosis in 5 cases). Recurrences were observed, often after a long period, up to 3 to 5 years. Hypercalcaemia was corrected by the 2nd operation in only 5 out of 8 cases. In retrospect, it was found that the pathological examination could not always determine if the lesion was malignant or distinguish between adenoma and glandular hyperplasia.

Adenoma↗
PubMedDate not supplied

[Periarteritis nodosa complicated by intrapancreatic vascular rupture].

Clinical pancreatic manifestations are unusual in polyarteritis nodosa. A case of intrapancreatic hemorrhage due to vascular rupture occurring during the course of histologically proven polyarteritis nodosa is described. The patient presented with massive hemoperitoneum requiring emergency laparotomy. Splenopancreatectomy was performed to control bleeding. Steroid therapy was continued during the postoperative course, with favorable outcome. The mechanism of vascular rupture is not clear, but is probably related to focal arteritis with consequent infarction. No ruptured microaneurysm was found in this case.

Arteries↗
PubMedDate not supplied

[Protection of cervical anastomosis after retrosternal coloplasty by an resorbable collagen impregnated lattice].

One of the main problems of retrosternal oesophagoplasty is the frequent fistulization of the cervical anastomosis. In 27 consecutive patients we protected the cervical anastomosis by means of a new absorbable polyglactin 910 mesh impregnated with collagen. The mesh, which was 3 cm wide and 4 cm long, was applied on two-thirds of the circumference of the anastomosis. A comparison between these patients and a series of 27 consecutive patients with unprotected cervical anastomosis showed a fall in fistulization rate from 41% to 14%, the difference being significant (P less than 0.05). No complication due to the use of this material was observed.

Adolescent↗
PubMedDate not supplied

[Retrosternal coloplasties: contribution of postoperative mesenteric arteriography].

Postoperative mesenteric angiograms were obtained after substernal coloplasty (SC) in fifteen patients, 8 male and 7 female, aged from 18 to 61 yrs old (mean = 34 yrs old). The aim of this study was to determine whether: 1) vascularization as assessed by angiography was correlated with the occurrence of cervical complications (fistulae and/or stenosis), 2) postoperative arteriography was of any practical value in this situation. Images obtained were classified into 3 groups according to the quality of vascular visualization. Clinical results were also classified into 3 groups according to whether no, one or two cervical complications were present, respectively. Angiographic and clinical results were concordant in 8 cases and discordant in 7. No definite relationship between the quality of coloplasty vascularization and the quality of clinical outcome was found in this study, but results suggest that retromanubrium compression might play a major role in outcome as visualization of colonic vascularization was obtained in only 9 of 15 cases. When clinical results are poor, characteristic images of ischemia may help in determining the indication for reoperation.

Adult↗