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Biomedical subjects

D Querleu

Publications and source records attributed to D Querleu.

At least 127 records · Page 7Linked to original sources
PubMed1993

Laparoscopically assisted radical vaginal hysterectomy.

A vaginal or a laparoscopic approach in radical surgery for cervical carcinoma has been proposed. A pilot study of eight cases shows that an oncologic surgeon familiarized with these techniques is able to take advantage of the benefits of both routes in the same patient: laparoscopic surgery is adapted to lymph node dissection, section of the origin of the uterine artery, and dissection of the ureter under direct vision; vaginal surgery allows a precise incision of the vaginal cuff. Both routes may be used for the section of parameters, but we propose the use of the vaginal route. The combination of vaginal and laparoscopic surgery spares the pain and discomfort of both laparotomy and perineotomy.

Adult↗
PubMed1993

Comparison of the Bologna and Ingelman-Sundberg procedures for stress incontinence associated with genital prolapse: prospective randomized study.

It is difficult to make a choice among the many surgical procedures designed for the correction of stress urinary incontinence by the vaginal route because their results have not been correctly compared. The Bologna (B) operation uses two flaps from the anterior vaginal wall that are anchored to the abdominal wall; the Ingelman-Sundberg (IS) operation is a suburethral sling made from two transplants from the pubococcygeus muscle. A prospective randomized study has been carried out in order to compare these two procedures. A selection of cases has been based upon the presence of genuine or potential stress incontinence, genital prolapse and available tissues (anterior vaginal wall excess and palpable pubococcygeus muscles) for both procedures. No significant difference was noted for clinical results (91.7% and 93.7% of patients cured by the B and IS operations, respectively) or for transmission rate gain at 3 months and 1 year. Maximum urethral closing pressure was maintained in both treatment arms. No significant postoperative complication or persistent dysuria occurred. The Bologna procedure is best indicated in case of frank anterior vaginal excess, and the Ingelman-Sundberg procedure when strong anterior parts of pubococcygeus muscles are available. Both are excellent in the cure of stress incontinence associated with genital prolapse.

Female↗
PubMed1993

[Ovarian cysts: strategy and prognosis].

The management of an adnexal masses involves several steps: establish the diagnosis of organic ovarian cyst, avoiding a useless and iatrogenic surgery of a functional cyst, knowing that functional cysts may persist more than 3 months and may occur even on low-dose oral contraceptives; cure painful cysts, by ultrasound guided aspiration of some functional cysts or laparoscopic detorsion of twisted adnexae; exclude malignancy, with the help of ultrasound, Doppler and Ca-125 preoperatively, then laparoscopic examination and pathology; failed diagnosis of cancer becomes rare (1 out of 300 laparoscopic surgeries for ovarian cyst); the association of a benign ultrasound and Doppler pattern and of a Ca-125 lower than 35 mUI/ml is almost pathognomonic of a benign cyst; cure benign ovarian cysts with a minimum of surgical trauma; in our series, 84.4% of ovarian cysts are managed laparoscopically, 11.1% by elective laparotomy, 4.5% by laparotomy after an attempt at laparoscopic surgery (that implies that the patient must be informed of the risk of laparotomy); adapt the surgical technique to the pathologic type and size of the cyst, with a high rate of laparotomy in large dermoid cysts, and a high rate of (salpingo-)oophorectomy in peri or postmenopausal cysts; ensure an adequate therapy of early ovarian carcinomas, avoiding understadification and undertreatment; prevent ovarian cancer by a careful long-term follow-up of patients with benign ovarian cysts and by the use of bilateral oophorectomy in postmenopausal patients.

Aftercare↗
PubMed1993

[Gynecologic cancers and pregnancy. With the exception of breast cancer].

Pregnancy should be a privileged opportunity to detect the two gynecologic cancers which occur most frequently during this period (breast cancer excepted). Their detection during pregnancy doesn't influence the maternal prognosis on condition that an ideal therapeutic protocol is applied. The embryonic and fetal toxicity of anticancerous treatments is known to justify medical pregnancy interruption in some cases, and in others allow their utilization looking forward to fetal viability.

Embryonic and Fetal Development↗
PubMed1993

[Pelvic endoscopic lymphadenectomy in the assessment of early cancer of the uterine neck: survey of 25 French hospital centers].

Accurate staging of invasive cervical cancer is essential to its adequate treatment. Current clinical staging of cervical cancer is inaccurate, particularly for lymph-nodes evaluation. At reduced cost and risks laparoscopic pelvic lymphadenectomy allows accurate detection of lymph-node metastases. Its place in the staging of early cervical cancer is being evaluated. Our inquiry, multicentric and including more than 500 laparoscopic pelvic lymphadenectomies, leads to the conclusion that this technique is accurate and is associated with a reduced but variable morbidity depending on the technique and operator's ability. The implications of the results of laparoscopic lymphadenectomy in the type and modalities of subsequent treatment are discussed.

Female↗
PubMed1992

Folate status during pregnancy: relationship with alcohol consumption, other maternal risk factors and pregnancy outcome.

This study was designed to identify the factors affecting folate status in pregnant women and to explore the relationship between folate status and alcohol consumption during pregnancy. For this purpose, 347 French women were recruited during 1985-1986 on their first visit to the antenatal clinic at Roubaix Hospital (northern France). Alcohol consumption was ascertained by a standardized interview. Folate status assessment was available for 246 pregnant women who were not given folate supplementation. Average folate levels during pregnancy were lower among young women and smokers. Serum folate values diminished with the educational level, and red cell folate values increased with high parity. Unexpectedly, high red cell folate values were strongly related with high alcohol consumption after adjustment for the maternal risk factors associated with alcohol consumption and folate status. This was probably because in the Roubaix region where the study was conducted women consume mostly beer, which contains folates. Pregnancy outcome was not related to folate levels; birthweight was negatively associated with alcohol consumption during the first trimester of pregnancy.

Adult↗
PubMed1992

The effect of tubal injection of methotrexate on fertility in the rabbit.

OBJECTIVE: To investigate the fertility of rabbits after tubal injection of methotrexate (MTX). DESIGN: The side of injection of MTX was randomly decided in a prospective experimental trial. PARTICIPANTS: Fourteen female New Zealand White Rabbits were believed to be of normal reproductive status. INTERVENTIONS: Methotrexate or Ringer's solution were injected into the tubes of the rabbits. The nidation index was used to measure the fertility of the animals. RESULTS: The average nidation index of the control tubes was not statistically different of the one of the tubes treated with MTX. CONCLUSION: Tubal injection of MTX has no adverse effect on fertility of rabbits. It seems ethical to investigate tubal injection of MTX as an alternative to laparoscopic management of unruptured ectopic pregnancy in the human.

Animals↗
PubMed1992

[Ureteral risk in celioscopic surgery].

In recent years, there has been a significant improvement in laparoscopic surgery which had led to more and more frequent use of this technic in various cases. As a consequence, the ureteral injury which have been a less common iatrogenic pathologic up to know is likely to be more and more frequent in the years to come. The authors present 2 cases of 28 and 36 years old patients. In both cases the laparoscopy was indicated for gynecologic pathology. The healing ureteral occurred in those cases during a revealing postoperative peritonitis. Treatment consisted in healing up the lesion by ureteral stent. Treatment and evolution of this injury are discussed.

Adult↗
PubMed1992

[Complications of gynecologic laparoscopy. Multicentric study of 7,604 laparoscopies].

In a series of 7,604 laparoscopic procedures, the authors report one death and a rate of 2.76 per thousand (21 cases) for complications requiring laparotomy. When exclusively diagnostic laparoscopic procedures are considered (1,191 cases) this rate drops to 1.67 per thousand. The likelihood of laparotomy being required is directly related to the degree of importance of the laparoscopic surgical procedure. For major laparoscopic surgery the rate of laparotomy is 4.46 per thousand (18 cases), whereas it is only 0.42 per thousand (1 case) for minor laparoscopic surgery (p less than 0.01). Intestinal injuries represent 52.4% (11 out of 21) of cases requiring laparotomy. The main problem with this type of accident is to recognize them, because in almost half the cases (42.8%; 3 out of 7) the intestinal injury went unseen during the laparoscopic procedure and gave rise to peritonitis. Vascular complications are less frequent and required laparotomy in only 8 cases (38%; 8 out of 21). This low level of complications is yet further proof that laparoscopic surgery is a reliable technique and does not involve a high risk of laparotomy, provided that the surgeon has received specific training.

Female↗
PubMed1992

[Experimental histological study of the local toxicity of intra-tubal injections of methotrexate].

The injection of methotrexate is an alternative to laparoscopic surgical treatment of unruptured ectopic pregnancy. An experimental trial on rabbits was designed to evaluate this new approach. In situ injection of methotrexate does not cause either real tubal epithelial impairment, nor an adverse effect on treated rabbits' fertility. However, sub-peritoneal injections of methotrexate are responsible for a typical histological lesion. These results are discussed emphasising the importance of the way the administration is carried out.

Animals↗
PubMed1992

[Evaluation of spatial discrimination performances of newborn infants with the visual pursuit of structured stimuli].

Pursuit eye movements have been recorded with the photo-oculographic technique from newborn infants during the presentation of stimulations specific for spatial discrimination functions. 72.5 per cent of 51 subjects whose eye movements have been recorded have successfully followed stimuli of spatial frequency up to 0.4 cycles per degree. Estimations of grating visual acuity are similar to those provided by the preferential looking technique.

Eye Movements↗
PubMed1992

[Proximal tubal recanalization by endoluminal laser probe. I. Anatomic results in the female rat].

To evaluate the cicatrization of the uterine horn after the recanalization by endoluminal laser probe, 50 white female rats of Wistar's race have been separated into two groups. The group 1 (nb = 10) had for aim to validated the procedure of obstruction. In group 2 (nb = 40), we performed the recanalization six weeks after the obstruction. Histologic samples were obtained 48 hours, 3 weeks and 6 weeks after treatment. In group 1, we found a complete obstruction in 70% of the cases, and a tight stenosis in 30% of the cases. In group 2, at 48 hour's control after the treatment by laser, we found a drill hole with a blackened look without parietal sequel in 80% of the cases. At 6 week's control, we found a normal lumen with a regeneration of the epithelioma in 85% of the cases. For energy deposition under 30 Joules, we found good results in 95% of the cases. Above 30 Joules, we always found bad results (5 cases on 5).

Animals↗
PubMed1992

[Proximal tubular recanalization by endoluminal laser. II. Functional results in the female rabbit].

To evaluate the function of the fallopian tube after a recanalization by endoluminal laser probe, 34 mature female New Zealand white rabbits have been separated into two groups. The group 1 (nb = 12) had for aim to validate the procedure of obstruction. In group 2 (nb = 22), we performed the recanalization six weeks after the obstruction. The female rabbits underwent a fertilization six weeks after the laser treatment. The results have been appreciated by the ratio nidation/ovulation. In group 1, we valided the procedure of obstruction. In group 2 twelve rabbits on thirteen have been fecundated in the treated tube.

Animals↗
PubMed1991

Laparoscopic treatment of ectopic pregnancies: a one hundred cases study.

From June 1987 to December 1989, 100 ectopic pregnancies (93 patients) were operated on by laparoscopy. The different techniques included salpingostomy, salpingectomy and tubal expression. There were no intra-operative complications or unwanted laparotomy. Only one patient (1%), on the fourth post-operative day, underwent a laparotomy due to an occlusive syndrome. Six failures (9.5%), in cases of conservative treatment were observed including three (16.6%) after tubal expression. The length of operation and hospitalization is similar with regard to the different endoscopic procedures, and shorter than those observed after treatment by laparotomy. These results confirm that laparoscopic treatment of ectopic pregnancies is not only reliable but also significantly less expensive than treatment by means of classical surgery.

Adolescent↗
PubMed1991

[Fertility after conization].

Fertility after conization appears to be normal if all the endocervical gland tissue has not been excised. The miscarriage and premature delivery rates do not appear to be affected either, and cerclage generally seems to be unnecessary.

Cesarean Section↗