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Biomedical subjects

D Valleix

Publications and source records attributed to D Valleix.

54 records · Page 3Linked to original sources
PubMed1991

[Totally implantable venous access sites. Results of a series of 101 cases].

The authors report their results of the use of 101 totally implanted venous access systems for chemotherapy in 92 patients. They stress the high incidence (19.8%) of complications: thrombosis 6.8% and 6.9% linked to the material. The correct complication rate must be decreased by strict attention paid to the surgical procedure, use and greater education of the nursing staff. The value of this material is to give greater comfort to patients and to assess its widespread use for intensive long-term chemotherapy.

Adult↗
PubMed1989

[Double cystic duct. Apropos of a case].

In relation to a case of duplicated cystic duct encountered in surgical practice and based on a review of the literature, the authors stress the rarity of this condition. After reviewing the classification of the accessory hepatic ducts, they emphasise the surgical consequences of failure to recognise this type of anomaly during cholecystectomy.

Aged↗
PubMed1989

[Cystic dilatation of the common bile duct initially treated by cystojejunostomy and reoperation 25 years later because of infectious and lithiasic complications].

A case of cystic dilatation of the common bile duct is reported. Initially treated by Roux-Y cystojejunostomy, twenty five years after, the patient presented a cholecystitis. This patient was treated by cholecystectomy and a few months after by excision of the cyst with Roux-Y hepato-jejunostomy. This attitude is proposed to avoid the complications of the cystic dilatation of the common bile duct: secondary biliary cirrhosis, angiocholitis, and malignant degeneration.

Adult↗
PubMed1987

Ultrasonographic anatomy of the liver.

Two characteristics of the ultrasonic image, that it is rebuilt and non figurative in its details, led us to establish specific relationships between anatomic structures and their ultrasonic images. The anatomic study was made on fresh, injected, frozen, livers, sectioned along the classical echographic planes. The echographic study was conducted in healthy patients, without any hepatic lesions. The results fall under three heads: analysis of the basic structures (portal vein, hepatic vein, and bile ducts) enables to establish perfect relationship between the anatomic and echographic features; the echo-anatomic study of the echographic planes pertaining to percutaneous examination of the liver provides a satisfactory correlation between the anatomy and the ultrasonogram; analysis of the hepatic vascular arrangement enables to define a sectorial systematization of liver structure. Segmental systematization of the right side of the liver is more difficult to define because of the virtual limits of the upper and lower segments of the right paramedian and lateral sectors. This study leads to better echographic understanding of the liver and to a tentative systematization essential to the localization of focal hepatic lesions.

Bile Ducts↗
PubMed1987

[Endometriosis localized in the sigmoid. Apropos of a case].

Colic endometriosis is a classical but rare localization. The authors present one case treated by partial colectomy associated with a total hysterectomy and preservation of ovarian parenchyma. The hysterectomy was necessary because of adenomyosis and inflammatory adhesions undissociable from the sigmoid.

Adult↗
PubMedDate not supplied

[Inferior mesenteric arteriovenous fistulas. Report of a case].

We report a case of postoperative inferior mesenteric arteriovenous fistula. Arteriovenous fistula represents a rare disease. Symptoms are due to portal hypertension and distal ischemy. Treatment of these fistulas is embolization. Surgery is possible by ligature or excision of the fistula because vascularisation is obtained by Riolan arcade and hypogastric artery.

Arteriovenous Fistula↗
PubMedDate not supplied

[Cecal volvulus].

The cecum is the second most common site of colonic volvulus after the sigmoid. The mechanism is torsion or hyperflexion of the enlarged, poorly-fixed, and hypermobile cecum. It presents clinically as an acute bowel obstruction with strangulation. Diagnosis can be made by plain abdominal X-ray in more than half the cases on the basis of cecal distention (with a classical "teardrop" or "comma" appearance), proximal small bowel distention with air-fluid levels, and a gasless distal colon. Barium enema shows lack of filling of the cecum, often with a "beaked" termination of the column of contrast. CT images are pathognomonic when they reveal a cecal "vortex". After surgical reduction of the torsion, ileo-cecal resection is usually the best therapeutic alternative. Cecopexy may be aDDrouriate in older and debilitated Datients if there is no concomitant cecal necrosis.

Barium↗
PubMedDate not supplied

The value of fibrin sealant in thyroid surgery without drainage.

Fibrin sealant is widely used to achieve complete hemostasis in many fields of surgery. A retrospective review of the surgical management of 81 patients with thyroid diseases between 1992 and 1998 was undertaken to determine if drainage after thyroid surgery could be safely avoided and substituted by fibrin sealing before closure of the wound. Complications were few and resulted in one patient with hoarseness, four minor oedemas and one case of unexplained fever during 48 h. The subjective discomfort from the collar incision was unusual and aesthetic healing was obtained in most of the cases (93.8%). These results suggest that the application of fibrin sealant can be advocated in thyroid surgery as an adjunct to a good surgical procedure and perhaps that prophylactic drainage is unnecessary.

Adolescent↗
PubMedDate not supplied

[Value of Tissucol in cervical anastomosis of esophagoplasty].

There is an important fistula rate associated with the cervical anastomosis of oesophagoplasties. The authors report their experience with reinforcement of these anastomoses by adhesion using a fibrinogen based biological tissue glue. They propose that this technique be used in all high risk anastomoses, in particular, for those affecting a non peritonealized section of the digestive tract.

Anastomosis, Surgical↗
PubMedDate not supplied

[Voluminous retroperitoneal liposarcoma. Apropos of a case and review of the literature].

The authors report a case of bulky retroperitoneal liposarcoma (6 kg) in a 42-year-old woman. This observation of liposarcoma is interesting in that diagnosis was incidental during check up for recent hypertension. The diagnosis was suggested by ultrasonography, essentially computed tomography and suspected by multiple subcutaneous lipomas. Treatment was exclusively surgical with complete tumor resection including the left adrenal gland. The authors review literature data of retroperitoneal liposarcoma. Because of frequent recurrency, follow-up of tumor resection must be made by CT scanning every six months. An aggressive surgical approach including adjacent organs if necessary and total excision of local recurrencies can improve long-term prognosis. Postoperative adjuvant radio- and/or chemotherapy does not effect survival.

Adult↗
PubMedDate not supplied

[Total gastrectomy and viscerosynthesis].

A retrospective study of 134 total gastrectomies performed between 1982 and 1992 was conducted with regular follow-up. There were 96 males and 38 women (mean age 66.66 years, range 27-82). The indication for total gastrectomy was malignant tumour (n = 115), mostly adenocarcinoma (79.1%, 91/115) with 7 cases of stump degeneration after partial gastrectomy (5.2%) and benign lesions (n = 19), mostly gastric ulcers. Gastrectomy was associated with node dissection in 53 cancer cases (47.8% 53/115) and dissection of neighbouring organs in 16 patients. Y anastomosis with circular mechanical suture was performed in 78 cases (62.9%) with pre-stapling in 30 (38.5%). Operative mortality was 8.2% (11/134). The oesophagealjejunal disunion occurred in 7/133 patients (5.3%) including two fatal cases. Early reoperation was necessary in 10.5%. Long-term follow-up for 2 to 12 years in 119 patients gave the following data. For malignant tumours: 5-year survival rate 10.1% (n = 8), recurrence an anastomosis 6.3% (n = 5), distant recurrence 28.2% (n = 21). For all patients sequellae were: reflux oesophagitis 8.1% (n = 10), stenosis of the anastomosis 7.3% (n = 9) requiring late reoperation in 2. The quality of life was considered satisfactory by 28.57% (n = 8) and good in 39.29% (n = 11). These results were compared with those reported in the literature and led to the conclusion that the general view as to the gravity of gastrectomy should be reconsidered in light of the progress in viscerostapling.

Adenocarcinoma↗
PubMedDate not supplied

Major liver resections without vascular clamping: retrospective study of 84 cases.

BACKGROUND/AIMS: The question as to whether vascular clamping aggravates mortality and morbidity of major liver resection was investigated in this study. Major liver resection with vascular clamping for parenchyma transection has mortality between 0 and 5%, and higher morbidity reaching 47% with healthy liver in recent report. METHODOLOGY: Eighty-four major liver resection without vascular clamping were carried out between January 1986 to December 1996 were reviewed. There were 57 men and 27 women with average age of 58.2 (12.2) years old. Indications of resection were adenoma (4.8%) angioma (11.9%) focal nodular hyperplasia (1.2%) hematoma (1.2%) metastases (60.7%) hepatocellular carcinoma (14.3%) and cholangiocarcinoma (5.9%). Resections used ultrasonic dissector (Sonoca) with intraoperative ultrasonography were right hepatectomy in 56 cases extended right hepatectomy in 10 cases left hepatectomy in 17 cases and middle hepatectomy in 1 case. Remnant liver was cirrhotic in 3 cases. RESULTS: Three patients died (3.5%) and the rate of major complications were 11.2%. 46 patients (54.8%) had no blood transfusion. The mean of blood transfusion was 1.5 (2.7) units. The mean of operative length was 286.23 (63.3) minutes and the mean hospital stay was 15.8 (8.1) days. Liver function tests are same with the others authors at day 1, 4 and 7 after operation with return to normal value after 1 week. CONCLUSION: In major liver resection, vascular clamping is not always necessary.

Blood Loss, Surgical↗