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Biomedical subjects

F Fekete

Publications and source records attributed to F Fekete.

At least 91 records · Page 5Linked to original sources
PubMedDate not supplied

What is the place of antrectomy with Roux-en-Y in the treatment of reflux disease? Experience with 83 total duodenal diversions.

Antrectomy with Roux-en-Y gastrojejunostomy was performed in 83 patients with "complicated" forms of peptic esophagitis. The esophagitis was considered complicated either because of the severity of the lesions (stricture, brachyesophagus, or endobrachyesophagus) or because of postoperative conditions after one or more previous operations (Heller's myotomy, esophagogastric resections, or hiatal hernia repair). A standard procedure was performed in 56 patients while technical adjustments were required for 27 patients who had previously undergone surgery. Two patients died from pulmonary embolism. Early postoperative complications occurred in 11% of patients. Healing of esophagitis was observed for all the patients treated with the standard procedures. Six partial regressions and 1 complete regression of Barrett's mucosa were observed. Digestive sequellae were minor and decreased with time. Assessment of pH and small bowel manometry showed that the reflux was controlled and no small bowel motility disturbance was observed when the standard technique was used including a small gastric resection. The main digestive sequellae, including lack of healing of esophagitis, dumping syndrome, and gastrojejunal anastomotic ulcer, occurred when a two-thirds gastrectomy was performed in order to avoid vagotomy.

Adult↗
PubMedDate not supplied

[Retro-peritoneal tumors. Report of 21 cases (author's transl)].

The authors report their experience about 21 cases of retroperitoneal tumors. They emphasise their often late revelation, the frequent malignity and the involvement of the surroundings organs. They insist on the interest of the opacification of urinary tract and angiography and the value of echo-ranging and total body scanner to evaluate the characteristics of these tumors and theirs extensions. Recurrents are frequents and must be operated each time necessary.

Adult↗
PubMedDate not supplied

[Major hepatic resections. 74 home cases and general review (author's transl)].

Reporting 74 home cases and data of recent litterature, the Authors try to take stock of major hepatic resection in 1978. Technical difficulties are recalled. The control of vena cava and major hepatic veins remains critical. So are blood coagulation troubles (6 cases). The technical choice amounts of either the ruled hepatectomy first described by J. L. Lortat-Jacob, or the finger-fracture technique. The latter should be preferred in resection for trauma (faster with healthy liver and on unchanged anatomy). In any other cases, we prefer the ruled technique. So do many authors. Vascular isolation techniques should deserve a larger use cross-clamping techniques are available for huge posterior tumours, in normovolhemic and healthy hearted patients. This procedure is fairly advisable in case of significant hemorragic risks. It might increase the resecavility rate (27). Tight monitoring and heavy material means make it available only in specialized centers. Intra-caval shunts, first conceived for caval and hepatic wounds, are an isolation procedure of choice in trauma and hypovolhemy. A larger experience should make the indications more precise. Advance in hepatectomy should reduce morbidity and mortality rates to those of other major digestive surgery. The post-operative course is studied; hemorrhagic and septic complications head the list. The biliary drainage is discussed: its indications should be consistantly reduced. Coagulation troubles and metabolic problems are analyzed advance in hepatic regeneration is pointed out. Indications of major hepatic resections are studied. It seems they should be spead out.

Adolescent↗
PubMedDate not supplied

Four hundred esophageal anastomoses with a stapler.

Four-hundred esophageal anastomoses were performed with a stapler in the Department of Digestive Surgery, Hospital Beaujon in Paris, in a six year period. The experience of the 14 different surgeons in esophageal surgery was very uneven (zero to 25 years). Two-hundred and sixty-eight esophagogastrostomies (220 in the chest and 48 in the neck), 83 esophagojejunostomies and 49 esophagocolostomies were done. The overall mortality rate was 9.2%, three per cent owing to leaks. The average incidence of leakage was 7% falling to 5.5% if cervical anastomoses were excluded. The incidence of stenoses was 8%. Several points which might account for problems are discussed. Stapled anastomoses seem to reduce the mortality and the morbidity rates of esophageal anastomoses, especially for surgeons with no experience in esophageal surgery.

Anastomosis, Surgical↗
PubMedDate not supplied

[Peroperative echotomography in the surgery of liver tumors].

Intra-operative ultrasonography was performed in 10 patients with apparently single malignant tumours of the liver without invasion of the portal or hepatic veins. Five patients had hepatocellular carcinoma associated with cirrhosis and 5 had a secondary liver cancer. At laparotomy other tumoral lesions in 3 cases, portal vein thrombosis in 2 cases and invasion of the left hepatic vein in 1 case were detected by ultrasonography. In 2 patients deep intra-hepatic tumours less than 2 cm in diameter, which were neither visible nor palpable, were also detected by this method. As a result of the examination, subsegmental resection was carried out in 3 cases and hepatic lobectomy in 2 cases. Intra-operative ultrasonography therefore is a useful method to locate invisible tumours and vascular structures, thus preventing vascular injuries during the operation, facilitating limited tumoral resections and generally improving prognosis in patients operated upon for malignant hepatic tumours.

Adult↗