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Biomedical subjects

G Audry

Publications and source records attributed to G Audry.

68 records · Page 4Linked to original sources
PubMed1989

[Urethral fistula following reconstructive surgery of hypospadias. Apropos of 34 cases].

Thirty-four children, ten of them coming from another Surgical Center, underwent repair for urethral fistula after hypospadias reconstructive surgery, over a period of three years (1985-1987). After the first operation, there was no recurrence in 59% (20 cases). Currently, all fistulas have been closed, except in 3 cases. Closure by direct suture was used in 30 cases (88%). The best results were observed with suture in three planes and without diversion, on an outpatient basis (91% of success for 12 cases). The Leveuf method is a safe operation for complex penile fistulas after repeated surgery.

Adolescent↗
PubMed1989

[Postoperative recurrence of esophago-tracheal fistula. Significance of peroperative catheterization of the fistula with tracheoscopy. Apropos of 10 cases].

Ten children with recurrent tracheo-oesophageal fistula have been treated over 13 years (1976-1988). Five patients were referred from other centers. The original pathology was oesophageal atresia in eight and two patients had a tracheo-oesophageal fistula alone. Barium swallow demonstrated the recurrent fistula in only five of eight cases. In fact, the key examination is tracheoscopy providing that catheterisation of the fistula. The position of the catheter is verified radiologically. The difficulties of surgery in recurrent fistula are linked to the problem of locating the level of the fistula peroperatively. Without catheterisation of the fistula, there were one failure out of three cases (one dead). By contrast, in the seven cases where the fistula was catheterised, a successful outcome was always obtained. The failure of surgery for recurrent tracheo-oesophageal fistula is not linked to a technical problem of closure of the fistulous tract but to failure to localize the fistula adequately.

Adolescent↗
PubMed1988

[Ureteropelvic junction syndromes: antenatal diagnosis].

Seventy-four hydronephrosis by uretero-pelvic obstruction, discovered by antenatal real-time ultrasound, have been managed on sixty-one children. Three groups, with a specific management, are distinguished. The minimal forms have been only watched over (15 cases). The average forms have been operated (49 cases); considering the results (3 immediate complications and 2 early stenoses), it seems better to wait for 4 months to operate and to place a drain in renal cavities. In major forms (silent kidney on IVP), the diagnosis and therapeutic management use the percutaneous nephrostomy (10 cases). The interest of antenatal diagnosis of uretero-pelvic obstructions is to allow to operate, not only before the renal deterioration emphasizes, but principally before septic complications.

Age Factors↗
PubMed1987

[Polycystic renal dysplasia in children].

Ultrasonography has profoundly modified the diagnostic conditions of polycystic renal dysplasia in children. Non-palpable forms, which were previously most frequently missed, can now be detected during the antenatal period. In infants, ultrasonography generally provides a definite diagnosis, which can be confirmed by aspiration-opacification of the cysts. On the basis of a series of 40 cases and a review of the literature, the authors discuss the therapeutic implications of these new data. Surgery remains essential in cases of palpable polycystic renal dysplasia, especially when it is complicated. However, in the sub-clinical forms, as the risks of malignant degeneration and the incidence of post-operative complications are minimal in the one case and undefinable in the other, surgical excision is possible but not essential.

Child↗
PubMed1987

[Partial splenectomy for epidermoid cysts of the spleen in children. Apropos of 3 cases].

Three cases of epidermoid cyst of the spleen treated by partial splenectomy are reported on children. The diagnosis rests now on the ultrasonography. The operative indication is systematic because of the risks of complication. The polar localisation of the cysts permits one to make a conservative surgery. The partial splenectomy is a technique of choice in this benign tumoral pathology. Postoperative digital intravenous subtraction angiography demonstrated the good vascularization of the remaining part of the spleen.

Adolescent↗
PubMed1987

[Treatment,in girls, of ectopic ureters, due to duplication, using reimplantation of the single pathological ureter into the bladder].

Mostly the ectopic ureter belongs to the upper pole in urinary tract duplications. In the pelvis, the two ureters are clearly separated. The only dissection of the ectopic ureter is in no case dangerous for the ureter of the lower pole. Therefore the reimplantation of the ectopic ureter can be performed separately. This only reimplantation of the ectopic ureter has been performed 9 times, without any mortality nor morbidity. The scar is almost invisible and the child is cured without any risk for the upper pole and saving the whole of the renal parenchyma. If the upper pole is functional, which happened in 1/4 of the cases, this technique is the best way and the less dangerous to recovery.

Adolescent↗
PubMed1987

[Value of the Goebbel-Stoeckel operation in the treatment of neurogenic bladder in girls].

Repeated catheterisation and drugs with a pharmacodynamic action are not always able to ensure perfect continence in children with meningomyeloceles. To treat uncontrollable incontinence, the authors propose an aponeurotic suspension of the bladder neck as described by Goebbel-Stoeckel in order to increase the peripheral resistance. At the same time, sufficient bladder compliance can also be obtained either by means of pharmacodynamic treatment or by enlargement enterocystoplasty. The aim is to obtain catheterisation every 4 to 6 hours without any incontinence. Young girls constitute the ideal indication for this programme as catheterisation is safe and easily accepted. Ten girls underwent Goebbel-Stoeckel operation, associated with sigmoido-cystoplasty in 6 cases. Eight of these girls are now perfectly continent with a normal social life, including one case with a follow-up of 12 years and a pregnancy. The authors stress the need, in cases of enterocystoplasty, to resect almost all of the pathological detrusor and to use the caecum rather than the hypertonic sigmoid.

Adolescent↗
PubMed1987

[Obstruction after uretero-vesical reimplantation in children. Apropos of 40 cases].

Fourteen cases of obstruction after ureteroneocystostomy in children have been cured by surgery between 1972 and 1986; nine patients were referred from outside our hospital. This failure as been observed after reimplantation of simple thin ureter (29 cases) megaureter (7) or duplication (4). The diversity of lesions, of which 52 percent were ischemic stenosis, required surgery without any preconceived idea. A new reimplantation is often necessary, usually with Politano-Leadbetter procedure, and, if necessary, with a hitch-bladder. The operation is successful in 85 percent of patients, but the result is uncertain when the operation is late or when the value of renal parenchymal is initially poor.

Anuria↗
PubMed1986

[Varicocele in the child and adolescent].

Based on a series of 31 cases of children and adolescents with varicocele, the authors stress the high incidence of left testicular atrophy (71%). Other authors have emphasised the almost constant presence of histological lesions which are generally bilateral. These findings suggest that the harmful action of varicocele on spermatogenesis is more marked in children and adolescents than in adults, encouraging early surgical treatments which is almost always effective.

Adolescent↗
PubMed1985

[Partial nephrectomy in nephroblastoma].

The authors analyse their 18 partial nephrectomies performed on 12 children with either a bilateral or a Wilms' tumor of a single remaining kidney: 13 affected kidneys were otherwise normal, the 5 others were sites of a diffuse nephroblastomatosis. The short term results are good (one technical failure only). The long term results were excellent for Wilms' tumors on otherwise healthy kidneys (no recurrence), as opposed to kidneys with diffuse nephroblastomatosis, where invariable tumor recurrence was observed. Because of the low risk of tumor development in the controlateral healthy kidney, and the established value of classical total nephrectomy, the authors, however, consider partial nephrectomy only in highly selected cases of unilateral nephroblastoma.

Child↗
PubMedDate not supplied

Prenatal diagnosis of a congenital bladder diverticulum. Case report and benefits of prenatal diagnosis.

A case of congenital bladder diverticulum diagnosed at 37 weeks of gestation (measured from the first day after the last day of the last menstrual period) is reported. Delivery took place 24 h later. A postnatal urologic work-up confirmed the diagnosis of asymptomatic congenital bladder diverticulum. The infant underwent laparotomic surgery at the age of 6 months, with an extravesical diverticulectomy and ureteral reimplantation. There were no complications. This is the first case reported in the literature of a prenatal diagnosis of a congenital bladder diverticulum. This new aspect allows early management and avoidance of the diagnostic meanders to which the discovery of a pelvic mass might lead, as well as the complications that can follow bladder diverticula.

Adult↗