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Biomedical subjects

G Benoit

Publications and source records attributed to G Benoit.

329 records · Page 19Linked to original sources
PubMedDate not supplied

[The treatment of urinary fistula in renal transplantation].

61 renal transplant patients developed a urinary fistula (4%). The diagnosis was established rapidly (after an average of 12 days) by the presence of urine in the drains and a urine collection on ultrasonography. The exact topographical diagnosis, the nature of the fistula, necrosis or dehiscence, is more difficult, even with modern imaging techniques. The incidence of fistula was decreased by the use of a short ureter, a Lich-Grégoir ureterovesical anastomosis and the prophylactic insertion of a ureterovesical stent. The first 36 ureteric fistulae were treated by open surgery and the last 7 were treated by antegrade stent insertion. 87% of patients were cured of their fistula and retained their transplant: 31 of the 36 patients undergoing open surgery and all 7 patients treated percutaneously. Percutaneous treatment should be proposed as first-line treatment in the case of ureteric fistula after renal transplantation.

Anastomosis, Surgical↗
PubMedDate not supplied

[Surgical treatment of hyperparathyroidism in renal transplant patients].

The authors present their experience of surgery for persistent hyperparathyroidism in renal transplant recipients, based on a series of 944 patients transplanted between 1983 and 1992. 56 patients underwent subtotal parathyroidectomy for persistent secondary hyperparathyroidism. Control of serum calcium was excellent in 83% of patients: 2 patients retained a well controlled hypocalcaemia, 2 are still hypercalcaemic and 3 others have developed recurrent hyperparathyroidism. The postoperative course was marked by one death not related to parathyroidectomy and one recurrent laryngeal nerve palsy. Subtotal parathyroidectomy combined with removal of the thyrothymic tissue is an effective operation to control phosphorus and calcium metabolism in patients with persistent hyperparathyroidism after renal transplantation.

Adult↗
PubMedDate not supplied

[Frequency of adherent colibacillus in a population with acute pyelonephritis and a population with acute cystitis].

Urothelial adhesion of Escherichia coli is one of the principal factors of colonisation and infection of the upper urinary tract. We compared 3 measurements of bacterial adhesion: 1) Mannose-Resistant Haemagglutination (MRHA), é) Adhesion to urothelial cells, 3) Latex particle agglutination, to test 85 strains of Escherichia coli in 42 cases of acute pyelonephritis and 43 cases of acute cystitis. These tests were positive in 73.8% to 85.7% of the acute pyelonephritis population and in 4% to 2.3% of the acute cystitis population (statistically significant difference). This study confirms the major role of strains carrying type PAP adhesion in the pathogenesis of acute pyelonephritis.

Acute Disease↗
PubMedDate not supplied

[Surgical technics of kidney transplantation].

The renal transplantation operative technique obeys simple rules which must allow for surgical revision or a new transplantation. Ideally, the first transplantation is performed in the right iliac fossa, in a low, retroperitoneal position. A side-to-end arterial anastomosis is performed onto the external iliac artery, and an end-to-side venous anastomosis is performed onto the external iliac vein. In the case of a right kidney, the renal vein is elongated by means of a vena cava patch graft and the ureter is reimplanted into the bladder according to Gregoir's technique, intubated by a stent. Second transplantations are performed retroperitoneally in the left iliac fossa, according to the same technique. Third transplantations are performed in the right iliac fossa in a high, retroperitoneal position. The end-to-side arterial anastomosis is performed onto the common iliac artery, the side-to-end venous anastomosis is performed onto the origin of the inferior vena cava and the ureterovesical anastomosis is replaced by an uretero-ureteric anastomosis when the approach to the bladder is difficult. As end-to-side or end-to-end arterial anastomoses give virtually equivalent results, it seems preferable to preserve the blood supply of erectile organs by avoiding anastomosis with the internal iliac artery. Among the various urinary anastomoses, uretero-ureteric anastomosis is associated with more complications than the Leadbetter or Cregoir anastomoses. When a Gregoir anastomosis is performed, a long submucosal track must be performed to reduce the risk of reflux, a factor responsible for subsequent acute pyelonephritis. Insertion of a stent appears to facilitate anastomosis and prevents the risk of fistula. Antibiotic prophylaxis is required while the stent is in place.

Anastomosis, Surgical↗