Search PubMed⌕ Search

Biomedical subjects

G Champault

Publications and source records attributed to G Champault.

At least 73 records · Page 4Linked to original sources
PubMed1997

[Adrenal gland resection with laparoscopy or lumboscopy. The Paris experience].

A survey of 7 surgeons in Paris collected 173 cases of adrenal gland resection using laparoscopes or lomboscopes in 164 patients. Video-assisted surgery techniques were used in the past 4 years for: Conn's syndrome (n = 69), fortuitously observed tumors (n = 39), Cushing's syndrome (n = 24), phyeochromocytoma (n = 18) and Cushing's disease (n = 4). There were 155 unilateral tumors and 9 bilateral tumors in patients with Cushing's disease. This survey showed that conversion rate was 14% and local complications rate 2.4%, mean operative time for unilateral operations was 144 minutes (range 50-240) and 266 minutes (range 125-480) for bilateral tumors. Although this was a retrospective uncontrolled survey, pain relief and hospitalization time were greatly improved over traditional open surgery. The difference between the transperitoneal and the retroperitoneal route could not be evaluated due to differences in the number of patients for which each technique was used. Surgeon experience varied greatly, but it appears that video-assisted adrenal gland surgery is the preferred route due to reduced risk and improved post-operative period. Tumors with a diameter greater than 6 cm and malignant or suspected malignant tumors still require open surgery.

Adrenal Gland Diseases↗
PubMed1997

[Laparoscopic surgery. Does smoke transport cells?].

The study was designed to test the hypothesis that whole cells can be carried as an aerosol in the pneumoperitoneum during laparoscopy. Twelve patients undergoing laparoscopic surgery for benign and metastatic disease were included in the study. Throughout the 12 procedures, the smoke and the gas of the pneumoperitoneum was evacuated through 17 filters. Twelve filters and the tubing were washed. The liquid was centrifuged and stained immunocytochemically to identify the cells. Five other filters were also photographed with an electron microscope. On immunocytochemistry, nine of the twelve samples were identified as mesothelial in origin and the electron micrograph show many other cells stuck to the filter which appeared to be blood cells and mesothelial cells. Malignant cells were not conclusively identified, but ethical considerations prevented any intentional coagulation of malignant tissue. The presence of whole identifiable cells in the pneumoperitoneum could partly explain, port site metastasis after laparoscopic surgery for cancer.

Carbon Dioxide↗
PubMed1997

[Peroperative investigation of the common bile duct during laparoscopic cholecystectomy. Laparoscopic ultrasonography versus cholangiography. A prospective study of 150 cases].

From November 1994 to March 1996, 150 patients treated by laparoscopic cholecystectomy were included in a prospective study, in order to compare intraoperative cholangiography and laparoscopic ultrasound. The biliary tree was successively explored by the two methods in the systematic detection of common bile duct stones. The feasibility of laparoscopic ultrasound was 100 per cent. Cholangiography was performed in only 125 cases (83 per cent). The duration of the laparoscopic ultrasound exam was significantly shorter (11.6 vs 17.6 minutes, p = 0.0001). In this study, common bile duct stones were found in 14 cases (9 per cent). The detection rates with laparoscopic ultrasound and intraoperative cholangiography were similar. For laparoscopic ultrasound, sensitivity was 80 per cent and specificity was 99 per cent, versus 78 per cent and 97 per cent for cholangiography, respectively. The combination of the 2 examinations had a 100 per cent sensitivity and specificity. Laparoscopic ultrasound failed to recognize the intrapancreatic part of the bile duct (25 cases: 17 per cent), did not show anatomical abnormalities detected by cholangiography, but detected unsuspected digestive lesions. Laparoscopic ultrasound is safe repeatable, and non invasive, but a learning curve is necessary to increase this efficacy. Comparison of cost must be evaluated.

Adult↗
PubMed1997

The use of laparoscopic ultrasound in the assessment of pancreatic cancer.

26 consecutive cases of obstructive jaundice due to a carcinoma of the head of the pancreas were studied prospectively with ultrasound (US), computerized tomography (CT), endoscopic ultrasonography (EUS) and laparoscopic ultrasound (LUS). Sensitivity of US, CT were comparable, although CT seems better to evaluate the size of the tumor and for lymph node detection. 50 percent of patients had a criterion for noncurative resection. EUS (16 cases) had the best sensitivity (100 percent) for the staging of small tumors (less than 20 mm), detection of adjacent nodes and the relation between tumors- and mesenteric and portal vein. EUS was not able to detect peritoneal and/or liver micro-metastases. The criterion for noncurative resection was 57.6%. LUS exactly assessed all tumors larger than 2 cm. The accuracy compared with EUS was not as good for small tumors, but better concerning micro-peritoneal or hepatic metastasis. The criterion for noncurative resection was 80.7 percent. These results suggest to use of US and CT as first-line procedures in the preoperative staging and assessment of resectability of pancreatic cancers. When the patient does not appear to have disseminated lesions, EUS gives a good estimation of the size of the tumor, node assessment and vascular relations. LUS could be the first step for a curative surgical treatment. LUS revelated to discover 15 to 30 percent of unknown micro-metastases and avoided useless laparotomy in these patients.

Adolescent↗
PubMed1997

Bacterial contamination of pneumoperitoneum gas in peritonitis and controls: a prospective laparoscopic study.

There is a theoretical risk that the pneumoperitoneum gas could carry bacteria in aerosol form and spread infection throughout the peritoneal cavity during laparoscopy for infective conditions such as appendicitis. The aim of this study was to attempt to culture bacteria from the pneumoperitoneum gas during laparoscopy for potentially infected cases and a group of controls. A total of 53 consecutive laparoscopies were studied, of which 21 were potentially infected and 32 served as controls. A lavage of the operative site was positive for pathogenic bacteria in almost 30% of the potentially infected group and only 3% of the control group. The pneumoperitoneum gas was bubbled through blood culture medium at the beginning and the end of the procedure, but only one of the 106 bottles grew any bacteria, and the specimen was a likely contaminant. In conclusion, we were unable to grow any significant bacteria from any of our cases despite using a sensitive method and demonstrating pathogenic bacteria in the peritoneal lavages. The pneumoperitoneum itself is unlikely to disperse bacteria.

Case-Control Studies↗
PubMed1997

[Laparoscopic correction of recurrent gastro-esophageal reflux following laparoscopic fundoplication (4 cases)].

A series of 98 laparoscopic fundoplications, included 7 cases (7.1%) of recurrent gastro-oesophageal reflux. Six of these cases occurred within 12 months of surgery. Four were successfully treated by a second laparoscopic procedure. The mean interval between the initial and corrective operations was 10 months. Factors related to failure were: technical errors, operative inexperience, obesity and the size of the hiatus hernia (when crural closure was not performed). Laparoscopic re-operation to was relatively easy and without mortality but had an increased risk of pleural effusions. The mean length of hospital stay for re-operations was identical to that of initial operations (4 days). No further recurrences were noted after a mean follow-up of one year (280-475 days). We conclude that early failures following laparoscopic fundoplication can be effectively dealt with laparoscopic surgery.

Adult↗
PubMed1997

[Laparoscopic resection of a bladder diverticulum].

The authors report a case of laparoscopic resection of a bladder diverticulum performed at the same time as endoscopic treatment of its presumed cause. Dissection of the diverticulum, particularly its neck, and dissection of diverticula of the ureter and vas deferens are facilitated by magnification of the video image. This approach is only indicated in particular anatomical sites (posterior). The results of this technique must be compared with those of conventional treatments.

Adult↗
PubMed1997

[Port-site metastases. A prospective study of 131 cases].

UNLABELLED: Laparoscopic staging and laparoscopic treatment of gastrointestinal malignancy is still controversial because some studies report port-site metastases. BACKGROUND: The aim of the study is to determine in 131 patients, with prospective follow-up, after laparoscopic staging or laparoscopic treatment the incidence of port-site metastases. METHODS: 131 patients, with gastro intestinal malignancy, proved or with peritoneal carcinomatis or liver metastases, were included. In 57 cases only laparoscopic staging is performed in 49 cases laparotomic treatment is performed a after laparoscopic staging; in 57 cases (43.5 per cent) tumor invaded serosa. RESULTS: The median follow-up was 17.7 months (3 to 62 months). 502 port-sites were controlled. One patient (0.7%) has presented one port site metastasis 3 months after right colectomy for carcinoma with local carcinomatis. CONCLUSION: The study affirm that port-site metastases are rare. They are favorised by serosa invasion. The low rate indulge in laparoscopic staging to recognize occults lesions which are not detected by conventionals examinations in 44.2 per cent in this study.

Adult↗
PubMed1997

[Laparoscopic resection of gastric conjunctive tumor. Apropos of 2 cases].

We report two cases of benign gastric tumours which were resected laparoscopically. The lesions were diagnosed pre-operatively by upper endoscopy and endoscopic ultrasound. Excisions were complete with satisfactory resection margins. The post-operative courses were uncomplicated: the length of hospital stay for both patients was 6 days. This technique would appear to be a promising alternative to laparotomy for selected cases.

Endosonography↗
PubMed1996

[Ultrasonic laparoscopy in digestive diseases].

Laparoscopic ultrasound combines the advantage of diagnostic laparoscopy with intraoperative ultrasonography. This new technique allows visualisation of deep structures that are not palpable. The technical aspects and the application in abdominal surgery are described. The principal indications are detection of common bile duct stones during laparoscopic cholecystectomy and staging of abdominal cancers. The information provided by laparoscopic ultrasound influences therapeutic decisions.

Biliary Tract Neoplasms↗