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Biomedical subjects

G Chapuis

Publications and source records attributed to G Chapuis.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Treatment of irreducible hiatal hernia with reflux esophagitis by Collis-Niessen gastroplasty-fundoplication. Indications, technique, results of a series of 17 cases].

Hiatus hernia with reflux can be asymptomatic or can lead to severe, complicated esophagitis or even to metaplasia, dysplasia and carcinoma. Ideally all refluxing patients with esophagitis who are not easily and completely controlled with medical therapy should undergo anti-reflux surgery before complications such as ulcers, stricture or columnar metaplasia (Barrett's esophagus) occur. When esophagitis is long-lasting or severe, shortening of the esophagus is common. In such cases the esophagus must be "lengthened" before an anti-reflux procedure can be performed safely. This is the Collis gastroplasty. We have performed 17 Collis-Nissen procedures over 5 years for complicated gastroesophageal reflux disease (GERD). Results were good to excellent in 8 cases, satisfactory in 6 and poor in 3. We conclude that a complete preoperative workup with esophagoscopy (and biopsies), 24-hour pH monitoring and esophageal manometry must be performed in all patients with complicated GERD to allow the best operative procedure to be chosen (gastroplasty-fundoplication, resection or total duodenal diversion). The role of alkaline reflux is also discussed.

Aged↗
PubMed1993

Partial cricoid resection with primary tracheal anastomosis for subglottic stenosis in infants and children.

Fifteen infants and children with a severe subglottic stenosis underwent a partial cricoid resection with primary tracheal anastomosis. The etiology of the stenosis was congenital in 3 cases and was acquired after prolonged intubation in 12. Fourteen patients were tracheotomy dependent at the time of surgery, and 13 (87%) of the 15 were classified grade III (7 cases) and IV (6 cases) according to Cotton. The resection included the cricoid only in 5 cases and the cricoid and a segment of trachea (1 to 4 rings) in 10 cases. Decannulation was achieved after a single open procedure in 14 (93%) of the cases. The authors encountered no lesion of the recurrent laryngeal nerves and no fatalities. There was, however, 1 restenosis. Twelve cases were decannulated within 6 months, most of them at 2 months. The postoperative voice is normal in 10 cases, and a slight dysphonia is present in 4 cases. Twelve patients show no exertional dyspnea, and 2 exhibit a slight stridor while practicing sports. Ten of 14 cases have been followed for more than 5 years, with the longest follow-up now being 14 years. In all cases, the laryngotracheal development is normal. The results of this small series compare favorably with those of laryngotracheoplasty procedures usually performed for subglottic stenosis in infants and children. In the future, partial cricoid resection with primary tracheal anastomosis should be considered as an important treatment option for severe subglottic stenoses in infants and children.

Adolescent↗
PubMed1993

Combined small-cell and transitional cell carcinoma of the renal pelvis. A light microscopic, immunohistochemical, and ultrastructural study of a case with literature review.

Primary small-cell carcinomas of the kidney are rare, locally aggressive, and rapidly fatal neoplasms in elderly people. We report an example of combined small-cell and transitional cell carcinoma of the renal pelvis in a 71-year-old woman who had a history of heavy smoking. The cells that pertained to the small-cell component were morphologically mostly of an intermediate type. Immunohistochemically, they reacted with synaptophysin, carcinoembryonic antigen, and epithelial markers (Lu-5, EAB902, EAB903, and cytokeratin 19), and they contained scanty neurosecretory granules at the ultrastructural level. We review the literature on small-cell carcinoma of the kidney and renal pelvis, and we discuss the histogenesis of such a tumor.

Aged↗
PubMed1993

[Value of antral mucosectomy, selective proximal vagotomy and a combination of the 2 procedures in serum gastrin production and inhibition of stomach acid. An experimental study].

This experimental study was aimed at determining the volume and acidity produced by the normal stomach, following antral mucosectomy (MA), proximal selective vagotomy (VSP) and combination of both procedures. In 10 mongrel dogs, a double-lumen tube was placed in the stomach under general anesthesia. One of the lumen was rinsed with a constant flow and the other retrieved the gastric secretion. Gastric secretion and acidity were calculated every 10 minutes for 120 minutes. At 60 minutes, pentagastrin was injected. After these controls, a MA was carried out in half the animals and a VSP in the other half. 6 and 12 weeks postoperatively, the same controls were repeated. The dogs were then submitted to the operation of the other group. Following MA and pentagastrin stimulation, the gastric secretion (volume) is not modified with regard to the preoperative levels. On the other hand, after VSP, pentagastrin stimulation induces only a small volume response. The vagus thus seems to be involved in liquid secretion of the stomach. Following MA, pentagastrin stimulation lowers gastric pH at 6 weeks but not at 12 weeks postoperatively. Gastrin is known to have a trophic effect on the oxyntic mucosa. This effect disappears in a few weeks and explains these different figures. Following VSP, gastric acidity decreases and plasmatic gastrin increases. In this situation, pentagastrin directly acts on a trophic mucosa and produces the important lowering of the gastric pH. Finally, after MA, pentagastrin induces an increase in plasmatic gastrin. This effect seems to be mediated by central stimulation of the nuclei of the vagus nerve.

Animals↗
PubMed1992

[Acquired factor V inhibitor treated with intravenous immunoglobulins].

We report the appearance of a factor V inhibitor in an 82-year-old female patient following abdominal surgery. This anomaly was totally corrected following 9-day treatment with i.v. immunoglobulins (0.4 g/kg/day), which allowed a needed further surgical intervention to be performed without hemorrhagic diathesis. The activity of this inhibitor was partly reversed by the in vitro addition of immunoglobulins, suggesting a concentration-effect relationship. This finding supports the hypothesis that anti-idiotypic antibodies could play a role in the therapeutic effect of immunoglobulins in such situations.

Aged↗
PubMed1992

[Development of a gastroplasty with variable diameter. Experimental study using artificial sphincters].

The vertical banded gastroplasty is currently the most popular technique in the surgical treatment of morbid obesity. This experimental study was aimed to create a gastroplasty with a variable stoma. The Marlex band was replaced by the cuff of an artificial sphincter to allow selective variation of the diameter of the stoma. The study was carried out on four mongrel dogs. The artificial sphincter was connected to a subcutaneous port. Injection of sterile fluid into the port inflates the cuff and decreases the surface of the stoma. The study was followed up for one year. Under gastroscopic control the system was regularly activated, the diameter and the surface of the stoma was measured and calculated. The sphincter allowed the surface of the stoma to decrease from 103 +/- 2.0 mm2 to 61 +/- 2.1 mm2. There was no significant variation of the surface for each volume unit injected into the system. After one year, the systems and stomachs were harvested and examined. It is possible to create a gastroplasty with a variable stoma. This system works without any technical problem. Microscopic examination of the stoma shows no peri-sphincteric fibrosis.

Animals↗
PubMed1992

[Leiomyosarcoma of the inferior vena cava. Three cases].

We report three new cases of leiomyosarcoma of the inferior vena cava observed between 1985 and 1990. Two of them developed in women and one in a man. The age of the patients were 56, 29 and 57 years. The three tumors have been removed completely. One patient received postoperative radio- and chemotherapy and is well 68 months after excision. One patient developed liver metastasis 18 months after resection despite chemotherapy and died after 3 years. The last one refused postoperative radio- and chemotherapy, developed massive local recurrence and pulmonary metastasis three months postoperatively, and is still alive with disease after 8 months. The diagnostic modalities of these rare tumors as well as the problems created by their surgical resection and the need for a complementary treatment are discussed.

Adult↗
PubMed1991

[Biliopancreatic bypass and disorders of iron absorption].

Sideropenic anemia is a common long-term complication of surgical bilio-pancreatic bypass for morbid obesity, and is frequently resistant to oral iron therapy. To study the pathogenesis of this phenomenon we investigated 7 such patients clinically and biologically, with special emphasis on iron absorption. Our results show that sideropenia, consistently present and frequently complicated by anemia, is due to deficient iron absorption and that this malabsorption is non-selective. Replacement therapy, when indicated, should therefore use the parenteral route.

Adult↗
PubMed1991

Long-time survival of a patient with glioblastoma and Turcot's syndrome. Case report.

A rare case of Turcot's syndrome is reported in a long-time survivor of glioblastoma multiforme. The patient was treated for his tumor in 1976 with macroscopically complete surgical resection and radiotherapy consisting of 60 Gy to the tumor bed and 40 Gy to the whole brain. Five years later, in 1981, he developed adenocarcinoma of the colon Dukes Stage B which was successfully treated at another hospital by surgery alone. In 1990, he presented with multiple colon polyps and adenocarcinoma Dukes Stage A. For more than 15 years, the patient has been afflicted with cystic and conglobate acne. Possible mechanisms and treatment with 13-cis retinoic acid are discussed.

Acne Vulgaris↗
PubMed1990

[Status of the Delorme operation in surgery of rectal prolapse].

The surgical treatment of complete rectal prolapse has been the object of great controversy. Currently, it is believed that best results are obtained by transabdominal rectopexy. Even though these operations have low morbidity and mortality, a laparotomy may not be advisable for certain elderly or poor-risk patients. An alternative would then be the Delorme operation. The principle consists of an extensive perineal excision of the mucosa covering the prolapse, and a longitudinal plication of the rectal wall. From January 1988 to March 1989, 12 patients underwent the Delorme repair of rectal prolapse in our service with good results.

Aged↗
PubMed1989

[Gastroduodenal ulcer disease: what surgical indications are left?].

Between 1976, date of the introduction of anti-H2, and 1987, 716 patients were hospitalized and operated on for ulcer disease in the surgical department of this hospital. The present study shows that 1. the annual number of operations has regressed by some 30%, 2. while the number of gastric ulcers remains constant on the whole, cases of acute duodenal ulcer have diminished by half, 3. cases of chronic, recurrent, or therapy-resistent duodenal ulcer have increased some tenfold (2 out of 78 in 1976 and 14 out of 45 in 1987), 4. the same is true of perforated ulcers (12 out of 78 in 1976 and 10 out of 45 in 1987) and hemorrhages (12 out of 78 and 10 out of 45), 5. surgery for stenosis has remained constant. -Proximal selective vagotomy has been the treatment of choice since 1981 in over 80% of duodenal ulcers. Operative mortality affects only elderly patients undergoing emergency surgery for complicated ulcer (two thirds perforations, one third hemorrhages). It is 2.6%. We thus confirm the reduced role of surgery in the treatment of gastric ulcer, while redefining the present surgical indications.

Aged↗