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Biomedical subjects

G Lagache

Publications and source records attributed to G Lagache.

At least 37 records · Page 2Linked to original sources
PubMed1980

[Thyroid autonomous nodule. Surgical treatment and postoperative outcome, retrospective study of 102 cases (author's transl)].

Follow-up of 102 patients operated upon for autonomous thyroid nodules is reported. Retrospective study of operative findings and aftermath of surgery clearly demonstrates that the patho-physiological concept of autonomous nodule does not snugly fit practical problems experienced with the management of such patients. The autonomous nodule can be a malignancy. Ipsilateral thyroid lobectomy seems more suitable than nodulectomy. Gross appearance of the thyroid remnant makes sometimes post-operative hormonotherapy unexpectedly advisable. From a theoretical point of view, post-operative thyroid scan, TSH assay and TRH test are mandatory, to assess recovery.

Adolescent↗
PubMed1980

[Advantages of systematic recurrent laryngeal nerve resection during thyroid surgery. Results of 422 thyroidectomies employing this procedure (author's transl)].

Thyroidectomy for different thyroid disorders was conducted in 422 patients during 1978, after normal pre-operative laryngoscopy findings. Dissection of the recurrent laryngeal nerve was employed systematically in all patients except those having isthmectomy or enucleation operations, with a total number of 556 nerves dissected. Pre-and post-operative laryngoscopic examinations in the alert patient was conducted in all cases. After one year, 8% of the patients with abnormal post-operative laryngoscopic findings had not returned for follow-up. The known rate of recurrent nerve paralysis after one year was 0.7% of the nerves exposed, the maximum rate being 2% if patients not followed-up are included. These results confirm the value of systematic recurrent nerve dissection during thyroid surgery.

Humans↗
PubMed1980

[Massive pulmonary embolism due to post-traumatic pseudo-aneurysm due to rupture of the left hepatic artery, revealed by dissecting aneurysm below the capsule of the right lobe of the liver (author's transl)].

We report a case of trauma of the left lobe of the liver causing left centro-hepatic contusion (stage III) revealed by infective jaundice. Secondarily, the appearance of a right subcapsular hematoma corrected the diagnosis, permitting the authors to proceed to angiographic exploration and consider operation on the right side, but the patient had a massive pulmonary embolism. This case recalls the diagnostic difficulties soon after a contusion, the diffusion of a hematoma under pressure from left to right, then from the liver towards the hepatic venous system, the risk of pulmonary embolism, from an aneurysm of the hepatic artery.

Adult↗
PubMed1980

[Systematic or selective frozen sections during surgery for suspected malignant thyroid lesions? Results in 674 cases over a period of 6 years (author's transl)].

Results of a retrospective study of 674 frozen sections in thyroid surgery, demonstrated on over all reliability of 98.2%, when compared with final pathological findings, with 651 confirmation in 674 cases. False negatives of malignancy represented 1.6% of lesions thought to be benign, while false positives were obtained in 4.8% of lesions thought to be malignant on frozen sections. Prior to frozen sections, 221 patients had needle punctures and cytological smears studies of the thyroid lesion. When comparing the results after using the two methods, no false positive for malignancy, assessed by cytology, was found on frozen sections, which also corrected but two false negatives of malignancy given by the 177 smears affirmative of benignancy, but reduced the number of equivocal results of cytology from 36 to 1. Both pre-operative cytological examination by needle puncture and intra-operative frozen sections appear, therefore, to be very reliable methods for studying thyroid lesions. Frozen sections are complementary to cytological studies. These results suggest that, in surgical thyroid diseases, frozen sections, need perhaps not to be systematically conducted, but should be selective and reserved for cases in which pre-operative needle cytology affirms malignancy, or raises suspicion.

Biopsy, Needle↗