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J C Sarles

Publications and source records attributed to J C Sarles.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Urinary disorders following anorectal surgery].

Troubles of micturition are common after anorectal surgery. They range from transient slight dysfunction to protracted retention necessitating catheterization. Surgical procedures for hemorrhoids are the main cause regardless of technique. Anesthesia and age of the patient are of minor importance. Men are more often affected than women. Innervation of the vesical sphincter is connected to that of the anorectal region be it by common innervation or by shared reflexes. Two mechanisms prevail: surgical trauma can lead to early sphincter contraction and atonia of the bladder or constipation after surgery may play a role. Psychologic environment and administration of sedatives play an important role in the treatment of postoperative micturition disorders. Parasympathomimetics are often successful. Catheterization can not always be avoided. It should not be used within first 18 hours after surgery. Rapid institution of intestinal motility has a preventive effect.

Adult↗
PubMed1990

[Immediate and late results of surgical treatment for chronic pancreatitis. Apropos of 127 operated cases].

From 1960 to 1987, 127 patients (105 males and 22 females, mean age: 45.9 years) underwent surgical treatment for CP. The aim of this study was to assess the results of surgical treatment intentionally oriented towards conservative surgical procedures (CPS). Ninety-one patients benefited from either pancreato-intestinal bypasses (84 cases) sometimes associated with other intestinal bypasses and/or transhiatal splanchnicotomy (THS) or isolated biliary (5 cases) or gastric (2 cases) bypasses. Thirty-one resections were carried out: 26 pancreatoduodenal resections (PDR) associated 3 times with TSH and 5 distal pancreatectomies. Other types of conservative treatment were performed in 5 cases. There were 5 post-operative deaths (3.9%): 1 after resection (6.6%) and 4 after CSP (p greater than 0.7). Postoperative complications occurred twice after resections (6.6%) and in 13 cases (16.2%) after CSP (p greater than 0.3). A further surgical procedure was required in 3 cases after pancreatic resection (3/25.12%) and in 14 cases after CSP (14/71, 19.7%) (p greater than 0.5). In the late postoperative course 15 deaths occurred but only 6 of them were directly related to the course of the pancreatitis. Five and 10 year overall survival probability after surgical treatment was respectively 81.5% and 64.7%. This probability was 70.4 and 60.4% after resections and 87.1% and 68.8% after CSP (p = 0.29). After CSP 75% of good functional results were observed between 1 and 4 years and 60% afterwards. Although non statistically significant these results suggest that: CSP and resections have the same operative risk, late reoperations are more frequent after CSP, the chance of late survival rate is better after CSP than after resection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[Biofeedback as a complementary treatment in surgery for anal incontinence].

Anal incontinence is a severe condition which may be treated by surgery, with unpredictable results. Biofeedback technique is designed to re-educate the function of the anal sphincter; it employs a probe for anorectal manometry, connected to the screen of an oscilloscope. The use of this technique in 43 patients with incontinence, treated with surgery resulted in 48.1% of total continence, 39.53% of partial continence and 11.62% of null response.

Adult↗
PubMed1989

Endo-rectal repair of rectocele.

Rectocele may cause colorectal symptoms particularly difficulty in evacuation. It is readily identified on clinical examination of the perineum but the pathophysiological abnormality can easily be defined by defaecography. Between 1984 and 1988 we have operated on 16 patients who presented with difficulty in evacuation associated with rectocele. We have used a simple endo-anal repair aimed to restore a firm recto-vaginal septum. Excellent functional results were obtained in 11 patients, 4 were considerably improved and one patient had a poor result.

Adult↗
PubMed1989

[Chronic postoperative rectal fistulae. Treatment by transanal colo-anal anastomosis. Apropos of 4 cases].

In a few cases, the postoperative rectal fistulas progress towards chronicity despite correct treatment and left iliac derivation. In 4 cases of such fistulas (3 females and 1 male, mean age 46 years), developed after rectal surgery and persisting for 2 to 16 months in young subjects, in good general condition and with a good long-term prognosis, we performed rectal resection with transanal colo-anal anastomosis according to the Parks technique. This procedure led to healing of the course of the fistulas, then closure of the derivation anus in the 4 patients. The functional results proved to be satisfactory, following short-term rehabilitation with biofeedback. After discussing the other surgical possibilities, the authors estimate that such a radical cure must be decided upon without delay, in case of chronic rectal fistula.

Adult↗
PubMed1988

[Leiomyosarcoma of the anal canal].

Leiomyosarcoma originating in the anal canal internal sphincter is an extremely rare malignant tumor of often late diagnosis, since usually asymptomatic, and with malignancy criteria that are sometimes difficult to define. These tumors affect men and women with equal frequency, usually in the 6 th decade. Two cases are reported in patients aged 67 and 65 respectively in whom the tumor was revealed by a painful perianal mass shown on rectoscopy to be due to a submucous tumor projecting into anal canal, Prognosis and treatment of these tumors is discussed, diagnosis being confirmed only after excision biopsy. Tumoral extension was both local and regional by continuity but blood dissemination had occurred with metastases more frequently in liver (1 case) but also in lungs. Glandular extension was exceptional. Limited local exeresis of small tumors appears justified if sufficiently wide, since malignancy of leiomyosarcoma appears to remain circumscribed over long periods. However, this limited procedure runs the risk of local recurrence with the need for abdominoperineal amputation (the case in the 2 patients reported), although long-term results appear to be similar whether excision is or is not extensive, the abdominoperineal amputation failing to avoid the unfavorable course. Complementary radiotherapy or chemotherapy is ineffective, and prognosis is related more to the degree of tumoral differentiation than to the operative treatment itself.

Aged↗
PubMed1987

Mixed familial polyposis syndromes.

Three cases of polyposis consisting of adenomatous and hamartomatous elements are described. The literature on mixed polyposis syndromes is reviewed.

Adenomatous Polyposis Coli↗
PubMed1986

[Effect of somatostatin on the rabbit Oddi's sphincter in vivo. Interrelation of somatostatin and cholecystokinin].

The action of somatostatin on the myoelectrical activity of the sphincter of Oddi was studied in anesthetized rabbits equipped with bipolar electrodes. The activity of the sphincter was recorded at the basal state and during 30 min after injection of somatostatin. After a bolus injection of somatostatin (1 to 8 micrograms/kg), the myoelectrical activity of the sphincter of Oddi decreased between the 2nd and the 10th min with a parallel decrease of the biliary pressure. These modifications were significant at the doses of 4 and 8 micrograms/kg only. There was a good dose-effect relationship. Moreover, the infusion of somatostatin (60 micrograms/kg/h) led to a decrease in sphincter activity. Bolus injection of cholecystokinin (2 UD/kg) under somatostatin infusion (60 micrograms/kg/h) induced an increase in the activity of the sphincter of Oddi. However, this activity never returned to basal levels.

Ampulla of Vater↗
PubMed1984

Role of the autonomic nervous system in the rabbit sphincter of Oddi.

In vivo myoelectrical activity and pressure of the SO have been studied in intact, vagotomized and splanchnicectomized rabbits. Preganglionic nerve sections made no significant differences compared to the control group. Acetylcholine (3-11 mu g/kg) and adrenaline (1-50 micrograms/kg) increased and decreased respectively the myoelectrical activity. Hyoscine (0.5 mg/kg) and verapamil (35 micrograms/kg/min.) but not pentolinium (2 mg/kg) inhibited the excitatory activity of ACh; phentolamine (3 mg/kg) but not propranolol (3 mg/kg) antagonized the inhibitory activity of adrenaline. It can be concluded that the neurotransmission in the rabbit SO has both pathways: excitatory transmission mediated by cholinergic muscarinic receptors which are calcium dependent, and relaxation mediated by inhibitory alpha-adrenoceptors.

Acetylcholine↗