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Biomedical subjects

J Cuilleret

Publications and source records attributed to J Cuilleret.

At least 19 recordsLinked to original sources
PubMed1993

[Postoperative respiratory function and cholecystectomy by laparoscopic approach].

Open cholecystectomy is associated with characteristic changes in pulmonary function showing a restrictive pattern. Laparoscopic cholecystectomy without opening of the peritoneal cavity could be an alternative in reducing postoperative respiratory dysfunction. Having given their informed consent, 13 healthy ASA1 patients (age: 41 +/- 18 yrs) undergoing laparoscopic cholecystectomy were enrolled in this study, in order to assess their postoperative pulmonary function tests (forced vital capacity [FRC], forced expiratory volume [FEV1], functional residual capacity [FRC]) before operation (T0) and 4 h (T4), 24 h (T24), 48 h (T48) after surgery. Anaesthesia technique was the same associating propofol-atracurium-fentanyl, 50% N2O/O2. Ventilation was adapted to maintain end-tidal carbon dioxide pressure up to 30-35 mmHg. Postoperative analgesic regimen consisted of paracetamol-ketoprofen. Mean length of surgery was 84 +/- 15 min; mean duration of anaesthesia was 110 +/- 24 min. An immediate and harmonious restrictive breathing pattern developed postoperatively. Postoperative FVC measured 65% (T4), 63% (T24), 72% (T48) of preoperative function (p < 0.025); postoperative FEV1 measured respectively 60, 66 and 75% of preoperative function (p > 0.001), without change in FEV1/CV and FRC; a significant hypoxia occurred (T0: 86 mmHg, T4: 80 mmHg, T24: 75 mmHg, T48: 81 mmHg [p < 0.05]). Laparoscopic cholecystectomy resulted in less postoperative respiratory dysfunction than conventional cholecystectomy, as previously reported; this restrictive pattern observed without changes in FRC was similar to that following lower abdominal surgery.

Adult↗
PubMed1993

[An unusual complication of perforated sigmoid diverticulitis: gas in the portal vein with miliary liver abscesses].

A patient presented with gas in the portal vein and miliary liver abscesses due to perforation of a sigmoid diverticulitis abscess. The outcome was favorable after surgical treatment. Gas in the portal vein, a sign of extreme seriousness, is generally the result of intestinal necrosis from ileo-mesenteric artery infarction, responsible for more than 75% of deaths. Diagnosis of this exceptional complication, suggested from a straight abdominal film, was confirmed by hepatic ultrasound and scan imaging. Urgent surgical intervention can hopefully, as in the present case, result in the patient's survival.

Aged↗
PubMed1990

[Primary adenocarcinoma of the ileostomy after total proctocolectomy for ulcerative colitis].

A 61-year-old man developed primary adenocarcinoma with skin invasion, at the ileostomy site 33 years after a proctocolectomy for ulcerative colitis. A total of eleven patients with ileostomy adenocarcinoma have been reported in the literature. Ten patients were treated surgically for ulcerative colitis and the other for adenomatous polyposis coli. The diagnosis of stomal malignancy was made 9 to 36 years after the ileostomy (mean interval, 22 years). The pathogenesis of the malignant growth is uncertain and several possibilities are discussed: stasis, severe chronic inflammation, colonic metaplasia and severe dysplasia of the ileal mucosa. When an ileostomy requires late revision for inflammatory changes, careful pathologic examination of the entire stoma and surrounding skin is essential.

Adenocarcinoma↗
PubMed1986

Radio-anatomic study of the carotid axis with regard to the implantation of microsurgical vascular anastomoses.

The authors report a radio-anatomic study of the carotid axis in the context of the implantation of microsurgical vascular anastomoses. The information derived from 36 dissections and 50 arteriographic studies suggests the preferential use of the superior thyroid, facial and lingual branches. Section and turning-down of the external carotid and direct end-to-side implantation on the common carotid could provide fall-back solutions when the collaterals are slender. Because of anatomic variations and frequent atheromatous lesions, arteriographic study before implantation appears essential.

Adult↗
PubMed1986

[Difficult diagnosis of a rapidly developing post-traumatic tumor of the thymus region. Encysted hematoma or intracystic hemorrhage?].

We report a case of rapidly developing (subacute) post-traumatic mediastinal haematoma which initially suggested a malignant tumour of the thymus region. The lesion, discovered on the basis of non-specific signal symptoms 2 months after a mild chest injury, consisted of a voluminous tumour of the thymus region associated with pericardial effusion. At angiography, the mass proved to be extravascular. CT scans of the thorax showed that it surrounded, but did not compress, the mediastinal vessels. Surgery revealed an organized encysted haematoma of the thymus region that had ruptured into the pericardial cavity containing a blood collection. The possibility of an intracystic haemorrhage in a cystic tumour preexisting to the trauma is discussed, but a more likely diagnosis would be chronic haematoma, especially since a similar case independent of any injury has already been published.

Adult↗
PubMed1985

Tubular colonic duplications. A case report and literature review.

Tubular colonic duplication is a rare abnormality. The authors report here on a patient with rather nonspecific symptoms, whose abnormality was only discovered at operation. The good results obtained by a simple operative treatment of such forms contrast with the difficulties arising in clinical and radiological diagnosis. The characteristics of tubular colonic duplication are pointed out, which set it apart from all other types of duplication.

Barium Sulfate↗
PubMed1985

[Marion's calibrated latero-lateral portacaval anastomosis: a truncular shunt maintaining hepatopetal portal blood flow?].

The authors report the hemodynamic study of 22 cases of calibrated side-to-side portacaval shunts performed in patients with liver cirrhosis. In all patients, hepatopetal portal blood flow was present before the operation. According to the data obtained by scintiangiography and angiography, hepatopetal portal flow was maintained in 70 p. 100 of the patients immediately after the operation. After one year there was a discrepancy between the results of scintiangiography and those of conventional angiography: while portal flow seemed to be hepatopetal on the scintigraphy in 11 of controlled patients, it decreased or disappeared on the angiography in 6 other controlled patients. These results are comparable to those of selective shunts and suggest that the calibrated side-to-side portacaval shunt is a valuable procedure in maintaining hepatopetal portal flow. A controlled trial would be useful to assess the place of this operation in the treatment of portal hypertension due to cirrhosis.

Adult↗
PubMed1984

[Carney's triad].

The triad described by J.A. Carney in 1977 is characterized by the successive or concomitant occurrence of three rare tumours of different origin: gastric leiomyoblastoma, functioning extra-adrenal paraganglioma and pulmonary chondroma. It is found mainly in young female patients with prevalent blood group A and may be incomplete, with only two of the three tumours occurring. The case of a young woman who developed gastric leiomyoblastoma and, six years later, pelvic paraganglioma is reported; she died of metastases from the paraganglioma with malignant hypertension. The 16 cases already published are reviewed. The authors insist upon the severity of paragangliomas and the need for a systematic search for the other tumours in patients who present with one tumour of the triad. A histogenetic interpretation relating the tumours to pathology of the neural crest is suggested.

Adult↗
PubMed1984

Anatomical and experimental study of the ductus venosus.

The authors report an anatomical study of the ductus venosus in the stillborn fetus based on resin-corrosion casts and angiography. Study in adult material was done by dissection. In the first part of this paper the classical anatomy of the ductus venosus is described and an anomalous case of a hepatic parenchymal bridge between the left and caudate lobes of the liver is reported. In the second part of this paper study of patency and dilation of the ligamentum venosum to a diameter exceeding 10 mm in adult cadavers is presented. A brief study of portal flow demonstrated that an increase in flow of 30% can be obtained by experimental induction of patency. A patent ligamentum venosum was grafted onto the abdominal aorta in the rabbit. The transplanted segment was fully patent and competent immediately after grafting, but showed thrombosis when the animal was sacrified two months after the operation. In the opinion of the authors, it may be possible to use the patent ductus venosus in man once the problems of long term resistance and patency have been solved. The latter problems are currently under investigation in our laboratory.

Adult↗
PubMed1984

[A new concept of dressing: silastic foam].

The authors report their experience, still short, of a new type of dressing based upon Silastic foam used in general surgery. They emphasise the considerable progress achieved in the everyday care of their patients with easy to manage dressings and the virtual disappearance of pain. This has transformed the patients' existence and has made early physiotherapy possible in certain of them. The simplicity of use of this dressing leads to savings in time and cost and if the patient is cooperative the possibility of widespread use at home by the patient himself. The properties of this foam form the basis for a wide range of indications going beyond general surgery, with applications in ENT, dermatology, rehabilitation centres, etc. Results are satisfactory in 90% of cases, the only failures being due to a failure to obey the basic principles of care: doubtful indication (inadequate disinfection of wounds), neglect of concomitant pathology (diabetes, nutritional state) or lack of patient cooperation.

Adolescent↗
PubMed1983

[Tubular gastrostomy].

Development and generalization of the use of mechanical suturing apparatuses has led to re-evaluation of tubular gastrostomy. Use of the 1AG clamp ensures gastric tubulization under good safety conditions (quality of the suture and absence of opening of the gastric tube). The choice of location of the tube depends upon the size of the stomach. The main indication is for feeding gastrostomies of long duration, particularly cases with irreversible lesions of the esophagus or in the ENT sphere. The quality of the apparatus and the facility with which it can be employed has transformed survival in these patients. A further possible indication is in acute necrotic pancreatitis, its use suppressing complications of classical gastrostomies (Fontan type) (gastric fistulae, disinsertions, difficulties with the apparatus). The only inconvenience of this procedure, minimal in regard to the benefits obtained, is the need for surgical closure.

Abdominal Muscles↗