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J Domergue

Publications and source records attributed to J Domergue.

At least 109 records · Page 6Linked to original sources
PubMed1990

[Ileal pouch in the treatment of ulcerative rectocolitis and familial polyposis. Analysis of morbidity in a series of 30 cases].

Between 1984 and 1989, 30 patients underwent total coloproctectomy with J ileal pouch and ileo-anal anastomosis. They corresponded to 29 cases of ulcerative colitis and one case of familial polyposis. The authors report their own experience and the related morbidity and functional results. There were 23% fistulae, 6.6% pouchitis, 10% stenoses, 8.7% pelvic abscesses, 10% bowel obstructions, 6.6% fistulae after ileostomy closure. Only one pouch had to be removed for severe pouchitis. Functional results were partly related to post-operative complications: 50% of patients had normal continence, 57% at least 6 stools per day, 81% had one stool per night, 15% had soiling. Morbidity is discussed for the various types of complications.

Adenomatous Polyposis Coli↗
PubMed1990

The thumb and index finger as principal surgical instruments to secure the inferior vena cava between the liver and the diaphragm in routine operations of the liver.

Presented herein is a simple and safe technique to secure the IVC in its segments above the liver and below the diaphragm through a simple incision in the abdomen. After complete division of the hepatic ligaments, the index finger is passed through the upper recessus of the lesser sac, behind the vein, and just above the caudate lobe, meeting the right thumb on the right side of the vein. A tissue string is then passed, and the IVC is secured. The experience of the authors with more than 100 consecutive hepatectomies has shown this technique to be a reliable approach to secure the IVC during routine hepatic operations.

Diaphragm↗
PubMed1990

pH monitoring for 24 hours of gastroesophageal reflux and gastric function after intrathoracic gastroplasty after esophagectomy.

Gastroesophageal reflux is the main complaint after intrathoracic gastroplasty for carcinoma of the esophagus. Eighteen patients who underwent intrathoracic gastroplasty were studied by 24 hour pH monitoring. Two groups of patients were separately evaluated according to the surgical procedure performed--group 1, nine patients with tubulized stomach and gastroesophageal anastomosis at the apex of the thorax, and group 2, nine patients without tubulized stomach and with low gastroesophageal anastomosis. Gastroesophageal reflux and gastric function were analyzed. Gastroesophageal reflux was clinically present in 36 per cent of patients. During the 24 hour pH monitoring period, the percentage of time that the esophageal electrode showed a pH value of less than 4 was shorter for group 1 than for group 2 (13.3 +/- 11.3 versus 32.7 +/- 21.7), indicating less gastroesophageal reflux. Gastric secretion was also studied with 24 hour pH monitoring. Gastric secretion was reduced after gastroplasty, compared with a control group. Gastric secretion was identical between groups 1 and 2. Tubulization did not impair gastric secretion. Findings from this study show that good functional results can be achieved after intrathoracic gastroplasty if the anastomosis is performed on the neck or at the apex of the thorax. This technique can reduce gastroesophageal reflux without an antireflux procedure.

Adult↗
PubMed1989

Tamoxifen treatment increases the concentration of 52K-cathepsin D and its precursor in breast cancer tissue.

The pro-cathepsin D of Mr 52,000 is regulated by estrogens via the estrogen receptor (RE) and is secreted by breast cancer cells in vitro. In an attempt to predict the hormone responsiveness of breast cancer in vivo, we have assayed total 52K cathepsin D and its precursor in the primary breast cancer cytosol of 36 patients treated before surgery with 30 mg of tamoxifen daily for 1 to 5 weeks (average, 3 weeks). Compared to a similar control population, total 52K cathepsin D was increased by tamoxifen (P = 0.02) but less so than its precursor (P less than 0.001). Furthermore, 45% of the RE-positive tumors from tamoxifen-treated patients had a higher cathepsin D precursor concentration than the same type of tumor from control patients, or than RE-negative tumors from tamoxifen-treated patients. This 3-week challenge test was probably too short to avoid partial estrogenic activity of tamoxifen (flare) and the authors infer that longer time of treatment would decrease rather than increase the concentration of cathepsin D in the RE-responsive tumors. However, two cancers from patients with relapses after prolonged tamoxifen treatment (greater than 6 months) also had high concentrations of 52K cathepsin D and its precursor. The authors conclude that the concentration of cathepsin D and its precursor in breast cancer cytosol can be increased by short-term tamoxifen treatment, suggesting that these tumors are estrogen responsive.

Adult↗
PubMed1989

Multivariate analysis of prognostic factors for curative resectable rectal cancer.

Several reports have shown that prognostic factors of rectal cancer are pathological parameters such as lymph node metastases, tumour infiltration, perineural and venous infiltration, and clinical parameters such as tumour level, mobility of the tumour and number of quadrants involved. From 1979 to 1983, 208 patients were treated curatively for rectal cancer in Montpellier Cancer Institute. A multivariate analysis was done to evaluate prognostic factors of our population. Prognosis was influenced by lymph node metastases, preoperative radiotherapy, tumour infiltration and histological type. The role of preoperative radiotherapy in local control and in survival appeared highly significant. Our results confirm the importance of external beam irradiation in local recurrence and in survival as shown randomly in the EORTC prospective trial. The growing trend in sphincter-saving surgery should be associated with preoperative radiotherapy.

Adult↗
PubMed1989

Inaugural intra-atrial neoplastic thrombosis in stage II Hodgkin's disease.

We report the first case of intra-atrial neoplastic thrombosis discovered in the initial stage of Hodgkin's disease. Considering the course of the case and the recurrence after 18 months we emphasize the necessity of screening cardiac cavities by CT Scan with a bolus, and of treating such a case as an initial stage IV Hodgkin's disease.

Adult↗
PubMed1989

A new technique of total three-stage esophagectomy for carcinoma with a combined right cervical and thoracic approach.

Total esophagectomy with a combined right cervicothoracic approach can be considered to be an extension of the classic right abdominothoracic method. The inclusion of a wide operating field composed of the neck and thorax, as well as the upper right limb, makes the method applicable to both provisional and obligatory operations. The nonobligatory cervical phase constitutes a useful safety approach when frozen section biopsy of the residual esophagus yields positive specimens, if a conventional Lewis-Santy right abdominothoracic procedure has been chosen.

Anastomosis, Surgical↗
PubMed1989

[Colorectal cancers in young adults: the reasons for poor prognosis].

Over an 18-year period, 2,600 patients were treated for colorectal carcinoma in the Montpellier Cancer Institute. Of the 93 patients younger than 40 years of age (3.6%), 78 records were retrospectively studied. The overall 5-year survival rate was 30%. Their survival was not significantly affected by the site of the primary tumor, the degree of tumor differentiation, or sex. The only significant parameter was Dukes staging at presentation (p less than 0.0001). An analysis of sites of recurrence revealed the frequency of liver metastases, ovarian metastasis in women, and local recurrence of rectal cancer. Although the high failure rate in these areas clearly justifies aggressive combined therapy, the high frequency of inaugural Stade D patients (27%) and their short mean survival time (5 months), underline the crucial importance of early detection. However, it is unfortunate that colorectal cancer screening in young patients is difficult because of the low rates of precancerous states (4%).

Adult↗
PubMed1988

Colorectal carcinoma in patients younger than 40 years of age. Montpellier Cancer Institute experience with 78 patients.

During an 18-year period, 2600 patients were treated for colorectal carcinoma in the Montpellier Cancer Institute. Of the 93 patients younger than 40 years of age (3.6%), 78 records were retrospectively studied. The overall 5-year survival rate was 30%. Their survival was not significantly affected by the site of the primary tumor, the degree of tumor differentiation, or sex. The only significant parameter was Dukes' staging at presentation (P less than 0.0001). An analysis of sites of recurrence revealed the frequency of liver metastasis, ovarian metastasis in women, and local recurrence of rectal cancer. Although the high failure rate in these areas clearly justifies aggressive combined therapy, the high frequency of inaugural Stage D patients (27%) and their short mean survival time (5 months), underline the crucial importance of early detection. However, it is unfortunate that colorectal cancer screening in young patients is difficult because of the low rates of precancerous states (4%).

Adenocarcinoma↗
PubMed1988

[Cancer of the rectum: treatment by a radiosurgical combination of 328 patients. Mono- and multivariate analysis of prognostic factors].

From 1973 to 1983, 328 patients have been treated for rectal carcinoma in the Centre Paul Lamarque by preoperative radiotherapy (40 Grays) followed by surgical excision. The average age was 64 years and the sex ratio was 2:1. Abdominoperineal resection was performed in 219 patients anterior resection in 99 patients and transanal resection in 10 patients. Overall 3 years survival was 82 p. 100 and 5 year survival was 73 p. 100. The five year local recurrence rate was 9.4 p. 100 with 3.5 p. 100 of patients having liver metastases. Monovariate analysis revealed that the local recurrence rate was influenced by tumor circumference (p = 0.005), tumor reduction after radiotherapy (p less than 0.001), histological type (p = 0.049), lymph node metastases and tumor infiltration (p = 0.001). Survival was influenced by lymph node metastases, tumor infiltration (p = 0.001) and histological type (p = 0.01). The multivariate analysis revealed that prognosis was influenced by lymph node metastases and tumor infiltration. The "down staging" induced by the radiotherapy did not modify the predictive value of these 2 prognostic parameters when compared to groups treated by surgery only.

Adult↗
PubMed1988

[The role of surgery in primary gastric non-Hodgkin's malignant lymphoma].

A total of 15 cases of primary gastric non-Hodgkin's malignant lymphoma (PGML) seen between 1974 and 1985 were reviewed, and data obtained combined with reports in the literature, to define the place of surgery in this affection becoming the monopoly of chemotherapists. The indication for surgery is indisputable when the diagnosis is in doubt, and justified for ulcerated and preperforating forms and in extirpable tumoral forms of loco malignancy. It should be avoided in high grade PGML unless the operation does not delay chemotherapy. Total gastrectomy should not be performed by principle but by necessity. Abdominal exploration should include lymph node and liver biopsies. An effective total care of these patients requires close cooperation between medical and surgical teams.

Adult↗
PubMed1987

Immunodetection of estrogen receptor and 52,000-dalton protein in fine needle aspirates of breast cancer tumors.

The double immunohistochemical detection of estrogen receptor (ER) and the estrogen-regulated 52,000-dalton protein (52kDa-P) was performed on 35 fine needle aspirates of primary breast cancers. The nuclear ER, stained brown, was differentiated from the 52kDa-P, stained in red, in the cytoplasm of the same cells. The significant correlation obtained between the percentages of positive aspirated cells and the cytosolic concentrations of these two markers showed the validity of semiquantitative detection in fine needle aspirates, which appeared to be more representative of the content of these markers in tumors than was the detection in a single tissue section. Tumor heterogeneity also was defined by this double immunostaining, since among the tumors positive for both ER and 52kDa-P (18 of 35 cases), a heterogeneous group of 12 tumors contained the markers in two distinct cell populations, whereas a more homogeneous group of 6 tumors contained double-stained cells. The first information provided by this study is that the 52kDa-P is not correlated with the ER. This absence of correlation is in accordance with other studies and indicates that the 52kDa-P is associated with tumor proliferation and possibly invasion, rather than with hormone responsiveness or differentiation. The feasibility and validity of double immunostaining of these two markers in human breast cancer aspirates should stimulate larger studies--with clinical follow-up of the patients--aimed at establishing the clinical usefulness of this presurgical test.

Biopsy, Needle↗