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J F Obadia

Publications and source records attributed to J F Obadia.

69 records · Page 4Linked to original sources
PubMed1990

[Factors influencing survival after resection of cancer of the cardia. Comparison of total esophagogastrectomy and upper pole esophagogastrectomy].

Total oesophagogastrectomy (TOG) is the best surgical technique for carcinoma of the cardia. However, oesophagogastric anastomosis is easier in upper pole oesophagogastrectomy (UPOG). This is a retrospective study excluding post-operative deaths and palliative surgery. We studied the factors affecting the survival and then compared TOG (n = 15) and UPOG (n = 26) in carcinomas of the cardia. Bad prognosis was related to several factors: poorly differentiated adenocarcinomas, tumor size, lymph node involvement and residual tumor at the resection margins. The survival rate of resected carcinomas of the cardia was 22 +/- 13%. No difference was noted between extended and limited resections. 5-year survival after UPOG was 20 + 18% and after TOG 11% (0-30) (p = 0.21). In stage 1B, 5-year survival after UPOG 11% and TOG was 50% (19-81) and 33% (0-82) (p = 0.54). In stages II and III A, 3-year survival after UPOG and TOG was 7% (0-20) and 0% (p = 0.16). For a given tumor size, 5-year survival is the same whatever the technique.

Adenocarcinoma↗
PubMed1990

[Anuria associated with an aorto-iliac aneurysm. Apropos of a case].

The authors report a case of a perianeurysmal retroperitoneal fibrosis (RPF) with oligoanuric renal failure. A complete assessment was performed with computed tomography. Bilateral ureteral catheterization restored normal renal function and allowed surgical treatment to be performed including an aorto-iliac replacement and a bilateral ureterolysis with intra-peritoneal diversion of the ureter. A review of the literature revealed 15 similar cases. Pathophysiology and treatment of the retroperitoneal peri-aneurysmal fibrosis are discussed.

Aneurysm↗
PubMed1990

[Pelvic arteriovenous fistula after ligation of the spermatic cord].

The authors report the case of a 40 year old man undergoing left orchiectomy for Leydig cell tumour. Eight months later, the patient presented with a thrill in the left femoral triangle which angiography revealed to be due to a voluminous pelvic arteriovenous fistula arising at the expense of the left hypogastric artery, especially the arteries supplying the external genitalia. Surgical repair of the arteriovenous fistula was performed without prior embolisation. This haemorrhagic surgery was facilitated by the use of a blood recovery apparatus. The immediate postoperative course was uneventful and follow-up angiography one year later showed perfect stability of the result. This case offers an occasion to recall the risks of fistula during massive ligation of arteriovenous pedicles even in the case of small pedicles which should be treated with the same preventive approach as for the renal or splenic pedicle, i.e. separate ligation of the arterial and the venous element.

Adult↗
PubMed1989

[Pharmacokinetics of dextromoramide in the surgical patient].

The pharmacokinetics of dextromoramide were studied in nine patients undergoing peripheral vascular surgery. All the patients were anaesthetised with thiopentone and vecuronium. After tracheal intubation, anaesthesia was maintained with 0.5 to 1.5 vol % halothane and a 60%-40% vol nitrous oxide-oxygen mixture. Once the patient's status was stable, a 0.8 mg.kg-1 bolus of dextromoramide was given intravenously. Blood samples were obtained 2, 5, 10, 30, 60, 90, 120, 180, 240, 300, 360, and 420 min afterwards by an arterial catheter. Dextromoramide serum concentrations were measured with high performance liquid chromatography after extraction with an original technique. The pharmacokinetic parameters were calculated by computer using TRIOMPHE. In five patients, a bi-exponential equation best fitted the results, whereas a tri-exponential equation was necessary for the other four. Mean elimination half-life was 215.3 +/- 78.4 min, and the apparent final volume of distribution was 0.58 +/- 0.20 l.kg-1. Hepatic extraction was low, as shown by a mean systemic clearance of 2.0 +/- 0.9 ml.kg-1.min-1. Liposolubility of this drug is the highest of all opiates, with a heptane/water partition coefficient of 12.3. These parameters demonstrate that, in the opiate drug group, dextromoramide has a place apart from the others.

Aged↗
PubMed1989

[Right-left auricular shunt caused by patent foramen ovale at a multi-purpose intensive care unit. Apropos of 3 cases].

Three cases of symptomatic right-to-left interatrial shunt through a patent foramen ovale were detected in the course of a case of paradoxical embolism related to a massive pulmonary embolism, a case of refractory hypoxemia after cardiopulmonary bypass and a case of refractory hypoxemia in a patient with tricuspid endocarditis. According to anatomic studies, the incidence of patent foramen ovale is 25-30% in healthy people. In that case any pathological event generating an increase in the right atrial pressure higher than the left atrial pressure may induce a right-to-left shunt with systemic arterial desaturation and possible paradoxical embolization. The reported cases emphasize the advantage of ultrasonic examinations (contrast sonocardiography, pulsated or coloured Doppler) to show the right-to-left atrial shunt. The demonstration of this acquired shunt requires appropriate measures in order to reverse the atrial gradient. Sometimes a specific therapy is required such as caval filter insertion in case of pulmonary embolization or surgical closure of foramen ovale in some patients.

Adult↗
PubMed1988

[Pericardio-peritoneal shunt with the automatic stapler EEA].

Transdiaphragmatic pericardio-peritoneal shunt is an effective answer to the problem of recurrent pericardial effusion. The EEA (end to end anastomosis) stapler is a perfect tool for this technique, being easy to handle and offering the possibility of a pathological examination of the pericardic fragment removed. Five patients underwent this type of surgery with satisfactory results on a 3 to 29 months' follow-up.

Anastomosis, Surgical↗
PubMed1986

[Treatment of eventration after transverse laparotomy].

In the few cases of incisional hernia consecutive to transverse laparotomy the classical approximation of the rectus muscles cannot be performed due to the presence of transverse fibrotic scar tissue. An original technique using 4 aponeurotic quadrants cut out of the anterior surface of the rectus sheaths is described.

Abdominal Muscles↗
PubMed1985

Extensor tendon injuries. Presentation of a series of ninety-nine cases.

A series of 99 cases of injuries of the extensor system, followed in the 3 Traumatology and Orthopedics Ward (Dijon, France) is presented. Results were analyzed according to Verdan's classification. In most cases, a Jenning "barb-wire" type repair, introduced in France by Y. Allieu, was made. Early mobilization and skin tension problems are emphasized; two cases of degloving on the dorsum of the hand are presented with details. As well, a special place concerning the results of repair in the proximal interphalangeal joint must be reserved, because of the very frequent association of articular destruction and the very difficult problem s of surgical management which arise in these cases.

Early Ambulation↗