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J Girodet

Publications and source records attributed to J Girodet.

50 records · Page 3Linked to original sources
PubMedDate not supplied

Effects of preoperative chemotherapy on liver function tests after hepatectomy.

BACKGROUND/AIMS: Surgical resection of liver metastases is performed increasingly frequently after chemotherapy, which can induce fatty degeneration, possibly modifying the postoperative course after hepatectomy. This study evaluated the effect of chemotherapy on postoperative liver function tests according to the use of preoperative chemotherapy or not. METHODOLOGY: Thirty-two patients were operated on for isolated breast cancer hepatic metastases, after stabilization or complete response to systemic therapy. The first group included 20 patients operated on after chemotherapy (9 major and 11 minor hepatic resections). The second group included 12 patients operated on without chemotherapy (3 major and 9 minor hepatic resections). RESULTS: Histological examination after chemotherapy confirmed micronodular fatty degeneration in 85% of cases, versus none in the control group (P = 0.05). Fall in prothrombin time on day 1 (D1) was more marked in the chemotherapy group (58%) versus control group (74%) (P = 0.001). gamma-glutamyl transpeptidase did not rise on D7 in the chemotherapy group (1.4 x N), even after major hepatectomy (1.6 x N), in contrast with the control group, in which the mean gamma-glutamyl transpeptidase on D7 was 4.6 x N after major hepatectomy and 2 x N after minor hepatectomy (P = 0.05). CONCLUSIONS: Chemotherapy induces almost constant fatty degeneration of the liver. Hepatic regeneration in the postchemotherapy liver is delayed, as reflected by a later and lower elevation of gamma-glutamyl transpeptidase. The predictive risk of liver failure, reflected by prothrombin time, following minor hepatectomy on postchemotherapy liver is similar to that of major hepatectomy to healthy liver.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

[Prognostic value of the Lauren and Ming classifications in gastric adenocarcinoma. Multidimensional analysis].

Of the various pathology classifications for gastric carcinoma, those of Lauren and of Ming have been claimed to be of prognostic value. We therefore reviewed the charts of 101 patients (mean age 64 +/- 11 years) treated for gastric carcinoma between 1960 and 1983 at the Institut Curie. We excluded the following patients: 1) those with distant metastases; 2) those who were not operated on; 3) those who underwent laparotomy only, and 4) those who had a palliative procedure. The type of surgery performed was partial gastrectomy in 73 cases and total gastrectomy in 28. Pathology was reviewed according to the WHO, Lauren, and Ming classifications. Were taken into consideration: 1) whether the surgeon believed that removal of tumor was grossly complete or not, 2) the degree of parietal involvement according the pTNM classification system, and 3) the number of positive lymph nodes. Survival was analyzed by the Kaplan Meier method after exclusion of all postoperative deaths. Mean overall survival was 30 months, while that for patients undergoing grossly complete removal of tumor was 34 months. In univariate analysis, no correlation was found between survival and pathology according to Lauren's or Ming's classifications, sex, parietal involvement, or age. Survival was statistically correlated with the size of the tumor (p = 0.015), the gross completeness of surgery (p = 0.008), the type of surgery performed (prognosis was better after partial gastrectomy than after total gastrectomy) and the number of positive lymph nodes (p = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMedDate not supplied

[Annular stenosis of the main bile duct after laparoscopic cholecystectomy].

Although celioscopic cholecystectomy provides acknowledged advantages, lesions of the common bile duct appear to be more frequent with this technique than with laparotomy. Two cases of annular stenosis of the common bile duct after celioscopic cholecystectomy are presented. Evidence of their ischemic origin is available, and they lead to reflexions on the use of monopolar coagulation. In both cases, the stenosis was repaired surgically, with resection and anastomosis in one case and with a hepaticojejunal anastomosis in the other. Laying an endoprosthesis as used in case 2 seems to be interesting as a temporary solution to prepare for surgery.

Adult↗