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Biomedical subjects

J L Caillot

Publications and source records attributed to J L Caillot.

26 records · Page 2Linked to original sources
PubMed1991

[Massive small bowel resection. Apropos of 27 cases].

27 patients were admitted in the Digestive intensive care unit of Croix-Rousse Hospital after a massive bowel resection (residual bowel 120 cm). The etiology was of vascular origin in 15 cases. The length of intestine was nil in 4 cases, between 20 and 50 cm in 12 cases, and between 50 and 120 cm in 11 cases. A colon resection was performed in 20 cases. For 5 patients, a "double temporary intestinal stoma" for ischemic bowel was made. A "second look laparotomy" was performed in 11 cases. The definitive intestinal continuity restauration was made in 23 cases (7 immediately, 16 later) with 3 duodenocolic anastomoses. 8 patients were able to find back a oral alimentation. 19 patients (with 4 total bowel resections) received a home parenteral nutrition. Actually, 11 are alive.

Adolescent↗
PubMed1990

[Gastro-omental free flap: technique, indications and results in buccopharyngeal reconstruction after cancer excision. Apropos of 7 cases].

The gastro-omental flap is centered around the midportion of the greater curve of the stomach, with the attached omentum. The flap is based on the right gastro-epiploïc pedicle. The size of the mucosal patch is adaptable. This flap offers several practical advantages: great plasticity (including the omentum), large length and size of the pedicle, mucus secretion which may improve xerostomia, and less morbidity. Disadvantages include the propensity for excessive mucus production (needing tracheotomy), the requirement for an abdominal operation, and the possibility of peptic ulceration (no case reported in the literature). Seven patients have been treated, with a good result. This flap is suitable for repair of complex soft-tissue defects after extensive cancer surgery.

Adult↗
PubMed1990

[Emergency vascular access in patients with renal failure. Apropos of 32 implantations of permcath].

Central venous catheters allow for the most rapid hemodialysis procedure with sparing of peripheral blood vessels. 32 flexible, double-lumen "permcath" catheters were implanted to 27 patients over a period spanning 42 months (February 86-August 89). Catheter placement was definitive in 2 cases while another 30 provided previsory intravenous access for plasmapheresis (25 cases), acute renal insufficiency (7 cases), and chronic renal failure (17 cases). The mean utilization time per patient was 10.7 +/- 8.01 (SE) weeks. As respects chronic renal failure, this provided a time-opportunity for prospective maturation of conventional venous routes of access or transplantation. Permcath thrombosis occurred in 6 instances (18.75%), 5 times unremittingly (15.4%). Infection occurred in 6 patients (18.75%), leading to ablation of the permcath only once. Thus, permcath ensures safe, effective access for hemodialysis and enables maturation of a conventional venous cutdown. It may be used directly as a permanent vascular approach in case of limited life expectancy or of an extremely precarious vascular bed.

Acute Kidney Injury↗
PubMed1986

[Tracheal rupture in closed cervicothoracic injuries].

Two cases are reported of tracheal fracture occurring during blunt cervico-thoracic trauma. The first case emphasized the impossibility of passing a tracheal tube below the fracture preoperatively, without the fibreoptic or rigid tracheoscope which has the added advantage of making an accurate diagnosis of the fracture. The clinical and paraclinical signs could only lead to a suspicion of the diagnosis, but not its confirmation. The second case showed the use of different ventilatory means during and after surgery (separate lung ventilation, jet ventilation, high frequency ventilation) in case of proximal fractures. The monitoring of intratracheal pressure should be used so as to have the best ventilation for the lowest pressures in the suture zone.

Accidents, Traffic↗
PubMedDate not supplied

[Surgical glove use in France].

Since the end of the 19th century, surgeons have used gloves to prevent infectious complications to the patient. The AIDS epidemic of the 1980's sparked the use of universal precautions to protect the surgeon from infection and vice-versa. The interface between surgeon and patient is in effect a two-way street. Surgical techniques must be modified and barrier protection optimized to minimize these risks. A single layer glove is a fragile barrier to blood exposure; unrecognized glove perforations may lead to unrecognized and prolonged exposure. Double gloving, though far from being a widespread practice in France, seems to be the best protection from pathogen exposure. Glove powder and latex allergies have their own inherent risks to both surgeon and patient in the form of latex allergies and adhesive peritonitis. New institutional protocols will be necesssary in order to make powder-free non-latex gloves available to French surgeons.

France↗
PubMedDate not supplied

Peritonectomy combined with intraperitoneal chemohyperthermia in abdominal cancer with peritoneal carcinomatosis: phase I-II study.

OBJECTIVE: To evaluate the feasibility and the tolerance of Peritonectomy Procedure (PP) combined with Intraperitoneal Chemohyperthermia (IPCH) in patients with peritoneal carcinomatosis, a phase I-II study has been realised from January 1997 to September 1998. METHODS: Eighteen patients were included for peritoneal carcinomatosis from colorectal cancer (13), ovarian cancer (2), gallbladder cancer (1), gastric cancer (1) and peritoneal mesothelioma (1). Peritoneal carcinomatosis were mainly advanced disease (16 stage 3 and 4, 2 stage 2). All the patients underwent surgical resection of their primary tumor with PP as described by Sugarbaker and IPCH (with Mitomycin C, Cisplatinum or both). IPCH used in this study was a "closed sterile circuit" device with inflow temperatures ranging from 46 to 48 degrees C. IPCH was performed on the same day as PP (8118) or delayed (10/18). RESULTS: Significant down-staging of peritoneal carcinomatosis was achieved for 16 patients. One patient died postoperatively, while the morbidity rate was 6/18 (long postoperative ileus, grade 3 leucopenia and anastomotic leakage). CONCLUSIONS: Combination of PP and IPCH could achieve significant tumoral volume reduction in peritoneal carcinomatosis. This aggressive treatment must be employed selectively because of its morbidity. Larger phase III studies are now needed.

Abdominal Neoplasms↗
PubMedDate not supplied

A new case of congenital cyst of the pancreas.

A new case of congenital cyst of the pancreas is reported. A 34-year-old woman was admitted with a painless, large, epigastric mass. Ultrasonography revealed an anechogenic retrogastric tumor. Computed tomography scan described a liquid cyst of the pancreas which was 15 cm in diameter. During surgery, a well-delimited translucent cyst was found and no local malignancy was observed. Extensive distal pancreatic resection with preservation of the spleen was performed and a thin part of cephalic pancreas was preserved. The liquid of the cyst did not contain any mucus. Microscopic study of the cyst wall described normal cuboidal cells and congenital cyst of the pancreas was diagnosed. Several diagnoses including hydatid cyst, pseudocyst and cystic tumors of the pancreas are discussed. Before surgery, lack of acute pancreatitis in recent medical history rules out pseudocyst and hydatid cyst. During the operation, if cystadenocarcinoma is easily ruled out, macrocystic serous cystadenoma is more difficult to exclude. Only histological examination of the cystic wall confirms the difference between cystadenoma and congenital cyst which remains an exceptional entity.

Adult↗