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Biomedical subjects

J Loygue

Publications and source records attributed to J Loygue.

At least 37 records · Page 2Linked to original sources
PubMed1985

[Leiomyosarcoma of the small intestine. Apropos of 3 cases].

The authors report three cases of leiomyosarcomas of the small intestine and review the literature on this subject. Leiomyosarcomas of the small intestine are rare tumours, representing 0.2% of all malignant tumours of the gastrointestinal tract. These large, round, hypervascular tumours are derived from smooth muscle cells in the intestinal wall and often develop extra-luminally. The malignant nature is often difficult to confirm on the histological examination. The clinical signs often only appear when the tumour has reached a large volume. It is rare to make the diagnosis pre-operatively, despite the use of a number of investigations. Arteriography is the most reliable examination. Spread of the disease is essentially haematogenous. The malignant tumour invades adjacent organs, causes hepatic metastases and peritoneal seedlings and tends to recur locally. The treatment is essentially surgical and the prognosis varies according to the size of the tumour, its grade, its activity and its degree of extension. The 5-year survival of all forms of the disease varies between 20 and 50%, according to the series.

Aged↗
PubMed1984

[Fistulas of the small intestine with evisceration. New therapeutic approach. 120 cases].

One hundred and twenty cases of post-operative jejuno-ileal fistula with evisceration are reported: 90% of the patients came from other departments. Depending on their mechanism, these fistulae fell into two categories: out-flowing fistulae (93 cases) consecutive to spontaneously opened peritonitis draining through the surgical incision, and in-flowing fistulae (24 cases) resulting from trauma of a superficial small bowel loop; 48% of open small bowel fistulae were due to a questionable operation. Unfavourable prognostic factors were: age over 50, supramesocolic initial lesion, fluid production equal or superior to 1000 ml/24 h, history of at least 2 previous median laparotomies and presence of one or several of 7 severity factors. The overall mortality rate was 46%, falling to 38.5% (inoperable cases excluded) after active treatment. The authors propose to concentrate on prolonged medical intensive care, salvage operations being reduced to a minimum. Over the last 4 years, this approach has brought down to 36% the overall mortality rate.

Adolescent↗
PubMed1984

Final results of a randomized trial on the treatment of rectal cancer with preoperative radiotherapy alone or in combination with 5-fluorouracil, followed by radical surgery. Trial of the European Organization on Research and Treatment of Cancer Gastrointestinal Tract Cancer Cooperative Group.

To improve surgical results of potentially operable rectal cancer, the European Organization on Research and Treatment of Cancer conducted a two-arm randomized clinical trial to compare the efficiency of preoperative administration of radiotherapy, with or without 5-fluorouracil before radical surgery. Two hundred forty-seven eligible patients were admitted from November 1972 through April 1976. The overall survival observed in the group treated with preoperative radiotherapy appears to be better than in the group of patients where preoperative combined modality was administered. Five-year survival is 59% versus 46% with a marginal statistical significance of P = 0.06. Although the combined modality arm had a higher incidence of side effects and postoperative deaths, it had a greater effect than the radiotherapy-alone arm in controlling the disease process, mainly distant metastases to the liver with a result bordering on statistical significance (P = 0.07). The incidence of nonmalignant and intercurrent deaths were higher in the combined modality group, whereas deaths due to malignancy were higher in the radiotherapy-alone group. Observing more stringent selection in disease and patients' criteria, side effects and intercurrent deaths can be effectively reduced with further improvement in adjuvant therapy results.

Adenocarcinoma↗
PubMed1984

Postoperative peritonitis due to gastric and duodenal fistulas. Operative management by continuous intraluminal infusion and aspiration: report of 23 cases.

A new surgical procedure is presented for the management of postoperative peritonitis due to a leak from a suture line in the stomach or the duodenum. At re-operation, an intraluminal unit made of three silicone tubes is inserted through the fistula into the bowel lumen. Extraluminal drains are placed near the fistula. A Witzel jejunostomy is constructed in order to provide continuous high energy enteral support. Intraluminal infusion and aspiration starts immediately after operation. Twenty-three patients have been treated according to this technique. Five died (22 per cent): one from mediastinitis and four from complications unrelated to the fistula. Three (13 per cent) patients developed recurrent abdominal abscesses and underwent re-operation for drainage with no mortality. In the first 2 weeks after operation, most of the discharge was collected by the extraluminal drains. Thereafter the intraluminal unit collected the majority of the fluid, thus allowing the extraluminal drains to be removed. At an average time of 27 days after operation the intraluminal unit was withdrawn. The external fistula created by this technique healed spontaneously in 15 of the 18 survivors, and was surgically closed in three, with no complication. This procedure prevents the recurrence of intra-abdominal sepsis and local complications due to the enzymatic action of the gastroduodenal secretions.

Adult↗
PubMed1984

Development of the human pancreas: variations and pathology. A tentative classification.

The pathology of the pancreas is sometimes related to the embryological development of the organ. The first part of this paper is a presentation of the embryology, morphogenesis and cytogenesis of the pancreas. A tentative classification is then proposed to group together the lesions directly related to anomalies of the position and differentiation of the pancreatic buds. Pathological processes affecting the pancreas can be divided into those related to the ducts and those related to the parenchyma of the gland. In each case anomalies arising at a given stage of development lead to different diseases of the pancreas.

Chronic Disease↗
PubMed1984

Rectopexy to the promontory for the treatment of rectal prolapse. Report of 257 cases.

From 1953 to 1982, 257 patients with complete rectal prolapse were operated upon. To the procedure described by Orr, we have added mobilization of the rectum prior to its suspension and eliminated the pouch of Douglas, and nylon strips have been used for suspension in most patients. There were 57 male and 200 female patients. Ages ranged from 11 to 90 years. Sixty-one patients had already undergone surgery for rectal prolapse with another procedure and prolapse had recurred. The postoperative course was uneventful in 96 per cent of patients. Two patients, aged 79 to 83 years, died of cardiac failure. Follow-up of 115 patients ranged from five to 23 years. Recurrent rectal prolapse was observed in 4.3 per cent of the patients in whom nylon strips were used to suspend the rectum. In 136 patients anal incontinence was associated with rectal prolapse. Normal continence was restored in 84.1 per cent of 107 patients with rectopexy alone and in 64.2 per cent of 14 patients who underwent rectopexy and anal sphincter repair. It is concluded that rectopexy to the promontory with nylon strips after mobilization of the rectum is a safe and efficient procedure for the treatment of rectal prolapse.

Adolescent↗