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Biomedical subjects

J Moreaux

Publications and source records attributed to J Moreaux.

At least 55 records · Page 3Linked to original sources
PubMed1983

[Remote results of surgical treatment in chronic pancreatitis. Study of a series of 107 patients].

The aim of the present study was to report the follow-up results of 107 consecutive patients (among whom there were 105 males and 90 p. 100 chronic alcoholics) who have been operated from 1963 to 1976, for chronic calcifying pancreatitis. Pancreatic resection was performed in 66 patients and one or several palliative procedures in 41 patients. There was one post-operative death, after pancreatico-duodenectomy; 13 patients were lost to follow-up, 43 were dead and 50 were reviewed with a 5- to 18-year (mean: 10 years) follow-up. Secondary deaths mainly occurred during the five years following pancreatic resection. For a mean follow-up of ten years, the mortality rate was 49 p. 100 for patients who underwent pancreatic resections and 41 p. 100 for those who underwent palliative procedures. Besides pancreatitis, other complications of chronic alcohol consumption associated with smoking-related diseases were the main causes of death (carcinoma of upper respiratory tract in 6 of the 27 cases for whom the cause of death was known). Clinical results were judged as excellent or good in 70 p. 100 of the 30 patients followed after pancreatic resection, and in 65 p. 100 of the 20 patients followed after palliative surgery. Persistent alcoholism (50 p. 100 of dead patients, 10 p. 100 in living patients) appeared as a decisive factor, influencing long-term survival and determining surgical indications. In conclusion, the present study shows that: (a) in patients with chronic calcifying pancreatitis who have not stopped alcohol consumption, surgery seems indicated only in the event of complications; the surgical procedure should be limited to palliative treatment of the complication, without pancreatic resection; (b) in patients who have freed themselves from alcoholism, surgery is indicated in the event of persistent pain or complications; the choice between a partial pancreatic resection and a palliative procedure should be based on clinical symptoms and operative findings.

Adult↗
PubMed1982

[Biliary lithiasis in patients over 75. 100 cases operated upon (author's transl)].

This is a retrospective study of 100 elderly patients (36 men and 64 women aged 75 years or more) operated upon for biliary tract calculi. Thirty-one patients had one or several underlying visceral diseases and 5 had associated carcinoma of the digestive tract. Calculi of the common bile duct were present in 48 cases, and 41 patients had acute infection, including cholecystitis (14) and cholangitis (27). Surgery included cholecystectomy in every case and opening of the common bile duct in 49 cases with either choledocho-duodenal anastomosis (31 cases) or external biliary drainage (18 cases). Only one patient with gastric carcinoma died. The morbidity rate was low (11 post-operative complications) and each group of patients spent about the same time in hospital. Neither mortality nor morbidity were aggravated by the presence of calculi in the common bile duct and/or acute infection. In uncomplicated lithiasis the surgical indications mainly depend upon the severity of underlying visceral diseases. Early intervention seems desirable in most patients with acute cholecystitis or cholangitis. Surgery of the biliary tract is basically the same in elderly and in young patients, but the operation must be simple and, if possible, complete. The quality of medical surveillance and nursing has considerable influence on the results.

Aged↗
PubMed1981

[Carcinoma of the stomach. Resectability and survival rates in 408 operated patients (author's transl)].

In 125 cases (30,6%) the tumour could not be removed, mainly because of peritoneal metastases and posterior extra-gastric extension. Tumoral resection was performed in 283 cases (69.4%), being palliative in 76 and considered as curative in 216 (52.9%). There were 177 distal gastrectomies, 40 proximal and 66 total gastrectomies with oesophageal resection adapted to the extent of the tumour. Operative mortality was 2.1% after resection and 8% after exploratory and derivative surgery. The five-year survival rates among 213 patients operated upon before December 1973, were 50.8% after curative resection, 39% for all resections and 27.7% for all patients who underwent surgery. The long-term prognosis was evaluated in relation to the site of the lesion, its depth of penetration into the gastric wall and its extension to the lymph nodes. Spreading superficial carcinomas had a five-year survival rate of 89.6% and their incidence (14% of all operated patients) did not change in recent years despite the increasing use of gastric endoscopy. Extension to the lymph nodes was a very important prognostic factor, since the five-year survival rate was 75% in patients with non-invaded primary lymph nodes, as opposed to 32% in patients with invaded primary lymph nodes and only 5% in patients with secondary node involvement.

Adenocarcinoma↗
PubMed1980

[Colonic anastomoses: principles and early complications on the basis of a serie of 663 colectomies (author's transl)].

In this serie of 663 colectomies performed mainly for carcinoma (510 cases), all of the anastomoses were performed by single layer suture. Elective surgery was done routinely after intestinal preparation except in 19 emergency cases which include 13 obstructions. Terminal anastomoses were performed in 605 cases (91 per cent). Among ileo-transverse anastomoses (140 cases) there were 22 per cent of termino-lateral anastomoses, and out of 114 low rectal anastomoses 15 per cent of latero-terminal anastomoses. Since 1970, drainage tubes have been used in only seven cases, out of 518 colectomies. Among the 18 colostomies present at the time of operation, 13 could be closed at the same time as the colectomy. A diversity transverse colostomy was performed in seven cases only. In this series, there were ten postoperative haemorrhages without gravity and three cases of patent anastomotic dehiscence requiring reoperation. There was one death due to anastomotic dehiscence among the four postoperative deaths. Terminal anastomosis is the technique of choice in colonic surgery but must be avoided in cases of marked incongruence between the two ends. Intestinal preparation decreases the number of postoperative complications. Drainage after colectomy is useless when haemostasis is complete and there is no dead space around the anastomosis. A covering colostomy is very rarely indicated. The main factor in the prevention of colonic anastomosis complications, lies, in the preparation of the colonic sections and in the fashioning of the anastomosis.

Colectomy↗
PubMed1979

[A case of distal mesenteric arteritis (author's transl)].

A case is reported of distal mesenteric arteritis discovered during operation and confirmed by arteriography. The arteritis was probably not inflammatory in origin, but could have been due to atheroma. Only one other case of this type has been reported.

Arteritis↗