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Biomedical subjects

J Rubay

Publications and source records attributed to J Rubay.

At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

Intra-operative acute leg ischaemia after free fibula flap harvest for mandible reconstruction.

Osteosarcomas of the cranial bones need a large surgical radical resection. The best option to reconstruct mandible defect after resection is the free fibula flap. In our patient an acute ischaemic leg occurred just after the free fibula flap harvest for mandible reconstruction. The abnormal distribution of the calf arteries leads to catastrophic consequences. The peroneal artery could be the main dominant artery of the leg in a small number of patients. We reported an extremely rare case of "peronea magna", described in less than 0.2% of the global population. A careful pre-operative workup of the calf vessels is required in all the patients who need free fibula flap harvest.

Adult↗
PubMedDate not supplied

Surgical treatment of subvalvular aortic stenosis. Long-term results.

From 1966 till May 1988, 53 patients underwent surgery for fixed subaortic stenosis. Subvalvular obstruction was isolated in 27 patients (Group I) and associated with aortic valve lesions in 26 (Group II). A membranous stricture was documented in 5 patients and a fibromuscular ring in 48. Excision of the ring and myectomy were performed in all patients, and an associated aortic valve replacement or reconstruction in 7 and 4 patients respectively. There were no hospital deaths. Follow-up evaluation in 50 patients ranged from 6 months to 22 years. Eight patients had to be reoperated upon (1 from group I, 7 from group II): aorto-ventriculoplasty was performed in 3, aortic valve replacement with redo myectomy in 3 and mitro-aortic valve replacement in 2. One of them had 2 reoperations. Functional status at the time of the last outpatient visit was most satisfactory. Continued evaluation remains necessary as obstruction may reappear despite the absence of symptoms.

Adolescent↗
PubMedDate not supplied

Total anomalous pulmonary venous connection. Long-term results following repair under 3 months of age.

The surgical experience with total anomalous pulmonary venous connection (TAPVC) at the University of Louvain (Brussels) between the years 1975 and 1986 is reviewed. Nineteen patients aged two days to three months with TAPVC were studied. The types of TAPVC were supracardiac in 9 patients, cardiac in 4, infracardiac in 4 and mixed in 2. Profound hypothermia induced by surface cooling, limited cardiopulmonary by-pass and total circulatory arrest were used in all cases. The 4 early deaths concerned the first four neonates who were critically ill. All operative survivors are followed for a mean of 3.5 years (12 months to 8 years). There are two late deaths due to reoperation for pulmonary venous obstruction. All 13 survivors are well at last review. Eleven of them have been recatheterized 4 to 33 months after repair (19 months in average). The pulmonary artery and capillary pressures fell to a normal level after a few months. Ventricular function which was markedly depressed preoperatively, was evaluated by quantitative angiocardiography and echocardiography. It returned to normal late postoperatively. The hospital mortality for the repair of TAPVC in the neonates remains appreciable. Total correction at one operation is advisable. The incidence of postoperative pulmonary venous obstruction is of particular concern. The late postoperative functional and hemodynamic results are excellent. The repair of TAPVC can be considered curative.

Age Factors↗
PubMedDate not supplied

[Pulmonary embolectomy. Clinical experience].

Between 1969 and 1984, twenty-three patients underwent an emergency pulmonary embolectomy under extracorporeal circulation in the Catholic University of Louvain (UCL), Department of Cardiovascular and Thoracic Surgery. The aim of this paper is to delineate the indications of this procedure. Patients were 23 to 70 years old. Diagnosis of Pulmonary Embolism was made according to clinical signs, ECG and Chest X Ray with Swan-Ganz catheter insertion into the pulmonary artery and the help of pulmonary angiogram if time permitted. The surgical technique is briefly described. Four patients died during the immediate postoperative period and three died later. The sixteen survivors all enjoy a normal life.

Adult↗
PubMedDate not supplied

[Treatment of the first episode of pulmonary embolism in the hospital. Anticoagulants, anti-platelet aggregation drugs and thrombolysis stimulants].

The treatment of the first pulmonary embolic accident in Hospital consist in the administration of anticoagulants. Heparin will be first used intravenously or subcutaneously during 10 to 12 days and will be followed by oral anticoagulants (VKA) during 3 to 12 months. These treatments must be controlled following national or international standardized technics and can be associated with antiplatelet drugs or thrombolytic activators. The most important and frequent complications observed are haemorrhages. They are consecutive to a non conformed administration of the drugs or overdosage bound to a non correct control or drugs interferences or to a misappreciated counterindication. They will be corrected in most of the cases by a simple anticoagulant dosage reduction and exceptionally by the interruption of the therapy with administration of antidotes and plasma substitutes. Other complications are extremely rare and bound to the nature of the drugs used.

Anticoagulants↗
PubMedDate not supplied

[The surgical treatment of cancer of the rectum. Analysis of 391 cases (author's transl)].

From 1963 to 1977 included, the authors operated 391 cancers of the rectum, out of 396 cases, which makes up for 98.5%. The tumor was felt on rectal examination in 60% of patients. Resection was performed in 86% of the cases. Schematically the authors recognize 2 types of operations: the anterior resection and the abdomino-perineal amputation by 2 synchronic teams--operation of Lloyd-Davies--that represents a significant progress compared to Miles' operation. Lately preoperative cobalt therapy (2,500 r) has been used for low tumors. Postoperative mortality remains elevated: 9.1% of which 10.1% for the Lloyd-Davies procedures and 7.2% for the anterior resections. Two hundred and sixty-seven patients have at least a 5 year follow-up; four, i.e. 1.5%, were last to follow-up and are considered dead. Gross overall 5 year survival is 36%. Non corrected 5 year survival, after resection is 42.8% dividing in 37.3% for Lloyd-Davies procedures and 51.2% for anterior resections; these figures include all operated patients and not only those who survived the operation.

Humans↗
PubMedDate not supplied

[Drainage in biliary surgery].

Over the past six years, the authors performed 1 018 biliary tract operations. Surgery for biliary tract cancer is not included. Drainage of the wound was only used for technical reasons and in complicated cases of cholecystitis. Five hundred sixty eight (64,3%) cholecystectomies were performed without drainage. The operative mortality in this group was 0.7% (4 patients). One of those 4 died of hemoperitoneum inspite of a rather late reintervention. From their experience the authors conclude that close postoperative follow-up and, when necessary, early reoperation is far more important than routine drainage which is often ineffective when problems arise. Multiple recent randomised studies support this attitude.

Aged↗
PubMedDate not supplied

[Surgical experience in 48 cases of early gastric carcinoma].

The authors are reporting their surgical experience of the early gastric carcinoma (EGC). In the last twenty-one years, 48 patients with 54 EGC were operated on: 30 men and 18 women. The proportion of early gastric carcinoma (EGC) among treated gastric carcinoma which was 8% during the first period has risen to 12.5% during the last six years and to 30% during the last year. The average age was 59 years. Symptoms and means of diagnose are analysed. Gastroscopy with multiple biopsies is the most important method of diagnose. The EGC were limited to the mucosa in 27 cases, in another 27 lesions the submucosa was invaded. Most lesions were type II c and III. There were five associations with another cancer. Distal gastric resection (subtotal) was employed in all cases except in one case of total resection. The over all operative mortality rate (30 days) was 6%. The five years survival rate (excluding operative mortality) is 85% (corrected 93%). The ten years survival rate is 75% (corrected 92%).

Adult↗