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Biomedical subjects

J Visset

Publications and source records attributed to J Visset.

At least 163 records · Page 9Linked to original sources
PubMedDate not supplied

[A rare form of cancer of the common bile duct: papillary epithelioma. Report of 4 cases].

Papillary carcinoma is rare as it represents only 5 p. cent of carcinomas of the common bile duct. The authors report 4 cases and emphasize the special characteristics of this carcinoma. The long prodromal phase, dominated by attacks of cholangitis and the incomplete appearance of the jaundice when fully constituted. It affects mainly the common bile duct and has, on microscopy, a villous appearance. Its papillary structure consists of fine coalescent fringes producing a typical glandular appearance. Finally, it evolves very little, therefore there is a good hope of survival even after palliative treatment.

Aged↗
PubMedDate not supplied

Study of survival and prognostic factors in patients undergoing resection for gastric linitis plastica: a review of 86 cases.

A retrospective study was conducted in a series of 86 patients (51 men and 35 women; mean age 63.4 years) treated from 1979 to 1995 for linitis plastica of the stomach (LP). The mean interval between the first manifestations and surgery was 3.5 months. The most frequent clinical sign was epigastric pain which occurred in 80.4% of cases. Biopsies were positive in 75.6% of cases. Typical features of LP were found in only 46% of esogastric barium enemas and 11.8% of upper gastrofiberscopic examinations. Seventy-four patients had surgical excision (51 total and 23 partial gastrectomies). There were 6 (7%) postoperative deaths and 10 (11.6%) surgical complications. Node involvement was found in 54 (72.9%) patients. Overall actuarial survival (n = 86) was 50% at 12 months, 40% at 18 months and 7.5% at 84 months. Survival did not depend on the delay in diagnosis, histological analysis of the extremities of the excised piece, associated tissue differentiation, node involvement or the type of surgical excision. The prognosis differed according to tumor height (P<0.01) and involvement of the deep stomach wall (P<0.001). No independent prognostic factor was found in multivariate analysis. Surgery remains the sole possibility for curative therapy in these patients.

Female↗
PubMedDate not supplied

[Surgical experience with 50 transplantations of neoprene-occluded segmental pancreas. Technique and postoperative complications].

UNLABELLED: Since the beginning of our pancreas transplantation program in November, 1987, 50 patients have received a segmental intraperitoneal neoprene-occluded pancreas graft and a contralateral kidney graft. The aim of this study is to present our surgical technique and the postoperative complications encountered. Operation in the donor: subtotal pancreatectomy is performed. A venous patch is preserved at the end of the splenic vein. The splenic artery is removed with a patch taken from the end of the celiac trunk and the origin of the common hepatic artery, even in case of right (n = 1) or left (n = 4) hepatic artery. The canal is injected with neoprene (2 to 3 cc) ex vivo and the pancreatic parenchyma is recut after stappling. Operation in the recipient: the transplant is inserted in an extraperitoneal location, between the bladder and the pubic arch, then anastomosed to the external iliac vessels. RESULTS: All pancreas grafts functioned immediately. All patients but 3 are alive at present. Seven pancreas transplants were lost postoperatively due to venous thrombosis (n = 3), hemorrhage (n = 3) and death at D27 (n = 1). Many patients developed peripancreatic fluid collections and/or fistulae (the most frequent complication, probably due to the extraperitoneal site of transplantation). The actuarial survival rate of the patients, kidneys and pancreas after 2 years is 96%, 92% and 80%, respectively.

Actuarial Analysis↗
PubMedDate not supplied

[Cystic adenoid cancer of the esophagus. Report of a case and review of the literature].

A 59-year-old man had adenoid cystic carcinoma of the esophagus. The tumor, in the lower third of the esophagus, was resected; the patient died 7 months after surgery from widespread distant metastases. The initial diagnostic was epidermoid carcinoma on the biopsy. In the literature adenoid cystic carcinoma are frequently associated with epithelial abnormalities. Also of interest within the literature was the fact that radiotherapy and combination chemotherapy may be an effective treatment modality for this cancer.

Carcinoma, Adenoid Cystic↗
PubMedDate not supplied

[Giant fibrovascular polyp of the esophagus. Apropos of a case. Review of the literature].

Two operations were necessary to establish the diagnosis, in a patient with giant fibrovascular polyp of esophagus, imaging data suggesting an erroneous perioperative diagnosis of idiopathic mega-esophagus. This intraluminal tumor is benign and pedunculated, the symptoms arising from the esophageal obstruction. During vomiting, blockage at the laryngeal level by the fibrovascular polyp can provoke an acute asphyxia. Treatment is a function of polyp size, small tumors being removed endoscopically with the ever present risk of hemorrhage. Large tumors require surgery, the approach depending on the pedicle site.

Diagnosis, Differential↗
PubMedDate not supplied

[Encapsulating perihepatitis. Report of four cases (author's transl)].

The authors report 4 cases of encapsulating perihepatitis, the macroscopic appearance of which corresponded to the morphological definition of the condition. The circumstances surrounding the diagnosis were very variable: association of ascites and porial hypertension, sub-obstructive syndrome due to associated encapsulating peritonitis, chance discovery at laparotomy or an unexpected finding at autopsy. The diagnosis was made pre-operatively in 2 cases by peritoneoscopy. All the patients had portal hypertension with, in particular, evidence of oesophageal varices. Three patients were treated surgically: hepatic decortication in all cases, combined in one another with umbilico-caval anastomosis. In all cases, the underlying perihepatic matrix produced epiglissonian fibrosis. However the inderlying hepatic lesions varied, ranging from definite cirrhosis to mild fibrosis. In one case, cirrhosis was associated with a hepato-cholangioma with nodular metastatic spread. The prognosis depended essentially upon the effects of general condition and the severity of hepatic lesions. In the light of cases reported over the past twenty years, the authors review the various clinical, pathogenic and therapeutic aspects of encapsulating perihepatitis.

Aged↗
PubMedDate not supplied

[Is portacaval anastomosis still valid treatment for portal hypertension in alcoholic cirrhotic patients?].

Mortality and quality of survival after portacaval anastomosis in cirrhotic patients are such that the validity of the operation was investigated during a retrospective study of 242 cases, operation being for hemorrhage and involving emergency or delayed surgery. Operative mortality was higher in emergency cases, but was improved by stricter selection criteria, particularly of pathological features. Cause of death from secondary factors varied during the two years following anastomosis, with perhaps a high frequency of hepatic failure. Recurrence of hemorrhage was a serious complication often related to hepatic insufficiency, while the onset of combined jaundice-edema-ascites (1 out of 4 patients) was frequently the result of continued alcohol abuse. Portacaval encephalopathy (24,4%) did not worsen the vital prognosis, and was severe in only 3 cases. Alcohol intoxication was very frequent in minor forms. Edema of the lower limbs (34,4% of cases), a frequent complication, appeared to result mainly from hemodynamic causes. A return to work was not possible in 20% of patients, but in only 12% was this due to the anastomosis. Portacaval anastomosis would not, therefore, appear to alter survival of patients from complications of cirrhosis. It suppresses the hemorrhagic risk, however, and the course of the disease is then related only to the cirrhosis and to its stability if abstinence is maintained.

Adult↗
PubMedDate not supplied

[Voice, laryngeal nerves and thyroid surgery. Anatomic and clinical study. Results apropos of a homogeneous series of 378 interventions].

The authors report their experience of thyroidectomy on the basis of 378 excisions (230 bilateral procedures). Their surgical attitude limiting nerve dissection is supported by pathological findings in 24 specimens injected with latex, emphasising the importance of the medial lateral thyrotracheal ligament as a marker. Postoperative laryngoscopy revealed 11 cases of nerve damage (8 recurrent laryngeal nerve, 3 lateral laryngeal nerve). This affected 1.3% of the recurrent laryngeal nerves and 0.57% of the lateral laryngeal nerves exposed. The lack of routine laryngoscopic follow up undoubtedly led to underestimation of the prevalence but the number of recurrent node excisions in this group undoubtedly led to overestimation.

Female↗