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Biomedical subjects

K Slim

Publications and source records attributed to K Slim.

At least 145 records · Page 8Linked to original sources
PubMed1995

Villous tumors of the duodenum: a retrospective study of 47 cases by the French Associations for Surgical Research.

BACKGROUND: We evaluated villous tumors of the duodenum in regard to preoperative diagnosis of malignancy and the choice of treatment. STUDY DESIGN: From January 1974 to October 1992, forty-seven patients with a benign or malignant tumor arising from the duodenal mucosa were studied. Forty-two patients underwent a macroscopically complete resection of the tumor. Nineteen tumors were malignant. RESULTS: Preoperative endoscopic biopsy results had a 52 percent sensitivity and 100 percent specificity for the diagnosis of malignancy. For the 42 patients who underwent complete resection, jaundice was predictive of malignancy (p < 0.01), whereas tumor size was not (p < 0.2). The five-year survival rate of this group was 69.5 percent (confidence interval: 50 to 84). The recurrence rate was higher (p < 0.01) and the survival rate shorter (p < 0.001) for patients who underwent ampullectomy (n = 8) compared with patients treated by limited resection (n = 20) or pancreatoduodenectomy (n = 14). CONCLUSIONS: Preoperative diagnosis of malignancy is difficult for villous tumors of the duodenum. For tumors located near the papilla, it seems that pancreatoduodenectomy is the best treatment.

Actuarial Analysis↗
PubMed1994

[Large eventrations of the abdominal wall. A technique of aponeurotic plasty associated with a prosthesis].

Surgical repair of major incisional hernia of the abdominal wall is a technically challenging operation. It is not exceptional to be faced with major loss of parietal tissue requiring associated aponevrosis plasty and prosthesis implantation. We report a new technique involving transposition of the aponevrosis sheaths of the rectus abdominis creating a new muscular sheath. The prosthesis thus becomes extra-peritoneal and is inserted deep into the new muscular sheath thus protecting both the intestine and the skin. This technique can be used as an alternative when the size of the defect makes it impossible to bring the two borders of the rectus sheath together. Due to the transposition of the aponevroses, the sutures are placed laterally to the rectus abdominis so the plasty can also be applied when prosthesis implantation is contraindicated.

Fascia↗
PubMed1994

[Celioscopy in digestive oncology].

In patients with suspected or patent cancer involving digestive tract organs, laparoscopy can be successfully used both as a diagnostic tool for initial diagnosis or evaluation of cancer extension and as a therapeutic tool, either in successive or in a single operation. For diagnosis, the main aim of laparoscopy is to confirm the clinical diagnosis or search for neoplastic diffusion. Diagnostic laparoscopy is particularly important in cases of advanced cancer when extension may render laparotomy unjustifiable. Needle biopsies of the liver can be obtained under visual control and non-resectable tumours can be identified. For cancer of the pancreas laparoscopic findings are highly specific, reaching 100% in cases with peritoneal carcinoma. Laparoscopy has similar advantages for staging cancer of the gall bladder which is often discovered after extension to other organs. There are few indications for cancer of the digestive tract itself although laparotomy would be more sensitive than echography or computed tomography for recognizing hepatic or peritoneal metastasis. Palliative treatment via laparoscopy is just at its beginnings and will require continued development in techniques and material. Currently, palliative hyperthermia for peritoneal carcinoma is under clinical evaluation. The future role of curative laparoscopy for abdominal cancers must be evaluated on the basis of prospective protocols.

Digestive System Neoplasms↗
PubMed1994

Prospective analysis of 40 initial laparoscopic colorectal resections: a plea for a randomized trial.

The experience reported herein is on our initial 40 cases of laparoscopic-assisted (LA) colorectal resection that were prospectively evaluated. The operations were performed for colonic tumors of the right segment (n = 4), sigmoid (n = 11), or rectum (n = 7), diverticular disease (n = 17), and chronic constipation (n = 1). Among 22 tumors, 11 were malignant. The operative procedures were 4 right hemicolectomies, 28 segmental left colectomies, 5 anterior resections, 2 abdominoperineal resections, and 1 total colectomy. Thirty-one patients (77.5%) had a successfully completed LA resection. The reasons for conversion in the majority of the cases (66.6%) were difficulties in dissection. In the entirely LA procedures, the mean flatus postoperative day was 3, the mean postoperative hospitalization was 10.7 days, and there were 8 complications (25%) in 7 patients. Two patients were reoperated 2 and 3 months later for adhesion and ischemic stenosis of the colon above the anastomosis. There was 1 death in the LA group (3.2%). The length of operative specimen was 19.6 cm, and the mean number of resected lymph node was six. In contrast to laparoscopic biliary surgery, the benefits of LA colorectal surgery are not obvious. A randomized trial comparing LA and open colorectal resection must be carried out.

Colectomy↗
PubMed1990

[Textile foreign bodies left in the abdomen].

The authors relate eleven cases of forgotten foreign bodies (5 swabs and 6 laparotomy pads) in the abdomen after laparotomies for biliary and digestive (5 cases), gynaecologic (3 cases), or abdominal-wall (3 cases) diseases. Ten patients recovered after surgical extraction of foreign bodies (morbidity: 2 cases) and one patient died before reoperation. This study emphasizes the severity of this complication which can and should be prevented.

Abdomen↗
PubMed1989

[Textile foreign bodies retained in the abdomen].

The authors relate eleven cases of forgotten foreign bodies (5 swabs and 6 laparotomy pads) in the abdomen after laparotomies for biliary and digestive (5 cases), gynaecologic (3 cases), or abdominal-wall (3 cases) diseases. Ten patients recovered after surgical extraction of foreign bodies (morbidity: 2 cases) and one patient died before reoperation. This study emphasizes the severity of this complication which can and should be prevented.

Abdomen↗
PubMed1989

[Pelvic hydatidosis in women. Apropos of 3 cases].

In 80 to 90% of cases, hydatid disease affects the liver and the lung. In only 2% of cases is it localised in the pelvis. On the clinical level there is no specific sign of pelvic hydatid disease. The diagnosis used to be difficult but it has become easy, thanks to modern methods of imaging. The authors report 3 cases that were diagnosed by ultrasound and tomodensitometry. Surgical removal, which was carried out in each case without difficulty, was successful. They review the ultrasound and tomodensitometry pictures of hydatid disease and the principles of its surgical treatment.

Adolescent↗
PubMed1988

[Perineal gangrene secondary to abscesses of the anal margin. Apropos of 9 cases].

Of 9 patients with perineal gangrene secondary to abscess of anal margin, 7 presented deficiency states. Diagnosis was established after an average of 7.4 days following onset of signs, although the clinical picture was obvious and the lesions extended beyond the perineum towards the genital organs, buttocks or thigh. Essential therapy consisted of antibiotic cover, immediate and repeated surgical excision (average number of operations per patient = 6) and stools bypass by colostomy for severe perineal lesions. This resolutely aggressive treatment reduced mortality of this reputedly serious affection to 2 cases (22%), but morbidity was high and a perineoplasty was necessary in a third of the patients.

Abscess↗