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Biomedical subjects

L Bresler

Publications and source records attributed to L Bresler.

68 records · Page 4Linked to original sources
PubMed1986

[Surgical treatment of villous tumors of the rectum and sigmoid. Apropos of 79 cases].

The authors analyse a series of 79 villous tumors of the rectum and sigmoid. These tumors are observed more often in men at an average age of 65. They distinguish benign tumors (44 cases), premalignant (21 cases) and malignant tumors (14 cases). The histology of the whole piece has a greater value than a preoperative biopsy. There are many clinical symptoms and the forms with electrolyte depletion are not rare (6 cases). Tumors with wide implantation need a surgical treatment. It will be conservative in benign cases, but the excision will be wide in cases of invasive malignancy. The indication are based upon the localisation of the tumor on the rectum. Mortality of wide excision is quite important (10) because of the bad general feature of the patients. Recurrences must be detected early by regular endoscopic follow-up.

Adult↗
PubMed1986

[Emergency surgery in colonic obstructions. Retrospective study of 70 cases].

70 patients with complete colonic obstruction requiring emergency surgery were treated at the "Clinique Chirurgicale C" between 1977 and 1984. Carcinoma was the cause of obstruction in 65 cases. Obstruction was situated on the right colon 8 times, on the splenic flexure 13 times, and on the left colon 49 times. In emergency obstruction of the right colon was treated by right hemicolectomy in 6 cases with 0 death. Obstruction of the splenic flexure was treated in 10 cases by simple loop colostomy, twice by resection with ileo-sigmoid anastomosis, 1 by resection without anastomosis with 5 deaths. Obstruction of the left colon was treated by simple loop colostomy in 46 cases. Of the 34 patients who survived after loop colostomy, 26 were reoperated and in 23 cases a resection could be performed with 2 deaths and the colostomy could be closed in a third stage in 20 cases without death. 5 years survival of curative resection was 57%. It is concluded that primary resection is the best treatment for obstruction of the right colon and of the splenic flexure. But three stage resection seems to be a good procedure for obstruction of the left colon with low mortality, low morbidity and good 5 year survival.

Adult↗
PubMed1985

[Rectal metastasis of breast cancer. Apropos of 2 cases].

2 cases of rectal metastatic breast carcinoma were treated by an abdomino-perineal resection. The rectal involvement is quite uncommon, and only 6 others cases treated with surgery have been described in the international literature. We think that only radical surgery can give a good palliation.

Adenocarcinoma↗
PubMed1985

[Retrospective study of a series of 62 cases of hydatid liver cysts].

Sixty-two cases of hydatid cyst of liver were treated and followed up between 1968 and 1982. Current pre-operative investigations include immunologic tests (immunoelectrophoresis, tests for hemagglutination inhibiting antibodies) and medical imaging (ultrasound, scanner). Vascular exploration is now very rarely performed. Surgical treatment is mainly by pericystectomy and was conducted in 90% of cases with a postoperative mortality of 5,2%. Chemotherapy with Albendazole was combined routinely.

Adult↗
PubMed1985

[Prognosis and surgical indications in acute pancreatitis. Contribution of abdominal x-ray computed tomography].

The authors have retrospectively studied 17 patients with acute pancreatitis to see if computed tomography (CT) findings were correlated with the clinical type of acute pancreatitis. This study permit to say that a normal CT scan is possible with an edematous pancreatitis. There is no necrotizing pancreatitis with normal CT scan. But, in 11 CT scan with severe appearance, 6 patients had an edematous pancreatitis of good prognosis. Several explanations are given, but the important thing is the lack of correlation that make CT scan of a bad prognosis value. Any way, CT scan is still the best examination for diagnosis of acute pancreatitis.

Acute Disease↗
PubMedDate not supplied

Major hemorrhage from pseudocysts and pseudoaneurysms caused by chronic pancreatitis: surgical therapy.

Acute hemorrhage from pseudocysts and pseudoaneurysms is the most rapidly lethal complication of chronic pancreatitis. Diagnostic procedures and therapy are still a subject of controversy. We report our experience with 10 patients operated on during the past 10 years. Of these patients, 5 had acute gastrointestinal hemorrhage, 2 had intraperitoneal bleeding, and 3 presented with severe unexplained anemia. Selective visceral angiography performed in 6 patients provided a specific diagnosis in 5 cases. All patients underwent surgical therapy: transcystic arterial ligation and external pancreatic pseudocyst drainage in 5 cases, distal pancreatectomy in 3 cases, and pancreaticoduodenectomy in 2 cases. Gastrectomy was necessary for control of hemorrhage in 1 case. One patient died of sepsis after a pancreaticoduodenectomy. No rebleeding occurred. Surgical therapy with low mortality and morbidity is an acceptable procedure to control bleeding and to treat the underlying pseudocyst. Distal pancreatectomy is recommended to treat bleeding lesions situated in the tail of the pancreas and transcystic arterial ligation seems to be the appropriate procedure to treat bleeding lesions situated in the head and body of the pancreas.

Adult↗
PubMedDate not supplied

Alveolar echinococcosis of the liver: MR findings.

Nineteen cases of proven hepatic alveolar echinococcosis were examined by magnetic resonance (MR) and the results were compared with CT. Fibrous and parasitic tissue showed low signal both on T1- and, generally, on T2-weighted images. In a few cases a high signal on T2-weighted images may be observed, due either to central necrotic zones or to small peripheral cysts. Central necrosis was more easily identified by MR than by CT. However, MR seemed to be less effective than CT in allowing us to reach a positive diagnosis, due to its inability to show microcalcifications. In addition, MR may not reveal small lesions. In most cases T1-weighted images revealed more clearly than CT did the margins of the lesions and the hepatic extension, especially to hepatic veins, vena cava, and perihepatic spaces.

Echinococcosis, Hepatic↗
PubMedDate not supplied

Left hepatic duct injury and thoracobiliary fistula after abdominal blunt trauma.

Thoracobiliary fistula after blunt hepatic trauma is rare. We report a case of pleurobiliary fistula after a blunt hepatic trauma leading to a left hepatic lobe laceration together with a left hepatic duct injury. The management of this traumatic lesion is discussed and related to the existing literature data. The diagnosis of traumatic thoracobiliary fistula rests upon clinical suspicion in the setting of a persistent right pleural effusion. Demonstration of the presence of bile in the pleural cavity by thoracocentesis is considered a proof of pleural biliary fistula. We think that laparotomy is an appropriate route for the treatment of pleurobiliary fistulas. However, when a bronchobiliary fistula is suspected, the patient should be treated with thoracotomy and may require pulmonary resection to remove the fistulous tracts.

Abdominal Injuries↗
PubMedDate not supplied

[Treatment of sub-levator rectocele by transrectal approach. Value of the automatic stapler with linear clamping].

Surgical treatment of rectocele causing outlet blockage is still a subject of controversy. A retrospective study of eight rectocele repairs endorectally using a surgical stapling device done over a two years period was performed. The most common indication was constipation. All patients underwent in the preoperative period complete physiologic examination including defecography, anorectal manometry, electromyography and colonic transit studies. All patients underwent colonoscopy to exclude an obvious physical disorder. There was no postoperative morbidity and the mean hospital stay was four days. Good functional results were obtained in seven patients with a one year follow-up. Endorectal resection using a stapling device is both a simple and effective technique to treat rectocele associated with difficulty in evacuation.

Adult↗
PubMedDate not supplied

What are the small bowel obstructions to operate and how to do it?

Small bowel obstruction is one of the main surgical emergencies. CT scan is today the best exam to detect occlusions requiring an urgent surgical procedure. It also specify the cause of the obstruction. Post-operative adhesions are the first etiology and justify 3.5%-5% of laparotomies in Western Countries. Recently, small bowel obstructions due to adhesions could be treated by a laparoscopic procedure. The authors report a series of 35 patients presenting an acute small bowel obstruction treated by laparoscopy. The laparoscopic procedure was successful in 70% of cases when occlusion was due to acute adhesions. Compared with open procedure, coelioscopy had an immediate benefit on intestinal mobility re-establishment and hospital stay. The morbidity was 4.5% with no mortality. CT has to be part of pre-operative check-up in front of a small bowel obstruction in order to propose a laparoscopic procedure when postoperative adhesions are suspected.

Adolescent↗