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Biomedical subjects

L Couraud

Publications and source records attributed to L Couraud.

104 records · Page 6Linked to original sources
PubMedDate not supplied

[Strangulated or impacted diaphragmatic hernias. Treatment of six cases (author's transl)].

The authors report the cure of six recent cases of strangulated or impacted diaphragmatic hernia: 3 post-traumatic, 2 hiatal, one congenital. Strangulation or simple impaction are responsible for ischemic phenomena with necrosis and intrathoracic visceral perforation. Intensive care for respiratory, cardio-vascular and metabolic complications, including gastric aspiration, has transformed the prognosis which was recently so poor in this condition. The thoracic approach is advised for the usual reasons and owing to frequent intrathoracic adhesions. It is also advised for ease of treatment of the strangulated viscus and local septic complications.

Adult↗
PubMedDate not supplied

Prevention and treatment of complications and sequelae of tracheal resection anastomosis.

Deaths following tracheal resection anastomosis for tumoral or iatrogenic disease have become fairly rare (four deaths in 122 cases in our experience). Complications can usually be prevented or treated successfully. The most common of these were: infectious lesions of the operated area (6 cases), infection of the tracheal anastomosis with subsequent disruption (1 case), erosion of the innominate artery (no case), granulomatous lesions and recurrence of stenosis (3 cases). The risk of complications can be greatly reduced by meticulous preparation, both anti-infectious and anti-inflammatory, which is always possible even in cases of acute respiratory deficiency. The use of non-sclerogenic sutures is also important.

Asphyxia↗
PubMedDate not supplied

[Left thoracotomy in the excision of cancers of the cardia and the lower third of the esophagus. Apropos of a series of 210 cases].

From January 1 1980 to December 1993, 210 patients underwent exeresis of a cancer of the cardia or the lower third of the oesophagus. There were 193 males and 17 females (mean age 63.5 years, range 18-84). Cancers were in an advanced stage in 56.6% (stage 0, 0.95%; stage 1, 9.04%; stage 3, 43.3%; stage 4, 6.19%). Postoperative morbidity was 21% and hospital mortality was 3.81%. Actuarial survival rate at 1, 3, 5 and 10 years were 64.1%, 23.9%, 17.7% and 12.8% respectively. The advent of the CT scan, better patient selection and improved nutrition management and postoperative care have greatly improved hospital mortality (7 deaths for 118 operations before 1987, i.e. 5.93% and 1 death for 92 operations since 1987, i.e. 1.08%. Creating a circumferential instead of radial phrenotomy and the possibility of raising the anastomosis to upper thorax or in combination with left access and cervicotomy have led to excellent immediate results and confirm our choice in this method.

Adult↗
PubMedDate not supplied

Tuberculosis in transplanted lungs.

Over a 4-year period in four of 61 patients (6.5%) who survived lung transplantation, pulmonary tuberculosis developed at a mean of 7.5 months (range 3 to 13 months) after operation. Clinical and radiologic features were atypical. Definitive bacteriologic diagnosis, which was established on bronchial, sputum, and pleural fluid samples, may be delayed by the concomitant presence of other infective organisms and the necessity for repeated sampling. All patients were treated successfully with antituberculous chemotherapy, but one patient also required lobectomy. At a mean follow-up of 2.25 years (range, 1 to 3 years), three patients are free of active disease, and one patient had a recurrence at 2 years. Tuberculosis in transplanted lungs is an uncommon but serious infection that may elude diagnosis but respond well to treatment.

Adult↗