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Biomedical subjects

M Gruner

Publications and source records attributed to M Gruner.

At least 91 records · Page 5Linked to original sources
PubMed1987

[Post-anastomotic stenosis in atresia of the esophagus. Study apropos of 23 cases].

Between 1977 and 1984, a total of 23 patients with post-anastomotic stenosis after surgery for esophageal atresia were treated conjointly by the ORL and digestive surgery departments of Hôpital Trousseau, France. Most cases were type III atresias treated by direct anastomosis, favoring factors for stenosis being gastro-esophageal reflux, post-anastomotic fistula and the surgical act. Stenosis usually develops early, provokes only moderately severe symptomatology and requires treatment by dilatation mainly, in association with anti-reflux medication. Prognosis was usually good in the 23 cases reported, 21 being able to take food normally. Surgery should be reserved for cases with severe reflux and for those with persistent stenosis.

Dilatation↗
PubMed1987

[Obstruction after uretero-vesical reimplantation in children. Apropos of 40 cases].

Fourteen cases of obstruction after ureteroneocystostomy in children have been cured by surgery between 1972 and 1986; nine patients were referred from outside our hospital. This failure as been observed after reimplantation of simple thin ureter (29 cases) megaureter (7) or duplication (4). The diversity of lesions, of which 52 percent were ischemic stenosis, required surgery without any preconceived idea. A new reimplantation is often necessary, usually with Politano-Leadbetter procedure, and, if necessary, with a hitch-bladder. The operation is successful in 85 percent of patients, but the result is uncertain when the operation is late or when the value of renal parenchymal is initially poor.

Anuria↗
PubMed1986

Treatment of neonatal hydronephrosis by malformation of the ureteropelvic junction: interest of percutaneous nephrostomy.

The authors have studied 42 children less than 1 month of age, who had hydronephrosis due to ureteropelvic junction obstruction. Most of them were detected by antenatal ultrasound. Bilateral forms were found in 13 patients. Thus a total of 55 kidneys were involved. Three forms were distinguished. The benign forms (n = 15) were operated. The mild forms (n = 29) must be operated, but not in emergency. Immediate complications (n = 5) and failures (n = 4) are more frequent than in older children. The severe forms (n = 11) are characterized by renal mutation on IVU. In these forms, percutaneous nephrostomy confirms the diagnosis and shows the functional value of the kidney. Only 5 of these 11 children underwent nephrectomy.

Female↗
PubMed1986

[Pathology of the bile ducts in children with homozygous sickle-cell anemia. Apropos of 5 recent cases].

Five cases of biliary complications in childhood sickle cell disease are reported. In four cases, the pathology was gall stones causing recurrent abdominal pain in a 10 year old boy, a 13 year old girl and a 2 year old infant, and responsible for a "Salmonella septicaemia" in a 17 year old adolescent. In one case, a biliary cyst was diagnosed at 3 years of age. Four children underwent successful surgery. The complications of gall stones are difficult to distinguish from episodes of vasoocclusive abdominal pain. Ultrasonography is an easy method of detecting gall stones and may be repeated regularly in children over 10 years of age. All the children operated in this series were improved by surgery. Patients with sickle cell disease must be carefully prepared for general anaesthesia with a strict protocol of blood transfusion which is only possible in well equipped centers. Elective surgery is by far the best management as postoperative complications are much less common than after emergency surgery. A review of the literature shows that the general tendency is for surgical intervention as gall stones are a cause of recurrent abdominal pain, cholecystitis and dangerous infective complications in those patients.

Adolescent↗
PubMed1985

[Partial nephrectomy in nephroblastoma].

The authors analyse their 18 partial nephrectomies performed on 12 children with either a bilateral or a Wilms' tumor of a single remaining kidney: 13 affected kidneys were otherwise normal, the 5 others were sites of a diffuse nephroblastomatosis. The short term results are good (one technical failure only). The long term results were excellent for Wilms' tumors on otherwise healthy kidneys (no recurrence), as opposed to kidneys with diffuse nephroblastomatosis, where invariable tumor recurrence was observed. Because of the low risk of tumor development in the controlateral healthy kidney, and the established value of classical total nephrectomy, the authors, however, consider partial nephrectomy only in highly selected cases of unilateral nephroblastoma.

Child↗
PubMed1985

[Hepatectomy in children using the trans-parenchymatous compressing suture as a hemostatic procedure].

Intraoperative hemorrhage during hepatic veins approach or during liver parenchyma transsection is the major risk of liver resection for children. We report a technique for hepatic resection based upon facility of safe ligation or clamping of vessels and ductules on a bloodless cut surface during transsection. This technique limits risk of extensive hemorrhage or damage to residual parenchyma, without heavy procedures of anatomical resections. Particularities of liver tissues and capsula of children are used. Perfect hemostasis of the cut edge is obtained by mattress sutures on Silastic * straps performed after clamping with specially designed liver clamps. The 3 main interests of this clamping are detailed. 21 liver resections were performed on children ranging in age from 9 months to 11 years. There was one intra-operative death and one within 30 days. Total blood loss during procedure was about 1/3 blood mass.

Child↗
PubMed1985

[Translation esophageal flap in the repair of traumatic stenosis of the hypopharynx].

A surgical technique is proposed which makes use of a cervical esophageal flap to repair a hypopharyngeal stenosis from traumatic intubation. The technique is also applicable for identical stenosis of caustic or traumatic origin, other procedures described in the literature being suitable only for more extensive or more limited lesions. This simply performed technique provides important mucosal gains in the piriform sinus region and a satisfactory hypopharyngeal line.

Child, Preschool↗
PubMed1984

[Abscessed adrenal hematoma with arterial hypertension].

A neonate presented with anemia. Its relationship to bilateral adrenal hematoma was recognized only at one month of age, when hepatomegaly, inflammatory syndrome and hypertension associated with ultrasonographic findings suggested the diagnosis of right adrenal abscess with compression of the renal pedicle. The child underwent surgery at 6 weeks of age. Surgical drainage associated with antibiotic treatment led to recovery without sequelae. The authors consider the steps in the diagnosis of an abscessed hematoma in the presence of adrenal hematoma and the screening which may detect complications.

Abscess↗
PubMed1984

[Radiology in the diagnosis of volvulus caused by mesenteric rotation anomaly].

Thirty-eight children were operated on between 1974 and 1979 at the hôpital Trousseau for a volvulus of the small intestine due to an abnormal mesenteric rotation. These children may be classified into 3 groups: (1) peracute volvulus, most often neonatal, with intestinal necrosis, generally lethal; (2) acute volvulus, also neonatal, with a favorable outcome after treatment; (3) chronic volvulus, which may occur at any age and may be symptomatic or not. They carry a risk of acute complication, with possible intestinal necrosis. Radiology plays a part in the diagnosis of such anomalies of rotation complicated with volvulus. Upper gastrointestinal tract opacification with barium sulfate, showing the abnormal position of the duodenojejunal flexure and a corkscrew appearance allows surgical decision, as in all cases, treatment is surgical. It consists of derotation and setting in complete common mesentery position.

Acute Disease↗