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Biomedical subjects

M Lacombe

Publications and source records attributed to M Lacombe.

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

Acute non-traumatic obstructions of the renal artery.

Twenty patients were operated upon for acute obstruction of their main renal arteries (25 kidneys at risk), 18 hours to 68 days after the onset of obstruction. Three nephrectomies were necessary because of total renal infarction but revascularization was possible in all the other cases. The postoperative mortality rate was 15%; definitive kidney salvage rate was 64%. The function of the preserved kidneys was usually satisfactory. This surgical experience has led us to the following conclusions: acute obstruction of a main renal artery does not necessarily cause renal infarction as viability of the kidney can be maintained over long periods of time by the collateral circulation; neither non-function of the kidney, nor the duration of renal artery obstruction must be regarded as signs of renal infarction; no investigation can provide information as to the exact condition of the kidney before surgery. Apart from critically ill patients or segmental renal obstructions, the treatment should be surgical, irrespective of the time that has elapsed from the onset of the obstruction.

Acute Disease↗
PubMedDate not supplied

[Surgical treatment of abdominal aortic aneurysms after renal transplantation].

A new technique of abdominal aortic aneurysmectomy in renal transplant patients is described. The main features of this technique are: 1) absence of protective measures against kidney ischemia, 2) minimal duration of circulatory arrest for the transplant, 3) preservation of retrograde flow from aortic branches during aortic clamping, 4) management of aneurysmal sac postponed after renal revascularization. This technique was used in six patients with satisfactory results.

Aorta, Abdominal↗
PubMedDate not supplied

[Value of the kidney revascularization in renovascular hypertension with kidney failure].

The effects of renal revascularization on blood pressure and renal function were evaluated in 8 hypertensive patients with renal impairment and renal artery stenosis in both kidneys (6 cases) or in a solitary kidney (2 cases). Mean age was 66 +/- 7 years. The mean duration of arterial hypertension was 13 +/- 8 years. In spite of treatment with 3 antihypertensive drugs (or more in 5 cases) blood pressure values ranged from 170-90 to 260-150 mmHg. Adding captopril (in 3 cases) or minoxidil (in 1 case) resulted in control of hypertension in 1 patient and further deterioration of renal function in 2. Two patients underwent surgery after failure of percutaneous transluminal angioplasty. There were 6 revascularizations and 2 nephrectomies with contralateral revascularization. One patient died post-operatively. In the remaining 7 patients, the hypertension was controlled with one or two drugs and the renal function remained stable or improved over a mean follow-up period of 2 years. We consider that these results warrant radiological exploration in all patients, even old, with renal impairment and drug-resistant hypertension. Renal revascularization must be performed as early as possible in view of the rapid degradation of renal function under medical treatment in these patients.

Acute Kidney Injury↗
PubMedDate not supplied

[Renal arteriovenous fistulae (author's transl)].

Five cases of renal arteriovenous fistulae are described: four after needle biopsy of the kidney, one due to intrarenal aneurysmal rupture. One fistula closed spontaneously, the other four patients were operated on and treated by nephrectomy. 243 other cases from the literature were reviewed. The clinical manifestations involve the cardiovascular (arterial hypertension, congestive heart failure) or the urologic (hematuria, renal colic, flank pain) systems. The diagnosis is usually made by flank auscultation (which detects a continuous sound) and by use of renal arteriograms. The causes of these fistulae are numerous: congenital or acquired from biopsy examinations, trauma, surgery, neoplasia, infection, aneurysmal rupture. The usual treatment of these fistulae is a nephrectomy but selective embolization or direct surgical repair make possible, with greater frequency now, renal parenchymal preservation.

Adenocarcinoma↗