Search PubMed⌕ Search

Biomedical subjects

M Le Guillou

Publications and source records attributed to M Le Guillou.

At least 19 recordsLinked to original sources
PubMed1992

A new biodegradable elastin-fibrin material; its use in urological, digestive and cardiovascular surgery.

A new original artificial connective matrix mainly made of elastin and fibrin-like product is used to reinforce damaged tissues and to close and restore a loss of substance in several domains of surgery: all sites in the digestive system and urinary tract; besides, it can substitute for the pericardium in iterative heart operations. In all cases, the original tissue is restored ad integrum while the biodegradable material disappears completely, without any complications.

Animals↗
PubMed1992

[Placenta praevia percreta with bladder invasion: a case report].

The authors report a rare case of placenta praevia percreta with bladder invasion giving rise to the need to carry out an emergency hysterectomy in order to stop the bleeding. The literature when analysed showed the possible outcome of this complication in a woman who had already had a caesarean section and who had placenta praevia that required a second caesarean. In this situation it is almost inevitable that a hysterectomy has to be carried out to stop the bleeding. The hysterectomy should be a total hysterectomy but this can be difficult because of the invariable "fusion" that takes place between the uterus and the posterior wall of the bladder. What has to the done bladder can range from simple closure of a hole in the bladder to ureteric diversion with reimplantation of the ureter depending on how badly the bladder has been invaded. In our case after a sub-total hysterectomy had been carried out with simple closure of the bladder, it was necessary to re-operate to treat a fistula between the bladder and the cervix.

Adult↗
PubMed1991

Detection of vascular complications in renal allografts with color Doppler flow imaging.

One hundred ninety-five color Doppler flow (CDF) examinations were performed in 146 renal allografts to assess the capabilities of this technique in detecting intra- or extrarenal vascular complications. Conventional angiography was also performed in 44 transplants. In the group of transplants with angiographic correlation, CDF sonography enabled correct identification of 30 of 34 vascular complications. CDF showed 10 of 11 significant stenoses of the renal artery or of one of its main branches. There were two false-positive renal artery stenoses (one normal artery and one 40% stenosis). Nine of nine renal artery thromboses and the single pseudoaneurysm were also identified. Within the parenchyma, CDF sonography demonstrated five of five segmental infarcts, two of two postbiopsy arteriovenous fistulas, and three of six segmental or interlobar artery stenoses. Measurement of peak systolic velocity showed a significant difference (P less than .05) between a group (n = 8) with significant stenosis of the renal artery or one of its main branches (mean, 215.2 cm/sec +/- 32) and a group (n = 14) without stenosis (mean, 99.2 cm/sec +/- 19).

Adult↗
PubMed1991

[Functional and metabolic results of 24 Bordeaux-type bladder replacements following total prostato-cystectomy with a more than 2 years follow-up].

In March 1985, we realised the first Bordeaux neo-bladder, with detubularized ileo-colic segment (15 cm of ascending colon and 20 to 25 cm of ileum). The urethra is anastomosed at the lowest point of the caecum. 61 male patients underwent total replacement of the bladder, and we analyse the results in 24 of them, with a follow up more than 2 years. The following results were noted: the sensation of voiding is always physiological, daytime continence is quite perfect, while nighttime continence is good for 71% of patients, the filling pressure of the neobladder is low with a maximum of 20 cm H 0 (range 5-20 cm H20), and its capacity ranged from 300 ml to 400 ml, the mean flow rate is 21 ml/s. We encountered no complication, nothing but 2 gall-stones and two patients with low vitamin B 12. We didn't note neither diarrhea, nor hyperchloremic acidosis. All patients maintained normal renal function. Initially, the indication of Bordeaux ileo-colic neobladder was limited to bladder replacement after cysto-prostatectomy for bladder cancer. Now, the good results obtained, and their durability without any major complication allow us to extend our indications to bladder enlargements in neurogenic bladders.

Cystectomy↗
PubMed1990

[A critical study of the prognosis of renal adenocarcinoma and an attempted classification. Apropos of a series of 322 cases].

The prognosis of adult renal adenocarcinoma was evaluated by analyzing 322 cases treated by extensive nephrectomy (1979-1988). Five-year actuarial survival curves showed that prognosis was closely correlated with anatomic spread: no clear prognostic significance could be ascribed to venous invasion but involvement of retroperitoneal lymph nodes proved to be nearly as negative a prognostic factor as metastatic disease. The grade of malignancy also had a major impact on prognosis. Because the TNM classification, although accurate, is difficult to use and relies solely on descriptive data, a simple five-stage classification is proposed but remains to be validated. The classification system advocated by Robson groups stages with very different outcomes and consequently seems unhelpful.

Adenocarcinoma↗
PubMed1990

[Treatment of post-reno-contusive arterial hypertension by upper polar nephrectomy. Results after 10 years].

The authors report the observation of arterial hypertension occurring six years after renal trauma, secondary to the upper polar infarction of the left kidney accompanied by a hypersecretion of bilateral renin and whose cure was obtained by partial nephrectomy. According to a literature review, it seems that post-reno-contusive arterial hypertension is not rare and can be due to various lesions whose common denominator is renal ischaemia. At present, no clinical or paraclinical element enables the prediction with certainty of the reversibility of the hypertension after the surgical intervention. However, the earlier the intervention, the better the chances of recovery, thus showing the importance of the systematic screening of renal lesions after lumbo-abdominal trauma.

Child↗
PubMed1989

[Oncocytic tumors of the kidney. 11 cases (1978-1987)].

Analysis of this series of cases reveals the following points: complementary investigations (computed tomography, magnetic resonance imaging) sometimes suggest the diagnosis, the oncocytic nature is often a surprise pathological finding, it is difficult to determine whether the lesion is a pure oncocytoma and the exact grade cannot be determined on frozen section, the choice between radical surgery and conservative surgery is made even more difficult, the study of the course of the disease raises the question of whether the term of oncocytoma should not be reserved to low grade tumours.

Adenoma↗
PubMed1989

[Renal autotransplantation. An exceptional solution for salvage of the kidney following failure of surgery of bilateral megaureter].

The authors report the case of a patient with primary bilateral mega-ureter presenting with recurrent pyelonephritis due to reflux occurring after 3 successive reimplantations. Transposition of the right kidney into the homolateral iliac fossa allowed correct anti-reflux with a good clinical, radiological and bacteriological result with a follow-up of 3 years. Renal auto-transplantation represents a last resort solution in certain extreme situations when other simpler procedures are impossible and when preservation of the kidney is essential (solitary kidney or bilateral lesions).

Abnormalities, Multiple↗
PubMed1988

[Vesical replacement by ileo-caecal graft detubulized after total prostato-cystectomy].

Following total prostato-cystectomy, the nearest substitute to a physiological reservoir is a constructed ileo-caecal pouch. The non-mesenteric sides of the caecum and ileum are incised on a length of 15 cm for each apex of the caecum which is anastomosed with the urethra, respecting the striated sphincter. The ureters are implanted into the caecal portion of the pouch. Owing to the length of the ileo-caecal mesenterium, this technique can be used in every case of prostato-cystectomy. Twelve cases followed up for 6 to 18 months are reported.

Cecum↗
PubMed1988

Exploration of acid gastroesophageal reflux by 24-h pH metry in infants at risk of sudden infant death syndrome: a study of 50 cases.

This study focused on the frequency of pathological acid gastroesophageal reflux (AGER) on 50 children considered to be at risk for sudden infant death syndrome: that is to say, 30 near misses and 20 subsequent siblings. Four parameters were studied in a 24-h pH metry: (1) The percentage of time spent at pH less than 4. (2) The length of the longest reflux. (3) The number of refluxes greater than 5 min/h. (4) Esophageal clearance. In comparison to a control group of 46 normal children, we noted a rate of 20% of AGER on the near misses and 31% on children whose siblings had died from sudden infant death syndrome. The pH level of these two groups was significantly more often less than 4, compared to the normal children. The role of AGER in sudden infant death syndrome will, therefore, be discussed.

Gastroesophageal Reflux↗
PubMed1988

[Diagnostic and therapeutic strategy in injuries of the kidney. Apropos of a series of 248 cases].

The analysis of a series of 248 cases led to the following conclusions: intravenous pyelography, together with nephrotomography and ultrasonography represent, the pillars of emergency assessment; computed tomography, performed systematically since 1985, is the most appropriate examination for the precise assessment of the lesions in a functioning kidney; arteriography is still essential in cases of urographically silent kidneys. The choice of therapeutic approach essentially depends on the type of the lesion: severe parenchymal lesions (type III) (58 cases) and certain cases of type II trauma (25 cases) underwent a deferred emergency operation which was as conservative as possible; pedicle lesions (type IV) and serious haemorrhagic lesions required emergency surgery (11 cases); type I or type II lesions with moderate hematomas were usually treated by simple observation (145 cases); cases of trauma seen at the stage of sequelae (8 cases) sometimes required a surgical solution (arteriovenous fistula, segmental ischaemia of the parenchyma with hypertension, encysted urinoma).

Adolescent↗
PubMed1988

[Cisplatin-based chemotherapy in the treatment of advanced-stage tumors of the bladder].

Since October 1984, 39 patients have been treated with cisplatin based chemotherapy for advanced bladder tumour of for pelvic recurrence or metastasis after total cystectomy. Cisplatin-methotrexate protocol (23 cases): 2 cases died during the first two cycles and 21 were evaluated after three cycles: only 39% of objective responses (2 CR-5 PR-2 MR) were observed with a mean survival not exceeding 12.6 months (7 deaths, 2 patients alive at the present time). All of the non-responders died within 4 to 16 months following the start of treatment (mean survival: 8.7 months). These particularly disappointing results led to the suspension of this protocol. Cisplatin-methotrexate-vinblastine protocol: 16 cases since September 1986. Eleven patients have been evaluated after three cycles: 3 CR-3 PR-5 PROG. The C.M.V. protocol appears to have a superior efficacy, principally on bladder, lymph node or lung lesions, at the cost of a higher but acceptable toxicity. Hepatic and central nervous system metastases were observed secondarily in this case.

Adult↗
PubMed1988

[Preventive antibiotic therapy and endoscopic resection. A randomized study of 52 patients].

In an open randomised comparative study, the efficacy of perioperative treatment with pivmecillinam (from the evening before the operation to the day after removal of the catheter) in urinary tract endoscopic surgery complicated by a serious uronephrological history was evaluated in 27 subjects versus a control group of 25 subjects. 80% of patients in this group had an uncomplicated postoperative course compared with only 40% of the subjects in the control group (p less than 0.010). The authors conclude on the value of this type of prophylaxis.

Amdinocillin↗
PubMed1988

[Use of the laser in urology].

The usage of laser therapy in urology is based upon thermal effects that lead to tissue destruction by coagulation necrosis and volatilization. The endoscopic treatment of bladder tumors has been its most important utilization. The authors report their experience with 681 bladder tumors in 198 patients and present the technical details of laser therapy, the indications and the results. The recurrence rate at the previously treated tumor area was found to be rather improved: 0.75/100 months/patient for stage pTa and 0.92/100 months/patient for stage pT1. Other utilizations for laser therapy exist: upper tract urothelial tumors mainly in selected cases as solitary kidney; urethral localizations of urothelial tumors and condylomata acuminata; urethral stenosis, as a complement of optical urethrotomy; hemorrhagic cystitis after radiotherapy and some forms of chemotherapy. The pulsed dye laser may become an important advance in endoscopic treatment of ureteral calculi.

Cystitis↗
PubMed1988

[Bladder replacement with colon segments].

The authors report their experience of 81 cases of bladder replacement with colonic grafts between 1980 and 1986. The operative technique is presented and its complications and functional results analysed. Bladder tumors were the most frequent indication although some cases of tuberculosis, bilharziosis and neurogenic bladder were also included. After a critical study of the literature, the authors state that the ileocecal segment has become their preferred material. Over the last fourty months, 42 patients have been treated by the latter form of bladder replacement.

Cecum↗