[Unusual lithiasis].
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Anastomosis, Surgical↗
Biomedical subjects
M Sautier
Publications and source records attributed to M Sautier.
[Mortality in the surgical unit of a general hospital. Study of 27 postoperative deaths among patients operated on during 1990-1492].
This study takes in account all post operative deaths during the year 1990 in one surgical Professorial unit of Lille academic hospital (France). During this year, 1492 consecutive patients underwent surgery. The mean age of deceased patients was 63.7 years. 15 died after emergency procedure and 12 after elective surgery. Lastly 2 patients died without any operation. The most common condition encountered in those cases was oesophageal carcinoma, thereafter gastric or duodenal complicated peptic ulcer, and finally colonic carcinoma and diverticular disease. 13 patients had neoplasia (45%). From a critical point of view, 14 patients died after surgical indication or procedure of questionable legitimacy. The comparison with a similar study conducted five years ago and the analysis of these charts allow us to reaffirm some basic principles of surgery.
Adult↗
[Familial recto-colonic polyposis. Treatment].
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Adenomatous Polyposis Coli↗
[Hyperparathyroidism in patients with chronic renal failure: subtotal parathyroidectomy or total parathyroidectomy with autotransplantation? Experience with 121 cases].
From 1973 to 1988 121 patients with chronic renal failure underwent parathyroidectomy (PTX) for secondary hyperparathyroidism. The surgical decision was made upon clinical and/or radiological signs and symptoms. Two kinds of operation were performed: Subtotal PTX 87 cases; Total PTX + parathyroid autograft 34 cases. Post-operative results are discussed. For all cases, the authors emphasize: the need of transcervical thymectomy (ectopic supernumerary gland = 17.3%); the need of routine cryopreservation. Subtotal PTX should be the routine operation. Total PTX with autograft is elicited when a combined thyroidectomy is performed, if parathyroid remnant's blood supply is questionable and in case of recurrent Secondary HPT.
Adolescent↗
Exclusive use of calcium channel blockers in preoperative and intraoperative control of pheochromocytomas: hemodynamics and free catecholamine assays in ten consecutive patients.
This study investigates the role of nicardipine hydrochloride in preoperative and intraoperative blood pressure control and intraoperative catecholamines (norepinephrine and epinephrine) release in 10 patients undergoing pheochromocytoma resection. Nicardipine was used orally in the preoperative period for either 1 or 8 days (60 to 120 mg/24 hr) and then was infused during anesthesia until tumor removal, continuously at a rate of 2.5 to 7.5 micrograms/kg/min, depending on systolic arterial pressure level. All patients were successfully operated on. No severe hypertensive crisis occurred during tumor manipulation, although several patients had a 3- to 85-fold (norepinephrine) and 3- to 40-fold (epinephrine) increase of catecholamines from baseline levels. Hemodynamics data suggest that nicardipine caused significant inhibition of vascular smooth muscle contraction (42% decrease in systemic vascular resistance); calcium-dependent catecholamines release was not inhibited by nicardipine infused as mentioned. Use of nicardipine may be recommended for perioperative and intraoperative control of pheochromocytomas and might substitute for routine alpha-adrenergic blockade.
Adrenal Gland Neoplasms↗
[Immunoscintigraphy or intraoperative isotopic detection of colorectal neoplastic lesions using labelled monoclonal antibodies. Preliminary study. 20 cases].
20 patients submitted to surgery for colo-rectal malignancies, had I.V. injection of 500 microcuries of 125 I F (ab')2 anti CEA, 3 to 5 days preoperatively, after previous thyroid blockade by iodine. At the time of laparotomy, any obvious neoplastic growth or suspicious area was checked by "intra-operative scintigraphy" according to the technique already developed in thyroid surgery by Sten Lennquist. Result was considered as positive when the uptake ratio suspicious tissue/normal tissue was greater normal tissue than 1.5. 18 out of 19 pathologically proven carcinomas, 1 out of 3 liver metastasis, 3 out of 3 extra-hepatic deposits, and 3 out of 9 metastatic nodes only were positive at scintigraphy. These results are not correlated with preoperative plasma level of CEA. Perhaps some colo-rectal carcinomas might be able to secrete CEA but not to excrete it. Improvement of intraoperative decision-making by this method needs further experience to be appreciated. It was helpful in 2 of our 20 cases.
Adult↗
[Pheochromocytoma. Experience of 60 operations].
Between 1971 and 1987, 60 patients presenting 68 pheochromocytomas were operated on in the University Teaching Hospital of Lille. Diagnosis has been transformed by the use of CT scan, which for the last 10 years has enabled the lesion to be more reliably localized than by MIBG scintigraphic scanning. Combination of the two investigations enables the diagnosis to be confirmed in 100% of cases. The following topics are covered: preparation for surgery with the indications for alpha and beta blockers, route of approach--preferably median laparotomy--and operative sequelae as a function of the benign or malignant nature of the tumor.
Adrenal Gland Neoplasms↗
[Mortality in a general surgery department of a University Hospital Center. A study during 1985: 1409 surgically treated cases, 45 postoperative deaths].
In 1985, 1409 consecutive patients underwent surgery in one surgical Professorial Unit of Lille (France). 45 (3.2%) died post-operatively: 28 (62%) were more than 70 years of age, 23 (50%) died after emergency procedure and 18 (40%) died in sepsis. Nothwerthy in retrospect, 20 (44%) died after surgical indication or procedure of questionable legitimacy. Preoperative appraisal of the surgical risk is still challenging nowadays but conclusions drawn from those charts should avoid identical outcome in similar patients.
Adult↗