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M Trias

Publications and source records attributed to M Trias.

At least 55 records · Page 3Linked to original sources

Laparoscopic splenectomy: an evolving technique. A comparison between anterior and lateral approaches.

BACKGROUND: The success of laparoscopic cholecystectomy has favored the application of this technique in abdominal surgery. Laparoscopic splenectomy (LS) suffers from several technical problems for mobilization and manipulation of a solid organ. Lateral approach has been proposed as an alternative to the anterior approach which facilitates LS. The aim of this paper is to compare the results of LS using and anterior or lateral approach. METHODS: Between February 1993 and May 1995, 27 LS were performed (group I, Ant-LS, n: 10; group II, Lat-SL, n: 17). LS was indicated in 19 patients for treatment of an idiopathic purpura, for spherocytosis in four; for AIDS-related thrombocytopenia in two; and for autoimmune anemia and leucopenia in two. Gallstones were associated in two cases and an ovarian cyst in another. RESULTS: LS was completed in 8 patients of group I (80%) and 17 of group II (100%). Operative time (236 +/- 21 min vs 159 +/- 71 min p < 0.003), number of trocars (4.5 +/- 0.5 vs 4 +/- 0.5, p < 0.02), transfusion requirements (60 vs 17%, p < 0.04) and mean stay (6.5 +/- 3.6 days vs 4 +/- 2 days, p < 0.05) were significantly lower in the group of LS with a lateral approach. CONCLUSIONS: The lateral approach significantly facilitates the performance of LS compared with the anterior approach.

Adult↗

Influence of smoking in the glutathione-S-transferase M1 deficiency--associated risk for squamous cell carcinoma of the bladder in schistosomiasis patients in Egypt.

In this study we show an effect of the glutathione-S-transferase M1 (GSTM1) null phenotype on the risk for squamous cell carcinoma (SCC) of the bladder among male smokers in Egypt, with an adjusted odds ratio of 4.8 (95% confidence interval: 1.06-21.77). However, no overall effect of the GSTM1 null phenotype on the risk for bladder SCC was observed.

Adult↗

[Xanthogranulomatous cholecystitis simulating gallbladder neoplasm: therapeutic implications].

Xanthogranulomatous cholecystitis (XGC) is an infrequent type of chronic cholecystitis whose histologic features, in some cases, show a macroscopic appearance which may lead to suspicion of a gallbladder neoplasm with the consequent contraindication of the laparoscopic approach. The incidence of XGC was reviewed in a prospective series of 514 cholecystectomies performed in the authors' department from January 1991 to January 1996. Fourteen cases (2.7%) of XGC were identified with a male/female ratio of 1/1.8 and a mean age of 71 +/- 9 years. The most frequent form of presentation observed was hepatic cholic (43%). Echography showed cholelithiasis in 13 patients (93%). In 3 cases (21%), clinical and echographic suspicion of neoplasm was established, two being in the gallbladder, thus contraindicating the laparoscopic approach. A third patient underwent surgery for suspicion of a colon neoplasm. Xanthogranulomatous cholecystitis presents a macroscopic appearance which may be interpreted as a gallbladder neoplasm in up to 25% of the cases thus leading to treatment with laparoscopy.

Aged↗

Phenotype of glutathione S-transferase Mu (GSTM1) and susceptibility to malignant melanoma. MMM group. Multidisciplinary Malignant Melanoma Group.

The isoenzyme Mu of glutathione S-transferase (GSTM1) is dominantly inherited, and the prevalence of this isoenzyme in the population is about 60%. The lack of GSTM1 has been linked with cancer risk. The frequency of the phenotypes of this isoenzyme in melanoma (MM) patients (n = 197) is reported here. A significantly higher proportion of individuals in the control group (n = 147) had measurable GSTM1 than MM patients (59.1% vs 42%, P = 0.002); there was a higher proportion of positive phenotypes in general among women than among men. Odds ratio analysis indicated that individuals with this polymorphic variant have an approximately 2-fold risk of developing these cancers. GSTM1 phenotype distribution depends on age, smoking habit and tumour pathology. A group of MM patients with dysplastic naevi was also studied.

Adult↗

[Is there a relationship between cholelithiasis and colorectal cancer?].

PROBLEM: The pathogenesis of colorectal cancer must be perceived as a complex interaction between the genetic make-up of the individual and the environment. Recent publications stress the association between colorectal carcinoma and cholelithiasis. OBJECTIVE: A retrospective study was set up to compare the presence of cholelithiasis/cholecystectomy in patients with colorectal carcinoma vs gastric carcinoma. PATIENTS: In 481 patients with colorectal carcinoma, and in another group of 126 patients with gastric carcinoma, the incidence of prior cholelithiasis/cholecystectomy was investigated. RESULTS: In the colorectal carcinoma cases a personal history the cholelithiasis was observed more often than cholecystectomy, 88 vs 8 (P < 0.001) patients, and cholelithiasis was more commonly observed in cases of right-sided colonic cancer, than in cancer of the left colon and rectum. In the group with gastric carcinoma the cholelithiasis incidence was 5.6 percent. CONCLUSIONS: These findings suggest that a relationship was found more often between colorectal cancer and cholelithiasis, that with cholecystectomy.

Adult↗

Myeloperoxidase activity and whole blood chemiluminescence in bladder cancer--influence of smoking.

Polymorphonuclear leukocytes (PMNs) from 63 male bladder cancer patients do not differ from 65 cases of the control group in myeloperoxidase activity (MPO) nor in whole blood chemiluminescence response (CL). MPO activity increased in control smokers compared with the control nonsmokers (p < 0.05) and correlated significantly with cigarette consumption. CL response was also higher in control smokers (p < 0.05) than in control nonsmokers, and correlates significantly with the MPO activity. Both MPO and CL showed significant association with the increased number of peripheral blood PMNs. Although substantial evidence implicates oxygen free radicals, not only in chemical carcinogenesis, but also in the antitumor system (especially the myeloperoxidase system), we were unable to establish either an increase or a decrease in the axidant generating capacities in bladder cancer patients, although a trend towards a higher MPO and CL activity was observed in nonsmokers of this group. In conclusion, we found an enhanced oxidant-generating status of the smokers' PMNs, but its biological significance in carcinogenesis of the bladder remains to be established.

Adult↗

Laparoscopic splenectomy: technical aspects and preliminary results.

UNLABELLED: The success of laparoscopic cholecystectomy has prompted the application of laparoscopic techniques to other abdominal procedures. Laparoscopic splenectomy poses certain specific difficulties for the control of the vascular pedicle, handling and mobilisation of a parenchymatous organ and the retrieval of the specimen. The aim of this paper is to present a technique for laparoscopic splenectomy. MATERIAL AND METHODS: Between February and October, 1993 we attempted laparoscopic splenectomy (LS) in 7 patients. Splenectomy was indicated in 5 patients for treatment of an idiopathic thrombocytopenic purpura and in two patients for treatment of hereditary microspherocytosis. One patient had concomitant cholelithiasis. RESULTS: LS was completed in 6 and converted in one patient to an open procedure due to blood from the splenic bed obscuring vision. Laparoscopic cholecystectomy and splenectomy were performed simultaneously in the patient with cholelithiasis. Three patients required transfusion of two packed cell units. In one patient, the bag broke during extraction of the spleen, and a minilaparotomy was required to remove the spleen. In one patient an accessory spleen was removed. Oral intake was started the next morning. Two patients developed pulmonary atelectasis. Analgesia requirements ranged between 2 and 10 doses, and postoperative stay ranged between 4-8 days. CONCLUSION: LS is technically feasible, and offers the functional and aesthetic advantages of laparoscopic surgery.

Adolescent↗

[Ambulatory treatment of hemorrhoids].

We present a study on 110 patients who were operated of hemorrhoids, on ambulatory basis using the elastic rubber-band ligation. Twenty-six of this patients had degree I hemorrhoids, 54 degrees II and 30 degrees III hemorrhoids. In 19 patients, only one hemorrhoidal mass was bound by session, 84 patients had two masses bound and 17 patients three or more masses. During the postoperative course 76% of the patients had a sensation of incomplete evacuation, but only a 7% of all needed analgesia. About 79% of the patients thought that they had received an excellent treatment. We conclude that this is a very simple technique, allowing excellent results with few complications.

Adult↗