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Biomedical subjects

P Fuentes

Publications and source records attributed to P Fuentes.

123 records · Page 7Linked to original sources
PubMed1977

[Surgery for carcinoma of the esophagus. Methods and techniques].

Given the poor prognosis in carcinoma of the oesophagus, and with the aid of advances in anaesthesia and postoperative care, surgery has progressively evolved towards wider excision and a reduction in the number of operative stages. Partial oesophagectomy, with gastrolysis and gastro-oesophageal anastomosis, via a left thoracotomy, is favoured by large number of authors. However, it involves a certain number of disadvantages: by definition a limited excision, unsuitable for carcinomas in the cervical region and a marked risk of postoperative gastro-oesophageal reflux. Total oesophagectomy offers a hope of better results from an oncological standpoint, the more so since excision may be extended superiorly (laryngectomy) or inferiorly (total gastrectomy with lymph node excision). Continuity is re-established using a colonic transplant. The operation may be performed in two stages, though a single stage procedure with two teams would appear to be preferable, overall mortality and morbidity being reduced. Finally, colonic oesophagoplasty may be used alone, as a simply palliative measure, without associated tumour excision. By short-circuiting the oesophageal stenosis, it permits continued alimentation per os and the patient's period of survival is more comfortable.

Colon↗
PubMed1977

[Postoperative complications in esophageal surgery].

Apart from certain complications which may follow any surgical procedure, the authors sought to emphasise in particular the problems posed by fistulae occurring after oesophageal surgery. They draw a clear distinction between cervical fistulae which, draining adequately, do not affect the vital prognosis, merely prolonging the period of hospitalisation, and intrathoracic or sub-diaphragmatic fistulae, with a grave prognosis and which pose delicate problems of re-operation, drainage and intensive care. They feel that the possibility of prevention of these digestive fistulae must be stressed, combining the most meticulous surgical technique with appropriate pre- and postoperative care.

Diaphragm↗
PubMed1977

[Preoperative assessment: value and limitations in the preparation for surgery of esophageal or cardia carcinoma].

Pre-operative assessment of a patient suffering from a carcinoma of the oesophagus demonstrates numerous pathological features and marked malnutrition. The authors give details of their method of nutritional preparation: operation is scheduled only when the patients are restored to a state of anabolism, i.e. when daily potassium balance is greater than 40 mEq and daily nitrogen balance exceeds 4 g. Carolies are provided either intravenously or via a gastric tube. Alimentation consists on average of 2,000 to 2,6000 calories as carbohydrate and lipids and 12 to 14 g of nitrogen. This preparation lasts on average for one week. It is associated with a reduction in mortality and the number of postoperative complications.

Cardia↗
PubMedDate not supplied

[Bony tumors of the thoracic wall. Report of 35 cases (author's transl)].

The authors report 35 cases of bony tumours of the thoracic wall and emphasize:--the necessity of wide removal even in the case of benign tumours to avoid possible relapses;--the use of rigid material which in the case of anterior parietal breaches, is alone able to give satisfactory solidity to the thoracic wall which is essential to ensure satisfactory respiratory mechanics;--the interest of surgery whether or not associated with radiotherapy or chemotherapy.

Adult↗
PubMedDate not supplied

[Tuberculous ganglio-oesophageal fistula. A case revealed by hematemese (author's transl)].

The authors report the observation of a tuberculous ganglio-oesophageal fistula which revealed itself through several severe digestive hemorrhages. On this occasion, they recall that these fistulae are unusual and exceptionally hemorrhagic. Diagnosis can only be made by a thorough endoscopic examination. If medical treatment can be envisaged when the tuberculous nature of the lesion has been ascertained, surgery is to be prefered in case of uncertain etiology; the intervetion enables the opening of the tuberculous abscess and, at the same time, the treatment of the oesophageal perforation and the suppression of hemorrhages.

Adult↗