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Biomedical subjects

P Segol

Publications and source records attributed to P Segol.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Orthotopic liver transplantation for metastases of bronchial carcinoid tumor].

We report the case of a 42 year old man in whom orthotopic liver transplantation was performed successfully for unresectable hepatic metastases of a bronchial carcinoid tumor. Prior to transplantation, somatostatin therapy, pulmonary lobectomy, and systemic chemotherapy (streptozotocin and fluorouracil) were performed. After 9 months there were no signs of clinical or biological recurrence. Orthotopic liver transplantation might be indicated for unresectable and limited liver metastases of neuroendocrine tumor.

Adult↗
PubMed1992

[Adenocarcinoma on endobrachyesophagus. Results and prognostic factors apropos of 19 cases surgically-treated].

The authors report about a retrospective series of 19 operated patients with adenocarcinomas in a columnar lined esophagus. The resection rate was 95%, the postoperative mortality rate was 5.5%. The survival rate following curative exeresis (n = 14) was 32% (+/- 14) at 5 years. All patients with a stage III lesion died after 2 years, while 46% (+/- 19) of those with stage I or II tumors (p less than 0.001) survived at 5 years. In a multivariative analysis, the most important prognostic factor is the histological grade (p less than 0.01), then the extension to the lymph nodes (p less than 0.1). As the adenocarcinoma often reveals the columnar lined esophagus, the improvement of the prognosis certainly depends on the evaluation of the treatment, which combines pre- or postoperative radiation and chemotherapy, in multidepartmental prospective studies.

Adenocarcinoma↗
PubMed1991

[Spontaneous and instrumental perforations of the thoracic esophagus (non-neoplastic, non-caustic). Apropos of 20 cases].

The authors present twenty cases of spontaneous or instrumental perforation of the thoracic esophagus (neoplastic and caustic perforations excluded). The delay before treatment was less than 24 hours in only one case. Mortality rate was 15%, concerning three patients (three cases of Boerhaave's syndrome) treated by T tube drainage. The contribution of exclusion using stapling technique should increase the indications of direct suture, which remains elective treatment. Esophagectomy retains its indications for perforations with pathologic esophagus or late diagnosis.

Adult↗
PubMed1989

[Adjuvant radiochemotherapy in operable cancers of the thoracic esophagus. Preliminary results of a multicenter study. A study of 119 cases].

119 operable patients with an oesophageal squamous cell carcinoma were treated preoperatively by a combination of radiotherapy (37 Gy in two courses) and chemotherapy by cisplatin (delivered before each course of radiation). The response was evaluated on the resected specimen. 111 patients underwent operation and 101 tumours were resected. The toxicity was acceptable by reducing the Cisplatin dosage from 100 mg/m2 to 80 mg/m2 for the last 67 patients. A complete response was observed in 24 patients and a partial response in 46. The preliminary results show a 57% eighteen-month survival in the group of resected patients. A controlled study is needed to compare this combined regimen versus surgery alone in curatively resectable patients.

Adult↗
PubMed1989

[Surgical treatment of gastroesophageal reflux: which operation to choose: Nissen, Toupet or Lortat-Jacob? A multicenter randomized trial].

Five surgical centers conducted a clinical randomized prospective trial in order to objectively evaluate the two-year results of three anti-reflux procedures regularly performed in France: complete (360 degrees) fundoplication (Nissen), posterior partial (180 degrees) fundoplication (Toupet) and cardiophrenopexy (Lortat-Jacob). Fifty-two patients, mean age 53 years, range 28 to 74 yrs, with uncomplicated gastroesophageal reflux, as defined according to clinical, radiologic, endoscopic and pHmetry criteria, were included in this study. Twenty patients underwent a Nissen procedure, 18 had a Toupet procedure, while 14 had a Lortat-Jacob procedure. The main criterion of assessment was Minaire's pHmetry score evaluated at two years postoperative. All three groups were well matched for clinical, radiologic, endoscopic, manometry and pHmetry findings. At two years, the number of asymptomatic patients did not statistically differ within the three groups. Four patients, however, required reoperation for invalidating recurrences: three following Lortat-Jacob's procedure and one after Toupet's procedure. Nissen's and Toupet's procedures significantly improved pHmetry scores compared with Lortat-Jacob's procedure; pHmetry was improved, but non significantly, by Nissen's procedure, as compared with Toupet's procedure. Lower sphincter pressure was significantly increased (p less than 0.01) by Nissen's procedure as compared with the two other techniques. The lower sphincter was significantly lengthened by Nissen's and Toupet's procedures as compared with Lortat-Jacob's technique (p less than 0.01). The total length of esophagus was significantly increased (p less than 0.01) by Nissen's and Lortat-Jacob's procedures in comparison with Toupet's technique. The distance separating the lower sphincter of the esophagus and point of pressure reversal was significantly decreased (p less than 0.05) by the Nissen procedure only.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Esophagectomy without thoracotomy using a stripping method: technic, results, indications in benign and malignant diseases of the esophagus].

A technique of esophagectomy without thoracotomy using a stripper with limited dissection of the mediastinum has been applied to 48 patients: neoplasia in 41 (squamous-cell carcinoma of the esophagus: 34, carcinoma of the gastric cardia: 5, pharyngeal carcinoma: 2) and non-malignant pathology in 7 (2 caustic necroses, 2 ruptured esophagus, 2 anastomotic leakages after gastro-esophageal resection, 1 caustic stenosis). There were 3 post-operative deaths. The best indications of this procedure are extended tumors of the lower esophagus in poor-risk patients, and perhaps superficial carcinomas of the esophagus whatever the site. The usefulness of this technique in such situations as perforations and mediastinitis is emphasized.

Adult↗
PubMed1987

[Chemoembolization of hepatic metastases. Preliminary study].

Twenty-one patients with hepatic metastases were treated by chemoembolization over a 2-year period, the technique consisting of selective injection of a mixture of Spongel powder and Adriamycin plus 5-FU into the hepatic artery. Indications and results are discussed as a function of clinical, biologic and radiologic criteria.

Adult↗
PubMed1986

[Functional studies of the esophagus in gastroesophageal reflux: application to anti-reflux surgery].

A functional exploration of the esophagus, an acid reflux test, a manometry and an endoscopic examination were performed on 56 patients in succession, who had undergone a complete fundoplication for gastro-esophageal reflux. These tests were done pre-operatively as well as post-operatively at short term (1 year) and long term (4 years). The functional and endoscopic pre-operative work-up did not enable to isolate a group of patients likely to present a therapeutic failure. 54 patients were seen again at 1 year, with a good clinical result in 50 of them (92 per cent). At 4 years, 39 out of 48 patients (81 per cent) maintained that result. The acid reflux test was abnormal in all cases of clinical recurrence. Two asymptomatic patients had an abnormal test. One presented a clinical recurrence subsequently, the other had a severe esophagitis confirming the recurrence. On manometry, a significant and stable increase of the pressure of the lower esophageal sphincter was noticed after fundoplication (8.1 +/- 1.8 mmHg pre-operatively, 15.5 +/- 1.4 mmHg at 1 year, 14.5 +/- 1.5 mmHg at 4 years). In case of recurrence, the pressures were in an average lower although values within normal limits could not exclude a recurrence. A complete fundoplication is therefore a reliable long term procedure. The functional exploration of the esophagus post-operatively enables to select asymptomatic patients with a high recurrence risk and gives an objective evaluation of the operative results.

Adolescent↗
PubMed1985

[Evaluation of the activity and quality of care in a digestive surgery department].

Since 1980, details of all patients operated upon in a digestive surgery unit have been entered on record-cards with the view of obtaining information on the activity of the unit and improving post-operative care. Over a 3-year period, 2005 patients underwent surgery, 25% of them for cancerous lesions. Biliary tract operations (385 patients), fundoplication by the abdominal route for gastro-oesophageal reflux (58 patients) and curative resection of the colon for carcinoma (100 patients) were set apart for evaluation. For each of the above pathologies, morbidity, mortality and duration of stay in hospital in cases with uneventful or complicated post-operative course were analyzed. Annual audits of this kind result in accurate evaluation and periodical reappraisal of the therapeutic habits of the medico-surgical team.

Adolescent↗
PubMed1985

[Completed calibrated fundoplication].

Complete fundoplication at present is the most effective surgical treatment of gastro-oesophageal reflux. However, it has a number of side-effects, including post-operative dysphagia, inability to eructate and painful gastric distension. Fifty-five patients were operated upon using a technique which comprises wide gastric release and fabrication of a tension-free valve around a 50F probe introduced through the mouth. After 1 year, 94% of patients were free of reflux and 22% had mild dysphagia. After 3 years, the proportion of reflux-free patients still was 94%; 12% suffered from mild dysphagia and 6% had problems with eructation. Thus, calibration of the oesophagus with a 50F probe reduces the side-effects of complete fundoplication while remaining effective against gastro-oesophageal reflux.

Esophagus↗
PubMed1985

Histology and ultrastructure of the human esophageal epithelium. I. Normal and parakeratotic epithelium.

The authors present a histological and ultrastructural analysis of normal and parakeratotic human esophageal epithelium. Parakeratosis is encountered frequently during routine examinations of noncancerous esophageal mucosa in patients with carcinoma of the esophagus. Morphologically, this alteration corresponds to an incomplete keratinization of the esophageal epithelium with an excessive accumulation of keratin microfilaments, nuclear maturation reaching the stages of pyknosis and lysis, and anomalies in surface cell desquamation.

Epithelium↗