Search PubMed⌕ Search

Biomedical subjects

R Daou

Publications and source records attributed to R Daou.

14 recordsLinked to original sources
PubMed1998

[Hyperthyroidism and cancer of the thyroid].

STUDY AIM: The idea that thyrotoxicosis is insurance against thyroid cancer has prevailed for a long time. However this association has been reported frequently in the recent literature. The aim of this study is to report our experience concerning this association and to discuss its incidence and its consequences in the light of the present data. PATIENTS AND METHOD: Among the 734 patients who underwent a thyroidectomy between January 1983 and January 1998, there were 125 patients with hyperthyroidism, ten with associated cancer (8%). All patients were female (mean age: 43.8 years) with Graves' disease (n = 2), a toxic adenoma (n = 5), or a multi nodular toxic goiter (n = 3). The cancer was recognized intraoperatively in eight patients. A total thyroidectomy was performed in five cases and a total lobectomy associated with a subtotal contralateral lobectomy in five cases, completed by a treatment with l131 in nine cases. RESULTS: Concurrent carcinoma was present in 10% of the patients with toxic nodular goiter and in 4.4% in those with Graves' disease. Papillary carcinoma presented in all cases. The size of the cancer was between 0.2 and 1.5 cm. Nodal involvement was present in one patient. With a follow-up of 1 to 15 years, there was no local recurrence and no metastasis. CONCLUSION: The diagnosis of hyperthyroidism does not preclude concurrent thyroid carcinoma. The prognostic and therapeutic consequences of this association are still debated.

Adenoma↗
PubMed1998

[Cholecystectomy using a minilaparotomy].

Recent randomized studies have shown that laparoscopic cholecystectomy has little or even no advantage when compared to minilaparotomy cholecystectomy. The authors report the results of a prospective study of minilaparotomy performed at Dahr el Bacheq governmental hospital where laparoscopic equipment was not available. From July 1994 to July 1997 minilaparotomy cholecystectomy was performed on one hundred consecutive patients (75 women and 25 men with an age varying between 26 and 93 years). However, the cholecystectomy could be accomplished through the mini-incision in only 88 cases. Lengthening of the incision was necessary in 12 cases: common duct stones (8 cases), cancer (2 cases), cholecystoduodenal fistula (2 cases). Intraoperative cholangiography was not performed in 3 cases: very thin cystic duct (2 cases), technical problem (1 case). Two patients operated for acute cholecystitis had wound infection. Postoperative course of the 88 completed minilaparotomy cholecystectomies was uneventful: no mortality, no biliary complications, little pain with low analgesia requirement, oral intake on day 1, discharge from hospital on day 2, return to normal activity between day 8 and day 14. Results of minilaparotomy cholecystectomy compare favorably with those of laparoscopic cholecystectomy. It should be an alternative to laparoscopic cholecystectomy especially when cost is a problem or when laparoscopic equipment is not available and an alternative to conventional open cholecystectomy in the case of contraindication to laparoscopic cholecystectomy.

Acute Disease↗
PubMed1997

[Thyroidectomy without drainage].

Recent randomized series did not support routine prophylactic drainage after thyroidectomy. We undertook a prospective study in order to evaluate the effectiveness and the morbidity of a non drainage strategy after thyroidectomy. Between april 1993 and may 1995, one hundred fifty consecutive patients underwent thyroidectomy without drainage. During this period, two thyroid cancers were treated by total thyroidectomy with a modified radical neck dissection and drainage; they are not included in the study. Age range was 16 to 72 years. Sex ratio was 126F/124M. Indication for surgery was: solitary nodule (16), multinodular goiter (56), Graves' disease (21), toxic nodular goiter (34), cancer (8), retrosternal goiter (13), thyroiditis (2). The surgery done was: total lobectomy + isthmusectomy (15), total lobectomy + subtotal controlateral thyroidectomy (42), bilateral subtotal thyroidectomy (84), total thyroidectomy (9). Surgical technique was identical to that used previously by the author when drainage was installed routinely. Patients left the hospital on the first or second postoperative day and were reexamined on day 7 and day 30. There was no mortality, no suffocating hematoma, no reoperation and no laryngeal nerve paralysis. One patient developed a transient hypocalcemia that regressed one month later. Two patients developed a minor hematoma of which one disappeared after two weeks and the other drained spontaneously through the surgical incision on the seventh postoperative day. We conclude that drainage after thyroidectomy has no adverse effects and can be avoided if meticulous surgery is done. Absence of drainage simplifies the early postoperative course, improves the comfort of the patient, decreases hospital stay and reduces hospital cost. However, drainage may be of value in case of hemostatic problems or associated cervical neck dissection.

Adolescent↗
PubMed1996

[Papillary carcinoma developed in the wall of a thyroglossal duct cyst].

A case of papillary carcinoma arising in the wall of a thyroglossal duct cyst is described. This is a rare occurrence (1% of cases). Controversies exist concerning its nature (cancer of the thyroid or primary cancer of the thyroglossal cyst) and its treatment (Sistrunk's operation alone or combined with thyroidectomy).

Carcinoma, Papillary↗
PubMed1992

[Retro-costo-xyphoid hernia in adults. Apropos of 3 cases].

Three cases of retrosternal diaphragmatic hernia (Morgagni hernia) are reported. Diagnosis have been made by conventional radiology (Chest X-ray, Upper G-I series) in 2 cases: the third one was found incidentally during a laparotomy. Peritoneography, CT scan, NMR are recommended in the difficult cases. ONe case presented as acute gastric outlet obstruction secondary to an intra-thoracic volvulus of the herniated stomach. Surgical treatment is indicated in all cases of retrosternal diaphragmatic hernia because of the high-risk of complications (gastric volvulus, colonic obstruction). Surgery through an abdominal approach is preferred and post-operative course is benign.

Adult↗
PubMed1991

[Substernal goiter].

In a series of 363 patients operated for goiter, 60 were retrosternal (16.5%). The female incidence although less than in cervical goiters remains predominant (2.5:1). Most patients are in older age group, 68% being above 40 years. The majority of goiters are multinodular and of long duration. Bilateral (37%) and left sided location (43%) were common. The incidence of cancer was 7%, thyrotoxicosis was noted in 5 patients (8%). Most patients were symptomatic (97%). Diagnosis is easily done by physical examination, chest X-ray and thyroid scintigraphy. Computed tomography might be helpful. Retrosternal goiter is an indication to surgery except in high risk patients. The cervical approach has been used in 98% of cases. There were no post-operative death and no major complications (compressive hematoma, laryngeal nerve paralysis, hypocalcemia).

Adult↗
PubMed1991

[Substernal goiters].

In a series of 363 patients operated for goiter, 60 were retrosternal (16.5%). The female incidence although less than in cervical goiters remains predominant (2,5:1). Most patients are in older age group, 68% being above 40 years. The majority of goiters are multinodular and of long duration. Bilateral (37%) and left sided location (43%) were common. The incidence of cancer was 7%, thyrotoxicosis was noted in 5 patients (8%). Most patients were symptomatic (97%). Diagnosis is easily done by physical examination, chest X-Ray and thyroid scintigraphy. Computed tomography might be helpful. Retrosternal goiter is an indication to surgery except in high risk patients. The cervical approach has been used in 98% of cases. There were no post-operative death and no major complications (compressive hematoma, laryngeal nerve paralysis, hypocalcemia).

Adult↗
PubMed1990

[Synovial chondromatosis of the hip].

The authors report a case of synovial chondromatosis of the hip in physically active male adult operated on three years ago and apparently cured. Review of the literature shows that the diagnosis, essentially based on X-ray examination, bone-scan and arthrography, needs to be confirmed by histological examination. Treatment must be surgical and must be carried out as soon as possible to prevent arthrosis. Surgery should include thorough excision of the synovial membrane and a curettage of the acetabular fossa to avoid recurrence. Under these conditions, prognosis appears to be excellent.

Adult↗
PubMed1989

[Synovial chondromatosis of the hip].

The authors report a case of synovial chondromatosis of the hip in physically active male adult operated on three years ago and apparently cured. Review of the literature shows that the diagnosis, essentially based on X-ray examination, bonescan and arthrography, needs to be confirmed by histological examination. Treatment must be surgical and must be carried out as soon as possible to prevent arthrosis. Surgery should include thorough excision of the synovial membrane and a curettage of the acetabular fossa to avoid recurrence. Under these conditions, prognosis appears to be excellent.

Adult↗