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Biomedical subjects

R Lombard

Publications and source records attributed to R Lombard.

At least 19 recordsLinked to original sources
PubMed1994

Laparoscopic highly selective vagotomy.

Between February 1991 and August 1992, 35 patients underwent laparoscopic highly selective vagotomy (HSV) for recurrent duodenal ulcer disease. An antireflux procedure was also performed in 25 of these patients. There was no 30-day mortality and morbidity. The mean operating time was 110 (range 85-205) min for HSV and 155 (range 100-300) min for vagotomy and antireflux repair. Follow-up is short but initial postoperative gastric acid secretion studies have demonstrated results similar to those obtained after conventional open HSV. The main advantage of laparoscopic HSV is the reduction of 70 per cent in hospital stay and 50 per cent in the overall recovery period compared with open surgery.

Adolescent↗
PubMed1993

Colpocystodefecography.

PURPOSE: To assess, in one single procedure, a complete study of the female pelvis, including the Douglas pouch. METHODS: Colpocystodefecography (CCD) combines vaginal opacification, voiding cystography, and defecography. Three hundred examinations are reviewed. RESULTS: Thanks to the simultaneous visualization of the pelvic structures, CCD proved to be more useful than clinical evaluation to diagnose prolapses and particularly Douglas pouch hernias (enteroceles), the clinical diagnosis of which was missed in 93 of 111 cases. Moreover, in addition to morphologic and functional information, CCD brings about a new insight in the study of pelvic organs reciprocal influences, should they be positive (supporting function) or negative (external compression). Finally, significative pelvic surgery and particularly hysterectomy enhances greatly the risk of enteroceles. CONCLUSION: CCD is helpful in the preoperative staging, especially in the selection of the surgical procedure that will least likely predispose to possible late postoperative complications such as vaginal prolapses or enteroceles.

Adult↗
PubMed1993

Laparoscopic Nissen fundoplication: detailed analysis of 132 patients.

With the world-wide use of laparoscopy, new applications have been found, particularly in the field of esophageal and gastric surgery. From January 1991 through April 1992, 132 patients underwent laparoscopic Nissen fundoplication. The indication for laparoscopic intervention was symptomatic gastroesophageal reflux disease (GERD) not responding to medical treatment. The preoperative assessment included esophagogastroscopy, barium meal, esophageal manometry, and, in selected cases, 24 h pH studies. There was no operative-related mortality. The overall morbidity was 7.5%. Ninety-eight patients were seen 3 months after surgery and evaluated for control of reflux symptoms. One patient complained of mild recurrence of reflux symptoms; however, endoscopic examination revealed no evidence of recurrent esophagitis. Three complained of occasional dysphagia and two, of mild dysphagia. One individual required reoperation for persistent, severe dysphagia. The excellent results observed so far with this procedure have led us to believe that laparoscopic Nissen fundoplication is the procedure of choice for patients with intractable GERD.

Adolescent↗
PubMed1993

Percutaneous catheter drainage of abdominal abscess after abdominal surgery. Results in 121 cases.

One hundred and twenty-one peritoneal, retroperitoneal and pelvic abscesses were treated percutaneously using CT or US guidance. The lesions developed after abdominal surgery. Sixty-three abscesses (52%) were situated in the peritoneal cavity, 31 (26%) in the retroperitoneal cavity and 27 (22%) in the pelvis. A definitive treatment was obtained in 74% of peritoneal abscesses, 67% of retroperitoneal abscesses and 82% of pelvic abscesses. Failure most commonly occurred with multiloculated lesions or lesions associated with fistulous communication. There was a low rate of complication (1%). percutaneous drainage avoids the risks inherent in surgery and anesthesia, saves considerable time and meets greater patient acceptance. If a total cure is not systematic, a beneficial temporizing effect may however be obtained by percutaneous drainage. This procedure should be indicated for the initial treatment of postsurgical abscesses.

Abdomen↗
PubMed1991

Laparoscopic Nissen fundoplication: preliminary report.

Twelve patients presenting with symptomatic esophagitis associated with hiatal hernia and gastroesophageal reflux underwent operative management under laparoscopic guidance. The antireflux procedure employed was the Nissen fundoplication. The authors completed the operation laparoscopically in nine patients. Postoperatively, patients were evaluated with repeat fiberoptic endoscopy, esophageal manometry, and barium contrast studies. Postoperative results were considered excellent on the basis of these studies and complete control of symptoms. The mortality rate was 0%. The only major operative complication was a pneumonia that occurred in one patient. At 1 month follow-up, six patients were totally asymptomatic. The authors conclude that laparoscopic treatment of gastroesophageal reflux associated with a hiatal hernia is feasible by a procedure that has already proven its value during open surgery.

Adult↗
PubMed1990

[Reinforced colposuspension (modified Cukier's operation). Immediate results, complications, indications].

In order to avoid mean term failures of colposuspension and short term obstructive complications of sling procedure, the author present a technique of urethropexy combining the two principles: reinforced colposuspension. A series of 67 consecutive procedures is subdivided in 45 stress incontinence and 22 incontinence with prolapse simultaneously treated by spinofixation. Continence is obtained in 97.6% and 91% respectively. Severe obstruction is observed in 3%, all of the first group. There is no infection due to this combined approach. The closure pressure remains similar or increases in 75% of the cases. Compared to others colposuspensions, this technique offers a conceptual advantage, without added morbidity. It is especially indicated when the closure pressure is low, the vaginal wall is weak, or when combined with a spinofixation.

Aged↗
PubMed1990

[2 classical contraindications for enteroplasty in spina bifida].

The authors report two cases of spina bifida which illustrate the two major contraindications of enteroplasty and stress the importance of a detubulated intestinal patch and an isometric ureterocystometry in the diagnosis and treatment of neurogenic bladder.

Child↗
PubMed1987

[Incidence of the degeneration of cutaneous nerve tumors in Recklinghausen's disease].

A retrospective study was conducted in 85 patients with clinically certain von Recklinghausen's neurofibromatosis seen between 1972 and 1982. A similar study was conducted in 105 patients without neurofibromatosis observed during the same period who underwent excision of a cutaneous neurofibroma or schwannoma. Thirty-nine of the patients with neurofibromatosis never had surgical treatment for a nervous skin tumour; 46 had one or several tumours excised for diagnostic purposes or for cosmetic reasons. More than 300 tumours had been removed in these 46 patients. The post-operative follow-up period is now at least 2 years for all patients, 5 years for 85 p. 100 of them and more than 10 years for one-third. Only one case of malignant nervous skin tumour was observed in a patient who never had surgical treatment; it was a neurofibrosarcoma which resulted in death within two years. Two other deaths related to neurofibromatosis were recorded: one after surgical treatment of a duodenal schwannoma, the other due to septicaemia after infection of ulcers on a giant plexiform neurofibroma. Three other deaths unrelated to neurofibromatosis occurred. Local relapses without suspicion of malignancy were observed in 8 of the 46 surgical patients; 3 cases concerned large plexiform neurofibromas of the face; excision was histologically incomplete in most cases with or without relapse. No case of malignancy was recorded in the follow-up of the 105 patients without neurofibromatosis but with nervous skin tumours.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗