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Biomedical subjects

R Parc

Publications and source records attributed to R Parc.

At least 181 records · Page 10Linked to original sources
PubMed1983

[Colovesical fistula of diverticular origin. Diagnostic and therapeutic aspects. 17 cases].

Seventeen patients presenting with diverticular colovesical fistula were treated surgically between 1975 and 1979. Any treatment of the fistula must aim at the cause--colonic diverticulitis--by resection of the colon and colorectal anastomosis. Colostomy was performed in two cases. The bladder was closed by simple suture and a urethral catheter was left in place for ten days. There were few complications, though one patient died. Pneumaturia and fecaluria are specific symptoms. Intravenous pyelography and cystoscopy are of little assistance and only a barium enema should be performed for preoperative diagnosis.

Aged↗
PubMed1983

[Protection of the pancreaticojejunal anastomosis after cephalic duodenopancreatectomy for tumor].

The main risk in cephalic duodeno-pancreatectomy for cancer is disruption of the anastomosis between the jejunum and the fragile pancreatic isthmus, as it may result in pancreato-biliary fistula with highly damaging local and regional repercussions. This risk can be reduced by inserting a 60 cm jejunal loop between the pancreatic and biliary anastomoses. The loop prevents biliary reflux and turns any possible disruption into a pure pancreatic fistula, better tolerated. The authors have used this techniques in 20 consecutive patients. The mortality rate was nil. In each of the four-fistulae that occurred, discharge of pancreatic juice ceased within 3 weeks.

Duodenum↗
PubMed1983

Inhibition of upper gastrointestinal secretions by reinfusion of succus entericus into the distal small bowel. A clinical study of 30 patients with peritonitis and temporary enterostomy.

We prospectively studied peritonitis secondary to small bowel leakage in 30 critically ill patients, each of whom had complete diversion of intestinal continuity by stoma, fistula, or both. All patients received total parenteral nutrition during implementation of the protocol. The proximal intestinal effluent was collected and recycled into the distal small bowel. During reinfusion of succus entericus, a significant reduction in the output of the proximal stoma was observed (mean 30.2%, p less than 0.001). The reinfusion also significantly reduced the volume from isolated small bowel loops in six patients (32.6%, p less than 0.001). When isotonic dialysate solution was infused into the distal intestine, a lesser though significant reduction in stoma output occurred (mean 20.3%, p less than 0.001). These findings demonstrate a consistent inhibitory effect upon upper gastrointestinal secretions by reinfusion of succus entericus. Clinical benefits of this technique include simplified control of fluid and electrolyte balance in patients with high output stomas and optimal utilization of remaining absorptive capacity for enteral nutrition.

Colostomy↗
PubMed1983

[Surgical resection of hepatic metastases of cancers of the colon and rectum].

Surgical resection of metastatic colorectal carcinoma remains controversial. Few patients are eligible for resection since out of 2,725 patients operated upon for colonic or rectal adenocarcinomas in 11 years, 14 p. 100 had liver metastases and only 0.9 p. 100 could be resected. Twenty-nine patients who have undergone partial liver resections for metastatic colorectal carcinomas are reported. The primary neoplasms were Duke's class B(8), Dukes' C (12) or extended to another organ (5). Local extension was unknown in 4 cases. Eight metastases were unique and measured less than 5 cm; seven, although unique, measured more than 5 cm. Fourteen patients had multiple but unilateral hepatic deposits. Twenty major resections and 9 wedge liver resections were performed. One patient died (3.4 p. 100). Average hospital stay was 19 days. Pain was relieved by surgery in 10/11 patients. In 19 patients follow-up exceeds one year: six underwent the resection of a unique and small liver metastasis: one died after 3 and a half years and two are doing well 4 and 10 years after surgery. Thirteen patients underwent major liver resections for large or multiple liver deposits: 9 lived less than one year and 4 are alive after 16, 19, 26 and 60 months respectively. All patients with a follow-up of less than one year are alive. The low operative mortality, the efficacy in relieving pain, and the prolonged survival which can be obtained in some cases justify an aggressive surgical approach to colorectal liver metastases.

Adult↗
PubMed1982

[Palliative treatment of carcinoma of the hepatic duct junction. Intra-hepatic derivation or trans-tumoral intubation? (author's transl)].

Intra-hepatic cholangiojejunostomy (group I patients) and simple trans-tumoral intubation (group II patients) were retrospectively compared in a series of 44 patients with primary carcinoma of the hepatic duct junction. Hospital mortality was 30% in the 13 group I patients and 9.5% in the 21 group II patients. Jaundice and pruritus were equally relieved in both groups. The mean survival time (hospital deaths excluded) was 16 months in group I and 12 months in group II patients. It is concluded that the decision as to which of these two palliative surgical procedures should be performed must rest on the degree of biliary duct distension as well as on the patient's age and general condition.

Adult↗
PubMed1981

[Rupture of the liver secondary to external cardiac massage in a patient with coronary disease : recovery after partial hepatectomy and aortocoronary by-pass (author's transl)].

A 55-year-old man developed ventricular fibrillation during an attack of acute Prinzmetal-type angina, and was treated by external cardiac massage and a defibrillator. Hemorrhagic shock due to laceration of the left side of the liver developed 48 hours later. A liver lobectomy was performed. The postoperative course was uneventful enabling a coronarography examination to be followed by an aortocoronary by-pass, good results being still present after one year. Complications of cardiac massage, especially those involving the liver, are discussed, as well as the treatment of traumatic liver lesions.

Coronary Artery Bypass↗
PubMed1981

[Contribution of Babcock's operation to the treatment of rectal cancer. Results in 170 cases (author's transl)].

When conducted as a curative procedure, for tumors with a lower pole at least 7 cm from the anal margin, Babcock's operation can avoid the need for a definitive abdominal colostomy in some patients, without compromising the chances of survival. Postoperative care is often longer and more difficult than after abdomino-perineal amputation, but immediate mortality and long-term survival appear to be totally comparable. Functional results are good in most cases, and though some hygienic and dietary restrictions are often necessary, these constitute a more minor handicap than that of an abdominal colostomy. On the contrary, Babcocks operation should not be used as a palliative measure, as important restrictive postoperative conditions on a patient with a short survival prognosis, to obtain a functional result after several months when he will not be able to benefit from it, appears to be unwarranted.

Adult↗