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Biomedical subjects

S Houry

Publications and source records attributed to S Houry.

104 records · Page 6Linked to original sources
PubMedDate not supplied

Lymph node involvement as the only prognostic factor in curative resected gastric carcinoma: a multivariate analysis.

The aim of this study was to evaluate the independent influence of clinical and pathological variables on survival of patients with gastric carcinoma using the Cox regression proportional hazard model. Of 156 patients operated on for gastric carcinoma, 46 (29.5%) underwent palliative operation, 24 (15.5%) had a palliative resection, and 86 (55%) had a curative resection. The overall 5-year survival rate was 25 +/- 4%. After curative resection, the 5-year survival rate was 44 +/- 6%. Univariate analysis applied to these patients showed that poor survival was related (p less than 0.01) to: age (over 80 years), absence of epigastric pain, vomiting and dysphagia, total gastrectomy, tumor size (more than 4 cm), lymph node involvement (LNI), invasion through the muscularis propria, absence of intestinal metaplasia near the tumor, and linitis plastica. In multivariate analysis, lymph node involvement was found to be the only independent prognostic factor. The 5-year survival rate was 75.5 +/- 8% without LNI, 28 +/- 10% with proximal LNI, and 7 +/- 6% with distal LNI. Our results suggest that classification into 3 LNI groups is the best staging system for curative resection in gastric carcinoma.

Adenocarcinoma↗
PubMedDate not supplied

Gallbladder cancer: role of radiation therapy.

BACKGROUND/AIMS: Gallbladder carcinoma is characterized by late diagnosis, ineffective treatment and poor prognosis. These tumors were usually considered to be radioresistant. So far, the role of radiotherapy has not been adequately evaluated. The aim of this report is to assess the value of radiotherapy in carcinoma of the gallbladder. METHODOLOGY: We reviewed all publications concerning the role of radiation therapy in gallbladder carcinoma. External radiation therapy, intra-operative radiation therapy, and brachytherapy were evaluated in two groups in which the prognosis is quite different; a group operated on, with apparent complete resection of the tumor, and a palliative surgery group. RESULTS: It appears that gallbladder carcinomas are not as radioresistant as was formerly thought. Local control of the tumor and reduction of tumor size was reported in several publications. Collected data showed a slight improvement of survival after adjuvant or palliative radiotherapy, especially in the advanced stage of gallbladder carcinomas. It appears preferable to give a "boost" (15 Gy) to the gross lesion or residual lesion at operation (intra-operative irradiation or brachytherapy), and deliver an additional 45-50 Gy post-operatively. CONCLUSIONS: The results published encourage further trials in well defined populations. Radiotherapy seems to be a safe procedure, morbidity is minimal, and a slight effect on survival is observed after curative or palliative surgical procedures.

Brachytherapy↗
PubMedDate not supplied

[Septic shock during the immediate post-partum period revealing a liver abscess in a woman with Crohn's disease].

Liver abscess is a rare complication of Crohn's disease. We report one case in a 27 year-old woman, presenting as a sepsis after delivery. Crohn's disease was quiescent at presentation. Pregnancy was the only predisposing condition. An intestinal fistula was diagnosed by ultrasonography. The patient was treated by antibiotics, bowel resection and surgical drainage of the abscess.

Adult↗
PubMedDate not supplied

[Endocrine component of exocrine pancreatic tumors. Apropos of 2 cases].

Two cases of pancreatic exocrine tumors with endocrine component are reported. The first case concerned a microcystic cystadenoma including an endocrine tumor identified by Grimelius staining and positive immunostaining for neurone specific enolase and the second a tubular adenocarcinoma including cells with positive immunostaining for glucagon and neurone specific enolase. The malignant nature of the endocrine component of both tumors which was certain for the first one and probable for the second whose endocrine component was distinct from the hyperplastic endocrine reaction observed at the periphery of the tumor, seems to support the hypothesis of exocrine and endocrine differentiation from a common precursor cell. The precise value of such a sub-group of pancreatic tumors with double component need to be clarified.

Adenocarcinoma↗
PubMedDate not supplied

[Technic of partial splenectomy with linear stapler instrument (TA 90, U.S., Surgical Corps].

Seven patients have been treated by partial splenectomy, performed with TA 90 linear stapler instrument (U.S. Surgical Corp). Three patients had non parasitic cyst of the spleen, two had malignant disease and two were operated for traumatic injuries. The section and the hemostasis of the spleen was performed with the linear stapler instrument. No patient required blood unit transfusion. Postoperative course was uneventful. Partial splenectomy with the TA 90 stapler, which does not supply the complications of total splenectomy, is an easy and safe procedure. It should be more often indicated.

Colonic Neoplasms↗
PubMedDate not supplied

[Choledochocele in the adult].

Choledochocele are cystic polypoid lesions of the end portion of the common bile duct. The occurrence of choledochocele is 4 p. cent among choledochal cysts. One case is presented in a 78-year-old woman. The treatment was surgical excision. This case was unusual by the age of the patient and by the diagnostic missed at the time of a cholecystectomy performed one year previously.

Aged↗
PubMedDate not supplied

A prospective comparison of costs and morbidity of laparoscopic versus open cholecystectomy.

BACKGROUND/AIMS: The aims of this study were to compare pain and discomfort after laparoscopic cholecystectomy (LC) and open cholecystectomy (OC), and to quantify the costs of both procedures. MATERIAL AND METHODS: Seventy-six patients undergoing a LC were prospectively compared with 24 patients who had an OC. Pain was assessed with a visual analog scale, and two rating indexes, one day, three months, and six months postoperatively. Hospital costs per patients covered direct expenditures, hospital overhead and depreciation of equipment, and salaries allocated on a per-diem basis. RESULTS: Pain and discomfort were significantly lower in the LC group than in the OC group. Cost for the operation was higher after LC, and lower for post operative care (p < 0.001). Total costs of hospitalization were similar. The mean number of days out of work was less in the LC group (14.7 days) than in the OC group (35.5 days) and the difference of cost due to loss of productivity was significant (p < 0.0001). CONCLUSIONS: The advantages of LC must be counter-balanced with a higher rate of postoperative complications than after OC, mainly common bile duct injuries.

Cholecystectomy↗