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See detailEarly Stage Results after Oesophageal Resection for Malignancy - Colon Interposition Vs. Gastric Pull-Up
Kolh, Philippe ULg; Honore, Pierre ULg; Degauque, C. et al

in European Journal of Cardio - Thoracic Surgery (2000), 18(3), 293-300

OBJECTIVE: The aims of our study were to determine if using the colon as a digestive transplant after oesophagectomy for cancer was associated with increased postoperative complications, and to assess the ... [more ▼]

OBJECTIVE: The aims of our study were to determine if using the colon as a digestive transplant after oesophagectomy for cancer was associated with increased postoperative complications, and to assess the impact of preoperative radiochemotherapy on postoperative hospital outcome. METHODS: From January 1990 to December 1998, 130 patients underwent oesophageal resection for malignancy. There were 103 males and 27 females (age: 61.3+/-11.5 years). Indications were squamous cell carcinoma in 69 patients and adenocarcinoma in 61. Preoperatively 30 patients (eight in stage IIB, 18 in stage III, and four in stage IV) received radiochemotherapy. There were 84 subtotal oesophagectomies, with anastomosis in the neck in 44 patients and at the thoracic inlet in 40, and 46 distal oesophageal resections. Digestive continuity was restored with the stomach in 92 patients (age: 63.4+/-10.2 years) and the colon in 38 (age: 52.3+/-12.8 years). With the exception of age (P<0.0001), there was no significant preoperative difference between gastric and colonic groups. RESULTS: Hospital mortality was 8.5% (11 patients), decreasing from 18.5% (before 1993) to 3.8% (since 1993). One patient (2.5%) died in the colonic graft group and ten (11%) in the gastric pull-up group (P=0.17). Postoperative complications occurred in 40 patients (31%), respectively, in ten (26%) and 30 (33%) patients after colonic and gastric transplants (P=0.48), and were pulmonary insufficiency or infection in 29 patients, anastomotic fistula in six, myocardial infarction in five, recurrent nerve palsy in four, renal insufficiency in three, and cerebrovascular accident in one. All fistulas occurred in the gastric pull-up group. The incidence of postoperative pulmonary complications was 70% (21/30 patients) in the subgroup who received preoperative radiochemotherapy, as compared to 11% (5/44 patients) in the subgroup of comparable staging, but without preoperative treatment (P<0.001). CONCLUSIONS: Colonic grafts are not associated with increased postoperative mortality or complications. Our results suggest that preoperative neoadjuvant treatment significantly increases postoperative pulmonary complications. [less ▲]

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See detailIntérêt de la tomographie a émission de positons dans l'évaluation des tumeurs digestives
Hustinx, Roland ULg; Paulus, Patrick; Daenen, Frédéric ULg et al

in Revue Médicale de Liège (1999), 54(12), 925-30

Imaging and endoscopic techniques have taken an increasing part in the management of gastroenterological disorders. Among these techniques, FDG-PET imaging has emerged as a powerful tool in the management ... [more ▼]

Imaging and endoscopic techniques have taken an increasing part in the management of gastroenterological disorders. Among these techniques, FDG-PET imaging has emerged as a powerful tool in the management of several cancer diseases, including tumors of the digestive tract. In particular, the role of PET for diagnosing and staging recurrent colorectal cancers, and for differentiating mass forming pancreatitis from carcinoma is now well established. In this review, we will briefly discuss the place of PET imaging in the work-up of the tumors of the digestive tract. [less ▲]

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See detailInteret clinique de la tomographie a emission de positons dans la detection et le bilan d'extension des recidives des cancers colorectaux
Hustinx, Roland ULg; Paulus, P.; Daenen, Frédéric ULg et al

in Gastroentérologie Clinique et Biologique (1999), 23(3), 323-9

BACKGROUND: Positron emission tomography (PET) has been shown useful for the staging of patients with various carcinomas. METHODS: We have applied this technique to 54 cases of colorectal carcinoma and ... [more ▼]

BACKGROUND: Positron emission tomography (PET) has been shown useful for the staging of patients with various carcinomas. METHODS: We have applied this technique to 54 cases of colorectal carcinoma and compared it to conventional imaging techniques. RESULTS: PET had moderately higher sensitivity and specificity than conventional techniques to detect individual lesion sites (75% vs 70.8% and 63% vs 21% respectively). It detected the same number of patients with recurrences (35/39) but overestimated disease less frequently (5 cases vs 12). PET favorably influenced therapeutic management in 17 patients, indicating different or additional surgery in 9 while avoiding surgery with curative intent or unnecessary surgery in 8. In 5 cases, erroneous information provided by PET could be corrected by conventional imaging techniques. CONCLUSION: We conclude that PET appears to provide complementary information useful for staging patients with colorectal carcinomas. It can significantly modify patients management. These data should be confirmed by a prospective study. [less ▲]

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See detailUsefulness of 18fdg Positron Emission Tomography in Detection and Follow-up of Digestive Cancers
Paulus, P.; Hustinx, Roland ULg; Daenen, Frédéric ULg et al

in Acta Gastro-Enterologica Belgica (1997), 60(4, Oct-Dec), 278-80

PET is a diagnostic method that creates high resolution, 3 dimensional tomographic images of the distribution of positron emitting radionuclides in the human body. Recent technological developments allow ... [more ▼]

PET is a diagnostic method that creates high resolution, 3 dimensional tomographic images of the distribution of positron emitting radionuclides in the human body. Recent technological developments allow the use of whole-body PET devices in clinical oncology. 18FDG is a glucose analog transported and competitively used with glucose reflecting the increased glucose metabolism into malignant cells. Differential diagnosis between chronic pancreatitis and pancreatic cancer is already a well-documented indication. For initial staging of gastro-esophageal and colorectal tumours, results are preliminary but the clinical impact seems to be rather limited. At present, the major indication of FDG-PET is the detection and staging of colorectal cancer recurrences. FDG-PET allows the differentiation between scared tissue and tumour when structural imaging is often confusing. In the same time, the whole-body imaging capability provides unique information that can modify loco-regional and liver staging. Overall, FDG-PET affects the clinical management of 30 to 40% of these patients. Quantitative assessment of therapeutic response to chemotherapy regimen appears to be one of the most promising applications of FDG-PET. Since the most effective therapy of colorectal cancer are often surgical, the role of chemotherapy in colorectal cancer remains limited to adjuvant therapy and in advanced disease. However, FDG-PET could be of great value in assessing the response of oesophageal carcinomas to chemo-radio therapy, before surgery. In our experience, FDG-PET appears to be the first line diagnostic method in the detection and staging of colorectal recurrence and differential diagnosis of pancreatic tumour versus chronic pancreatitis. [less ▲]

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See detailTransplantations de tumeurs malignes insoupçonnées lors de greffes d'organes
Detry, Olivier ULg; Detroz, Bernard ULg; D'Silva, M. et al

in Revue Médicale de Liège (1994), 49(1), 23-31

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See detailIntraoperative cytokines production during orthotopic liver transplantation
Pirenne, J.; Noizat-Pirenne, F.; De Groote, D. et al

in Transplant International : Official Journal of the European Society for Organ Transplantation (1992), 5(Suppl 1), 631-635

In summary, we established that a significant production of the monokines interleukin-6, tumor necrosis factor apha, and interleukin-1 occurred during orthotopic liver transplantation whereas the ... [more ▼]

In summary, we established that a significant production of the monokines interleukin-6, tumor necrosis factor apha, and interleukin-1 occurred during orthotopic liver transplantation whereas the lymphokines interferon gamma and interleukin-2 were not detected. Levels of interleukin-6 reached their maximum values before and especially at the end of the anhepatic phase. They remained high after the anhepatic phase, i. e. after reperfusion of the new livers. Tumor necrosis factor alpha and interleukin-1 reached their maximum values after the anhepatic phase. Not only were interleukin-6, tumor necrosis factor alpha, and interleukin-1 present in the serum but they could also be detected in the bile produced by these new livers. Mechanisms of monokine production during orthotopic liver transplantation is multifactorial in origin and further studies will have to evaluate the relative contribution of the various factors involved. The possibility of an association between peroperative monokines and transplant outcome and their potential clinical implication will have to be elucidated. [less ▲]

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See detailRésection hépatique ex situ
Honore, Pierre ULg; D'Silva, M.; Meurisse, Michel ULg et al

in Revue Médicale de Liège (1991), 46(11), 602-6

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