7 results on '"Gelas, T"'
Search Results
2. Spontaneous regression of suspected cystic dysplasia of the rete testis in three neonates.
- Author
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Gelas T, Margain Deslandes L, Mestrallet G, Pracros JP, and Mouriquand P
- Subjects
- Humans, Infant, Newborn, Male, Cysts diagnosis, Cysts therapy, Rete Testis, Testicular Diseases diagnosis, Testicular Diseases therapy
- Abstract
Introduction: Cystic dysplasia of the rete testis (CDRT) is a rare cause of scrotal swelling during infancy. It is a benign lesion that is often associated with ipsilateral renal, ureteral or genital abnormalities. Leissring and Oppenheimer described it for the first time in 1973., Case Reports: Since 2006, three neonates were referred to our pediatric surgery department because of a scrotal swelling related to intra-testicular cysts. Physical examination showed enlarged testicles without pain or inflammation. The ultrasound scan (USS) showed enlarged testicles related to multiple small cysts surrounded by normal parenchyma, and no other urinary abnormalities. As CDRT was suspected, a conservative strategy was proposed with repeated clinical examinations and USS. The cysts gradually regressed and disappeared in all cases, with a mean follow-up of 52 months., Discussion: As reported by Jeyaratnam et al., mean age at presentation was around 6 years. The most frequently associated urinary abnormalities were renal agenesis and multicystic dysplasia of the kidney. Differential diagnosis of CDRT included single testicular cyst, epidermoid cyst, albugina cyst, teratoma, cystic lymphangioma, testicular juvenile granulosa cell tumor, cystic transformation after orchitis, or spermatic cord torsion. Ultrasonography was the method of choice for the diagnosis of CDRT and its follow-up. The USS showed multiple small cysts with normal, but compressed, surrounding testicular parenchyma. A high-frequency transducer was mandatory to exclude other causes of scrotal swelling. With the involution of the cysts, the aspect of the parenchyma could be slightly heterogeneous or confused with microlithiasis. Historically, orchidectomy was the proposed treatment. However, because of a more precise diagnosis with USS, a conservative approach has been proposed. Nonetheless, recurrence after sparing surgery was frequent, as reported by many authors. Non-surgical management was reported in selected cases, sometimes after a surgical biopsy to confirm a benign lesion. Spontaneous regression of CDRT without any sequelae has been reported in six cases (see Summary Table) but long-term follow-up in the adult population has never been published. Limitations of the present series were related to the small number of cases, the absence of follow-up beyond puberty, and the absence of biopsy to confirm the diagnosis of CDRT., Conclusion: Spontaneous regression of CDRT was possible, and conservative attitude was an option, as CDRT is a benign lesion. Careful and prolonged 'watch and wait' management was a safe alternative to surgery, but other causes of scrotal swelling must be excluded, possibly with a testicular biopsy., (Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.) more...
- Published
- 2016
- Full Text
- View/download PDF
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3. [Does prenatal diagnosis modify neonatal management and early outcome of children with esophageal atresia type III?].
- Author
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Garabedian C, Sfeir R, Langlois C, Bonnard A, Khen-Dunlop N, Gelas T, Michaud L, Auber F, Piolat C, Lemelle JL, Fouquet V, Habonima É, Becmeur F, Polimerol ML, Breton A, Petit T, Podevin G, Lavrand F, Allal H, Lopez M, Elbaz F, Merrot T, Michel JL, Buisson P, Sapin E, Delagausie P, Pelatan C, Gaudin J, Weil D, de Vries P, Jaby O, Lardy H, Aubert D, Borderon C, Fourcade L, Geiss S, Breaud J, Pouzac M, Echaieb A, Laplace C, Gottrand F, and Houfflin-Debarge V more...
- Subjects
- Age Factors, Esophageal Atresia classification, Female, Humans, Infant, Newborn, Pregnancy, Prospective Studies, Treatment Outcome, Esophageal Atresia diagnosis, Esophageal Atresia therapy, Prenatal Diagnosis
- Abstract
Objective: Evaluate neonatal management and outcome of neonates with either a prenatal or a post-natal diagnosis of EA type III., Study Design: Population-based study using data from the French National Register for EA from 2008 to 2010. We compared children with prenatal versus post-natal diagnosis in regards to prenatal, maternal and neonatal characteristics. We define a composite variable of morbidity (anastomotic esophageal leaks, recurrent fistula, stenosis) and mortality at 1 year., Results: Four hundred and eight live births with EA type III were recorded with a prenatal diagnosis rate of 18.1%. Transfer after birth was lower in prenatal subset (32.4% versus 81.5%, P<0.001). Delay between birth and first intervention was not significantly different. Defect size (2cm vs 1.4cm, P<0.001), gastrostomy (21.6% versus 8.7%, P<0.001) and length in neonatal unit care were higher in prenatal subset (47.9 days versus 33.6 days, P<0.001). The composite variables were higher in prenatal diagnosis subset (38.7% vs 26.1%, P=0.044)., Conclusion: Despite the excellent survival rate of EA, cases with antenatal detection have a higher morbidity related to the EA type (longer gap). Even if it does not modify neonatal management and 1-year outcome, prenatal diagnosis allows antenatal parental counseling and avoids post-natal transfer., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.) more...
- Published
- 2015
- Full Text
- View/download PDF
4. Does prenatal diagnosis modify neonatal treatment and early outcome of children with esophageal atresia?
- Author
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Garabedian C, Sfeir R, Langlois C, Bonnard A, Khen-Dunlop N, Gelas T, Michaud L, Auber F, Gottrand F, and Houfflin-Debarge V
- Subjects
- Combined Modality Therapy, Esophageal Atresia mortality, Esophageal Atresia therapy, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Pregnancy, Registries, Survival Analysis, Treatment Outcome, Esophageal Atresia diagnosis, Prenatal Diagnosis
- Abstract
Objective: Our study aimed at (1) evaluating neonatal treatment and outcome of neonates with either a prenatal or a postnatal diagnosis of esophageal atresia (EA) and (2) analyzing the impact of prenatal diagnosis on outcome based on the type of EA., Study Design: We conducted a population-based study using data from the French National Register for infants with EA born from 2008-2010. We compared prenatal, maternal, and neonatal characteristics among children with prenatal vs postnatal diagnosis and EA types I and III. We defined a composite variable of morbidity (anastomotic esophageal leaks, recurrent fistula, stenosis) and death at 1 year., Results: Four hundred sixty-nine live births with EA were recorded with a prenatal diagnosis rate of 24.3%; 82.2% of EA type I were diagnosed prenatally compared with 17.9% of EA type III (P < .001). Transfer after birth was lower in case of prenatal diagnosis (25.6% vs 82.5%; P < .001). The delay between birth and first intervention did not differ significantly among groups. The defect size was longer among the prenatal diagnosis group (2.61 vs 1.48 cm; P < .001). The composite variables were higher in prenatal diagnosis subset (44% vs 27.6%; P = .003) and in EA type I than in type III (58.1% vs 28.3%; P < .001)., Conclusion: Despite the excellent survival rate of EA, cases with antenatal detection have a higher morbidity rate related to the EA type (type I and/or long gap). Even though it does not modify neonatal treatment and the 1-year outcome, prenatal diagnosis allows antenatal parental counselling and avoids postnatal transfers., (Copyright © 2015 Elsevier Inc. All rights reserved.) more...
- Published
- 2015
- Full Text
- View/download PDF
5. VAC® therapy a therapeutic alternative in giant omphalocele treatment: a multicenter study.
- Author
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Binet A, Gelas T, Jochault-Ritz S, Noizet O, Bory JP, Lefebvre F, Belouadah M, James-Robert I, Aubert D, Bouche-Pillon Persyn MA, Poli-Merol ML, and François-Fiquet C
- Subjects
- Female, Hernia, Umbilical, Humans, Infant, Newborn, Male, Retrospective Studies, Wound Healing, Negative-Pressure Wound Therapy methods
- Abstract
Giant omphalocele is associated to morbidity and mortality because of the strain the reintegrated herniated mass places on the hemodynamic equilibrium and breathing functions of affected infants. Currently, care management consists in a reintegration in one time or progressive reintegration. We report here a multicenter retrospective study about alternative management by VAC® therapy for giant omphaloceles. The study included three patients (1 girl, 2 boys) presenting with giant omphaloceles, born at full term in three different University Hospitals (prenatal diagnosis, normal karyotype). VAC® therapy was implemented at different times according to the cases (at Day 11, Month 1 and Month 5 after birth). The initial pressure applied was -10 mmHg progressively increased to -50 mmHg. A middle size VAC GranuFoam Silver® Dressing was used in all cases. Wound healing occurred at Month 4 for the first case, Month 6 and Month 8 for the other two. VAC® therapy is a good alternative for the care management of giant omphaloceles with more advantages especially when using prosthetic material. We also aimed at refining the most adapted indications in these specific situations, and finally we envisioned a harmonization of care for these children., (Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.) more...
- Published
- 2013
- Full Text
- View/download PDF
6. Retroperitoneoscopic vs open dismembered pyeloplasty for ureteropelvic junction obstruction in children.
- Author
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Valla JS, Breaud J, Griffin SJ, Sautot-Vial N, Beretta F, Guana R, Gelas T, Carpentier X, Leculee R, and Steyaert H
- Subjects
- Child, Preschool, Female, Humans, Infant, Male, Retroperitoneal Space, Retrospective Studies, Urologic Surgical Procedures methods, Kidney Pelvis surgery, Laparoscopy methods, Ureteral Obstruction surgery
- Abstract
Purpose: To compare the effectiveness, potential advantages and complications of classical open pyeloplasty with retroperitoneoscopic pyeloplasty in children., Materials and Methods: Two patient cohorts with confirmed ureteropelvic junction obstruction (UPJO) undergoing open or retroperitoneoscopic pyeloplasty over a 7-year period were analysed comparatively., Results: Operative time was significantly longer in the retroperitoneoscopic group (mean 155 min) compared to the open pyeloplasty group (mean 98 min, P<0.05). Mean hospital stay was shorter in the retroperitoneoscopic group (mean 4.1 days, compared to 5.1 days, open). Complication rates were similar (open, 27% vs retroperitoneoscopic, 29%). These included anastomotic urinary leakage, stenosis and infection. Anastomotic leakage was more common in the retroperitoneoscopic group. There was a 6.6% conversion rate in the retroperitoneoscopic group. Success, defined as improved ultrasonic or renographic parameters, with resolution of symptoms where discernable, was noted in 96% of the open group and 97% of the retroperitoneoscopic group with a mean follow up of 38 and 25 months, respectively., Conclusions: Retroperitoneoscopic pyeloplasty is as safe and effective as open pyeloplasty. This technique is now our procedure of choice for children>4 months old. The advantages are more obvious in children over 4 years than in infants. This technique remains difficult to perform and teach. more...
- Published
- 2009
- Full Text
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7. [Long-term outcomes of urinary flow impairement on renal hemodynamics: from animal experiments to clinical research].
- Author
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Mure PY, Gelas T, Benchaib M, Dijoud F, Feyaerts A, Roger T, and Mouriquand P
- Subjects
- Animals, Disease Models, Animal, Female, Humans, Hydronephrosis congenital, Hydronephrosis diagnostic imaging, Hydronephrosis pathology, Hydronephrosis physiopathology, Infant, Infant, Newborn, Ischemia physiopathology, Kidney pathology, Kidney physiopathology, Kidney Function Tests, Pregnancy, Radioisotope Renography, Sheep, Ultrasonography, Doppler, Ultrasonography, Prenatal, Ureteral Obstruction diagnostic imaging, Ureteral Obstruction pathology, Ureteral Obstruction physiopathology, Vascular Resistance physiology, Ischemia congenital, Kidney blood supply, Ureteral Obstruction congenital, Urodynamics physiology
- Published
- 2006
- Full Text
- View/download PDF
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