EMC - ChirurgiePub Date : 2005-08-01DOI: 10.1016/j.emcchi.2005.06.002
M. Perrin (Chirurgien vasculaire, ancien interne, ancien chef de clinique des Universités, ancien assistant des Hôpitaux de Lyon)
{"title":"Classification clinique, étiologique, anatomique et physiopathologique (CEAP) et scores de sévérité des affections veineuses chroniques","authors":"M. Perrin (Chirurgien vasculaire, ancien interne, ancien chef de clinique des Universités, ancien assistant des Hôpitaux de Lyon)","doi":"10.1016/j.emcchi.2005.06.002","DOIUrl":"https://doi.org/10.1016/j.emcchi.2005.06.002","url":null,"abstract":"<div><p>The need for an international classification of chronic venous disorders has prompted a new update. With the addition of severity scores, this classification provides us with a single tool. The CEAP classification which is divided into 4 items gives information on the clinical class, presence or absence of symptoms, aetiology, and anatomical and pathophysiological abnormalities. The CEAP classification may be used in different ways, basic or advanced; its use is detailed hereafter. Some classification items need to be validated, and it appears that in special cases the CEAP classification needs to be completed and fine-tuned. Similarly, tailored scores aimed at assessing treatment outcomes should be elaborated according to patients' clinical presentation.</p></div>","PeriodicalId":100414,"journal":{"name":"EMC - Chirurgie","volume":"2 4","pages":"Pages 388-395"},"PeriodicalIF":0.0,"publicationDate":"2005-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcchi.2005.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72032872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EMC - ChirurgiePub Date : 2005-08-01DOI: 10.1016/j.emcchi.2005.06.001
H. Kotobi (Praticien hospitalier) , A. Echaieb (Interne de chirurgie) , D. Gallot (Professeur des Universités)
{"title":"Traitement chirurgical des hernies rares","authors":"H. Kotobi (Praticien hospitalier) , A. Echaieb (Interne de chirurgie) , D. Gallot (Professeur des Universités)","doi":"10.1016/j.emcchi.2005.06.001","DOIUrl":"https://doi.org/10.1016/j.emcchi.2005.06.001","url":null,"abstract":"<div><p>Uncommon intra abdominal hernias in adult represent the herniation of some length of bowel through an intra abdominal congenital orifice or an acquired peritoneal orifice. A wide range of clinical and anatomical features have been described despite their infrequency. Three types of hernias are usually observed, depending on the anatomy: herniation through a normal orifice including the Winslow's foramen; herniation through a pathologic orifice, such as transomental hernias, transmesenteric hernias, transmesocolic hernias and hernias trough the broad ligament; retroperitoneal hernias, mainly right or left paraduodenal, paracaecal or supravesical hernias. Epidemiology, pathology, clinical presentation, diagnosis and complications are shortly described for each type, along with surgical techniques.</p></div>","PeriodicalId":100414,"journal":{"name":"EMC - Chirurgie","volume":"2 4","pages":"Pages 425-439"},"PeriodicalIF":0.0,"publicationDate":"2005-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcchi.2005.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72032871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EMC - ChirurgiePub Date : 2005-08-01DOI: 10.1016/j.emcchi.2005.07.002
E. Kieffer (Professeur à la faculté de médecine, praticien hospitalier)
{"title":"Chirurgie des anévrismes de l'aorte abdominale sous-rénale : techniques chirurgicales","authors":"E. Kieffer (Professeur à la faculté de médecine, praticien hospitalier)","doi":"10.1016/j.emcchi.2005.07.002","DOIUrl":"https://doi.org/10.1016/j.emcchi.2005.07.002","url":null,"abstract":"<div><p>The purpose of this chapter is to precise the techniques used for open surgical repair of subrenal abdominal aortic aneurysms. Perioperative care, surgical approaches and reconstructive techniques are exposed and the general principles and treatment of isolated aneurysms of the subrenal aorta, juxta-renal aneurysms and aortoiliac aneurysms are detailed. The limited role of palliative treatment is then discussed, as well as the management of ruptured, inflammatory, infected and dissecting aneurysms. Finally we review the specific problems raised by the relatively common combination of various occlusive atherosclerotic lesions, aneurysms of other localization, various urologic and digestive diseases and venous abnormalities.</p></div>","PeriodicalId":100414,"journal":{"name":"EMC - Chirurgie","volume":"2 4","pages":"Pages 347-387"},"PeriodicalIF":0.0,"publicationDate":"2005-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcchi.2005.07.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72032876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EMC - ChirurgiePub Date : 2005-08-01DOI: 10.1016/J.EMCCHI.2005.07.001
N. Munoz-Bongrand, É. Sarfati
{"title":"Œsophagectomie pour lésion non tumorale","authors":"N. Munoz-Bongrand, É. Sarfati","doi":"10.1016/J.EMCCHI.2005.07.001","DOIUrl":"https://doi.org/10.1016/J.EMCCHI.2005.07.001","url":null,"abstract":"","PeriodicalId":100414,"journal":{"name":"EMC - Chirurgie","volume":"30 1","pages":"440-452"},"PeriodicalIF":0.0,"publicationDate":"2005-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83928433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EMC - ChirurgiePub Date : 2005-08-01DOI: 10.1016/J.EMCCHI.2004.07.001
J. Chavoin, F. Canizares, A. Mojallal, G. Fabre, J. Grolleau
{"title":"Hypotrophie et ptôse mammaire","authors":"J. Chavoin, F. Canizares, A. Mojallal, G. Fabre, J. Grolleau","doi":"10.1016/J.EMCCHI.2004.07.001","DOIUrl":"https://doi.org/10.1016/J.EMCCHI.2004.07.001","url":null,"abstract":"","PeriodicalId":100414,"journal":{"name":"EMC - Chirurgie","volume":"5 5","pages":"500-516"},"PeriodicalIF":0.0,"publicationDate":"2005-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91426815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EMC - ChirurgiePub Date : 2005-08-01DOI: 10.1016/J.EMCCHI.2005.01.004
A. Barret, F. Accadbled, J. Bossavy, D. Garrigues, X. Chaufour
{"title":"Amputations des membres inférieurs au cours de l'évolution des artériopathies chroniques oblitérantes","authors":"A. Barret, F. Accadbled, J. Bossavy, D. Garrigues, X. Chaufour","doi":"10.1016/J.EMCCHI.2005.01.004","DOIUrl":"https://doi.org/10.1016/J.EMCCHI.2005.01.004","url":null,"abstract":"","PeriodicalId":100414,"journal":{"name":"EMC - Chirurgie","volume":"9 1","pages":"396-409"},"PeriodicalIF":0.0,"publicationDate":"2005-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84320030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EMC - ChirurgiePub Date : 2005-08-01DOI: 10.1016/j.emcchi.2005.07.004
A. Barret (Professeur), X. Chaufour (Praticien hospitalo-universitaire), L. Casbas (Chef de clinique-assistant), J.-P. Bossavy (Professeur)
{"title":"Sympathectomie thoracique","authors":"A. Barret (Professeur), X. Chaufour (Praticien hospitalo-universitaire), L. Casbas (Chef de clinique-assistant), J.-P. Bossavy (Professeur)","doi":"10.1016/j.emcchi.2005.07.004","DOIUrl":"https://doi.org/10.1016/j.emcchi.2005.07.004","url":null,"abstract":"<div><p>Upper thoracic sympathectomies, performed most of the time by coelioscopy, have become mildly aggressive interventions. Such procedure is primarily indicated for palmar and axillary hyperhidroses; it is also indicated in case of collagenosis-related disabling syndromes of Raynaud's disease, causalgias, distal arterial occlusions with thrombotic or embolic digital lesions, and lesions due to Buerger's disease. Thoracotomy is considered only in case of thoracoscopy failure or infeasibility. Other accesses are far less utilized. Ablation of the 2<sup>nd</sup> and 3<sup>rd</sup> thoracic sympathetic ganglia is sufficient for hand lesions; in case of axillary hyperhidrosis, further exeresis of the 4<sup>th</sup> and 5<sup>th</sup> ganglia is necessary. The only disadvantage related to this indication is the frequent postoperative compensatory hypersudation that involves both the thorax and the lumbar area, but which doesn't constitute a real complaint for the patients.</p></div>","PeriodicalId":100414,"journal":{"name":"EMC - Chirurgie","volume":"2 4","pages":"Pages 453-464"},"PeriodicalIF":0.0,"publicationDate":"2005-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcchi.2005.07.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72032868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EMC - ChirurgiePub Date : 2005-08-01DOI: 10.1016/j.emcchi.2005.07.003
A. Sauvanet (Professeur des Universités, praticien hospitalier)
{"title":"Dérivation chirurgicale du canal de Wirsung dans la pancréatite chronique","authors":"A. Sauvanet (Professeur des Universités, praticien hospitalier)","doi":"10.1016/j.emcchi.2005.07.003","DOIUrl":"https://doi.org/10.1016/j.emcchi.2005.07.003","url":null,"abstract":"<div><p>In chronic pancreatitis complicated by disabling pain, surgical drainage of the Wirsung duct by a wirsungojejunostomy using a Roux-en-Y loop is efficient, as proven by an experience with this procedure described 45 years ago. Dilatation of the Wirsung duct is considered necessary to perform this anastomosis by nearly all authors. Other complications of pancreatitis (biliary stenosis, pseudocyst, rarely duodenal stenosis) can be treated during the same procedure by an appropriate drainage. Inconstant efficacy of wirsungojejunostomy has lead to development of technical variants, such as Frey's procedure which includes drainage of the whole Wirsung duct after the local resection of the head (Frey's procedure) which is presented is this chapter. Compared with pancreatectomies, drainage procedures (anastomoses following partial pancreatectomies are excluded) are associated with a lower immediate morbidity and probably a better long-term functional result, especially on the endocrine function. Finally, surgical drainage of the Wirsung duct is presently in « competition » with endoscopic drainage (transpapillary drainage by endoprosthesis) and respective indications of both techniques remain to be clarified.</p></div>","PeriodicalId":100414,"journal":{"name":"EMC - Chirurgie","volume":"2 4","pages":"Pages 410-424"},"PeriodicalIF":0.0,"publicationDate":"2005-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcchi.2005.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72032874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EMC - ChirurgiePub Date : 2005-08-01DOI: 10.1016/j.emcchi.2005.07.001
N. Munoz-Bongrand (Praticien attaché), E. Sarfati (Professeur des Universités, praticien hospitalier)
{"title":"Œsophagectomie pour lésion non tumorale","authors":"N. Munoz-Bongrand (Praticien attaché), E. Sarfati (Professeur des Universités, praticien hospitalier)","doi":"10.1016/j.emcchi.2005.07.001","DOIUrl":"https://doi.org/10.1016/j.emcchi.2005.07.001","url":null,"abstract":"<div><p>Oesophagectomy in benign conditions is an uncommon situation. Most of the time, emergent oesophagectomy is required for caustic necrosis or following oesophageal perforation. The aim of the intervention is then to remove the whole oesophagus, avoiding additional morbidity. Oesophagectomy without thoracotomy, and specially oesophageal stripping, achieve those two goals, quickly and safely. Other indications for oesophagectomy in benign conditions are more uncommon, mainly represented by peptic or caustic stenosis. In these indications, there is a small place for standard oesophagectomies, with or without thoracotomy. However, recent advances in minimally invasive surgery, either by laparoscopy or thoracoscopy, may change surgical approach for oesophagectomy in these indications. Various approaches for oesophagectomy are described in the present article, focused on particular techniques indicated in benign conditions. Oesophageal stripping, and minimally invasive oesophagectomy are particularly detailed.</p></div>","PeriodicalId":100414,"journal":{"name":"EMC - Chirurgie","volume":"2 4","pages":"Pages 440-452"},"PeriodicalIF":0.0,"publicationDate":"2005-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcchi.2005.07.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72032870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EMC - ChirurgiePub Date : 2005-08-01DOI: 10.1016/j.emcchi.2005.01.004
A. Barret (Professeur de chirurgie vasculaire) , F. Accadbled (Interne des Hôpitaux) , J.-P. Bossavy (Professeur de chirurgie vasculaire) , D. Garrigues (Angéiologue) , X. Chaufour (Chef de clinique-assistant des Hôpitaux)
{"title":"Amputations des membres inférieurs au cours de l'évolution des artériopathies chroniques oblitérantes","authors":"A. Barret (Professeur de chirurgie vasculaire) , F. Accadbled (Interne des Hôpitaux) , J.-P. Bossavy (Professeur de chirurgie vasculaire) , D. Garrigues (Angéiologue) , X. Chaufour (Chef de clinique-assistant des Hôpitaux)","doi":"10.1016/j.emcchi.2005.01.004","DOIUrl":"https://doi.org/10.1016/j.emcchi.2005.01.004","url":null,"abstract":"<div><p>Lower limb amputations related to progressive chronic occlusive arterial diseases have some specific patterns that differentiate them substantially from amputations due to traumas or tumours. Precise evaluation of the underlying arterial circulation, minimal surgical aggression, concern for the stump healing, nursing care, nutrition, diabetes and all risk factors control, are of up most importance in this disease; nevertheless, functional prognosis remains also an important concern. The goal is to determine the most adequate amputation level for preventing life-threatening infectious gangrene while preserving optimal functional status for walking, after a reinforcement and device fitting as rapid as possible.</p></div>","PeriodicalId":100414,"journal":{"name":"EMC - Chirurgie","volume":"2 4","pages":"Pages 396-409"},"PeriodicalIF":0.0,"publicationDate":"2005-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcchi.2005.01.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72032873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}