EMC - Chirurgie最新文献_第8页

Techniques d’anastomoses iléoanales avec réservoir 回肠吻合技术与储液器

EMC - Chirurgie Pub Date : 2005-04-01 DOI: 10.1016/j.emcchi.2005.01.001

A.-C. Couchard (Chef de clinique-assistant des Hôpitaux) , Y. Panis (Professeur de chirurgie digestive) , A. Alves (Chef de clinique-assistant des Hôpitaux) , P. Mariani (Praticien hospitalier) , P. Valleur (Professeur de chirurgie digestive)

{"title":"Techniques d’anastomoses iléoanales avec réservoir","authors":"A.-C. Couchard (Chef de clinique-assistant des Hôpitaux) , Y. Panis (Professeur de chirurgie digestive) , A. Alves (Chef de clinique-assistant des Hôpitaux) , P. Mariani (Praticien hospitalier) , P. Valleur (Professeur de chirurgie digestive)","doi":"10.1016/j.emcchi.2005.01.001","DOIUrl":"https://doi.org/10.1016/j.emcchi.2005.01.001","url":null,"abstract":"<div><p>Complete proctocolectomy with ileoanal pouch anastomosis is the gold standard for the treatment of familial adenomatous polyposis and ulcerative colitis. In Crohn’s disease, this technique may be considered for selected patients free of anal or small bowel lesions. The two main techniques used for ileoanal anastomosis are the manual anastomosis following mucosectomy (Parks’ procedure, the reference technique), and the stapled anastomosis, the most used procedure worldwide. A third technique exists also, consisting in rectal eversion with section on the dentate line (Hautefeuille procedure); this technique avoid conservation of the anal transitional zone in stapled ileoanal anastomosis, and the risk of incomplete mucosectomy associate with Parks’ procedure. Finally, it is possible today to perform this intervention by laparoscopic approach, provided the operating team has the required training.</p></div>","PeriodicalId":100414,"journal":{"name":"EMC - Chirurgie","volume":"2 2","pages":"Pages 123-139"},"PeriodicalIF":0.0,"publicationDate":"2005-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcchi.2005.01.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72068010","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}

引用次数: 5

Traitement des séquelles de brûlures : brûlures de la face 烧伤后遗症的治疗：面部烧伤

EMC - Chirurgie Pub Date : 2005-04-01 DOI: 10.1016/j.emcchi.2005.01.003

J.-L. Foyatier, D. Voulliaume, A. Mojallal, K. Chekaroua, J.-P. Comparin

引用次数: 14

Traitement des séquelles de brûlures : brûlures de la face 烧伤后遗症的治疗:面部烧伤

EMC - Chirurgie Pub Date : 2005-04-01 DOI: 10.1016/J.EMCCHI.2005.01.003

J. Foyatier, D. Voulliaume, A. Mojallal, K. Chekaroua, J. Comparin

引用次数: 14

Réparation des déformations de la paroi thoracique antérieure : ostéochondroplastie modelante et stabilisation par attelle-agrafe de Borrelly 前胸壁变形的修复:整形骨软骨成形术和博雷利夹板稳定

EMC - Chirurgie Pub Date : 2005-02-01 DOI: 10.1016/J.EMCCHI.2004.10.003

J. Nloga, G. Grosdidier

引用次数: 2

Chirurgie laparoscopique de l’obésité morbide 病态肥胖的腹腔镜手术

EMC - Chirurgie Pub Date : 2005-02-01 DOI: 10.1016/j.emcchi.2004.11.002

P. Lointier (Ancien Professeur des Universités, praticien hospitalier)

{"title":"Chirurgie laparoscopique de l’obésité morbide","authors":"P. Lointier (Ancien Professeur des Universités, praticien hospitalier)","doi":"10.1016/j.emcchi.2004.11.002","DOIUrl":"https://doi.org/10.1016/j.emcchi.2004.11.002","url":null,"abstract":"<div><p>Morbid obesity has become a frequent disease. It refers to an overweight complicated by other diseases. Morbid or pathologic obesity is defined by the body mass index which is based on morbidity and mortality profiles as determined by insurance companies for Caucasian populations. Such high-risk patients may be treated by surgery after failure of conventional medical management and nutritional follow-up. Several surgical procedures – aimed at reducing the disease severity by decreasing patients’ body weight, improving their quality of life, and perhaps their life expectancy – are utilized in open surgery, i.e., laparotomy. Interventions are based on two basic principles of gastric restriction and/ or intestinal malabsorption; these are mainly gastroplasties and gastric bypasses. For a long time, except in some cases, such surgical treatments have been deplored and badly understood in France. Laparoscopic surgery has allowed less invasive interventions and hence, has promoted the development of these procedures. It should not modify their indications. Nevertheless, ideal or universal bariatric intervention still lack, and each of laparoscopic procedures has its own learning curve.</p></div>","PeriodicalId":100414,"journal":{"name":"EMC - Chirurgie","volume":"2 1","pages":"Pages 1-49"},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcchi.2004.11.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72056809","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}

引用次数: 3

Chirurgie laparoscopique de l’obésité morbide 病态肥胖的腹腔镜手术

EMC - Chirurgie Pub Date : 2005-02-01 DOI: 10.1016/J.EMCCHI.2004.11.002

P. Lointier

引用次数: 3

Traumatismes du pancréas. Principes de techniques et de tactique chirurgicales

EMC - Chirurgie Pub Date : 2005-02-01 DOI: 10.1016/J.EMCCHI.2004.06.002

C. Arvieux, C. Letoublon

引用次数: 7

Voies d'abord chirurgicales antérieures du thorax 胸部的第一个手术前通路

EMC - Chirurgie Pub Date : 2005-02-01 DOI: 10.1016/j.emcchi.2004.05.005

J. Jougon (Praticien hospitalier), F. Delcambre (Praticien hospitalier), J.-F. Velly (Professeur des Universités, praticien hospitalier)

{"title":"Voies d'abord chirurgicales antérieures du thorax","authors":"J. Jougon (Praticien hospitalier), F. Delcambre (Praticien hospitalier), J.-F. Velly (Professeur des Universités, praticien hospitalier)","doi":"10.1016/j.emcchi.2004.05.005","DOIUrl":"https://doi.org/10.1016/j.emcchi.2004.05.005","url":null,"abstract":"<div><p>Anterior surgical approaches of the chest are mainly used for cardiac surgery with cardiopulmonary bypass, mediastinal surgery, and lung and heart-lung transplantation. For years, posterolateral thoracotomy has been considered as the approach of choice to deal with pulmonary resection, while bilateral anterior thoracotomies with transverse sternotomy (clamshell incision) was historically the approach for cardiac surgery. Around 1957, clamshell incision was replaced by median sternotomy popularised by Julian. Development of video-assisted thoracic surgery around 1990 allowed to review surgical approaches, so minimal access with minor parietal injuries gain success. However, in the same period, clamshell approach was reintroduced by Cooper et al 1990 to facilitate access for double lung transplantation. In this article, the authors present different aspects of anterior surgical approaches of the chest : median sternotomy, anterolateral thoracotomy, anterior mediastinotomy, transsternal bilateral thoracotomy (clamshell incision), sternotomy and lateral thoracotomy (hemi-clampshell incision). Technical aspects in detail as well as indications, pitfalls, and complications are described through a strikingly illustrated text.</p></div>","PeriodicalId":100414,"journal":{"name":"EMC - Chirurgie","volume":"2 1","pages":"Pages 74-99"},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcchi.2004.05.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72056807","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}

引用次数: 9

Techniques de la décortication 脱壳技术

EMC - Chirurgie Pub Date : 2005-02-01 DOI: 10.1016/J.EMCCHI.2004.06.007

M. Riquet, M. Arab

引用次数: 7

Traumatismes du pancréas. Principes de techniques et de tactique chirurgicales 胰腺创伤。手术技术和战术原理

EMC - Chirurgie Pub Date : 2005-02-01 DOI: 10.1016/j.emcchi.2004.06.002

C. Arvieux (Praticien hospitalier), C. Létoublon (Professeur des Universités, praticien hospitalier)

{"title":"Traumatismes du pancréas. Principes de techniques et de tactique chirurgicales","authors":"C. Arvieux (Praticien hospitalier), C. Létoublon (Professeur des Universités, praticien hospitalier)","doi":"10.1016/j.emcchi.2004.06.002","DOIUrl":"https://doi.org/10.1016/j.emcchi.2004.06.002","url":null,"abstract":"<div><p>Early diagnosis of a pancreatic trauma (PT) is challenging due to discrepancies between severity of the lesions and initial symptomatology. Delayed diagnosis may be responsible for severe complications, the treatment of which is often difficult. A severe acute post-traumatic pancreatitis, for instance, is often associated with late death. The decisions depend on the circumstances in which the PT has been identified. If the patient is haemodynamically unstable, control of the haemorrhage is the priority, and immediate laparotomy must be undertaken, during which a damage control procedure must be decided if necessary. In the haemodynamically controlled patient, the surgeon has enough time to recognize the PT, its location and its severity. The main severity criteria are the disruption of the pancreatic duct and the association to a duodenal lesion. Minor injuries without ductal disruption are treated by external drainage. In case of distal injury with ductal disruption, resection of the distal segment is generally proposed, all the easier since the resection is less than 50-60 %. Drainage by a Roux-en-Y is actually not applicable to situations of emergency. In case of proximal pancreatic contusion with ductal injury, sump drainage will often be the best solution, because of the difficulties and bad results related to the Whipple procedure, because of the ability to complete such an option by complementary post-operative Endoscopic-Retrograde-Cholangio-Pancreatography (ERCP) with intra-ductal stent insertion, and because of the relative simplicity of the management of a pancreatic fistula. If, exceptionally, a pancreaticoduodenectomy is unavoidable, one must keep in mind the possibility to delay the reconstruction to the first or second postop day. An injury of the duodenum associated to a benign PT is treated by suture if simple and by a Roux-en-Y duodenojejunal diversion if severe. A venting gastrostomy, a feeding jejunostomy and possibly a stappled simplified duodenal exclusion can be performed if the duodeno-pancreatic lesions are very serious, and we recommend avoiding the pancreaticoduodenectomy, if possible. If the patient is haemodynamically stable, and the laparotomy not indicated, the best diagnosis tools are Computed Tomodensitometry, Magnetic Resonance Pancreatography and Endoscopic-Retrograde-Cholangio-Pancreatography. If these exams show a disruption of the main pancreatic duct, endoscopic transpapillary stent insertion may be successful. In case of failure, the management follows the same rules than those described in the operative treatment. Nonoperative management is appropriate for patients without any main pancreatic duct disruption, but it is obvious that this nonoperative option may eventually succeed, even if a disruption has been found, especially in children. The decision is based on the topography of the lesion, the clinical status, and the age of the patient.</p></div>","PeriodicalId":100414,"journal":{"name":"EMC - Chirurgie","volume":"2 1","pages":"Pages 50-73"},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcchi.2004.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72056806","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}

引用次数: 6