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Chirurgie; memoires de l'Academie de chirurgie最新文献

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[Total hip prostheses, friction lever and wear]. 全髋关节假体，摩擦杠杆和磨损。
Chirurgie; memoires de l'Academie de chirurgie Pub Date : 1997-01-01
P Hernigou, T Bahrami
{"title":"[Total hip prostheses, friction lever and wear].","authors":"P Hernigou,&nbsp;T Bahrami","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The increased number of joint prostheses now being implanted into younger and active patients has made wear on polyethylene more apparent. This wear is the consequence of the bearing surface of polyethylene against metal. Research into the problem of wear is complex and other models such as metal-on-metal implants, ceramic-on-ceramic implants are tried to decrease the amount of particles accumulated after wear and avoid inflammatory reactions leading to bone lysis and implant loosening between 10 and 20 years.</p>","PeriodicalId":10182,"journal":{"name":"Chirurgie; memoires de l'Academie de chirurgie","volume":"122 3","pages":"229-31"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20238750","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: 0
[Wear and loosening of prostheses]. [假体的磨损和松动]。
Chirurgie; memoires de l'Academie de chirurgie Pub Date : 1997-01-01
F Langlais, J C Lambotte, H Thomazeau, T Dreano
{"title":"[Wear and loosening of prostheses].","authors":"F Langlais,&nbsp;J C Lambotte,&nbsp;H Thomazeau,&nbsp;T Dreano","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In 1996, the outcome of any total joint replacement is loosening, occurring usually about 20 years after implantation. Loosening is not a mechanical failure of the bone-implant junction but the consequence of the osteolysis of the periprosthetic bone. It is due to an inflammatory pannus, a tissue constituted by macrophages, which are activated by wear particules originated by the articulating surfaces. The authors showed that this osteolysis is close from that observed with other inflammatory diseases and that it can be obtained with wear particules of many biomaterials, the polyethylene (PE) being the most common in clinical conditions. Several trends in order to reduce polyethylene wear or to replace PE by other materials are presented. Future improvements of the duration of joint prostheses depend on laboratories including surgeons involved in basic research: they are a mandatory link between the engineer and the biologist who study the mechanical and the biological aspects of the wear and of the fixation of biomaterials.</p>","PeriodicalId":10182,"journal":{"name":"Chirurgie; memoires de l'Academie de chirurgie","volume":"122 3","pages":"232-6"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20238751","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: 0
[Surgical treatment of genito-urinary prolapse by abdominal approach with promotofixation and setting of an anterior subvesical prosthesis combined with retropubic colpopexia: anatomical and functional results in 104 patients]. 【经腹入路促进固定及膀胱前下假体置入联合耻骨后阴道峡破术治疗泌尿生殖系统脱垂:104例解剖和功能结果】。
Chirurgie; memoires de l'Academie de chirurgie Pub Date : 1997-01-01
R Villet, E Mandron, D Salet-Lizee, M van den Akker, P Gadonneix, M Zafiropulo
{"title":"[Surgical treatment of genito-urinary prolapse by abdominal approach with promotofixation and setting of an anterior subvesical prosthesis combined with retropubic colpopexia: anatomical and functional results in 104 patients].","authors":"R Villet,&nbsp;E Mandron,&nbsp;D Salet-Lizee,&nbsp;M van den Akker,&nbsp;P Gadonneix,&nbsp;M Zafiropulo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A homogeneous series of 104 patients with genito-urinary prolapse or urinary incontinence is reported. Surgical treatment combined promotofixation with (n = 45) or without (n = 59) subtotal hysterectomy, retropubic colpopexia and in certain cases posterior colpoperineorraphia with myorraphia of the levator ani (n = 28). Anatomic results were excellent for bladder and uterine ptosis. Moderate results were obtained for rectoceles and procedures involving the posterior perineum. A rectovaginal prosthesis or complete repair of the rectovaginal wall appeared to be required to improve results for rectoceles. Urine function was good for urinary incontinence: 91% success. Results depended on the pressure of the uretral closure. A complete urodynamic work-up is required prior to surgery in case of sphincter failure. Poor results were also related to excessive posterior traction which can open the cervico-uretral angle. Treatment of genito-urinary prolapse with promotofixation in combination with retropubic colpopexia is a reliable reproducible technique which gives excellent long-term results if excessive promontory traction is avoided and if, in certain cases, the rectovaginal wall is repaired or a prosthesis implanted when maximum uretral closure pressure is weak.</p>","PeriodicalId":10182,"journal":{"name":"Chirurgie; memoires de l'Academie de chirurgie","volume":"122 5-6","pages":"353-8; discussion 358-9"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20509937","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: 0
[Surgical activity in health care facilities]. [医疗机构的外科手术活动]。
Chirurgie; memoires de l'Academie de chirurgie Pub Date : 1997-01-01
B Coladon, M Huguier
{"title":"[Surgical activity in health care facilities].","authors":"B Coladon,&nbsp;M Huguier","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Surgical activity for 144,000 beds in 1605 health care facilities in France in 1992 are reported. Both public (49%) and private (51%) hospital beds were studied. There were 2456 surgical theaters and a representative sample of 450,000 operations was examined. There were 4723 authorized beds which were not installed and 1168 non-authorized beds which were installed. The number of authorized beds per 10,000 inhabitants ranged from 16.1 (Picardie) to 33.2 (Corsica). Operations per 10,000 inhabitants ranged from 568 (Picardie) to 992 (Languedoc-Roussillon). The most frequent operations were adenoidectomies-amygdalectomies, cataract, appendectomy, herniacure, varicose veins of the lower limbs. Among the emergency operations, 91% of the operations were performed in 1156 permantly operating theaters. In these theaters, there was, on the average, one night operation every 4 nights. Regional variations in the number of beds demonstrate the need for improvement in organization. For operations, migratory flow and age differences cannot explain all the differences observed. Medical management varies greatly suggesting that more rigorous methodology and clinical training are needed.</p>","PeriodicalId":10182,"journal":{"name":"Chirurgie; memoires de l'Academie de chirurgie","volume":"122 2","pages":"117-21"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20181157","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: 0
[Spinal cord hemangioblastomas and pseudotumors: therapeutic strategy]. [脊髓血管母细胞瘤和假性肿瘤:治疗策略]。
Chirurgie; memoires de l'Academie de chirurgie Pub Date : 1997-01-01
J Brotchi
{"title":"[Spinal cord hemangioblastomas and pseudotumors: therapeutic strategy].","authors":"J Brotchi","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":10182,"journal":{"name":"Chirurgie; memoires de l'Academie de chirurgie","volume":"122 2","pages":"130-1"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20181160","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: 0
[Laparoscopically extended hysterectomy for cervix cancer: technique, indications and results. Apropos of a series of 41 cases in Clermont]. 腹腔镜扩大子宫切除术治疗宫颈癌:技术、适应证和结果。关于克莱蒙特的一系列41个案例]。
Chirurgie; memoires de l'Academie de chirurgie Pub Date : 1997-01-01
C Pomel, M Canis, G Mage, J Dauplat, G Le Bouëdec, J Raiga, J L Pouly, A Wattiez, M A Bruhat
{"title":"[Laparoscopically extended hysterectomy for cervix cancer: technique, indications and results. Apropos of a series of 41 cases in Clermont].","authors":"C Pomel,&nbsp;M Canis,&nbsp;G Mage,&nbsp;J Dauplat,&nbsp;G Le Bouëdec,&nbsp;J Raiga,&nbsp;J L Pouly,&nbsp;A Wattiez,&nbsp;M A Bruhat","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report a study of 41 radical hysterectomies performed through laparoscopic approach for carcinoma of the cervix uteri. According to the FIGO staging, the tumors were classified as 12 stages Ia2, 24 stages Ib, 4 stages IIa and 1 stage IIb. 17 patients were treated by exclusive surgical procedure. 24 patients received a combination of radiation therapy and surgery 2 patients had a tumor of the cervical stump after subtotal hysterectomy. The mean duration of the procedure was 270 minutes. The post-op stay was 6.5 days. There was no major operative and postoperative complication. Only one patient required a blood transfusion. The intravenous pyelogram control was correct in all cases. At this time, with a 4 to 76 months follow-up, no recurrence was observed. This experience suggests the faisability of the laparoscopic radical hysterectomy. This approach seems to be convenient in young and non obese women with a tumor less than 4 cm in the greatest diameter.</p>","PeriodicalId":10182,"journal":{"name":"Chirurgie; memoires de l'Academie de chirurgie","volume":"122 2","pages":"133-6; discussion 136-7"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20181162","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: 0
[Primary hyperparathyroidism. Optimization of surgical results with systematic preoperative 99mTc-Sestamibi scintigraphy]. 原发性甲状旁腺功能亢进(。术前系统99mTc-Sestamibi显像优化手术效果[j]。
Chirurgie; memoires de l'Academie de chirurgie Pub Date : 1997-01-01
D Melliere, E Hindie, M C Voisin, L Perlemuter, D Simon
{"title":"[Primary hyperparathyroidism. Optimization of surgical results with systematic preoperative 99mTc-Sestamibi scintigraphy].","authors":"D Melliere,&nbsp;E Hindie,&nbsp;M C Voisin,&nbsp;L Perlemuter,&nbsp;D Simon","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>The importance of preoperative 99mTc Sestamibi (MIBI) scintigraphy in case of reoperation for persistent hyperparathyroidism is well recognized, but it use as a systematic exploration technique remains a question of debate. We conducted this study to determine whether preoperative MIBI scans performed in all cases before surgery have any real impact.</p><p><strong>Method: </strong>Two successive series of 65 operated patients were included in the study. In the first group, the MIBI scan was not performed prior to surgery while in the second group the MIBI scan was part of the systematic work-up.</p><p><strong>Results: </strong>The sensitivity and positive predictive value of MIBI were 92% and 96% respectively. Sensitivity for unique adenomas was 95% and 80% for multiple forms. In the first group without systematic scans, there were two unproductive procedures. In the second group, all procedures were productive and no reoperations were required. Two mediastinal adenomas were removed at the first cervicotomy in this group. The rate of complications was similar for both groups. Mean operation time was 2 hours in the first group and 1 hour 30 minutes for the second.</p><p><strong>Conclusion: </strong>Our series shows that there are three main advantages of using MIBI scintigraphy systematically prior to surgery for hyperparathyroidism: the procedure is easier in patients with cervical adenomas, particularly in case of ectopic localizations; the mean duration of the operation is shortened by 30 minutes; mediastinal ectopic localizations can be removed by sternotomy at the first operation. These advantages appear to be great enough to propose systematic use of MIBI scan prior to surgery. When MIBI scan shows a single gland, the risk of missing a multiple localization is less than 2% in our experience. It appears possible to operate under local anesthesia via a single-sided approach in elderly patients or high-risk patients.</p>","PeriodicalId":10182,"journal":{"name":"Chirurgie; memoires de l'Academie de chirurgie","volume":"122 2","pages":"98-104; discussion 104-5"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20181836","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: 0
[Flexible locked centromedullary osteosynthesis. Results of 125 cases of unstable cortical bone fractures of the tibia]. 弹性锁定髓心骨固定。胫骨不稳定皮质骨骨折125例分析[j]。
Chirurgie; memoires de l'Academie de chirurgie Pub Date : 1997-01-01
J Y de la Caffinière
{"title":"[Flexible locked centromedullary osteosynthesis. Results of 125 cases of unstable cortical bone fractures of the tibia].","authors":"J Y de la Caffinière","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We present a series of 125 cases of centromedullary fixation with a flexible locked nail of unstable cortical bone fractures of the tibia in which we studied healing conditions in order to identify parameters which would predict the rate of consolidation. One hundred ten fractures followed more than 6 months were included in the statistical analysis. For 94 fractures, primary consolidation was achieved in a mean 11 weeks. Fractures situated in the lower portion of the tibia healed the fastest (10 weeks). However, opening the fracture site and comminutive fractures did not affect the rate of healing except for proximal fractures and for fractures with a gap exceeding 10 cm. These two parameters, width of the bone gap (whether trauma induced or iatrogenic) and proximal localization of the fracture were the cause of the cases with long periods of non-consolidation (14.5%). The speed of peripheral osteogenesis is considered to be accelerated with the flexible nail as seen in our 94 cases where no conversion was necessary. This method provides a mean 1 month gain over consolidation times compared with locked nailing where the distal locking probably increases the rigidity of the system.</p>","PeriodicalId":10182,"journal":{"name":"Chirurgie; memoires de l'Academie de chirurgie","volume":"122 10","pages":"552-60"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20536700","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: 0
[Criticisms against annealing and the concept of solid nails]. [对退火和实钉概念的批评]。
Chirurgie; memoires de l'Academie de chirurgie Pub Date : 1997-01-01
D Heim
{"title":"[Criticisms against annealing and the concept of solid nails].","authors":"D Heim","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":10182,"journal":{"name":"Chirurgie; memoires de l'Academie de chirurgie","volume":"122 3","pages":"170-1"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20238737","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: 0
[Should total hip prostheses be cemented?]. 全髋关节假体应该用水泥吗?
Chirurgie; memoires de l'Academie de chirurgie Pub Date : 1997-01-01
J Witvoet
{"title":"[Should total hip prostheses be cemented?].","authors":"J Witvoet","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":10182,"journal":{"name":"Chirurgie; memoires de l'Academie de chirurgie","volume":"122 3","pages":"217-9"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20238747","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: 0
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