Chirurgie最新文献

{"title":"Vagotomie tronculaire par vidéothoracoscopie sans drainage gastrique. Étude prospective de 250 cas opérés au Sénégal","authors":"J.M. Andreu,&nbsp;E. Tardat,&nbsp;P. Balandraud,&nbsp;L. Cador","doi":"10.1016/S0001-4001(00)80013-6","DOIUrl":"10.1016/S0001-4001(00)80013-6","url":null,"abstract":"<div><h3>Aim of the study</h3><p>The aim of this prospective study was to report early results of videothoracoscopic truncal vagotomy in non-complicated chronic duodenal ulcers.</p></div><div><h3>Patients and methods</h3><p>From 1995 to 1998, 250 patients suffering from chronic duodenal ulcer without pyloric stenosis were operated on in the main hospital of Dakar. They underwent videothoracoscopic truncal vagotomy without gastric drainage. The quality of gastric emptying and the incidence of secondary side-effects were assessed in the postoperative course and after one and three months.</p></div><div><h3>Results</h3><p>There were two intraoperative deaths, one due to aortic wound and the other one due to a poor surveillance after premature extubation. Postoperative complications included bronchopulmonary infection (<em>n</em>=9), one septic pleural effusion and one chylothorax. A postoperative gastroplegia occurred in 12 patients, which was always spontaneously regressive without endoscopic pyloric dilatation. After one month, 204 patients (82%) were classified Visik 1, and 44 (18%) classified Visik 2. An endoscopic control examination showed a healed peptic ulcer and open pylorus in all patients, and a gastric stasis present in 40 cases (16%). After three months and a new evaluation, 234 were classified Visik 1 (94%) and 14 Visik 2 (6%). Dumping syndrome was not observed in this series and the incidence of diarrhea, which was 40% after one month, decreased to 3% after three months.</p></div><div><h3>Conclusion</h3><p>The functional results of truncular vagotomy without gastric drainage were good or very good and improved with time. The quality of digestive comfort and the low frequency of side-effects are good arguments in favor of this procedure as an elective treatment of duodenal ulcers in developing countries.</p></div>","PeriodicalId":29786,"journal":{"name":"Chirurgie","volume":"124 4","pages":"Pages 406-411"},"PeriodicalIF":0.9,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0001-4001(00)80013-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21407538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholécystectomie cœlioscopique après 75 ans","authors":"P. Pessaux,&nbsp;J.J. Tuech,&nbsp;R. Duplessis,&nbsp;R. Seicean,&nbsp;J.P. Arnaud","doi":"10.1016/S0001-4001(00)80015-X","DOIUrl":"10.1016/S0001-4001(00)80015-X","url":null,"abstract":"<div><h3>Aim of the study</h3><p>The aim of this prospective study was to determine the feasibility, complications and benefits of laparoscopic cholecystectomy in the patients over 75 years of age.</p></div><div><h3>Methods</h3><p>From January 1992 to July 1998, among the 863 patients who underwent laparoscopic cholecystectomy, 102 patients over 75 years (group I) were compared to 761 younger patients (group II).</p></div><div><h3>Results</h3><p>The conversion rate was 22% in group I versus 13% in group II (<em>P</em> = 0.017). Mortality and morbidity rates were respectively 1% and 13.7% in elderly patients versus 0 and 6.6% in younger patients (<em>P</em> = 0.009). Mean length of hospital stay was higher in group I: 6.9 versus 4.5 d in group II (<em>P</em> &lt; 10⁻⁶).</p></div><div><h3>Conclusions</h3><p>Laparoscopic cholecystectomy is feasible in patients above 75 for the treatment of symptomatic gallstones and acute cholecystitis with a low morbidity rate.</p></div>","PeriodicalId":29786,"journal":{"name":"Chirurgie","volume":"124 4","pages":"Pages 419-422"},"PeriodicalIF":0.9,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0001-4001(00)80015-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21406788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hommage à Jacques Oudot pour le 50e anniversaire de la première greffe de bifurcation aortique","authors":"J. Natali","doi":"10.1016/S0001-4001(00)80020-3","DOIUrl":"10.1016/S0001-4001(00)80020-3","url":null,"abstract":"","PeriodicalId":29786,"journal":{"name":"Chirurgie","volume":"124 4","pages":"Pages 448-454"},"PeriodicalIF":0.9,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0001-4001(00)80020-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21406793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Société française d'anesthésie et de réanimation","authors":"","doi":"10.1016/S0001-4001(00)80019-7","DOIUrl":"https://doi.org/10.1016/S0001-4001(00)80019-7","url":null,"abstract":"","PeriodicalId":29786,"journal":{"name":"Chirurgie","volume":"124 4","pages":"Pages 441-447"},"PeriodicalIF":0.9,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0001-4001(00)80019-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136558412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chimiothérapie et chirurgie comparées à la chirurgie seule dans les cancers localisés de l'œsophage","authors":"M. Huguier","doi":"10.1016/S0001-4001(00)80021-5","DOIUrl":"10.1016/S0001-4001(00)80021-5","url":null,"abstract":"","PeriodicalId":29786,"journal":{"name":"Chirurgie","volume":"124 4","pages":"Pages 455-456"},"PeriodicalIF":0.9,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0001-4001(00)80021-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21406794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endobrachyœsophage et chirurgie antireflux: étude d'une série de 26 patients","authors":"J. Baulieux ,&nbsp;J.Y. Mabrut ,&nbsp;C. Ducerf ,&nbsp;M. Adham ,&nbsp;E. De La Roche ,&nbsp;N. Berthoux ,&nbsp;O. Bourdeix ,&nbsp;J.L. Gaudin ,&nbsp;J.C. Souquet","doi":"10.1016/S0001-4001(00)80012-4","DOIUrl":"10.1016/S0001-4001(00)80012-4","url":null,"abstract":"<div><h3>Study aim</h3><p>The aim of this study was to report the results of a retrospective series of 26 patients with Barrett's esophagus treated by antireflux surgery.</p></div><div><h3>Patients and methods</h3><p>From 1979 to 1998, 21 men and five women (mean age: 53 years) with histologically proven Barrett's esophagus underwent an antireflux procedure. The mean length of Barrett's epithelium was 5.9 cm for 19 patients (73.1%).Six patients (23.1%) had tongue lesions of Barrett's epithelium, and one (3.8%) had ectopic gastric mucosa. None of the patients had a preoperative esophageal biopsy that revealed high-grade dysplasia or carcinoma. Laparotomy was performed in 17 cases and laparoscopy in nine cases. Preoperative endoscopic local treatment with argon coagulation was performed in one patient.</p></div><div><h3>Results</h3><p>Clinical mean follow-up was 78 months and endoscopic mean follow-up was 59.3 months. No increase in the length of the Barrett's epithelium was observed. Seven patients (27%) had complete or partial regression (among them three patients with tongue lesions and one patient preoperatively treated by argon). No patients developed high-grade dysplasia or carcinoma.</p></div><div><h3>Conclusion</h3><p>Regression of Barrett's esophagus is possible but not frequent and unpredictable after antireflux procedure. However, endoscopic and histological surveillance should be continued postoperatively.</p></div>","PeriodicalId":29786,"journal":{"name":"Chirurgie","volume":"124 4","pages":"Pages 398-405"},"PeriodicalIF":0.9,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0001-4001(00)80012-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21407537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Résultats des hernioplasties cœlioscopiques. Étude de 401 cas chez 318 patients","authors":"P. Blanc ,&nbsp;J. Porcheron ,&nbsp;C. Breton ,&nbsp;P. Bonnot ,&nbsp;S. Baccot ,&nbsp;O. Tiffet ,&nbsp;J. Cuilleret ,&nbsp;J.G. Balique","doi":"10.1016/S0001-4001(00)80014-8","DOIUrl":"10.1016/S0001-4001(00)80014-8","url":null,"abstract":"<div><h3>Study aim</h3><p>The aim of this retrospective study was to report a series of laparoscopic hernioplasty performed in two surgical centers, and to evaluate the results with a mean follow-up of 31 months.</p></div><div><h3>Patients and methods</h3><p>From January 1992 to January 1997, 318 patients with 401 inguinal hernias were operated on through laparoscopy by six senior surgeons and six junior surgeons. There were 302 men and 16 women (mean age: 53 years). The operation was performed through an extra-peritoneal approach (TEP) in 298 hernias, a trans-abdomino-preperitoneal approach (TAPP) in 62 hernias, and an intra-abdominal approach (IPOM) in 41 hernias.</p></div><div><h3>Result</h3><p>Conversion into open surgery was necessary in 7% of the patients. There was no postoperative death. The postoperative morbidity rate was 10%. The average hospital stay was three days. With a 1 to 5 year follow-up, 4% of the 94% of the patients who answered the questionnaire showed a recurrence (3% in the extra-peritoneal group; 4% in the trans abdomino-preperitoneal group; 10% in the intra-abdominal group).</p></div><div><h3>Conclusion</h3><p>Laparoscopic hernioplasty seems as efficient as traditional hernoplasty with the advantages of miniinvasive surgery. The extra-peritoneal approach was preferred and performed in most cases of this series. The intra-peritoneal approach was abandoned.</p></div>","PeriodicalId":29786,"journal":{"name":"Chirurgie","volume":"124 4","pages":"Pages 412-418"},"PeriodicalIF":0.9,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0001-4001(00)80014-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21407539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stratégie chirurgicale dans le traitement des métastases hépatiques synchrones des cancers colorectaux. Analyse d'une série de 59 malades opérés","authors":"D. Jaeck,&nbsp;P. Bachellier,&nbsp;J.C. Weber,&nbsp;K. Boudjema,&nbsp;A. Mustun,&nbsp;F. Pâris,&nbsp;J.C. Schaal,&nbsp;P. Wolf","doi":"10.1016/S0001-4001(99)80091-9","DOIUrl":"10.1016/S0001-4001(99)80091-9","url":null,"abstract":"<div><h3>Aim of the study</h3><p>The surgical strategy for the treatment of resectable synchronous hepatic metastases of colorectal cancer remains controversial. The retrospective analysis of our series of resectable synchronous hepatic metastases is focused on the percentage of simultaneous resections, the circumstances, the indications, and the results of the one-step procedure compared to the two-step strategy.</p></div><div><h3>Methods</h3><p>From January 1 st 1982 to December 31 st 1996, 146 patients were operated on for resection of hepatic metastases of colorectal cancer. Fifty-nine (40%) presented with synchronous metastases, 28 (47.5%) of whom under-went simultaneous resection of the primary tumor and of the hepatic metastases (simultaneous resection group: SR). For the other 31 patients (52.5%), the hepatic resection was delayed for a mean interval of 6 ± 4 months (delayed resection group: DR).</p></div><div><h3>Results</h3><p>The mean age in the two groups was not significantly different (56 years vs. 60 years). The need for blood transfusion and the volume required were not significantly different between the two groups. The duration of each surgical operation was comparable between the two groups (320 ± 76 min vs. 308 ± 88 min). Postoperative complications were observed in 18% of patients in the SR group and in 16% of patients in the DR group (no significant difference). There was no postoperative mortality in either group. Survival was 86, 63 and 43% at 1, 2, 3 years respectively in the SR group, and 81, 51 and 36% in the DR group, with no significant difference between the groups.</p></div><div><h3>Conclusion</h3><p>Simultaneous resection of the primary tumor and the hepatic métastases does not increase neither mortality nor morbidity in our series. The best candidate for a one-step procedure is a patient with a right colonic tumor, in a good status, with liver synchronous metastases resectable by mean of a minor hepatectomy.</p></div>","PeriodicalId":29786,"journal":{"name":"Chirurgie","volume":"124 3","pages":"Pages 258-263"},"PeriodicalIF":0.9,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0001-4001(99)80091-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21294102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nouvelles perspectives dans l'étiologie des hernies de l'aine","authors":"A. Pans","doi":"10.1016/S0001-4001(99)80095-6","DOIUrl":"10.1016/S0001-4001(99)80095-6","url":null,"abstract":"<div><h3>Aim of the study</h3><p>To explore new etiological hypotheses of groin hernias, using a biomechanical and histochemical study of the transversalis fascia and of the rectus sheath.</p></div><div><h3>Patients and methods</h3><p>The samples were collected from 63 patients with uni- or bilateral hernias and from 30 control subjects without hernia. The biomechanical properties were assessed using a computerized-suction device (Cutometer ^®). Sections were stained with hematoxylin and eosin, Masson-trichrome and double-stained with sirius red and orcein.</p></div><div><h3>Results</h3><p>There was no major biomechanical and histological difference between the control and patient aponeuroses. The patient fascias from the non-herniated sides presented an increased extensibility and elasticity, as compared with the control fascias. Those fascias also showed a collagen framework with disorganized areas and an increased number of isolated fibers.</p></div><div><h3>Conclusion</h3><p>The transversalis fascia from the non-herniated side appears to be a pathological fascia. Therefore, a connective tissue pathology seems to be involved in the genesis of groin hernias, with a preferential manifestation in the inguinal region which affects mainly the collagen fibers.</p></div>","PeriodicalId":29786,"journal":{"name":"Chirurgie","volume":"124 3","pages":"Pages 288-297"},"PeriodicalIF":0.9,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0001-4001(99)80095-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21294106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drain tuteur transanastomotique ou non dans les pancréatico-jejunostomies après duodénopancréatectomie ? Étude prospective","authors":"M. Huguier","doi":"10.1016/S0001-4001(99)80106-8","DOIUrl":"10.1016/S0001-4001(99)80106-8","url":null,"abstract":"","PeriodicalId":29786,"journal":{"name":"Chirurgie","volume":"124 3","pages":"Pages 344-345"},"PeriodicalIF":0.9,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0001-4001(99)80106-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87839945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}