Day case appendectomy in adults: a review.

Background: Day-case appendectomy (DCA) for acute appendicitis has been suggested as a valuable alternative to traditional appendectomy but many surgeons are reluctant to apply this technique in adults. The aim of the present review is to discuss the feasibility of DCA in adults.

Methods: Three reviewers independently searched the Pubmed and Embase databases for articles on DCA.

The gentamicin-collagen sponge for surgical site infection prophylaxis in colorectal surgery: a prospective case-matched study of 606 cases.

Purpose: Surgical site infection (SSI) is a major concern in colorectal surgery (CRS). It accounts for 60 % of all postoperative complications and has an incidence of between 10 and 30 %. The gentamicin-collagen sponge (GCS) was developed to help avoid SSI.

Partial removal of infected parietal meshes is a safe procedure.

Introduction: Open tension-free hernioplasty using prosthetic meshes dramatically reduced recurrence rates after hernia or incisional hernia repair and has become the rule. Mesh infections (MI) are the major complication of prosthetic material. The aim of this study was to assess the efficacy of partial removal of mesh (PRM) therapy in the treatment of MI.

The feasibility of short-stay laparoscopic appendectomy for acute appendicitis: a prospective cohort study.

Background: Short-stay laparoscopic appendectomy for acute appendicitis (AA) has not yet been validated. This study was designed to prospectively evaluate the hospital length of stay (LOS) after laparoscopic appendectomy for AA and to determine predictive factors for successful short-stay surgery (LOS <24 h).

Methods: Between January and December 2010, all consecutive adults admitted for AA were prospectively treated with LOS <24 h as a patient management goal.

Is there a place for pigtail drains in the management of gastric leaks after laparoscopic sleeve gastrectomy?

Laparoscopic sleeve gastrectomy (LSG) has a specific morbidity profile in which gastric leak (GL) is the main complication. With a view to defining a standardized protocol for GL management, the present retrospective study sought to describe the clinical patterns of post-LSG GL and treatment of the latter in our university medical center. From July 2004 to December 2010, 25 patients were included.

Management of supra-mesocolic peritonitis using the Levy helicoid drain (Hélisonde®).

Introduction: Postoperative peritonitis arising in the upper abdomen requiring reoperative surgery has a mortality rate of up to 50%. One therapeutic modality for these patients is the use of the Hélisonde(®) drain, designed by Levy, the Levy Helical Drain (LHD), but it has not seen widespread use. In this paper, we describe our experience in managing supramesocolic peritonitis with this drain at the University Surgical Center at Amiens and we analyze our results.

The current abdominoperineal resection: oncological problems and surgical modifications for low rectal cancer.

Abdominoperineal resection is the one of the oldest surgical procedures for rectal cancer. Outcome after abdominoperineal resection for rectal carcinoma is not as good as anterior resection as the risk of local recurrence is higher and survival is poorer. During abdominoperineal resection, the rate of rectal perforation is high and the circumferential margin is often involved.

Double L-shaped free-style perforator flap for perineal and vaginal reconstruction after cylindrical abdominoperineal resection.

The improvement of patient carcinological status by an abdominoperineal resection by extended posterior perineal approach in a prone position requires the plastic surgeon to consider other reconstructive options. We present an original double L-shaped free-style propeller flap used to reconstruct the vagina and the perineum of a 57-year-old patient after the resection of a T4 tumour of the lower rectum.

Technique of open laparoscopy for supramesocolic surgery in obese patients.

Background: Incidence of obesity and related diseases are increasing in the world. Visceral surgeons are more often confronted with laparoscopic surgery in obese patients. Besides validated surgery procedures, such as cholecystectomy and gastroesophageal reflux surgery, bariatric procedures are increasingly performed.

Two-year results on morbidity, weight loss and quality of life of sleeve gastrectomy as first procedure, sleeve gastrectomy after failure of gastric banding and gastric banding.

Background: Sleeve gastrectomy (SG) is an alternative to gastric bypass and laparoscopic adjustable gastric banding (GB).

Methods: From January 2004 to January 2006, 111 patients with a follow-up longer than 24 months were prospectively followed. Three treatment groups were defined.

Stapled marsupialisation of chronic low rectal anastomotic sinuses.

Purpose: This report describes a technique for the treatment of patients with chronic pelvic anastomotic sinuses (AS) after low anastomosis for rectal cancer in which transanal stapled marsupialisation is performed.

Methods: We reviewed the clinical history of a 62-year-old patient who had a symptomatic chronic pelvic AS more than 6 months after stapled low colorectal side-to-end anastomosis with loop ileostomy for a stage II cancer of the mid rectum without preoperative radiochemotherapy. Pelvic abscess was recurrent three times after percutaneous drainage, operative transanal drainage, and treatment with fibrin glue and ileostomy closure.

Healing of stoma orifices: multicenter, prospective, randomized study comparing calcium alginate mesh and polyvidone iodine mesh.

Background: The aim of this multicenter, randomized, prospective study was to reveal a difference in terms of a guided healing period in the case of stoma orifices after reestablishing digestive continuity by comparing an alginate mesh with a polyvidone iodine mesh.

Methods: Between April 2004 and September 2005, a total of 73 patients were randomized into two groups: A (alginate mesh) and M (polyvidone iodine mesh). The groups were comparable for demographic data, indications for and the type of stoma, and perioperative data.

A Pitfall in the Diagnosis of Unresectable Liver Metastases: Multiple Bile Duct Hamartomas (von Meyenburg Complexes).

Von Meyenburg complexes (VMC) are a cluster of benign liver malformations including biliary cystic lesions, with congenital fibrocollagenous stroma. This rare entity can mimick multiple secondary hepatic lesions. We report a case of a 56-year-old woman who had multiples liver lesions 12 years after operation for breast cancer.

Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity.

Background: Sleeve gastrectomy is a new restrictive bariatric procedure increasingly indicated in the treatment of morbid obesity. The authors report their experience of laparoscopic sleeve gastrectomy (LSG), evaluate the efficacy of this procedure on weight loss, and analyze the short-term outcome.

Methods: The data of 135 consecutive patients undergoing LSG between July 2004 and October 2007 were analyzed prospectively.

Progressive pneumoperitoneum increases the length of abdominal muscles.

The aim of this prospective observational study was to determine the effects of progressive preoperative pneumoperitoneum (PPP) on the size of large incisional hernia (IH) and abdominal muscles by abdominal computed tomography (CT) scan. PPP was performed in 18 patients. All IH were large.

Surgical conservative treatment of recurrent bleeding duodenal ulcer.

Background/aims: Endoscopic hemostasis and proton pump inhibitors (PPI) have decreased the incidence of rebleeding and reduced the need for surgery for bleeding duodenal ulcer (BDU). The gold standard surgical treatment of BDU remains vagotomy-antrectomy. Currently, no recommendation is made on the best procedure when emergency surgery is necessary.

[Surgical management of duodenal ulcer with hemorrhage from the gastroduodenal artery: antrectomy versus conservative surgery?].

When surgery is indicated for bleeding duodenal ulcer, the traditional standard of care has been "radical surgical treatment is preferable to conservative therapy since the risk of rebleeding is reduced without an augmentation in morbidity and mortality". This principle is based on two prospective studies published before 1995. Radical surgery at that time consisted of antrectomy, while conservative therapy included oversewing of the bleeding vessel in the ulcer bed and ligation of the gastroduodenal artery (Weinberg procedure).

Elective (planned) colectomy in patients with colorectal obstruction after placement of a self-expanding metallic stent as a bridge to surgery: the results of a prospective study.

Introduction: Acute malignant colorectal obstruction (CRO) can be satisfactorily dealt by the placement of a self-expanding metallic stent (SEMS). The aim of this prospective study was to evaluate the rate of elective (planned) colectomy (EPC) in patients with CRO after SEMS placement as a bridge to surgery on an intention-to-treat (ITT) basis.

Method: From 2002 to 2007, 30 SEMS were placed as a bridge to surgery in 30 CRO patients (median age 73 +/- 12 years).

[Not Available].

O. Brehant, D. Fuks, C.

Colorectal carcinoma with potentially resectable metastases: factors associated with the failure of curative schedule.

Background: The management of patients with colorectal cancer (CRC) and synchronous liver metastases (SLM) depends on the primitive tumor, resectability of the metastatic disseminations and the patient's comorbid condition(s). Considering all patients with potentially resectable primary CRC and SLM, curative resection (R0) will be possible in some patients, although in others surgery will never be performed. The purpose of our study was to identify factors of failure of the curative schedule in these patients.

Effect of preoperative endoscopic biliary drainage on infectious morbidity after pancreatoduodenectomy: a case-control study.

Background: The utility of preoperative endoscopic biliary drainage (PEBD) in jaundiced patients before pancreatoduodenectomy (PD) is still debated. This is in part due to the heterogeneity of the studied population, including different tumor location, drainage techniques, and surgical procedures. The aim of the current study was to report the influence of PEBD on postoperative infectious morbidity of PD.

Management of patients with carcinoma of the right colon invading the duodenum or pancreatic head.

Background: Only few case series have been published about locally advanced carcinoma of the right colon invading the duodenum or pancreas (CRCDP). We report results of a retrospective study about this rare entity focusing on management and prognosis.

Methods: We reviewed the complete data of patients operated for CRCDP between 1988 and 2005 in four French digestive-surgery departments.