[Anterior desinsertion of the transversus abdominalis in the prosthetic treatment of major eventrations].

An original procedure is suggested for the prosthetic treatment of major incisional hernias: transversus abdominalis muscle desinsertion. The aim is to create an opening between two cleavage planes which are the underperitoneal space externally and the posterior face of the rectus abdominalis muscle internally. The single space thus created allows the wide implantation of a subperitoneal Mersilene prosthesis which is isolated from the viscera as well as from the skin.

[Response to hepatic intra-arterial chemotherapy for metastases of colorectal cancer. Anatomo-pathological evaluation apropos of 3 cases of secondary hepatic excision].

Following intra-arterial chemotherapy (5-fluorouracil), wide hepatic resection was performed in three patients with metastases from colorectal cancer. These surgical procedures had been considered to be unfeasible before chemotherapy in two of the three cases because of the extension of the metastases. In contrast to the results of preoperative imaging techniques (CT scan, ultrasonography), the histologic response of tumors to chemotherapy was found to be significant (1/3) or complete (2/3).

[Infectious complications of diverticular sigmoiditis: can the failure of medical treatment be predicted?].

A retrospective study of case histories of 36 patients with infectious complications of sigmoid diverticulitis (excluding peritonitis) compared clinical, biologic and radiologic signs in a group responding favorably to medical treatment (24 cases) and a group requiring surgery after a mean of 9 days of treatment in a surgical ward (12 cases). Six signs were found to be related to the course of the disease: a painful left iliac mass on admission, persistence or increase in pain after 48 hours, absence of restoration of normal intestinal transit, temperature below 36.5 degrees C or above 37.

[Peripheral intravenous infusions. Reduction of morbidity owing to an electronic controller of infusion flow rate].

The ability of an electronic infusion controller (IVAC 230) to reduce morbidity in peripheral intravenous infusions was investigated in a controlled randomized trial. The results were assessed on the number of sites of injection in relation to the total duration of perfusion, with an adjustment for the quality of the fluids infused. Using the controller resulted in a 50% decrease in the number of sites of injection (risk alpha = 1%, beta = 10%).

[Acute pancreatitis: severity factors. Retrospective analysis of 78 cases].

Retrospective analysis of clinical and laboratory findings was undertaken in 78 patients in which pancreatitis was confirmed pathologically. In our experience, severity factors are as follows: age over 55 years and, during the first 48 hours, fall in haematocrit of more than 10%, corrected plasma calcium lower than 8 mg %, plasma creatinine greater than 30 mg/1, hypoxia less than 60 mm Hg, resistant to assisted ventilation, liquid sequestration more than 6 litres. These objective parameters define the group of patients who, in our experience, should derive benefit from new suggested forms of treatment.

[Postoperative cholecystitis. Apropos of 9 cases (3 lithiasic and 6 alithiasic)].

Postoperative cholecystitis (three cases with and six cases without associated stones) was found following 25.00 operations performed over a period of 8 years. Analysis of these cases and a literature review suggest that the onset of a postoperative lithiasic cholecystitis is probably only the result of coincidence, where as alithiasic cholecystitis is a definite postoperative complication, these affections having to be considered within the more general framework of post-aggression cholecystitis.

Celiac artery aneurysm.

Aneurysms of the celiac axis are rare, since only 50 cases were reported in 1976, 14 of which were operated on successfully. We report here the 15th case. This celiac aneurysm involved the origin of the splenic left gastric and common hepatic arteries.

[Bilio-digestive fistulae of lithiasic origin. A report of seventeen cases (author's transl)].

17 spontaneous bilio-digestive fistulae of lithiasic origin have been regrouped for study. 15 cases underwent operation and represent 1.3% of concomitant biliary diseases treated by surgery.

[Diverticula of the duodenal window. 36 cases (author's transl)].

The authors have studied 36 cases of duodenal diverticula detected during 500 biliary operations. Initial pre-operative diagnosis was based on upper gastrointestinal barium series alone. Fiberopticduodenoscopy was unable to detect the diverticula.

[Gastric ulcer: conservative surgical treatment in 100 patients (author's transl)].

One hundred patients with gastric ulcer underwent surgery without gastric mutilation by a technique initially directed against stasis by pyloroplasty, vagotomy and, according to the site of the ulcer, its limited resection or biopsy. In half of the cases, the indication was that of the development of a complication. Eight patients died, 6 of them from amongst the 44 haemorrhagic ulcers.