A lymph node ratio of 10% is predictive of survival in stage III colon cancer: a French regional study.

Lymph node ratio (LNR) (positive lymph nodes/sampled lymph nodes) is predictive of survival in colon cancer. The aim of the present study was to validate the LNR as a prognostic factor and to determine the optimum LNR cutoff for distinguishing between "good prognosis" and "poor prognosis" colon cancer patients. From January 2003 to December 2007, patients with TNM stage III colon cancer operated on with at least of 3 years of follow-up and not lost to follow-up were included in this retrospective study.

Surgical patient advocacy: role and value in surgery.

Patient advocacy may be necessary during medical care in the home or office as well as during hospitalization in either private or public sector care. Patients may choose a relative, a close friend or a physician as their patient advocate. The patient advocate may provide physical assistance and usually accompanies the patient throughout the course of disease.

[Suing the surgeon: what are procedures? How to conduct an assessment?].

Surgeons are particularly exposed to lawsuits. Most will be threatened or confronted with litigation several times during their career. The surgeon can be held directly and personally liable during a penal procedure.

Rectal stenosis caused by foreign body reaction to sodium polystyrene sulfonate crystals (Kayexalate).

Sodium polystyrene sulfonate (SPS) (Kayexalate) is a cation-exchange resin used to treat hyperkaliema. Administered with sorbitol, it usually has minor adverse effects, but it may cause colonic or intestinal necrosis in uremic patients. We report an unusual case of rectal stenosis due to SPS crystals in a 46-year-old man.

[Tissue adhesive treatment of persistent recto-cutaneous fistula following Hartmann procedure].

Background: Cutaneous fistulas from the rectal stump after Hartmann procedure are not rare. Rarely do they require operative intervention, but they may result in prolonged skin care during hospitalization.

Purpose: of study: To describe the use of fibrin glue in the treatment of rectocutaneous fistulas occurring after Hartmann procedure.

[The Association Française de Chirurgie (AFC) colorectal index: a reliable preoperative prognostic index in colorectal surgery].

Introduction: Evaluation of outcome after colorectal surgery is always necessary. A new index which permits to appreciate preoperatively postoperative mortality after colorectal resection in colorectal cancer (CRC) and in diverticular disease has been published (i.e.

[Morbi-mortality after Hartmann procedure for peritonitis complicating sigmoid diverticulitis. A retrospective analysis of 85 cases].

Introduction: Hartmann's procedure (HP) is a simple operation, which can be performed by all the surgeons. However, it remains criticized (high morbimortality, low rate of intestinal continuity restoration). The aim of this study was to analyse natural history of HP and intestinal continuity restoration for sigmoid diverticulitis, and to assess risk factors for mortality, morbidity and absence of intestinal continuity restoration.

[Angiomyofibroblastoma of the male genital tract. Pathological and immunohistochemical study of three cases].

Angiomyofibroblastoma of the male genital tract is a rare tumor with only 20 cases reported in the literature to date. We report three cases in males aged from 23 to 44 years. They presented with painless inguinal, scrotal and perineal masses, ranging from 3 to 8 cm in diameter.

[Autopsies and surgical service].

The aim of autopsy is to define the causes of a patient's death by studying the gross and microscopic visceral lesions. It is in actual decline but nevertheless the post-mortem examination remains one of the basic tools for the assessment of medical care in hospital. The aim of this paper is to finalize the present French legislation of autopsy and to show its importance in surgical practice.

Groove pancreatitis and pancreatic heterotopia in the minor duodenal papilla.

Groove pancreatitis is a rare form of segmental chronic pancreatitis that involves the anatomic space between the head of the pancreas, the duodenum, and the common bile duct. We report 2 cases of groove pancreatitis with pancreatic heterotopia in the minor papilla. Patients were a 44-year-old woman and a 47-year-old man.

[Pancreas divisum and the dominant dorsal duct syndrome].

Pancreas divisum, the most frequent congenital malformation of the pancreas, results from the absence of embryologic fusion of the dorsal and ventral pancreatic ducts which keep an autonomy of drainage. The dorsal pancreatic duct is dominant and drains the major part of the pancreatic fluid through a non adapted accessory papilla. The high prevalence of pancreas divisum in patients presenting recurrent acute pancreatitis, the presence of obstructive pancreatitis electively located on the dorsal pancreatic duct and the results of the treatments targeted on the accessory papilla are the arguments pleading for the pathogenic character of the pancreas divisum.

[Self expanding metallic stent in the management of malignant colonic obstruction].

Introduction: Fifteen to thirty percent of colonic cancers are diagnosed at acute colic obstruction stage. In this situation surgery is associated with a high morbi-mortality. The self-expandable metallic stents (SEM) have two objectives: (a) resolution of the obstructive to allow secondary planified radical surgical procedure; (b) palliative in the event of advanced disease.

[Umbilical hernias treatment by the "stamp mesh technique"].

We describe an original technique for umbilical hernia repair ("stamps mesh technique") during which no umbilical ring widening is carried out. A non-absorbable mesh is positioned in the preperitoneal space.

[Urologic presentation of acute appendicitis: a frequent cause of delayed diagnosis, including in HIV infected patients].

Acute appendicitis rarely presents in the form or urinary tract symptoms. Atypical forms of acute appendicitis occur more frequently in subjects infected by the human immunodeficiency virus (HIV). The authors report a case of acute appendicitis in an HIV-infected subject mimicking acute pyelonephritis secondary to obstruction.

[Management of umbilical hernia in cirrhotic patients].

The treatment of umbilical hernia in the setting of cirrhosis poses unique and specific management problems due to the pathophysiology of cirrhotic ascites. The high intra-abdominal pressures generated by ascites when applied to areas of parietal weakness are the cause of hernia formation and enlargement. Successful surgical treatment depends on minimization or elimination of ascites.

[Laparoscopy: incisional hernias].

Post-laparoscopics incisionals hernias are among the serious complications of laparoscopy, however they are probably under-reported. We undertook a literature review to discuss their main characteristics. We emphasized on the need of controlled studies regarding their prevention measures.

[Hematoma of the abdominal large right muscles: diagnosis and treatment].

Rectus sheath hematoma is an uncommon event, and exception post-trauma hematoma, affects predisposed patients. The typical clinical case combine abdominal pain, a palpable mass, and parietal eccymosis appearing when a patient under anticoagulant therapy coughs. Diagnosis is confirmed by abdominal ultrasonography or CT scan.