Ivor Lewis procedure for epidermoid carcinoma of the esophagus. A series of 264 patients.

Since 1982, Ivor Lewis esophagectomy has been performed on 264 patients with epidermoid esophageal carcinoma in our series. The mean age was 59. There were 243 men and 21 women; 91 patients had respiratory or cardiovascular problems.

[Effect of the parenteral feeding regimen on postoperative nitrogen sparing. Comparison of 3 regimens containing 0%, 30% and 50% lipid calories].

Forty one non emaciated patients undergoing major visceral surgery were randomly divided into three groups according to the postoperative parenteral diet (0% fat versus 30% or 50% fat). During five days daily nitrogen balance was studied. There was no evidence of any significant difference between the group 0% and the group 50%.

[Postoperative hypophosphoremia in digestive surgery. Influence of the parenteral diet].

Twenty-seven non emaciated patients undergoing major visceral surgery were randomly divided into two different groups according to the postoperative parenteral diet (100% glucose versus 50% fat 50% glucose). All patients received the same anaesthetic protocol and, peroperatively, none received any glucose. In the postoperative phase, parenteral feeding was started on the day of operation (18.

[Severe hypophosphoremia in a patient on parenteral nutrition with phosphorus enrichment].

A twenty-four year old patient showed severe hypophosphataemia after emergency surgery for colectasia. A critical study of the case isolated the factors which had favoured the development of this metabolic complication. The necessity for great care in the nutrition of emaciated patients as well as that of a phosphorus supply adapted to the metabolic status of the patient were emphasized.

[Influence of epidural anesthesia on postoperative nitrogen sparing in major digestive surgery].

In order to determine the role of epidural anaesthesia on protein sparing, eighteen patients undergoing major visceral surgery were randomly divided into three different groups according to the mode of anaesthesia used (general anaesthesia, epidural anaesthesia, continuous epidural anaesthesia for 24 h). These patients were intravenously fed for five days postoperatively; their nitrogen balance was studied. Compared with the "general anaesthesia" group, only the daily averages of nitrogen balance of the "continuous epidural" group were significantly better.

[Postoperative gas gangrene. Apropos of 22 cases].

The authors report twenty two cases of post-operative gas gangrene. In the series studied mortality was 40.9 p.

[Significance of skin tests in pre-operative assessment].

The authors report their experience of skin tests used to investigate cellular immunity in the detection of a high risk population pre-operatively. Over an 18 month period, 114 patients about to undergo major surgery were tested. The following three antigens were used: candinin, varidase and tuberculin.

[Value of cimetidine in the prevention of Mendelson's syndrome in abdominal surgery].

The action of cimetidine on gastric acid secretion being perfectly known, the authors sought to confirm the possible efficacy of a single injection of cimetidine, by the intramuscular route, combined with the premedication, on the reduction in gastric secretion during the operative period. Fifty patients undergoing routine surgery were divided into two groups at random. One group was used as a control.