Continuous high-energy low-flow-rate enteral support: a panoramic review of 1000 cases.

One thousand intensive care digestive surgical cases are reviewed concerning continuous low-flow-rate enteral support (CLFRES), using Nutripompe: 607 males and 393 females, average age 51 years. The average duration of CLFRES is 21.5 days +/- 13, range 4 to 180 days.

[Leiomyosarcoma of the small intestine. Apropos of 3 cases].

The authors report three cases of leiomyosarcomas of the small intestine and review the literature on this subject. Leiomyosarcomas of the small intestine are rare tumours, representing 0.2% of all malignant tumours of the gastrointestinal tract.

[Surgical resection of hepatocellular carcinoma. Retrospective study of 42 cases].

We studied the results 42 liver resections performed for hepatocellular carcinoma. Thirty-three patients underwent major liver resections. Hepatocellular carcinomas were associated with cirrhosis in 30.

Postoperative peritonitis due to gastric and duodenal fistulas. Operative management by continuous intraluminal infusion and aspiration: report of 23 cases.

A new surgical procedure is presented for the management of postoperative peritonitis due to a leak from a suture line in the stomach or the duodenum. At re-operation, an intraluminal unit made of three silicone tubes is inserted through the fistula into the bowel lumen. Extraluminal drains are placed near the fistula.

[Fistulas of the small intestine with evisceration. New therapeutic approach. 120 cases].

One hundred and twenty cases of post-operative jejuno-ileal fistula with evisceration are reported: 90% of the patients came from other departments. Depending on their mechanism, these fistulae fell into two categories: out-flowing fistulae (93 cases) consecutive to spontaneously opened peritonitis draining through the surgical incision, and in-flowing fistulae (24 cases) resulting from trauma of a superficial small bowel loop; 48% of open small bowel fistulae were due to a questionable operation. Unfavourable prognostic factors were: age over 50, supramesocolic initial lesion, fluid production equal or superior to 1000 ml/24 h, history of at least 2 previous median laparotomies and presence of one or several of 7 severity factors.

Rectopexy to the promontory for the treatment of rectal prolapse. Report of 257 cases.

From 1953 to 1982, 257 patients with complete rectal prolapse were operated upon. To the procedure described by Orr, we have added mobilization of the rectum prior to its suspension and eliminated the pouch of Douglas, and nylon strips have been used for suspension in most patients. There were 57 male and 200 female patients.

[Megacolon in adults. Apropos of 76 cases].

27 patients with Hirschsprung's disease and 49 patients with idiopathic megacolon were followed for a period ranging between 6 months and 15 years. The diagnosis is essentially based on the barium enema and functional ano-rectal investigations. Duhamel's operation was performed in 26 patients with Hirschsprung's disease and in 34 patients with idiopathic megacolon.

Radiological anatomy of the right gastroepiploic artery.

Most gastroplasties performed to replace the esophagus are vascularized by the right gastroepiploic artery alone. Its origin, course and anatomical relations are classical and subject to little variation. Conversely, its mode of termination and relations to the left gastroepiploic artery have received quite different descriptions in the literature.

[Superficial and extensive epidermoid cancer of the esophagus].

A case of extensive squamous cell carcinoma of the esophagus in a 56 year old man, with an history of excessive alcoholic and tobacco consumption, is reported. After subtotal esophagectomy, the course was favorable 10 months after surgery. The pathological study of the surgical specimen showed that the tumor was superficial and confined to the mucosa and submucosa.