Surgical management of internal fistulas in Crohn's disease.

Background: Internal fistulas in Crohn's disease join a diseased intestinal segment to a "victim organ" (VO) that is affected by proximity. While the diseased segment is resected, the other can be sutured in selected cases.

Study Design: Seventy-four patients with 100 internal fistulas were retrospectively reviewed to assess the results of this conservative operative approach.

Heterotopic gastric mucosa presenting as gallbladder polyps.

The authors report the case of a 16-year-old man with recurrent abdominal pain. Ultrasonography showed two gallbladder polyps, one of them larger than 10 mm. Laparoscopic cholecystectomy was performed.

Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients. Association Française de Chirurgie.

Background: Five-year survival rates after resection of liver metastases from colorectal carcinoma are close to 25%. Recurrences occur in two-thirds of the patients after surgery. Selection of patients likely to benefit from surgery remains controversial and subjective.

[200 first hepatic transplantation at the Rennes University Hospital].

Unlabelled: From 21st of april 1978 to 1st september 1994, 200 liver transplantations in 172 patients were performed in the Medical Center of University of Rennes. Three patients had a liver and kidney transplant. 26 patients received a second transplant (13%) and 2 patients a third transplant (1%).

[Surgical treatment of hepatocarcinoma in cirrhosis].

In 1986, our institution published the first results of surgical résection of hepatocarcinoma in cirrhotic patients. The aim of this paper is to present long term results of this surgical management. From April 1978 to February 1992, 74 patients were operated on at the surgical clinic of University Medical Center of Rennes (35000) France.

Ruptured subcapsular hepatic haematoma secondary to "HELLP syndrome".

We report the history of a pregnant woman who suffered from a ruptured hepatic subcapsular haematoma, responsible for a major haemoperitoneum. This rare event, final evolution of the "HELLP Syndrome" led us to review pathophysiology and treatment of the syndrome.

Surgical management of ileosigmoid fistulas in Crohn's disease: role of preoperative colonoscopy.

Purpose: Surgical treatment of ileosigmoid fistulas in Crohn's disease remains controversial and can be radical (resection of both segments) or conservative (ileal resection with suture or wedge resection of the sigmoid). At our institution, the sigmoid defect is sutured if the sigmoid is not affected by primary Crohn's disease or by important stricture; otherwise, the sigmoid is resected. We reviewed our experience to evaluate our results with this procedure.

[Surgical treatment of hepatocarcinoma in cirrhosis].

In 1986, our institution published the first results of surgical resection of hepatocarcinoma in cirrhotic patients. The aim of this paper is to present long term results of this surgical management. From April 1978 to February 1992, 74 patients were operated on at the surgical clinic of University Medical Center of Rennes (35000) France.

[Enterovesical fistulas in Crohn disease: diagnosis and treatment].

Internal fistula is a complication of Crohn's disease. Among 589 patients operated upon at Hôpital Saint-Antoine between 1970 and 1992, 17 (2.9%) had entero-vesical fistula.

[Treatment of metastases of colorectal cancers].

Important advances have been made in the management of advanced colorectal cancers during the past decade, even though prognosis remains poor. Quality of life, and sometimes overall survival have been increased. Surgery is the only potentially curative treatment of liver metastases from colorectal cancer.

[Transplantation of allogeneic hepatocytes without immunosuppression: long-term survival].

Unlabelled: Hepatocyte transplantation could be an alternative to whole liver transplantation. Allogeneic hepatocytes are rejected if transplanted without immunosuppression. The aim of this study was to transplant allogeneic hepatocytes in the peritoneum and to protect them from rejection by encapsulation in a new semi-permeable membrane.

Survival benefit of repeat liver resections for recurrent colorectal metastases: 143 cases. Association Francaise de Chirurgie.

Purpose: Resection is the only chance for cure in patients with colorectal liver metastases (LM). Five-year survival rates are close to 25%. Unfortunately, recurrences occur in most patients.

[Transplantation of allogeneic hepatocytes without immunosuppression: long term survival].

Unlabelled: Hepatocyte transplantation could be an alternative to whole liver transplantation. Allogeneic hepatocytes are rejected if transplanted without immunosuppression. The aim of this study was to transplant allogeneic hepatocytes in the peritoneum and to protect them from rejection by encapsulation in a new semi-permeable membrane.

[Entero-enteral fistulas in Crohn disease: radical or conservative surgical treatment of the "victim" segment?].

Objectives And Methods: Entero-enteral fistulas join a segment affected by Crohn's disease to another which becomes a drainage route and a "victim" of the process. Surgical treatment can be radical (extensive resection of both segments) or conservative (resection of involved bowel and conservation of the "victim"). Fifty-nine patients operated on for Crohn's disease and having 80 entero-enteral fistulas were retrospectively studied.

[Did the stage of diagnosis and the surgical management of colonic cancers change over the last ten years? Apropos of 303 patients].

The major prognostic factors in colonic cancer are parietal invasion, lymph node spread and distant metastasis, as summarized in the Dukes classification. The aims of this study were to find any variation of these parameters between patients operated in 1981 and those operated in 1991 and whether the mortality and morbidity rate were modified. One hundred and twenty seven patients in 1981 and 176 in 1991 were considered.

[Esophagectomy without thoracotomy. Comparison between a retrospective study and a prospective randomized trial].

From 1983 to 1989, 96 oesophagectomies (30% of all oesophagectomies performed during this period) were performed without thoracotomy and then analyzed retrospectively. Most were performed due to contraindications including age (17%), respiratory disease (47%), heart disease (37%) or for superficial oesophageal lesions (35% were stage T1). Operative mortality was 3.

[Cancer of the esophagus. Principles of treatment].

Preoperative evaluation of esophageal cancer is fundamental to assess the degree of extension of the tumor and operability. Surgery remains the reference treatment for tumors with limited loco-regional extension. The prognosis depends on the degree of mural infiltration and lymph node involvement.

[Biliary scintigraphy. Application to the study of chronic cholestasis].

In a sample population of 49 subjects (7 normal, 42 with various liver diseases), the parameters of the activity/time curve of trimethylbromo-iminodicetic acid (TBIDA) biliary scintigraphy were compared with the clearances of bromosulfophthalein (BSP) and indocyanine green (ICG). Correlation between T1/2 and P2 BSP slope was r = 0.50 (n = 33; P < 0.

Surgical polypectomy of duodenal adenomas in familial adenomatous polyposis: experience of two European centres.

Between 1978 and 1988, 12 patients with familial adenomatous polyposis (FAP) and severe duodenal polyposis underwent duodenotomy and duodenal polypectomy. The patients were from two separate institutions; all were women, with a mean age of 45.6 (range 25-62) years at the time of duodenotomy.

Repeat liver resection for recurrent colorectal metastases.

Sixteen patients underwent 18 repeat liver resections for recurrence of colorectal hepatic metastases that had been previously resected. Only minor liver resection had been undertaken at the first operation; three were palliative. The second operation was major hepatectomy in ten patients, minor resection in five and orthotopic liver transplantation in one.