ABSTRACT
Several modalities of varicocele treatment are available, however, no therapeutic technique showed its superiority with regard to the other one. To compare the results of three techniques of varicocelecomy. Retrospective Analytical and comparative study of 128 patients treated by of three techniques of varicocelectomy: the opensurgery by retro peritoneal way for 42 patients [GI], the varicocelectomie coelioscopique for 41 patients [GII] and the antegrade scrotal sclerotherapy done for 45 patients [GIII], between march 2001 and January 2009.The mean age was 28 years. The main motive for consultation was represented by the painful varicocele in 67% of the cases, followed by the hypofertility in 20.3% of the cases and the association both in 12,5% of the cases. The varicocele was in leftsider in 71.1% of the cases, to the right side in 5.4% of the cases and was bilateral in 23.43% of the cases. Varicocele was infra-clinical at 6 patients, grade 1 in 16 sides, grade 2 in 105 sides and grade 3 in 31 sides. The numeration, the mobility as well as the morphology of sperm cells were comparable between the three groups. The global rate success was 81.2%, with the highest rate found in the group III which was treated by antgrade scrotal sclerotherapy [84.4%]. The improvement of the parameters of the spermogramme was noted in the three groups, however a statistically significant difference was found only in patients treated by antgrade scrotal sclerotherapy; it mainly concerned numeration and the mobility of spermatozoides. The highest rate of pregnancy was recorded in patients treated by antgrade scrotal sclerotherapy [13.3%]. The main postoperative complications were hydrocele [16%] followed by testicular hypotrophy [3 patients]. Three techniques of varicocele treatment, offer either a similar succes rate, and improvement of parameters of the sperm cells. However, antegrade scrotal sclerotherpy seem to be the best treatment of first intention in proposed, regarding its efficiency, of the ease of its realization, its moderate cost and its feasibility in case of recurrence if varicocele was treated with open way'GIII]
ABSTRACT
The aim was to evaluate the reliability and safety of laparoscopic ileocecal resection for Crohn's disease and to report our preliminary results. A retrospective analysis of 20 patients undergoing a laparoscopic ileocecal resection for Crohn's disease was carried out between November 2003 and June 2005. First of all, we defined the inclusions and exclusions criteria which allowed us to select the patients who would be resected laparoscopically. Fistulizing disease, emergent surgery [perforation, occlusion], large mass and patients with previous laparotomy were excluded. Duration of operation, rate of conversion, complications and time from discharge from hospital were evaluated. Median operation time was 160 min. Conversion to laparotomy was needed in three cases. There was no death. Minor complications occured in 2 patients. Median postoperative time for discharge was 5 days. These preliminary results indicate that laparoscopic ileocecal resection is a feasible and safe alternative in patient with Crohn's disease offering many advantages thanks to a strict patient selection
ABSTRACT
Two cases of retrocostoxiphoid hernia are reported. Both patients were adults. The hernia was strangled in one case and symptomatic in the second case. The diagnosis was confirmed by radiology. Reduction of the visceral hernia and closure of the orifice was carried out after laparotomy. A review of literature and of clinicopathological features are given in the present article. Histogensis and differential diagnosis are also discussed