[Place of the hormonotherapy by HCG in treatment of ectopia testis in children]

Although cryptorchidism is known since the antiquity, some of its aspects are still not very clear and its treatment, particularly by hormone doesn't realize the unanimity. In order to codify the indication of HCG in cryptorchidism, a prospective study has been realized at the Infant Surgical Clinic of the Hospital Center lbn Rochd of Casablanca. This study concerned also a group of children treated in a "non codified" way since 1988, in order to analyse better the correlation between clinic and surgery. This study concerned 415 children with 528 ectopia testis. 318 of them have been treated with HCG, 6000 to 12000 UI according to the age. The whole success of hormonotherapy has been about 41%. The parameters that conditionned this success are: the age of the child [children older than 6 have had a better result], the seat of the testis [the lower was the testis, the easier was the success], the testicular mobility and the absence of the peritoeal process. In the case of unsuccess of the hormonotherapy, the surgical act permitted to notice aperirtoneal process undiagnosed clinically [95%], a gubernaculum testis high inserted [95%], a short spermatic pedicle [10%] or an non permeable inguinoscrotal duct [35%]. The analysis of this series and data of litterature permits to recommend HCG in the children from 2 to 10 years old, of whom the testis is palpable, without peritoneal process and with a notable mobility of testis. The other cases must belong to the surgery

[Treatment of Hydatic cyst of the lung in children]

A Conservative treatment was adopted in 340 cases of hydatic cyst of the lungin children The authors relate the results and discuss the well-founded of this attitude. 313 patients totalizing 394 cysts were treated surgically. In 306 cases, the treatment was conservative and consisted either a cystectomy with or without capitonnage of the cavity or a pericystectomy. In 7 cases, the treatment consisted in a regulated exeresis egmentectomy or lobe ctomy. 6 death [1,7 p. cent] were noted, they were due to bronchic fistula in most cases. 37 patients [11,8 P. cent] presented post-operative complications. Global results, compared to other series with high rate of exeresis, show that there is no difference between conservative treatment and regulated exeresis. Otherwise, many fistulas of whom some were responsible of deceases would have been avoided through a more eclectic attitude, adjusted to the nature of lesions. This study allows to precise the surgical attitude to adapt according the nature of the cyst

[ biliary fistulae of hydatid cyst of the liver in the child]

The authors report on a series of 40 cases of biliary fistula complicating hydatic cysts of the liver in the child observed during 15 years. They discuss the frequency of the fistula in the child, its mechanism and treatment. The anatomical and clinical characters of the immediate fistula [30 cases] affirmed by the billions or purulent contain of the cyst or by the visualization of the fistula in peroperative, and secondary fistula [10 cases] complicating healthy but voluminous cysts, were localized in the right side of the liver. All the cysts were treated by resection of the projecting vault with drainage of the covity. The average duration of the exhaustion of the fistula is 20 days with an extreme from 7 to 90 days. Four patients deceased. In the case of the immediate fistula, the mortality and the morbidity are more important as in the adult. Certain measures would permit to decrease the complications which are especially subphrenic abscess and purulent retention in the cavity, and permit to shorten the duration of hospitalization without resorting to agression methods as the pericystectomy

Pott's disease in children: medical or surgical treatment? About 100 cases

Between 1976 and 1984, 100 children aged 13 months to 15 years were treated for tuberculosis of the spine. 29 patients seen at an early stage and presenting limited lesions healed completely with mild or moderate residual kyphosis after orthopaedic treatment associating antibiotherapy and strict immobilization in plaster shells. 71 patients having extensive vertebral destruction or after failure of the orthopaedic treatment underwent surgery for excision and anterior spine fusion. A supplementary posterior spine fusion was performed in 48 patients. This procedure, in conjunction with preoperative traction, obtained stabilization of the spine and healing of vertebral lesions in most cases with excellent correction of recent kyphosis. In view of these results, it seems possible to determine which treatment is best adapted according to: - the extent, severity and level of the lesions, - the degree and age of kyphosis, - the existence or not of paraplegia. The possibility to reduce fixed severe kyphosis [6 cases] and the opportunity of a supplementary posterior fusion arc evaluated