[Longitudinal sleeve gastrectomy as a stand-alone bariatric procedure: Results of a multicenter retrospective study]. / La gastrectomie longitudinale (sleeve gastrectomy) comme unique chirurgie bariatrique : résultats d'une étude rétrospective multicentrique de 446 patients.

INTRODUCTION: Sleeve gastrectomy as an isolated procedure is a new option in bariatric surgery. The aim of this study was to evaluate its short and medium term (2 years) results in a multicenter setting. MATERIALS: This is a retrospective study including 446 patients undergoing surgery in 14 teaching, private, and public hospitals. RESULTS: The immediate post-operative course were uneventful in 83.3% of patients. Minor complications occurred in 10.9% of patients and major complications in 5.3%. Suture line leaks occurred in 4.3% of the whole series. There was no mortality and the rate of reoperation was 2%. Overall mean weight loss after two years was 32 kg and the mean excess weight loss was 62%. Weight loss was significantly greater in non super-obese patients (p=0.0003). CONCLUSIONS: This study confirms the feasibility of sleeve gastrectomy in a multicenter setting; it is efficacious at two years as an isolated bariatric procedure for non super-obese patients. It is possible that an additional second-stage procedure may be necessary for super-obese patients.

[A most unusual foreign body in the cecum]. / Un corps étranger particulier dans le caecum.

The authors report a rare complication of total hip replacement - the intrapelvic migration of a hip prosthesis resulting in a cecal fistula.

[Colo-rectal anastomosis. Early postoperative course]. / Anastomoses colo-rectales. Suites opératoires précoces.

A retrospective study of immediate postoperative events was carried out in 138 cases of colorectal anastomosis. The overall operative mortality rate was 7.2 percent. The proportion of clinical fistulae was 9.4 percent, and fistulae were responsible for death in 0.7 percent of the cases. Based on these results, a statistical analysis of the various factors that could have influenced the solidity of anastomoses (antibiotic prophylaxis, nature of the disease, level and technique of the anastomosis) was conducted. No significant difference was found between these factors, except for antibiotic prophylaxis which reduced the number of disjunctions.

Small carcinomas of the pancreas with associated chronic pancreatitis: two case reports.

Two cases of pancreatitis associated with papillary atypical hyperplastic lesions and micro-invasive cancers are reported. They are interesting from an etiopathogenic and diagnostic point of view by again illustrating the problem of transmission between hyperplastic lesions and cancer, together with the difficulties encountered in asserting the certainty of diagnosis. In each observation the association of pancreatic lesions, of all stages of hyperplasia, and of cancer can be observed. This suggests that transmission occurs between those different lesions. In such cases diagnosis of benignity or malignancy is always difficult to assert. No clinical, biological, morphological or even cytological criterion allows one to make a ruling. For this reason excision is recommended by the authors whenever the etiology of pancreatitis remains obscure and especially in the presence of important dystrophic lesions.

[Prognostic factors of surgically-treated cancers of the right colon. Multifactorial analysis of a series of 50 curative excisions]. / Les facteurs pronostiques des cancers du côlon droit opérés. Analyse multifactorielle d'une série de 50 exérèses à visée curative.

Between 1970 and 1986, 502 colorectal cancers were operated in our department. In 82 cases, it was located on the right, including 50 patients who underwent curative right hemicolectomy. Overall, at 5 years, 23 patients are alive with no recurrence (46%), 17 died from their cancer (34%) and 10 patients died of intercurrent causes (20%). Among the 13 prognostic factors analyzed, only the pathologic stage of the tumor (extend of dissemination to the abdominal wall and lymph nodes) and preoperative fever had a statistically significant effect on 5 year survival (p = 0.001 for fever and p = 0.01 for Duke's stage). The multifactor analysis clearly delineates a group with a poor prognosis (group with lymph node involvement and fever) in which the median of survival was 30 months.

[A Technic of re-using a thrombosed hepatic artery in hepatic intra-arterial chemotherapy]. / Technique de réutilisation d'une artère hépatique thrombosée lors d'une chimiothérapie intra-artérielle hépatique (C.I.A.H.).

Nowadays the palliative treatment of hepatic metastasis very often uses the hepatic arterial chemotherapy in subcutaneous injection cavity. Unfortunately in about ten per cent of the cases, the thrombosis of hepatic artery limits the lasting quality of use of the catheters which last about twelve months (more or less four). As mentioned in our observation, if the patient "answers" the chemotherapy, we propose reusing this thrombosized artery by means of an original technical artifice. In this observation, in fact, we grafted a small segment of submesenteric vein on the hepatic disobstructed artery. We think that this artifice could also be used in case of anatomic variations of the hepatic artery like trifurcation.

[A case of peritonitis due to perforation of the small intestines of tubercular etiology. Review of the literature]. / A propos d'un cas de péritonite par perforation du grêle d'origine tuberculeuse. Revue de la littérature.

The perforation into free peritoneum is a singular complication of the intestinal tuberculosis. Regarding a recent observation of this complication revealing small intestinal tuberculosis, we have tried to make the point on this exceptional form of small intestinal tuberculosis. By means of prolonged enteric nutrition and antitubercular treatment, the patient will be cured of this disease without any after-effects as we mentioned it in our observation. Very fearsome in the past (44 deaths out of 104 published cases), perforation into free peritoneum nowadays has a better prognosis.

[Cystic lymphangioma of the mediastinum. Radiologic data apropos of 7 cases]. / Les lymphangiomes kystiques du médiastin. Données radiologiques à propos de sept observations.

Cystic mediastinal lymphangiomas are rare benign uncommon slow-growing tumors. Seven cases of cystic mediastinal lymphangioma in adults are presented. In both cases a mediastinal opacity is evident on plain chest radiographs. Roentgen findings are not specific. The mass is noted to be non-pulsatile, and well circumscribed smooth-surfaced. There are no evidence of invasion to the neighboring structures and no calcification are seen within the lesions. In two patients, sonography examination confirmed the cystic nature of the mass. Four patients underwent computed tomography (CT) scan. Ct can offer considerable additional information: CT will show well circumscribed and uniform low density lesions without invasive characteristics. Attenuation values in CT scan cannot be considered conclusive for diagnosis in all cases, on the non contrast scan, attenuation varied between -49 to +27 UH, there was no contrast enhancement.

[Congenital diverticulum of the bile ducts. Apropos of a case and review of the literature]. / Le diverticule congénital des voies biliaires. A propos d'un cas et revue de la littérature.

The authors report a case of Congenital Diverticulum of the common bile duct treated by surgery. Literature reviews are giving detailed reports on this rare affection which falls within the scope of Congenital Diverticulum of the common bile duct, it has only a small share in this report. The comments relate the anatomic, pathogenic, diagnostic and evolutive data. The treatment appears to be possible in any case: surgical exeresis of the diverticulum.

[A rare form of intestinal invagination in infants: total ileocecocolic invagination. Apropos of 1 case]. / Une forme rare d'invagination intestinale du nourrisson: l'invagination iléo-caeco-colique totale. A propos de 1 cas.

The comment we are reporting refers to an exceptional form of acute intestinal invagination of the infant. It is question of a total ileocecocolic invagination in which the hump invaginated part came to lodge to the superior part of the rectal ampulla. The treatment was a radio-surgical one and the operative follow-up without any complications.

[Autotransplantation of the spleen. A new possibility in the conservative surgery of the spleen]. / L'autotransplantation de la rate. Une possibilité nouvelle dans la chirurgie conservatrice de la rate.

Conservative surgery to spleen is an ancient concept brought up-to date by improved knowledge of its fundamental roles in immunity and anti-bacterial defences. Suture of spleen and partial splenectomy ensure the best possible functional results but have technical limitations resulting frequently in splenectomy to provide hemostasis. Data from clinical and experimental studies and reports in the literature have demonstrated that autotransplantation of spleen is a simple, safe and effective method for preventing the true dangers of asplenia. Optimal results from autotransplantation of spleen are obtained when the injured organ is broken into small fragments which are then implanted into small spaces fashioned in the greater omentum. Clinical and biological tests to evaluate functional value of these transplants have shown that results approach those of a normal or sutured spleen. It is concluded that this procedure, which completes other conservative methods of splenic surgery, should definitely exclude hemostasis splenectomy from therapy of injuries to spleen.