[Retroperitoneal liposarcoma. Clinical, prognosis and therapeutic aspects apropos of 4 cases]. / Liposarcomes rétropéritonéaux. Aspect clinique, pronostique et thérapeutique à propos de 4 cas.

Four further cases of retroperitoneal liposarcoma are reported. Principal modes of revelation and diagnostic features are discussed, values of different complementary examinations evaluated, and prognostic factors and therapeutic elements of this serious affection outlined.

[Surgery for carcinoma of the oesophagus. A plea for precise technique and pleuro-mediastinal drainage (author's transl)]. / Traitement chirurgical du cancer de l'oesophage. Plaidoyer pour une technique et un drainage pleuro-médiastinal rigoureux.

During surgery for carcinoma of the oesophagus, the authors emphasise the need for selective intubation using a Carlens tube, of avoiding damage to the diaphragm and the phrenic nerve at all levels, and of draining the hemithorax involved in the operation by three drains: anterior and posterior thoracic and madiastino-abdominal. These precautions reduce post-operative difficulties, justifiy excision surgery for carcinoma of the oesophagus, and to a certain extent make it possible to reduce the contraindications, in particular in the presence of tracheo-bronchial spread. Amongst 107 patients undergoing surgery, in whom there was a risk of respiratory insufficiency in one quarter, surgery (sometimes with extension of the excision: one case in four) was associated with an operative and post-operative mortality of 18%.

[Perforation of the abdominal esophagus and peritonitis (author's transl)]. / Perforations de l'oesophage abdominal et péritonites. Revue de la littérature. A propos d'un cas.

Perforation of the abdominal esophagus is not exceptional, either after endoscopy of the esophagus or after surgery of hiatus hernia. The clinical symptoms are not always clear especially during surgery. Immediate diagnosis is however essential for any delay in treatment causes the mortality to rise from 15% to more than 60% for repairs carried out under septic conditions. The best surgical attitude is difficult to determine under these conditions.

[Single centro-hepatic biliary cyst (author's transl)]. / Kyste biliaire solitaire centro-hépatique.

This is a rare condition, often presenting late as a result of compression of adjacent organs, as demonstrated by radiological examinations. Laparoscopy reveals only hepatic hypertrophy whilst the intrahepatic lesion is seen on isotope scan, its irregular appearance sometimes leading to confusion with metastatic disease. Study by scanner confirms its cystic nature. This dysembryoplasic nature of this lesion is now generally accepted, its origins lying in the vestiges of the hepatic ducts. Resection of the overling dome is the usual treatment of exteriorised biliary cysts. The evacuation of large central cysts may be associated with haemorrhagic complications as a result of decompression, which explains the need for slow evacuation or even the preference sometimes expressed for excision at the outset, in particular in the case of a left-sided lesion.

[Intestinal mechanical sutures: macroscopic and histological aspects (author's transl)]. / Sutures mécaniques intestinales. Aspects macroscopiques et histologiques.

The authors studied healing in digestive sutures carried out using automatic clips in the Dog. The mechanical conditions of the suture and in particular the absence of crushing are responsible for an almost perfect scar healing by first intention. The absence of ischemic necrosis remains the main factor differentiating these sutures from manual sutures where necrosis is constant, whether due to repeated trauma from forceps or ischemia due to tightening the threads, and above all, constant inclusion of the mucosa within the scar. The use of non-ischemic sutures explains undoubtedly the low incidence of fistulas, but explains, on the contrary, the large number of cases which bleed from the divided margins of the sutured or anastomosed layers; in rare cases, severe bleeding requires reoperation. These sutures are everted sutures causing a significant number of adhesions. We did not find any significant difference in the healing of inverted or everted sutures from the 15th day onwards.