[Intraperitoneal resorbable mesh in the prevention of postoperative wound dehiscence. A comparative study]. / Le treillis résorbable intra-péritonéal dans la prévention des éviscérations post-opératoires. Une étude comparative.

The purpose of this study was to compare efficiency of polyamide mesh externally applied to the skin and intraperitoneal resorbable mesh of polyglactine 910, for the prevention of wound dehiscence. Two consecutive and homogenous groups of 100 patients, operated by the same surgical team and presenting one or more risk factors of evisceration, were retrospectively compared. Use of intraperitoneal polyglactine mesh, significantly reduced rate of wound dehiscence (4% vs 13%), lowered frequency of reoperation in eviscerated patients (25% vs 61%), but did not improve prognosis of this complication (50% mortality). Potential effect of resorbable mesh on late fascial disruption remains controversial.

[Bronchogenic esophageal cysts in the adult. Four cases]. / Kystes oesophagiens bronchogéniques de l'adulte. Quatre observations.

Bronchogenic oesophageal cysts possess a mucosa of the airway type but are unconnected to the tracheobronchial tree; they are in close anatomical relation with the oesophageal wall. These characteristics are explained by the fact that the respiratory and digestive tract share the same embryonic development. Four cases of bronchogenic oesophageal cyst are reported, and 21 well-documented cases from the literature are reviewed. The lesion is extremely rare in adults, often complicated and responsible for gastrointestinal, respiratory and sometimes even cardiac symptoms. Its features at radiology, endoscopy and computerized tomography are suggestive of the diagnosis. Treatment consists of excision by enucleation. Excision must be complete for recurrences to be avoided.

[Colonic stenosis in pancreatitis]. / Sténoses coliques au cours des pancréatites.

The author's personal series consists of 9 patients, representing 1.5 per cent of cases of chronic pancreatitis and 7 per cent of cases of acute pancreatitis. In the literature, this frequency is reported as being in the order of 2 to 3 per cent. Colonic involvement may be either acute as a result of ischaemia and necrosis due to acute pancreatitis or chronic, following acute pancreatitis or an acute episode of chronic pancreatitis by retraction of the colon or by compression by a pancreatic pseudocyst. The patient frequently presents with an acute intestinal obstruction. The most frequent site is in the left colonic flexure in 5 out of 9 cases (52 per cent in the literature). In general, the colonic involvement occurs as a result of the diffusion of the necrotic process in the mesentery. The diagnosis is based on the barium enema. Preservation of the mucous border is accompanied by mucosal inflammatory signs. The authors have identified two elements predictive of regression: the absence of fixed stenosis and the presence of mucosal inflammatory signs and the normal external appearance of the colon at exploratory laparotomy. During acute pancreatitis, colonic surgery is only required in the cases of an acute intestinal obstruction or necrosis associated with colonic stenosis. The surgical indications are more extensive in the case of chronic pancreatitis: fixed stenosis with definite signs of obstruction. The usual treatment in this case is colonic resection.