[Meckel's diverticulum and obstruction of the small intestine in adult patients: report of two cases]. / Diverticule de Meckel et occlusion de l'intestin grêle chez l'adulte: propos de deux cas.

Meckel's Diverticulum (MD) is the most frequent congenital anomaly of the ileum. However, its clinical manifestations in adult patients are rare. In this paper, we report cases with two different mechanisms of small intestine obstruction due to MD and we discuss diagnosis and management of these symptomatic lesions in adult patients.

Stromal tumour of the rectum: laparoscopic approach of a rare localization of GIST.

The authors present the case of a 60 year-old man known for a rectal polyp which was diagnosed in 1994 and since then followed-up by means of a colonoscopy associated with periodic biopsies. Recently, the results of a biopsy revealed positive markers for the diagnosis of Gastro-Intestinal Stromal Tumor (GIST). Despite the absence of malignant criteria, an anterior resection of the rectum was performed by laparoscopy and the patient rapidly recovered. Epidemiology, diagnosis and management of this rare location of GIST's are discussed.

Long-term results of laparoscopic extended surgery in advanced gastric cancer: a series of 101 patients.

BACKGROUND/AIMS: The objective of our paper is to report on the remote results of patients with gastric cancer treated by mini-invasive surgery as a surgical tool with the "intention to treat with laparoscopy". METHODOLOGY: Between June 1993 and January 2004, 101 patients comprising 72 men and 29 women with gastric adenocarcinoma were prospectively selected by two hospitals based on prior agreement (the CHU Charleroi, Belgium, and Zumárraga Hospital, the Basque Country, Spain). Patients with adenocarcinoma of the cardia were excluded. Average age of the patients was 67 (37-83). RESULTS: Postoperative mortality within 60 days of operation was of 5 patients; 87 patients were therefore properly followed-up for an average of 41 months (7-129). Average survival time for 10 non-resected patients was 4.5 months. Average survival rate of the 10 palliatively resected patients was 7.1 months. Actuarial 5-year survival rate RO-type surgery was 34%. The global actuarial 5-year survival rate after resective surgery was 29%. CONCLUSIONS: Laparoscopic gastrectomy with any kind of lymphadenectomy is a heavy but safe operation, and produces acceptable mortality and morbidity rates in patients with advanced gastric cancer in a general poor condition. Laparoscopic gastrectomies for locally advanced cancers are equivalent to those reported by laparotomy as far as long-term oncological results are concerned.

[Jejunal lipomatosis with intussusception and volvulus. A case report]. / Lipomatose du jéjunum avec invagination et volvulus: à propos d'un cas.

We report the unusual case of a 48 year old woman with jejunal lipomatosis complicated by intestinal intussusception and volvulus. Showing fatty masses CT allowed accurate diagnosis.

Mesenteric cysts. A case treated by laparoscopy and a review of the literature.

Mesenteric cysts are one of the rarest abdominal tumors. Since the first report of a mesenteric cyst by Benevienal in 1507, only 820 cases have been reported. The symptoms depend on the size and location of the cyst. The main presenting symptom is abdominal pain, followed by nausea and vomiting. Some mesenteric cysts may present as an acute abdomen due to a possible complication, such as hemorrhage, rupture, or torsion of the cyst. The treatment of choice for mesenteric cyst is complete excision to avoid recurrence and possible malignant transformation. We report an additional case of mesenteric cyst which, to our knowledge, is the first to be treated by laparoscopy.

[An acute pseudo-cholecystitis]. / Une pseudocholécystite aiguë.

In an emergency department, many patients were admitted with abdominal pain. The problem is to made the right diagnosis between an acute abdomen that must be manage by a medical approach and an acute abdomen with immediate surgical treatment. We present the case of a 44 year-old man admitted in our emergency department with clinical signs of acute cholecystitis. After a new interrogation and the inadequacy of the diagnostic procedures a lead intoxication treated by a medical approach was diagnosed.

Laparoscopic Toupet fundoplication: prospective study of 100 cases. Results at one year and literature review.

We report a prospective evaluation of 100 patients who underwent laparoscopic fundoplication according to Toupet. All these cases where suffering from gastro-oesophageal reflux resistant to medical treatment or recurring after stopping it. Only one conversion into laparotomy was required. Perioperative morbidity (4%), mortality (0%), median hospital stay (4 days) and return to work (3 weeks) were lower than in case of open surgery in the literature. One year after the operation, clinical results were similar to those of laparotomy with 93% of patients free of symptoms. Excellent results of this technique lead us to assert that laparoscopic Toupet procedure is an interesting way of treating the gastro-oesophageal reflux that does not respond to medical treatment.

[Indications and surgical technic in gynecomastia]. / Indications et techniques chirurgicales des gynécomasties.

In our opinion, very few publications represent a practical attitude on surgical level concerning a gynaecomasty; so we tried to sum up the operative indications and to establish a classification of the useful surgical techniques, not only in function of the existence or non-existence of a cutaneous excess, but also of the type and the localization of the vascular stalk feeding the nipple-plate. The post-operative complications are described and finally, we present you our personal experience in 21 cases.