Caecum and ascending colon herniated in the lesser sac through the Winslow's hiatus. A case report.

Herniation of the caecum and the ascending colon in the lesser sac through the Winslow's hiatus is an uncommon cause of intestinal occlusion. The clinical presentation can be acute or chronic. The diagnosis often remains unclear before surgical operation, even with the assistance of abdominal CT, providing an image of a digestive structure in the lesser sac and the presence of mesentery between the portal triad and the vena cava. The treatment consists of reducing the internal hernia, which could be considered under laparoscopy.

[The surgical treatment of cancer of the rectum. Analysis of 391 cases (author's transl)]. / Le traitement chirurgical du cancer rectal. Une analyse de 391 cas.

From 1963 to 1977 included, the authors operated 391 cancers of the rectum, out of 396 cases, which makes up for 98.5%. The tumor was felt on rectal examination in 60% of patients. Resection was performed in 86% of the cases. Schematically the authors recognize 2 types of operations: the anterior resection and the abdomino-perineal amputation by 2 synchronic teams--operation of Lloyd-Davies--that represents a significant progress compared to Miles' operation. Lately preoperative cobalt therapy (2,500 r) has been used for low tumors. Postoperative mortality remains elevated: 9.1% of which 10.1% for the Lloyd-Davies procedures and 7.2% for the anterior resections. Two hundred and sixty-seven patients have at least a 5 year follow-up; four, i.e. 1.5%, were last to follow-up and are considered dead. Gross overall 5 year survival is 36%. Non corrected 5 year survival, after resection is 42.8% dividing in 37.3% for Lloyd-Davies procedures and 51.2% for anterior resections; these figures include all operated patients and not only those who survived the operation.

[Surgical treatment of rectal cancer (author's transl)]. / Le traitement chirurgical du cancer du rectum.

The authors report there surgical experience with rectal cancer. From 1963 to 1974, 346 patients were hospitalized, of which 359 were operated, which constitute a operatory rate of 98%. A exeresis was performed in 85% of the cases. Briefly, the authors use two types of operation : an anterior resection and an abdominoperineal amputation of the rectum with two synchronized teams--the operation of Lloyd-Davies--which constitutes an obvious progress compared to the operation of Miles. The overall postoperatory mortality remained high : 8.8% which represents 10.1% for the operation of Lloyd-Davies, and 6.7% for the anterior resection. Two hundred and twenty-four patients have been operated with a follow-up of at least 5 years; 4 [1.6%] were not reseen and are considered deceased. The overall survival at 5 years was 36.4%. The survival rate at 5 years, not corrected, of operations including an exeresis was 43.1% which represents 37.2% for the operation of Lloyd-Davies and 51.2% for the anterior resection. This survival rate includes all patients operated and not only those who survived the operation.