Evaluation of pulmonary function in laparoscopic cholecystectomy.

Historically, values of pulmonary function tests, when taken on the day after open upper abdominal surgery and cholecystectomy, show decreases of 45% to 60% compared with preoperative determinations. In a group of 54 consecutive patients in whom many pulmonary function parameters were studied, forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1), measured the morning after laparoscopic cholecystectomy, revealed a 22% decrease (3.31/2.59 L) and a 21% decrease (2.68/2.11 L), respectively, on average compared with preoperative values, demonstrating better pulmonary function after laparoscopic cholecystectomy. Furthermore, there was no difference between patients above or below 60 years of age and between smokers and nonsmokers. Improved pulmonary function after laparoscopic cholecystectomy may account for the observed reduced rate of pulmonary complications after laparoscopic cholecystectomy.

[Splenectomy for idiopathic thrombopenic purpura. A retrospective study of 40 cases]. / La splénectomie dans le purpura thrombocytopénique idiopathique. Etude rétrospective de 40 cas.

The authors analysed retrospectively the files of 40 patients who underwent splenectomy for idiopathic thrombocytopenic purpura and who were totally or partially (relapse) resistant to a therapeutic trial of corticosteroids. There was no operative mortality but morbidity, especially respiratory, was substantial, being 40%. Drainage of the splenic bed should be avoided because this is clearly associated with a greater frequency of pulmonary complications. In 37 patients with a mean follow-up of 30.3 months, there was complete remission in 89.2% after splenectomy. This confirms the therapeutic value of splenectomy in idiopathic thrombocytopenic purpura, especially in those who showed a partial (transitory) response to corticosteroids.

[Use of automatic suturing devices in surgery of the digestive tract]. / Evaluation de l'utilisation des appareils d'autosuture en chirurgie digestive.

A review of 345 surgical procedures performed on the digestive tract with the use of automatic suturing devices is presented. The morbidity due to hemmorrhage, fistula formation and obstruction as well as the reoperation and mortality rates are discussed and compared with those reported in the literature for the same procedures using standard anastomotic and suturing techniques. This study confirms the safety of these stapling instruments in a wide variety of gastrointestinal procedures in which their use resulted in a considerable saving of operative time.