[Patient's perspectives with regard to anesthesia services]. / Point de vue des patients concernant la prise en charge anesthésique.

PURPOSE: Whereas patients most often select their surgeon, they don't usually select their anesthesiologist. Further, anesthesia frequently involves different physicians at different stages perioperatively. This inability to choose and the multiplicity of interveners may reduce patient satisfaction. Our study examined patients' willingness to choose their anesthesiologist for the operation, as well as their opinion on the way anesthesia is practiced presently. CLINICAL FEATURES: Nine hundred and twelve patients (mean age 51 +/- 16 yr, 58% moles) were requested, immediately after the preoperative visit, to choose their anesthesiologist for the operation. The request was formuled by a nurse, in the absence of the anesthesiologist, in order to avoid a courteous response. After surgery, prior to leaving the hospital, patients were invited to give their opinion on the anesthesia core received and to name the anesthesiologist(s) and surgeon involved. RESULTS: Women chose an anesthesiologist more frequently than men, but only 34% of patients overall elected to do so. Eighty percent of patients were cared for by an anesthesiologist other than the one seen at the preoperative visit. Four percent of patients regretted the change. Patients recalled the surgeon's name more frequently (60%) than the attending anesthesiologist's (4%). CONCLUSION: In France, the preoperative visit is required by law and must precede the operation by at least 48 hr. Despite this preoperative interview, patients were unwilling to choose the anesthesiologist responsible for surgery, did not object to multiple interveners and seldom remembered their anesthesiologist's name. Efforts to improve the image of the profession are required.

[Adenoid cystic carcinoma of the trachea. Treatment by combined laser therapy and surgery]. / Carcinome adénoïde kystique de la trachée. Traitement par l'association laser-chirurgie.

In the group of adenomas of the trachea and bronchi, cystic adenocarcinomas or cylindromas are malignant tumours, whose outcome is much slower than those of the usual type of cancer. An unusual case is reported in which treated was firstly carried out with laser therapy and then surgery.