[Leiomyoma of the esophagus]. / Léiomyome de l'oesophage.

BACKGROUND: Leiomyoma is a benign tumor rarely occurring in the esophagus. Only 1% of esophageal tumors are leiomyomas. CASE REPORT: A 70-year-old man underwent surgery for an asymptomatic tumor of the thoracic esophagus. The tumor was enucleated via right thoracotomy and histology confirmed the diagnosis of leiomyoma. Outcome was favorable. DISCUSSION: Leiomyomas of the esophagus generally develop from the muscularis and exceptionally from the muscularis mucosae, producing a parietal tumor or a pediculated endoluminal tumor respectively. Surgery is indicated for all cases, with the possible exception of asymptomatic leiomyoma. Encleation can be achieved by videothoracoscopy. Resection of the esophagus can be discussed if enucleation is impossible for giant tumors, or ring tumors at the esogastric junction, or if the mucosae wound cannot be repaired. Endoscopic resection is indicated for pediculated leiomyoma. Malignant transformation is exceptional but an association between esophageal myomatosis and carcinoma of the esophagus is possible. Certain authors thus advocate resection for all cases, even small asymptomatic leiomyomas.

[Liver function after 65% hepatectomy in the dog: role of pancreatic blood flow]. / Fonction hépatique après hépatectomie de 65% chez le chien: rôle du flux sanguin pancréatique.

The effects of different types of porto-systemic shunts were judged on vitamin D 25-hydroxylation and proaccelerin synthesis, in 65% hepatectomized dogs. Three types of shunts were performed: termino-lateral porto-caval shunt, mesenterico-caval shunt and spleno-pancreatico-caval shunt. The mesenterico-caval shunt provided better results than the other shunts, probably because of a better preservation of pancreatic hormone supplies to the liver.

[Segment I of the liver or spigelian lobe. Anatomic study and surgical value]. / Le segment I du foie ou lobe de Spigel. Etude anatomique et intérêt chirurgical.

Spigel's lobe, or segment I of the liver, currently represents the "smallest amount of hepatic parenchyma capable of regeneration". It is an autonomous lobe by virtue of its site and vasculo-biliary distribution, a true "accessory" liver connected to the "main" liver. Lesions of Spigel's lobe are rare, which is explained by the anatomy of the portal bifurcation. Hence the value of making every effort to preserve this segment during hepatectomy because of the possibilities of additional hepatic vein drainage. Segment I surgery is difficult and falls within the context of extended hepatectomies. Can Spigel's lobe be considered to be a "safety liver"? The possibility of subtotal hepatectomy, retaining only segment I, is being studied in the animal. It may be possible in man in the case of extensive hepatic lesions where only segment I is unaffected, as soon as effective artificial liver support is developed.