[Abdominal rectopexy (Orr-Loygue) in rectal prolapse: celioscopic approach or conventional surgery]. / La rectopexie au promontoire (Orr-Loygue) dans le prolapsus rectal: approche coelioscopique ou chirurgie conventionnelle.

One of the treatment modalities for rectal prolapse is abdominal rectopexy, a comparison of the Orr-Loygue procedure, performed by laparotomy and by laparoscopy was done. From June 1981 and May 1993, 31 females and 3 males, with an average of age of 58.8 were operated. Twelve patients were operated by laparoscopy (group I) and 22 patients by laparotomy (group II). Two patients (16.7%) in group I were converted to a laparotomy due in one to operative hemorrhage and in the other to adhesions. Seven patients in group I and 18 in group II had had previous abdominal surgery. Average operative time was 2.56 hours and 2.25 hours for groups I and II respectively. A reduction in post operative hospital stay (5 vs 8.3 days) as well as in intramuscular analgesic requirements (5.5 vs. 14.1 doses) was observed in group I vs. group II respectively. Time to oral intake and cessation of intravenous fluids were also reduced in group I compared to group II (1.0 vs. 3.9 days and 2 vs. 5.8 days respectively). No mortality and minimal morbidity was observed in both groups. No recurrence of prolapse was noted in either group with an average of 12.6 mouths follow-up (2.8 to 17 months). We concluded that rectopexy by laparoscopy is technically feasible and has undeniable advantages over laparotomy.

[Cancerous Peutz-Jeghers syndrome with disseminated metastases]. / Syndrome de Peutz-Jeghers cancérisé avec métastases disséminées.

This report of a patient with Peutz-Jeghers syndrome is unusual in a number of ways: the patient, a 49-year-old woman, was first seen with deep thrombophlebitis of the leg which appeared to be part of a paraneoplastic syndrome. The patient had an adenocarcinoma originating in a hamartoma of the terminal ileum, with ovarian and lymph-node metastases. During the course of the disease the patient was found to have metastatic disease in the cervical lymph nodes which responded, temporarily, to chemotherapy. The authors review the literature on metastatic Peutz-Jeghers syndrome. Although the rate of metastatic disease is low, they believe that all patients with Peutz-Jeghers syndrome deserve a close long-term follow-up.

Factors influencing survival with complete obstruction and free perforation of colorectal cancers.

A review of 26 years' experience in the management of patients with obstruction and perforation of the colon due to carcinoma at Hôpital Notre-Dame, Montréal, is reported. We try, in the present paper to identify the factors responsible for the very poor prognosis in complete obstruction and free perforation of colorectal cancers. As we are comparing these complicated cancers with a larger group of uncomplicated cancers, our results are analyzed by the chi-square test.