[Thyroid autonomous nodule. Surgical treatment and postoperative outcome, retrospective study of 102 cases (author's transl)]. / Le nodule thyroïdien hyperfixant et extinctif. Traitement chirurgical et devenir post-opératoire. Etude rétrospective de 102 observations.

Follow-up of 102 patients operated upon for autonomous thyroid nodules is reported. Retrospective study of operative findings and aftermath of surgery clearly demonstrates that the patho-physiological concept of autonomous nodule does not snugly fit practical problems experienced with the management of such patients. The autonomous nodule can be a malignancy. Ipsilateral thyroid lobectomy seems more suitable than nodulectomy. Gross appearance of the thyroid remnant makes sometimes post-operative hormonotherapy unexpectedly advisable. From a theoretical point of view, post-operative thyroid scan, TSH assay and TRH test are mandatory, to assess recovery.

[Advantages of systematic recurrent laryngeal nerve resection during thyroid surgery. Results of 422 thyroidectomies employing this procedure (author's transl)]. / Valeur de la dissection systématique du nerf récurrent en chirurgie thyroïdienne: 428 thyroäidectomies en 1978.

Thyroidectomy for different thyroid disorders was conducted in 422 patients during 1978, after normal pre-operative laryngoscopy findings. Dissection of the recurrent laryngeal nerve was employed systematically in all patients except those having isthmectomy or enucleation operations, with a total number of 556 nerves dissected. Pre-and post-operative laryngoscopic examinations in the alert patient was conducted in all cases. After one year, 8% of the patients with abnormal post-operative laryngoscopic findings had not returned for follow-up. The known rate of recurrent nerve paralysis after one year was 0.7% of the nerves exposed, the maximum rate being 2% if patients not followed-up are included. These results confirm the value of systematic recurrent nerve dissection during thyroid surgery.

[Intermittent postoperative gastric aspiration. New equipment (author's transl)]. / Aspiration gastrique post-opératoire discontinue. Nouvel appareillage.

Gastric suction is prescribed routinely by some, even though it is responsible for complications which are sometimes extremely serious, such as haemorrhagic gastritis or even perforation. It is indicated in all cases of postoperative gastric ileus or of stenosis causing marked dilatation of the stomach. However, experience would tend to show that in addition to problems immediately secondary to the presence of the tube in the gastric lumen, it sometimes leads to a false sense of security since the apertures of the tube tend to suck in the mucosa, giving rise to a suction-like effect whilst the stomach remains full of fluid. In order to overcome this disadvantage, we have designed an apparatus which varies the times of suction over a selected period. It fills the troublesome role previously filled by nursing staff in confirming the satisfactory function of gastric tubes. Thus not only does the tube not become blocked but gastric transit is restored more rapidly which not only leads to savings in the cost of intensive care but offers additional technical security.