Annales de chirurgie
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Annales de chirurgie · Jan 1999
Comparative Study[Carotid surgery under loco-regional anesthesia. Early results of 100 recent cases].
A prospective single-centre study was performed to evaluate the safety and efficacy of carotid revascularisation under local anesthesia. Between November 1, 1996 and March 30, 1998, 92 patients underwent surgery for 100 carotid artery stenoses under local cervical block anesthesia. Fifty-eight stenoses were asymptomatic and 42 were symptomatic. ⋯ Incomplete circle of Willis on MRA was a significant predictive test of clamping intolerance (p < 0.0001). Carotid artery surgery under local anesthesia reduces the cumulative mortality and morbidity rate (TCMM) to a very low level: 0% in this study. These recent results are the modern reference for current carotid artery surgery evaluation.
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Annales de chirurgie · Jan 1999
Comparative Study[Cancer of the cardia: value of total gastrectomy with partial esophagectomy by laparotomy-right thoracotomy approach].
Surgical resection of cardial and subcardial cancers is often associated with pathological involvement of esophageal section margin, resulting in early anastomotic recurrences. Total gastrectomy associated with partial esophagectomy through combined abdominal and right thoracic approach allows esophageal section under azygos vein. ⋯ Total gastrectomy with partial esophagectomy through combined abdominal and right thoracic approach seems therefore to be considered as a good alternative in the surgical management of cardial and subcardial carcinomas.
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Annales de chirurgie · Jan 1999
Biography Historical Article[A pioneering anesthesiologist, the surgeon Theodore Tuffier].
Théodore Tuffier (1857-1929) was a great surgeon. A part of his interest non well know and reported in this paper was fundamental and technical research in anesthesia.
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Annales de chirurgie · Jan 1999
[Correlation study between spinal curvatures and vertebral and disk deformities in idiopathic scoliosis].
Idiopathic scoliosis involves complex tridimensional (3D) deformations of the spine associated with intrinsic alterations (wedging) of vertebral bodies (VB) and intervertebral disks (ID). This study intends to evaluate analytically in vivo 2D and 3D scoliotic descriptors, based on clinical data from 40 thoracic curves of scoliotic adolescents, and to establish relationships between the regional curve deformations and the local VB and ID deformities. A multiplanar radiographic technique provided 3D positioning of vertebral landmarks. ⋯ Scoliosis severity, as measured by Cobb angles, evolves simultaneously to a coronalization of the plane of maximum deformity, revealing an hypokyphotic phenomenon, and to a real vertebral wedging shifting towards the frontal plane of the vertebra. These 3D in vivo analyses allowed interpretation of spatial relationships between regional and local scoliotic deformities. Compared to 2D in vivo or 3D in vitro analyses alone, this 3D in vivo study provides a more complete assessment of spinal curve progression to fully interpret the real 3D curvature and intrinsic deformations as well as their evolution processes.
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The surgical treatment of Ebstein's anomaly is still controversial. Therefore we have retrospectively studied the results of tricuspid valve replacement (TVR) performed for this anomaly at Sainte Justine Hospital. From October 1977 to December 1997, 9 patients with Ebstein's anomaly, aged from 31 to 248 months (mean 176 +/- 66), have undergone TVR. ⋯ One patient required a second TVR 162 months after the first surgery because of bioprosthesis failure. Seven of the surviving patients are in functional class I, while one patient is in class II. This experience suggests that TVR with bioprosthesis is a good therapeutical option for children with Ebstein's anomaly since the operative risk is low, the functional status improved in all patients and the durability of bioprosthesis in tricuspid position has been good.