Annales de chirurgie
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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.
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Annales de chirurgie · Jan 1998
Review Comparative Study[Diagnostic strategy in abdominal injuries].
There is persistent controversy concerning the management of patients with abdominal trauma. The major point is to determine whether or not the abdominal trauma is penetrating. ⋯ In the case of anterior penetrating abdominal trauma, diagnostic peritoneal lavage, which is an over sensitive method, could be replaced by laparoscopy, which allows both diagnosis and treatment. Triple-contrast CT scan is the first-line diagnostic modality in penetrating back and flank trauma.
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Annales de chirurgie · Jan 1998
Review Case Reports[Pleuro-peritoneal Denver shunt in treatment of chronic pleurisy].
The first utilisation in our hospital of a pleuraperitoneal shunt for the treatment of chronic pleurisy enabled us to study, in the light of published data, the place for such a procedure in the management of resistant pleural effusion. The aetiology of the pleurisy in a 70-year old patient who underwent this mini-invasive surgery was unknown when the shunt was inserted, but his symtoms clearly improved afterwards. At the present time with a follow-up of 13 months, there are no local complications and the system is in good working order. ⋯ A complication rate of 25% is noted depending on the type of infection or obstruction leading to replacement of the shunt. No case of erosion has been noted. The long term patency, measured by radio-isotope injections (Tc99m), has not been studied but there is a significant reduction in the length of hospital stay which gives a clear economic advantage to such procedures.
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Annales de chirurgie · Jan 1998
Review Case Reports[Value of celioscopy in treatment of isolated torsion of the Fallopian tube. Review of the literature. Apropos of 3 cases].
Isolated fallopian tube torsion (ITT) is infrequent and associated with morphologic and dynamic disturbances. Mr L, 31 years old, suffered from right lower quadrant pain which became worse during the following 48 hours. Laparoscopy revealed a right necrotic ITT which was resected by laparotomy. ⋯ Diagnosis was easily established by laparoscopy. In case of clinical symptoms suggestive of ITT, pelvic and endovaginal ultrasonography and laparoscopy are indicated. Tubal preservation must be the rule.
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Annales de chirurgie · Jan 1998
Clinical Trial[Exclusive use of calcium channel blockers and cardioselective beta-blockers in the pre- and per-operative management of pheochromocytomas. 70 cases].
The pre and intraoperative use of calcium channel blockers (CCB) has been suggested for the management of either eutopic or ectopic pheochromocytomas. We report our experience of 70 pheochromocytomas, operated between 1988 and 1996 and managed with CCB, especially nicardipine. 59 were hypertensive (84.2%). Preparation consisted of nicardipine in 61 patients or another CCB in 9 cases with duration ranging from 24 hours to several weeks depending on plasma volume and blood pressure control. ⋯ Heart rate greater than 100 b p m occureed in 51 patients and was easily controlled with esmolol whenever used (n = 27). Arythmias were unfrequent (n = 4) and required treatment in only one case. This study confirms the ability to adequately manage pheochromocytomas with the use of nicardipine as sole vasodilating agent.