Annales de chirurgie
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We report a series of 40 patients treated by intraoperative radiotherapy between 1988 and 1992 (18 primary tumors, 13 local recurrences and 9 nodal extensions). The doses delivered were 15 Gy to 25 Gy, completed by external radiotherapy (15 to 45 Gy) in 13 cases. The local tumor control rate was 61% for initial therapy in primary tumors (70% for adenocarcinoma of the stomach) and 80.9% after complete en bloc surgery. ⋯ Two patients died (5%) during the postoperative period. We observed 2 hemorrhages and 3 cases of stone-free cholecystitis. The value of this approach must be confirmed in rigorous indications in comparison with surgery alone in controlled and randomised clinical trials.
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Annales de chirurgie · Jan 1994
Case Reports[Non occlusive mesenteric ischemia: a late complication of cardiogenic shock].
The case of a diabetic 62-year-old man with a past history of myocardial infarction, developing a cardial arrest followed by successful cardiopulmonary resuscitation, is reported. In the late clinical course, the patient displayed abdominal signs related to mesenteric ischaemia. ⋯ Risk factors such as diabetes, cardiovascular disease, hemodialysis, the use of digoxine or alpha-adrenergic drugs are listed. Non-occlusive mesenteric ischaemia is not an infrequent complication of cardiac failure in high risk patients.
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This study is based on the observations of 86 pleurodesis done by talc insufflation during thoracoscopy in 82 patients suffering from benign (8%) and malignant (92%) pleural effusions. Serial chest films were obtained on every patient. Chest computed tomography was obtained in ten patients. ⋯ In the late phase with a mean evolution time of 6 months, these loculations evolve in 77% of patients in areas of pleural thickening. CT of the chest demonstrates the presence of characteristic pleural thickening in the form of coarse (5/12) and/or fine linear densities (7/12) corresponding to talc deposits, on the pleural surface. These modifications are shown by light microscopy examination of the pleural done at the autopsy.
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Annales de chirurgie · Jan 1994
[Open fractures caused by gunshot in civilian practice. Apropos of 31 cases].
The authors report their experience of the treatment of 31 gunshot open fractures in civilian practice. The fractures, comminuted in two thirds of cases, were produced by various fire-arms. ⋯ The were also 7 cases of delayed union, 3 mal unions and 7 cases of joint stiffness. To improve the prognosis of these lesions, the authors emphasize that surgeons must be familiar with ballistic wounds and carry out an early initial and appropriate treatment.