This article provides a macroscopic and microscopic anatomical study of the structure of Denonvilliers' fascia, and suggests that it is embryologically connected with the anlage of the Wolffian duct, prostate and trigone.

Connective Tissue↗

PubMedDate not supplied

[Product of choice for maintenance sclerosis: 66% glucose solution].

The use of a 66% hypertonic glucose saline solution provides absolute security in sclerosant treatment. It has no side effects and does not provoke any allergic reactions and it produces a good quality sclerosis without pigmentation or thrombus. The injection can sometimes be painful, so it should be made very slowly. Its effectiveness is good, although less than that of sodium tetradecyl sulphate. Intra-arterial injection in animals dose not cause gangrene of the limb. Extravascular injection does not cause necrosis.

Glucose↗

PubMedDate not supplied

[Peroperative multi-sclerosis using 66% glucose. Treatment of choice and best prevention of pigmentations of venous origin].

The complete and rapid destruction, at the one time, of the incompetent surface venous network is the best form of prevention of trophic changes, in particular pigmentation and leads to a marked and rapid regression of these lesions when they are already present. The combined method, associating surgery and peri-operative multi-sclerosis, allows the use of a gentle sclerosant, 66% glucose, which is particularly well tolerated.

Glucose↗

PubMedDate not supplied

Reinterventions for primary varices.

Out of more than 6,000 patients operated for varices since 1949, in private practice, 281 had already been operated on once before. In 230 of these cases, the first operation performed elsewhere had been incorrect or incomplete: partial stripping, a badly performed excision of the saphenofemoral-junction, neglect of gross perforants, neglect of the saphena parva which was partly or wholly responsible for 96% of the recurrences. Moreover, a partial operation, even if correct, does not check the development of a disorder which is often bilateral (89%) and which often affects the four saphenous veins (59%). 51 had been operated by myself, hoping that they would not have to come back; 29 cases in which 2/3 of the long saphenous vein was stripped and with crossectomy of the short saphenous vein until 1964, and 22 cases of complete stripping after 1965. 49 short saphenae had been causal in the first group but we noted 14 popliteal recurrences in the second. A mistaken anatomical abnormality, sixteen perforants but more particularly 30 regrown internal saphenofemoral junctions were noted in these two groups. It is difficult to give reasons for them. Finally the post-operative phlebological follow-up is often irregular or neglected. Re-operations are difficult but, with the aid of a phlebographical control, they give good results, except for deteriorations of the deep tract necessitating certain static hygiene. The best guarantees of a satisfying and lasting result are a complete and correct initial treatment of the main varices, and regular phlebological check-up.

Humans↗

PubMedDate not supplied

[Varicose recurrence: opinion of a team].

Relapse, or the continuation of the development of varicose disorder, seems to us to be common after sclerosis when there is a manifest insufficiency of the saphenous valves. Relapse following surgical operation is rare : 0.4 p. cent in our files. Most often it follows initial surgery which has been too limited, or else faulty. However, one out of every thousand of our patients has relapsed, and there has been no possible valid explanation of the venous redevelopment, whose factors are analysed.

Female↗

PubMedDate not supplied

[Limitation of surgical indications in postoperative recurrence of varicose veins].

Varicose disorders develop further after sclerotherapy when there is clear saphenous valvular incompetence, or when the surgical operation has been too limited, or faulty. Further surgery in these cases is simple and not dangerous, and clearly brings the same results as complete initial surgery. But about 1% of the patients undergoing correct and complete surgery relapse without there being any valid explanation for the venous redevelopment whose causes we have analysed. Their cure is difficult, is more dangerous, and less satisfactory results are obtained, partly because the surface area is harder to work with. In developed forms, there is no less need of the cure, combined with rigorous checks for the sclerosis of all residual veins and the treatment of associated disfiguration by the phlebologist and general practitioner. It's only in this way that we can hope for more or less satisfactory stability in these forms.

Humans↗

PubMedDate not supplied

[Philosophy of the treatment of intermittent claudication].

Everything points to the prime importance of good health habits and the prevention of risk factors. Long-term medication has only a limited and still questionable impact. Surgery will never be proposed straight off, but only if the claudication is persistent and troublesome in an active individual. Lumbar sympathectomy always provides a degree of improvement and entails a minimal risk. There is no secondary deterioration. Yet in cases of associated phlebites, it can aggravate trophic skin problems. Reconstructive surgery gives far better immediate results but at the price of increased risk and a secondary deterioration that makes difficult repeat operations necessary. It is thus necessary to be very careful in using surgery to deal with intermittent claudications.

Humans↗

PubMedDate not supplied

[Iliocaval thrombosis].

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Fibrinolytic Agents↗

PubMedDate not supplied

[Radiographic anatomy of the inferior azygos system, the ovarian and spermatic veins].

The spermatic vein is tributary at the right of the infra-renal cava mainstem and at the left of the renal vein. It is fitted with an ostium or pre-ostium valvula which is normally tight. In the broad ligament of the uterus, the ovarian vein exchanges plexiform anastomosi with the homolateral or contralateral uterine vein through pre- or retro-uterine arches. The spermatic or ovarian reflux is more frequent on the left. Retrograde venography under cava occlusion is a good means to explore these vessels. The big Azygous vein joins the sub-renal vena cava by two roots. The internal root, which is often slender, perforates vertically the dialitic membrane. The external root, bigger, is the vein in L2; the lateral part of its track takes place in the psoas where it gains veins proceeding from the foramina of the adjacent conjugations. On the left side, the roots of the hemi-Azygos appear most frequently in the left-renal vein. There may be a single root: the external root is the Lejars' arch. The variations of the derivative cavo-cava system represented by the Azygos veins are studied on the anatomical plan. Pathological literature complements this study.

Azygos Vein↗

PubMedDate not supplied

[Lejars' sole. "A minimal network which secretes more saliva and ink than blood"].

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Anatomy↗