[Preparation and installation of patients for arterial surgery of the lower extremities].
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Biomedical subjects
Publications and source records attributed to E Tiret.
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The results of rectal excision with colonic pouch-anal anastomosis are reviewed from a series of 162 patients covering 7 years. All patients have been operated upon in the same institution and consecutively. The follow-up is now sufficient to allow an accurate evaluation of the outcome of the patients. The main goal of this study was to provide a detailed report of the functional results. Continence was satisfactory in 96% of the patients, with either a perfect continence or minor troubles that would not have been detectable other than by a rigorous questioning. The mean number of bowel movements was 2 per 24 hours. Fragmentation of the defecation and urgency were absent. Twenty-five per cent of the patients had to elicit the evacuation of the reservoir with a suppository or an enema. Improvement of function yielded by a reservoir over straight colo-anal and low colo-rectal anastomoses are significant and, as suggested by manometric studies, are directly related to the restoration of a reservoir function.
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AIMS: To report the results of a pancreaticojejunostomy in the treatment of chronic pancreatitis, and to assess the role of residual cephalic ductal obstruction in pain recurrence. METHODS: Thirty seven patients with painful chronic pancreatitis whose pancreatic duct diameter exceeded 6 mm were treated by lateral pancreaticojejunostomy and were retrospectively studied. Deobstruction of the cephalad portion of the main pancreatic duct was complete in 21 patients (group A), while residual obstruction was noted in 16 patients (group B). RESULTS: One patient died post-operatively (2.7%) and 6 patients underwent complications (16%) that were treated without reoperation. With a median follow-up of 52 months, 26 patients were pain free (70%). Pain recurrence occurred in 3 patients in group A (14%) who were treated medically, versus in 8 patients in group B (50%) of whom 4 needed iterative surgery. Ongoing alcoholic addiction did not influence pain recurrence, which onset significantly altered the weight increase observed after pancreaticojejunostomy. CONCLUSION: Lateral pancreaticojejunostomy has a low morbidity rate and offers long lasting pain relief in 86% of patients whose cephalad main pancreatic duct is completely deobstructed.
Two hundred twenty-four ileal pouch-anal anastomoses have been made, 122 for ulcerative colitis and 102 for familial adenomatous polyposis. All the patients had a J pouch and a diverting temporary ileostomy. Mortality was 0.5%. Twenty-eight % of the patients with ulcerative colitis and 24% of the patients with familial adenomatous polyposis had various postoperative complications. Seventy-two patients with ulcerative colitis had a follow-up of more than one year. They had a mean of 4.6 stools per 24 hours; 84% had a normal day-time continence and 70% a normal nocturnal continence. Sixty-nine patients with familial adenomatous polyposis had a follow-up of more than one year. They had a mean of 4.1 stools per 24 hours; 93% had a normal daytime continence and 91% a normal nocturnal continence. In conclusion, ileal pouch-anal anastomosis can be made safely, with good functional results.
BACKGROUND/AIM: The purpose of this study was to determine the characteristics of bleeding of the pancreatic stump after pancreatoduodenal resection with pancreatojejunal anastomosis. PATIENTS AND METHODS: Between February 1970 and December 1990, 223 patients underwent a Whipple resection for cancer. RESULTS: Twenty patients (9%) had post-operative hemorrhage. In 10 patients bleeding arose within the operative field and in the 10 later within the gastrointestinal tract. Six patients bled from the gastroenterostomy and 4 (1.7%) from the pancreatic cut surface. In all four severity of the hemorrhage required urgent relaparotomy. CONCLUSIONS: Diagnosis and hemostasis could be achieved through a jejunostomy near the pancreatic anastomosis. Two patients had pancreatic fistula,one of them died.