[Use of madreporaria coral skeletal fragments in orthopedic and reconstructive surgery: experimental studies and human clinical application (author's transl)].
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Biomedical subjects
Publications and source records attributed to G Guillemin.
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A lateral ileostomy permits perfect exclusion, easy fitting of an ileostomy bag and easy secondary closure. An analogous procedure may be used to perform a terminal ileostomy and/or a perfectly vascularised ileal bladder, specially suitable for the obese patient.
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A simple procedure of reconstitution of the angle of His applied to the treatment of hiatus hernia and malposition of the greater tuberosity is reported. Applied to 242 cases, it presents compared with the classical procedure several advantages : easy to carry out, including no complex manoevre, it does not endanger the vagus nerve and maintains firmly the anastomosis. Radiological control and, above all, the clinical results were excellent or good in 96% of cases, suggesting that this new procedure is perfectly valid.
We studied the relationship between pregnancy and pancreatitis together with reviewing the bibliography after having had 4 cases. As far as the aetiology is concerned there does not seem to be a mechanical factor associated with the pregnant uterus but a vesicular factor (gall bladder) of stasis and hypersecretion, with hyperlipidaemia of pregnancy and pancreatic oversecretion in pregnancy, all of which are finally associated with a neuro-vegetative lack of tone and with the part played by certain drugs that are often prescribed in pregnancy. The fetal prognosis is relatively good except for the risks of premature delivery. Management of a case of acute severe pancreatitis is difficult to work out. All the same, the treatment should be above all conservative, which means medical. Surgery should be reserved for those cases with definite indications such as progressive deterioration in spite of medical treatment with the knowledge beforehand that it will not make much difference to the final prognosis.
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The authors report and analyse two series of observations of colonic and rectal villous tumours. 47 treated initially by surgical removal, 57 treated by radiotherapy, (contact radiotherapy or interstitial radium therapy). After recalling the basic pathology, they expose the results of each group of treatment and draw practical conclusions. The treatment should first be surgical, the method depending on the site and volume of the tumour; radiotherapy may be a beneficial complement when the tumour is malignant and non-invasive or when a recurrence occurs. It may exceptionally be used as a cure when the tumour has a small diameter (less than 3 cm) and is situated less than 12 cm from the anus.
The authors report a series of 72 cases of Crohn's disease, and discuss the clinical and pathological aspects, the surgical treatment and results. A critical study of the operations in view of the requirements of the disease showed that incomplete resection was mainly responsible for the recurrences. In most cases, the word relapse was more suitable to describe the poor results noted. Immediate radical removal gives such good results that these outweigh the functional disadvantages.
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