The authors are reviewing a series of 110 cases of operated diverticulitis. Emergency operations mainly concerned cases of fecal peritonitis. Mortality is still fairly high (27 percent). In these cases, immediate resection (two-stages operation) brings better results than the classical three-stages operation. The latter, however, remains in some cases a safe solution. Concerning chronic patients, surgical procedures always require immediate resection, whatever the anatomic lesions can be. Hartmann operation has been given up by the authors. Presently, in every cases, continuity is carried out by ideal colectomy or by anastomosis protected by a transverse colostomy. In such cases, mortality has been, 2,6 percent and functional results are most satisfactory.

Adult↗

PubMedDate not supplied

[Treatment of peptic stenosis of the esophagus. Conservative techniques (author's transl)].

Peptic stenosis of the esophagus is no longer considered as an irreversible lesion. It may stabilize or even regress if gastro-esophageal reflux is suppressed. The treatment of these stenoses during the last decade has been progressively oriented towards conservative techniques, the only ones capable of conferring the necessary low degree of complexity on this type of surgery. The authors report their experience between 1965 and 1980 on 151 operations. Resection was performed in 1/3 of the cases and the remainder were treated conservatively, by either thoracic or abdominal routes. The route of choice is abdominal. Peroperative dilatation of the stenosis is done with a finger or a bougie. The anti-reflux configuration is a Nissen type fundoplicatio when the cardia can be lowered in the abdomen. If the cardia cannot be lowered because of a shortening of the esophagus, the authors utilize a complete wrapping of the gastric cone since 1969. This technique has been used 45 times, often in old and weak patients who would have tolerated no other procedure. Mortality was zero. Long-term results are satisfactory and longlasting in 75% of the cases. Secondary dilatations are sometimes (18%) necessary, especially during the first postoperative year. In case of failure, it remains possible to perform another conservative operation through the thoracic route. No late-arising adenocarcinoma has been observed in the stenotic zone.

Dilatation↗

PubMedDate not supplied

[External fistulas of the small intestine].

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Humans↗