Annales de chirurgie
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Annales de chirurgie · Jan 1995
Review[Total hysterectomy for benign pathologies. Conventional celiosurgical technique].
The standard technique for total laparoscopic hysterectomy is characterised by two essential points. The first is that all instruments are reusable and the second is that hemostasis is ensured by bipolar coagulation. It is a safe technique with a cost comparable to that of vaginal or abdominal hysterectomies. ⋯ Laparoscopic surgery is only indicated when vaginal surgery is difficult and/or contra-indicated. The elective indications for total laparoscopic hysterectomy are severe adhesions, deep endometriosis and especially a limited vaginal accessibility associated with a narrow vagina and a fixed or non prolapsed uterus. While a average of three quarters of hysterectomies (excluding cases of uterogenital prolapse) are currently performed via a laparotomy, laparoscopic surgery can reduce this rate to approximately 10 to 20 per cent.
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Annales de chirurgie · Jan 1995
Review[Upper thoracic sympathectomy by thoracoscopic approach. A method of choice for the treatment of palmar hyperhidrosis].
Palmar hyperhidrosis is excessive sweating beyond physiological needs in the palm without recognized etiology. Although a benign disease, it is annoying to most patients. Currently the best treatment for this condition is upper thoracic sympathectomy via many different approaches. ⋯ Transaxillary thoracoscopic sympathectomy for palmar hyperhidrosis is a relatively simple and effective procedure which can be performed with standard laparoscopic instruments. The advantages are, short recovery time and hospital stay along with excellent functional and cosmetic results. We are convinced that thoracoscopic sympathectomy is the procedure of choice for the treatment of palmar hyperhidrosis.
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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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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.
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Twelve patients with refractory angina pectoris previously treated with angioplasty or coronary bypass and under optimal medical therapy were treated with spinal cord electrical stimulation (SCES) at the C7 to D2 level since 1988. Six patients had a significant improvement of symptoms confirmed by a reduced incidence of chest pain and decreased used of nitroglycerin. ⋯ Three patients died. The SCES may improve the quality of life by reducing the incidence of chest pain in patients previously uncontrolled with maximal medical and surgical therapy.