Biomedical subjects
Publications and source records attributed to C Avisse.
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Between January 1, 1984 and December 31, 1993, we treated 191 patients with diverticular sigmoiditis. Three groups of patients were distinguished in this retrospective study. In group 1, there were 108 patients (56.5%) who were referred by gastroenterologists after one or two episodes of sigmoiditis and who underwent planned exeresis. In group 2, there were 42 patients (21.9%) in whom the sigmoiditis was revealed by a complication and who underwent and emergency procedure. In group 3, there were 41 patients (21.6%) over 70 years of age with major risk for anesthesia and/or surgery who were treated medically. Mortality, morbidity and duration of hospital stay were analyzed by group. Operative mortality was 0.92, 19 and 7.3% respectively. Operative morbidity among the survivors was 21 and 35% in groups 1 and 2 respectively. Mean hospital stay varied from 15 days for planned procedures up to 20 days for emergency surgery. It was 9 days in group III. These findings recall the need for radical preventive exeresis for diverticular sigmoiditis.
Ten years after nephrectomy a renal cell carcinoma of the felt kidney, the patient presented successively pancreatic, adrenal gland, thyroid gland and contralateral renal metastases. Surgical exeresis was performed for the different metastases with a survival period of 7 years. No similar observation (non-necropsic discovery, surgical treatment, prolonged survival) of multiple metastasis of renal cell carcinoma to endocrine glands was found in the literature. The important role of modern imaging techniques are emphasized together with the need for long-term follow-up of operated renal cell cancer since the clinical course can be unpredictable. Long-term remission has been reported and surgical exeresis of metastasis should always be proposed when possible.
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