[Comparative evaluation of the respiratory consequences of supraumbilical and bi-subcostal median laparotomy incisions].
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Biomedical subjects
Publications and source records attributed to G Spay.
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In cancer recognized less than one month after first signs, frequently by pancreatography via fiberoptic endoscopy, in a young patient patient with no other major disease, total pancreatectomy with systematic lymphadenectomy must be proposed. Total splenopancreatoduodenectomy carried out from left to right provides the longest delay for the final section stages. Simultaneous study of lymph nodes enables one to estimate the survival to approximately two years in case of involvement and hopefully five, if they are intact.
In spite of sphincter paralysis, the peripheric moto-neurone lesions induces bladder retention. Secondary retention forces fail to open the bladder neck owing to detrusor flaccidity. Long-dated, abdominal straining increases this static dysfunction by inducing posterior bladder prolapsus upon a flaccid perineum. This disorder est characterized by three components: --posterior prolapsus of the bladder, --horizontal position of the proximal urethra, --deepening of Douglas peritoneum. These patients may get a micturation using a perineal compression; similarly, surgical management consists in a making-up and fastening of the bladder by means of the rectum which is used as a hammack (colocystopexia). The procedure had been used in five cases with good results.
Resection of the sternum and adjacent, cartilages raises difficult problems of reconstruction. The tumour, which, exceeding 5 kg was considered histologically as a chondroma, was replaced by a silastic prosthesis with an excellent result 13 months later.
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