[Technics of esophageal exeresis for cancer].
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Anastomosis, Surgical↗
Biomedical subjects
M Vix
Publications and source records attributed to M Vix.
[A promising alternative for the treatment of type I diabetes. The implantable insulin pump].
Recent improvements in miniaturization of implantable pumps and the ability of their control by tele transmission allowed implantation of autonomous pumps which administer insulin into the peritoneal cavity. Fifty-six patients with diabetes mellitus underwent implantation of 66 pumps with a mean function life of 21.8 months per patient. No patient died to this day. Tolerance of implanted components was good. Morbidity was limited to local events, in this series 4 cutaneous erosions, two of them dictating final pump explantation. Dosages of mean global blood-sugar, pre- and post-prandial blood-sugar, and glycosylated hemoglobin were all lower versus dosages before implantation. Statistically significant difference was demonstrated regarding mean global blood-sugar. Frequency of sever hypoglycemia incidents (4 in our series) and of biological hypoglycemia (blood-sugar < 65 mg/100 ml) was decreased, representing major benefit of the technique. The patients well-being and quality of life were notably amended. Implantable insulin-pump may be offered as a treatment alternative to conventional insulin-therapy, especially in cases of diabetes which are difficult to balance and particularly in cases with frequent hypoglycemic malaise.
Adult↗
[Fundoplication by the Nissen-Rosetti technique using celioscopy. 10 cases].
Ten patients presenting with hiatus hernia and gastro-oesophageal reflux underwent laparoscopic Nissen-Rossetti fundoplication. All patients had either medical treatment failure or invalidating reflux. At present, complete fundoplication is the most effective surgical treatment of gastro-oesophageal reflux. The laparoscopic procedure was rigorously identical with the habitually used "open" procedure, the only difference being the abdominal access. No laparotomy was necessary in our patients, and no major complication was observed. The follow-up showed good clinical results. Laparoscopy has been reported to decrease postoperative pain and ventilatory disorders. Morover, this minimally invasive surgical technique enables rapid resumption of social and professional activities.
Adult↗
[Gallbladder actinomycosis. A rare entity].
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Actinomycosis↗
[Celioscopic digestive surgery: from the explosion to a critical reflexion].
A critical review of laparoscopic digestive surgery indications is proposed. Patient's benefit by laparoscopy is to undergo the same procedure as by open surgery with identical security conditions but with less postoperative pain and an earlier recovery. Today laparoscopy in digestive surgery is mainly indicated in the fields of functional and benign diseases. Oncology seems for our team to stay a relative contra-indication as yet. Taken into account the future technical progresses, this 1996 state of the art is obviously only a temporary view of the technique before expected mutations.
Cholecystectomy, Laparoscopic↗
[Sequential treatment of lithiasis of the common bile duct].
The purpose of this study is to evaluate the sequential endoscopic-laparoscopic approach for clearance of common bile duct (CBD) and removal of gallbladder in patients with simultaneous cholecystolithiasis and choledocholithiasis. A data base of 990 patients undergoing Laparoscopic Cholecystectomy (LC) was compiled during an 5 years period. 88 patients were suspected of having CBD stones based upon clinical, biological and ultrasound evidence. The CBD cannulation rate was 93% (82/88). CBD stones were found in 43 patients (49%). The stones were removed preoperatively by Endoscopic Sphincterotomy (ES) in 37 patients of these 43 cases (86%). LC was performed in all patients after endoscopic retrograde cholangiopancreatography (ERCP). This treatment had showed no mortality and a morbidity of 14%. Efficacy of this sequential method of treatment of LVBP was 86%. With inclusion of laparoscopic extractions, the efficacy rate was 91%. The rate of residual stones was 1% (1/88). Experience with ERCP and ES before LC has been growing. ERCP-SE in the treatment of choice to clear the CBD before LC in high risk elderly patients (26) as well as in complicated stones. However, in this era of laparoscopic surgery, CBD stone can be removed laparoscopically in specialized centres with the advantage of a non-invasive single procedure for the patient. Laparoscopic CBD desobstruction and ES are not opposite but complementary. Preoperative ERCP and ES should be reserved for patients with serious illness. All other patients should be managed laparoscopically; in this case the future of sequential treatment resides in a one step-approach: preoperative ERCP if cholangiography is positive.
Cholecystectomy, Laparoscopic↗