Utilization of gas heater humidifier in the course of coelioscopies.

The increasing utilization of coelioscopic interventions has needed the use of a larger number of trocars, which involves in some cases (especially at the beginning of personal experience) longer operations. In our clinical experience we have met hypothermies that compelled us to modify our way of working. The use of conventional means (like warming cushion, warming of irrigation fluids) could limit the temperature loss only moderately. So we imagined to warm and moisten the gases insufflated into the peritoneal cavity. We give a description of the accessories and the results with some patients

[Complications of laparoscopic cholecystectomy. Free intraperitoneal calculi].

With the use of laparoscopic cholecystectomy, increasing numbers of gallstones are being left in the peritoneal cavity. To our knowledge, the rarely cause complications. We present two cases with stone spillage after laparoscopic cholecystectomy, with a different outcome

Systematic use of total vascular exclusion in 14 elective hepatic resections.

Between March 1992 and May 1995, 14 hepatic resections under total vascular exclusion were performed (10 major resections and 4 minor resections involving central segments). Mean age was 64 years (SD +/- 12). During hepatic resection, 4 patients required blood transfusion. The reason was a too low level of haemoglobin (< 10 gr/100 ml) to undergo Hepatic Vascular Exclusion (HVE) (1 patient), an unacceptable decrease in blood pressure following HVE leading to insertion of venovenous bypass (1 patient), or an extensive bleeding following removal of the clamps (2 patients). The 10 remaining patients did not need peroperative blood transfusion. Two patients were transfused after the 6th postoperative day. Complications usually described during HVE were not encountered except for one pleural effusion needing thoracocentesis

[Study of the toxicity and results of intraperitoneal hyperthermic chemotherapy in 28 patients with peritoneal carcinomatosis].

Based on a few previous studies, intra-peritoneal hyperthermic perfusion (IPHP) with Mitomycin C could become a beneficial treatment for peritoneal carcinomatosis. Twenty eight patients with peritoneal carcinomatosis arising from intra-abdominal cancers were treated by IPHP, Mitomycin C, diluted in 3 liters of saline solution warmed to a mean temperature of 45 degrees C, was injected into the abdominal cavity for one hour. Median survival for the whole series (postoperative mortality included) was 260 days. For patients with incomplete resection, median survival was 104 days. For patients with complete resection of carcinomatous nodules larger than 3 mm (19 patients), it was 450 days. In this group, actuarial survival was 56% at 1 year and 42% at 2 years. Only 5 (18%) of the 28 patients developed ascitic effusion during follow-up. These results confirm the efficacity of IPHP on ascitic effusion and on survival rate in patients with nearly complete resection of peritoneal carcinomatosis