Autogenous valve reconstruction technique for post-thrombotic reflux.

Post-thrombotic reflux in deep veins of the lower extremities cannot be treated by in situ valvuloplasty because of valve degeneration. The outcome of transplantation and transposition of segments with valves is controversial. From feasibility tests in animals and fresh human cadavers we have developed an autogenous valve reconstruction technique. The valve is fashioned from the proximal end of the greater saphenous vein that is left attached to the femoral vein, invaginated, and fixed to the venous wall. This technique provides a competent bicuspid valve. In a series of 19 patients operated on in 1995 we performed 20 valve reconstruction procedures at the level of the femorosaphenous junction by invagination of a fragment from the proximal end of the greater saphenous vein in the common femoral vein. Mean follow-up time was 10 months. No complications were observed. All femoral veins were patent and competent except one in which mild reflux was observed because of insufficient valve size. Further follow-up is needed to confirm the efficacy of this simple, new technique.

[Villous adenoma of the duodenum. Apropos of a case]. / Adénome villeux du duodénum. A propos d'un cas.

We report a case of recurrent villous tumors (1989-1995) of the second duodenum. The diagnosis of these rare tumors was obtained by endoscopy. Risk of recurrence and degeneration raise the question of surgical or endoscopic treatment.

[Leiomyoblastoma of the stomach. Diagnosis and therapy]. / Léiomyoblastome de l'estomac. Diagnostic et thérapeutique.

Leiomyoblastoma is a rare tumour of the stomach which general by develops in an exogastric location. We report a case in a 60-year-old patient who was seen for dark stools and acute anaemia. The tumour was located in the antrum and developed into the endogastric mucosa with ulceration. The extemporaneous examination revealed leiomyoblastoma of the stomach. A triangular resection of the antrum was performed. The diagnosis was confirmed by the pathology examination. Based on a review of the literature, we recalled the latest advances in diagnosis and therapy for leiomyoblastoma of the stomach.

[Cockett's syndrome caused by an ectopic kidney. Apropos of two cases]. / Syndrome de Cockett par rein ectopique. Rapport de deux cas.

Two original cases of Cockett's syndrome caused by an ectopic and/or malformed kidney are reported. Intravenous pyelography and computed tomography allow establishing the diagnosis. The choice of the therapy depends on the patency of the left common iliac vein.

Treatment of stage II chronic arterial disease of the lower limbs with the serotonergic antagonist naftidrofuryl: results after 6 months of a controlled, multicenter study.

A study was carried out in patients with intermittent claudication (Fontaine's stage II). The atheromatous origin of the disease was confirmed and localized by angiography or Doppler. One hundred eight-three patients were selected initially (day -30) with a pain-free walking distance on a treadmill (at a speed of 3 km/h and a slope of 10%) ranging from 150 to 300 m. During the first month (washout period) all patients received two placebo tablets daily. At the end of this run-in period (day -30; day 0) and after checking walking distance stability (allowed variation: 20% between the two measurements), patients were included in the study. According to this criterion, 112 patients were selected and 94 remained during the whole study. The study was designed in double-blind, using two parallel, randomly selected groups. Fifty-two patients received naftidrofuryl (2 x 316.5 mg tablets daily with meals) for 6 months; 42 patients received placebo under the same conditions. During this period, clinical and paraclinical examinations were carried out every quarter (day 90 and day 180). After checking the initial homogeneity of the naftidrofuryl and placebo groups, the comparison between the two groups indicates a significant improvement in the naftidrofuryl group after 3 months and 6 months of treatment, for the pain-free walking distance. For the maximal walking distance, a significant improvement was found at day 180. Nonparametric analysis (chi 2 test) also indicated a significant improvement for the naftidrofuryl group. These results confirm that naftidrofuryl is beneficial in the treatment of patients with chronic arterial disease.

[Surgical results of renal transplantation (62 cases) (author's transl)]. / Résultats chirurgicaux de la transplantation rénale. A propos de 62 observations

Over a period of 16 months, 62 renal transplantations were carried out by the same medicosurgical team. The follow-up period being 3 months for the most recent cases, 57 patients are still alive and 44 grafts are functional. No surgical complication was the cause of loss of a graft and even less so that of a transplanted patient. Reestablishment of urinary continuity was carried out by ureteroneosystostomy and no fistula or ureteral stenosis was noted. Only 5 vesical fistulae were related to this technique but they healed with no problem. Parietal infectious complications (32%) were much more preoccupying, and frequently the very cause of the majority of urinary complications. Finally vascular stenosis, found in a little more than 6 p. 100 of cases only lead to surgical restoration on one occasion. These different results are compared with those of other teams published today.

[Familial reno-vascular hypertension (author's transl)]. / Hypertension réno-vasculaire familiale

The authors report a case of hypertension due to dysplasia of the renal arteries in a young man, and found the same disease in siblings. Two sisters and one brother also had renal hypertension, whereas the other relatives were unaffected. Two similar cases found in the world literature, did not permit the authors to determine the cause of this disease. This case is reported in order to stimulate research and the discovery of new cases.