[Construction of a neo-vagina by sigmoidocolpoplasty]. / Reconstruction vaginale par sigmoïdoplastie pour aplasie utérovaginale: Technique chirurgicale et avantages.

Construction of a neo-vagina by sigmoidocolpoplasty has been effective in the treatment of vaginal aplasia, a condition most commonly seen with the Mayer Rokitansky Syndrome. This article describes the surgical technique and principal complications, and reviews the literature to compare this technique with other methods of repair, particularly the Davydov technique.

[Lipofilling in breast reconstruction: is there any population with higher risk of local recurrence? Literature systematic review]. / Transfert de tissu adipeux en reconstruction mammaire: y a-t-il des populations à risque? Revue systématique de la littérature.

Safety of the autologous fat grafting (AFG) in the breast parenchyma remains a debated topic, particularly in reconstruction following breast cancer. This procedure still raises many questions, especially considering recent in vitro studies warning about the fact that lipofilling could promote tumor recurrence through increased neoangiogenesis, or facilitate metastasis. Through a systematic literature review on oncological risk and radiological follow-up, conducted from January 2010 to August 2014, we tried to identify populations at risk of recurrence after AFG. The study selection process was adapted from the Prisma statement. Out of the seven analysed patients cohorts, i.e. approximately 1500 AFG procedures, results on the risk of local recurrence appear reassuring after an average follow-up of 42 months. These results should be cautiously interpreted because of the heterogeneity of the studies. However, recurrences have been analysed based on the characteristics of the original tumor and many of them warn about population that seem more at risk of recurrence. Studies on radiological modifications after AFG emphasize the need for the radiologists to know the importance of radiological images induced by this procedure, however, AFG does not seem to interfere with radiological screening of local recurrence. In order to deliver clear information to patients receiving breast reconstruction by lipofilling, prospective studies focused on populations that seem to be most at risk of recurrence are required.

[Hurt eczematiforme column (chronicle) of the breast after implementation of a surgical clip]. / Lésion eczématiforme chronique du sein après mise en place d'un clip chirurgical.

We report a case of atopic dermatitis in relation with a surgical titanium clip. Such a complication has only been reported once in the literature. We advocate to ask the patients about query atopic manifestations especially contact dermatitis to metal before any procedure involving metallic implants.

Predictors of recurrence in high-grade cervical lesions and a plan of management.

UNLABELLED: PRÉCIS: Positive endocervical margins are an important predictor of recurrence in high-grade cervical lesions, and though they do not always warrant retreatment, closer surveillance is recommended. OBJECTIVE: To identify predictors of recurrence and persistence of high-grade cervical dysplasia and to determine appropriate follow-up. DESIGN: prospective pilot study. SETTING: Gynaecological surgical center. POPULATION: Three hundred fifty-two patients were treated between 1999 and 2002 for high-grade lesions. METHODS: According to the accessibility of the transformation zone and the degree of dysplasia, patients were treated either by conization or by loop electrosurgical excision procedure (LEEP). Follow-up comprised colposcopy and Pap-smear screening 4-6 months after treatment as well as high-risk human papillomavirus (HR-HPV) testing before and after treatment. MAIN OUTCOME MEASURES: underscore predictors of recurrence and propose a treatment flowchart for both management and follow-up. RESULTS: Of the 352 patients, 37 (10.5%) had true recurrence 6 months after initial surgical treatment and 6 patients (1.7%) had persistent lesions. Overall, 43 patients (12.2%) were considered as having recurrent disease. Patients were followed up for 5 years with a mean of 73 months. The most important predictor of recurrence was a positive HR-HPV test at 6 months postoperatively (odds ratio 38.8, 95% confidence interval 14.09, 107.05). The second significant predictor was positive endocervical margins and the third was positive pre-treatment HPV typing. A positive post-treatment HPV test had a more significant influence on risk than a positive test before treatment. CONCLUSION: In agreement with recent findings, our study supports the usefulness of the HR-HPV test in the follow-up of treated high-grade lesions, especially when excision margins were positive.