[Diverticular and instrumental perforations of the colon]. / Considérations sur les perforations diverticulaires et instrumentales du côlon.

From july 1976 to july 1982, two groups of patients consisting of eleven peritonitis due to acute perforated diverticulitis, and five instrumental colonic perforations were treated in our department. None of the patients died in both groups. The relative infrequency, the important morbidity and the inaugural aspect of the perforation in the diverticular disease are in agreement with the literature. The ideal surgical attitude is still controversial. With the majority of the authors, we prefer the Hartmann's operation. The frequency of iatrogenic perforations is not negligible, and could increase in the future, with the development of endoscopic investigations. The morbidity is lower than in the first group, provided that the surgical treatment is applied early.

[106 inguinal hernias treated under local anesthesia]. / Etude de 106 cures de hernie inguinale sous anesthésie locale.

About two series of inguinal hernia, 106 operated under local anesthesia and 100 operated under general anesthesia, the authors reviewed retrospectively the local and general complications and the immediate and long-term results (1 year). The authors observed the same results in both groups; they conclude that local anesthesia can be considered as the first choice procedure in the treatment of uncomplicated hernia of high risk and geriatric patients.

[Surgery in the octogenarian (introduction). Results of a national survey]. / Chirurgie de l'octogénaire (introduction). Résultats d'une enquête nationale.

Presentation of the results of a national, multicentric and retrospective study regarding the surgery of the octogenarian. The series counts 7,407 patients accepted for surgery, and which can be divided into 4,581 women (61.8%) and 2,826 men (38.2%) of an average age of 84.4 years old (extremities 80-101 years old). The global mortality of this population of elderly (whether operated on or not) amounts to 16.7%. The postoperative mortality of the 4,177 operated patients is 18.2% with different rates according to the surgical disciplines: 34.7% for surgery of the colon, 23.2% for bone surgery, 22.4% for vascular surgery, 15.3% for biliary surgery, 8.7% for urologic surgery and 5.6% for cardiac surgery.

[Implantation of a cardiac pacemaker in the octogenarian]. / Implantation de stimulateur cardiaque chez l'octogénaire.

Thirteen centres, specialized in pacemakers and studying the implantation, brought together their material. Consequently, 785 patients living with a pacemaker (PM) were grouped. The average age at the time of the first implantation is 83,5 years old. The mortality of 7.5% as well as the morbidity of 16% lie very low. Nevertheless, their causes are discussed and compared to those resulting from other types of surgical pathologies on the octogenarian. It seems that the implantation of a PM, even on a person of 80 or older, is an efficient therapeutic gesture, benign and capable of normalizing the chances and quality of life on a long term basis.

[Arterial thrombosis of the lower limb in patients over 80 years of age. Belgian multicentric experience concerning 802 patients]. / Arteriële thrombose van het onderste lidmaat boven de 80 jaar. Belgische multicentrische ervaring betreffende 802 patiënten.

This report concerns a joint study of fourteen centres about the treatment of arterial occlusion of the low extremity. Eight hundred and two patients older than 80 years have been studied during a period from 1 to 27 years. The operative mortality was 25.2%. There was no significant difference in mortality between emergency cases and those patients who were operated under elective conditions. Leg amputations are followed by a significant higher mortality than more conservative surgery such as arterial by-pass, sympathectomy or embolectomy. The most frequent cause of death was from cardiopulmonar origin (57%). The postoperative morbidity of cardiac, pulmonary, urinary or infectious origin was frequent (50%). Surgical complications in the true sence of the word are quite rare and their frequency is limited to 7%. The conclusion of this study is that conservative surgery such as reascularisation or sympathectomy is, whenever possible, to be preferred over amputation not only because of their lower mortality (13 to 19%) but also since they permit better revalidation of these elderly patients.

[Prostate hypertrophy. Surgical experience in Belgium. Multi-center study of 1,140 patients of 80 years and older]. / Prostaathypertrofie. Chirurgische ervaring in België. Multicenter studie over 1.140 patiënten 80 jaar en ouder.

An inquiry organized by the Belgian Society of Surgery brought data on the mortality and morbidity of surgery on patients of 80 years and older for benign prostatic hypertrophy in a total number of 1,140 operations. Consensus exist to see this surgery as planned surgery. The mortality was 73 (6.3%) without statistical difference between endoscopic and open surgery. The morbidity of 824 patients was 165. This last figure relates to the big series in the literature. The mortality is in direct relation to the age of the patients. Evaluation of cardio-pulmonary risk (70.8% of the mortality), operation on indication at earlier diagnosis and prospective studies on the risk of operation in this population group are indicated.