[Identification of sentinel lymph node: Comparison between SNOLL and routine isotopic procedure]. / Identification isotopique du ganglion sentinelle : comparaison du SNOLL avec la technique isotopique de référence.

INTRODUCTION: Axillary staging remains the most accurate predictive factor for recurrence risk and survival in patients with invasive breast carcinoma. Sentinel Node Occult Lesion Localization (SNOLL) allows with a single intra-lesion injection both localization of impalpable breast lesion and sentinel node biopsy. Our aim was to compare the efficacy of SNOLL and standard radio isotopic method for sentinel node localization by lymphoscintigraphy. METHODS: This retrospective study enrolled 100 patients treated for breast carcinoma with indication of sentinel node biopsy between may 2017 and January 2019 in breast surgery unit of Montpellier university hospital. RESULTS: SNOLL and standard radio isotopic method were realized in respectively 65 and 35 patients. Failure rates of sentinel node localization were respectively 34% and 11% by lymphoscintigraphy (P=0.02), 17% and 9% intraoperatively and 11% et 6% using radioisotope combined with colorimetric method. DISCUSSION: Failure rate of sentinel node localization is higher using SNOLL. This rate is reduced by additional radioisope migration in the time between isotope injection and surgery and by the use of combined method. SNOLL should therefore be combined with colorimetric method. These results must be confirmed in a larger study.

[Acute gangrenous acalculous cholecystitis disclosed by postoperative septic shock]. / Cholécystites aiguës gangréneuses alithiasiques révélées par un choc septique postopératoire.

Three cases of acute gangrenous acalculous cholecystitis, revealed by a postoperative septic shock, are reported. Clinical examination was negative and the surgery gave the diagnosis. Infection with biliary stasis and ischaemia accounts for this pathological entity. The very serious prognosis of this condition can only be reversed by cholecystectomy.

[Prolonged curarization with suxamethonium in a four-week old infant]. / Curarisation prolongée après suxaméthonium chez un nourrisson de 4 semaines.

A case of a 28-day-old infant who developed suxamethonium apnoea is described. He was found to be homozygous for atypical cholinesterase. Main characteristics of this disorder are reviewed. Other causes of prolonged apnoea in infants recovering from anaesthesia for surgery of pyloric stenosis are discussed.

[Primary retroperitoneal tumors in adults]. / Tumeurs rétro-péritonéales primitives de l'adulte.

The authors report a series of eight primitive retro-peritoneal tumors, which were difficult to diagnose because of the late appearance of the symptoms. The intravenous urogram is the only satisfactory fundamental examination, possibly completed with ultrasound, CT scanning, and, if necessary, angiography. Extensive surgery allowed total exeresis in most cases. But histological examination remains difficult. Mesenchymomas, the most frequent, are very often malignant. Two cases of association with other malignant tumors were observed. Adjuvant procedures add little to life expectancy and total surgery is alone likely to be effective.