[Totally implantable venous access ports by cephalic vein cut-down for patients receiving chemotherapy]. / Impact thérapeutique de l'utilisation de la veine céphalique pour la mise en place des chambres implantables pour chimiothérapie.

BACKGROUND: The use of an implantable room has become indispensable in the clinical practice for the cancer patients. The increasing use of these devices was associated with a greater incidence of complications. AIM: To verify the feasibility of the cephalic vein cut-down technique for placement of venous access devices. METHODS: A prospective study of 58 port placements was performed at our department of general surgery. The surveillance of devices was collectively insured by the operator and by the oncologists. RESULTS: The indication for implantation was the infusion of intravenous chemotherapy in patients with colorectal cancer in 55.1% cases and breast cancer in 27.5%. The specific complication rate was 7%. The cephalic vein cut-down approach was used successful in 45 (77.5%) patients. When the cephalic vein could not be used, a percutaneous technique was employed using the subclavian vein in 22.4% of the patients. CONCLUSION: Cephalic vein cut-down technique should be considered a safe and feasible approach for placement of venous access devices.

[Cystic lymphangioma of the adrenal gland, from radiologic diagnosis to laparoscopic treatment. A case report]. / Lymphangiome kystique de la surrénale, du diagnostic radiologique au traitement laparoscopique. A propos d'une observation.

BACKGROUND: Cystic lymphangioma of the adrenal gland is a rare tumor, which is often asymptomatic. Pre-operative diagnosis is difficult. Echography and CT scan are essential exploratory techniques. Surgical exploration is usually indicated due to uncertain diagnosis. AIM: Report of a new case CASE: We report a new case of cystic lymphangioma of the left adrenal gland, in a 30 year-old female, treated with a laparoscopic excision and confirmed by anatomopathologic features.

Hydatid cyst of the adrenal gland: a clinical study of six cases.

Hydatid cyst of the adrenal gland (HCAG) is an exceptional occurrence. We report our experience of six cases of HCAG and discuss the diagnosis and treatment of this hydatid localization. We retrospectively reviewed and analyzed the clinical files of six patients admitted to our institution from January 1990 to December 2000 for HCAG. Patients varied in age from 24-59 years. They were five males and one female. One patient had a history of pulmonary hydatidosis treated surgically 10 years previously. Five patients presented with lumbar pain and one patient had bouts of hypertension, headache, and palpitation. Physical examination was normal except in one patient who was hypertensive. Preoperative diagnosis was highly suggested by ultrasonography. CT scan performed in all cases clearly showed the relationship of the cyst with adjacent organs. Serology tests were positive in two cases. One patient had elevated urine VMA and was operated on with the diagnosis of cystic phaeochromocytoma. All six patients were operated on and had either an adrenalectomy (two cases) or partial pericystectomy (four cases). In one case, partial pericystectomy was conducted through a retroperitoneal laparoscopic approach. The hydatid nature of the cyst was confirmed pathologically. All patients had a smooth postoperative course with no cystic recurrence on follow-up. The diagnosis of HCAG is based mainly on ultrasonography and CT scan. Surgery with either partial or total excision of the cyst, with or without preservation of the adrenal gland, is the treatment of choice.

[Solid cystic papillary tumor of the pancreas]. / Tumeur papillaire solide et kystique du pancreas.

Solid cystic papillary tumors of the pancreas are rare. This tumors were seen in young women. They have distinct clinicopathologic characteristics. Their prognosis is excellent because of their low grad of malignancy. The tumor was encapsulated and have favorable prognosis after complete surgical resection. We report one case of solid cystic papillary tumor of the pancreas occuring in female patient who are 20 years old. This observation have been a pre operative morphologic and ultrastructural study (CT, Ctscan, EE, IRM and immunohistochemistry study) who permetted to elaborate diagnosis.