The posterior approach for villous tumors of the rectum. Report of eleven cases.

Use of the posterior surgical approach for the management of villous adenoma of the rectum below the peritoneal reflection has been evaluated in eleven patients. There has been no mortality and no recurrence. The Kraske approach was also suitable in four patients with noninvasive adenocarcinoma arising within villous adenomas, although there is no place for this procedure in the treatment of invasive carcinoma.

Effect of obstructive jaundice on wound healing. An experimental study in rats.

The effect of obstructive jaundice on wound healing was investigated in an experimental study of gastric and abdominal wounds in rats after ligation and division of the common bile duct. The healing of a parietal defect in these animals showed histologic evidence of delayed healing compared with controls. The bursting strength of the abdominal incision was also decreased, but not that of the stomach. These findings suggest that the biochemical changes in the wounds of jaundiced animals interfere with wound repair. The possible causes of this delay in healing and its clinical implications require further investigation.

Hepatic resection for isolated tumor-like nodules in the liver.

We have reported two cases of focal nodular hyperplasia of the liver in adults. One case is the first in which the regenerative process that occurred nine months after localized hepatic necrosis was implicated in the development of focal nodular hyperplasia. The other case concerned an idiopathic isolated liver nodule that occurred in a woman who never had taken oral contraceptives. These tumor-like lesions were removed by a right and a partial hepatectomy respectively. The two patients remained asymptomatic during the first 13 postoperative months with no additional therapy.

Intestinal changes after jejuno-ileal shunt in obesity: a report of 2 cases.

Two cases of end-to-end and end-to-side jejuno-ileal bypass for the treatment of obesity are reported in which both patients underwent reoperation 17 and 23 months later respectively. Macroscopic examination and measurements of length of the various segments of the small intestine have been performed twice in each patient: at the time of the bypass and at the second surgical procedure. In one patient a histological study of both the excluded and functioning small intestine was carried out at the time of each surgical procedure. The functioning intestine had increased in size while the excluded segment had become narrowed. The height of the villi had increased slightly in the functioning ileum and more so in the functioning jejunum compared with the preoperative measurements. In contrast, the height of the villi was moderately reduced in both the bypassed jejunal and ileal segments. These findings confirm the results of experimental studies in animals.