There is, I think, something ethereal about i —the square root of minus one. I remember first hearing about it at school. It seemed an odd beast at that time—an intruder hovering on the edge of reality.

Usually familiarity dulls this sense of the bizarre, but in the case of i it was the reverse: over the years the sense of its surreal nature intensified. It seemed that it was impossible to write mathematics that described the real world in …

I and i

Background and Aims:The lack of consensus on how to define and grade adverse postoperative events has greatly hampered the evaluation of surgical procedures. A new classification of complications, initiated in 1992, was updated 5 years ago. It is based on the type of therapy needed to correct the co

The Clavien-Dindo classification of surgical complications: five-year experience.

Prospective Cohort Study

ObjectiveThere is a need for clearly defined and widely applicable clinical criteria for the selection of patients who may benefit from hepatic resection for metastatic colorectal cancer. Such criteria would also be useful for stratification of patients in clinical trials for this disease.MethodsCli

/pdf/clinical-score-for-predicting-recurrence-after-hepatic-2a004axarc.pdf

Clinical Score for Predicting Recurrence After Hepatic Resection for Metastatic Colorectal Cancer: Analysis of 1001 Consecutive Cases

Bevacizumab plus Irinotecan,Fluorouracil,and Leucovorin for Metastatic Colorectal Cancer

Appendicite aiguë et grossesse extra-utérine simultanées : qui est la responsable ?☆

Emergent central pancreatectomy for a blunt abdominal trauma

https://www.journalacs.org/article/S1072-7515(05)00534-X/pdf

Preservation of middle hepatic vein during left hepatectomy.

Oncovascular teams are known to be a cornerstone in planning and facilitating en bloc resection of large retroperitoneal masses. Vascular surgeons can help with dissection close to major vessels by vascular reconstruction when necessary, and also in performing specific procedures that can facilitate safe and optimal tumour mass resection. Two cases are reported where temporary vascular debranching of major arteries allowed safe tumour harvesting.A 68 year old man with a necrotic retroperitoneal carcinoma underwent en bloc resection with temporary debranching of the coeliac trunk, superior mesenteric artery, and right renal artery using a multibranched bypass from the axillary artery. The post-operative course included septic shock related to pulmonary infection requiring a 10 day stay in the intensive care unit (ICU). Renal function was normalised on day two. The patient was discharged on day 18. However, he died 78 months post-operatively from pulmonary metastases after anti-angiogenic treatment.A 34 year old man with a retroperitoneal mature teratoma underwent en bloc resection with temporary debranching of the coeliac trunk, superior mesenteric artery, left and right renal arteries, and left and right common iliac arteries, with a multibranched bypass from the axillary artery. Post-operatively he required a five day stay in the ICU. Acute kidney injury (AKI) was noted, but it resolved without dialysis. The patient was discharged on day 16. After 78 months follow up he presented with chronic renal failure requiring dialysis. Follow up computed tomography angiography showed pulmonary metastases; although the metastases were manageable with surgical treatment, the patient refused further care.Temporary extra-anatomical bypass from the axillary artery to the visceral arteries could be considered as an option to provide adequate perfusion and to prevent visceral ischaemia during en bloc resection of large retroperitoneal masses. 

https://doi.org/10.1016/j.ejvsvf.2022.01.001

Temporary Vascular Debranching to Facilitate Retroperitoneal Tumour en bloc Resection

Doxorubicin-eluting-bead embolization (DEB) is considered a safe and efficient treatment of hepatocellular carcinoma (HCC) with a low complication rate and an increased tumor response compared with conventional transarterial chemoembolization. We describe a case of a 69-year-old patient who underwent DEB for HCC and who developed a liver abscess requiring urgent left liver lobectomy. Despite this severe complication, efficacy of DEB embolization was histologically proved as a large ischemic zone with complete tumor necrosis.

Philippe Bachellier

Papers

Appendicite aiguë et grossesse extra-utérine simultanées : qui est la responsable ?☆

Emergent central pancreatectomy for a blunt abdominal trauma

Preservation of middle hepatic vein during left hepatectomy.

Temporary Vascular Debranching to Facilitate Retroperitoneal Tumour en bloc Resection

Severe Complication After a Doxorubicin-Eluting-Bead Embolization: Surgical Management and Pathological Findings