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Both technical and anatomical features and the need for a long follow-up, usually over several years, explain the specificity of lung surgery in children. Apart from the oncological resections, the main indications for this surgery are congenital lung anomalies (cystic adenomatoid malformation, bronchopulmonary sequestration, lobar emphysema), symptomatic postinfectious lesions (bronchiectasis, atelectasis, abscess) and pneumothorax. Advances in miniaturization of the surgical equipment are used to carry the majority of these interventions by thoracoscopy, except when performed at the neonatal period. In the newborn, for which the indications for lung surgical resections are exceptional, ventilatory conditions and the tightness of the chest lead to still prefer open surgery. Pulmonary malformations can also be managed prenatally when they affect lung development or cause heart failure because of compressive complications. These interventions, performed after the 30th week of gestation, are not intended to remove the lesions, but to release the compression. But these procedures are still under evaluation and, in light of possible fetal and maternal complications, they should only be performed in tertiary centers and in the context of specific protocols., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

A duodenal carcinoma centered on the vater ampulla is reported in a child of 15 years with Lynch syndrome. This case illustrates the problem of early diagnosis and treatment of Lynch syndrome associated tumors.

The prognosis of primary lung cancer associated with hypertrophic osteopulmonary arthropathy is not well known. Between July 1973 adn August 1995, we cared for 53 consecutive patients with resectable non-small-cell lung cancer associated with osteoplumonary arthropathy. There were 51 men and 2 women, mean age 56 years. In 83% of the cases the lung cancer was revealed by hypertrophic osteopulmonary arthropathy. The tumor generally involved the right lung (n = 38) and the upper lobe (n = 35). There was no peripheral or central predominance. Complete tumoral resection was performed in 47 patients, incomplete resection in 4 and exploratory thoracotomy in 2. The main histologies were adenocarcinoma (50%) and squamous cell carcinoma (40%). Among the 51 resected tumors, 27 were grade I, 5 grade II, 17 grade III and 2 grave IV. Overall 5-year survival was 39%, reaching 51% for grade I, 40% for grade II, 27% for grade III and 0% for grade IV. The pulmonary manifestations of hypertrophic osteopulmonary arthropathy regressed within the first postoperative hours in all the patients whose tumor was resected and in 1 of the 2 patients who underwent exploratory thoracotomy. AT follow-up, the hypertropic pulmonary arthropathy had disappeared in all resected patients except 1 with a grade I tumor. Tumor recurrence was proven in 18 resected patients, 5 of whom also had recurrent osteopulmonary arthropathy. Our results suggest that primary lung cancer associated with hypertrophic pulmonary arthropathy has characteristic features and that prognosis is comparable with primary lung cancer alone.

The aim of a combined liver/intestinal transplantation experimental model in rats is the study of the liver-induced tolerance of a solid, vascularized and highly immunogenic organ. Animals. Inbred Lewis rats were divided in two syngenic groups: 1. small intestine grafting (n = 10); 2. combined liver/intestinal grafting (n = 10). Intestinal grafting was performed 15 days after liver transplantation. Results. 10/10 animals were alive after 60 days in the first group and 7/10 in the second. Intestinal graft viability was good and 3 intestinal biopsies were done without any complication in each animal. All samples were histologically normal. Our study using syngenic animals prove that combined liver/intestinal transplantation is technically possible and reliable.

Fifteen children with rhabdomyosarcoma of the bladder and prostate or vagina treated by combined chemotherapy radiotherapy and surgery, are reported. Eleven were submitted to preoperative chemotherapy. Ten children are alive with a follow up of 7 month to 16.2 years after treatment. All five deceased patients were boys. Nine children were submitted to a conservative approach of the lesions; 8 of there ar alive, 3 of which with sequelae. Four boys were treated with total cystectomy and one girl had a colpohysterectomy: 2 of these children also have sequelae. The point of this report is to underline the possibility of a conservative surgical approach when possible, especially in cases where tumor reduction is obtained by preoperative chemotherapy and completed by local irradiation when necessary. The late sequelae of these treatment modalities are also analysed.