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Sabbagh C, Beyer-Berjot L, Ouaissi M, Zerbib P, Bridoux V, Manceau G, Karoui M, Panis Y, Buscail E, Venara A, Khaoudy I, Gaillard M, Ortega-Deballon P, Viennet M, Thobie A, Menahem B, Eveno C, Bonnel C, Mabrut JY, Badic B, Godet C, Eid Y, Duchalais E, Lakkis Z, Cotte E, Laforest A, Defourneaux V, Maggiorri L, Rebibo L, Christou N, Talal A, Mege D, Bonnamy C, Germain A, Mauvais F, Tresallet C, Ahmed O, Regimbeau JM, Roudie J, Laurent A, Trilling B, Bertrand M, Massalou D, Romain B, Tranchart H, Giger U, Dejardin O, Pellegrin A, Alves A. Risk factors for severe morbidity and definitive stoma after elective surgery for sigmoid diverticulitis: a multicenter national cohort study. Tech Coloproctol 2024; 28:34. [PMID: 38369674 DOI: 10.1007/s10151-023-02906-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/18/2023] [Indexed: 02/20/2024]
Abstract
BACKGROUND In the decision to perform elective surgery, it is of great interest to have data about the outcomes of surgery to individualize patients who could safely undergo sigmoid resection. The aim of this study was to provide information on the outcomes of elective sigmoid resection for sigmoid diverticular disease (SDD) at a national level. METHODS All consecutive patients who had elective surgery for SDD (2010-2021) were included in this retrospective, multicenter, cohort study. Patients were identified from institutional review board-approved databases in French member centers of the French Surgical Association. The endpoints of the study were the early and the long-term postoperative outcomes and an evaluation of the risk factors for 90-day severe postoperative morbidity and a definitive stoma after an elective sigmoidectomy for SDD. RESULTS In total, 4617 patients were included. The median [IQR] age was 61 [18.0;100] years, the mean ± SD body mass index (BMI) was 26.8 ± 4 kg/m2, and 2310 (50%) were men. The indications for surgery were complicated diverticulitis in 50% and smoldering diverticulitis in 47.4%. The procedures were performed laparoscopically for 88% and with an anastomosis for 83.8%. The severe complication rate on postoperative day 90 was 11.7%, with a risk of anastomotic leakage of 4.7%. The independent risk factors in multivariate analysis were an American Society of Anesthesiologists (ASA) score ≥ 3, an open approach, and perioperative blood transfusion. Age, perioperative blood transfusion, and Hartmann's procedure were the three independent risk factors for a permanent stoma. CONCLUSIONS This series provides a real-life picture of elective sigmoidectomy for SDD at a national level. TRIAL REGISTRATION Comité National Information et Liberté (CNIL) (n°920361).
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Affiliation(s)
- C Sabbagh
- Department of Digestive Surgery Service, Amiens University Hospital, Rond Point du Pr Cabrol, 80054, Amiens Cedex 01, France.
| | - L Beyer-Berjot
- Department of Digestive Surgery Assistance Publique Hôpitaux de Marseille, North University Hospital, Marseille, France
| | - M Ouaissi
- Department of Digestive, Oncological, Endocrine, Hepatobiliary and Liver Transplant, Trousseau Hospital, University Hospital of Tours, Tours, France
| | - P Zerbib
- Department of Digestive Surgery and Transplantation, Huriez Hospital, Universite Lille Nord de France, Lille, France
| | - V Bridoux
- Department of Digestive Surgery, University Hospital of Rouen, Rouen, France
| | - G Manceau
- Department of Surgery, European Georges Pompidou Hospital, AP-HP, Paris, France
| | - M Karoui
- Department of Surgery, European Georges Pompidou Hospital, AP-HP, Paris, France
| | - Y Panis
- Colorectal Surgery Center, Groupe Hospitalier Privé Ambroise Paré-Hartmann, Neuilly, France
| | - E Buscail
- Department of Surgery, CHU Toulouse-Rangueil and Toulouse University, Toulouse, France
| | - A Venara
- Department of Digestive Surgery, University Hospital of Angers, Angers, France
| | - I Khaoudy
- Department of Digestive Surgery, Le Havre Hospital, Le Havre, France
| | - M Gaillard
- Department of Digestive Surgery, Cochin Hospital, Paris, France
| | - P Ortega-Deballon
- Department of General Surgery, University Hospital of Bocage, Dijon, France
| | - M Viennet
- Department of General Surgery, University Hospital of Bocage, Dijon, France
| | - A Thobie
- Department of Digestive Surgery, Avranches-Granville Hospital, Avranches, France
| | - B Menahem
- Department of Digestive Surgery, University Hospital of Caen, Caen, France
| | - C Eveno
- Department of Digestive Surgery, University Hospital of Lille, Lille, France
| | - C Bonnel
- Department of Digestive Surgery, Nord-Essonne Hospital, Longjumeau, France
| | - J-Y Mabrut
- Department of Digestive Surgery and Transplantation, Croix Rousse University Hospital, Lyon, France
| | - B Badic
- Department of General and Digestive Surgery, University Hospital, Brest, France
| | - C Godet
- Department of Digestive Surgery, Memorial Hospital of Saint-Lô, Saint-Lô, France
| | - Y Eid
- Department of Digestive Surgery, Robert Bisson Hospital, Lisieux, France
| | - E Duchalais
- Department of Oncological, Digestive and Endocrine Surgery, University Hospital of Nantes, Nantes, France
| | - Z Lakkis
- Department of Digestive Surgical Oncology and Liver Transplantation, University Hospital of Besançon, Besançon, France
| | - E Cotte
- Department of Digestive Surgery, Hôpital Lyon Sud, Lyon, France
| | - A Laforest
- Department of Digestive Surgery, Montsouris Institut, Paris, France
| | - V Defourneaux
- Department of Digestive Surgery, CHU Rennes, Rennes, France
| | - L Maggiorri
- Department of Digestive Surgery, Hôpital Saint-Louis, Université Paris VII, APHP, Paris, France
| | - L Rebibo
- Department of Digestive, Oesogastric and Bariatric Surgery, Hôpital Bichat-Claude-Bernard, Paris, France
| | - N Christou
- Department of Digestive Surgery, Limoges Hospital, Limoges, France
| | - A Talal
- Department of Digestive Surgery, Argentan Hospital, Argentan, France
| | - D Mege
- Department of Digestive Surgery, Aix Marseille Univ, APHM, Timone University Hospital, Marseille, France
| | - C Bonnamy
- Department of Digestive Surgery, Bayeux Hospital, Bayeux, France
| | - A Germain
- Department of Digestive Surgery, CHRU Nancy, Nancy, France
| | - F Mauvais
- Department of Digestive Surgery, Beauvais Hospital, Beauvais, France
| | - C Tresallet
- Department of Digestive Surgical Oncology, Avicenne University Hospital, Paris, France
| | - O Ahmed
- Department of Digestive Surgical Oncology, Avicenne University Hospital, Paris, France
| | - J-M Regimbeau
- Department of Digestive Surgery Service, Amiens University Hospital, Rond Point du Pr Cabrol, 80054, Amiens Cedex 01, France
| | - J Roudie
- Department of Digestive Surgery, Martinique Hospital, Fort-de-France, France
| | - A Laurent
- Department of Digestive Surgery, Créteil Hospital, Créteil, France
| | - B Trilling
- Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, Grenoble, France
| | - M Bertrand
- Department of Digestive Surgery, Universitary Hospital of Nîmes, Nîmes, France
| | - D Massalou
- Department of Digestive Surgery, Hôpital L'Archet, Nice University, Nice, France
| | - B Romain
- Department of General and Digestive Surgery, Hautepierre Hospital, Strasbourg University Hospital, Strasbourg, France
| | - H Tranchart
- Department of Minimally Invasive Digestive Surgery, Antoine Beclere Hospital, AP-HP, Clamart, France
| | - U Giger
- ANTICIPE, Inserm Unity, UMR 1086, Caen, France
| | - O Dejardin
- ANTICIPE, Inserm Unity, UMR 1086, Caen, France
- Department of Clinical Research, University Hospital of Caen, Caen, France
| | - A Pellegrin
- Department of Digestive Surgery Service, Amiens University Hospital, Rond Point du Pr Cabrol, 80054, Amiens Cedex 01, France
| | - A Alves
- Department of Digestive Surgery, University Hospital of Caen, Caen, France
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Sabbagh C, Regimbeau JM. Ghost anastomosis: a new option for coloanal anastomosis. Tech Coloproctol 2024; 28:24. [PMID: 38200345 DOI: 10.1007/s10151-023-02902-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/12/2023] [Indexed: 01/12/2024]
Affiliation(s)
- C Sabbagh
- Department of Digestive Surgery, CHU d'Amiens Picardie, Amiens Cedex 01, France.
- Université de Picardie Jules Verne, Amiens, France.
| | - J M Regimbeau
- Department of Digestive Surgery, CHU d'Amiens Picardie, Amiens Cedex 01, France
- Université de Picardie Jules Verne, Amiens, France
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Mourad M, Kazour F, Sleilaty G, Bou Khalil R, El Hage W, Richa S, Sabbagh C. Positive and negative correlates of suicidal ideations and behaviors in the emergency department of a university hospital in Beirut: A cross-sectional comparative study. Encephale 2022; 49:248-253. [DOI: 10.1016/j.encep.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/04/2021] [Accepted: 11/23/2021] [Indexed: 11/26/2022]
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Zarzour M, Hachem C, Kerbage H, Richa S, Choueifaty DE, Saliba G, Haddad E, Melki E, Sleilaty G, Saliby R, Sabbagh C, Choucair J. Anxiety and sleep quality in a sample of Lebanese healthcare workers during the COVID-19 outbreak. Encephale 2021; 48:496-503. [PMID: 34728067 PMCID: PMC8457956 DOI: 10.1016/j.encep.2021.06.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/22/2021] [Accepted: 06/30/2021] [Indexed: 12/23/2022]
Abstract
A cross-sectional, survey based study was conducted in order to assess mental health outcomes among healthcare workers in a private university hospital involved in the COVID-19 response in Lebanon. The main objective was to quantify symptoms of anxiety and sleep quality using self-rating scales (the State-Trait Anxiety Inventory (STAI) and Pittsburgh Sleep Quality Index (PSQI) respectively), while identifying factors that might affect those symptoms. A total of 628 healthcare workers completed the survey; 409 (66.2%) were younger than 40 years, and 441 (71.4%) were women. Of all participants, 503 (81.4%) were nurses, 52 (8.4%) were physicians and 63 (10.2%) were residents. Registered nurses, residents, women, and younger participants presented higher scores on both scales than other categories of participants. Among factors related with COVID-19, those associated with higher scores were having relatives affected by the virus (22.2%), being excessively exposed to media (12.9%), and increasing the consumption of substances/alcohol (31.2%) during this period. Factors associated with higher risk of anxiety symptoms after multivariable logistic regression analysis were: female sex, young age, poor sleep quality, and living with elderly. Our findings contribute to the understanding of the psychological wellbeing of health care workers involved in the acute COVID-19 outbreak in Lebanon.
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Affiliation(s)
- M Zarzour
- Department of Psychiatry, Hôtel-Dieu de France Hospital, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon.
| | - C Hachem
- Department of Psychiatry, Hôtel-Dieu de France Hospital, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
| | - H Kerbage
- Department of Psychiatry, Hôtel-Dieu de France Hospital, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
| | - S Richa
- Department of Psychiatry, Hôtel-Dieu de France Hospital, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
| | - D El Choueifaty
- Department of Psychiatry, Hôtel-Dieu de France Hospital, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Nursing, Damas Rd, Beirut, 1104 2020, Lebanon
| | - G Saliba
- Department of Infectious Disease, Hôtel-Dieu de France, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
| | - E Haddad
- Department of Infectious Disease, Hôtel-Dieu de France, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
| | - E Melki
- Emergency Department, Hôtel-Dieu de France, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
| | - G Sleilaty
- Clinical Research Centre, Hôtel-Dieu de France, Alfred Naccache, Beirut, 1104 2020, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
| | - R Saliby
- Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
| | - C Sabbagh
- Emergency Department, Hôtel-Dieu de France, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
| | - J Choucair
- Department of Infectious Disease, Hôtel-Dieu de France, Alfred Naccache, Beirut, 166830, Lebanon; Saint Joseph University, Faculty of Medicine, Damas Rd, Beirut, 1104 2020, Lebanon
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Collard MK, Christou N, Lakkis Z, Mege D, Bridoux V, Millet I, Sabbagh C, Loriau J, Lefevre JH, Ronot M, Maggiori L. Adult appendicitis: Clinical practice guidelines from the French Society of Digestive Surgery and the Society of Abdominal and Digestive Imaging. J Visc Surg 2021; 158:242-252. [PMID: 33419677 DOI: 10.1016/j.jviscsurg.2020.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The French Society of Digestive Surgery (SFCD) and the Society of Abdominal and Digestive Imaging (SIAD) have collaborated to propose recommendations for clinical practice in the management of adult appendicitis. METHODS An analysis of the literature was carried out according to the methodology of the French National Authority for Health (HAS). A selection was performed from collected references and then a manual review of the references listed in the selected articles was made in search of additional relevant articles. The research was limited to articles whose language of publication was English or French. Articles focusing on the pediatric population were excluded. Based on the literature review, the working group proposed recommendations whenever possible. These recommendations were reviewed and approved by a committee of experts. RESULTS Recommendations about appendicitis in adult patients were proposed with regard to clinical, laboratory and radiological diagnostic modalities, treatment strategy for uncomplicated and complicated appendicitis, surgical technique, and specificities in the case of macroscopically healthy appendix, terminal ileitis and appendicitis in the elderly and in pregnant women. CONCLUSION These recommendations for clinical practice may be useful to the surgeon in optimizing the management of acute appendicitis in adults.
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Affiliation(s)
- M K Collard
- Department of digestive surgery, Sorbonne université, Saint-Antoine hospital, AP-HP, Paris, France
| | - N Christou
- Department of digestive, general and endocrine surgery, CHU Dupuytren, Limoges, France
| | - Z Lakkis
- Department of visceral, digestive and oncological surgery, CHU Besançon, Besançon, France
| | - D Mege
- Department of digestive and general surgery, Timone hospital, Marseille, France
| | - V Bridoux
- Department of digestive surgery, Charles-Nicolle hospital, Rouen, France
| | - I Millet
- Radiology department, Lapeyronie hospital, Montpellier, France
| | - C Sabbagh
- Department of digestive surgery, CHU Amiens-Picardie, Amiens, France
| | - J Loriau
- Department of digestive surgery, Saint-Joseph hospital, Paris, France
| | - J H Lefevre
- Department of digestive surgery, Sorbonne université, Saint-Antoine hospital, AP-HP, Paris, France
| | - M Ronot
- Radiology department, Beaujon hospital, Clichy-la-Garenne, France
| | - L Maggiori
- Department of digestive, oncologic and endocrine surgery, Saint-Louis Hospital, Assistance Publique-Hopitaux de Paris (AP-HP), Université de Paris, Paris, France.
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Brac B, Sabbagh C, Regimbeau JM. Strategy and technique for colostomy reversal by laparoscopy after left colectomy with end colostomy (Hartmann procedure). J Visc Surg 2021; 158:506-512. [PMID: 34059482 DOI: 10.1016/j.jviscsurg.2020.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- B Brac
- Service de chirurgie digestive, centre hospitalier universitaire Amiens-Picardie, avenue René-Laënnec-Salouël, 80054 Amiens cedex 1, France; Université de Picardie-Jules-Verne, Picardie, Amiens, France
| | - C Sabbagh
- Service de chirurgie digestive, centre hospitalier universitaire Amiens-Picardie, avenue René-Laënnec-Salouël, 80054 Amiens cedex 1, France; Université de Picardie-Jules-Verne, Picardie, Amiens, France; Unité de Recherche UPJV 7518 SSPC "Simplification des Soins des Patients Complexes", Université de Picardie-Jules-Verne, Amiens, France
| | - J M Regimbeau
- Service de chirurgie digestive, centre hospitalier universitaire Amiens-Picardie, avenue René-Laënnec-Salouël, 80054 Amiens cedex 1, France; Université de Picardie-Jules-Verne, Picardie, Amiens, France; Unité de Recherche UPJV 7518 SSPC "Simplification des Soins des Patients Complexes", Université de Picardie-Jules-Verne, Amiens, France.
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Denost Q, Rouanet P, Faucheron JL, Panis Y, Meunier B, Cotte E, Meurette G, Portier G, Sabbagh C, Loriau J, Benoist S, Piessen G, Sielezneff I, Lelong B, Mauvais F, Romain B, Barussaud ML, Capdepont M, Laurent C, Rullier E. Impact of early biochemical diagnosis of anastomotic leakage after rectal cancer surgery: long-term results from GRECCAR 5 trial. Br J Surg 2021; 108:605-608. [PMID: 33793764 DOI: 10.1093/bjs/znab003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 12/28/2020] [Indexed: 12/12/2022]
Abstract
Elevated C-reactive protein, should be used to prompt early detection of AL prior to the development of clinical symptoms. Early biochemical diagnosis and intervention of AL mitigates the negative impact of AL on oncological outcomes in patients with rectal cancer.
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Affiliation(s)
- Q Denost
- Département de Chirurgie Colorectal, Hôpital Haut-Lévèque, CHU Bordeaux, Pessac, France
| | - P Rouanet
- Département de Chirurgie Oncologique, ICM Val d'Aurelle, Montpellier, France
| | - J-L Faucheron
- Service de Chirurgie Digestive, Hôpital A. Michallon, La Tronche, France
| | - Y Panis
- Service de Chirurgie Digestive, Hôpital Beaujon, AP-HP, Clichy, France
| | - B Meunier
- Service de Chirurgie Viscérale, CHU Pontchaillou, Rennes, France
| | - E Cotte
- Service de Chirurgie Digestive, Hôpital Lyon Sud, CHU Lyon, Pierre-Bénite, France
| | - G Meurette
- Service de Chirurgie Digestive, Site Hôtel Dieu, Nantes, France
| | - G Portier
- Service de Chirurgie Digestive, Hôpital Purpan, Toulouse, France
| | - C Sabbagh
- Service de Chirurgie Digestive et Métabolique, CHU d'Amiens, Amiens, France
| | - J Loriau
- Service de Chirurgie Digestive et Obésité, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - S Benoist
- Service de Chirurgie Générale et Digestive, Hôpital Bicêtre, AP-HP, Le Kremlin-Bicêtre, France
| | - G Piessen
- Service de Chirurgie Digestive, Hôpital Claude Huriez, CHU Lille, Lille, France
| | - I Sielezneff
- Service de Chirurgie Digestive et Viscérale, CHU Timone, Marseille, France
| | - B Lelong
- Service de Chirurgie Digestive, Institut Paoli Calmette Institut Paoli Calmette, Marseille, France
| | - F Mauvais
- Service de Chirurgie Viscérale, CH de Beauvais, Beauvais, France
| | - B Romain
- Service de Chirurgie Générale et Digestive, Hôpital Universitaire de Hautepierre, Strasbourg, France
| | - M-L Barussaud
- Service de Chirurgie Digestive, CHU de Poitiers, Poitiers, France
| | - M Capdepont
- Département de Chirurgie Colorectal, Hôpital Haut-Lévèque, CHU Bordeaux, Pessac, France
| | - C Laurent
- Département de Chirurgie Colorectal, Hôpital Haut-Lévèque, CHU Bordeaux, Pessac, France
| | - E Rullier
- Département de Chirurgie Colorectal, Hôpital Haut-Lévèque, CHU Bordeaux, Pessac, France
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Sabbagh C, Regimbeau JM. Re: "Cecal distension on non-tumoral left colonic obstacle: Management strategy in two cases". J Visc Surg 2020; 157:537-538. [PMID: 33289650 DOI: 10.1016/j.jviscsurg.2020.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- C Sabbagh
- Department of visceral surgery, CHU Amiens-Picardie, Rond point du Pr Cabrol, 80054 Amiens cedex, France; UR UPJV 7518 SSPC (simplifying the care of complex surgical patients), Picardie Jules Verne University, 80054 Amiens cedex, France; Picardie Jules Verne University, 80054 Amiens cedex, France
| | - J M Regimbeau
- Department of visceral surgery, CHU Amiens-Picardie, Rond point du Pr Cabrol, 80054 Amiens cedex, France; UR UPJV 7518 SSPC (simplifying the care of complex surgical patients), Picardie Jules Verne University, 80054 Amiens cedex, France; Picardie Jules Verne University, 80054 Amiens cedex, France.
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Manceau G, Sabbagh C, Mege D, Lakkis Z, Bege T, Tuech JJ, Benoist S, Lefèvre JH, Karoui M, Bridoux V, Venara A, Beyer‐Berjot L, Codjia T, Dazza M, Gagnat G, Hamel S, Mallet L, Martre P, Philouze G, Roussel E, Tortajada P, Dumaine AS, Heyd B, Paquette B, Brunetti F, Esposito F, Lizzi V, Michot N, Denost Q, Rullier E, Tresallet C, Tetard O, Rivier P, Fayssal E, Collard M, Moszkowicz D, Lupinacci R, Peschaud F, Etienne JC, Loge L, Bege T, Corte H, D’Annunzio E, Humeau M, Issard J, Munoz N, Abba J, Jafar Y, Lacaze L, Sage PY, Susoko L, Trilling B, Arvieux C, Mauvais F, Ulloa‐Severino B, Pitel S, Vauchaussade de Chaumont A, Badic B, Blanc B, Bert M, Rat P, Ortega‐Deballon P, Chau A, Dejeante C, Piessen G, Grégoire E, Alfarai A, Cabau M, David A, Kadoche D, Dufour F, Goin G, Goudard Y, Pauleau G, Sockeel P, Villeon B, Pautrat K, Eveno C, Abdalla S, Couchard AC, Balbo G, Mabrut JY, Bellinger J, Bertrand M, Aumont A, Duchalais E, Messière AS, Tranchart A, Cazauran JB, Pichot‐Delahaye V, Dubuisson V, Maggiori L, Panis Y, Djawad‐Boumediene B, Fuks D, Kahn X, Huart E, Catheline JM, Lailler G, Baraket O, Baque P, Diaz de Cerio JM, Mariol P, Maes B, Fernoux P, Guillem P, Chatelain E, de Saint Roman C, Fixot K, Voron T, Parc Y. Colon sparing resection versus extended colectomy for left-sided obstructing colon cancer with caecal ischaemia or perforation: a nationwide study from the French Surgical Association. Colorectal Dis 2020; 22:1304-1313. [PMID: 32368856 DOI: 10.1111/codi.15111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/02/2020] [Indexed: 02/08/2023]
Abstract
AIM It is not known whether patients with obstructive left colon cancer (OLCC) with caecal ischaemia or diastatic perforation (defined as a blowout of the caecal wall related to colonic overdistension) should undergo a (sub)total colectomy (STC) or an ileo-caecal resection with double-barrelled ileo-colostomy. We aimed to compare the results of these two strategies. METHOD From 2000 to 2015, 1220 patients with OLCC underwent surgery by clinicians who were members of the French Surgical Association. Of these cases, 201 (16%) were found to have caecal ischaemia or diastatic perforation intra-operatively: 174 patients (87%) underwent a STC (extended colectomy group) and 27 (13%) an ileo-caecal resection with double-end stoma (colon-sparing group). Outcomes were compared retrospectively. RESULTS In the extended colectomy group, 95 patients (55%) had primary anastomosis and 79 (45%) had a STC with an end ileostomy. In the colon-sparing group, 10 patients (37%) had simultaneous resection of their primary tumour with segmental colectomy and an anastomosis which was protected by a double-barrelled ileo-colostomy. The demographic data for the two groups were comparable. Median operative time was longer in the STC group (P = 0.0044). There was a decrease in postoperative mortality (7% vs 12%, P = 0.75) and overall morbidity (56% vs 67%, P = 0.37) including surgical (30% vs 40%, P = 0.29) and severe complications (17% vs 27%, P = 0.29) in the colon-sparing group, although these differences did not reach statistical significance. Cumulative morbidity included all surgical stages and the rate of permanent stoma was 66% and 37%, respectively, with no significant difference between the two groups. Overall survival and disease-free survival were similar between the two groups. CONCLUSION The colon-sparing strategy may represent a valid and safe alternative to STC in OLCC patients with caecal ischaemia or diastatic perforation.
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Affiliation(s)
- G Manceau
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Pitié Salpêtrière University Hospital, Sorbonne Université, Paris, France
| | - C Sabbagh
- Department of Digestive Surgery, Amiens University Hospital, Amiens, France
| | - D Mege
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Marseille, Timone University Hospital, Marseille, France
| | - Z Lakkis
- Department of Digestive Surgery, Besançon University Hospital, Besançon, France
| | - T Bege
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Marseille, North University Hospital, Marseille, France
| | - J J Tuech
- Department of Digestive Surgery, Charles Nicolle University Hospital, Rouen, France
| | - S Benoist
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Bicêtre University Hospital, Université Paris-Sud, Le Kremlin Bicêtre, France
| | - J H Lefèvre
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Saint-Antoine University Hospital, Sorbonne Université, Paris, France
| | - M Karoui
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Pitié Salpêtrière University Hospital, Sorbonne Université, Paris, France
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Allart K, Sabbagh C, Regimbeau JM. Intraperitoneal catheter introduction for pre-operative progressive pneumoperitoneum for abdominal hernia with loss of domain (Goni-Moreno technique). J Visc Surg 2020; 157:335-340. [PMID: 32741730 DOI: 10.1016/j.jviscsurg.2020.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- K Allart
- Digestive surgery department, CHU Amiens Picardie, avenue René-Laennec, 80054 Amiens cedex 01, France; University of Picardie Jules-Vernes, 1, chemin du Thil, 80000 Amiens cedex 01, France; Simplifications des soins des patients chirurgicaux complexes (SSPC), Research Clinic Unit, Amiens, France
| | - C Sabbagh
- Digestive surgery department, CHU Amiens Picardie, avenue René-Laennec, 80054 Amiens cedex 01, France; University of Picardie Jules-Vernes, 1, chemin du Thil, 80000 Amiens cedex 01, France; Simplifications des soins des patients chirurgicaux complexes (SSPC), Research Clinic Unit, Amiens, France
| | - J-M Regimbeau
- Digestive surgery department, CHU Amiens Picardie, avenue René-Laennec, 80054 Amiens cedex 01, France; University of Picardie Jules-Vernes, 1, chemin du Thil, 80000 Amiens cedex 01, France; Simplifications des soins des patients chirurgicaux complexes (SSPC), Research Clinic Unit, Amiens, France.
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Sabbagh C, Siembida N, Dupont H, Diouf M, Schmit JL, Boddaert S, Regimbeau JM. The value of post-operative antibiotic therapy after laparoscopic appendectomy for complicated acute appendicitis: a prospective, randomized, double-blinded, placebo-controlled phase III study (ABAP study). Trials 2020; 21:451. [PMID: 32487213 PMCID: PMC7268648 DOI: 10.1186/s13063-020-04411-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 05/14/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Approximately 30% of appendectomies are for complicated acute appendicitis (CAA). With laparoscopy, the main post-operative complication is deep abscesses (12% of cases of CAA, versus 4% for open surgery). A recent cohort study compared short and long courses of postoperative antibiotic therapy in patients with CAA. There was no significant intergroup difference in the post-operative complication rate (12% of organ/space surgical site infection (SSI)). Moreover, antibiotic therapy is increasingly less indicated for other situations (non-complicated appendicitis, post-operative course of cholecystitis, perianal abscess), calling into question whether post-operative antibiotic therapy is required after laparoscopic appendectomy for CAA. METHODS/DESIGN This study is a prospective, multicenter, parallel-group, randomized (1:1), double-blinded, placebo-controlled, phase III non-inferiority study with blind evaluation of the primary efficacy criterion. The primary objective is to evaluate the impact of the absence of post-operative antibiotic therapy on the organ/space surgical site infection (SSI) rate in patients presenting with CAA (other than in cases of generalized peritonitis). Patients in the experimental group will receive at least one dose of preoperative and perioperative antibiotic therapy (2 g ceftriaxone by intravenous injection every 24 h up to the operation) and metronidazole (500 mg by intravenous injection every 8 h up to the operation) and, in the post-operative period, a placebo for ceftriaxone (2 g/24 h in one intravenous injection) and a placebo for metronidazole (1500 mg/24 h in three intravenous injections, for 3 days). In the control group, patients will receive at least one dose of preoperative and perioperative antibiotic therapy (2 g ceftriaxone by intravenous injection every 24 h up to the operation) and metronidazole (500 mg by intravenous injection every 8 h up to the operation) and, in the post-operative period, antibiotic therapy (ceftriaxone 2 g/24 h and metronidazole 1500 mg/24 h for 3 days). In the event of allergy to ceftriaxone, it will be replaced by levofloxacin (500 mg/24 h in one intravenous injection, for 3 days). The expected organ space SSI rate is 12% in the population of patients with CAA operated on by laparoscopy. With a non-inferiority margin of 5%, a two-sided alpha risk of 5%, a beta risk of 20%, and a loss-to-follow-up rate of 10%, the calculated sample size is 1476 included patients, i.e., 738 per group. Due to three interim analyses at 10%, 25%, and 50% of the planned sample size, the total sample size increases to 1494 patients (747 per arm). TRIAL REGISTRATION Ethical authorization by the Comité de Protection des Personnes and the Agence Nationale de Sécurité du Médicament: ID-RCB 2017-00334-59. Registered on ClinicalTrials.gov (NCT03688295) on 28 September 2018.
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Affiliation(s)
- C Sabbagh
- Department of Digestive Surgery, Amiens University Hospital, Amiens University Medical Center, Avenue Laennec, F-80054, Amiens cedex 01, France.,Jules Verne University of Picardie, Amiens, France.,SSPC (Simplifications des Soins Patients Chirurgicaux Complexes) Research Unit, University of Picardie Jules Verne, Amiens, France
| | - N Siembida
- Department of Digestive Surgery, Amiens University Hospital, Amiens University Medical Center, Avenue Laennec, F-80054, Amiens cedex 01, France.,SSPC (Simplifications des Soins Patients Chirurgicaux Complexes) Research Unit, University of Picardie Jules Verne, Amiens, France
| | - H Dupont
- Jules Verne University of Picardie, Amiens, France.,SSPC (Simplifications des Soins Patients Chirurgicaux Complexes) Research Unit, University of Picardie Jules Verne, Amiens, France.,Intensive Care Unit, Amiens University Medical Center, Amiens, France
| | - M Diouf
- Department of Methodology, Biostatistics, Direction of Clinical Research, Amiens University Medical Center, Amiens, France
| | - J L Schmit
- Jules Verne University of Picardie, Amiens, France.,Department of Infectious Diseases, Amiens University Medical Center, Amiens, France
| | - S Boddaert
- Department of Pharmacology, Amiens University Medical Center, Amiens, France
| | - J M Regimbeau
- Department of Digestive Surgery, Amiens University Hospital, Amiens University Medical Center, Avenue Laennec, F-80054, Amiens cedex 01, France. .,Jules Verne University of Picardie, Amiens, France. .,SSPC (Simplifications des Soins Patients Chirurgicaux Complexes) Research Unit, University of Picardie Jules Verne, Amiens, France.
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Collard M, Lakkis Z, Loriau J, Mege D, Sabbagh C, Lefevre JH, Maggiori L. [Antibiotics alone as an alternative to appendectomy for uncomplicated acute appendicitis in adults: Changes in treatment modalities related to the COVID-19 health crisis]. ACTA ACUST UNITED AC 2020; 157:S33-S43. [PMID: 32355509 PMCID: PMC7190476 DOI: 10.1016/j.jchirv.2020.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
La saturation intrahospitalière liée à l’arrivée massive de patients atteints du COVID-19 nécessitant une prise en charge urgente conduit à reconsidérer la prise en charge des autres patients. Différer au maximum les hospitalisations et les opérations chirurgicales non urgentes est un des objectifs des chirurgiens afin de désengorger autant que possible le système de soins. Alors que la majorité des opérations programmées sont annulées, la réduction de la chirurgie d’urgence est évidemment compliquée à proposer sans altérer la qualité de la prise en charge et conduire à une perte de chance pour le patient. Cependant, l’appendicite aiguë constitue une situation spécifique bien particulière et la fréquence de cette pathologie conduit à considérer ce cas particulier. En effet, tandis que le traitement recommandé de l’appendicite aiguë non compliquée est chirurgical, l’alternative non chirurgicale par antibiothérapie seule a été largement évaluée dans la littérature au cours de travaux de qualité. Dans la mesure où la limite principale du traitement médical exclusif de l’appendicite aiguë non compliquée est le risque de récidive à distance, cette option thérapeutique représente une alternative de choix pour réduire la surcharge intrahospitalière dans ce contexte de crise sanitaire. L’objectif de ce travail est donc de mettre à disposition des médecins et des chirurgiens un guide pratique issu d’une analyse de la littérature sur le traitement médical de l’appendicite aiguë non compliquée de l’adulte afin de pouvoir proposer ce traitement alternatif aux bons patients et dans des bonnes conditions, notamment lorsque l’accès au bloc opératoire est impossible.
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Affiliation(s)
- M Collard
- Service de chirurgie digestive, Sorbonne université, hôpital Saint-Antoine, AP-HP, 75012, Paris, France
| | - Z Lakkis
- Service de chirurgie digestive et oncologique , et de transplantation hépatique, CHU de Besançon, 2, boulevard Alexander-Fleming, 25000, Besançon, France
| | - J Loriau
- Service de chirurgie viscérale, groupe hospitalier Paris Saint-Joseph, 75014, Paris, France
| | - D Mege
- Service de chirurgie digestive, assistance publique hôpitaux de Marseille, hôpital de la Timone, CHU de Marseille, France
| | - C Sabbagh
- Service de chirurgie digestive, CHU Amiens-Picardie, 8000 Amiens, France.,Unité de recherche SSPC (simplification des soins des patients chirurgicaux complexes), université de Picardie Jules-Verne, 80025 Amiens, France
| | - J H Lefevre
- Service de chirurgie digestive, Sorbonne université, hôpital Saint-Antoine, AP-HP, 75012, Paris, France
| | - L Maggiori
- Service de chirurgie colorectale, hôpital Beaujon, université de Paris, AP-HP, 92110 Clichy, France
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Collard M, Lakkis Z, Loriau J, Mege D, Sabbagh C, Lefevre JH, Maggiori L. Antibiotics alone as an alternative to appendectomy for uncomplicated acute appendicitis in adults: Changes in treatment modalities related to the COVID-19 health crisis. J Visc Surg 2020; 157:S33-S42. [PMID: 32362368 PMCID: PMC7181971 DOI: 10.1016/j.jviscsurg.2020.04.014] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The massive inflow of patients with COVID-19 requiring urgent care has overloaded hospitals in France and impacts the management of other patients. Deferring hospitalization and non-urgent surgeries has become a priority for surgeons today in order to relieve the health care system. It is obviously not simple to reduce emergency surgery without altering the quality of care or leading to a loss of chance for the patient. Acute appendicitis is a very specific situation and the prevalence of this disease leads us to reconsider this particular disease in the context of the COVID-19 crisis. Indeed, while the currently recommended treatment for uncomplicated acute appendicitis is surgical appendectomy, the non-surgical alternative of medical management by antibiotic therapy alone has been widely evaluated by high-quality studies in the literature. Insofar as the main limitation of exclusively medical treatment of uncomplicated acute appendicitis is the risk of recurrent appendicitis, this treatment option represents an alternative of choice to reduce the intra-hospital overload in this context of health crisis. The aim of this work is therefore to provide physicians and surgeons with a practical guide based on a review of the literature on the medical treatment of uncomplicated acute appendicitis in adults, to offer this alternative treatment to the right patients and under good conditions, especially when access to the operating room is limited or impossible.
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Affiliation(s)
- M Collard
- Digestive Surgery Department, Sorbonne University, Saint-Antoine Hospital, AP-HP, 75012 Paris, France
| | - Z Lakkis
- Department of Digestive Surgical Oncology, Liver Transplantation Unit, University Hospital of Besançon, 2, boulevard Alexander Fleming, 25000, Besançon, France
| | - J Loriau
- Department of Visceral Surgery, Groupe Hospitalier Paris Saint Joseph, 75014, Paris, France
| | - D Mege
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Marseille, Timone University Hospital, Marseille, France
| | - C Sabbagh
- Digestive surgery department, CHU Amiens-Picardie, 80000 Amiens, France; Research Unit SSPC (simplification des soins des patients chirurgicaux complexes), université de Picardie Jules Verne, 80025 Amiens, France
| | - J H Lefevre
- Digestive Surgery Department, Sorbonne University, Saint-Antoine Hospital, AP-HP, 75012 Paris, France
| | - L Maggiori
- Department of Colorectal surgery, Beaujon Hospital, Paris University, AP-HP, 92110, Clichy, France.
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Manceau G, Mege D, Bridoux V, Lakkis Z, Venara A, Voron T, De Angelis N, Ouaissi M, Sielezneff I, Karoui M, Dazza M, Gagnat G, Hamel S, Mallet L, Martre P, Philouze G, Roussel E, Tortajada P, Dumaine AS, Heyd B, Paquette B, Brunetti F, Esposito F, Lizzi V, Michot N, Denost Q, Tresallet C, Tetard O, Regimbeau JM, Sabbagh C, Rivier P, Fayssal E, Collard M, Moszkowicz D, Peschaud F, Etienne JC, loge L, Beyer L, Bege T, Corte H, D'Annunzio E, Humeau M, Issard J, Munoz N, Abba J, Jafar Y, Lacaze L, Sage PY, Susoko L, Trilling B, Arvieux C, Mauvais F, Ulloa‐Severino B, Lefevre JH, Pitel S, Vauchaussade de Chaumont A, Badic B, Blanc B, Bert M, Rat P, Ortega‐Deballon P, Chau A, Dejeante C, Piessen G, Grégoire E, Alfarai A, Cabau M, David A, Kadoche D, Dufour F, Goin G, Goudard Y, Pauleau G, Sockeel P, De la Villeon B, Pautrat K, Eveno C, Brouquet A, Couchard AC, Balbo G, Mabrut JY, Bellinger J, Bertrand M, Aumont A, Duchalais E, Messière AS, Tranchart A, Cazauran JB, Pichot‐Delahaye V, Dubuisson V, Maggiori L, Djawad‐Boumediene B, Fuks D, Kahn X, Huart E, Catheline JM, Lailler G, Baraket O, Baque P, Diaz de Cerio JM, Mariol P, Maes B, Fernoux P, Guillem P, Chatelain E, de Saint Roman C, Fixot K. Thirty-day mortality after emergency surgery for obstructing colon cancer: survey and dedicated score from the French Surgical Association. Colorectal Dis 2019; 21:782-790. [PMID: 30884089 DOI: 10.1111/codi.14614] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 02/27/2019] [Indexed: 02/08/2023]
Abstract
AIM The aim was to define risk factors for postoperative mortality in patients undergoing emergency surgery for obstructing colon cancer (OCC) and to propose a dedicated score. METHOD From 2000 to 2015, 2325 patients were treated for OCC in French surgical centres by members of the French National Surgical Association. A multivariate analysis was performed for variables with P value ≤ 0.20 in the univariate analysis for 30-day mortality. Predictive performance was assessed by the area under the receiver operating characteristic curve. RESULTS A total of 1983 patients were included. Thirty-day postoperative mortality was 7%. Multivariate analysis found five significant independent risk factors: age ≥ 75 (P = 0.013), American Society of Anesthesiologists (ASA) score ≥ III (P = 0.027), pulmonary comorbidity (P = 0.0002), right-sided cancer (P = 0.047) and haemodynamic failure (P < 0.0001). The odds ratio for risk of postoperative death was 3.42 with one factor, 5.80 with two factors, 15.73 with three factors, 29.23 with four factors and 77.25 with five factors. The discriminating capacity in predicting 30-day postoperative mortality was 0.80. CONCLUSION Thirty-day postoperative mortality after emergency surgery for OCC is correlated with age, ASA score, pulmonary comorbidity, site of tumour and haemodynamic failure, with a specific score ranging from 0 to 5.
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Affiliation(s)
- G Manceau
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - D Mege
- Department of Digestive Surgery, Timone University Hospital, Marseille, France
| | - V Bridoux
- Department of Digestive Surgery, Charles Nicolle University Hospital, Rouen, France
| | - Z Lakkis
- Department of Digestive Surgery, Besançon University Hospital, Besançon, France
| | - A Venara
- Department of Digestive Surgery, Angers University Hospital, Angers, France
| | - T Voron
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Saint Antoine Hospital, Sorbonne Université, Paris, France
| | - N De Angelis
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Henri Mondor Hospital, Université Paris-Est (UEP), Créteil, France
| | - M Ouaissi
- Department of Digestive Surgery, Tours University Hospital, Tours, France
| | - I Sielezneff
- Department of Digestive Surgery, Timone University Hospital, Marseille, France
| | - M Karoui
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière Hospital, Sorbonne Université, Paris, France
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Mege D, Manceau G, Bridoux V, Voron T, Sabbagh C, Lakkis Z, Venara A, Ouaissi M, Denost Q, Kepenekian V, Sielezneff I, Karoui M. Surgical management of obstructive left colon cancer at a national level: Results of a multicentre study of the French Surgical Association in 1500 patients. J Visc Surg 2019; 156:197-208. [DOI: 10.1016/j.jviscsurg.2018.11.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Abstract
Pseudomyxoma peritonei is a rare tumor characterized by the presence of mucous disseminated throughout the peritoneal cavity generally arising from the rupture of an appendicular mucocele. Liver scalloping is a highly suggestive image of pseudomyxoma and corresponds to the indentation of the liver compressed by the gelatinous mucin.
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Affiliation(s)
- K Allart
- Service de chirurgie digestive, centre hospitalier universtaire Amiens, avenue René-Laennec, 80054 Amiens cedex 01, France; Université Picardie-Jules-Verne, 1, chemin du Thil, 80000 Amiens cedex 01, France
| | - C Sabbagh
- Service de chirurgie digestive, centre hospitalier universtaire Amiens, avenue René-Laennec, 80054 Amiens cedex 01, France; Université Picardie-Jules-Verne, 1, chemin du Thil, 80000 Amiens cedex 01, France
| | - J-M Regimbeau
- Service de chirurgie digestive, centre hospitalier universtaire Amiens, avenue René-Laennec, 80054 Amiens cedex 01, France; Université Picardie-Jules-Verne, 1, chemin du Thil, 80000 Amiens cedex 01, France; Simplifications des soins patients chirurgicaux complexes, or Simplication of care of complex surgical patients (SSPC), unité de recherché clinique, université Picardie-Jules-Vernes, 80000 Amiens, France.
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Ammar-Khodja N, Sabbagh C, Regimbeau JM. Laparoscopic right colectomy for adenocarcinoma (with video). J Visc Surg 2018; 155:505-506. [PMID: 30429102 DOI: 10.1016/j.jviscsurg.2018.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- N Ammar-Khodja
- Service de chirurgie digestive, CHU Amiens Picardie, Avenue René Laënnec-Salouël, 80054 Amiens, France; Unité de recherche SSPC (simplification des soins des patients chirurgicaux complexes), Université de Picardie Jules Verne, Amiens, France
| | - C Sabbagh
- Service de chirurgie digestive, CHU Amiens Picardie, Avenue René Laënnec-Salouël, 80054 Amiens, France; Unité de recherche SSPC (simplification des soins des patients chirurgicaux complexes), Université de Picardie Jules Verne, Amiens, France
| | - J-M Regimbeau
- Service de chirurgie digestive, CHU Amiens Picardie, Avenue René Laënnec-Salouël, 80054 Amiens, France; Unité de recherche SSPC (simplification des soins des patients chirurgicaux complexes), Université de Picardie Jules Verne, Amiens, France.
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Sabbagh C, Siembida N, Yzet T, Robert B, Chivot C, Browet F, Mauvais F, Regimbeau JM. What are the predictive factors of caecal perforation in patients with obstructing distal colon cancer? Colorectal Dis 2018; 20:688-695. [PMID: 29495118 DOI: 10.1111/codi.14056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 02/05/2018] [Indexed: 02/08/2023]
Abstract
AIM In the presence of large bowel obstruction, the choice of treatment is determined by the patient's general status, the tumour characteristics and the perceived risk of caecal perforation. This study was designed to evaluate the predictive factors of impending caecal perforation, and also investigated the use of caecal volumetry. METHOD From January 2011 to June 2016, patients with obstructive distal colon cancer undergoing emergency laparotomy, for whom a pretreatment CT scan was available, were included in this retrospective, case-control, two-centre study. Two patient groups were defined: patients with and without impending caecal perforation. The primary end-point of the study was a determination of predictive factors for caecal perforation. RESULTS A total of 72 patients (45 men, 62.5%) were included. Univariate analysis revealed that the presence of pericaecal fluid (P < 0.0001), caecal pneumatosis (P < 0.0001), mean maximum caecal diameter (P = 0.001), mean caecal diameter at the ileocaecal junction (P = 0.0001) and mean caecal volume (P = 0.001) were associated with caecal perforation. Receiver operating characteristic curve analysis revealed that a caecal volume greater than 400 cm3 (P < 0.0001), a maximum caecal diameter > 9 cm (P = 0.002) and a caecal diameter at the ileocaecal junction > 7.5 cm (P = 0.001) were associated with impending caecal perforation. In multivariate analysis, only caecal volume > 400 cm3 (P = 0.001) was correlated with the risk of impending caecal perforation. CONCLUSION Caecal volumetry is an easy and useful tool to predict impending caecal perforation in patients with large bowel obstruction.
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Affiliation(s)
- C Sabbagh
- Department of Digestive Surgery, Amiens University Medical Center, Amiens, France.,Jules Verne University of Picardie, Amiens, France
| | - N Siembida
- Department of Digestive Surgery, Amiens University Medical Center, Amiens, France
| | - T Yzet
- Department of Radiology, Amiens University Medical Center, Amiens, France
| | - B Robert
- Department of Radiology, Amiens University Medical Center, Amiens, France
| | - C Chivot
- Department of Radiology, Amiens University Medical Center, Amiens, France
| | - F Browet
- Department of Digestive Surgery, Department of Digestive Surgery, Amiens, France
| | - F Mauvais
- Department of Digestive Surgery, Department of Digestive Surgery, Amiens, France
| | - J M Regimbeau
- Department of Digestive Surgery, Amiens University Medical Center, Amiens, France.,Jules Verne University of Picardie, Amiens, France
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Mariage M, Sabbagh C, Yzet T, Dupont H, NTouba A, Regimbeau JM. Distinguishing fecal appendicular peritonitis from purulent appendicular peritonitis. Am J Emerg Med 2018; 36:2232-2235. [PMID: 29779677 DOI: 10.1016/j.ajem.2018.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 04/06/2018] [Accepted: 04/06/2018] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Fecal appendicular peritonitis (FAP) is a poorly studied, rare form of acute appendicitis, corresponding to peritoneal inflammation with the presence of feces secondary to ruptured appendix. The purpose of this study was to describe FAP and to compare FAP with purulent appendicular peritonitis (PAP). PATIENTS AND METHODS This single-center, retrospective study was conducted in consecutive patients to compare the FAP group and the PAP group. The primary endpoint was the 30-day postoperative morbidity and mortality according to the Clavien-Dindo classification. The secondary endpoints were description and comparison of intraoperative data (laparoscopy rate, conversion rate, type of procedure and the mean operating time), and short-term outcomes (types of complications, length of stay, readmission rate, and reoperation rate), comparison of intraoperative bacteriological samples of FAP and PAP as well as the rate of resistance to amoxicillin and clavulanic acid, used as routine postoperative antibiotic therapy. RESULTS Between January 2006 and January 2016, 2.2% of appendectomies were performed for FAP. Patients of the FAP group reported a longer history of pain than patients of the PAP group (mean: 58 h [range: 24-120] vs 24 h [range: 6-504], p = 0.0001) and hyperthermia was more frequent in the FAP group than in the PAP group (72% vs 26%, p = 0.0001). Mean preoperative CRP was also higher in the FAP group than in the PAP group (110 mg/L [range: 67-468] vs 37.5 mg/L [range: 3.1-560], p = 0.007). Significantly less patients were operated by laparoscopy in the FAP group (89.7% vs 96.6%, p < 0.0001). Mean length of stay was significantly longer in the FAP group than in the PAP group (10 days [range: 3-24] vs 5 days [range: 1-32], p = 0.001). The overall 30-day complication rate was significantly higher in the FAP group than in the PAP group (62.1% vs 24.7%, p = 0.0005). The readmission rate was not significantly different between the two groups (14% vs 11.2%, p = 0.2), but the reoperation rate was higher in the FAP group than in the PAP group (31% vs 11%, p = 0.01). No significant difference was observed between the FAP and PAP groups in terms of the positive culture rate (75.9% vs 65.6%, p = 0.3). No significant difference was observed between the two groups in terms of resistance to amoxicillin and clavulanic acid (18.2% vs 20.5%, p = 0.8). CONCLUSION FAP is associated with significantly more severe morbidity compared to PAP. Clinicians must be familiar with this form of appendicitis in order to adequately inform their patients.
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Affiliation(s)
- M Mariage
- Department of Digestive Surgery, Amiens University Medical Center, Amiens, France; Jules Verne University of Picardie, Amiens, France
| | - C Sabbagh
- Department of Digestive Surgery, Amiens University Medical Center, Amiens, France; Jules Verne University of Picardie, Amiens, France; SSPC (simplification des soins des patients chirurgicaux complexes) research unit, Jules Verne University of PIcardie, Amiens, France
| | - T Yzet
- Department of Radiology, Amiens University Medical Center, Amiens, France
| | - H Dupont
- Intensive Care Unit, Amiens University Medical Center, Amiens, France; SSPC (simplification des soins des patients chirurgicaux complexes) research unit, Jules Verne University of PIcardie, Amiens, France
| | - A NTouba
- Intensive Care Unit, Amiens University Medical Center, Amiens, France
| | - J M Regimbeau
- Department of Digestive Surgery, Amiens University Medical Center, Amiens, France; Jules Verne University of Picardie, Amiens, France; SSPC (simplification des soins des patients chirurgicaux complexes) research unit, Jules Verne University of PIcardie, Amiens, France.
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Passot G, Dumont F, Goéré D, Arvieux C, Rousset P, Regimbeau JM, Elias D, Villeneuve L, Glehen O, Abba J, Abboud K, Carere S, Durand-Fontanier S, Eveno C, Facy O, Gelli M, Gilly FN, Karoui M, Lo Dico R, Ortega-Deballon P, Pocard M, Quenet F, Rat P, Sabbagh C, Sgarbura O, Thibaudeau E, Vaudoyer D, Wernert R. Multicentre study of laparoscopic or open assessment of the peritoneal cancer index (BIG-RENAPE). Br J Surg 2018; 105:663-667. [DOI: 10.1002/bjs.10723] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 07/01/2017] [Accepted: 09/06/2017] [Indexed: 02/04/2023]
Abstract
Abstract
Background
The peritoneal cancer index (PCI) is a comparative prognostic factor for colorectal peritoneal metastasis (CRPM). The ability of laparoscopy to determine the PCI in consideration of cytoreductive surgery remains undetermined, and this study was designed to compare it with laparotomy.
Methods
A prospective multicentre study was conducted for patients with no known CRPM, but at risk of peritoneal disease. Surgery began with laparoscopic exploration followed by open exploration to determine the PCI. Concordance between laparoscopic and open assessment was evaluated for the diagnosis of CRPM and for the PCI.
Results
Among 50 patients evaluated, CRPM recurrence was found in 29 (58 per cent) and 34 (68 per cent) at laparoscopic and open surgery respectively. Laparoscopy was feasible in 88 per cent (44 of 50) and deemed satisfactory by the surgeon in 52 per cent (26 of 50). Among the 25 evaluable patients with satisfactory laparoscopy, there was concordance of 96 per cent (24 of 25 patients) and 38 per cent (10 of 25) for laparoscopic and open assessment of CRPM and the PCI respectively. Where there were discrepancies, it was laparoscopy that underestimated the PCI.
Conclusion
Laparoscopy may underestimate the extent of CRPM.
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Affiliation(s)
- G Passot
- Department of Surgical Oncology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, Lyon, France
- Equipe Mixte de Recherche 3738, Lyon 1 University, Lyon, France
| | - F Dumont
- Department of Surgery, Institut de Cancérologie de l'Ouest (René Gauducheau), Site Hospitalier Nord, Saint-Herblain, France
| | - D Goéré
- Department of Surgical Oncology, Gustave Roussy, Cancer Campus, Villejuif, France
| | - C Arvieux
- Department of Visceral Surgery, Grenoble University Hospital, Hôpital Albert Michallon, Grenoble, France
| | - P Rousset
- Department of Radiology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, Lyon, France
- Equipe Mixte de Recherche 3738, Lyon 1 University, Lyon, France
| | - J-M Regimbeau
- Department of Digestive Surgery, Amiens-Picardie University Medical Centre, Amiens, France
| | - D Elias
- Department of Surgical Oncology, Gustave Roussy, Cancer Campus, Villejuif, France
| | - L Villeneuve
- Equipe Mixte de Recherche 3738, Lyon 1 University, Lyon, France
- Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité de Recherche Clinique, Lyon, France
| | - O Glehen
- Department of Surgical Oncology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, Lyon, France
- Equipe Mixte de Recherche 3738, Lyon 1 University, Lyon, France
| | - J Abba
- Department of Digestive Surgery, Grenoble University Hospital, Grenoble, France
| | - K Abboud
- Department of General Surgery, St Etienne University Hospital, St Etienne, France
| | - S Carere
- Department of Surgical Oncology, Montpellier Cancer Institute, Montpellier, France
| | - S Durand-Fontanier
- Department of Visceral Surgery and Transplantation, Dupuytren University Hospital, Limoges, France
| | - C Eveno
- Surgical Oncological and Digestive Unit, Lariboisiere University Hospital, Paris, France
| | - O Facy
- Department of Digestive Surgical Oncology, University Hospital of Dijon, Dijon, France
| | - M Gelli
- Department of Surgical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - F-N Gilly
- Department of Digestive Surgery, Lyon-Sud University Hospital, Lyon, France
| | - M Karoui
- Department of Digestive Surgery, La Pitié-Salpétriêre University Hospital, Paris, France
| | - R Lo Dico
- Surgical Oncological and Digestive Unit, Lariboisiere University Hospital, Paris, France
| | - P Ortega-Deballon
- Department of Digestive Surgical Oncology, University Hospital of Dijon, Dijon, France
| | - M Pocard
- Surgical Oncological and Digestive Unit, Lariboisiere University Hospital, Paris, France
| | - F Quenet
- Department of Surgical Oncology, Montpellier Cancer Institute, Montpellier, France
| | - P Rat
- Department of Digestive Surgical Oncology, University Hospital of Dijon, Dijon, France
| | - C Sabbagh
- Department of Digestive Surgery, University Hospital of Amiens, Amiens, France
| | - O Sgarbura
- Department of Surgical Oncology, Montpellier Cancer Institute, Montpellier, France
| | - E Thibaudeau
- Department of Surgery, lnstitut de Cancerologie de l'Ouest (Rene Gauducheau), Saint-Herblain, France
| | - D Vaudoyer
- Department of Digestive Surgery, Lyon-Sud University Hospital, Lyon, France
| | - R Wernert
- Department of Surgical Oncology, Institut de Cancerologie de l'Ouest, Paul Papin Cancer Center, Angers, France
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Cossé C, Sabbagh C, Fumery M, Zogheib E, Mauvais F, Browet F, Rebibo L, Regimbeau JM. Serum procalcitonin correlates with colonoscopy findings and can guide therapeutic decisions in postoperative ischemic colitis. Dig Liver Dis 2017; 49:286-290. [PMID: 28089622 DOI: 10.1016/j.dld.2016.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 12/02/2016] [Accepted: 12/07/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Postoperative ischaemic colitis (POIC) is a life-threatening vascular gastrointestinal condition. Serum procalcitonin (PCT) levels be of value in the detection of necrosis. AIMS To evaluate the correlation between serum PCT levels and the colonoscopic assessment of the severity of POIC. METHODS Between January 2007 and November 2014, 150 patients with POIC and PCT data were included in the study. The main outcome measure was the correlation between serum PCT and the colonoscopy-based assessment of the severity of POIC (according to Favier's classification: stage 1/2 without multi-organ failure vs. stage 2/3 with multi-organ failure). RESULTS Eighty-five percent of the stage 1 cases (n=22) had a serum PCT level ≤2μg/L; 63% (n=19) of the stage 2 cases with multi-organ failure had a PCT level between 4 and 8μg/L, and 70% (n=52) of the stage 3 cases had a PCT level ≥8μg/L. The PCT level was strongly correlated with the Favier stage (Spearman's rho: 0.701; p<0.0001). PCT levels were similar in stage 2 cases with multi-organ failure and in stage 3 cases (16.06μg/L vs. 7.79μg/L, respectively; p=0.35). CONCLUSION AND RELEVANCE Serum PCT is correlated with stage 2/3 POIC requiring surgery. If PCT ≥5μg/L, surgery should be considered.
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Affiliation(s)
- C Cossé
- Department of Digestive and Oncological Surgery, Amiens University Hospital, Jules Verne University of Picardie, Amiens, France; INSERM U1088, Jules Verne University of Picardie, Amiens, France; Clinical Research Centre, Amiens University Hospital, Jules Verne University of Picardie, Amiens, France
| | - C Sabbagh
- Department of Digestive and Oncological Surgery, Amiens University Hospital, Jules Verne University of Picardie, Amiens, France; INSERM U1088, Jules Verne University of Picardie, Amiens, France
| | - M Fumery
- Department of Gastroenterology, Amiens University Hospital, Jules Verne University of Picardie, Amiens, France
| | - E Zogheib
- Department of Anaesthesiology and Cardiovascular Intensive Care, Amiens University Hospital, Jules Verne University of Picardie, Amiens, France
| | - F Mauvais
- Department of Visceral Surgery, Beauvais General Hospital, Beauvais, France
| | - F Browet
- Department of Visceral Surgery, Beauvais General Hospital, Beauvais, France
| | - L Rebibo
- Department of Digestive and Oncological Surgery, Amiens University Hospital, Jules Verne University of Picardie, Amiens, France
| | - J M Regimbeau
- Department of Digestive and Oncological Surgery, Amiens University Hospital, Jules Verne University of Picardie, Amiens, France; Clinical Research Centre, Amiens University Hospital, Jules Verne University of Picardie, Amiens, France; EA4294, Jules Verne University of Picardie, Amiens, France.
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Cossé C, Sabbagh C, Carroni V, Galmiche A, Rebibo L, Regimbeau JM. Impact of a procalcitonin-based algorithm on the management of adhesion-related small bowel obstruction. J Visc Surg 2017; 154:231-237. [PMID: 28153520 DOI: 10.1016/j.jviscsurg.2017.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Adhesion-related small bowel obstruction (ASBO) management is difficult if there are no signs of strangulation or peritonitis when intestinal transit has not been restored. The aim of the present study was to determine the impact of combining a procalcitonin (PCT)-based algorithm with clinical signs on the management of uncomplicated ASBO. METHOD We performed a pilot, retrospective, single-center "before-after" study. During the "before" period (2007 to 2012), patients with uncomplicated ASBO (n=93, the Gastrografin® group) underwent a clinical examination and a Gastrografin® index. During the "after" period (2013 to 2016), patients with uncomplicated ASBO (n=70, the algorithm group) underwent a clinical examination and were assessed with the PCT-based algorithm. The study's primary outcome was the appropriateness of ASBO management. The secondary outcomes were the need for surgery and the time to surgery, the LOS, the morbidity and mortality rates, and the recurrence rate. RESULTS The proportion of well-managed patients was higher in the algorithm group than in the Gastrografin® group (86% vs. 47%; P<0.001). The time to surgery (48h vs 72h; P=0.02) and the LOS (4 vs. 6days, P=0.02) were significantly lower in the algorithm group. The need for surgery was similar in both groups (31% vs. 37%, P=0.49). The morbidity (P=0.69), mortality (P=0.82) and recurrence rates (P=0.57) were similar in the two groups. CONCLUSION The use of a PCT-based algorithm is of value in the routine clinical management of ASBO; it reduces the LOS and the time to surgery without increasing the need for surgery.
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Affiliation(s)
- C Cossé
- Department of Digestive and Oncological Surgery, Amiens University Medical Center, Jules Verne University of Picardie, Amiens, France; INSERM U1088, Jules Verne University of Picardie, Amiens, France; Clinical Research Centre, Amiens University Medical Center and Jules Verne University of Picardie, Amiens, France
| | - C Sabbagh
- Department of Digestive and Oncological Surgery, Amiens University Medical Center, Jules Verne University of Picardie, Amiens, France; INSERM U1088, Jules Verne University of Picardie, Amiens, France
| | - V Carroni
- Department of Digestive and Oncological Surgery, Amiens University Medical Center, Jules Verne University of Picardie, Amiens, France
| | - A Galmiche
- Department of Biochemistry, Amiens University Medical Center and Jules Verne University of Picardie, Amiens, France
| | - L Rebibo
- Department of Digestive and Oncological Surgery, Amiens University Medical Center, Jules Verne University of Picardie, Amiens, France
| | - J-M Regimbeau
- Department of Digestive and Oncological Surgery, Amiens University Medical Center, Jules Verne University of Picardie, Amiens, France; Clinical Research Centre, Amiens University Medical Center and Jules Verne University of Picardie, Amiens, France; EA4294, Jules Verne University of Picardie, Amiens, France.
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Hanes A, Rebibo L, Sabbagh C, Badaoui R, Hubert V, Cosse C, Regimbeau JM. A critical analysis of factors leading to next-day discharge in ambulatory surgery patients. J Visc Surg 2016; 153:433-437. [PMID: 27318584 DOI: 10.1016/j.jviscsurg.2016.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Ambulatory surgery (AS) is becoming the rule. However, some patients do not have AS despite correct indications. The purpose of this retrospective study of prospectively collected data was to analyze why these patients do not have AS and evaluate their immediate post-operative course, in order to broaden the indications for AS. MATERIAL AND METHODS Between January and December 2013, the reasons why patients who had appropriate indications for ambulatory cholecystectomy or hernia repair but later had conventional hospital management were recorded. The primary endpoint was early post-operative morbidity. Secondary endpoints were demographic, surgical, anesthetic, post-operative data as well as analysis of criteria leading to conventional hospital stay. RESULTS Among 410 patients undergoing surgery for accepted AS indications, 158 (39%) did not have AS; 113 out of these patients (72%) were discharged the day following surgery. Of the 69 patients (43.6%) who did not have AS for medical reasons (50 by the surgeon's decision alone), 60 patients could have undergone AS since their outcome was uneventful in 96% of cases; only three patients (2.5%) had post-operative complications. CONCLUSION The AS rate could have been increased by 15% through better surgical and anesthetic collaboration.
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Affiliation(s)
- A Hanes
- Service de Chirurgie Digestive, CHU d'Amiens, Avenue René-Laennec, 80054 Amiens Cedex 01, France
| | - L Rebibo
- Service de Chirurgie Digestive, CHU d'Amiens, Avenue René-Laennec, 80054 Amiens Cedex 01, France; EA4294, Université de Picardie Jules-Verne, 80054 Amiens, France
| | - C Sabbagh
- Service de Chirurgie Digestive, CHU d'Amiens, Avenue René-Laennec, 80054 Amiens Cedex 01, France; EA4294, Université de Picardie Jules-Verne, 80054 Amiens, France
| | - R Badaoui
- Service d'Anesthésie et de Réanimation, CHU d'Amiens, Avenue René-Laennec, 80054 Amiens Cedex 01, France
| | - V Hubert
- Service d'Anesthésie et de Réanimation, CHU d'Amiens, Avenue René-Laennec, 80054 Amiens Cedex 01, France
| | - C Cosse
- Service de Chirurgie Digestive, CHU d'Amiens, Avenue René-Laennec, 80054 Amiens Cedex 01, France; EA4294, Université de Picardie Jules-Verne, 80054 Amiens, France
| | - J-M Regimbeau
- Service de Chirurgie Digestive, CHU d'Amiens, Avenue René-Laennec, 80054 Amiens Cedex 01, France; EA4294, Université de Picardie Jules-Verne, 80054 Amiens, France; Centre de Recherche Clinique, CHU d'Amiens, Avenue René-Laennec, 80054 Amiens Cedex 01, France.
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Villeneuve L, Thivolet A, Bakrin N, Mohamed F, Isaac S, Valette PJ, Glehen O, Rousset P, Abba J, Abboud K, Arvieux C, Balagué G, Barrau V, Rejeb H, Bereder JM, Bibeau F, Bouzard D, Brigand C, Carrère S, Carretier M, de Chaisemartin C, Chassang M, Chevallier A, Courvoisier T, Dartigues P, Delroeux D, Desolneux G, Dohan A, Dromain C, Dumont F, Durand-Fontanier S, Elias D, Eveno C, Evrard S, Fay O, Ferron G, Geffroy D, Gilly FN, Fontaine J, Goasguen N, Ghouti L, Goéré D, Guilloit JM, Guyon F, Heyd B, Kaci R, Karoui M, Kianmanesh R, Labbé C, Lacroix J, Lang-Averous G, Laverriere MH, Lefevre J, Lelong B, Leroux A, Dico R, Loi V, Lorimier G, Marchal F, Mariani A, Mariani P, Mariette C, Meeus P, Mery E, Messager M, Msika S, Nadeau C, Ortega-Deballon P, Passot G, Petorin C, Peyrat P, Pezet D, Piessen G, Pirro N, Pocard M, Poizat F, Porcheron J, Pourcher G, Quenet F, Rat P, Regimbeau JM, Rousselot P, Sabbagh C, Svrcek M, Tetreau R, Thibaudeau E, Tuech JJ, Valmary-Degano S, Vaudoyer D, Velasco S, Verriele-Beurrier V, Wernert R, Zinzindohoue F. A new internet tool to report peritoneal malignancy extent. PeRitOneal MalIgnancy Stage Evaluation (PROMISE) application. Eur J Surg Oncol 2016; 42:877-82. [DOI: 10.1016/j.ejso.2016.03.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 03/12/2016] [Accepted: 03/16/2016] [Indexed: 11/17/2022] Open
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Abstract
Two principal branches from the aorta provide the colonic blood supply: the superior and inferior mesenteric arteries. There are numerous anatomical variations, which the surgeon must fully understand before embarking on any colonic surgery. A good knowledge of these variations is particularly important when the patient has already undergone colectomy or presents with occlusive vascular disease. The aim of this review is to summarize the standard anatomy and the main variations of the colonic blood supply as they apply to colorectal surgery in this setting.
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Affiliation(s)
- F Prevot
- Service de chirurgie digestive, centre hospitalier universitaire Amiens-Picardie, avenue René-Laënnec-Salouël, 80054 Amiens cedex 1, France; Université de Picardie-Jules-Verne, 80000 Amiens, France
| | - C Sabbagh
- Service de chirurgie digestive, centre hospitalier universitaire Amiens-Picardie, avenue René-Laënnec-Salouël, 80054 Amiens cedex 1, France; Université de Picardie-Jules-Verne, 80000 Amiens, France
| | - F Mauvais
- Service de chirurgie viscérale et digestive, centre hospitalier de Beauvais, avenue Léon-Blum, BP 40319, 60021 Beauvais cedex, France
| | - J-M Regimbeau
- Service de chirurgie digestive, centre hospitalier universitaire Amiens-Picardie, avenue René-Laënnec-Salouël, 80054 Amiens cedex 1, France; Unité Inserm EA4294, université de Picardie-Jules-Verne, 80000 Amiens, France; Centre de recherche clinique, centre hospitalier universitaire Amiens-Picardie, avenue René-Laënnec-Salouël, 80054 Amiens cedex 1, France; Université de Picardie-Jules-Verne, 80000 Amiens, France.
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Sabbagh C, Khazzaka A, Rizkallah J, El Kary N, Chaddad M, El Rassy E. Value of electrocardiograms ordered by junior medical officers in the emergency department. Intern Med J 2016; 46:105-8. [DOI: 10.1111/imj.12958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 07/26/2015] [Accepted: 11/08/2015] [Indexed: 11/30/2022]
Affiliation(s)
- C. Sabbagh
- Emergency Department; Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University; Beirut Lebanon
| | - A. Khazzaka
- Emergency Department; Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University; Beirut Lebanon
| | - J. Rizkallah
- Emergency Department; Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University; Beirut Lebanon
| | - N. El Kary
- Emergency Department; Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University; Beirut Lebanon
| | - M. Chaddad
- Emergency Department; Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University; Beirut Lebanon
| | - E. El Rassy
- Emergency Department; Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University; Beirut Lebanon
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Messager M, Sabbagh C, Denost Q, Regimbeau JM, Laurent C, Rullier E, Sa Cunha A, Mariette C. Is there still a need for prophylactic intra-abdominal drainage in elective major gastro-intestinal surgery? J Visc Surg 2015; 152:305-13. [PMID: 26481067 DOI: 10.1016/j.jviscsurg.2015.09.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Prophylactic drainage of the abdominal cavity after gastro-intestinal surgery is widely used. The rationale is that intra-abdominal drainage enhances early detection of complications (gastro-intestinal leakage, hemorrhage, bile leak), prevents collection of fluid or pus, reduces morbidity and mortality, and decreases the duration of hospital stay. However, dogmatic attitudes favoring systematic drain placement should be questioned. The aim of this review was to evaluate the evidence supporting systematic use of prophylactic abdominal drainage following gastrectomy, pancreatectomy, liver resection, and rectal resection. Based on this review of the literature: (i) there was no evidence in favor of intra-peritoneal drainage following total or sub-total gastrectomy with respect to morbidity-mortality, nor was it helpful in the diagnosis or management of leakage, however the level of evidence is low, (ii) following pancreatic resection, data are conflicting but, overall, suggest that the absence of drainage is prejudicial, and support the notion that short-term drainage is better than long-term drainage, (iii) after liver resection without hepatico-intestinal anastomosis, high level evidence supports that there is no need for abdominal drainage, and (iv) following rectal resection, data are insufficient to establish recommendations. However, results from the French multicenter randomized controlled trial GRECCAR5 (NCT01269567) should provide new evidence this coming year. Accumulating data support that systematic drainage of the abdominal cavity in digestive surgery is a non-beneficial and obsolete practice, except following pancreatectomy where the consensus appears to indicate the usefulness of short-term drainage. While the level of evidence is high for liver resections, new randomized controlled trials are awaited regarding gastric, pancreatic and rectal surgery.
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Affiliation(s)
- M Messager
- Service de Chirurgie Digestive et Générale, Centre Hospitalier Régional Universitaire de Lille, Hôpital Claude-Huriez, Place de Verdun, 59037 Lille cedex, France
| | - C Sabbagh
- Service de Chirurgie Digestive et Oncologique, CHU d'Amiens, Amiens, France
| | - Q Denost
- Service de Chirurgie Colorectale, Hôpital Saint-André, CHU de Bordeaux, Bordeaux, France
| | - J M Regimbeau
- Service de Chirurgie Digestive et Oncologique, CHU d'Amiens, Amiens, France
| | - C Laurent
- Service de Chirurgie Colorectale, Hôpital Saint-André, CHU de Bordeaux, Bordeaux, France
| | - E Rullier
- Service de Chirurgie Colorectale, Hôpital Saint-André, CHU de Bordeaux, Bordeaux, France
| | - A Sa Cunha
- Service de Chirurgie Digestive, Hôpital Paul-Brousse, Villejuif, France
| | - C Mariette
- Service de Chirurgie Digestive et Générale, Centre Hospitalier Régional Universitaire de Lille, Hôpital Claude-Huriez, Place de Verdun, 59037 Lille cedex, France.
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Sabbagh C, Cosse C, Chauffert B, Nguyen-Khac E, Joly JP, Yzet T, Regimbeau J. Management of colon cancer in patients with cirrhosis: A review. Surg Oncol 2015; 24:187-93. [DOI: 10.1016/j.suronc.2015.06.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 12/29/2014] [Accepted: 06/08/2015] [Indexed: 01/22/2023]
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Ferron G, Simon L, Guyon F, Glehen O, Goere D, Elias D, Pocard M, Gladieff L, Bereder JM, Brigand C, Classe JM, Guilloit JM, Quenet F, Abboud K, Arvieux C, Bibeau F, De Chaisemartin C, Delroeux D, Durand-Fontanier S, Goasguen N, Gouthi L, Heyd B, Kianmanesh R, Leblanc E, Loi V, Lorimier G, Marchal F, Mariani P, Mariette C, Meeus P, Msika S, Ortega-Deballon P, Paineau J, Pezet D, Piessen G, Pirro N, Pomel C, Porcheron J, Pourcher G, Rat P, Regimbeau JM, Sabbagh C, Thibaudeau E, Torrent JJ, Tougeron D, Tuech JJ, Zinzindohoue F, Lundberg P, Herin F, Villeneuve L. Professional risks when carrying out cytoreductive surgery for peritoneal malignancy with hyperthermic intraperitoneal chemotherapy (HIPEC): A French multicentric survey. Eur J Surg Oncol 2015; 41:1361-7. [PMID: 26263848 DOI: 10.1016/j.ejso.2015.07.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 07/10/2015] [Accepted: 07/15/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Over the last two decades, many surgical teams have developed programs to treat peritoneal carcinomatosis with extensive cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). Currently, there are no specific recommendations for HIPEC procedures concerning environmental contamination risk management, personal protective equipment (PPE), or occupational health supervision. METHODS A survey of the institutional practices among all French teams currently performing HIPEC procedures was carried out via the French network for the treatment of rare peritoneal malignancies (RENAPE). RESULTS Thirty three surgical teams responded, 14 (42.4%) which reported more than 10 years of HIPEC experience. Some practices were widespread, such as using HIPEC machine approved by the European Community (100%), individualized or centralized smoke evacuation (81.8%), "open" abdominal coverage during perfusion (75.8%), and maintaining the same surgeon throughout the procedure (69.7%). Others were more heterogeneous, including laminar flow air circulation (54.5%) and the provision of safety protocols in the event of perfusate spills (51.5%). The use of specialized personal protective equipment is ubiquitous (93.9%) but widely variable between programs. CONCLUSION Protocols regarding cytoreductive surgery/HIPEC and the associated professional risks in France lack standardization and should be established.
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Affiliation(s)
- G Ferron
- Department of Surgical Oncology, Claudius Regaud Institute - IUCT, Toulouse, France.
| | - L Simon
- Department of Surgical Oncology, Claudius Regaud Institute - IUCT, Toulouse, France
| | - F Guyon
- Department of Surgical Oncology, Bergonie Institute, Bordeaux, France
| | - O Glehen
- Department of Digestive Surgery, Lyon-Sud University Hospital, Lyon, France; EMR 3738, Lyon 1 University, Lyon, France
| | - D Goere
- Department of Surgical Oncology, Gustave Roussy Institute, Villejuif, France
| | - D Elias
- Department of Surgical Oncology, Gustave Roussy Institute, Villejuif, France
| | - M Pocard
- Surgical Oncologic & Digestive Unit, Lariboisière University Hospital, Paris, France; INSERM, U 965, Paris, France
| | - L Gladieff
- Department of Medical Oncology, Claudius Regaud Institute - IUCT, Toulouse, France
| | - J M Bereder
- Department of General Surgery, Archet 2 University Hospital, Nice, France
| | - C Brigand
- Department of General Surgery, Hautepierre University Hospital, Strasbourg, France
| | - J M Classe
- Department of Surgical Oncology, René Gauducheau Cancer Center, Nantes, France
| | - J M Guilloit
- Department of Surgical Oncology, Francois Baclesse Comprehensive Cancer Center, Caen, France
| | - F Quenet
- Department of Surgical Oncology, Val d'Aurelle Montpellier Cancer Center, Montpellier, France
| | - K Abboud
- Department of Digestive Surgery, University Hospital of Saint Etienne, Saint Etienne, France
| | - C Arvieux
- Department of Digestive Surgery, Michallon University Hospital, Grenoble, France
| | - F Bibeau
- Department of Pathology, Val d'Aurelle Montpellier Cancer Center, Montpellier, France
| | - C De Chaisemartin
- Department of Surgical Oncology, Paoli-Calmettes Institute, Marseille, France
| | - D Delroeux
- Department of Digestive Surgery, Jean Minjoz University Hospital, Besançon, France
| | - S Durand-Fontanier
- Department of Visceral Surgery and Transplantation, Dupuytren University Hospital, Limoges, France
| | - N Goasguen
- Department of General Surgery, Diaconesses Croix Saint Simon Group Hospital, Paris, France
| | - L Gouthi
- Department of Digestive Surgery, Purpan University Hospital, Toulouse, France
| | - B Heyd
- Department of Digestive Surgery, Jean Minjoz University Hospital, Besançon, France
| | - R Kianmanesh
- Department of Digestive Surgery, Robert Debré University Hospital, Reims, France
| | - E Leblanc
- Department of Gynaecological Surgery, Oscar Lambret Cancer Center, Lille, France
| | - V Loi
- Department of Digestive Surgery, Tenon University Hospital, Paris, France
| | - G Lorimier
- Department of Surgical Oncology, Paul Papin Cancer Center, Angers, France
| | - F Marchal
- Department of Surgical Oncology, Lorraine Institute of Oncology, Vandoeuvre-les-Nancy, France
| | - P Mariani
- Department of Surgical Oncology, Curie Institute, Paris, France
| | - C Mariette
- Department of Digestive and Oncological Surgery, Claude-Huriez University Hospital, Lille, France
| | - P Meeus
- Department of Surgery, Léon Bérard Comprehensive Cancer Center, Lyon, France
| | - S Msika
- Department of Surgery, Louis Mourier University Hospital, Colombes, France
| | - P Ortega-Deballon
- Department of Digestive Surgical Oncology, University Hospital of Dijon, Dijon, France
| | - J Paineau
- Department of Surgical Oncology, René Gauducheau Cancer Center, Nantes, France
| | - D Pezet
- Department of Digestive Surgery, Estaing University Hospital, Clermont-Ferrand, France
| | - G Piessen
- Department of Digestive and Oncological Surgery, Claude-Huriez University Hospital, Lille, France
| | - N Pirro
- Department of Digestive Surgery, Timône University Hospital, Marseille, France
| | - C Pomel
- Department of Surgical Oncology, Jean Perrin Comprehensive Cancer Center, Clermont-Ferrand, France
| | - J Porcheron
- Department of Digestive Surgery, University Hospital of Saint Etienne, Saint Etienne, France
| | - G Pourcher
- Department of General Surgery, Antoine-Béclère University Hospital, Clamart, France
| | - P Rat
- Department of Digestive Surgical Oncology, University Hospital of Dijon, Dijon, France
| | - J M Regimbeau
- Department of Digestive Surgery, University Hospital of Amiens, Amiens, France
| | - C Sabbagh
- Department of Digestive Surgery, University Hospital of Amiens, Amiens, France
| | - E Thibaudeau
- Department of Surgical Oncology, René Gauducheau Cancer Center, Nantes, France
| | - J J Torrent
- Department of Gynecology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - D Tougeron
- Department of Hepato-Gastroenterology, University Hospital, Poitiers, France
| | - J J Tuech
- Department of Digestive Surgery, Charles Nicolle University Hospital, Rouen, France
| | - F Zinzindohoue
- Department of Digestive and General Surgery, G. Pompidou European Hospital, Paris, France
| | - P Lundberg
- Department of Digestive Surgery, Lyon-Sud University Hospital, Lyon, France; EMR 3738, Lyon 1 University, Lyon, France
| | - F Herin
- Department of Occupational Medicine, University Hospital, Toulouse, France
| | - L Villeneuve
- Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité de Recherche Clinique, Lyon, France
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Sabbagh C, Chaddad M, El Rassy E. Experience of morning reports in the emergency department. Intern Med J 2015; 45:780-3. [PMID: 26134698 DOI: 10.1111/imj.12809] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 03/27/2015] [Indexed: 11/29/2022]
Abstract
Morning report in the emergency medicine departments is an emerging teaching modality in the medicine curriculum. Our institution, Hotel-Dieu de France hospital, a multidisciplinary tertiary care university hospital affiliated to the Saint Joseph University of Medical Sciences, is the only hospital in Middle East to hold morning reports in the emergency department (ED). We evaluate the usefulness of the morning report as a pedagogic tool as it assesses the content, quality of the discussions, professionalism, leadership, participation and duration of the morning report. The particularity of this paper is that it takes into consideration the interns' input often under-recognised in the studies. An anonymous questionnaire was diffused to the residents and interns that rotated in the ED during the previous year. It consisted of seven multiple-choice questions to evaluate the quality of the presentations, targeted discussions, ethics and professionalism, evidence-based medicine, clinical reasoning, relation of cases to discussions and implication of the ED physician. Overall, of the 63 patients who answered the survey, 65.1% were satisfied by the content. The majority considered the quality of the discussions acceptable and the leadership and participation satisfactory, professionalism was judged poor. Both residents and interns were satisfied of the teaching point of the morning reports. The only fail back observed was professionalism and pathophysiological discussions that require to be added to the sessions, whereas clinical management, teaching points, leadership and time management were completely satisfactory.
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Affiliation(s)
- C Sabbagh
- Emergency Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - M Chaddad
- Emergency Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - E El Rassy
- Emergency Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
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Tartar L, Sabbagh C, Chivot C, Cosse C, Regimbeau JM. Does radiotherapy have an impact on the thickness of the puborectal muscle? Colorectal Dis 2015; 17:542-3. [PMID: 25827604 DOI: 10.1111/codi.12966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 02/26/2015] [Indexed: 02/08/2023]
Affiliation(s)
- L Tartar
- Department of Digestive and Oncological surgery, Amiens University Hospital, Amiens, France
| | - C Sabbagh
- Department of Digestive and Oncological surgery, Amiens University Hospital, Amiens, France.,Jules Verne University of Picardie, Amiens, France.,INSERM unit U1088, Jules Verne University of Picardie, Amiens, France
| | - C Chivot
- Department of Radiology, Amiens University Hospital, Amiens, France
| | - C Cosse
- Department of Digestive and Oncological surgery, Amiens University Hospital, Amiens, France.,Jules Verne University of Picardie, Amiens, France.,INSERM unit U1088, Jules Verne University of Picardie, Amiens, France.,Clinical Research Centre, Amiens University Hospital, Amiens, France
| | - J M Regimbeau
- Department of Digestive and Oncological surgery, Amiens University Hospital, Amiens, France. .,Jules Verne University of Picardie, Amiens, France. .,Clinical Research Centre, Amiens University Hospital, Amiens, France. .,EA4294, Jules Verne University of Picardie, Amiens, France.
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Affiliation(s)
- E Chapuis-Roux
- Department of oncologic and digestive surgery, Amiens University Center, place Victor-Pauchet, 80054 Amiens, France
| | - C Sabbagh
- Department of oncologic and digestive surgery, Amiens University Center, place Victor-Pauchet, 80054 Amiens, France
| | - J-M Regimbeau
- Department of oncologic and digestive surgery, Amiens University Center, place Victor-Pauchet, 80054 Amiens, France.
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Cosse C, Sabbagh C, Browet F, Mauvais F, Rebibo L, Zogheib E, Chatelain D, Kamel S, Regimbeau JM. Serum value of procalcitonin as a marker of intestinal damages: type, extension, and prognosis. Surg Endosc 2015; 29:3132-9. [PMID: 25701059 DOI: 10.1007/s00464-014-4038-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 12/09/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Ischemic and necrotic damages are complications of digestive diseases and require emergency management. Nevertheless, the decision to surgically manage could be delayed because of no sufficiently preoperative accurate marker of ischemia diagnosis, extension, and prognosis. METHODS The aim of this study was to assess the predictive value of serum procalcitonin (PCT) levels for diagnosing intestinal necrotic damages, their extension, and their prognosis in patients with ischemic disease including ischemic colitis and mesenteric infarction by a gray zone approach. Between January 2007 to June 2014, 128 patients with ischemic colitis and mesenteric infarction (codes K55.0 and K51.9) were operated, for whom data on PCT were available. We perform a retrospective, multicenter review of their medical records. Patients were divided into subgroups: ischemia (ID group) versus necrosis (ND group); the extension [focal (FD) vs. extended (ED)] and the vital status [deceased (D) vs. alive (A)]. RESULTS PCT levels were higher in the ND (n = 94; p = 0.009); ED (n = 100; p = 0.02); and D (n = 70; p = 0.0003) groups. With a gray zone approach, the predictive thresholds were (i) for necrosis 2.473 ng/mL, (ii) for extension 3.884 ng/mL, and (iii) for mortality 7.87 ng/mL. CONCLUSION In our population, PCT could be used as a marker of necrosis; especially in case of extended damages and reflects the patient's prognosis.
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Affiliation(s)
- C Cosse
- Department of Digestive and Oncological Surgery, Amiens North Hospital, University of Picardie, Place Victor Pauchet, 80054, Amiens Cedex 01, France.,INSERM U1088, Jules Verne University of Picardie, Amiens, France
| | - C Sabbagh
- Department of Digestive and Oncological Surgery, Amiens North Hospital, University of Picardie, Place Victor Pauchet, 80054, Amiens Cedex 01, France
| | - F Browet
- Department of Digestive Surgery, Beauvais Hospital, Beauvais, France
| | - F Mauvais
- Department of Digestive Surgery, Beauvais Hospital, Beauvais, France
| | - L Rebibo
- Department of Digestive and Oncological Surgery, Amiens North Hospital, University of Picardie, Place Victor Pauchet, 80054, Amiens Cedex 01, France
| | - E Zogheib
- Department of Anesthesiology, Amiens South Hospital, University of Picardie, 80054, Amiens Cedex 01, France
| | - D Chatelain
- Department of Pathology, Amiens North Hospital, University of Picardie, 80054, Amiens Cedex 01, France
| | - S Kamel
- INSERM U1088, Jules Verne University of Picardie, Amiens, France.,Department of Biochemistry, Amiens South Hospital, University of Picardie, 80054, Amiens Cedex 01, France
| | - J M Regimbeau
- Department of Digestive and Oncological Surgery, Amiens North Hospital, University of Picardie, Place Victor Pauchet, 80054, Amiens Cedex 01, France. .,EA4294, Jules Verne University of Picardie, Amiens, France. .,Department of Digestive and Oncological Surgery, CHU Nord Amiens and University of Picardie, Place Victor Pauchet, 80054, Amiens Cedex 01, France. .,Clinical Research Center, Amiens University Hospital, Amiens, France.
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Affiliation(s)
- L Gauduchon
- Service de chirurgie digestive et oncologique, CHU d'Amiens, place Victor-Pauchet, 80000 Amiens, France
| | - C Sabbagh
- Service de chirurgie digestive et oncologique, CHU d'Amiens, place Victor-Pauchet, 80000 Amiens, France
| | - F Mauvais
- Service de chirurgie viscérale, centre hospitalier de Beauvais, avenue Léon-Blum, 60021 Beauvais, France
| | - J-M Regimbeau
- Service de chirurgie digestive et oncologique, CHU d'Amiens, place Victor-Pauchet, 80000 Amiens, France; Unité Inserm EA 4294, université de Picardie Jules-Verne, 80054 Amiens cedex 1, France.
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Chapuis-Roux E, Sabbagh C, Regimbeau JM. Stricture of an ileoanal or coloanal anastomosis: conservative management by radial division (with video). J Visc Surg 2014; 151:389-92. [PMID: 25240796 DOI: 10.1016/j.jviscsurg.2014.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- E Chapuis-Roux
- Service de chirurgie digestive et oncologique, CHU Amiens, place Victor-Pauchet, 80054 Amiens, France
| | - C Sabbagh
- Service de chirurgie digestive et oncologique, CHU Amiens, place Victor-Pauchet, 80054 Amiens, France
| | - J-M Regimbeau
- Service de chirurgie digestive et oncologique, CHU Amiens, place Victor-Pauchet, 80054 Amiens, France.
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Affiliation(s)
- R Brice
- Service de radiologie, département de radiologie digestive, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 01, France.
| | - C Chivot
- Service de radiologie, département de radiologie digestive, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 01, France
| | - J-B Deguisne
- Service de chirurgie digestive et métabolique, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 01, France
| | - C Sabbagh
- Service de chirurgie digestive et métabolique, CHU d'Amiens, place Victor-Pauchet, 80054 Amiens cedex 01, France
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Prevot F, Rebibo L, Cosse C, Browet F, Sabbagh C, Regimbeau JM. Effectiveness of intraoperative cholangiography using indocyanine green (versus contrast fluid) for the correct assessment of extrahepatic bile ducts during day-case laparoscopic cholecystectomy. J Gastrointest Surg 2014; 18:1462-8. [PMID: 24916587 DOI: 10.1007/s11605-014-2560-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 05/27/2014] [Indexed: 01/31/2023]
Abstract
INTRODUCTION During cholecystectomy, intraoperative cholangiography using contrast fluid (IOC-CF) is still the "gold standard" for biliary tract identification but has many associated pitfalls. A new IOC technique using indocyanine green (IOC-IG) appears to be promising. Here, we studied the effectiveness of IOC-IG (vs IOC-CF) during day-case laparoscopic cholecystectomy. MATERIALS AND METHODS Over a 6-month period, we included 23 patients (with no cirrhosis or risk factors for choledocholithiasis) scheduled for day-case laparoscopic cholecystectomy. The primary efficacy criterion was the "analyzability rate" (i.e., the ability to identify the cystic duct, the cystic duct-hepatic duct junction, and the common bile duct) for the IOC-CF and IOC-IG procedures after dissection. Indocyanine green was infused under general anesthesia. The same near-infrared laparoscopic imaging system was used for IOC-IG and conventional visual inspection. IOC-CF was always attempted after dissection. Each patient served as his/her own control. Cholecystectomies were video-recorded for subsequent off-line, blind analysis. RESULTS The analyzability rate was 74 % for IOC-IG after dissection, 70 % for IOC-CF (p = 0.03), 26 % for conventional visual inspection, and 48 % for IOC-IG before dissection. When each IOC modality (conventional visual inspection, IOC-IG before and after dissection) was considered as a diagnostic test, the accuracy for simultaneous identification of the three anatomic elements was respectively 48, 52, and 74 %. No adverse events occurred during the IOC-IG procedure. CONCLUSION IOC-IG was feasible and safe. Our results suggest that this technique is more effective than IOC-CF for biliary tract identification after dissection and may constitute a powerful diagnostic test for the detection of extrahepatic ducts.
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Affiliation(s)
- F Prevot
- Department of Digestive and Metabolic Surgery, North Hospital, Amiens University Medical Center, Place Victor Pauchet, F-80054, Amiens, Cedex 1, France
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Cosse C, Sabbagh C, Grelpois G, Brehant O, Regimbeau J. Day case appendectomy in adults: A review. Int J Surg 2014; 12:640-4. [DOI: 10.1016/j.ijsu.2014.05.072] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 05/16/2014] [Accepted: 05/19/2014] [Indexed: 01/07/2023]
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Sabbagh C, Vanbiervliet G, Lecomte T, Laugier R, Karoui M. Place of colorectal stents in therapeutic management of malignant large bowel obstructions. Endoscopy 2014; 46:546-52. [PMID: 24870715 DOI: 10.1055/s-0034-1365307] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
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- Department of Digestive Diseases, CHU Pontchaillou, 2 rue H Guilloux, 35000 Rennes
| | - C. Sabbagh
- Department of Digestive and Metabolic Surgery, CHU Amiens, 354 Boulevard de Beauville, 80000 Amiens
| | - G. Vanbiervliet
- Pôle Digestif, Digestive Endoscopy, Hôpital Archet 2, 151 route de Saint Antoine de Ginestière, BP 3079, 06202 Nice, Cedex 3
| | - T. Lecomte
- Department of Hepato-Gastroenterology and Digestive Oncology, Hôpital Trousseau, Tours University Hospital, 37044 TOURS Cedex 09
| | - R. Laugier
- Hepato-Gastroenterology, Hôpital de la Timone, 264 rue St Pierre, 13385 Marseille
| | - M. Karoui
- Department of Digestive and Hepato-biliary-pancreatic Surgery, Groupe Hospitalier Pitié Salpêtrière, 75013 Paris
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Abstract
Gastrointestinal surgery is feasible in patients with Child A cirrhosis, but is associated with higher morbidity and mortality. Hernia repair, biliary and colonic surgery are the most frequently performed interventions in this context. Esophageal and pancreatic surgery are more controversial and less frequently performed. For patients with decompensated liver function (Child B or C patients), the indications for surgery should be discussed by a multi-specialty team including the hepatologist, anesthesiologist, surgeon; liver function should be optimized if possible. During emergency surgery, histologic diagnosis of cirrhosis should be confirmed by liver biopsy because the histologic diagnosis has therapeutic and prognostic implications. The management of patients with Child A cirrhosis without portal hypertension is little different from the management of patients without cirrhosis. However, the management of patients with Child B or C cirrhosis or with portal hypertension is more complex and requires an accurate assessment of the balance of benefit vs. risk for surgical intervention on a case-by-case basis.
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Affiliation(s)
- C Sabbagh
- Department of digestive and oncological surgery, hôpital Nord, place Victor-Pauchet, 80054 Amiens cedex 01, France
| | - D Fuks
- Department of digestive and oncological surgery, hôpital Nord, place Victor-Pauchet, 80054 Amiens cedex 01, France
| | - J-M Regimbeau
- Department of digestive and oncological surgery, hôpital Nord, place Victor-Pauchet, 80054 Amiens cedex 01, France.
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Perez RO, Habr-Gama A, São Julião GP, Lynn PB, Sabbagh C, Proscurshim I, Campos FG, Gama-Rodrigues J, Nahas SC, Buchpiguel CA. Predicting complete response to neoadjuvant CRT for distal rectal cancer using sequential PET/CT imaging. Tech Coloproctol 2014; 18:699-708. [DOI: 10.1007/s10151-013-1113-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Accepted: 12/27/2013] [Indexed: 12/26/2022]
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Mariette C, Wind P, Micelli Lupinacci R, Tresallet C, Adham M, Arvieux C, Benoist S, Berdah S, Berger A, Briez N, Brigand C, Caiazzo R, Carrere N, Casa C, Collet D, Deguelte S, Dousset B, Dubuisson V, Glehen O, Gineste JC, Hamy A, Lacaine F, Laurent C, Lehur PA, Mabrut JY, Mathieu P, Mathonnet M, Meunier B, Michot F, Ouaissi M, Palot JP, Parc Y, Pattou F, Paye F, Pezet D, Piessen G, Pocard M, Regenet N, Regimbeau JM, Sabbagh C, Zerbib P, Toussaint JM. Practice patterns in complex ventral hernia repair and place of biological grafts: A national survey among French digestive academic surgeons. J Visc Surg 2014; 151:9-16. [DOI: 10.1016/j.jviscsurg.2013.12.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sabbagh C, Amiot A, Maggiori L, Corcos O, Joly F, Panis Y. Non-transplantation surgical approach for chronic intestinal pseudo-obstruction: analysis of 63 adult consecutive cases. Neurogastroenterol Motil 2013; 25:e680-6. [PMID: 23895212 DOI: 10.1111/nmo.12191] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 06/24/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND Chronic intestinal pseudo-obstruction (CIPO) is a recurrent disorder caused by intestinal dysmotility. Although, CIPO is not a surgically remediable condition, surgery is a common issue in CIPO patients. The aim of this study was to assess postoperative morbidity and mortality of patients operated on for CIPO and risk of re-operation. METHODS Adult patients that have undergone surgery for CIPO since 1980 were included in this retrospective study using a prospective database. Postoperative morbidity, according to Clavien-Dindo classification and CIPO-related re-operation rates were evaluated with univariate and multivariate analysis. KEY RESULTS Sixty-three patients (33 women, median age 37 [range: 15-79] years) were included. Median follow-up was 6 (0.2-28) years. Overall postoperative mortality rate was 7.9%. Overall morbidity rate was 58.2% (Clavien-Dindo ≥3 in 20.7%) leading to re-operation in 17% of cases. In multivariate analysis, major postoperative morbidity (Clavien-Dindo ≥3) was significantly increased when there was an intraoperative bowel injury (HR = 15.7 [2.4-102], P = 0.004), idiopathic CIPO (HR = 4.2 [1.5-12], P = 0.007) and emergency procedure (HR = 3 [1.3-6.8]. After the first surgery, probabilities of CIPO-related re-operation were 44%, 60%, and 66% at 1, 3, and 5 years respectively. In multivariate analysis, CIPO-related reoperation for CIPO was significantly increased when there was a major postoperative morbidity (HR = 2.1 [1.1-4.4], P = 0.040) and intraoperative bowel injury (HR = 33.1 [2-553], P = 0.015) after the first procedure. CONCLUSIONS & INFERENCES The surgical management of CIPO patients was associated with high postoperative morbidity and mortality rates and frequent re-operation. Attempts should be made to avoid surgery when possible and optimize nutritional status.
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Affiliation(s)
- C Sabbagh
- Department of Colorectal Surgery, Beaujon Hospital, APHP, Clichy, France; University Diderot Paris 7, Paris, France
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Abstract
The most serious early complication after rectal resection with low anastomosis is anastomotic leakage (AL). AL may compromise the long-term conservation of the anastomosis and also worsen oncological results. The aim of this review was to identify those factors that contribute to the prevention of AL and to delineate the various treatment options (endoscopic, perineal surgical approach, abdominal surgical approach) for chronic AL or anastomotic stricture. Treatments for AL or anastomotic stricture should be protected by proximal diversion of fecal flow, ideally by a diverting stoma created at the time of the initial proctectomy. Local approaches to surgical treatment should include perineal examination under general anesthesia by the surgeon and drainage of the fistula. Trans-abdominal interventions should be reserved for high AL and for failure of perineal procedures. Although they have only limited indications for the treatment of AL, endoscopic treatments can be used in a complementary manner to surgical treatment. Balloon dilation is the first-line treatment for anastomotic strictures.
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Affiliation(s)
- C Sabbagh
- Service de chirurgie colorectale, Pôle des maladies de l'appareil digestif, Hôpital Beaujon, Assistance publique des Hôpitaux de Paris, Université Paris-VII (Denis Diderot), 100, boulevard du Général-Leclerc, 92118 Clichy cedex, France
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Affiliation(s)
- C Sabbagh
- Department of digestive and metabolic surgery, Amiens Universitary hospital, University of Picardie Jules Verne, 80054 Amiens cedex 01, France
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Sabbagh C, Bartoli E, Regimbeau JM. Which data should be used to define the role of the colonic stent in the management of acute, left-side, malignant colonic obstruction? Clin Res Hepatol Gastroenterol 2011; 35:689-90. [PMID: 21945029 DOI: 10.1016/j.clinre.2011.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2011] [Revised: 05/31/2011] [Accepted: 06/07/2011] [Indexed: 02/04/2023]
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