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Ferrandis C, Souche R, Bardol T. Reply to "A Commentary on "Personalized pre-habilitation reduces anastomotic complications compared to up front surgery before ileocolic resection in high-risk patients with Crohn's disease: A single center retrospective study" [Int. J. Surg. 105 (2022) 106815]". Int J Surg 2022; 108:106979. [PMID: 36396120 DOI: 10.1016/j.ijsu.2022.106979] [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] [Received: 10/11/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Charlotte Ferrandis
- Department of Digestive Surgery (IBD Surgical Unit), University Hospital Center, Montpellier-Nimes University, 641 Avenue du Doyen Gaston Giraud, 34090, Montpellier, France
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Ferrandis C, Souche R, Bardol T, Boivineau L, Fabre JM, Altwegg R, Guillon F. Personalized pre-habilitation reduces anastomotic complications compared to up front surgery before ileocolic resection in high-risk patients with Crohn's disease: A single center retrospective study. Int J Surg 2022; 105:106815. [DOI: 10.1016/j.ijsu.2022.106815] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 12/12/2022]
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Bardol T, Ferrandis C, Souche R. A retropancreatic celio-mesenteric paraganglioma. Clin Res Hepatol Gastroenterol 2022; 46:101866. [PMID: 35038577 DOI: 10.1016/j.clinre.2022.101866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 02/04/2023]
Abstract
Paragangliomas are extra-adrenal pheochromocytomas that arise from chromaffin cells in the sympathetic or parasympathetic neural paraganglia. Surgery remains the only curative treatment, although prominent vascularity can make excision difficult. We have recently encountered a patient with a retropancreatic celio-mesenteric paraganglioma unusually located between celiac trunk (CT) and superior mesenteric artery.
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Affiliation(s)
- Thomas Bardol
- Département de Chirurgie Digestive et Transplantation, Centre hospitalo-universitaire de Montpellier, Université de Montpellier-Nimes, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France; Université de Montpellier, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Charlotte Ferrandis
- Département de Chirurgie Digestive et Transplantation, Centre hospitalo-universitaire de Montpellier, Université de Montpellier-Nimes, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France; Université de Montpellier, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Regis Souche
- Département de Chirurgie Digestive et Transplantation, Centre hospitalo-universitaire de Montpellier, Université de Montpellier-Nimes, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France; Tumor Microenvironment and Resistance to Treatment Lab, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, 208 rue des Apothicaires, Montpellier, 34298 Cedex 5, France; Université de Montpellier, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France.
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Bardol T, Souche R, Genet D, Ferrandis C, Guillon F, Pirlet I, Fabre JM. Outcomes of elective left colectomy in renal-transplanted patients: a single-center case-control study (LECoRT study). Int J Colorectal Dis 2021; 36:1209-1219. [PMID: 33511479 DOI: 10.1007/s00384-021-03860-7] [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] [Accepted: 01/21/2021] [Indexed: 02/04/2023]
Abstract
PURPOSE Renal-transplanted patients are reported to have a high anastomotic leakage (AL) rate after colorectal surgery. We aimed to define AL-related morbidity and mortality rates after elective left colectomy in renal-transplanted patients. METHODS Data were prospectively collected between 2010 and 2015 from patients who underwent elective left colectomy with supra-peritoneal anastomosis in a single French referral hospital. We compared AL rate, and morbidity and mortality rates between renal-transplanted patients and controls. RESULTS We identified 120 patients who underwent elective left colectomy during the study period. We retrospectively divided this cohort into 20 (17%) kidney-transplanted recipients (KTR-group) and the remaining 100 patients comprised the control group (C-group). There were no significant differences in sex, age, ASA score, body mass index, history of abdominal surgery and benign/malignant disease ratio between the KTR-group and the C-group. The AL rate was approximately four times higher in the KTR-group versus the C-group (25% vs 7%, p = 0.028). Intra-abdominal septic complications (p = 0.0005) and reoperation rates (p = 0.025) were also higher in the KTR-group. The laparoscopic approach was performed less in the KTR-group (35% versus 93%, p < 0.0001). CONCLUSION Renal transplantation was identified as a risk factor of AL following elective left colectomy, as well as increased intra-abdominal septic morbidity and higher reoperation rate. Further multicentric studies are required to identify potential independent risk factors of AL after colorectal surgery in these frail populations. TRIAL REGISTRATION The present study was declared on ClinicalTrials.gov (ID: NCT04495023).
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Affiliation(s)
- Thomas Bardol
- Digestive and Mini-invasive Surgery Unit, Department of Digestive Surgery and Transplantation, Montpellier University Hospital, University of Montpellier-Nimes, 641 Avenue du Doyen Gaston Giraud, 34090, Montpellier, France.
| | - Regis Souche
- Digestive and Mini-invasive Surgery Unit, Department of Digestive Surgery and Transplantation, Montpellier University Hospital, University of Montpellier-Nimes, 641 Avenue du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Diane Genet
- Digestive and Mini-invasive Surgery Unit, Department of Digestive Surgery and Transplantation, Montpellier University Hospital, University of Montpellier-Nimes, 641 Avenue du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Charlotte Ferrandis
- Digestive and Mini-invasive Surgery Unit, Department of Digestive Surgery and Transplantation, Montpellier University Hospital, University of Montpellier-Nimes, 641 Avenue du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Françoise Guillon
- Digestive and Mini-invasive Surgery Unit, Department of Digestive Surgery and Transplantation, Montpellier University Hospital, University of Montpellier-Nimes, 641 Avenue du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Isabelle Pirlet
- Digestive and Mini-invasive Surgery Unit, Department of Digestive Surgery and Transplantation, Montpellier University Hospital, University of Montpellier-Nimes, 641 Avenue du Doyen Gaston Giraud, 34090, Montpellier, France
- Department of Visceral and Digestive Surgery, Hospital Center of Dunkerque, Avenue Louis Herbeaux, 59240, Dunkerque, France
| | - Jean-Michel Fabre
- Digestive and Mini-invasive Surgery Unit, Department of Digestive Surgery and Transplantation, Montpellier University Hospital, University of Montpellier-Nimes, 641 Avenue du Doyen Gaston Giraud, 34090, Montpellier, France
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Souche R, Ferrandis C, Gautier A, Guillon F, Bardol T, Fabre JM. Registrar performance in minimally invasive distal pancreatectomy and effects on postoperative outcomes. Langenbecks Arch Surg 2021; 406:2357-2365. [PMID: 34036406 DOI: 10.1007/s00423-021-02212-x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 05/20/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Minimally invasive distal pancreatectomy (MIDP) is nowadays an established standard procedure for non-locally advanced pancreatic lesions without celio-mesenteric vascular invasion. However, little is known about how the involvement of junior surgeons in MIDP affects postoperative outcomes. We performed a retrospective case series study in order to determine whether registrar involvement in MIDP is associated with adverse outcomes. METHODS Data were analyzed from a prospectively created database of consecutive patients undergoing MIDP. Only data from 91 patients who underwent MIDP for non-PDAC lesions were included. Patients were divided in 3 groups: Consultant P1 (first 20 MIDP, n=20), Consultant P2 (after 20 MIDP, n=44), and Registrar group (n=27). Conversion rates and 90-day postoperative outcomes were compared. RESULTS Conversion rates were 5%, 0%, and 14% in Consultant P1 and P2 and Registrar groups, respectively (P1 vs. P2, p = 0.312 and P1 vs. Registrar, p=0.376). Only Comprehensive Complication Index was higher in Registrar group compared to Consultant P1 group (13 vs. 3.7; p = 0.041). Comparison between Consultant P2 and Registrar groups resulted in a significant higher conversion rate (0 vs. 14%, p = 0.029), increased blood loss (77 vs. 263 ml, p = 0.018), and longer surgery duration (156 vs. 212 min, p=0.001) for registrars MIDP. However, no differences were found in clinically relevant postoperative pancreatic fistula (CR-POPF) (16 vs. 7.5%, p=0.282), Clavien-Dindo severe complication ≥3 score (11 vs. 4%, p=0.396), or length of hospital stay (9 vs. 9 days; p=0.614) between the consultant and registrar cohorts. CONCLUSIONS With all the limitations of a retrospective study with a small sample size, junior surgeons' involvement in MIDP for non-PDAC lesions resulted in higher conversion rate, blood loss and duration of surgery without statistically significant difference on clinical outcomes compared to a consultant.
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Affiliation(s)
- Regis Souche
- Department of Digestive Surgery and Transplantation, Montpellier University Hospital Center, University of Montpellier-Nimes, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France. .,Tumor Microenvironment and Resistance to Treatment Lab, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, 208 rue des Apothicaires, 34298, Montpellier Cedex 5, France. .,University of Montpellier, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France. .,Digestive and Mini-invasive Surgery Unit, Department of Digestive Surgery and Transplantation, Saint Eloi Hospital, 80 avenue Augustin Fliche, 34295, Montpellier, France.
| | - Charlotte Ferrandis
- Department of Digestive Surgery and Transplantation, Montpellier University Hospital Center, University of Montpellier-Nimes, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France.,University of Montpellier, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Antoine Gautier
- Department of Digestive Surgery and Transplantation, Montpellier University Hospital Center, University of Montpellier-Nimes, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France.,University of Montpellier, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Françoise Guillon
- Department of Digestive Surgery and Transplantation, Montpellier University Hospital Center, University of Montpellier-Nimes, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France.,University of Montpellier, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Thomas Bardol
- Department of Digestive Surgery and Transplantation, Montpellier University Hospital Center, University of Montpellier-Nimes, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France.,University of Montpellier, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France
| | - Jean-Michel Fabre
- Department of Digestive Surgery and Transplantation, Montpellier University Hospital Center, University of Montpellier-Nimes, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France.,University of Montpellier, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France
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Coste T, Nedelcu M, Ferrandis C, Loureiro M, Souche R, Nedelcu A, Nocca D. Revised Sleeve Gastrectomy: Our Experience. J Laparoendosc Adv Surg Tech A 2021; 31:161-165. [DOI: 10.1089/lap.2020.0724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Thibaut Coste
- Bariatric Department, Polyclinique Sainte Thérèse, Sete, France
| | - Marius Nedelcu
- Bariatric Department, ELSAN, Clinique Bouchard, Marseille, France
- Bariatric Department, ELSAN, Clinique Saint Michel, Toulon, France
| | - Charlotte Ferrandis
- Bariatric Department, CHU de Montpellier, Montpellier, France
- University Montpellier 1, Montpellier, France
| | - Marcelo Loureiro
- Bariatric Department, CHU de Montpellier, Montpellier, France
- University Montpellier 1, Montpellier, France
- Universidade Positivo, Curitiba, Brazil
| | - Regis Souche
- Bariatric Department, CHU de Montpellier, Montpellier, France
- University Montpellier 1, Montpellier, France
| | - Anamaria Nedelcu
- Bariatric Department, ELSAN, Clinique Saint Michel, Toulon, France
| | - David Nocca
- Bariatric Department, CHU de Montpellier, Montpellier, France
- University Montpellier 1, Montpellier, France
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Ferrandis C, De Faucal D, Fabreguette JM, Borie F. Efficacy of Doppler-guided hemorrhoidal artery ligation with mucopexy, in the short and long terms for patients with hemorrhoidal disease. Tech Coloproctol 2020; 24:165-171. [PMID: 31919601 DOI: 10.1007/s10151-019-02136-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 02/11/2019] [Accepted: 12/10/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND Several studies comparing Doppler-guided hemorrhoidal artery ligation (DG HAL) with or without mucopexy with hemorrhoidopexy and hemorrhoidectomy techniques show no difference in short-term efficacy. The aim of this study was to evaluate efficacy of DG HAL with mucopexy (DG HAL+m) in the long term (beyond 5 years) for patients with hemorrhoidal disease. METHODS A retrospective observational study was conducted on patients with symptomatic hemorrhoidal disease of any stage treated with DG HAL m at our outpatient colorectal surgery unit in April 2009-April 2013. Patients were followed clinically for 1 month and with a questionnaire until 5 years after surgery or until they underwent a second surgery for recurrent hemorrhoids. RESULTS Of 150 patients who underwent DG HALm during the study period 50 (33.3%) were lost to follow-up. A total of 100 patients (47 women, 53 men) were analysed. The average age was 50 (± 12) years. Twenty-six patients (17.3%) had had one or more prior procedures. The mean length of hospital stay was 2.2 days (median = 2 days; range = 1-8 days). No major complications were described. There were no deaths. At 5 years the mean bleeding, local discomfort and pain scores were significantly improved. Thirty-six patients (35.6%) had a recurrence during the follow-up period, and 20 (19.8%) of them underwent reoperation. The mean time between the operation and the second procedure was 36 months (median 27.4 months). The majority (61.4%) of patients were satisfied with the procedure. CONCLUSIONS Despite the low invasiveness of DG HALm the low morbidity associated with the procedure and the satisfactory functional outcomes, the long-term recurrence rate can be very high. However, only about half of the patients who experienced a recurrence needed a second operation.
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Affiliation(s)
- C Ferrandis
- Chirurgie Digestive, CHU Carémeau, Place de Pr Debré, 30029, Nîmes, France
| | - D De Faucal
- Department of Hepatogastroenterolgy, CHU Carémeau, Nîmes, France
| | - J-M Fabreguette
- Department of Hepatogastroenterolgy, CHU Carémeau, Nîmes, France
| | - F Borie
- Chirurgie Digestive, CHU Carémeau, Place de Pr Debré, 30029, Nîmes, France.
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Díez-Calzadilla N, March-Villalba J, Ferrandis C, Hernández J, Martínez-Jabaloyas J, Chuan P, Martínez-García R. Factores de riesgo en el fracaso de la reparación quirúrgica del prolapso de suelo pelviano. Actas Urol Esp 2011. [DOI: 10.4321/s0210-48062011000800003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Díez-Calzadilla N, March-Villalba J, Ferrandis C, Hernández J, Martínez-Jabaloyas J, Chuan P, Martínez-García R. [Risk factors in the failure of surgical repair of pelvic organ prolapse]. Actas Urol Esp 2011; 35:448-53. [PMID: 21550143 DOI: 10.1016/j.acuro.2011.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2011] [Revised: 03/13/2011] [Accepted: 03/14/2011] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Pelvic organ prolapse (POP) surgery has variable results of recurrence and complications. We have aimed to analyze our outcomes in order to know the factors associated with anatomical and functional failure in POP surgery. MATERIAL AND METHODS A retrospective study of 69 patients who underwent POP surgery at our hospital was performed. Registered variables were: Age, BMI, number of deliveries, previous pelvic surgery, menopause, quality of life, urinary incontinence, associated frequency-urgency symptoms, high POP stage, vaginal compartments repaired, type of mesh, urethro-suspension and vaginal hysterectomy during POP surgery and its complications. Patients were evaluated at 1, 6 and 12 months post-surgery. The technique was considered as failed when relapse or mesh erosion occurred and when the patient is not satisfied or there was relapse. The sample is described, analyzing the relationship of the variables studied by univariate analysis (Chi square and Mann-Whitney U test) and a study was made of which variables may have predictive value in the failure of the repair (multiple logistic regression). RESULTS Surgery failed in 17 patients during the follow-up at one year. BMI (29.6±2.03 vs 27.1±3.32), delivery number (3.4±0.71 vs. 2.8±1.88), menopause, frequency- urgency symptoms and number of vaginal compartments repaired were associated with treatment failure although only BMI, delivery number and frequency-urgency symptoms were defined as independent predictive variables when the logistic regression was carried out. CONCLUSIONS Overweightness-obesity, previous delivery number and frequency-urgency symptoms before surgery are factors associated to anatomical and functional failure after POP repair.
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Ferrandis C, March J, Martínez J, Hernández J, Diez N, Morillo V, García F, Chuan P. [Combined external radiotherapy and hormone therapy in patients with locally advanced prostate cancer: predictive factors of genitourinary toxicity]. Actas Urol Esp 2011; 35:146-51. [PMID: 21334103 DOI: 10.1016/j.acuro.2010.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Revised: 08/14/2010] [Accepted: 08/31/2010] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Radiotherapy and androgen deprivation are an established treatment option for locally advanced prostate cancer. We evaluate outcomes in efficacy and toxicity for patients treated with this combined therapy at our institution. METHODS A retrospective study of 80 patients with locally advanced prostate cancer treated with radiotherapy combined with neo-adjuvant (2 months) and adjuvant (24 months) androgen deprivation. We studied the clinical variables and side effects. We evaluated treatment outcomes using PSA nadir and biochemical failure, and recorded acute and late gastrointestinal and urinary toxicity. We assessed the correlation between clinical variables and urinary toxicity by means of univariate and multivariate analyses (multiple logistic regression). RESULTS The mean patient age was 68 ± 5.81 years; the initial PSA was 20.05 ± 16.27 ng/ ml and the mean prostate volume 43.7 ± 27.57 cc. The clinical stage was T3a in 33% and T3b in 66%. The Gleason score was <7 in 39%, 7 in 46% and ≥8 in 15%. The mean follow-up was 44.4 months and biochemical failure was observed in 3 cases. Acute urinary toxicity was recorded in 90% of the patients (chronic in 35%) and acute gastrointestinal toxicity in 75% (late in 32%). In a univariate analysis, prostate volume and urinary symptoms were statistically correlated to acute and late urinary toxicity. Both prostate volume and urinary symptoms were independently associated with an increase in urinary toxicity in the logistic regression analysis. CONCLUSIONS Hormone-radiotherapy is a valid option to locally treat advanced prostate cancer with optimal short-term outcomes, although it is not devoid of side effects. Prostate volume and urinary symptoms before treatment can predict genitourinary toxicity.
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Ferrandis C, March J, Martínez J, Hernández J, Diez N, Morillo V, García F, Chuan P. Tratamiento combinado con radioterapia externa y hormonoterapia en los pacientes con cáncer de próstata localmente avanzado: factores predictivos de toxicidad genitourinaria. Actas Urol Esp 2011. [DOI: 10.4321/s0210-48062011000300005] [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] [Indexed: 11/11/2022]
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