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Godet C, Sabbagh C, Beyer-Berjot L, Ouaissi M, Zerbib P, Valérie B, Manceau G, Panis Y, Buscail E, Venara A, Khaoudy I, Gaillard M, Viennet M, Thobie A, Menahem B, Eveno C, Bonnel C, Mabrut JY, Badic B, Chautard J, Eid Y, Duchalais E, Lakkis Z, Cotte E, Laforest A, Desfourneaux-Denis V, Maggiori L, Rebibo L, Niki C, Talal A, Mege D, Bonnamy C, Germain A, Mauvais F, Tresallet C, Roudie J, Laurent A, Trilling B, Bertrand M, Massalou D, Romain B, Tranchart H, Pellegrin A, Dejardin O, Alves A. Risk factors for emergency surgery for diverticulitis: A retrospective multicentric French study at 41 hospitals. Surgery 2024:S0039-6060(24)00072-2. [PMID: 38609785 DOI: 10.1016/j.surg.2024.02.009] [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] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/10/2023] [Accepted: 02/06/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND The observed increase in the incidence of complicated diverticulitis may lead to the performance of more emergency surgeries. This study aimed to assess the rate and risk factors of emergency surgery for sigmoid diverticulitis. METHOD The primary outcomes were the rate of emergency surgery for sigmoid diverticulitis and its associated risk factors. The urgent or elective nature of the surgical intervention was provided by the surgeon and in accordance with the indication for surgical treatment. A mixed logistic regression with a random intercept after multiple imputations by the chained equation was performed to consider the influence of missing data on the results. RESULTS Between 2010 and 2021, 6,867 patients underwent surgery for sigmoid diverticulitis in the participating centers, of which one-third (n = 2317) were emergency cases. In multivariate regression analysis with multiple imputation by chained equation, increasing age, body mass index <18.5 kg/m2, neurologic and pulmonary comorbidities, use of anticoagulant drugs, immunocompromised status, and first attack of sigmoid diverticulitis were independent risk factors for emergency surgery. The likelihood of emergency surgery was significantly more frequent after national guidelines, which were implemented in 2017, only in patients with a history of sigmoid diverticulitis attacks. CONCLUSION The present study highlights a high rate (33%) of emergency surgery for sigmoid diverticulitis in France, which was significantly associated with patient features and the first attack of diverticulitis.
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Affiliation(s)
- Camille Godet
- Department of Digestive Surgery, University Hospital of Caen, France.
| | - Charles Sabbagh
- Department of Digestive Surgery, Amiens University Hospital, France
| | - Laura Beyer-Berjot
- Department of Digestive Surgery Assistance Publique Hôpitaux de Marseille, North University Hospital, France
| | - Mehdi Ouaissi
- Department of Digestive, Oncological, Endocrine, Hepatobiliary, and Liver Transplant, Trousseau Hospital, University Hospital of Tours, France
| | - Philippe Zerbib
- Department of Digestive Surgery and Transplantation, Huriez Hospital, Universite Lille Nord de France, France
| | - Bridoux Valérie
- Department of Digestive Surgery, University Hospital of Rouen, France
| | - Gilles Manceau
- Department of Digestive and Oncological Surgery, European Georges Pompidou Hospital, Paris Cité University, AP-HP, Paris, France
| | - Yves Panis
- Colorectal surgery Center, Groupe Hospitalier Privé Ambroise-Paré Hartmann, Neuilly/Seine, France
| | - Etienne Buscail
- Department of Surgery, CHU Toulouse-Rangueil and Toulouse University, Toulouse, France
| | - Aurélien Venara
- Department of Digestive Surgery, University Hospital of Angers, Angers, France
| | - Iman Khaoudy
- Department of Digestive Surgery, Le Havre Hospital, Le Havre, France
| | - Martin Gaillard
- Department of Digestive Surgery, Cochin Hospital, Paris, France
| | - Manon Viennet
- Department of General Surgery, University Hospital of Bocage, Dijon, France
| | - Alexandre Thobie
- Department of Digestive Surgery, Avranches-Granville Hospital, Avranches, France
| | | | - Clarisse Eveno
- Department of Digestive Surgery, University Hospital of Lille, France
| | - Catherine Bonnel
- Department of Digestive Surgery, Nord-Essonne Hospital, Longjumeau, France
| | - Jean-Yves Mabrut
- Department of Digestive Surgery and Transplantation, Croix Rousse University Hospital, Lyon, France
| | - Bogdan Badic
- Department of General and Digestive Surgery, University Hospital, Brest, France
| | - Julien Chautard
- Department of Digestive Surgery, Memorial Hospital of Saint-Lô, France
| | - Yassine Eid
- 21 Department of Digestive Surgery, Robert Bisson Hospital, Lisieux, France
| | - Emilie Duchalais
- 22 Department of Oncological, Digestive and Endocrine Surgery, University Hospital of Nantes, France
| | - Zaher Lakkis
- Department of Digestive Surgical Oncology and Liver Transplantation, University Hospital of Besançon, France
| | - Eddy Cotte
- Department of Digestive Surgery, Hospital Lyon Sud, France
| | - Anaïs Laforest
- Department of Digestive Surgery, Montsouris Institut, Paris, France
| | | | - Léon Maggiori
- Department of Digestive Surgery, Hôpital Saint-Louis, Université Paris VII, APHP, France
| | - Lionel Rebibo
- Department of Digestive, Oesogastric and Bariatric Surgery, Hôpital Bichat-Claude-Bernard, Paris, France
| | - Christou Niki
- Department of Digestive Surgery, Limoges Hospital, France
| | - Ali Talal
- Department of Digestive Surgery, Argentan Hospital, France
| | - Diane Mege
- Department of Digestive Surgery, Aix Marseille Univ, APHM, Timone University Hospital, Marseille, France
| | - Cécile Bonnamy
- Department of Digestive Surgery, Bayeux Hospital, France
| | | | | | - Christophe Tresallet
- Department of Digestive Surgical Oncology, Avicenne University Hospital, Bobigny, Sorbonne Paris Nord University, France
| | - Jean Roudie
- Department of Digestive Surgery, Martinique Hospital, Fort-de-France, France
| | - Alexis Laurent
- Department of Digestive Surgery, Créteil Hospital, France
| | - Bertrand Trilling
- Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, Grenoble, France; Department of Digestive Surgery and Emergency, University Hospital of Grenoble, Alpes, France
| | - Martin Bertrand
- Department of Digestive Surgery, University Hospital of Nîmes, France
| | - Damien Massalou
- Department of Digestive Surgery, Hospital L'Archet, Nice University, Nice, France
| | - Benoit Romain
- Department of General and Digestive Surgery, Hautepierre Hospital, Strasbourg University Hospital, France
| | - Hadrien Tranchart
- Department of Minimally Invasive Digestive Surgery, Antoine Beclere Hospital, AP-HP, Clamart, France
| | | | - Olivier Dejardin
- Department of Research; CHU de Caen, ANTICIPE, Inserm Unity UMR 1086, France
| | - Arnaud Alves
- Department of Digestive Surgery, University Hospital of Caen, France; Department of Research; CHU de Caen, ANTICIPE, Inserm Unity UMR 1086, France
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Aubert M, Buscail E, Duchalais E, Cazelles A, Collard M, Charleux-Muller D, Jeune F, Nuzzo A, Pellegrin A, Theuil L, Toutain A, Trilling B, Siproudhis L, Meurette G, Lefevre JH, Maggiori L, Mege D. Management of adult intestinal stomas: The 2023 French guidelines. J Visc Surg 2024; 161:106-128. [PMID: 38448363 DOI: 10.1016/j.jviscsurg.2024.02.002] [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] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
AIM Digestive stoma are frequently performed. The last French guidelines have been published twenty years ago. Our aim was to update French clinical practice guidelines for the perioperative management of digestive stoma and stoma-related complications. METHODS A systematic literature review of French and English articles published between January 2000 and May 2022 was performed. Only digestive stoma for fecal evacuation in adults were considered. Stoma in children, urinary stoma, digestive stoma for enteral nutrition, and rare stoma (Koch, perineal) were not included. RESULTS Guidelines include the surgical landmarks to create digestive stoma (ideal location, mucocutaneous anastomosis, utility of support rods, use of prophylactic mesh), the perioperative clinical practice guidelines (patient education, preoperative ostomy site marking, postoperative equipment, prescriptions, and follow-up), the management of early stoma-related complications (difficulties for nursing, high output, stoma necrosis, retraction, abscess and peristomal skin complications), and the management of late stoma-related complications (stoma prolapse, parastomal hernia, stoma stenosis, late stoma retraction). A level of evidence was assigned to each statement. CONCLUSION These guidelines will be very useful in clinical practice, and allow to delete some outdated dogma.
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Affiliation(s)
- Mathilde Aubert
- Department of Digestive Surgery, hôpital Timone, Aix Marseille University, AP-HM, Marseille, France
| | - Etienne Buscail
- Digestive Surgery Department, hôpital Rangueil, Toulouse, France
| | | | - Antoine Cazelles
- Digestive Surgery Department, hôpital européen Georges-Pompidou, AP-HP, Paris, France
| | - Maxime Collard
- Digestive Surgery Department, hôpital Saint-Antoine, AP-HP, Sorbonne université, 75012, Paris, France
| | | | - Florence Jeune
- Digestive Surgery Department, hôpital Saint-Louis, AP-HP, Paris, France
| | - Alexandre Nuzzo
- Digestive Surgery Department, hôpital Beaujon, AP-HP, Paris, France
| | | | | | - Amandine Toutain
- Digestive Surgery Department, hôpital Saint-Louis, AP-HP, Paris, France
| | | | | | | | - Jérémie H Lefevre
- Digestive Surgery Department, hôpital Saint-Antoine, AP-HP, Sorbonne université, 75012, Paris, France
| | - Léon Maggiori
- Digestive Surgery Department, hôpital Saint-Louis, AP-HP, Paris, France
| | - Diane Mege
- Department of Digestive Surgery, hôpital Timone, Aix Marseille University, AP-HM, Marseille, France.
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3
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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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Avellaneda N, Al Masri M, Baimakhanov A, Balasubramaniam D, Bhangu A, Bouchagier K, Bozbiyik O, Carpelan A, Chwat C, Cunha M, Dawson BE, Mallen MVD, Ellebæk MB, Gonzalez TE, Elshami M, Fakhradiyev I, Ozkan OF, Fleres F, Futaba K, Gallo G, Ghosh D, Glasbey JC, Harrison E, Hooper RL, Jain R, Kamarajah S, Veetil SK, Kamer E, Keatley J, Knowles CH, Kulimbet M, Lal P, Li E, Polamreddy BM, Minaya-Bravo A, Mittal R, Morton DG, Nadal LRM, Negoi I, Nepogodiev D, Omar O, Pata F, Pinkney T, Potter MA, Rottoli M, Santos G, Smith I, Spinelli A, Venn M, Hooper R, Morton D, Bywater E, Evans J, Magill L, McKay S, Bordom DO, Simões J, Venn ML, Adeyeye A, Avellaneda N, Buchs N, Cato L, Finch D, Umar GI, Bravo AM, Junior HM, Neary P, Poskus T, Roslani A, Samadov E, Sbaih M, Shalaby M, Singh B, Sinha A, Vardanyan A, Chaudhry S, Frasson M, Millward J, Sánchez-Guillén L, Stijns J, Zimmerman DDE, Beard D, Campbell M, Moug S, Aytac E, Blackwell S, Buchwald P, Chowdhury SM, Dardanov D, Dulskas A, Elhadi M, El-Hussuna A, Garoufalia Z, Aslam MI, Kelly M, Knowles C, Mendes B, Ng S, Pellino G, Sebastian S, Sivrikoz E, Tejedor P, Vaizey C, Bianchi R, Christensen P, Lee SH, Lohsiriwat V, Mantoo SK, Mazlan L, Um JW, Wang JY, Watanabe J, Yao H, Bengueddach A, Tidjane A, Tabeti B, Behilil C, Boudjenan-Serradj N, Bensafir S, Meharzi SEI, Aissat A, Ghouali AK, Larabi K, Riffi O, Kacimi SEO, Mesli SN, Rezoug W, Mitidieri A, José A, Pablo C, Rodriguez CA, Panettiere MF, Barbalace N, Juan T, Lucena J, Houdin A, Fernandez E, Lococo J, Pedro L, Loban M, Vecchio P, Grinblat A, Carrie A, Veracierto F, Santillan M, Napolitano M, Rosa SL, Gonzalez CM, Ferro E, Muñoz JP, Ventorutti T, Cabrera C, Carrizo C, Mospane C, Leiro F, Espino J, Trama M, Potolicchio A, Dindri F, Buey L, Lucas N, Catalano P, Astilleta R, Quiroga Y, Valli D, Alexandre F, Martres G, Rosato G, Lemme G, Romero V, Doniquian AM, Pachajoa DAP, Llahi F, Fiorenza JM, Parodi M, Ocaña N, Gallardo A, Valenzuela A, Perriello J, Nador R, Fermani C, Garay L, Blanco P, Villalobos S, Posner F, Vieyra N, Fiorito P, Ciabattari P, de Kort C, Daryanani D, Smit J, Gosselink MP, Janssen N, Feiss A, Lee CHA, Taylor D, Edington J, Chen N, Ong WM, Aigner F, Moitzi G, Gemes G, Braumille M, Mitteregger M, Gerald S, Uranitsch S, Belarmino A, Waha J, Kahn J, Treiber M, Schemmer P, Mikalauskas S, Ibrahimli A, Orujova E, Namazov I, Alikhanli J, Asgarov M, Kutkut A, Almahmeed E, Aljawder H, Juma I, Johnston K, Saeed MF, Khairi S, Matovic E, Omerasevic M, Delibegovic S, Hodzic S, Rudell AG, Fuzari J, Farah JF, Dos Santos MBA, Lupinacci RA, Pereira TS, da Silveira Sete A, Filho AL, de Souza Pires BL, de Queiroz FL, Amaral HAT, Dos Santos MAM, de Miranda Silvestre SC, Hanan B, Reis C, Cassia G, da Luz M, Delgado M, Campanati R, Silva R, Bomfa-Barbosa A, Alves BC, Costa BXM, Cortes BGW, Lemos FHT, Arreguy-Borges K, Silva TB, Assis A, Freitas AH, Rezende D, Silva H, Alvarenga I, Cascais R, Silva T, Pinto H, Silva I, Leite L, Massahud M, Meyer M, Tibúrcio R, Martinez CAR, Espinha DR, Marson FAL, de Oliveira Góes IA, de Souza Artioli LM, Boschiero MN, Takahashi CY, de Oliveira FG, Junior HFL, de Oliveira JCC, Dos Santos JM, Gerber MT, Erdmann TR, Barbosa A, Fernandes A, Júnior AN, Júnior HM, Moreira J, Ribeiro M, Moreira P, Carvalho A, Santos B, Fidelis F, Cruz I, Codes L, Aibe R, Boudoux S, Favacho BC, Pinto F, Gava G, Pivati IR, Vilain LF, Kim N, Nunes RL, Dimitrov D, Peneva K, Karamanliev M, Dimitrova S, Ivanov T, Atanasov B, Dzharov G, Shtereva M, Slavchev M, Belev N, Krastev P, Arabadzhiev A, Tonova D, Tzoneva D, Sokolov M, Gribnev P, Maslyankov S, Pavlov V, Bakmaz B, Dijan E, Ćoza I, Mihanovic J, Kučić J, Sulen N, Katušić Z, Hudáček K, Farkašová M, Marková M, Grolich T, Kala Z, Pazdírek F, Hoch J, Filipová L, Kocián P, Přikryl P, Høgn A, Møller B, Slot DK, Bælum JK, Cour KL, Eriksen ND, Mahmoud A, Abdellatif A, Nafea A, Ewedah M, Soliman M, Yakout N, Argawy O, Sallam I, Kamel I, Sherif M, Ashmawy S, Ali A, Saad M, Ahmed M, 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Vázquez-Fernández A, Pascual A, de Andrés-Asenjo B, Beltrán de Heredia J, Ruiz-Soriano M, Rodríguez-Jiménez R, Iribarren EM, Rodríguez EVF, Del Carmen Casas García M, García-Señoráns MP, Valderrama ÓC, Rodríguez PF, Santos RS, Currás RP, Vigorita V, Roche CG, Delgado E, Lafuente F, Gascon I, Saudi S, Fraj V, Wickramasinghe D, de Zoysa I, Samarasekera N, Wickramarathne R, Dassanayake V, Balathayalan Y, de Silva D, Perera M, Pulleperuma S, Jayasekara S, Wijenayake W, Gunetilleke B, Abeysinghe N, Chandrasinghe P, Kumarage S, Abdalradiy AG, Widatalla ABH, Ahmed AY, Mohamed HA, Hamid HKS, Ali MH, Eldin SJ, Agger E, Jutesten H, Lindgren J, Lepsenyi M, Azhar N, Hansdotter P, Ekepil A, Lindén Å, Brandström G, Smedberg J, Schiffer E, Ris F, Longchamp G, Meyer J, Dupret L, Galetti K, Regusci L, Grischott M, Malugani M, Mouhandes AEF, Danial AK, Khayat M, Sbahi MHE, Marawy MK, Abdullah MA, Douba Z, Mansour A, Niazi A, Hamza A, Mohamad AH, Awead M, Mohammad S, Salloum S, Jabar AA, Zazo A, Shebli B, Ayoub K, Younes L, Bannoud MH, Zazo R, Saad A, Hamdan A, Wakkaf H, Adra L, Souliman M, Anton M, Hannouf S, Li KL, Cheng KI, Ji SJ, Hsieh YC, Parlak EA, Demir M, Kara U, Peker YS, Yiğit D, Unal N, Iflazoğlu N, Yalkin Ö, Topal S, Gulcu B, Ozturk E, Gümbelek G, Terkanlıoğlu S, Koklucan A, Ince G, Sen M, Isik O, Kural S, Akesen S, Yilmazlar T, Sungurtekin H, Sungurtekin U, Vural U, Ozgen U, Isik A, Onk D, Kurnaz E, Ozker TS, Ipek A, Ferlengez A, Erturk C, Tatar C, Sevik H, Akay O, Sensoy O, Hayirlioglu MB, Aktas S, Ozben V, Aliyeva Z, Mutlu AU, Gökay BV, Saraçoğlu C, Aytaç E, Gülmez M, Işık MÜ, Hacim A, Akbas A, Soyhan F, Turgut MA, Demirgan S, Meric S, Altinel Y, Baris B, Akova E, Kahraman E, Kucuk HF, Saracoglu KT, Kaya S, Lel S, Gurbulak EK, Caz E, Kostek M, Mihmanli M, Yazici P, Oba S, Kırkan EF, Ulgur HS, Kalın M, Dinkci MD, Duzgun O, Ozturk S, Zengin AK, Aşkar A, Şanlı AN, Erginöz E, Özçelik MF, Ergün S, Uludağ SS, Kara D, Yılmaz G, Sarıcı IŞ, Kara Y, Incesu A, Arican C, Atici SD, Kaya T, Gezer T, Kirmizi Y, Aydin G, Namdaroglu O, Adakaya S, Canda AE, Ozzeybek D, Coskun N, Sokmen S, Ozkardesler S, Bisgin T, Miftari A, Caliskan C, Akgun E, Avseren G, Deniz N, Yoldas T, Güreşin A, Zayakov G, Pösteki G, Utkan NZ, Tatar OC, Akçay Ö, Güler SA, Mantoğlu B, Demirel E, Akın E, Gonullu E, Altintoprak F, Palabıyık O, Bayhan Z, Ciftci AB, Colak E, Aybar E, Celik HK, Eraslan H, Yemez K, Ozbilgin SS, Senol S, Gultekin FA, Piskin O, Guler O, Karadere Y, Kakeeto A, Oguttu B, Sikakulya FK, Lule H, Rybachuk A, Shudrak A, Beznosenko A, Lisnyy I, Rozhkova V, Zvirych V, Alawlaqi D, El Jamali F, Balooshi IA, Ahmed M, Albers M, Ali NA, Church R, Dudas G, Wells J, Pavlova M, Sebastiani S, Paterson C, Kaushal M, Patel P, Panchal S, Handa S, Tezas S, Zaidi SN, Raj G, Wright J, Hallam S, Karandikar S, Gates Z, Marshall A, Thompson A, Tennakoon A, Rao M, Callan R, Tufail S, Rajendran G, Polisetty K, Husain N, Clarke N, Naranayanasamy S, Hallett A, Lorejo E, Ward N, Antakia R, Xanthis A, Simillis C, Tweedle E, Panagiotopoulou I, Grimes L, Mounstephen L, Bocancia R, Carden C, Lynch J, Noveros MS, Shaalan R, Khalil T, Marshall W, Hodge K, Balfour J, Mcintosh K, Buijs L, Yule M, Vaughan-Shaw PG, Smith S, Anderson T, Mcdermott FD, Daniels IR, Tapp J, Smart N, Rajaretnam N, Bethune R, Clark T, Delimpalta C, Liao C, Banham G, Induruwage L, Velchuru V, Lawrence A, Rahman A, Bennett J, Badawi M, Harshen R, Bhargava A, Gorrela K, Jumah M, Hanson M, Arya S, Atendido T, Shrestha A, Cook E, Rakhimov I, Collins J, Alamin N, Vigneswaran N, Basnyat P, Shamardal A, Chacko A, Wanshantha D, Bisheet G, Ebdewi H, Abdellatif M, Adu-Poku P, Tore A, Adams F, Allen K, Ahmed K, Kulkarni N, Chitnis A, Patel H, Magsino J, Sarodaya V, Minicozzi A, Dempsy C, Ahmed H, Jayasinghe JD, Okail MH, Thaha M, Hallworth S, Parmar C, Chua L, Pizanias M, Samin R, Young T, Sagar J, Yorkmui L, Cirocchi N, Ahmed S, Barreda SC, Kudchadkar S, Baker A, Jayasankar B, Jackson J, Abdelsaid K, Hassan M, Shetty S, Coldwell C, Davies E, Nader H, Raistrick M, Ryska O, Hawkin P, Raymond T, Witjes C, Van de Steen K, Crabtree N, Boyce S, Somera W, Woodward A, Ryan K, Kassai M, Aleem M, Ghosh A, Rixson D, Lewis E, Lynch N, Shovelton C, Zywicka E, Guest F, Barton J, Purnell R, Bamford R, Teare T, Adams B, Chmielewski G, Smith L, Connolly L, Niblett R, Singh A, Halliwell G, Paraoan M, Doree N, Asaad P, Kilbride C, Carpenter H, Wilson J, Fletcher J, Vijayagopal KA, Abbakar M, Zaimis T, Walsh A, Kubisz-Pudelko A, Nono J, Pippard L, Chowdhary M, Dalton R, Moussa T, Dominguez F, Solla G, Curbelo J, Laurini M, Viola M, Brito N, Al-Alnsi A, Al-Naggar H, Saryah L, Al-Shehari M, Alsayadi R, Al-Hutheifi R, Shream S, Saeed S, Spurring EM. Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries. Br J Surg 2024; 111:znad370. [PMID: 38029386 PMCID: PMC10771257 DOI: 10.1093/bjs/znad370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/10/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. METHODS The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. RESULTS A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). CONCLUSION Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov).
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Nizet P, Grivel C, Feldman D, Brochet E, Le Gouill C, Lindenberg F, Corbineau E, Cormier N, Clouet J, Duchalais E, Huon JF. Multi-professional development of a competency framework for patients with a Port-a-Cath (PAC). J Oncol Pharm Pract 2024; 30:100-104. [PMID: 37021465 DOI: 10.1177/10781552231168573] [Citation(s) in RCA: 1] [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: 04/07/2023]
Abstract
PURPOSE In France, 40,000 Port-a-Cath (PAC) are inserted each year. These medical devices are prone to complications during their insertion or use. The education of patients wearing these devices could be a lever to reduce the risk of complications. The objective of this work was to develop, in a multi-professional and consensual manner, a unique and specific skills reference framework for patients with PAC and to propose it as a reference tool for health professionals. METHODS A multidisciplinary working group was set up to draw up this reference framework of skills. The first stage of the work consisted of a reflection leading to an exhaustive list of competencies necessary for the patient. These skills were then classified according to three different fields of knowledge (theoretical, know-how and attitudes). Finally, the working group identified priority competencies and established a grid that can be used to evaluate the level of acquisition of these competencies. RESULTS Fifteen competencies were identified: five relating to theoretical knowledge, six relating to know-how and four relating to attitudes. These competencies were broken down into sub-competences. Seven competencies or sub-competencies were selected to constitute the list of priority competencies. DISCUSSION This competency framework provides a reference framework for the education of patients with PAC and will help to harmonise practices within the different teams that care for patients with PAC.
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Affiliation(s)
- Pierre Nizet
- Nantes Université, CHU Nantes, Pharmacie, France
| | | | | | | | | | | | | | | | | | - Emilie Duchalais
- Nantes Université, CHU Nantes, Chirurgie cancérologique, digestive et endocrinienne, France
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Gil C, Beyer-Bergeot L, Sabbagh C, Zerbib P, Bridoux V, Manceau G, Panis Y, Buscail E, Venara A, Khaoudy I, Gaillard M, 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, Maggiori L, Rebibo L, Christou N, Talal A, Mege D, Bonnamy C, Germain A, Mauvais F, Tresallet C, Roudie J, Laurent A, Trilling B, Bertrand M, Massalou D, Romain B, Tranchart H, Giger U, Alves A, Ouaissi M. Impact of the first wave of COVID-19 epidemy on the surgical management of sigmoid diverticular disease in France: National French retrospective study. Int J Colorectal Dis 2023; 38:276. [PMID: 38040936 DOI: 10.1007/s00384-023-04564-w] [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: 11/08/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVE To analyze the surgical management of sigmoid diverticular disease (SDD) before, during, and after the first containment rules (CR) for the first wave of COVID-19. METHODS From the French Surgical Association multicenter series, this study included all patients operated on between January 2018 and September 2021. Three groups were compared: A (before CR period: 01/01/18-03/16/20), B (CR period: 03/17/20-05/03/20), and C (post CR period: 05/04/20-09/30/21). RESULTS A total of 1965 patients (A n = 1517, B n = 52, C n = 396) were included. The A group had significantly more previous SDD compared to the two other groups (p = 0.007), especially complicated (p = 0.0004). The rate of peritonitis was significantly higher in the B (46.1%) and C (38.4%) groups compared to the A group (31.7%) (p = 0.034 and p = 0.014). As regards surgical treatment, Hartmann's procedure was more often performed in the B group (44.2%, vs A 25.5% and C 26.8%, p = 0.01). Mortality at 90 days was significantly higher in the B group (9.6%, vs A 4% and C 6.3%, p = 0.034). This difference was also significant between the A and B groups (p = 0.048), as well as between the A and C groups (p = 0.05). There was no significant difference between the three groups in terms of postoperative morbidity. CONCLUSION This study shows that the management of SDD was impacted by COVID-19 at CR, but also after and until September 2021, both on the initial clinical presentation and on postoperative mortality.
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Affiliation(s)
- Camille Gil
- Department of Digestive, Oncological, Endocrine, Hepatobiliary and Liver Transplant, Trousseau Hospital, University Hospital of Tours, Avenue de la République, F37044 Tours, France
| | - Laura Beyer-Bergeot
- Department of Digestive Surgery Assistance Publique Hôpitaux de Marseille, North University Hospital, Marseille, France
| | - Charles Sabbagh
- Department of Surgery Department, Amiens University Hospital, Amiens, France
| | - Philippe Zerbib
- Department of Digestive Surgery and Transplantation, Huriez Hospital, Universite Lille Nord de France, Lille, France
| | - Valérie Bridoux
- Department of Digestive Surgery, University Hospital of Rouen, Rouen, France
| | - Gilles Manceau
- Department of digestive Surgery, Assistance Publique Hôpitaux de Paris, Georges Pompidou University Hospital, univeristy Paris Cité, Paris, France
| | - Yves Panis
- Colorectal Surgery Center, Groupe Hospitalier Privé Ambroise Paré-Hartmann, Neuilly/Seine, France
| | - Etienne Buscail
- Department of Surgery, CHU Toulouse-Rangueil and Toulouse University, Toulouse, France
| | - Aurélien Venara
- Department of Digestive Surgery, University Hospital of Angers, Angers, France
| | - Iman Khaoudy
- Department of Digestive Surgery, Le Havre Hospital, Le Havre, France
| | - Martin Gaillard
- Department of Digestive Surgery, Cochin Hospital, Paris, France
| | - Manon Viennet
- Department of General Surgery, University Hospital of Bocage, Dijon, France
| | - Alexandre Thobie
- Department of Digestive Surgery, Avranches-Granville Hospital, Avranches, France
| | - Benjamin Menahem
- Unité INSERM UMR 1086 ANTICIPE Registre spécialisé des Tumeurs Digestives du calvados-Service de chirurgie digestive, Université de Caen Normandie 14000, Caen, France
| | - Clarisse Eveno
- Department of Digestive Surgery, University Hospital of Lille, Lille, France
| | - Catherine Bonnel
- Department of Digestive Surgery, Nord-Essonne Hospital, Longjumeau, France
| | - Jean-Yves Mabrut
- Department of Digestive Surgery and Transplantation, Croix Rousse University Hospital, Lyon, France
| | - Bodgan Badic
- Department of General and Digestive Surgery, University Hospital, Brest, France
| | - Camille Godet
- Department of Digestive Surgery, Memorial Hospital of Saint-Lô, Saint-Lô, France
| | - Yassine Eid
- Department of Digestive Surgery, Polyclinique de Lisieux, Lisieux, France
| | - Emilie Duchalais
- Department of Oncological, Digestive and Endocrine Surgery, University Hospital of Nantes, Nantes, France
| | - Zaher Lakkis
- Department of Digestive Surgical Oncology and Liver Transplantation, University Hospital of Besançon, Besançon, France
| | - Eddy Cotte
- Department of Digestive Surgery, Hôpital Lyon Sud, Lyon, France
| | - Anais Laforest
- Department of Digestive Surgery, Montsouris Institut, Paris, France
| | | | - Léon Maggiori
- Department of Digestive Surgery, Hôpital Saint-Louis, Université Paris VII, APHP, Paris, France
| | - Lionel Rebibo
- Department of Digestive, Oesogastric and Bariatric Surgery, Hôpital Bichat-Claude-Bernard, Paris, France
| | - Niki Christou
- Department of Digestive Surgery, Limoges Hospital, Limoges, France
| | - Ali Talal
- Department of Digestive Surgery, Argentan Hospital, Argentan, France
| | - Diane Mege
- Department of Digestive Surgery, Aix Marseille Univ, APHM, Timone University Hospital, Marseille, France
| | - Cécile Bonnamy
- Department of Digestive Surgery, Bayeux Hospital, Bayeux, France
| | | | - François Mauvais
- Department of Digestive Surgery, Beauvais Hospital, Beauvais, France
| | - Christophe Tresallet
- Department of Digestive Surgical Oncology, Avicenne University Hospital, Sorbonne Paris Nord University, Paris, France
| | - Jean Roudie
- Department of Digestive Surgery, Martinique Hospital, Fort-de-France, France
| | - Alexis Laurent
- Department of Digestive Surgery, Créteil Hospital, Créteil, France
| | - Bertrand Trilling
- Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, Grenoble, France
| | - Martin Bertrand
- Department of Digestive Surgery, Universitary Hospital of Nîmes, Nîmes, France
| | - Damien Massalou
- Department of Digestive Surgery, Hôpital L'Archet, Nice University, Nice, France
| | - Benoit Romain
- Department of General and Digestive Surgery, Hautepierre Hospital, Strasbourg University Hospital, Strasbourg, France
| | - Hadrien Tranchart
- Department of Minimally Invasive Digestive Surgery, Antoine Beclere Hospital, AP-HP, Clamart, France
| | - Urs Giger
- Fliedner Fachhochschule, University of Applied Sciences, Düsseldorf, Germany
| | - Arnaud Alves
- Unité INSERM UMR 1086 ANTICIPE Registre spécialisé des Tumeurs Digestives du calvados-Service de chirurgie digestive, Université de Caen Normandie 14000, Caen, France
| | - Mehdi Ouaissi
- Department of Digestive, Oncological, Endocrine, Hepatobiliary and Liver Transplant, Trousseau Hospital, University Hospital of Tours, Avenue de la République, F37044 Tours, France.
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Bourgeois A, Girardot-Miglierina A, Thomières A, Podevin J, Perrot P, Duchalais E. Technique for treatment of recurrent perianal fistula in Crohn's disease using autologous fat. Tech Coloproctol 2023; 27:1377-1378. [PMID: 37429980 DOI: 10.1007/s10151-023-02836-9] [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: 03/21/2023] [Accepted: 06/14/2023] [Indexed: 07/12/2023]
Affiliation(s)
- A Bourgeois
- Loire Atlantique, University Hospital of Nantes, Nantes, France.
| | | | - A Thomières
- Loire Atlantique, University Hospital of Nantes, Nantes, France
| | - J Podevin
- Loire Atlantique, University Hospital of Nantes, Nantes, France
| | - P Perrot
- Loire Atlantique, University Hospital of Nantes, Nantes, France
| | - E Duchalais
- Loire Atlantique, University Hospital of Nantes, Nantes, France
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Collard MK, Rullier E, Tuech JJ, Sabbagh C, Souadka A, Loriau J, Faucheron JL, Benoist S, Dubois A, Dumont F, Germain A, Manceau G, Marchal F, Sourrouille I, Lakkis Z, Lelong B, Derieux S, Piessen G, Laforest A, Venara A, Prudhomme M, Brigand C, Duchalais E, Ouaissi M, Lebreton G, Rouanet P, Mège D, Pautrat K, Reynolds IS, Pocard M, Parc Y, Denost Q, Lefevre JH. Is Delaying a Coloanal Anastomosis the Ideal Solution for Rectal Surgery?: Analysis of a Multicentric Cohort of 564 Patients From the GRECCAR. Ann Surg 2023; 278:781-789. [PMID: 37522163 DOI: 10.1097/sla.0000000000006025] [Citation(s) in RCA: 1] [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] [Indexed: 08/01/2023]
Abstract
OBJECTIVES To assess the specific results of delayed coloanal anastomosis (DCAA) in light of its 2 main indications. BACKGROUND DCAA can be proposed either immediately after a low anterior resection (primary DCAA) or after the failure of a primary pelvic surgery as a salvage procedure (salvage DCAA). METHODS All patients who underwent DCAA intervention at 30 GRECCAR-affiliated hospitals between 2010 and 2021 were retrospectively included. RESULTS Five hundred sixty-four patients (male: 63%; median age: 62 years; interquartile range: 53-69) underwent a DCAA: 66% for primary DCAA and 34% for salvage DCAA. Overall morbidity, major morbidity, and mortality were 57%, 30%, and 1.1%, respectively, without any significant differences between primary DCAA and salvage DCAA ( P = 0.933; P = 0.238, and P = 0.410, respectively). Anastomotic leakage was more frequent after salvage DCAA (23%) than after primary DCAA (15%), ( P = 0.016).Fifty-five patients (10%) developed necrosis of the intra-abdominal colon. In multivariate analysis, intra-abdominal colon necrosis was significantly associated with male sex [odds ratio (OR) = 2.67 95% CI: 1.22-6.49; P = 0.020], body mass index >25 (OR = 2.78 95% CI: 1.37-6.00; P = 0.006), and peripheral artery disease (OR = 4.68 95% CI: 1.12-19.1; P = 0.030). The occurrence of this complication was similar between primary DCAA (11%) and salvage DCAA (8%), ( P = 0.289).Preservation of bowel continuity was reached 3 years after DCAA in 74% of the cohort (primary DCAA: 77% vs salvage DCAA: 68%, P = 0.031). Among patients with a DCAA mannered without diverting stoma, 75% (301/403) have never required a stoma at the last follow-up. CONCLUSIONS DCAA makes it possible to definitively avoid a stoma in 75% of patients when mannered initially without a stoma and to save bowel continuity in 68% of the patients in the setting of failure of primary pelvic surgery.
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Affiliation(s)
- Maxime K Collard
- Department of Colorectal Surgery, Hôpital Saint-Antoine, Assistance Publique Hôpitaux de Paris, Sorbonne University, Paris, France
| | - Eric Rullier
- Department of General and Digestive Surgery, Saint André Hospital, Bordeaux, France
| | - Jean-Jacques Tuech
- Department of General and Digestive Surgery, Hospital Charles Nicole, Rouen, France
| | - Charles Sabbagh
- Department of General and Digestive surgery, Amiens Hospital, France
| | - Amine Souadka
- Department of General and Digestive surgery, National Institute of Oncology, Rabat, Marocco
| | - Jérome Loriau
- Department of Digestive Surgery, Saint-Joseph Hospital, Paris, France
| | - Jean-Luc Faucheron
- Department of Colorectal Surgery, Hôpital Unversitaire de Grenoble, France
| | - Stéphane Benoist
- Department of General and Digestive surgery, Hôpital du Kremlin-Bicêtre, Kremlin-Bicêtre, France
| | - Anne Dubois
- Department of General and Digestive surgery, CHU Clermont-Ferrand Site Estaing, Clermont-Ferrand, France
| | - Frédéric Dumont
- Department of General and Digestive Surgery, Institut de cancérologie de l'ouest, Saint-Herblain, France
| | - Adeline Germain
- Department of General and Digestive Surgery, Hôpital Universitaire de Nancy, France
| | - Gilles Manceau
- Department of General and Digestive Surgery, Hôpital Européen Georges Pompidou, Paris, France
| | - Frédéric Marchal
- Department of Surgical Oncology, Institut de Cancérologie de Lorraine, Université de Lorraine, Vandoeuvre-les-Nancy, France
| | | | - Zaher Lakkis
- Department of Digestive Surgery, University Hospital of Besancon, Besancon, France
| | - Bernard Lelong
- Department of General and Digestive Surgery, Institute Paoli-Calmettes, Marseille, France
| | - Simon Derieux
- Department of General and Digestive Surgery, Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris, France
| | - Guillaume Piessen
- Department of General and Digestive Surgery, Hôpital Huriez, Lille, France
| | - Anaïs Laforest
- Department of General and Digestive Surgery, Institute Monsouris, Paris, France
| | - Aurélien Venara
- Department of General and Digestive Surgery, Hôpital Universitaire d'Angers, France
| | - Michel Prudhomme
- Department of General and Digestive Surgery, Hôpital Universitaire de Nîmes, France
| | - Cécile Brigand
- Department of General and Digestive Surgery, Hôpital de Hautepierre-Hôpitaux Universitaires, Strasbourg, France
| | - Emilie Duchalais
- Department of General and Digestive Surgery, Centre Hospitalier Universitaire de Nantes, France
| | - Mehdi Ouaissi
- Department of General and Digestive Surgery, Hôpital Trousseau - CHRU Hôpitaux de Tours, Chambray-lès-Tours, France
| | - Gil Lebreton
- Department of General and Digestive Surgery, CHU côte de Nâcre, Caen, France
| | - Philippe Rouanet
- Department of General and Digestive Surgery, Institut du Cancer de Montpellier, Montpellier, France
| | - Diane Mège
- Department of General and Digestive Surgery, Hôpital de la Timone, Marseille, France
| | - Karine Pautrat
- Department of General and Digestive Surgery, Hôpital Lariboisière, Paris, France
| | - Ian S Reynolds
- Department of Colorectal Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Marc Pocard
- Department of General and Digestive Surgery, Hôpital Pitié-Salpêtrère, Paris, France
| | - Yann Parc
- Department of Colorectal Surgery, Hôpital Saint-Antoine, Assistance Publique Hôpitaux de Paris, Sorbonne University, Paris, France
| | - Quentin Denost
- Department of General and Digestive Surgery, Bordeaux Colorectal Institute, Bordeaux, France
| | - Jérémie H Lefevre
- Department of Colorectal Surgery, Hôpital Saint-Antoine, Assistance Publique Hôpitaux de Paris, Sorbonne University, Paris, France
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Sérénon V, Rouanet P, Charleux-Muller D, Eveno C, Poirot K, Trilling B, Benoist S, Manceau G, Panis Y, Alves A, Kartheuser A, Venara A, Pocard M, Sabbagh C, Laforest A, Lakkis Z, Badic B, Chau A, Christou N, Beyer-Berjot L, Dumont F, Germain A, Valverde A, Duchalais E, Ouaissi M, Benhaim L, Collard M, Tuech JJ, Buscail E, Mege D. Iatrogenic ureteral injury during colorectal surgery has a significant impact on patient outcomes: a French multicentric retrospective cohort study. Colorectal Dis 2023. [PMID: 37254657 DOI: 10.1111/codi.16630] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 04/10/2023] [Accepted: 04/13/2023] [Indexed: 06/01/2023]
Abstract
AIM The long-term urological sequelae after iatrogenic ureteral injury (IUI) during colorectal surgery are not clearly known. The aims of this work were to report the incidence of IUI and to analyse the long-term consequences of urological late complications and their impact on oncological results of IUI occurring during colorectal surgery through a French multicentric experience (GRECCAR group). METHOD All the patients who presented with IUI during colorectal surgery between 2010 and 2019 were retrospectively included. Patients with ureteral involvement needing en bloc resection, delayed ureteral stricture or noncolorectal surgery were not considered. RESULTS A total of 202 patients (93 men, mean age 63 ± 14 years) were identified in 29 centres, corresponding to 0.32% of colorectal surgeries (n = 63 562). Index colorectal surgery was mainly oncological (n = 130, 64%). IUI was diagnosed postoperatively in 112 patients (55%) after a mean delay of 11 ± 9 days. Intraoperative diagnosis of IUI was significantly associated with shorter length of stay (21 ± 22 days vs. 34 ± 22 days, p < 0.0001), lower rates of postoperative hydronephrosis (2% vs. 10%, p = 0.04), anastomotic complication (7% vs. 22.5%, p = 0.002) and thromboembolic event (0% vs. 6%, p = 0.02) than postoperative diagnosis of IUI. Delayed chemotherapy because of IUI was reported in 27% of patients. At the end of the follow-up [3 ± 2.6 years (1 month-13 years)], 72 patients presented with urological sequalae (36%). Six patients (3%) required a nephrectomy. CONCLUSION IUI during colorectal surgery has few consequences for the patients if recognized early. Long-term urological sequelae can occur in a third of patients. IUI may affect oncological outcomes in colorectal surgery by delaying adjuvant chemotherapy, especially when the ureteral injury is not diagnosed peroperatively.
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Affiliation(s)
- Victor Sérénon
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Marseille, Timone Hospital, Aix Marseille University, Marseille, France
| | - Philippe Rouanet
- Department of Digestive Surgery, Cancer Institute of Montpellier, Montpellier, France
| | | | - Clarisse Eveno
- Department of Digestive Surgery, Lille University Hospital, Lille, France
| | - Karine Poirot
- Department of Digestive Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Bertrand Trilling
- Department of Digestive Surgery, Grenoble University Hospital, Grenoble, France
| | - Stéphane Benoist
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Gilles Manceau
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Georges-Pompidou European Hospital, Paris, France
| | - Yves Panis
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Beaujon Hospital, Clichy, France
| | - Arnaud Alves
- Registre des Cancers Digestifs, Unité INSERM 1086 ANTICIPE, Department of Digestive Surgery, Caen University Hospital, University Caen Normandy, Caen, France
| | - Alex Kartheuser
- Department of Digestive Surgery, University Clinics Saint-Luc, Bruxelles, Belgium
| | - Aurélien Venara
- Department of Digestive Surgery, Angers University Hospital, Angers, France
| | - Marc Pocard
- Department of Digestive Surgery, Hepato-Biliary-pancreatic Gastrointestinal Surgery and Liver Transplantation, Pitié Salpêtrière Hospital, Paris, France
| | - Charles Sabbagh
- Department of Digestive Surgery, Amiens University Hospital, Amiens, France
| | - Anaïs Laforest
- Department of Digestive Surgery, Institut Mutualiste Montsouris, Paris, France
| | - Zaher Lakkis
- Department of Digestive Surgery, Besançon University Hospital, Besançon, France
| | - Bogdan Badic
- Department of Digestive Surgery, Brest University Hospital, Brest, France
| | - Amélie Chau
- Department of Digestive Surgery, Hénin-Beaumont Hospital, Hauts-de-France, France
| | - Niki Christou
- Department of Digestive Surgery, Limoges University Hospital, Limoges, France
| | - Laura Beyer-Berjot
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Marseille, North Hospital, Marseille, France
| | - Frederic Dumont
- Department of Digestive Surgery, Cancer Institute of West, Saint-Herblain, France
| | - Adeline Germain
- Department of Digestive Surgery, Nancy University Hospital, Nancy, France
| | - Alain Valverde
- Department of Digestive Surgery, Diaconesses Croix Saint Simon Hospital, Paris, France
| | - Emilie Duchalais
- Department of Digestive Surgery, Nantes University Hospital, Nantes, France
| | - Mehdi Ouaissi
- Department of Digestive Surgery, Tours University Hospital, Tours, France
| | - Leonor Benhaim
- Department of Digestive Surgery, Gustave Roussy Institute, Villejuif, France
| | - Maxime Collard
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Saint-Antoine Hospital, Paris, France
| | - Jean-Jacques Tuech
- Department of Digestive Surgery, Rouen University Hospital, Charles Nicolle Hospital, Rouen, France
| | - Etienne Buscail
- Department of Digestive Surgery, Toulouse University Hospital, Toulouse, France
| | - Diane Mege
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Marseille, Timone Hospital, Aix Marseille University, Marseille, France
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10
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Valès S, Bacola G, Biraud M, Touvron M, Bessard A, Geraldo F, Dougherty KA, Lashani S, Bossard C, Flamant M, Duchalais E, Marionneau-Lambot S, Oullier T, Oliver L, Neunlist M, Vallette FM, Van Landeghem L. Erratum to "Tumor cells hijack enteric glia to activate colon cancer stem cells and stimulate tumorigenesis" [EBioMedicine 49 (2019) 172-188]. EBioMedicine 2023; 88:104448. [PMID: 36689913 PMCID: PMC9876818 DOI: 10.1016/j.ebiom.2023.104448] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Simon Valès
- Bretagne Loire University, Nantes University, INSERM 1235, IMAD, The Enteric Nervous System in Gut and Brain Disorders, Nantes, France
| | - Gregory Bacola
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Mandy Biraud
- Bretagne Loire University, Nantes University, INSERM 1235, IMAD, The Enteric Nervous System in Gut and Brain Disorders, Nantes, France
| | - Mélissa Touvron
- Bretagne Loire University, Nantes University, INSERM 1235, IMAD, The Enteric Nervous System in Gut and Brain Disorders, Nantes, France,Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Anne Bessard
- Bretagne Loire University, Nantes University, INSERM 1235, IMAD, The Enteric Nervous System in Gut and Brain Disorders, Nantes, France
| | - Fanny Geraldo
- Nantes University, INSERM 1232, CRCINA, Nantes, France
| | - Kelsie A. Dougherty
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Shaian Lashani
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | | | - Mathurin Flamant
- Nantes University Hospital, Nantes, France,Jules Verne Clinic, Nantes, France
| | - Emilie Duchalais
- Bretagne Loire University, Nantes University, INSERM 1235, IMAD, The Enteric Nervous System in Gut and Brain Disorders, Nantes, France,Nantes University Hospital, Nantes, France
| | | | | | - Lisa Oliver
- Nantes University, INSERM 1232, CRCINA, Nantes, France,Nantes University Hospital, Nantes, France
| | - Michel Neunlist
- Bretagne Loire University, Nantes University, INSERM 1235, IMAD, The Enteric Nervous System in Gut and Brain Disorders, Nantes, France,Nantes University Hospital, Nantes, France
| | | | - Laurianne Van Landeghem
- Bretagne Loire University, Nantes University, INSERM 1235, IMAD, The Enteric Nervous System in Gut and Brain Disorders, Nantes, France; Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
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11
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Hamel JF, Joris J, Slim K, Régimbeau JM, Cotte E, Léger M, Venara A, Agut E, Alfonsi P, Alili A, Amraoui J, Andre A, Arimon JM, Arnalsteen L, Asztalos R, Audouy C, Aumont O, Auvray S, Baietto H, Balbo G, Aguilera MB, Beaupel N, Beaupel N, Lazreg ZB, Beguinot-Holtzscherer S, Beller JP, Bellouard A, Henda IB, Bentamene M, Bernard P, Berthon N, Biblocque A, Bievre T, Bilosi M, Blanc B, Blatt A, Blehaut D, Bock A, Bongiovanni JP, Bonnet M, Bouarroudj N, Boissier D, Boret H, Borg R, Bouchair Z, Bouchard F, Boumadani M, Bounicaud D, Bourdeix O, Bourseau JC, Bozio G, Brachet D, Brek A, Briez N, Buisset-Subiran C, Calvet B, Cartaux-Taieb A, Castiglioni M, Catinois M, Du Rieu MC, Chalumeau C, Chambrier G, Chamlou R, Chapel N, Chenet P, Chirac P, Chokkairi S, Chopin X, Christou N, Chuffart E, Corfiotti F, Craus C, Cuellar E, Dardenne G, de Angelis N, de Ioro U, Dechanet F, Dellis R, Demasles L, Denet C, Deroo B, Desfourneaux-Denis V, Dileon S, Douard R, Dorado C, Dorscheid E, Dumont F, Durame F, Duchalais E, Dupre A, Dufraisse S, Elghali MA, Hutin E, Emna A, Essome E, Fabre N, Faivre V, Faucheron JL, Favoulet P, Fernou P, Firtion O, Flamein R, Florea S, de la Fontaine C, Forestier D, Fourn E, Frentiu DV, Frisoni R, Frisoni A, Gautier T, Genty F, Georgeanu S, Germain A, Gibert S, Gilbert B, Gignoux B, Goasguen N, Goubault P, Gres P, Guedj J, Guignard B, Gugenheim J, Guaquiere C, Guiot JL, Guinier D, Hail K, Hatwel C, Iatan E, Janecki T, Jany T, Jaspart J, Journe F, Jouffret L, Kassoul A, Kattou F, Keller P, Knepfler T, Khouri T, Kothonidis K, Landreau P, Langlois G, Le Bartz G, Lebas S, Leonard D, Leonard D, Leporrier J, Lescure G, Lewandowski R, Liddo A, Longeville JH, Lucescu I, Mariani A, Mariani P, Martin G, Martinet O, Massalou D, Massard JL, Mauvais F, Mazza D, Katapile JM, Milou F, Mirre F, Martinez CM, Mensier A, Mergui C, Mestrallet JP, Meyer C, Mocellin N, Montagne S, Naseef O, Orville M, Ostermann-Bucher S, Ouaissi M, Paqueron X, Paquet C, Passebois L, Pichot-Delahaye V, Pillet M, Pottie JC, Plard L, Plumereau F, Poincenot J, Poisblanc M, Poupard B, Proske JM, Puche P, Raspado O, Riboud R, Rakotoarisoa B, Raynaud K, Razafindratsira T, Renaud M, Rio D, Rio D, Ripoche J, Roussel B, Denis MS, Salaun P, Sage PY, Scherrer ML, Sirisier F, Smeets B, Smejkal M, Steinmetz JP, Tavernier M, Thievenaz R, Tirca M, Toque L, Triki E, Tzanis D, Vacher B, Vanwymeersch S, Vauclair E, Verhaeghe R, Vetrila V, Vieuille C, Vermeulen F, Vignal JC, Voilin C, de Wailli P, Wolthuis A, Zaepfel S. Transversus Abdominis Block or Wound Infiltration Should be Performed in Colorectal Surgery Patients in an Enhanced Recovery Setting: a Propensity Score Analysis of a National Database. J Gastrointest Surg 2022; 27:798-802. [PMID: 36376728 DOI: 10.1007/s11605-022-05514-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/29/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Jean-Francois Hamel
- Department of Biostatistics, Maison de La Recherche, University Hospital of Angers, 4 Rue Larrey, Cedex 9, 49933, Angers, France.,Faculty of Health, Department of Medicine, Angers, France
| | - Jean Joris
- Department of Anesthesiology, CHU Liège, Liège, Belgium
| | - Karem Slim
- Department of Visceral Surgery, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France
| | - Jean Marc Régimbeau
- Service de Chirurgie Digestive, CHU Amiens Picardie Et Université de Picardie Jules Verne, Amiens, France.,Unité de Recherche Clinique SSPC (Simplifications Des Soins Des Patients Complexes) UR UPJV 7518, Université de Picardie Jules Verne, Amiens, France
| | - Eddy Cotte
- Department of Visceral Surgery, CHU Lyon, Centre Hospitalier Lyon-Sud, 69495, Pierre-Bénite Cedex, France.,Université de Lyon, Lyon, France
| | - Maxime Léger
- Faculty of Health, Department of Medicine, Angers, France.,Department of Anesthesiology, University Hospital of Angers, 4 Rue Larrey, Cedex 9, 49933, Angers, France
| | - Aurélien Venara
- Faculty of Health, Department of Medicine, Angers, France. .,Department of Visceral and Endocrinal Surgery, University Hospital of Angers, 4 Rue Larrey, Cedex 9, 49933, Angers, France. .,IHFIH, UPRES EA 3859, University of Angers, Angers, France.
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12
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Rogier-Mouzelas F, Drissi F, Podevin J, Duchalais E, Meurette G. Anatomic and functional results of ventral biological mesh rectopexy for posterior pelvic floor disorders. J Visc Surg 2022:S1878-7886(22)00149-7. [DOI: 10.1016/j.jviscsurg.2022.09.009] [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: 11/06/2022]
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13
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Venara A, Trilling B, Ngoma M, Brochard C, Duchalais E, Siproudhis L, Faucheron J, de Parades V, Alves A, Cotte E, Ouaissi M, Bridoux V, Corbière L, Heraud J, Ortega‐Deballon P, Abo‐Alhassan F, Hamel J. Ano-rectovaginal fistula after obstetrical anal sphincter injury: Diverting stoma does not improve the surgical results. Colorectal Dis 2022; 24:1371-1378. [PMID: 35656842 PMCID: PMC9796529 DOI: 10.1111/codi.16211] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/25/2022] [Accepted: 05/29/2022] [Indexed: 01/01/2023]
Abstract
AIM Ano-rectovaginal fistulas (ARVF) are challenging for the surgeon. Most of the series mix aetiologies, leading to confusion with respect to the conclusion. The aim of this study was to assess the factors associated with the success of ARVF management following obstetrical anal sphincter injury (OASIS). METHODS This retrospective multicentric study included all the patients undergoing surgery for ARVF identified by the hospital codes. Patients for whom the aetiology of ARVF was not OASIS were excluded. The major outcome measure was the success of the procedure. RESULTS Sixty patients with treated ARVF due to OASIS were identified. The success of overall management was 91.7%. Female patients underwent a mean of 2.5 (±1.7) procedures. A diverting stoma was formed in 29 patients (48.3%) of which 26 were closed at the end of the management period (89.7%). Of the 148 surgical procedures, only 55 were successful (37.2%). The order of the procedures (OR = 1.38; 95% CI: 0.75-2.51) or the diverting stoma (OR = 1.46; 95% CI: 0.31-6.91) were not significantly associated with the success of the surgery. However, Martius flap (OR = 4.13; 95% CI: 1.1-15.54) and Musset procedures (OR = 5.79; 95% CI: 1.77-18.87) produced better results than the endorectal advancement flap (ERAF). The other procedures did not show a significant correlation with management success. CONCLUSION A diverting stoma is not mandatory in the management of ARVF due to OASIS to improve the success of the surgical procedure. While the Martius flap procedure offers better results, the ERAF procedure may be preferred as a primary intervention in the absence of sphincter injury as it is less invasive. In cases of residual sphincter injury, the Musset procedure is most likely to be the best option.
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Affiliation(s)
- Aurélien Venara
- Department of Digestive SurgeryUniversity Hospital of AngersAngers Cedex 9France,CHU AngersUniversity of AngersAngersFrance,CHU AngersHIFIH, SFR ICATUniversity of AngersAngersFrance
| | - Bertrand Trilling
- TIMC‐IMAG Laboratory, National Centre for Scientific Research, Grenoble National Polytechnical Institute, Grenoble Alps University HospitalGrenoble Alps UniversityGrenobleFrance,Colorectal Surgery Unit, Visceral surgery and Acute Care surgery DepartmentGrenoble Alps University HospitalGrenobleFrance
| | - Marie Ngoma
- Institut Léopold Bellan, Groupe Hospitalier Paris Saint‐JosephService de Proctologie Médico‐ChirurgicaleParisFrance
| | - Charlène Brochard
- Unité D'explorations Fonctionnelles DigestivesCHU Rennes PontchaillouRennesFrance,Unité de Proctologie, Service des Maladies de l'appareil digestifCHU Rennes PontchaillouRennesFrance
| | - Emilie Duchalais
- Department of Digestive SurgeryUniversity Hospital of NantesNantesFrance
| | - Laurent Siproudhis
- Unité D'explorations Fonctionnelles DigestivesCHU Rennes PontchaillouRennesFrance,Unité de Proctologie, Service des Maladies de l'appareil digestifCHU Rennes PontchaillouRennesFrance
| | - Jean‐Luc Faucheron
- TIMC‐IMAG Laboratory, National Centre for Scientific Research, Grenoble National Polytechnical Institute, Grenoble Alps University HospitalGrenoble Alps UniversityGrenobleFrance,Colorectal Surgery Unit, Visceral surgery and Acute Care surgery DepartmentGrenoble Alps University HospitalGrenobleFrance
| | - Vincent de Parades
- Institut Léopold Bellan, Groupe Hospitalier Paris Saint‐JosephService de Proctologie Médico‐ChirurgicaleParisFrance
| | - Arnaud Alves
- Department of Digestive SurgeryUniversity Hospital of CaenCaen CedexFrance,UMR INSERM U1086 AnticipeCentre François BaclesseCaen CedexFrance
| | - Eddy Cotte
- Department of Digestive Surgery, Hôpital Lyon SudCHU LyonCedexFrance,Faculty of Medicine of Lyon Sud‐Charles MérieuxUniversity Lyon 1CedexFrance
| | - Mehdi Ouaissi
- Department of Digestive, Oncological, Endocrine, Hepato‐Biliary Pancreatic and Liver Transplant SurgeryTrousseau HospitalChambray les ToursFrance
| | - Valérie Bridoux
- Department of Digestive SurgeryRouen University HospitalRouenFrance
| | - Lisa Corbière
- Department of Digestive SurgeryCHU Rennes PontchaillouRennesFrance
| | - Jeanne Heraud
- Department of Gynecology and ObstetricsUniversity Hospital of AngersAngers Cedex 9France
| | | | | | - Jean‐Francois Hamel
- Department of Biostatistics. La Maison de la RechercheUniversity Hospital of AngersAngers Cedex 9France
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14
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Ducoin K, Oger R, Bilonda Mutala L, Deleine C, Jouand N, Desfrançois J, Podevin J, Duchalais E, Cruard J, Benlalam H, Labarrière N, Bossard C, Jarry A, Gervois-Segain N. Targeting NKG2A to boost anti-tumor CD8 T-cell responses in human colorectal cancer. Oncoimmunology 2022; 11:2046931. [PMID: 35295095 PMCID: PMC8920231 DOI: 10.1080/2162402x.2022.2046931] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Recently, the inhibitory CD94/NKG2A receptor has joined the group of immune checkpoints (ICs) and its expression has been documented in NK cells and CD8+ T lymphocytes in several cancers and some infectious diseases. In colorectal cancer (CRC), we previously reported that NKG2A+ tumor-infiltrating lymphocytes (TILs) are predominantly CD8+ αβ T cells and that CD94 overexpression and/or its ligand HLA-E were associated with a poor prognosis. This study aimed to thoroughly characterize the NKG2A+ CD8+ TIL subpopulation and document the impact of NKG2A on anti-tumor responses in CRC. Our findings highlight new features of this subpopulation: (i) enrichment in colorectal tumors compared to paired normal colonic mucosa, (ii) their character as tissue-resident T cells and their majority terminal exhaustion status, (iii) co-expression of other ICs delineating two subgroups differing mainly in the level of NKG2A expression and the presence of PD-1, (iv) high functional avidity despite reduced proliferative capacity and finally (v) inhibition of anti-tumor reactivity that is overcome by blocking NKG2A. From a clinical point of view, these results open a promising alternative for immunotherapies based on NKG2A blockade in CRC, which could be performed alone or in combination with other IC inhibitors, adoptive cell transfer or therapeutic vaccination.
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Affiliation(s)
- Kathleen Ducoin
- Nantes Université, Univ Angers, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302. F-44000 Nantes, France
- LabEx IGO, Université de Nantes, Nantes, France
| | - Romain Oger
- LabEx IGO, Université de Nantes, Nantes, France
- Université de Nantes, INSERM, CRCINA, F-44000 Nantes, France
| | - Linda Bilonda Mutala
- LabEx IGO, Université de Nantes, Nantes, France
- Université de Nantes, INSERM, CRCINA, F-44000 Nantes, France
- Institut Roche, Boulogne-Billancourt, France
| | - Cécile Deleine
- Nantes Université, Univ Angers, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302. F-44000 Nantes, France
- LabEx IGO, Université de Nantes, Nantes, France
| | - Nicolas Jouand
- Université de Nantes, CHU Nantes, Inserm, CNRS, SFR Santé, Inserm UMS 016, CNRS UMS 3556, F-44000 Nantes, France
| | - Juliette Desfrançois
- Université de Nantes, CHU Nantes, Inserm, CNRS, SFR Santé, Inserm UMS 016, CNRS UMS 3556, F-44000 Nantes, France
| | - Juliette Podevin
- CHU Nantes, Department of Digestive Surgery and IMAD, Nantes, France
| | - Emilie Duchalais
- CHU Nantes, Department of Digestive Surgery and IMAD, Nantes, France
| | - Jonathan Cruard
- Université de Nantes, INSERM, CRCINA, F-44000 Nantes, France
| | - Houssem Benlalam
- Nantes Université, Univ Angers, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302. F-44000 Nantes, France
- LabEx IGO, Université de Nantes, Nantes, France
| | - Nathalie Labarrière
- Nantes Université, Univ Angers, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302. F-44000 Nantes, France
- LabEx IGO, Université de Nantes, Nantes, France
| | - Céline Bossard
- LabEx IGO, Université de Nantes, Nantes, France
- Université de Nantes, INSERM, CRCINA, F-44000 Nantes, France
- CHU Nantes, Department of Digestive Surgery and IMAD, Nantes, France
| | - Anne Jarry
- Nantes Université, Univ Angers, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302. F-44000 Nantes, France
- LabEx IGO, Université de Nantes, Nantes, France
| | - Nadine Gervois-Segain
- Nantes Université, Univ Angers, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302. F-44000 Nantes, France
- LabEx IGO, Université de Nantes, Nantes, France
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15
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de la Codre F, Korkmaz C, Duchalais E, Regenet N, Meurette G. Obstructed defaecation associated with lateral perineal postoperative hernia: Robotic mesh positioning for pelvic floor reinforcement - A video vignette. Colorectal Dis 2022; 24:143-144. [PMID: 34599637 DOI: 10.1111/codi.15931] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/21/2021] [Accepted: 09/27/2021] [Indexed: 02/08/2023]
Affiliation(s)
- Frédéric de la Codre
- Clinique de chirurgie cancérologique, digestive et endocrinienne Centre hospitalier universitaire de Nantes, Nantes, France
| | - Carine Korkmaz
- Clinique de chirurgie cancérologique, digestive et endocrinienne Centre hospitalier universitaire de Nantes, Nantes, France
| | - Emilie Duchalais
- Clinique de chirurgie cancérologique, digestive et endocrinienne Centre hospitalier universitaire de Nantes, Nantes, France
| | - Nicolas Regenet
- Clinique de chirurgie cancérologique, digestive et endocrinienne Centre hospitalier universitaire de Nantes, Nantes, France
| | - Guillaume Meurette
- Clinique de chirurgie cancérologique, digestive et endocrinienne Centre hospitalier universitaire de Nantes, Nantes, France
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16
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Perry WRG, Abd El Aziz MA, Duchalais E, Grass F, Behm KT, Mathis KL, Kelley SR. Sexual dysfunction following surgery for rectal cancer: a single-institution experience. Updates Surg 2021; 73:2155-2159. [PMID: 34236596 DOI: 10.1007/s13304-021-01124-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 04/01/2021] [Accepted: 06/25/2021] [Indexed: 11/24/2022]
Abstract
Although much focus is placed on oncological outcomes for rectal cancer, it is important to assess quality of life after surgery of which sexual function is an important component. This study set about to describe the prevalence of sexual dysfunction by resection type and gender among patients undergoing surgery for rectal cancer, usingretrospective analysis. All English-speaking living patients who underwent surgery for stage I-III rectal cancer with curative intent between 2012 and 2016 were identified from a prospectively maintained database at our institution. Eligible patients were invited to complete either the Female Sexual Function Index (FSFI) or the International Index of Erectile Function (IIEF). Primary outcomes were overall rates of sexual dysfunction, defined as more than one standard deviation below the mean of the normal population for each tool. A total of 147 patients responded, yielding a response rate of 38%. The overall sexual dysfunction rate was 70% at a median time from surgery of 38 months. Sixty-two men (62%) and 41 women (87%) reported overall scores that fell below one standard deviation of the population mean. There was no significant difference in sexual dysfunction for both male and female patients between low anterior resection, coloanal anastomosis, or abdominoperineal resection.. The present study revealed a high rate of sexual dysfunction after rectal cancer surgery, particularly in female patients. This study serves as a reminder to surgeons and their teams to openly discuss the impact of surgery on sexual function and ensure adequate consent and appropriate peri-operative management strategies. The retrospective nature of the analysis is the limitation of this study.
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Affiliation(s)
- William R G Perry
- Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, 200 First Street SW, RochesterRochester, MN, 55905, USA
| | - Mohamed A Abd El Aziz
- Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, 200 First Street SW, RochesterRochester, MN, 55905, USA.,Internal Medicine Department, Texas Tech University HSC El Paso/The Hospitals of Providence Transmountain Campus, 2000B Transmountain Road, Suite 400
- MSC 42001, El Paso, TX, 79911, USA
| | - Emilie Duchalais
- Digestive and Endocrine Surgery Clinic (CCDE), Institute of Diseases of the Digestive System (IMAD), University Hospital Center of Nantes, 1, Place Alexis-Ricordeau, 44093, Nantes, France
| | - Fabian Grass
- Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, 200 First Street SW, RochesterRochester, MN, 55905, USA.,Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne, Lausanne, Switzerland
| | - Kevin T Behm
- Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, 200 First Street SW, RochesterRochester, MN, 55905, USA
| | - Kellie L Mathis
- Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, 200 First Street SW, RochesterRochester, MN, 55905, USA
| | - Scott R Kelley
- Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, 200 First Street SW, RochesterRochester, MN, 55905, USA.
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17
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Planade O, Dessomme B, Chapelle N, Verdier M, Duchalais E, Queneherve L, Le Rhun M, Coron E, Mosnier JF, Matysiak-Budnik T, Touchefeu Y. Systematic upper endoscopy concomitant with colonoscopy performed within the colorectal cancer screening program: Impact on the patients' management. Clin Res Hepatol Gastroenterol 2021; 45:101501. [PMID: 33714864 DOI: 10.1016/j.clinre.2020.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/07/2020] [Accepted: 07/07/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS The French colorectal cancer screening program is based on a fecal immunochemical test, followed by colonoscopy in case of positivity. The benefit of adding a concomitant upper endoscopy to detect upper digestive lesions (precancerous or others) is still debated. Our aim was to evaluate the frequency of upper digestive lesions detected by upper endoscopy performed concomitantly with colonoscopy following a positive fecal immunochemical test, and their impact on the patients' management (i.e., surveillance, medical treatment, endoscopic or surgical procedure). METHODS Data of all the patients who consulted for a positive test between May 2016 and May 2019 in our center, and for whom concomitant upper endoscopy and colonoscopy were performed, were analyzed retrospectively. Patients with significant history of upper gastrointestinal diseases or with current gastrointestinal symptoms were excluded. RESULTS One hundred patients were included [median age (min-max): 62 (50-75), men 64%]. Macroscopic and/or microscopic upper digestive lesions were found in 58 of them (58%): Helicobacter pylori infection in 17 patients, gastric precancerous lesions in 9 patients (chronic atrophic gastritis with intestinal metaplasia, n=8, low grade dysplasia, n=1), Barrett's esophagus requiring surveillance in 4 patients, and 1 duodenal adenoma with low-grade dysplasia. In 44 patients (44%), the upper endoscopy findings had an impact on patients' management, with no significant difference between the groups with positive (CRC or advanced adenoma)- or negative (any other lesions or normal) colonoscopy. CONCLUSION A systematic upper endoscopy combined with colonoscopy for positive fecal immunochemical test could represent an efficient strategy for upper digestive lesions screening in France. Further studies are necessary to confirm these results and to evaluate cost-effectiveness of this approach.
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Affiliation(s)
- Orianne Planade
- Institut des Maladies de l'appareil Digestif, Hépato-Gastroentérologie & Oncologie Digestive, Hôtel Dieu, Nantes University Hospital, 1 place Alexis Ricordeau, Nantes 44093, France
| | - Brigitte Dessomme
- Service d'Evaluation Médicale et d'Epidémiologie, Nantes University Hospital, 85 rue Saint-Jacques, Nantes 44093, France
| | - Nicolas Chapelle
- Institut des Maladies de l'appareil Digestif, Hépato-Gastroentérologie & Oncologie Digestive, Hôtel Dieu, Nantes University Hospital, 1 place Alexis Ricordeau, Nantes 44093, France
| | - Marine Verdier
- Institut des Maladies de l'appareil Digestif, Hépato-Gastroentérologie & Oncologie Digestive, Hôtel Dieu, Nantes University Hospital, 1 place Alexis Ricordeau, Nantes 44093, France
| | - Emilie Duchalais
- Institut des Maladies de l'appareil Digestif, Hépato-Gastroentérologie & Oncologie Digestive, Hôtel Dieu, Nantes University Hospital, 1 place Alexis Ricordeau, Nantes 44093, France
| | - Lucille Queneherve
- Institut des Maladies de l'appareil Digestif, Hépato-Gastroentérologie & Oncologie Digestive, Hôtel Dieu, Nantes University Hospital, 1 place Alexis Ricordeau, Nantes 44093, France
| | - Marc Le Rhun
- Institut des Maladies de l'appareil Digestif, Hépato-Gastroentérologie & Oncologie Digestive, Hôtel Dieu, Nantes University Hospital, 1 place Alexis Ricordeau, Nantes 44093, France
| | - Emmanuel Coron
- Institut des Maladies de l'appareil Digestif, Hépato-Gastroentérologie & Oncologie Digestive, Hôtel Dieu, Nantes University Hospital, 1 place Alexis Ricordeau, Nantes 44093, France
| | - Jean-Francois Mosnier
- Service d'anatomie et cytologie pathologiques, Nantes University Hospital, 1 place Alexis Ricordeau, Nantes 44093, France
| | - Tamara Matysiak-Budnik
- Institut des Maladies de l'appareil Digestif, Hépato-Gastroentérologie & Oncologie Digestive, Hôtel Dieu, Nantes University Hospital, 1 place Alexis Ricordeau, Nantes 44093, France.
| | - Yann Touchefeu
- Institut des Maladies de l'appareil Digestif, Hépato-Gastroentérologie & Oncologie Digestive, Hôtel Dieu, Nantes University Hospital, 1 place Alexis Ricordeau, Nantes 44093, France
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18
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Voron T, Moszkowicz D, Hobeika C, Collard M, Bruzzi M, Beghdadi N, Catry J, Duchalais E, Manceau G, Lakkis Z, Allard MA, Cauchy F, Maggiori L. Re: Moszkowicz D, et al. "Operating room hygiene: Clinical practice recommendations SFCD-ACHBT". J Visc Surg 2021; 158:285-286. [PMID: 33583727 DOI: 10.1016/j.jviscsurg.2021.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- T Voron
- Department of General and Digestive Surgery, Saint Antoine Hospital, Assistance Publique des Hôpitaux de Paris (APHP), University of Paris 6, France
| | - D Moszkowicz
- General and digestive surgery department, Louis Mourier Hospital, Assistance Publique Hôpitaux de Paris (APHP), University of Paris, France
| | - C Hobeika
- Service de chirurgie digestive, hépato-bilio-pancréatique et transplantation, Pitié-Salpétrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), University of Paris 6, France
| | - M Collard
- Department of digestive, hepato-bilio-pancreatic and transplantation surgery, Beaujon Hospital, Paris, Assistance Publique Hôpitaux de Paris, (APHP), University of Paris, France
| | - M Bruzzi
- Department of digestive surgery, Européen Georges Pompidou Hospital, Assistance Publique Hôpitaux de Paris (APHP), University of Paris, France
| | - N Beghdadi
- Hepatobiliary Center, Paul Brousse Hospital, Assistance Publique des Hôpitaux de Paris (APHP), University of Paris 11, France
| | - J Catry
- Department of General, Digestive and Endocrine Surgery, Saint-Louis Hospital, Assistance Publique des Hôpitaux de Paris (APHP), University of Paris, France
| | - E Duchalais
- Department of Digestive and Endocrine Surgery, CHU Nantes, University of Nantes, France
| | - G Manceau
- Service de chirurgie digestive, hépato-bilio-pancréatique et transplantation, Pitié-Salpétrière Hospital, Assistance Publique Hôpitaux de Paris (APHP), University of Paris 6, France
| | - Z Lakkis
- Department of Visceral, Digestive and Cancer Surgery, CHRU Besançon, University of Franche-Comté, France
| | - M-A Allard
- Department of digestive surgery, Européen Georges Pompidou Hospital, Assistance Publique Hôpitaux de Paris (APHP), University of Paris, France
| | - F Cauchy
- Department of digestive, hepato-bilio-pancreatic and transplantation surgery, Beaujon Hospital, Paris, Assistance Publique Hôpitaux de Paris, (APHP), University of Paris, France
| | - L Maggiori
- Department of General, Digestive and Endocrine Surgery, Saint-Louis Hospital, Assistance Publique des Hôpitaux de Paris (APHP), University of Paris, France.
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19
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Touchefeu Y, Duchalais E, Bruley des Varannes S, Alameddine J, Mirallie E, Matysiak-Budnik T, Le Bastard Q, Javaudin F, Rimbert M, Jotereau F, Montassier E. Concomitant decrease of double-positive lymphocyte population CD4CD8αα and Faecalibacterium prausnitzii in patients with colorectal cancer. Eur J Gastroenterol Hepatol 2021; 32:149-156. [PMID: 32675782 DOI: 10.1097/meg.0000000000001842] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION AND AIMS Changes in the composition of the gut microbiota in patients with colorectal cancer (CRC) compatible with a contribution of the gut microbiota in carcinogenesis have been reported. In particular, a decrease Faecalibacterium prausnitzii has been identified. A CD4CD8αα, double-positive lymphocyte population (DP8α) has recently been demonstrated in the human colon and blood with regulatory functions and specificity for F. prausnitzii. Here, we aimed to detect dysbiosis in the fecal microbiome of patients with CRC by metagenomic analysis, and to look for changes in the levels of DP8α circulating T cells specific for F. prausnitzii in these patients. PATIENTS AND METHODS Patients with CRC and control subjects were prospectively included. None had received antibiotics in the previous month or any anti-tumor treatment. A stool sample was collected for each participant, and analyzed by shotgun sequencing. The DP8α T cell population was identified and quantified on fresh whole blood by flow cytometry with anti-CD45, anti-CD3, anti-CD4 and anti-CD8α co-labeling. RESULTS Twenty-one patients with CRC and 20 controls subjects were included. We found that mean relative abundance of five species was significantly decreased in CRC patients compared with controls, including F. prausnitzii, Barnesiella intestinihominis, Alistipes finegoldii, Bacteroides eggerthii and Eubacterium siraeum. We also found that the DP8α T cell population was significantly decreased in the blood of CRC patients compared with controls. CONCLUSION In our work, we showed that a reduced abundance of F. prausnitzii in CRC patients was associated to a significant decrease in the circulating DP8α Treg population, suggesting a potential involvement of reduced activity of DP8α T cells in colonic carcinogenesis. These findings open new diagnostic and therapeutic strategies for CRC.
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Affiliation(s)
- Yann Touchefeu
- Institut des Maladies de l'Appareil Digestif, CHU Nantes
- INSERM U1235
| | - Emilie Duchalais
- Institut des Maladies de l'Appareil Digestif, CHU Nantes
- INSERM U1235
| | | | | | - Eric Mirallie
- Institut des Maladies de l'Appareil Digestif, CHU Nantes
| | | | - Quentin Le Bastard
- Université de Nantes, Microbiotas Hosts Antibiotics and bacterial Resistances (MiHAR)
- Department of Emergency Medicine, CHU Nantes
| | - François Javaudin
- Université de Nantes, Microbiotas Hosts Antibiotics and bacterial Resistances (MiHAR)
- Department of Emergency Medicine, CHU Nantes
| | - Marie Rimbert
- Laboratoire d'immunologie, CIMNA, CHU de Nantes
- Centre de Recherche en Transplantation et Immunologie (CRTI), UMR 1064, INSERM
| | | | - Emmanuel Montassier
- Université de Nantes, Microbiotas Hosts Antibiotics and bacterial Resistances (MiHAR)
- Department of Emergency Medicine, CHU Nantes
- EA3826 Thérapeutiques Anti-Infectieuses, Institut de Recherche en Santé 2 Nantes Biotech, Medical University of Nantes
- Surgical Intensive Care Unit, Hotel Dieu, CHU Nantes, Nantes, France
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20
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Mutala LB, Deleine C, Karakachoff M, Dansette D, Ducoin K, Oger R, Rousseau O, Podevin J, Duchalais E, Fourquier P, Thomas WEA, Gourraud PA, Bennouna J, Brochier C, Gervois N, Bossard C, Jarry A. The Caspase-1/IL-18 Axis of the Inflammasome in Tumor Cells: A Modulator of the Th1/Tc1 Response of Tumor-Infiltrating T Lymphocytes in Colorectal Cancer. Cancers (Basel) 2021; 13:cancers13020189. [PMID: 33430344 PMCID: PMC7825767 DOI: 10.3390/cancers13020189] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/29/2020] [Accepted: 01/04/2021] [Indexed: 12/12/2022] Open
Abstract
In colorectal cancer (CRC), a high density of T lymphocytes represents a strong prognostic marker in subtypes of CRC. Optimized immunotherapy strategies to boost this T-cell response are still needed. A good candidate is the inflammasome pathway, an emerging player in cancer immunology that bridges innate and adaptive immunity. Its effector protein caspase-1 matures IL-18 that can promote a T-helper/cytotoxic (Th1/Tc1) response. It is still unknown whether tumor cells from CRC possess a functional caspase-1/IL-18 axis that could modulate the Th1/Tc1 response. We used two independent cohorts of CRC patients to assess IL-18 and caspase-1 expression by tumor cells in relation to the density of TILs and the microsatellite status of CRC. Functional and multiparametric approaches at the protein and mRNA levels were performed on an ex vivo CRC explant culture model. We show that, in the majority of CRCs, tumor cells display an activated and functional caspase-1/IL-18 axis that contributes to drive a Th1/Tc1 response elicited by TILs expressing IL-18Rα. Furthermore, unsupervised clustering identified three clusters of CRCs according to the caspase-1/IL-18/TIL density/interferon gamma (IFNγ) axis and microsatellite status. Together, our results strongly suggest that targeting the caspase-1/IL-18 axis can improve the anti-tumor immune response in subgroups of CRC.
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Affiliation(s)
- Linda Bilonda Mutala
- Institut Roche, 92100 Boulogne-Billancourt, France; (L.B.M.); (C.B.)
- Inserm, CRCINA, Université de Nantes, 44000 Nantes, France; (C.D.); (K.D.); (R.O.); (N.G.); (C.B.)
- LabEx IGO, Université de Nantes, 44000 Nantes, France
| | - Cécile Deleine
- Inserm, CRCINA, Université de Nantes, 44000 Nantes, France; (C.D.); (K.D.); (R.O.); (N.G.); (C.B.)
- LabEx IGO, Université de Nantes, 44000 Nantes, France
| | - Matilde Karakachoff
- Clinique des Données, CHU de Nantes, INSERM, CIC 1413, 44093 Nantes, France; (M.K.); (O.R.); (P.-A.G.)
| | | | - Kathleen Ducoin
- Inserm, CRCINA, Université de Nantes, 44000 Nantes, France; (C.D.); (K.D.); (R.O.); (N.G.); (C.B.)
- LabEx IGO, Université de Nantes, 44000 Nantes, France
| | - Romain Oger
- Inserm, CRCINA, Université de Nantes, 44000 Nantes, France; (C.D.); (K.D.); (R.O.); (N.G.); (C.B.)
- LabEx IGO, Université de Nantes, 44000 Nantes, France
| | - Olivia Rousseau
- Clinique des Données, CHU de Nantes, INSERM, CIC 1413, 44093 Nantes, France; (M.K.); (O.R.); (P.-A.G.)
| | - Juliette Podevin
- Digestive Surgery Department and IMAD, CHU Nantes, 44093 Nantes, France; (J.P.); (E.D.)
| | - Emilie Duchalais
- Digestive Surgery Department and IMAD, CHU Nantes, 44093 Nantes, France; (J.P.); (E.D.)
| | - Pierre Fourquier
- Digestive Surgery Department, Hôpital Privé du Confluent, 44200 Nantes, France;
| | | | - Pierre-Antoine Gourraud
- Clinique des Données, CHU de Nantes, INSERM, CIC 1413, 44093 Nantes, France; (M.K.); (O.R.); (P.-A.G.)
| | - Jaafar Bennouna
- Digestive Oncology Department and IMAD, CHU, 44093 Nantes, France;
| | - Camille Brochier
- Institut Roche, 92100 Boulogne-Billancourt, France; (L.B.M.); (C.B.)
| | - Nadine Gervois
- Inserm, CRCINA, Université de Nantes, 44000 Nantes, France; (C.D.); (K.D.); (R.O.); (N.G.); (C.B.)
- LabEx IGO, Université de Nantes, 44000 Nantes, France
| | - Céline Bossard
- Inserm, CRCINA, Université de Nantes, 44000 Nantes, France; (C.D.); (K.D.); (R.O.); (N.G.); (C.B.)
- LabEx IGO, Université de Nantes, 44000 Nantes, France
- Pathology Department, CHU Nantes, 44093 Nantes, France;
| | - Anne Jarry
- Inserm, CRCINA, Université de Nantes, 44000 Nantes, France; (C.D.); (K.D.); (R.O.); (N.G.); (C.B.)
- LabEx IGO, Université de Nantes, 44000 Nantes, France
- Correspondence:
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21
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Tuech JJ, Manceau G, Ouaissi M, Denet C, Chau A, Kartheuser A, Desfourneaux V, Duchalais E, Bertrand M, Badic B, Alves A, Ceribelli C, Venara A, Mege D, Mauvais F, Dumont F, Mabrut JY, Lakkis Z, Cotte E, Meillat H. Are colorectal cancer patients at risk for COVID-19 infection during the postoperative period? The Covid-GRECCAR study. Int J Colorectal Dis 2021; 36:611-615. [PMID: 33495872 PMCID: PMC7835106 DOI: 10.1007/s00384-021-03847-4] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION During the COVID-19 pandemic, cancer patients have been regarded as having a high risk of severe events if they are infected with SARS-CoV-2, particularly those under medical or surgical treatment. The aim of this study was to assess the posttreatment risk of infection by SARS-CoV-2 in a population of patients operated on for colorectal cancer 3 months before the COVID-19 outbreak and who after hospitalization returned to an environment where the virus was circulating. MATERIALS AND METHODS This French, multicenter cohort study included consecutive patients undergoing elective surgery for colorectal cancer between January 1 and March 31, 2020, at 19 GRECCAR hospitals. The outcome was the rate of COVID-19 infection in this group of patients who were followed until June 15, 2020. RESULTS This study included 448 patients, 262 male (58.5%) and 186 female (41.5%), who underwent surgery for colon cancer (n = 290, 64.7%), rectal cancer (n = 155, 34.6%), or anal cancer (n = 3, 0.7%). The median age was 68 years (19-95). Comorbidities were present in nearly half of the patients, 52% were at least overweight, and the median BMI was 25 (12-42). At the end of the study, 448 were alive. Six patients (1.3%) developed COVID-19 infection; among them, 3 were hospitalized in the conventional ward, and none of them died. CONCLUSION The results are reassuring, with only a 1.3% infection rate and no deaths related to COVID-19. We believe that we can operate on colorectal cancer patients without additional mortality from COVID-19, applying all measures aimed at reducing the risk of infection.
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Affiliation(s)
- Jean-Jacques Tuech
- grid.41724.34Department of Digestive Surgery, Rouen University Hospital, 1 rue de Germont, F-76031 Rouen cedex, France
| | - Gilles Manceau
- Department of Digestive and Hepato-Pancreato-Biliary Surgery, Sorbonne University, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
| | - Mehdi Ouaissi
- grid.411167.40000 0004 1765 1600Department of Digestive, Oncological, Endocrine, and Hepatic Surgery, and Hepatic Transplantation, Trousseau Hospital, CHRU Trouseau, Tours, France
| | - Christine Denet
- grid.418120.e0000 0001 0626 5681Service de Chirurgie Digestive, Institut Mutualiste Montsouris, Paris, France
| | - Amélie Chau
- Polyclinique d’Hénin-Beaumont, Route de Courrières, 62110 Hénin-Beaumont, France
| | - Alex Kartheuser
- grid.7942.80000 0001 2294 713XColorectal Surgery Unit, Department of Abdominal Surgery and Transplantation Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCL), Brussels, Belgium
| | - Véronique Desfourneaux
- grid.411154.40000 0001 2175 0984Department of Hepatobiliary and Digestive Surgery, CHU Rennes, 2 rue Henri Le Guilloux, Rennes, France
| | - Emilie Duchalais
- grid.277151.70000 0004 0472 0371Chirurgie Cancérologique, Digestive et Endocrinienne (CCDE), Institut des Maladies de l’Appareil Digestif (IMAD), Centre Hospitalo-universitaire de Nantes (CHU) Hôtel-Dieu, Place Alexis Ricordeau, 44093 Nantes, France
| | - Martin Bertrand
- grid.121334.60000 0001 2097 0141Digestive surgery & digestive cancerology, CHU Carémeau, université de Montpellier, place du Professeur-Robert-Debré, 30029 Nîmes cedex 9, France
| | - Bogdan Badic
- grid.411766.30000 0004 0472 3249CHRU de Brest, Brest, France
| | - Arnaud Alves
- grid.411149.80000 0004 0472 0160Service de chirurgie digestive CHU Caen, registre des tumeurs digestive du calvados, Inserm U1086 ANTICIPE, 14000 Caen, France
| | - Cecilia Ceribelli
- grid.29172.3f0000 0001 2194 6418Department of Surgical Oncology, Institut de Cancérologie de Lorraine, Université de Lorraine, 54519 Vandoeuvre-lès-Nancy, France
| | - Aurelien Venara
- grid.411147.60000 0004 0472 0283Department of Endocrinal and Visceral Surgery, Angers University Hospital, 49933 Angers, France
| | - Diane Mege
- grid.411266.60000 0001 0404 1115Department of Digestive Surgery, Assistance Publique Hôpitaux de Marseille, Timone University Hospital, Marseille, France
| | - François Mauvais
- Digestive Surgery Department, Beauvais Hospital, Beauvais, France
| | - Fréderic Dumont
- grid.418191.40000 0000 9437 3027Department of Surgical Oncology, Comprehensive Cancer Center, Institut de Cancérologie de l’Ouest, Saint-Herblain, France
| | - Jean-Yves Mabrut
- grid.25697.3f0000 0001 2172 4233Department of Digestive Surgery and Transplantation, University Hospital Croix Rousse, Hospices Civils de Lyon, University of Lyon I, Lyon, France
| | - Zaher Lakkis
- grid.411158.80000 0004 0638 9213Department of Surgical Oncology, University Hospital Jean Minjoz, Besançon, France
| | - Eddy Cotte
- Department of Gastrointestinal Surgery, Hospices Civils de Lyon, Université de Lyon, Centre Hospitalier Lyon-Sud, 165 chemin du grand Revoyet, 69495 Pierre Bénite, France
| | - Helene Meillat
- grid.418443.e0000 0004 0598 4440Department of Digestive Surgical Oncology, Department of Mini Invasive Interventions (DIMI), Paoli Calmettes Institute, Marseille, France
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22
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Nardini P, Pini A, Bessard A, Duchalais E, Niccolai E, Neunlist M, Vannucchi MG. GLP-2 Prevents Neuronal and Glial Changes in the Distal Colon of Mice Chronically Treated with Cisplatin. Int J Mol Sci 2020; 21:ijms21228875. [PMID: 33238628 PMCID: PMC7700273 DOI: 10.3390/ijms21228875] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/19/2020] [Accepted: 11/21/2020] [Indexed: 12/20/2022] Open
Abstract
Cisplatin is a chemotherapeutic agent widely used for the treatment of solid cancers. Its administration is commonly associated with acute and chronic gastrointestinal dysfunctions, likely related to mucosal and enteric nervous system (ENS) injuries, respectively. Glucagon-like peptide-2 (GLP-2) is a pleiotropic hormone exerting trophic/reparative activities on the intestine, via antiapoptotic and pro-proliferating pathways, to guarantee mucosal integrity, energy absorption and motility. Further, it possesses anti-inflammatory properties. Presently, cisplatin acute and chronic damages and GLP-2 protective effects were investigated in the mouse distal colon using histological, immunohistochemical and biochemical techniques. The mice received cisplatin and the degradation-resistant GLP-2 analog ([Gly2]GLP-2) for 4 weeks. Cisplatin-treated mice showed mucosal damage, inflammation, IL-1β and IL-10 increase; decreased number of total neurons, ChAT- and nNOS-immunoreactive (IR) neurons; loss of SOX-10-IR cells and reduced expression of GFAP- and S100β-glial markers in the myenteric plexus. [Gly2]GLP-2 co-treatment partially prevented mucosal damage and counteracted the increase in cytokines and the loss of nNOS-IR and SOX-10-IR cells but not that of ChAT-IR neurons. Our data demonstrate that cisplatin causes mucosal injuries, neuropathy and gliopathy and that [Gly2]GLP-2 prevents these injuries, partially reducing mucosal inflammation and inducing ENS remodeling. Hence, this analog could represent an effective strategy to overcome colonic injures induced by cisplatin.
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Affiliation(s)
- Patrizia Nardini
- Histology and Embryology Research Unit, Department of Experimental and Clinical Medicine, University of Florence, 50139 Florence, Italy; (P.N.); (A.P.); (E.N.)
| | - Alessandro Pini
- Histology and Embryology Research Unit, Department of Experimental and Clinical Medicine, University of Florence, 50139 Florence, Italy; (P.N.); (A.P.); (E.N.)
| | - Anne Bessard
- Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, University of Nantes, 44035 Nantes, France; (A.B.); (E.D.); (M.N.)
| | - Emilie Duchalais
- Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, University of Nantes, 44035 Nantes, France; (A.B.); (E.D.); (M.N.)
| | - Elena Niccolai
- Histology and Embryology Research Unit, Department of Experimental and Clinical Medicine, University of Florence, 50139 Florence, Italy; (P.N.); (A.P.); (E.N.)
| | - Michel Neunlist
- Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, University of Nantes, 44035 Nantes, France; (A.B.); (E.D.); (M.N.)
| | - Maria Giuliana Vannucchi
- Histology and Embryology Research Unit, Department of Experimental and Clinical Medicine, University of Florence, 50139 Florence, Italy; (P.N.); (A.P.); (E.N.)
- Correspondence: ; Tel.: +39-055-275-8152
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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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Drissi F, Gillion JF, Duchalais E. Readmissions at 30 days after inguinal hernia repair: A series of 5126 patients. J Visc Surg 2020; 158:299-304. [PMID: 32811781 DOI: 10.1016/j.jviscsurg.2020.08.009] [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] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The evaluation of the re-admission rate within 30 days of inguinal hernia repair represents a patient management quality indicator. The goal of our study was to evaluate the re-admission rate at 30 days after inguinal hernia repair and identify the risk factors for re-admission. METHODS Based on a prospective national registry, patient data were collected during two years. The number of and reasons for re-admissions were compiled. RESULTS A total of 5126 patients, mean age 61 years, underwent inguinal hernia repair. Ambulatory surgery was performed in 4013 (78%) patients. Failed ambulatory surgery was recorded for 100 (2%) patients. Thirty-three (0.64%) patients were re-admitted within 30 days following surgery for 34 various reasons. The re-admission rate after ambulatory surgery was 0.5%. Half of patients re-admitted presented with a severe complication that required re-intervention. In multivariable analysis, emergency hernia repair (OR 4.899 [1.309-18.327]; P=0.01) and prolonged duration of operation (OR 1.023 [1.009-1.037]; P=0.001) were identified as independent risk factors for re-admission within 30 days after surgery. CONCLUSION Within this prospective national cohort, the overall re-admission rate after inguinal hernia repair was 0.64%, slightly less among the patients undergoing ambulatory surgery. Half of re-admitted patients required surgical re-operation. Emergency hernia repair and prolonged duration of operation were risk factors for re-admission.
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Affiliation(s)
- F Drissi
- Digestive and Endocrine Surgery Clinic (CCDE), Institute of Diseases of the Digestive System (IMAD), University Hospital Center of Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France.
| | - J-F Gillion
- Visceral and Digestive Surgery Unit, Hospital of Antony, 1, rue Velpeau, 92160 Antony, France
| | - E Duchalais
- Digestive and Endocrine Surgery Clinic (CCDE), Institute of Diseases of the Digestive System (IMAD), University Hospital Center of Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France
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Lallemand L, Duchalais E, Musquer N, Jacobi D, Coron E, des Varannes SB, Mirallié E, Blanchard C. Does Sleeve Gastrectomy Increase the Risk of Barret's Esophagus? Obes Surg 2020; 31:101-110. [PMID: 32725593 DOI: 10.1007/s11695-020-04875-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 03/21/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE Sleeve gastrectomy (SG) is the most commonly performed bariatric surgical procedure worldwide. However, the impact of SG on Barrett's esophagus (BE) remains unknown. The main objective was to determine the rate of BE 5 years after SG. MATERIALS AND METHODS Patients, operated in 2012 by SG in one center, who preoperatively and postoperatively (5 years) underwent upper gastrointestinal endoscopy (UGIE), 24-h pH monitoring, and esophageal manometry, were included. RESULTS A total of 59 (81.4% of females) patients were included. Preoperative mean age and body mass index were 45.2 ± 11.7 years and 45.2 ± 8.1 kg/m2 respectively. Preoperative 24-h pH monitoring reported gastroesophageal reflux disease (GERD) in 18 (30.5%) patients. The mean total body weight loss at 5 years was 16.1 ± 11.2%. No significant difference was observed between preoperative and postoperative de Meester's score (20.2 ± 27.1 and 21.0 ± 21.5 respectively (p = 0.91)) nor between preoperative and postoperative number of acid reflux episodes per 24 h (65.1 ± < 40.0 and 50.3 ± 40.3 (p = 0.21)). The UGIE revealed 5 patients (8.5%) with endoscopically suspected esophageal metaplasia, without confirmed metaplasia on histologic examination. GERD was diagnosed in 32 patients (54.2%), de novo GERD in 16 (27.1%) patients and esophagitis in 16 (27.1%) patients. At 5 years, 25 patients (42.4%) reported a lack of regular medical follow-up. CONCLUSIONS This study highlights the incidence of postoperative GERD and endoscopic lesions following SG. Even though SG is not contraindicated in case of reflux, GERD patients who undergo SG may be supervised by a close endoscopic surveillance.
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Affiliation(s)
- L Lallemand
- Chirurgie Cancérologique, Digestive et Endocrinienne (CCDE), Institut des Maladies de l'Appareil Digestif (IMAD), Centre Hospitalo-universitaire de Nantes (CHU) Hôtel-Dieu, Place Alexis Ricordeau, 44093, Nantes, France
| | - E Duchalais
- Chirurgie Cancérologique, Digestive et Endocrinienne (CCDE), Institut des Maladies de l'Appareil Digestif (IMAD), Centre Hospitalo-universitaire de Nantes (CHU) Hôtel-Dieu, Place Alexis Ricordeau, 44093, Nantes, France
- Université de Nantes, quai de Tourville, 44000, Nantes, France
| | - N Musquer
- Service d'Hépato-Gastroentérologie et Assistance Nutritionnelle, Institut des Maladies de l'Appareil Digestif (IMAD), Centre Hospitalo-Universitaire (CHU), Nantes, France
| | - D Jacobi
- Université de Nantes, quai de Tourville, 44000, Nantes, France
- L'Institut du Thorax, Service d'Endocrinologie, Maladies Métaboliques et Nutrition, CHU Nantes, Nantes, France
- L'Institut du Thorax, Inserm UMR-S1087, CNRS, UNIV Nantes, Nantes, France
| | - E Coron
- Université de Nantes, quai de Tourville, 44000, Nantes, France
- Service d'Hépato-Gastroentérologie et Assistance Nutritionnelle, Institut des Maladies de l'Appareil Digestif (IMAD), Centre Hospitalo-Universitaire (CHU), Nantes, France
| | - S Bruley des Varannes
- Université de Nantes, quai de Tourville, 44000, Nantes, France
- Service d'Hépato-Gastroentérologie et Assistance Nutritionnelle, Institut des Maladies de l'Appareil Digestif (IMAD), Centre Hospitalo-Universitaire (CHU), Nantes, France
| | - E Mirallié
- Chirurgie Cancérologique, Digestive et Endocrinienne (CCDE), Institut des Maladies de l'Appareil Digestif (IMAD), Centre Hospitalo-universitaire de Nantes (CHU) Hôtel-Dieu, Place Alexis Ricordeau, 44093, Nantes, France
- Université de Nantes, quai de Tourville, 44000, Nantes, France
| | - C Blanchard
- Chirurgie Cancérologique, Digestive et Endocrinienne (CCDE), Institut des Maladies de l'Appareil Digestif (IMAD), Centre Hospitalo-universitaire de Nantes (CHU) Hôtel-Dieu, Place Alexis Ricordeau, 44093, Nantes, France.
- Université de Nantes, quai de Tourville, 44000, Nantes, France.
- L'Institut du Thorax, Service d'Endocrinologie, Maladies Métaboliques et Nutrition, CHU Nantes, Nantes, France.
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Shogan BD, Chen J, Duchalais E, Collins D, Chang M, Krull K, Krezalek MA, Larson DW, Walther-Antonio MR, Chia N, Nelson H. Alterations of the Rectal Microbiome Are Associated with the Development of Postoperative Ileus in Patients Undergoing Colorectal Surgery. J Gastrointest Surg 2020; 24:1663-1672. [PMID: 32323252 DOI: 10.1007/s11605-020-04593-8] [Citation(s) in RCA: 9] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 04/02/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND The most common complications after colorectal surgery, postoperative ileus, surgical site infections, and anastomotic leaks continue to occur despite advances in surgical technique and enhanced recovery pathways. Preclinical studies have documented that intestinal bacteria play a role in the development of these complication, yet human data is lacking. Here we hypothesized that patients that develop ileus, surgical site infection, and/or anastomotic leak following colorectal surgery harbor a specific preoperative gut microbiome. METHODS We performed a prospective cohort study on 101 patients undergoing colon or rectal resection at the Mayo Clinic. Rectal samples were collected preoperatively and on the ward on postoperative day two. The bacterial community from each sample was characterized by 16S rRNA and associated with the development of complications. RESULTS The rectal microbiome collected from patients in the operating room (p = .003) and on postoperative day two (p = .001) was significantly difference in patients whom later developed postoperative ileus compared with patients that had a normal return of bowel function. Patients whom developed ileus showed increased abundance of Bacteroides spp., Parabacteroides spp., and Ruminococcus spp., bacteria that are associated with promoting intestinal inflammation. There were no differences in the microbiome in patients that developed surgical site infections or anastomotic leaks. CONCLUSIONS In this pilot study, patients that develop postoperative ileus harbor a specific gut microbiome during the perioperative period. These findings demonstrate that the preoperative bacterial composition may predispose patients to the development of ileus and that perioperative manipulation of the gut bacteria may provide a novel method to promote normal return of bowel function.
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Affiliation(s)
- Benjamin D Shogan
- Division of Colon and Rectal Surgery, University of Chicago, Room J557F, MC 5095, 5841 S. Maryland Ave, Chicago, IL, 60637, USA.
| | - Jun Chen
- Division of Biomedical Statistics, Mayo Clinic, Rochester, MN, USA
| | - Emilie Duchalais
- Department of Digestive and Endocrine Surgery, CHU de Nantes, Nantes, France
| | | | - Melissa Chang
- Department of Surgery, St. Joseph Mercy Hospital, Ann Arbor, MI, USA
| | - Kimberly Krull
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA
| | - Monika A Krezalek
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA
| | - David W Larson
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA
| | | | - Nicholas Chia
- Division of Biomedical Statistics, Mayo Clinic, Rochester, MN, USA
| | - Heidi Nelson
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA
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Abet E, Drissi F, Couëtte C, Jean MH, Denimal F, Podevin J, Duchalais E, Meurette G. Predictive value of inflammatory markers for postoperative recovery following colorectal surgery. Int J Colorectal Dis 2020; 35:1125-1131. [PMID: 32291509 DOI: 10.1007/s00384-020-03594-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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] [Accepted: 04/04/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Using biological markers to predict serious complications and global postoperative recovery, to ensure safe and timely patient discharge after elective colorectal surgery represents a major challenge. The aim of this study was to demonstrate that C-reactive protein levels < 172 mg/l on postoperative day 3 were associated with postoperative recovery within 5 days. METHODS This is a prospective study of a consecutive bicentric cohort. Successive patients scheduled for bowel resection with anastomosis, without stoma, were included. The main composite endpoint for overall postoperative recovery included absence of fever, absence of pain > 2 on the visual analog scale, intestinal gas transit, and patient autonomy for mobility and body care. RESULTS One hundred sixty-height patients, with a mean age of 65 years old, were analyzed. Ninety patients (53%) underwent right colectomy and 131 (77%) were operated on by laparoscopy. Severe postoperative complications were observed in 11 patients (6%). One hundred twenty patients (71%) recovered within 5 days. C-reactive protein levels < 172 mg/L on postoperative day 3 had a negative predictive value of 80% to predict recovery within 5 days. Ninety-five percent of patients with C-reactive protein < 172 mg/L at postoperative day 3 had no severe postoperative complications. CONCLUSION Levels of C-reactive protein < 172 mg/L at postoperative day 3 corresponded with an early recovery in 80% of cases, thus allowing safe and early discharge without risk of serious complications.
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Affiliation(s)
- Emeric Abet
- Department of Digestive Surgery, Vendée Medical Center, Les Oudairies, 85000, La Roche-sur-Yon, France
| | - Farouk Drissi
- Department of Digestive Surgery, Vendée Medical Center, Les Oudairies, 85000, La Roche-sur-Yon, France. .,Department of Digestive and Endocrine Surgery, University Hospital of Nantes, 1, Place Alexis Ricordeau, 44093, Nantes, France.
| | - Clément Couëtte
- Department of Digestive Surgery, Vendée Medical Center, Les Oudairies, 85000, La Roche-sur-Yon, France
| | - Marc-Henri Jean
- Department of Digestive Surgery, Vendée Medical Center, Les Oudairies, 85000, La Roche-sur-Yon, France
| | - Fabrice Denimal
- Department of Digestive Surgery, Vendée Medical Center, Les Oudairies, 85000, La Roche-sur-Yon, France
| | - Juliette Podevin
- Department of Digestive and Endocrine Surgery, University Hospital of Nantes, 1, Place Alexis Ricordeau, 44093, Nantes, France
| | - Emilie Duchalais
- Department of Digestive and Endocrine Surgery, University Hospital of Nantes, 1, Place Alexis Ricordeau, 44093, Nantes, France
| | - Guillaume Meurette
- Department of Digestive and Endocrine Surgery, University Hospital of Nantes, 1, Place Alexis Ricordeau, 44093, Nantes, France
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Abstract
BACKGROUND Anastomotic leak remains a critical complication after restorative rectal cancer surgery and is associated with significant morbidity and mortality rates, whereas reported rates range from 4% to 29%. Whether the occurrence of leak may have an impact on long-term oncological outcomes is under debate. OBJECTIVE This study aimed to describe the oncological impact of anastomotic leak on patients undergoing sphincter-preserving surgery for rectal adenocarcinoma. DESIGN This is a retrospective review of a prospectively maintained database. SETTINGS The study was conducted at a high-volume colorectal center. PATIENTS Data on patients who underwent restorative surgery for rectal adenocarcinoma from January 2000 until December 2013 were retrospectively analyzed. MAIN OUTCOME MEASURES The primary outcome measured was the impact of anastomotic leak, defined according to the classification proposed by the International Study Group of Rectal Cancer, on long-term overall survival, disease-free survival, disease-specific survival, and local recurrence. RESULTS A total of 787 patients undergoing sphincter-preserving surgery for rectal cancer met the inclusion criteria. Forty-two (5.3%) patients presented a symptomatic anastomotic leak. The median follow-up period was 64 months. Fifty-one (6.5%) patients experienced a cancer-related death, 2 of 42 in the anastomotic leak group. Five-year overall survival, disease-specific survival, and disease-free survival were 88%, 94.7%, and 85.3%. Local recurrence rate was 2%. There was no difference in long-term overall survival, disease-specific survival, disease-free survival, and local recurrence rate between groups. On a multivariable analysis, anastomotic leak did not impact oncological outcomes. LIMITATIONS This study was limited by retrospective analysis. CONCLUSIONS The occurrence of anastomotic leak after restorative resection for rectal cancer did not impact long-term oncological outcomes in our cohort of patients. See Video Abstract at http://links.lww.com/DCR/B187. RESULTADOS ONCOLÓGICOS A LARGO PLAZO DESPUÉS DE UNA FUGA ANASTOMÓTICA EN CIRUGÍA DE CÁNCER RECTAL: La fuga anastomótica sigue siendo una complicación crítica después de la cirugía restauradora del cáncer rectal y se asocia con tasas significativas de morbilidad y mortalidad, mientras que las tasas reportadas varían del 4% al 29%. Se está debatiendo si la aparición de fugas puede tener un impacto en los resultados oncológicos a largo plazo.Describir el impacto oncológico de la fuga anastomótica en pacientes sometidos a cirugía de preservación del esfínter para adenocarcinoma rectal.Revisión retrospectiva de una base de datos mantenida prospectivamente.El estudio se realizó en un centro colorrectal de alto volumen.Se analizaron retrospectivamente los datos de pacientes que se sometieron a cirugía reparadora por adenocarcinoma rectal desde Enero de 2000 hasta Diciembre de 2013.Impacto de la fuga anastomótica, definida de acuerdo con la clasificación propuesta por el Grupo de Estudio Internacional del Cáncer Rectal (International Study Group of Rectal Cancer), sobre la supervivencia general a largo plazo, la supervivencia libre de enfermedad, la supervivencia específica de la enfermedad y la recurrencia local.Un total de 787 pacientes sometidos a cirugía para preservar el esfínter por cáncer rectal cumplieron con los criterios de inclusión. Cuarenta y dos (5.3%) pacientes presentaron una fuga anastomótica sintomática. El tiempo mediano del período de seguimiento fue de 64 meses. Cincuenta y un (6.5%) pacientes sufrieron muerte relacionada con el cáncer, 2 de 42 en el grupo de fuga anastomótica. La supervivencia global a cinco años, la supervivencia específica de la enfermedad y la supervivencia libre de enfermedad fueron del 88%, 94.7% y 85.3%, respectivamente. La tasa de recurrencia local fue del 2%. No hubo diferencias en la supervivencia global a largo plazo, la supervivencia específica de la enfermedad, la supervivencia libre de enfermedad y la tasa de recurrencia local entre los grupos. En un análisis multivariable, la fuga anastomótica no afectó los resultados oncológicos.Este estudio fue limitado por análisis retrospectivo.La aparición de fuga anastomótica después de la resección restauradora para el cáncer rectal no afectó los resultados oncológicos a largo plazo en nuestra cohorte de pacientes. Consulte Video Resumen en http://links.lww.com/DCR/B187. (Traducción-Dr. Yesenia Rojas-Kahlil).
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Affiliation(s)
- Jacopo Crippa
- Division of Colon & Rectal Surgery, Mayo Clinic, Rochester, Minnesota
| | - Emilie Duchalais
- Division of Colon & Rectal Surgery, Mayo Clinic, Rochester, Minnesota
| | | | - Amit Merchea
- Division of Colon & Rectal Surgery, Mayo Clinic, Jacksonville, Florida
| | - Scott R Kelley
- Division of Colon & Rectal Surgery, Mayo Clinic, Rochester, Minnesota
| | - David W Larson
- Division of Colon & Rectal Surgery, Mayo Clinic, Rochester, Minnesota
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Prigent A, Chapelet G, De Guilhem de Lataillade A, Oullier T, Durieu E, Bourreille A, Duchalais E, Hardonnière K, Neunlist M, Noble W, Kerdine-Römer S, Derkinderen P, Rolli-Derkinderen M. Tau accumulates in Crohn's disease gut. FASEB J 2020; 34:9285-9296. [PMID: 32436623 DOI: 10.1096/fj.202000414r] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 03/03/2020] [Revised: 04/09/2020] [Accepted: 04/26/2020] [Indexed: 11/11/2022]
Abstract
A sizeable body of evidence has recently emerged to suggest that gastrointestinal (GI) inflammation might be involved in the development of Parkinson's disease (PD). There is now strong epidemiological and genetical evidence linking PD to inflammatory bowel diseases and we recently demonstrated that the neuronal protein alpha-synuclein, which is critically involved in PD pathophysiology, is upregulated in inflamed segments of Crohn's colon. The microtubule associated protein tau is another neuronal protein critically involved in neurodegenerative disorders but, in contrast to alpha-synuclein, no data are available about its expression and phosphorylation patterns in inflammatory bowel diseases. Here, we examined the expression levels of tau isoforms, their phosphorylation profile and truncation in colon biopsy specimens from 16 Crohn's disease (CD) and 6 ulcerative colitis (UC) patients and compared them to samples from 16 controls. Additional experiments were performed in full thickness segments of colon of five CD and five control subjects, in primary cultures of rat enteric neurons and in nuclear factor erythroid 2-related factor (Nrf2) knockout mice. Our results show the upregulation of two main human tau isoforms in the enteric nervous system (ENS) in CD but not in UC. This upregulation was not transcriptionally regulated but instead likely resulted from a decrease in protein clearance via an Nrf2 pathway. Our findings, which provide the first detailed characterization of tau in CD, suggest that the key proteins involved in neurodegenerative disorders such as alpha-synuclein and tau, might also play a role in CD.
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Affiliation(s)
- Alice Prigent
- Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, Université de Nantes, Nantes, France
| | - Guillaume Chapelet
- Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, Université de Nantes, Nantes, France.,Clinical Gerontology Department, CHU Nantes, Nantes, France
| | - Adrien De Guilhem de Lataillade
- Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, Université de Nantes, Nantes, France.,Department of Neurology, CHU Nantes, Nantes, France
| | - Thibauld Oullier
- Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, Université de Nantes, Nantes, France
| | - Emilie Durieu
- Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, Université de Nantes, Nantes, France
| | - Arnaud Bourreille
- Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, Université de Nantes, Nantes, France
| | - Emilie Duchalais
- Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, Université de Nantes, Nantes, France
| | - Kévin Hardonnière
- Inserm, Inflammation, Microbiome and Immunosurveillance, Université Paris-Saclay, Châtenay-Malabry, France
| | - Michel Neunlist
- Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, Université de Nantes, Nantes, France
| | - Wendy Noble
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK
| | - Saadia Kerdine-Römer
- Inserm, Inflammation, Microbiome and Immunosurveillance, Université Paris-Saclay, Châtenay-Malabry, France
| | - Pascal Derkinderen
- Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, Université de Nantes, Nantes, France.,Department of Neurology, CHU Nantes, Nantes, France
| | - Malvyne Rolli-Derkinderen
- Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, Université de Nantes, Nantes, France
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30
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Dumont F, Duchalais E, Aumont A, Thibaudeau E. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy by laparoscopy via a single-port approach for low-grade peritoneal malignancy. Surg Endosc 2020; 34:2789-2795. [PMID: 32166549 DOI: 10.1007/s00464-020-07492-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/21/2019] [Accepted: 03/02/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a long and complex procedure. A minimal invasive approach is rarely performed. The feasibility of laparoscopic CRS and HIPEC via a single port (SP) approach is unknown. The aim of this study was to assess the feasibility of CRS and HIPEC with a SP approach. METHODS This study is IDEAL stage I-IIa. Patients with low grade and limited peritoneal malignancy were included in a tertiary care cancer center. Intra- and post-operative adverse events were recorded and classified according to medical and surgical dedicated classifications. The main objective measurement to assess feasibility was the conversion to open or multiport surgery. RESULTS A total of 12 highly selected patients were assessed. The median operating time was 240 min (range, 180-360) and two near miss events were reported. Two conversions to open and multiport surgery occurred. The median comprehensive complication index was 0 (range, 0-42.6) with two severe adverse events (Clavien-Dindo or CTC-AE ≥ 3). The median length of stay was 8.5 days (range, 5-13). CONCLUSION CRS and HIPEC via a laparoscopic SP approach are feasible and safe in the short term. The next step should be a prospective development study.
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Affiliation(s)
- F Dumont
- Department of Digestive Oncological Surgery, West Cancer Institute, Boulevard Jacques Monod, 44800, Saint Herblain, France.
| | - E Duchalais
- Department of Digestive Surgery, University Hospital, Nantes, France
| | - A Aumont
- Department of Digestive Oncological Surgery, West Cancer Institute, Boulevard Jacques Monod, 44800, Saint Herblain, France
| | - E Thibaudeau
- Department of Digestive Oncological Surgery, West Cancer Institute, Boulevard Jacques Monod, 44800, Saint Herblain, France
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31
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Grass F, Behm KT, Duchalais E, Crippa J, Spears GM, Harmsen WS, Hübner M, Mathis KL, Kelley SR, Pemberton JH, Dozois EJ, Larson DW. Impact of delay to surgery on survival in stage I-III colon cancer. Eur J Surg Oncol 2020; 46:455-461. [PMID: 31806516 DOI: 10.1016/j.ejso.2019.11.513] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [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: 07/07/2019] [Revised: 10/11/2019] [Accepted: 11/27/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE To assess the impact of delay from diagnosis to curative surgery on survival in patients with non-metastatic colon cancer. METHODS National Cancer database (NCDB) analysis (2004-2013) including all consecutive patients diagnosed with stage I-III colon cancer and treated with primary elective curative surgery. Short and long delays were defined as lower and upper quartiles of time from diagnosis to treatment, respectively. Age-, sex-, race-, tumor stage and location-, adjuvant treatment-, comorbidity- and socioeconomic factors-adjusted overall survival (OS) was compared between the two groups (short vs. long delay). A multivariable Cox regression model was used to identify the independent impact of each factor on OS. RESULTS Time to treatment was <16 days in the short delay group (31,171 patients) and ≥37 days in the long delay group (29,617 patients). OS was 75.4 vs. 71.9% at 5 years and 56.6 vs. 49.7% at 10 years in short and long delay groups, respectively (both p < 0.0001). Besides demographic (comorbidities, advanced age) and pathological factors (transverse and right-vs. left-sided location, advanced tumor stage, poor differentiation, positive microscopic margins), treatment delay had a significant impact on OS (HR 1.06, 95% CI 1.05-1.07 per 14 day-delay) upon multivariable analysis. The adjusted hazard ratio for death increased continuously with delay times of longer than 30 days, to become significant after a delay of 40 days. CONCLUSION This analysis using a national cancer database revealed a significant impact on OS when surgeries for resectable colon cancer were delayed beyond 40 days from time of diagnosis.
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Affiliation(s)
- Fabian Grass
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA; Department of Visceral Surgery, Lausanne University Hospital, Bugnon 46, 1011, Lausanne, Switzerland
| | - Kevin T Behm
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Emilie Duchalais
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Jacopo Crippa
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Grant M Spears
- Department of Biostatistics, Mayo Clinic, Rochester, MN, 55905, USA
| | | | - Martin Hübner
- Department of Visceral Surgery, Lausanne University Hospital, Bugnon 46, 1011, Lausanne, Switzerland
| | - Kellie L Mathis
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Scott R Kelley
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - John H Pemberton
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Eric J Dozois
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - David W Larson
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
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Venara A, Meillat H, Cotte E, Ouaissi M, Duchalais E, Mor-Martinez C, Wolthuis A, Regimbeau JM, Ostermann S, Hamel JF, Joris J, Slim K. Correction to: Incidence and Risk Factors for Severity of Postoperative Ileus After Colorectal Surgery: A Prospective Registry Data Analysis. World J Surg 2020; 44:1331. [PMID: 31993721 DOI: 10.1007/s00268-020-05386-5] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In the list of participating investigators that appears in Acknowledgements, one of the investigators names appears incorrectly.
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Affiliation(s)
- A Venara
- Faculty of Medicine of Angers, Angers, France. .,Department of Visceral and Endocrinal Surgery (Service de chirurgie viscérale et endocrinienne), CHU Angers, 4, Rue Larrey, 49933, Angers Cedex 9, France. .,UMR INSERM U1235, TENS, The Enteric Nervous System in Gut and Brain Disorders, Institut des Maladies de l'Appareil Digestif, 1, Rue Gaston Veil, 44035, Nantes, France.
| | - H Meillat
- Institut Paoli-Calmette, 232 Boulevard de Sainte Marguerite, 13009, Marseille, France
| | - E Cotte
- Department of Visceral Surgery, CHU Lyon, Centre Hospitalier Lyon-Sud, 69495, Pierre-Bénite Cedex, France.,Université de Lyon, Lyon, France
| | - M Ouaissi
- Department of Visceral Surgery, CHU Tours, 2 Boulevard Tonnelé, 37000, Tours, France
| | - E Duchalais
- UMR INSERM U1235, TENS, The Enteric Nervous System in Gut and Brain Disorders, Institut des Maladies de l'Appareil Digestif, 1, Rue Gaston Veil, 44035, Nantes, France.,Department of Visceral Surgery, CHU Nantes, 1 Place Alexis Ricordeau, 44000, Nantes, France
| | - C Mor-Martinez
- Department of Visceral Surgery, Clinique de l'Alliance, 1 Boulevard A Nobel, 37540, Saint Cyr Sur Loire, France
| | - A Wolthuis
- Department of Abdominal Surgery, UZ Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - J M Regimbeau
- Department of Visceral Surgery, CHU Amiens, Avenue Laennec, 80054, Amiens, France
| | - S Ostermann
- Hirslanden Clinique La Colline, Geneva, Switzerland
| | - J F Hamel
- Department of Methodology and Biostatistics, CHU Angers, 4 Rue Larrey, 49933, Angers Cedex 9, France
| | - J Joris
- Department of Anesthesiology, CHU Liège, Domaine de Sart Tilman, Université de Liège, 4000, Liege, Belgium
| | - K Slim
- Department of Visceral Surgery, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France
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Montassier E, Al-Ghalith GA, Mathé C, Le Bastard Q, Douillard V, Garnier A, Guimon R, Raimondeau B, Touchefeu Y, Duchalais E, Vince N, Limou S, Gourraud PA, Laplaud DA, Nicot AB, Soulillou JP, Berthelot L. Distribution of Bacterial α1,3-Galactosyltransferase Genes in the Human Gut Microbiome. Front Immunol 2020; 10:3000. [PMID: 31998300 PMCID: PMC6970434 DOI: 10.3389/fimmu.2019.03000] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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: 06/25/2019] [Accepted: 12/06/2019] [Indexed: 12/20/2022] Open
Abstract
Because of a loss-of-function mutation in the GGTA1 gene, humans are unable to synthetize α1,3-Galactose (Gal) decorated glycans and develop high levels of circulating anti-α1,3-Galactose antibodies (anti-Gal Abs). Anti-Gal Abs have been identified as a major obstacle of organ xenotransplantation and play a role in several host-pathogen relationships including potential susceptibility to infection. Anti-Gal Abs are supposed to stem from immunization against the gut microbiota, an assumption derived from the observation that some pathogens display α1,3-Gal and that antibiotic treatment decreases the level of anti-Gal. However, there is little information to date concerning the microorganisms producing α1,3-Gal in the human gut microbiome. Here, available α1,3-Galactosyltransferase (GT) gene sequences from gut bacteria were selectively quantified for the first time in the gut microbiome shotgun sequences of 163 adult individuals from three published population-based metagenomics analyses. We showed that most of the gut microbiome of adult individuals contained a small set of bacteria bearing α1,3-GT genes. These bacteria belong mainly to the Enterobacteriaceae family, including Escherichia coli, but also to Pasteurellaceae genera, Haemophilus influenza and Lactobacillus species. α1,3-Gal antigens and α1,3-GT activity were detected in healthy stools of individuals exhibiting α1,3-GT bacterial gene sequences in their shotgun data.
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Affiliation(s)
- Emmanuel Montassier
- Microbiota Hosts Antibiotics and bacterial Resistances (MiHAR), Université de Nantes, Nantes, France.,Laboratoire EA3826 Thérapeutiques cliniques et expérimentales des infections IRS2 Nantes Biotech, Université de Nantes, Nantes, France.,Department of Emergency Medicine, CHU de Nantes, Nantes, France
| | - Gabriel A Al-Ghalith
- Bioinformatics and Computational Biology, University of Minnesota, Minneapolis, MN, United States
| | - Camille Mathé
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU de Nantes, Nantes, France
| | - Quentin Le Bastard
- Microbiota Hosts Antibiotics and bacterial Resistances (MiHAR), Université de Nantes, Nantes, France.,Department of Emergency Medicine, CHU de Nantes, Nantes, France
| | - Venceslas Douillard
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU de Nantes, Nantes, France.,CHU de Nantes, CIC 1413, Pôle Hospitalo-Universitaire 11 Santé Publique, Clinique des données, Nantes, France
| | - Abel Garnier
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU de Nantes, Nantes, France.,CHU de Nantes, CIC 1413, Pôle Hospitalo-Universitaire 11 Santé Publique, Clinique des données, Nantes, France
| | - Rémi Guimon
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU de Nantes, Nantes, France.,CHU de Nantes, CIC 1413, Pôle Hospitalo-Universitaire 11 Santé Publique, Clinique des données, Nantes, France
| | - Bastien Raimondeau
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU de Nantes, Nantes, France
| | - Yann Touchefeu
- Institut des Maladies de l'Appareil Digestif, CHU Nantes, Nantes, France.,INSERM U1235, Nantes, France
| | - Emilie Duchalais
- Institut des Maladies de l'Appareil Digestif, CHU Nantes, Nantes, France.,INSERM U1235, Nantes, France
| | - Nicolas Vince
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU de Nantes, Nantes, France
| | - Sophie Limou
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU de Nantes, Nantes, France
| | - Pierre-Antoine Gourraud
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU de Nantes, Nantes, France.,CHU de Nantes, CIC 1413, Pôle Hospitalo-Universitaire 11 Santé Publique, Clinique des données, Nantes, France
| | - David A Laplaud
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France.,Neurology department, CIC Neurology, CHU de Nantes, Nantes, France
| | - Arnaud B Nicot
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU de Nantes, Nantes, France
| | - Jean-Paul Soulillou
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU de Nantes, Nantes, France
| | - Laureline Berthelot
- Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU de Nantes, Nantes, France
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Valès S, Bacola G, Biraud M, Touvron M, Bessard A, Geraldo F, Dougherty KA, Lashani S, Bossard C, Flamant M, Duchalais E, Marionneau-Lambot S, Oullier T, Oliver L, Neunlist M, Vallette FM, Van Landeghem L. Tumor cells hijack enteric glia to activate colon cancer stem cells and stimulate tumorigenesis. EBioMedicine 2019; 49:172-188. [PMID: 31662289 PMCID: PMC6945247 DOI: 10.1016/j.ebiom.2019.09.045] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [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: 08/03/2018] [Revised: 09/25/2019] [Accepted: 09/25/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Colon cancer stem cells (CSCs), considered responsible for tumor initiation and cancer relapse, are constantly exposed to regulatory cues emanating from neighboring cells present in the tumor microenvironment. Among these cells are enteric glial cells (EGCs) that are potent regulators of the epithelium functions in a healthy intestine. However, whether EGCs impact CSC-driven tumorigenesis remains unknown. METHODS Impact of human EGC primary cultures or a non-transformed EGC line on CSCs isolated from human primary colon adenocarcinomas or colon cancer cell lines with different p53, MMR system and stemness status was determined using murine xenograft models and 3D co-culture systems. Supernatants of patient-matched human primary colon adenocarcinomas and non-adjacent healthy mucosa were used to mimic tumor versus healthy mucosa secretomes and compare their effects on EGCs. FINDINGS Our data show that EGCs stimulate CSC expansion and ability to give rise to tumors via paracrine signaling. Importantly, only EGCs that were pre-activated by tumor epithelial cell-derived soluble factors increased CSC tumorigenicity. Pharmacological inhibition of PGE2 biosynthesis in EGCs or IL-1 knockdown in tumor epithelial cells prevented EGC acquisition of a pro-tumorigenic phenotype. Inhibition of PGE2 receptor EP4 and EGFR in CSCs inhibited the effects of tumor-activated EGCs. INTERPRETATION Altogether, our results show that EGCs, once activated by the tumor, acquire a pro-tumorigenic phenotype and stimulate CSC-driven tumorigenesis via a PGE2/EP4/EGFR-dependent pathway. FUNDING This work was supported by grants from the French National Cancer Institute, La Ligue contre le Cancer, the 'Région des Pays de la Loire' and the UNC Lineberger Comprehensive Cancer Center.
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Affiliation(s)
- Simon Valès
- Bretagne Loire University, Nantes University, INSERM 1235, IMAD, The Enteric Nervous System in Gut and Brain Disorders, Nantes, France
| | - Gregory Bacola
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Mandy Biraud
- Bretagne Loire University, Nantes University, INSERM 1235, IMAD, The Enteric Nervous System in Gut and Brain Disorders, Nantes, France
| | - Mélissa Touvron
- Bretagne Loire University, Nantes University, INSERM 1235, IMAD, The Enteric Nervous System in Gut and Brain Disorders, Nantes, France,Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Anne Bessard
- Bretagne Loire University, Nantes University, INSERM 1235, IMAD, The Enteric Nervous System in Gut and Brain Disorders, Nantes, France
| | - Fanny Geraldo
- Nantes University, INSERM 1232, CRCINA, Nantes, France
| | - Kelsie A. Dougherty
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Shaian Lashani
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | | | - Mathurin Flamant
- Nantes University Hospital, Nantes, France,Jules Verne Clinic, Nantes, France
| | - Emilie Duchalais
- Bretagne Loire University, Nantes University, INSERM 1235, IMAD, The Enteric Nervous System in Gut and Brain Disorders, Nantes, France,Nantes University Hospital, Nantes, France
| | | | | | - Lisa Oliver
- Nantes University, INSERM 1232, CRCINA, Nantes, France,Nantes University Hospital, Nantes, France
| | - Michel Neunlist
- Bretagne Loire University, Nantes University, INSERM 1235, IMAD, The Enteric Nervous System in Gut and Brain Disorders, Nantes, France,Nantes University Hospital, Nantes, France
| | | | - Laurianne Van Landeghem
- Bretagne Loire University, Nantes University, INSERM 1235, IMAD, The Enteric Nervous System in Gut and Brain Disorders, Nantes, France,Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA,Corresponding author at: North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, CB# 8401, Raleigh, NC 27607, USA.
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35
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Moszkowicz D, Hobeika C, Collard M, Bruzzi M, Beghdadi N, Catry J, Duchalais E, Manceau G, Voron T, Lakkis Z, Allard MA, Cauchy F, Maggiori L. Operating room hygiene: Clinical practice recommendations. J Visc Surg 2019; 156:413-422. [DOI: 10.1016/j.jviscsurg.2019.07.010] [Citation(s) in RCA: 5] [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] [Indexed: 01/06/2023]
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Bossenmeyer C, Duchalais E, Moreau A, Bossard C. Unexpected DOG1 expression in gastrointestinal neuroectodermal tumor of the rectum: A diagnostic pitfall. Human Pathology: Case Reports 2019. [DOI: 10.1016/j.ehpc.2019.200317] [Citation(s) in RCA: 1] [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: 11/25/2022] Open
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Deidda S, Crippa J, Duchalais E, Kelley SR, Mathis KL, Dozois EJ, Larson DW. Hybrid minimally invasive/open approach versus total minimally invasive approach for rectal cancer resection: short- and long-term results. Int J Colorectal Dis 2019; 34:1251-1258. [PMID: 31139888 DOI: 10.1007/s00384-019-03311-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Accepted: 04/30/2019] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To reduce the technical challenges of a totally minimally invasive approach (TMA) and to decrease the morbidity associated with open surgery, a hybrid minimally invasive/open approach (HMOA) has been introduced as a surgical technique for rectal cancer. The aim of this study was to compare postoperative results and long-term oncologic outcomes between hybrid minimally invasive/open approach and totally minimally invasive approach in patients who underwent rectal resection for cancer. METHODS All patients with rectal cancer undergoing a totally minimally invasive approach or hybrid minimally invasive/open approach proctectomy between 2012 and 2016 were analyzed. Preoperative and postoperative outcomes were collected from a prospectively maintained institutional database. RESULTS Among 283 patients, 138 (48.8%) underwent a hybrid minimally invasive/open approach and 145 (51.2%) a totally minimally invasive approach. Preoperative characteristics were similar between groups except for distance from the anal verge, which was lower in totally minimally invasive approach group (50.7% vs 29%; p = 0.0008). Length of stay (LOS) was significantly longer in the hybrid minimally invasive/open approach group (6.4 vs 4.3; p = < 0.0001). The median follow-up was 29.6 (14-40.6) months. Overall survival and disease-free survival were not significantly different between groups. CONCLUSIONS Compared with a hybrid minimally invasive/open approach, a totally minimally invasive approach has a shorter length of stay and may improve short-term outcomes in patients undergoing proctectomy for cancer.
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Affiliation(s)
- Simona Deidda
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Jacopo Crippa
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Emilie Duchalais
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Scott R Kelley
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Kellie L Mathis
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Eric J Dozois
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - David W Larson
- Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
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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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Quénéhervé L, Duchalais E, Le Rhun M, Coron E. Author's reply: Outcomes of first-line endoscopic management for patients with sigmoid volvulus. Dig Liver Dis 2019; 51:1066. [PMID: 31171485 DOI: 10.1016/j.dld.2019.05.021] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 05/14/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Lucille Quénéhervé
- Institut des Maladies de l'Appareil Digestif (IMAD), University Hospital of Nantes place Alexis Ricordeau, Nantes, 44000, France.
| | - Emilie Duchalais
- Institut des Maladies de l'Appareil Digestif (IMAD), University Hospital of Nantes place Alexis Ricordeau, Nantes, 44000, France
| | - Marianne Le Rhun
- Institut des Maladies de l'Appareil Digestif (IMAD), University Hospital of Nantes place Alexis Ricordeau, Nantes, 44000, France
| | - Emmanuel Coron
- Institut des Maladies de l'Appareil Digestif (IMAD), University Hospital of Nantes place Alexis Ricordeau, Nantes, 44000, France
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Duchalais E, Larson DW. Correspondence. Br J Surg 2019; 106:950-951. [PMID: 31162660 DOI: 10.1002/bjs.11202] [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: 03/11/2019] [Accepted: 03/11/2019] [Indexed: 11/08/2022]
Affiliation(s)
- E Duchalais
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - D W Larson
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Dumont F, Duchalais E, Joseph S, Thibaudeau E. Laparoscopic total pelvic exenteration via an extraperitoneal approach. Surg Oncol 2019; 28:109. [PMID: 30851882 DOI: 10.1016/j.suronc.2018.11.020] [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: 01/27/2018] [Revised: 10/31/2018] [Accepted: 11/25/2018] [Indexed: 10/27/2022]
Affiliation(s)
- F Dumont
- Department of Digestive Oncological Surgery, West Oncologic Institut, Saint Herblain, France.
| | - E Duchalais
- Department of Digestive Surgery, Universitary Hospital, Nantes, France
| | - S Joseph
- Department of Digestive Oncological Surgery, West Oncologic Institut, Saint Herblain, France
| | - E Thibaudeau
- Department of Digestive Oncological Surgery, West Oncologic Institut, Saint Herblain, France
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Quénéhervé L, Dagouat C, Le Rhun M, Perez-Cuadrado Robles E, Duchalais E, Bruley des Varannes S, Touchefeu Y, Chapelle N, Coron E. Outcomes of first-line endoscopic management for patients with sigmoid volvulus. Dig Liver Dis 2019; 51:386-390. [PMID: 30377062 DOI: 10.1016/j.dld.2018.10.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 06/03/2018] [Revised: 08/27/2018] [Accepted: 10/03/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Sigmoid volvulus is a common cause of colonic obstruction in old and frail patients. Its standard management includes the endoscopic detorsion of the colonic loop, followed by an elective sigmoidectomy to prevent recurrence. However, these patients are often poor candidates for surgery. AIM The aim of this study was to compare death rate between elective sigmoidectomy and conservative management following endoscopic detorsion for sigmoid volvulus. METHODS The medical records of 83 patients undergoing endoscopic detorsion of a sigmoid volvulus from 2008 to 2014 were retrospectively reviewed. Patients were divided into two groups: 'elective surgery' and 'no surgery'. RESULTS Patients in the 'no surgery' group (n = 42) were older and had more loss of autonomy than in the 'elective surgery' group. Volvulus endoscopic detorsion was successful in 96% of patients with no complications. The median follow-up was 13 months (1 day-67 months). The death rate was 62% in the 'no surgery' group versus 32% in the 'elective surgery' group (p = 0.02). In the 'no surgery' group, 23/42 of patients had volvulus recurrence. No recurrence occurred after surgery. CONCLUSION Elective surgery must be planned as soon as possible after the first episode of sigmoid volvulus. In frail patients, other options must be developed.
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Affiliation(s)
- Lucille Quénéhervé
- Institute of Digestive Diseases (IMAD), University Hospital of Nantes, Hôtel Dieu, Nantes, France.
| | - Caroline Dagouat
- Institute of Digestive Diseases (IMAD), University Hospital of Nantes, Hôtel Dieu, Nantes, France
| | - Marianne Le Rhun
- Clinical Gerontology Department, University Hospital of Nantes, France
| | | | - Emilie Duchalais
- Institute of Digestive Diseases (IMAD), University Hospital of Nantes, Hôtel Dieu, Nantes, France
| | | | - Yann Touchefeu
- Institute of Digestive Diseases (IMAD), University Hospital of Nantes, Hôtel Dieu, Nantes, France
| | - Nicolas Chapelle
- Institute of Digestive Diseases (IMAD), University Hospital of Nantes, Hôtel Dieu, Nantes, France
| | - Emmanuel Coron
- Institute of Digestive Diseases (IMAD), University Hospital of Nantes, Hôtel Dieu, Nantes, France
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43
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Venara A, Jaouen R, Lermite E, Le Naoures P, Casa C, Mirallié E, Duchalais E, Hamy A. The Predictive Value of Pulse Wave Velocity for Anastomotic Leakage After Colorectal Surgery. World J Surg 2019; 43:252-259. [PMID: 30109387 DOI: 10.1007/s00268-018-4757-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Arterial perfusion defects are a risk factor for anastomotic leakage (AL) following colorectal surgery. Measuring arterial stiffness using pulse wave velocity (PWV) is known to reflect the performance of the arterial network. The objective of this study was to assess the predictive value of PWV for AL after colorectal surgery. METHODS A prospective monocentric study was conducted on all consecutive patients who underwent colorectal surgery scheduled between March 1, 2016 and May 1, 2017. Patients were divided into two groups according to the PWV which was measured preoperatively using the pOpmètre® device: PWV+ (PWV > 10 m/s) and PWV- (PWV ≤ 10 m/s). We then compared the PWV+ and PWV- groups. The primary endpoint was the AL rate. RESULTS A total of 96 patients were studied, including 60 in the PWV- group and 36 in the PWV+ group. Patients in the PWV+ group were more at risk of presenting with AL than those in the PWV- group (6.25 vs 0%) (p = 0.002). There was no difference in immediate postoperative complications between the two groups apart from the length of hospital stay. PWV predicted the appearance of AL with a sensitivity of and a negative predictive value of 100%. CONCLUSION Measuring PWV could be a used as a predictive examination in the early detection of AL after colorectal surgery.
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Affiliation(s)
- A Venara
- Department of Visceral and Endocrine Surgery, CHU Angers, Angers University Hospital, 4 Rue Larrey, 49933, Angers Cedex 9, France.
- Angers Medical University, Angers, France.
- INSERM U1235- TENS, The Enteric Nervous System in Gut and Brain Disorders, Institute of Digestive Tract Disorders, (Institut des maladies de l'appareil digestif), 1 Rue Gaston Veil 44035, Nantes, France.
| | - R Jaouen
- Department of Visceral and Endocrine Surgery, CHU Angers, Angers University Hospital, 4 Rue Larrey, 49933, Angers Cedex 9, France
- Angers Medical University, Angers, France
| | - E Lermite
- Department of Visceral and Endocrine Surgery, CHU Angers, Angers University Hospital, 4 Rue Larrey, 49933, Angers Cedex 9, France
- Angers Medical University, Angers, France
| | - P Le Naoures
- Department of Visceral and Endocrine Surgery, CHU Angers, Angers University Hospital, 4 Rue Larrey, 49933, Angers Cedex 9, France
| | - C Casa
- Department of Visceral and Endocrine Surgery, CHU Angers, Angers University Hospital, 4 Rue Larrey, 49933, Angers Cedex 9, France
| | - E Mirallié
- Department of Visceral and Endocrine Surgery, Nantes University Hospital, 1 Place Alexis Ricordeau, 44000, Nantes, France
| | - E Duchalais
- INSERM U1235- TENS, The Enteric Nervous System in Gut and Brain Disorders, Institute of Digestive Tract Disorders, (Institut des maladies de l'appareil digestif), 1 Rue Gaston Veil 44035, Nantes, France
- Department of Visceral and Endocrine Surgery, Nantes University Hospital, 1 Place Alexis Ricordeau, 44000, Nantes, France
| | - A Hamy
- Department of Visceral and Endocrine Surgery, CHU Angers, Angers University Hospital, 4 Rue Larrey, 49933, Angers Cedex 9, France
- Angers Medical University, Angers, France
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Ott E, Bilonda L, Dansette D, Deleine C, Duchalais E, Podevin J, Volteau C, Bennouna J, Touchefeu Y, Fourquier P, El Alami Thomas W, Chetritt J, Bezieau S, Denis M, Toquet C, Mosnier JF, Jarry A, Bossard C. The density of Tbet+ tumor-infiltrating T lymphocytes reflects an effective and druggable preexisting adaptive antitumor immune response in colorectal cancer, irrespective of the microsatellite status. Oncoimmunology 2019; 8:e1562834. [PMID: 30906656 PMCID: PMC6422378 DOI: 10.1080/2162402x.2018.1562834] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 09/20/2018] [Revised: 11/29/2018] [Accepted: 12/10/2018] [Indexed: 02/08/2023] Open
Abstract
Purpose: The recent success of anti-PD1 antibody in metastatic colorectal cancer (CRC) patients with microsatellite instability (MSI), known to be associated with an upregulated Th1/Tc1 gene signature, provides new promising therapeutic strategies. However, the partial objective response highlights a crucial need for relevant, easily evaluable, predictive biomarkers. Here we explore whether in situ assessment of Tbet+ tumor infiltrating lymphocytes (TILs) reflects a pre-existing functional antitumor Th1/Tc1/IFNγ response, in relation with clinicopathological features, microsatellite status and expression of immunoregulatory molecules (PD1, PDL1, IDO-1). Methodology: In two independent cohorts of CRC (retrospective n = 80; prospective n = 27) we assessed TILs density (CD3, Tbet, PD1) and expression profile of PDL1 and IDO-1 by immunohistochemistry/image analysis. Furthermore, the prospective cohort allowed to perform ex vivo CRC explant cultures and measure by Elisa the IFNγ response, at baseline and upon anti-PD1 treatment. Results: The density of Tbet+ TILs was significantly higher in MSI CRC, especially in the medullary subtype but also in a subgroup of MSS (microsatellite stable), and positively correlated with PD1 and PDL1 expression, but not with IDO-1. Finally, a high number of Tbet+ TILs was associated with a favorable overall survival. These Tbet+ TILs were functional as their density positively correlated with basal IFNγ levels. In addition, the combined score of Tbet+ PD1+ TILs coupled with IDO-1 expression predicted the magnitude of the IFNγ response upon anti-PD1. Conclusion: Altogether, immunohistochemical quantification of Tbet+ TILs is a reliable and accurate tool to recapitulate a preexisting Th1/Tc1/IFNγ antitumor response that can be reinvigorated by anti-PD1 treatment.
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Affiliation(s)
- Eva Ott
- Service d'Anatomie et Cytologie Pathologiques, Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France
| | - Linda Bilonda
- CRCINA, INSERM, Université d'Angers, Université de Nantes, Nantes, France.,Institut Roche, Boulogne-Billancourt, France
| | - Delphine Dansette
- Service d'Anatomie et Cytologie Pathologiques, Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France
| | - Cécile Deleine
- CRCINA, INSERM, Université d'Angers, Université de Nantes, Nantes, France
| | - Emilie Duchalais
- Institut des Maladies de l'Appareil Digestif, Oncologie Digestive, Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France.,Service de Chirurgie digestive et endocrinienne, Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France
| | - Juliette Podevin
- Institut des Maladies de l'Appareil Digestif, Oncologie Digestive, Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France.,Service de Chirurgie digestive et endocrinienne, Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France
| | - Christelle Volteau
- Plateforme de Biométrie, Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France
| | - Jaafar Bennouna
- Institut des Maladies de l'Appareil Digestif, Oncologie Digestive, Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France.,Faculté de Médecine, Université de Nantes, Nantes, France
| | - Yann Touchefeu
- Institut des Maladies de l'Appareil Digestif, Oncologie Digestive, Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France.,Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France
| | - Pierre Fourquier
- Service de Chirurgie Viscérale et Digestive, Hôpital privé du Confluent, Nantes, France
| | | | | | - Stéphane Bezieau
- Faculté de Médecine, Université de Nantes, Nantes, France.,Plateforme de Génétique moléculaire des cancers, Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France
| | - Marc Denis
- Faculté de Médecine, Université de Nantes, Nantes, France.,Plateforme de Génétique moléculaire des cancers, Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France
| | - Claire Toquet
- Service d'Anatomie et Cytologie Pathologiques, Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France.,Faculté de Médecine, Université de Nantes, Nantes, France
| | - Jean-François Mosnier
- Service d'Anatomie et Cytologie Pathologiques, Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France.,Faculté de Médecine, Université de Nantes, Nantes, France
| | - Anne Jarry
- CRCINA, INSERM, Université d'Angers, Université de Nantes, Nantes, France
| | - Céline Bossard
- Service d'Anatomie et Cytologie Pathologiques, Centre Hospitalier Universitaire Hôtel Dieu, Nantes, France.,CRCINA, INSERM, Université d'Angers, Université de Nantes, Nantes, France.,Faculté de Médecine, Université de Nantes, Nantes, France
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Abstract
Few series have reported on the impact of robotic right colectomy compared with conventional laparoscopy. Even fewer have reported on the outcomes of intracorporeal anastomoses. The aim of our study was to determine the impact of robotic surgery on short-term operative outcomes in patients undergoing right colectomy with intracorporeal anastomosis. One hundred and fourteen consecutive patients who underwent a right colectomy by two colorectal surgeons between 2012 and 2017 were included. Patients were separated into two groups: laparoscopic technique with extracorporeal anastomosis (n = 87) and robotic technique with intracorporeal anastomosis (n = 27). Univariate analysis was performed to determine differences in outcomes. Differences between cohorts were only identified with regard to gender (62 vs 37%, P = 0.022) and year of surgery. In comparison with laparoscopy, robotic colectomy resulted in a shorter time of GI recovery (1.3 ± 0.6 vs 3 ± 1.1, P < 0.0001), lower rates of postoperative ileus (4 vs 28%, P = 0.007), lower overall morbidity (26 vs 52%, P = 0.019), less blood loss ( P = 0.001), 50 per cent lower narcotic use, and longer operative time (255 ± 66 vs 139 ± 49, P < 0.001). Despite longer operative time, robotic surgery improved GI recovery, significantly lowered oral morphine equivalent usage, and decreased short-term complications.
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Affiliation(s)
- Scott R. Kelley
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota
| | - Emilie Duchalais
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota
| | - David W. Larson
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota
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46
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Kelley SR, Duchalais E, Larson DW. Short-Term Outcomes with Robotic Right Colectomy. Am Surg 2018; 84:1768-1773. [PMID: 30747631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Few series have reported on the impact of robotic right colectomy compared with conventional laparoscopy. Even fewer have reported on the outcomes of intracorporeal anastomoses. The aim of our study was to determine the impact of robotic surgery on short-term operative outcomes in patients undergoing right colectomy with intracorporeal anastomosis. One hundred and fourteen consecutive patients who underwent a right colectomy by two colorectal surgeons between 2012 and 2017 were included. Patients were separated into two groups: laparoscopic technique with extracorporeal anastomosis (n = 87) and robotic technique with intracorporeal anastomosis (n = 27). Univariate analysis was performed to determine differences in outcomes. Differences between cohorts were only identified with regard to gender (62 vs 37%, P = 0.022) and year of surgery. In comparison with laparoscopy, robotic colectomy resulted in a shorter time of GI recovery (1.3 ± 0.6 vs 3 ± 1.1, P < 0.0001), lower rates of postoperative ileus (4 vs 28%, P = 0.007), lower overall morbidity (26 vs 52%, P = 0.019), less blood loss (P = 0.001), 50 per cent lower narcotic use, and longer operative time (255 ± 66 vs 139 ± 49, P < 0.001). Despite longer operative time, robotic surgery improved GI recovery, significantly lowered oral morphine equivalent usage, and decreased short-term complications.
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47
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Duchalais E, Larson DW, Machairas N, Mathis KL, Dozois EJ, Kelley SR. Outcomes of Early Removal of Urinary Catheter Following Rectal Resection for Cancer. Ann Surg Oncol 2018; 26:79-85. [PMID: 30353391 DOI: 10.1245/s10434-018-6822-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Indexed: 01/01/2023]
Abstract
PURPOSE Early postoperative urinary catheter removal decreases urinary tract infection (UTI) rate and accelerates patient mobilization. The aim of this study is to determine the results of systematic urinary catheter removal on postoperative day (POD) 1 in patients undergoing rectal resection for cancer. PATIENTS AND METHODS Using a prospectively maintained database of 469 patients who underwent rectal resection for cancer, a retrospective review of all patients with urinary catheter removal on POD1 was conducted. Patients unable to void 6 h after catheter removal underwent in and out urinary catheterization (IOC group) and were compared with patients who voided spontaneously (non-IOC group) to determine risk factors for IOC. RESULTS A total of 417 patients were identified, including 274 (66%) men. Median age was 59 (50-68) years. Abdominoperineal resection (APR) was performed in 134 (32%), and complex surgery with resection of at least one other organ in 72 (17%) patients. Non-IOC and IOC groups included 245 (59%) and 172 (41%) patients, respectively. Five independent predictive factors for IOC were male gender, obesity, history of obstructive urinary disease, APR, and metastatic disease. The cumulative risk of IOC in patients with zero, one, two, and at least three risk factors was 8%, 31%, 52%, and 68% on POD1, and 2%, 12%, 23%, and 30% on POD5, respectively (p < 0.001). Thirteen patients (3%) developed UTI. CONCLUSIONS Early removal of urinary catheter resulted in 59% of patients voiding spontaneously with no need for IOC following rectal resection. Patients without any predictive factors had less than 10% risk of urinary dysfunction.
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Affiliation(s)
- E Duchalais
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA
| | - David W Larson
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA.
| | - N Machairas
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA
| | - K L Mathis
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA
| | - E J Dozois
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA
| | - S R Kelley
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA
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48
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Nguyen PH, Touchefeu Y, Durand T, Aubert P, Duchalais E, Bruley des Varannes S, Varon C, Neunlist M, Matysiak-Budnik T. Acetylcholine induces stem cell properties of gastric cancer cells of diffuse type. Tumour Biol 2018; 40:1010428318799028. [PMID: 30207200 DOI: 10.1177/1010428318799028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Gastric cancer is the third leading cause of cancer-related death worldwide, but the mechanisms of gastric carcinogenesis are not completely understood. Recently, the role of cholinergic neuronal pathways in promoting this process has been demonstrated. Our aim was to extend these studies and to evaluate, using an in vitro model of tumorspheres, the effect of acetylcholine on human gastric cancer cells, and the role of acetylcholine receptors and of the nitric oxide pathway, in this effect. The gastric cancer cell line MKN-45 of the diffuse type of gastric cancer was cultured in the presence of acetylcholine, or different agonists or inhibitors of muscarinic and nicotinic acetylcholine receptors, or nitric oxide donor or inhibitor of the nitric oxide pathway, and the number and size of tumorspheres were assessed. The expression of cancer stem cell markers (CD44 and aldehyde dehydrogenase) was also evaluated by immunofluorescence and quantitative reverse transcription polymerase chain reaction. We showed that acetylcholine increased both the number and size of tumorspheres and that this effect was reproduced with both muscarinic and nicotinic acetylcholine receptors agonists and was inhibited by both receptor antagonists. The nitric oxide donor stimulated the tumorsphere formation, while the nitric oxide synthesis inhibitor inhibited the stimulatory effect of acetylcholine. Moreover, acetylcholine increased the expression of stem cell markers on gastric cancer cells. These results indicate that acetylcholine induces the stem cell properties of gastric cancer cells and both muscarinic and nicotinic receptors and a nitrergic pathway might be involved in this effect.
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Affiliation(s)
- Phu Hung Nguyen
- 1 Université Bretagne Loire, Université de Nantes, INSERMU1235, TENS, Institut des Maladies de l'Appareil Digestif du CHU, Nantes, France.,2 Faculty of Biotechnology, Thai Nguyen University of Sciences, Thai Nguyen, Vietnam
| | - Yann Touchefeu
- 1 Université Bretagne Loire, Université de Nantes, INSERMU1235, TENS, Institut des Maladies de l'Appareil Digestif du CHU, Nantes, France.,3 Hépato-Gastroentérologie & Oncologie Digestive, IMAD, Hôtel Dieu, CHU de Nantes, Nantes, France
| | - Tony Durand
- 1 Université Bretagne Loire, Université de Nantes, INSERMU1235, TENS, Institut des Maladies de l'Appareil Digestif du CHU, Nantes, France
| | - Philippe Aubert
- 1 Université Bretagne Loire, Université de Nantes, INSERMU1235, TENS, Institut des Maladies de l'Appareil Digestif du CHU, Nantes, France
| | - Emilie Duchalais
- 1 Université Bretagne Loire, Université de Nantes, INSERMU1235, TENS, Institut des Maladies de l'Appareil Digestif du CHU, Nantes, France.,3 Hépato-Gastroentérologie & Oncologie Digestive, IMAD, Hôtel Dieu, CHU de Nantes, Nantes, France
| | - Stanislas Bruley des Varannes
- 1 Université Bretagne Loire, Université de Nantes, INSERMU1235, TENS, Institut des Maladies de l'Appareil Digestif du CHU, Nantes, France.,3 Hépato-Gastroentérologie & Oncologie Digestive, IMAD, Hôtel Dieu, CHU de Nantes, Nantes, France
| | | | - Michel Neunlist
- 1 Université Bretagne Loire, Université de Nantes, INSERMU1235, TENS, Institut des Maladies de l'Appareil Digestif du CHU, Nantes, France
| | - Tamara Matysiak-Budnik
- 1 Université Bretagne Loire, Université de Nantes, INSERMU1235, TENS, Institut des Maladies de l'Appareil Digestif du CHU, Nantes, France.,3 Hépato-Gastroentérologie & Oncologie Digestive, IMAD, Hôtel Dieu, CHU de Nantes, Nantes, France
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Le Fouler A, Duchalais E, Loong TH, Baayen C, Wyart V, Kubis C, Meurette G, Lehur PA. Long-Term Outcome Following Implanted Pulse Generator Change in Patients Treated With Sacral Nerve Modulation for Fecal Incontinence. Neuromodulation 2018; 21:694-699. [DOI: 10.1111/ner.12806] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 05/13/2018] [Accepted: 05/30/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Adrien Le Fouler
- Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif; University Hospital of Nantes; Nantes France
| | - Emilie Duchalais
- Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif; University Hospital of Nantes; Nantes France
| | - Tse-Han Loong
- Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif; University Hospital of Nantes; Nantes France
| | - Corine Baayen
- Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif; University Hospital of Nantes; Nantes France
| | - Vincent Wyart
- Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif; University Hospital of Nantes; Nantes France
| | - Caroline Kubis
- Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif; University Hospital of Nantes; Nantes France
| | - Guillaume Meurette
- Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif; University Hospital of Nantes; Nantes France
| | - Paul-Antoine Lehur
- Clinique de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif; University Hospital of Nantes; Nantes France
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50
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Merchea A, Ali SM, Kelley SR, Duchalais E, Alabbad JY, Dozois EJ, Larson DW. Long-Term Oncologic Outcomes of Minimally Invasive Proctectomy for Rectal Adenocarcinoma. J Gastrointest Surg 2018; 22:1412-1417. [PMID: 29594912 DOI: 10.1007/s11605-018-3751-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 01/07/2018] [Accepted: 03/17/2018] [Indexed: 01/31/2023]
Abstract
BACKGROUND Long-term oncologic outcomes after minimally invasive surgery (MIS) for rectal adenocarcinoma compared to open surgery continue to be debated. We aimed to review our high-volume single-institution outcomes in MIS rectal cancer surgery. METHODS A retrospective review of a prospectively collected database was completed of all consecutive adult patients with rectal adenocarcinoma treated from January 2005 through December 2011. Stage IV or recurrent disease was excluded. Demographics and operative and pathologic details were reviewed and reported. Primary endpoints include survival and recurrence. RESULTS A total of 324 patients were included and median follow-up was 54 months (IQR = 37.0, 78.8). The mean age was 58.2 ± 14.1 years. Tumors were in the upper rectum in 111 patients, mid-rectum in 113 patients, and lower rectum in 100 patients. Stage III disease was most common (49.4%). Overall conversion to open procedure rate was 13.9%. The circumferential radial margin was positive in only 1 patient (0.3%) and the mean lymph node yield was 24.7 ± 17.2. Cancer recurred in 42 patients (13%), 10 (2.5%) patients developed local recurrence, 32 (9.8%) developed distant metastasis, and 2 (0.6%) patients had both. The 5-year overall survival for stage 0, 1, 2, and 3 disease is 96, 91, 80, and 77%, respectively (p = 0.015). CONCLUSION In carefully selected rectal cancer patients treated with MIS, long-term outcomes of survival and recurrence appear to compare favorably to previously published series.
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Affiliation(s)
- Amit Merchea
- Division of Colon and Rectal Surgery, Mayo Clinic, Jacksonville, FL, 32224, USA.
| | - Shahzad M Ali
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Scott R Kelley
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA
| | - Emilie Duchalais
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA
| | - Jasim Y Alabbad
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA
| | - Eric J Dozois
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA
| | - David W Larson
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA
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