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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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Coutance G, Desiré E, Lescroart M, Lebreton G, Combes A, Bouglé A, Varnous S, Leprince P. Impact of the 2018 French Allocation Scheme on the Profile of Heart Transplantation Candidates and Recipients: Insights from a High-Volume Center. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.533] [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: 04/05/2023] Open
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Thomas F, Menahem B, Lebreton G, Bouhier-Leporrier K, Dejardin O, Alves A. Permanent stoma after sphincter preservation for rectal cancer. A situation that occurs more often than you might think. Front Oncol 2023; 12:1056314. [PMID: 36776358 PMCID: PMC9909408 DOI: 10.3389/fonc.2022.1056314] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/16/2022] [Indexed: 01/27/2023] Open
Abstract
Objectives This study aimed: (i) to assess the cumulative incidence of permanent stoma (PS) after sphincter-preserving surgery (SPS) for rectal cancer (RC): (ii) to analyze associated risk factors for primary and secondary PS; and (iii) to compare the long-term survival of patients according to the stoma state. Methods We conducted a retrospective single-center cohort study based on a prospectively maintained database of SRC patients undergoing SPS from January 2007 to December 2017. Incidence of both primary (no reversal of defunctioning stoma) and secondary (created after closure of defunctioning stoma) PS were investigated. Associations between potential risk factors and PS were analyzed using a logistic regression model. Cumulative survival curve was drawn by Kaplan-Meier method. Results Of the 257 eligible patients, 43 patients (16.7%) had a PS (16 primary PS and 27 secondary PS) after a median follow-up of 4.8 years. In multivariate analysis, the independent risk factors for primary PS were severe post-operative complications (OR 3.66; 95% CI, 1.19-11.20, p=0.022), and old age (OR 1.11; 95% CI 1.04-1.18, p=0.001) and those for secondary PS were local recurrence (OR 38.07; 95% CI 11.07-130.9, p<0.0001), anastomotic leakage (OR 7.01; 95% CI, 2.23-22.04, p=0.009), and severe post-operative complications (OR 3.67; 95% CI, 1.22-11.04, p=0.02), respectively. Both overall survival (OS) and disease-free survival (DFS) were significantly lower in patients with a PS compared with patients with SPS (p < 0.01). Conclusions This present study suggests that one out of 6 patients has a PS, 5 years after rectal resection with SPS for SRC.
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Affiliation(s)
- Flavie Thomas
- Centre Hospitalier Universitaire de Caen, Caen, France
| | - Benjamin Menahem
- Centre Hospitalier Universitaire de Caen, Caen, France,*Correspondence: Benjamin Menahem,
| | - Gil Lebreton
- Centre Hospitalier Universitaire de Caen, Caen, France
| | | | - Olivier Dejardin
- Institut Nationale de la Recherche Medicale (INSERM) U1086 Unité de recherche Interdisciplinaire pour la Prévention et le Traitement des Cancers, Caen, France
| | - Arnaud Alves
- Centre Hospitalier Universitaire de Caen, Caen, France
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Desiré E, Assouline-Reinmann M, Lescroart M, Bouglé A, Combes A, Lebreton G, Leprince P, Varnous S, Coutance G. Impact of the 2018 French allocation scheme on the profile of heart transplantation candidates, recipients and donors: Insights from a high-volume center. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.066] [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: 01/01/2023]
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Moiroux-Sahraoui A, Herpain A, Taccone F, Leprince P, Lebreton G, Creteur J. A total closed chest swine model of acute myocardial infarction-related cardiogenic shock: A critical double coronary sub-occlusion approach. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.227] [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: 12/31/2022]
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Daniel L, Desiré E, Lescroart M, Lebreton G, Leprince P, Varnous S, Coutance G. Application of the new cardiac allograft allocation scheme in clinical practice. Insights from a high-volume heart transplantation center. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.082] [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: 01/01/2023]
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Veziant J, Gagnière J, Gronnier C, Mariette C, Tzedakis S, Fuks D, Piessen G, Cabau M, Jougon J, Badic B, Lozach P, Cappeliez S, Lebreton G, Alves A, Flamein R, Pezet D, Pipitone F, Iuga BS, Contival N, Pappalardo E, Mantziari S, Hec F, Vanderbeken M, Tessier W, Briez N, Fredon F, Gainant A, Mathonnet M, Bigourdan JM, Mezoughi S, Ducerf C, Baulieux J, Pasquer A, Baraket O, Poncet G, Vaudoyer D, Enfer PJ, Villeneuve L, Glehen O, Coste T, Fabre JM, Marchal F, Frisoni R, Ayav A, Brunaud L, Bresler L, Cohen C, Aze O, Venissac N, Pop D, Mouroux J, Donici I, Prudhomme M, Felli E, Lisunfui S, Seman M, Petit GG, Karoui M, Tresallet C, Ménégaux F, Hannoun L, Malgras B, Lantuas D, Pautrat K, Pocard M, Valleur P. Non-occlusive Small Bowel Ischemia Related to Postoperative Feeding Jejunostomy Tube Use After Esophagectomy for Cancer: Propensity Score Analysis of the AFC-FREGAT Database. J Gastrointest Surg 2022; 26:1760-1763. [PMID: 35318593 DOI: 10.1007/s11605-021-05223-7] [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: 07/06/2021] [Accepted: 11/30/2021] [Indexed: 01/31/2023]
Affiliation(s)
- J Veziant
- Department of Digestive, Hepato-Biliary and Endocrine Surgery, Cochin Hospital, APHP, Centre, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.
| | - J Gagnière
- Department of Digestive and Hepato-Biliary Surgery, University Hospital Center of Clermont-Ferrand, Clermont-Ferrand, France
| | - C Gronnier
- Eso-Gastric Surgery Unit, Department of Digestive Surgery, Magellan Center, Bordeaux University Hospital, 33600, Pessac, France
| | - C Mariette
- Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Lille Cedex, France
| | - S Tzedakis
- Department of Digestive, Hepato-Biliary and Endocrine Surgery, Cochin Hospital, APHP, Centre, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - D Fuks
- Department of Digestive, Hepato-Biliary and Endocrine Surgery, Cochin Hospital, APHP, Centre, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - G Piessen
- Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Lille Cedex, France.,University Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 - CANTHER - Cancer Heterogeneity, Plasticity and Resistance To Therapies, 59000, Lille, France
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Bres C, Voron T, Benhaim L, Bergeat D, Parc Y, Karoui M, Genser L, Péré G, Demma JA, Bacoeur-Ouzillou O, Lebreton G, Thereaux J, Gronnier C, Dartigues P, Svrcek M, Bouzillé G, Bardier A, Brunac AC, Roche B, Darcha C, Bazille C, Doucet L, Belleannee G, Lejeune S, Buisine MP, Renaud F, Nuytens F, Benusiglio PR, Veziant J, Eveno C, Piessen G. Management of Pathogenic CDH1 Variant Carriers within the FREGAT Network: A multicentric Retrospective Study. Ann Surg 2022; 276:830-837. [PMID: 35856494 DOI: 10.1097/sla.0000000000005626] [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: 11/25/2022]
Abstract
OBJECTIVE To describe the management of pathogenic CDH1 variant carriers (pCDH1vc) within the FREGAT (FRench Eso-GAsTric tumor) network. Primary objective focused on clinical outcomes and pathological findings, Secondary objective was to identify risk factor predicting postoperative morbidity (POM). SUMMARY BACKGROUND DATA Prophylactic Total Gastrectomy (PTG) remains the recommended option for gastric cancer risk management in pCDH1vc with however endoscopic surveillance as an alternative. METHODS A retrospective observational multicenter study was carried out between 2003 and 2021. Data were reported as median [interquartile range] or as counts (proportion). Usual tests were used for univariate analysis. Risk factors of overall and severe POM (i.e. Clavien-Dindo grade 3 or more) were identified with a binary logistic regression. RESULTS 99 patients including 14 index cases were reported from 11 centers. Median survival among index cases was 12.0[7.6-16.4] months with most of them having peritoneal carcinomatosis at diagnosis (71.4%). Among the remaining 85 patients, 77 underwent a PTG (median age 34.6 [23.7 - 46.2], ASA score 1: 75%) mostly via a minimally-invasive approach (51.9%). POM rate was 37.7% including 20.8% of severe POM, with age≥ 40 years and low volume centers as predictors (P=0.030 and P=0.038). After PTG, the cancer rate on specimen was 54.5% (n=42, all pT1a) of which 59.5% had no cancer detected on preoperative endoscopy (n=25). CONCLUSION Among pCDH1vc, index cases carry a dismal prognosis. The risk of cancer among patients undergoing PTG remained high and unpredictable and has to be balanced with the morbidity and functional consequence of PTG.
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Affiliation(s)
- Capucine Bres
- Department of Digestive and Oncological Surgery, Claude Huriez Hospital, Chu Lille (France)
| | - Thibault Voron
- Department of Digestive Surgery, Sorbonne Université, Hôpital Saint-Antoine, APHP, Paris, France
| | - Leonor Benhaim
- Department of Digestive Surgery, Gustave Roussy, Villejuif (France)
| | - Damien Bergeat
- Department of Digestive Surgery, Chu Rennes, Rennes (France)
| | - Yann Parc
- Department of Digestive Surgery, Sorbonne Université, Hôpital Saint-Antoine, APHP, Paris, France
| | - Mehdi Karoui
- Department of Digestive Surgery, Georges Pompidou European Hospital, APHP, Paris (France)
| | - Laurent Genser
- Department of Digestive Surgery, Sorbonne Université, Hôpital Pitié-Salpétrière, APHP, Paris (France)
| | - Guillaume Péré
- Department of Digestive Surgery, Chu Toulouse, Toulouse (France)
| | | | | | - Gil Lebreton
- Department of Digestive Surgery, Chu Caen, Caen (France)
| | | | | | | | - Magali Svrcek
- Department of Pathology, Sorbonne Université, Hôpital Saint Antoine, APHP, Paris (France)
| | | | - Armelle Bardier
- Department of Pathology, Sorbonne Université, Hôpital Pitié-Salpétrière, APHP, Paris (France)
| | - Anne Cécile Brunac
- Department of Pathology, Institut Universitaire du Cancer-Oncopole de Toulouse; Centre Hospitalier Universitaire (CHU), Toulouse, France
| | - Brigitte Roche
- Department of Pathology, Chu Saint Louis, APHP, Paris (France)
| | - Claude Darcha
- Department of Pathology, Chu Clermont Ferrand, Clermont Ferrand (France)
| | | | | | | | | | - Marie Pierre Buisine
- Department of Molecular Oncogenetics, Chu Lille - Lille (France).,Univ. Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000 Lille, France
| | - Florence Renaud
- Univ. Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000 Lille, France.,Department of Pathology, Centre Biologie Pathologie, Chu Lille - Lille (France)
| | - Frederiek Nuytens
- Department of Digestive and Hepatobiliary/Pancreatic surgery, AZ Groeninge hospital, Kortrijk, Belgium
| | - Patrick R Benusiglio
- Department of Digestive Surgery, Sorbonne Université, Hôpital Saint-Antoine, APHP, Paris, France.,UF d'Oncogénétique Clinique, Département de Génétique Médicale et Institut Universitaire de Cancérologie, Sorbonne Université, Hôpital Pitié-Salpêtrière, AP-HP, Paris (France)
| | - Julie Veziant
- Department of Digestive and Oncological Surgery, Claude Huriez Hospital, Chu Lille (France)
| | - Clarisse Eveno
- Department of Digestive and Oncological Surgery, Claude Huriez Hospital, Chu Lille (France).,Univ. Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000 Lille, France
| | - Guillaume Piessen
- Department of Digestive and Oncological Surgery, Claude Huriez Hospital, Chu Lille (France).,Univ. Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000 Lille, France
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Pineton De Chambrun M, Charuel J, Dorgham K, Quentric P, Kerneis M, Lebreton G, Miyara M, Schmidt M, Luyt C, Melki I, Moyon Q, Lifermann F, Mathian A, Gorochov G, Amoura Z, Combes A, Hekimian G. Myocardites fulminantes associées aux auto-anticorps Anti-ARN-polymérases III. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.315] [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: 11/29/2022]
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Le Baut G, Kirchgesner J, Amiot A, Lefevre JH, Chafai N, Landman C, Nion I, Bourrier A, Delattre C, Martineau C, Sokol H, Seksik P, Nguyen Y, Marion Y, Lebreton G, Carbonnel F, Viennot S, Beaugerie L. A Scoring System to Determine Patients' Risk of Colectomy Within 1 Year After Hospital Admission for Acute Severe Ulcerative Colitis. Clin Gastroenterol Hepatol 2021; 19:1602-1610.e1. [PMID: 31927106 DOI: 10.1016/j.cgh.2019.12.036] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 08/11/2019] [Revised: 12/12/2019] [Accepted: 12/23/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS There is consensus on the criteria used to define acute severe ulcerative colitis (ASUC) and on patient management, but it has been a challenge to identify patients at risk for colectomy based on data collected at hospital admission. We aimed to develop a system to determine patients' risk of colectomy within 1 y of hospital admission for ASUC based on clinical, biomarker, and endoscopy data. METHODS We performed a retrospective analysis of consecutive patients with ASUC treated with corticosteroids, ciclosporin, or tumor necrosis factor (TNF) antagonists and admitted to 2 hospitals in France from 2002 through 2017. Patients were followed until colectomy or loss of follow up. A total of 270 patients with ASUC were included in the final analysis, with a median follow-up time of 30 months (derivation cohort). Independent risk factors identified by Cox multivariate analysis were used to develop a system to identify patients at risk for colectomy 1 y after ASUC. We developed a scoring system based on these 4 factors (1 point for each item) to identify high-risk (score 3 or 4) vs low-risk (score 0) patients. We validated this system using data from an independent cohort of 185 patients with ASUC treated from 2006 through 2017 at 2 centers in France. RESULTS In the derivation cohort, the cumulative risk of colectomy was 12.3% (95% CI, 8.6-16.8). Based on multivariate analysis, previous treatment with TNF antagonists or thiopurines (hazard ratio [HR], 3.86; 95% CI, 1.82-8.18), Clostridioides difficile infection (HR, 3.73; 95% CI, 1.11-12.55), serum level of C-reactive protein above 30 mg/L (HR, 3.06; 95% CI, 1.11-8.43), and serum level of albumin below 30 g/L (HR, 2.67; 95% CI, 1.20-5.92) were associated with increased risk of colectomy. In the derivation cohort, the cumulative risks of colectomy within 1 y in patients with scores of 0, 1, 2, 3, or 4 were 0.0%, 9.4% (95% CI, 4.3%-16.7%), 10.6% (95% CI, 5.6%-17.4%), 51.2% (95% CI, 26.6%-71.3%), and 100%. Negative predictive values ranged from 87% (95% CI, 82%-91%) to 92% (95% CI, 88%-95.0%). Findings from the validation cohort were consistent with findings from the derivation cohort. CONCLUSIONS We developed a scoring system to identify patients at low-risk vs high-risk for colectomy within 1 y of hospitalization for ASUC, based on previous treatment with TNF antagonists or thiopurines, C difficile infection, and serum levels of CRP and albumin. The system was validated in an external cohort.
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Affiliation(s)
| | - Julien Kirchgesner
- Sorbonne Université, Department of Gastroenterology, AP-HP, Hôpital Saint Antoine, Paris; Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris.
| | - Aurélien Amiot
- Department of Gastroenterology, Henri Mondor Hospital, APHP, Paris Est-Créteil (UPEC) Val de Marne University, Creteil; EA 7375 (EC2M3 research team), Paris Est-Créteil (UPEC) Val de Marne University, Creteil
| | - Jérémie H Lefevre
- Sorbonne Université, Department of Digestive Surgery, AP-HP, Hôpital Saint Antoine, Paris
| | - Najim Chafai
- Sorbonne Université, Department of Digestive Surgery, AP-HP, Hôpital Saint Antoine, Paris
| | - Cécilia Landman
- Sorbonne Université, Department of Gastroenterology, AP-HP, Hôpital Saint Antoine, Paris
| | - Isabelle Nion
- Sorbonne Université, Department of Gastroenterology, AP-HP, Hôpital Saint Antoine, Paris
| | - Anne Bourrier
- Sorbonne Université, Department of Gastroenterology, AP-HP, Hôpital Saint Antoine, Paris
| | - Charlotte Delattre
- Sorbonne Université, Department of Gastroenterology, AP-HP, Hôpital Saint Antoine, Paris
| | - Chloé Martineau
- Sorbonne Université, Department of Gastroenterology, AP-HP, Hôpital Saint Antoine, Paris
| | - Harry Sokol
- Sorbonne Université, Department of Gastroenterology, AP-HP, Hôpital Saint Antoine, Paris; Sorbonne Universités, École Normale Supérieure, CNRS, INSERM, APHP Laboratoire des Biomolécules (LBM), Paris
| | - Phillipe Seksik
- Sorbonne Université, Department of Gastroenterology, AP-HP, Hôpital Saint Antoine, Paris; Sorbonne Universités, École Normale Supérieure, CNRS, INSERM, APHP Laboratoire des Biomolécules (LBM), Paris
| | - Yann Nguyen
- Beaujon Hospital, Department of Internal Medicine, Clichy; Paris-Sud Université, INSERM U1018, Centre de Recherche en épidémiologie et santé des populations (CESP), Villejuif
| | - Yoann Marion
- University Hospital of Caen, Department of Surgery, Caen
| | - Gil Lebreton
- University Hospital of Caen, Department of Surgery, Caen
| | - Franck Carbonnel
- Department of Gastroenterology, Bicetre University Hospital, APHP, Université Paris Sud, le Kremlin Bicêtre, Paris, France
| | | | - Laurent Beaugerie
- Sorbonne Université, Department of Gastroenterology, AP-HP, Hôpital Saint Antoine, Paris; Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris
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11
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Sabouret P, Attias D, Beauvais C, Berthelot E, Bouleti C, Gibault Genty G, Galat A, Hanon O, Hulot JS, Isnard R, Jourdain P, Lamblin N, Lebreton G, Lellouche N, Logeart D, Meune C, Pezel T, Damy T. Diagnosis and management of heart failure from hospital admission to discharge: A practical expert guidance. Ann Cardiol Angeiol (Paris) 2021; 71:41-52. [PMID: 34274113 DOI: 10.1016/j.ancard.2021.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/07/2021] [Indexed: 10/20/2022]
Abstract
Heart failure (HF) has high event rates, mortality, and is challenging to manage in clinical practice. Clinical management is complicated by complex therapeutic strategies in a population with a high prevalence of comorbidity and general frailty. In the last four years, an abundance of research has become available to support multidisciplinary management of heart failure from within the hospital through to discharge and primary care as well as supporting diagnosis and comorbidity management. Within the hospital setting, recent evidence supports sacubitril-valsartan combination in frail, deteriorating or de novo patients with LVEF≤40%. Furthermore, new strategies such as SGLT2 inhibitors and vericiguat provide further benefit for patients with decompensating HF. Studies with tafamidis report major clinical benefits specifically for patients with ATTR cardiac amyloidosis, a remaining underdiagnosed and undertreated disease. New evidence for medical interventions supports his bundle pacing to reduce QRS width and improve haemodynamics as well as ICD defibrillation for non-ischemic cardiomyopathy. The Mitraclip reduces hospitalisations and mortality in patients with symptomatic, secondary mitral regurgitation and ablation reduces mortality and hospitalisations in patients with paroxysmal and persistent atrial fibrillation. In end-stage HF, the 2018 French Heart Allocation policy should improve access to heart transplants for stable, ambulatory patients and, mechanical circulatory support should be considered to avoid deteriorating on the waiting list. In the community, new evidence supports that improving discharge education, treatment and patient support improves outcomes. The authors believe that this review fills the gap between the guidelines and clinical practice and provides practical recommendations to improve HF management.
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Affiliation(s)
- P Sabouret
- Heart Institute, Cardiology department, La Pitié Salpetrière Hospital, Sorbonne University, Paris, France
| | - D Attias
- Cardiology department, Centre Cardiologique du Nord, Saint-Denis, France
| | - C Beauvais
- Cardiology department, La Riboisière Hospital, Inserm UMRS 942, University of Paris, Paris, France
| | - E Berthelot
- Cardiology department, Kremlin Bicêtre Hospital, Paris-Saclay University, Le Kremlin Bicêtre, France
| | - C Bouleti
- Cardiology department, Poitiers University Hospital, CIC INSERM 1402, Poitiers, France
| | - G Gibault Genty
- Cardiology department, André Mignot Hospital, Le Chesnay, France
| | - A Galat
- Cardiology department, University Hospital Henri Mondor, UPEC, Créteil, France
| | - O Hanon
- Geriatrics Department, Hospital Broca, Paris Descartes University, Paris, France
| | - J S Hulot
- Pharmacology Department, Georges-Pompidou European Hospital, INSERM, PARCC, CIC1418 Paris-Descartes University, Paris, France
| | - R Isnard
- Heart Institute, Cardiology department, La Pitié Salpetrière Hospital, Sorbonne University, Paris, France
| | - P Jourdain
- Cardiology department, Kremlin Bicêtre Hospital, Paris-Saclay University, Le Kremlin Bicêtre, France
| | - N Lamblin
- Cardiology Department, University Hospital, Lille, France
| | - G Lebreton
- Heart Institute, Cardiac Surgery department, La Pitié Salpêtrière Hospital, Sorbonne University, Paris, France
| | - N Lellouche
- Cardiology department, University Hospital Henri Mondor, UPEC, Créteil, France
| | - D Logeart
- Cardiology department, La Riboisière Hospital, Inserm UMRS 942, University of Paris, Paris, France
| | - C Meune
- Department of Cardiology, Avicenne Hospital, Paris 13 University, Bobigny, France
| | - T Pezel
- Cardiology department, La Riboisière Hospital, Inserm UMRS 942, University of Paris, Paris, France
| | - T Damy
- Cardiology department, University Hospital Henri Mondor, UPEC, Créteil, France.
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12
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Bay P, Lebreton G, Mathian A, Pierre D, Cohen Aubart F, Bréchot N, Chommeloux J, Schmidt M, Nieszkowska A, Desnos C, Leprince P, Hekimian G, Luyt C, Amoura Z, Combes A, Pineton De Chambrun M. Outcomes of Severe Systemic Rheumatic Disease Patients Requiring Extracorporeal Membrane Oxygenation. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.255] [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: 10/21/2022]
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13
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Jasseron C, Legeai C, Cantrelle C, Audry B, Lebreton G, Para M, Vincentelli A, Flecher E, Pattier S, Kerbaul F, Dorent R. Impact of the New French Heart Allocation System on Post-Transplant Mortality. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.720] [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: 12/01/2022] Open
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14
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Moiroux-Sahraoui A, Schoell T, Barreda E, Laali M, Rama A, Demondion P, Juvin C, D’alessandro C, Leprince P, Lebreton G. Atrioesophageal fistula following atrial fibrillation ablation: How to manage this dreaded complication? Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.316] [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: 10/22/2022]
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15
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Leclerc A, Lebreton G, Huet A, Alves A, Emery E. Management of giant presacral schwannoma. Clinical series and literature review. Clin Neurol Neurosurg 2020; 200:106409. [PMID: 33341090 DOI: 10.1016/j.clineuro.2020.106409] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/01/2020] [Accepted: 11/28/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Presacral schwannomas are rare tumors. Due to their benign nature and slow growth, these tumors are often giant and become difficult to treat. Their removal is a surgical challenge with different strategies reported in the literature. This study presents the consecutives cases of presacral schwannomas operated on in our institution, our surgical strategy and literature review. METHODS This retrospective study includes all consecutive patients operated on for a pre-sacral schwannoma in our department between 2006 and 2019, i.e. 6 patients. We report clinical features, pre and post-operative imaging, surgical data and post-operative outcomes. RESULTS All patients had symptoms before surgery (constipation, dysuria, radicular or lower back pain) with an average duration of 7.4 months. All patients underwent an MRI and a CT scan before the surgery. Five patients had type III schwannoma according to Klimo classification and one patient had a type II. The average size was 504,9 cm3 (range 53,1-1495,4). All the patients were operated on by an anterior approach in a double team with an mean duration of 246 min. Intraoperative bleeding was less than 500 ml for 4 patients, 2 patients had significant bleeding (2700 and 2900 mL). Excision was total or subtotal in all cases. One patient had an intraoperative complication (air embolism). Follow up at 3 months was excellent with a disappearance of symptoms for all patients except one patient who retained constipation. One patient had a late complication (bowel obstruction due to tissue adhesions). At last follow-up after phone interview, no patient had clinical symptoms that could suggest a recurrence. CONCLUSION The anterior approach with a double surgical team is a great option for the treatment of presacral schwannoma. Combined with adequate preoperative imaging and intraoperative stimulation, it reduces the risk of intra and postoperative complications.
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Affiliation(s)
- Arthur Leclerc
- CHU Caen, Department of Neurosurgery, Caen, F-14000, France; Université Caen Normandie, Medical School, Caen, F-14000, France.
| | - Gil Lebreton
- CHU Caen, Department of Digestive Surgery, Caen, F-14000, France
| | - Augustin Huet
- CHU Caen, Department of Imaging, Caen, F-14000, France; Université Caen Normandie, Medical School, Caen, F-14000, France
| | - Arnaud Alves
- CHU Caen, Department of Digestive Surgery, Caen, F-14000, France; INSERM, U1086 ANTICIPE Centre François Baclesse, 3 Avenue du Général Harris, 14000 Caen, France; Université Caen Normandie, Medical School, Caen, F-14000, France
| | - Evelyne Emery
- CHU Caen, Department of Neurosurgery, Caen, F-14000, France; INSERM, UMR-S U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), GIP Cyceron, Caen, F-14000, France; Université Caen Normandie, Medical School, Caen, F-14000, France
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16
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Gust L, Nafteux P, Allemann P, Tuech JJ, El Nakadi I, Collet D, Goere D, Fabre JM, Meunier B, Dumont F, Poncet G, Passot G, Carrere N, Mathonnet M, Lebreton G, Theraux J, Marchal F, Barabino G, Thomas PA, Piessen G, D'Journo XB. Hiatal hernia after oesophagectomy: a large European survey. Eur J Cardiothorac Surg 2020; 55:1104-1112. [PMID: 30596989 DOI: 10.1093/ejcts/ezy451] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 06/28/2018] [Revised: 11/08/2018] [Accepted: 11/17/2018] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Hiatal hernias (HH) after oesophagectomy are rare, and their surgical management is not well standardized. Our goal was to report on the management of HH after oesophagectomy in high-volume tertiary European French-speaking centres. METHODS We conducted a retrospective multicentre study among 19 European French-speaking departments of upper gastrointestinal and/or thoracic surgery. All patients scheduled or operated on for the repair of an HH after oesophagectomy were collected between 2000 and 2016. Demographics, details of the initial procedure, surgical management and long-term outcome were analysed. RESULTS Seventy-nine of 6608 (1.2%) patients who had oesophagectomies were included in the study. The postoesophagectomy diagnostic interval of an HH after oesophagectomy was ≤90 days (n = 17; 21%), 13 were emergency cases; between 91 days and 1 year, n = 21 (27%), 13 in emergency; ≥1 year, n = 41 (52%), 17 in emergency. The time to occurrence of HH after oesophagectomy was shorter after laparoscopy (median 308 days; interquartile range 150-693) compared to that after laparotomy (median 562 days, interquartile range 138-1768; P = 0.01). The incidence of HH after oesophagectomy was 0.73% (22/3010) after open surgery and 1.4% (26/1761) after laparoscopy (P = 0.03). Among the 79 patients, 78 were operated on: 35 had laparotomies (45%), 19 had laparoscopies (24%) and 24 (31%) had transthoracic approaches. Among the 43 urgent surgeries, 35 were open (25 laparotomies and 10 transthoracic approaches) and 8 were laparoscopies (conversion rate, 25%). Nine patients required bowel resections. Morbidity occurred in 36 (46%) patients with 1 postoperative death (1.2%). During the follow-up period, recurrent HH after oesophagectomy requiring revisional surgery developed in 8 (6 days-26 months) patients. CONCLUSIONS Surgical management of HH after oesophagectomy could be done by laparoscopy in patients with scheduled surgery but laparotomy or thoracotomy was preferred in urgent situations. The incidence of HH after oesophagectomy is higher and its onset earlier when laparoscopy is used at the initial oesophagectomy.
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Affiliation(s)
- Lucile Gust
- Department of Thoracic Surgery, Disease of the Esophagus and Lung Transplantation, North Hospital, Aix-Marseille University, Marseille, France
| | - Philippe Nafteux
- Department of Thoracic Surgery and Disease of the Esophagus, KUZ Gathuisberg, Leuven, Belgium
| | - Pierre Allemann
- Department of Thoracic Surgery, University Hospital Vaudois, Lausanne, Switzerland
| | - Jean-Jacques Tuech
- Department of Visceral Surgery, Rouen University Hospital, Rouen, France
| | - Issam El Nakadi
- Department of Visceral Surgery, ULB-Erasme-Bordet University Hospital, Brussels, Belgium
| | - Denis Collet
- Department of Visceral and Endocrine Surgery, Bordeaux University Hospital, Bordeaux, France
| | - Diane Goere
- Department of Visceral Surgery, Gustave Roussy Institute, Villejuif, France
| | - Jean-Michel Fabre
- Department of Visceral Surgery and Hepatic Transplantation, Montpellier University Hospital, Montpellier, France
| | - Bernard Meunier
- Department of Hepato-Biliary and Visceral Surgery, Rennes University Hospital, Rennes, France
| | - Frédéric Dumont
- Department of Oncological Surgery, Oncologic Institute of the West (Institut de Cancérologie de l'Ouest), Nantes, France
| | - Gilles Poncet
- Department of Visceral Surgery, Édouard-Heriot Hospital, Lyon, France
| | - Guillaume Passot
- Department of Visceral and Endocrine Surgery, Hospices Civils de Lyon-South Hospital, Lyon, France
| | - Nicolas Carrere
- Department of General and Visceral Surgery, Purpan University Hospital, Toulouse, France
| | - Muriel Mathonnet
- Department of General, Visceral and Endocrine Surgery, Dupuytren Hospital, Limoges, France
| | - Gil Lebreton
- Department of Visceral Surgery-Colo-rectal Surgery Unit, Caen University Hospital, Caen, France
| | - Jérémie Theraux
- Department of Visceral Surgery, Brest University Hospital, Brest, France
| | - Frédéric Marchal
- Department of Surgery, Lorraine Oncologic Institute, Nancy, France
| | - Gabriele Barabino
- Department of Visceral and Oncological Surgery, Saint-Étienne University Hospital, Saint-Etienne, France
| | - Pascal-Alexandre Thomas
- Department of Thoracic Surgery, Disease of the Esophagus and Lung Transplantation, North Hospital, Aix-Marseille University, Marseille, France
| | - Guillaume Piessen
- Department of General and Visceral Surgery, Lille University Hospital, Lille, France
| | - Xavier-Benoît D'Journo
- Department of Thoracic Surgery, Disease of the Esophagus and Lung Transplantation, North Hospital, Aix-Marseille University, Marseille, France
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17
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Le Breton C, Besset S, Freita-Ramos S, Amouretti M, Billiet PA, Dao M, Dumont LM, Federici L, Gaborieau B, Longrois D, Postel-Vinay P, Vuillard C, Zucman N, Lebreton G, Combes A, Dreyfuss D, Ricard JD, Roux D. Extracorporeal membrane oxygenation for refractory COVID-19 acute respiratory distress syndrome. J Crit Care 2020; 60:10-12. [PMID: 32731100 PMCID: PMC7365051 DOI: 10.1016/j.jcrc.2020.07.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/08/2020] [Accepted: 07/12/2020] [Indexed: 01/10/2023]
Affiliation(s)
- C Le Breton
- Médecine Intensive-Réanimation, AP-HP, Hôpital Louis Mourier, F92700 Colombes, France
| | - S Besset
- Médecine Intensive-Réanimation, AP-HP, Hôpital Louis Mourier, F92700 Colombes, France
| | - S Freita-Ramos
- Médecine Intensive-Réanimation, AP-HP, Hôpital Louis Mourier, F92700 Colombes, France
| | - M Amouretti
- Médecine Intensive-Réanimation, AP-HP, Hôpital Louis Mourier, F92700 Colombes, France
| | - P A Billiet
- Médecine Intensive-Réanimation, AP-HP, Hôpital Louis Mourier, F92700 Colombes, France; Common and Rare Kidney Diseases, French National Institute of Health and Medical Research, INSERM UMR_S 1155, Sorbonne Université, Paris, France
| | - M Dao
- Médecine Intensive-Réanimation, AP-HP, Hôpital Louis Mourier, F92700 Colombes, France
| | - L M Dumont
- Médecine Intensive-Réanimation, AP-HP, Hôpital Louis Mourier, F92700 Colombes, France; Université de Paris, Paris Nord Medical School, F-75018 Paris, France
| | - L Federici
- Médecine Intensive-Réanimation, AP-HP, Hôpital Louis Mourier, F92700 Colombes, France
| | - B Gaborieau
- Médecine Intensive-Réanimation, AP-HP, Hôpital Louis Mourier, F92700 Colombes, France; IAME, INSERM UMR1137, Université de Paris, F-75018 Paris, France
| | - D Longrois
- Université de Paris, Paris Nord Medical School, F-75018 Paris, France; Département d'Anesthésie, AP-HP, Hôpital Louis Mourier, F92700 Colombes, France
| | - P Postel-Vinay
- Médecine Intensive-Réanimation, AP-HP, Hôpital Louis Mourier, F92700 Colombes, France
| | - C Vuillard
- Médecine Intensive-Réanimation, AP-HP, Hôpital Louis Mourier, F92700 Colombes, France
| | - N Zucman
- Médecine Intensive-Réanimation, AP-HP, Hôpital Louis Mourier, F92700 Colombes, France; Université de Paris, Paris Nord Medical School, F-75018 Paris, France
| | - G Lebreton
- Cardio-Thoracic Surgery Department, AP-HP, Pitié-Salpétrière Hospital, Paris, France
| | - A Combes
- Sorbonne Université, INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, F-75013 Paris, France; Service de médecine intensive-réanimation, Institut de Cardiologie, APHP, Hôpital Pitié-Salpêtrière, F-75013 Paris, France
| | - D Dreyfuss
- Médecine Intensive-Réanimation, AP-HP, Hôpital Louis Mourier, F92700 Colombes, France; Common and Rare Kidney Diseases, French National Institute of Health and Medical Research, INSERM UMR_S 1155, Sorbonne Université, Paris, France; Université de Paris, Paris Nord Medical School, F-75018 Paris, France
| | - J D Ricard
- Médecine Intensive-Réanimation, AP-HP, Hôpital Louis Mourier, F92700 Colombes, France; Université de Paris, Paris Nord Medical School, F-75018 Paris, France; IAME, INSERM UMR1137, Université de Paris, F-75018 Paris, France
| | - D Roux
- Médecine Intensive-Réanimation, AP-HP, Hôpital Louis Mourier, F92700 Colombes, France; Université de Paris, Paris Nord Medical School, F-75018 Paris, France; IAME, INSERM UMR1137, Université de Paris, F-75018 Paris, France.
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18
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Guedeney P, Huchet F, Manigold F, Rouanet S, Vicaut E, Balagny P, Leprince P, Lebreton G, Letocart V, Barthelemy O, Montalescot G, Guerin P, Collet JP. P3855Incidence, risk factors and impact of readmission for heart failure after successful transcatheter aortic valve replacement. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Incidence and correlates of readmission for heart failure in all-comers, after successful transcatheter aortic valve replacement (TAVR) remain unclear.
Objective
We sought to evaluate the incidence, risk factors and clinical impact of readmission for HF after successful TAVR in an unselected patient population.
Methods
All patients who underwent successful TAVR in two high-volume French tertiary centers from February 2010 to December 2016 were prospectively included and followed-up for one year. Cox multivariate model was used to assess risk factors of readmission for heart failure, evaluated a time-updated covariate and mortality.
Results
A total of 1139 patients (mean age 82.4±7.7 years, 52.2% male) were included. Readmission for heart failure occurred in 99 (8.7%) patients. Risk factors of readmission for HF were chronic pulmonary disease (adjHR 1.8; 95% CI [1.2–2.8], p=0.008), chronic kidney disease (adjHR 1.7; 95% CI [1.1–2.6], p=0.01), diabetes mellitus (adjHR 1.7; 95% CI [1.1–2.5], p=0.01), prior atrial fibrillation (adjHR 1.6; 95% CI [1.1–2.4], p=0.02) and post-TAVR left ventricular ejection fraction (LVEF) ≤35% (adjHR 2.1 95% CI 1.2–3.7, p=0.009). Readmission for HF was strongly associated with mortality (Figure) along with increased STS score (adjHR 1.07 95% CI 1.03–1.12, p=0.002), prior atrial fibrillation (adjHR 2.13 95% CI 1.53–2.96, p<0.001) and shock during the index hospitalization (adjHR 2.68 95% CI 1.48–4.87, p=0.001).
Figure 1
Conclusion
Readmission for heart failure occurs in one out of ten patients after successful TAVR and is strong risk factor of mortality. Comorbidities and post-TAVR LVEF≤35% are the main correlates of readmission for heart failure.
Acknowledgement/Funding
ACTION study group
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Affiliation(s)
- P Guedeney
- Hospital Pitie-Salpetriere, Paris, France
| | - F Huchet
- University Hospital of Nantes, Cardiology, Nantes, France
| | - F Manigold
- University Hospital of Nantes, Cardiology, Nantes, France
| | - S Rouanet
- StatEthic, Statistician unit, Levallois Perret, France
| | - E Vicaut
- Action study group, Unité de recherche Clinique, Hôpital Lariboisière, Paris, France
| | - P Balagny
- Hospital Pitie-Salpetriere, Paris, France
| | - P Leprince
- Hospital Pitie-Salpetriere, Cardiac Surgery, Paris, France
| | - G Lebreton
- Hospital Pitie-Salpetriere, Cardiac Surgery, Paris, France
| | - V Letocart
- University Hospital of Nantes, Cardiology, Nantes, France
| | | | | | - P Guerin
- University Hospital of Nantes, Cardiology, Nantes, France
| | - J P Collet
- Hospital Pitie-Salpetriere, Paris, France
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19
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Eid Y, Menahem B, Bouvier V, Lebreton G, Thobie A, Bazille C, Finochi M, Fohlen A, Galais M, Dupont B, Lubrano J, Dejardin O, Morello R, Alves A. Has adherence to treatment guidelines for mid/low rectal cancer affected the management of patients? A monocentric study of 604 consecutive patients. J Visc Surg 2019; 156:281-290. [DOI: 10.1016/j.jviscsurg.2019.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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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20
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Eid Y, Bouvier V, Menahem B, Thobie A, Dolet N, Finochi M, Renier M, Gardy J, Launoy G, Dejardin O, Morello R, Alves A, Abdelli A, Ahkong MV, Alkofer B, Apoil B, Paul Argouarch L, Armand P, Arsène D, Auvray S, Barthélémy R, Bazille C, Laure Bignon A, Bonnamy C, Bouhier-Leporrier K, Borotto E, Brefort JL, Chomontovski J, Cohen D, Cojocaru M, Collet T, Congard P, Corbinais S, Couque M, Degoutte E, Desfachelles JP, Dupont B, Elfadel S, Galais MP, Genuist F, Girard N, Gloro R, Granveau A, Guilloit JM, Hervé S, Hessissen M, Jacob J, Kalinski E, Koutsomanis D, Lagriffoul L, Lartigau C, Lechevallier L, Lebreton G, Lefebvre AC, Lefrançois D, Lepoittevin C, Leporrier J, Le Roux Y, L’Hirondel A, L’Hirondel C, Lion L, Makki A, Marchand P, Marion Y, Mauger D, Mosquet L, Mura DN, Ollivier JM, Parzy A, Polycarpe E, Polycarpe F, Reijasse D, Renet C, Rodriguez C, Saadi L, Samama G, Saplacan M, Sleman F, Siriser F, Soufron J, Teste Y, Tiengou LE, Toudic JP. Digestive and genitourinary sequelae in rectal cancer survivors and their impact on health-related quality of life: Outcome of a high-resolution population-based study. Surgery 2019; 166:327-335. [DOI: 10.1016/j.surg.2019.04.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/28/2019] [Accepted: 03/29/2019] [Indexed: 02/06/2023]
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21
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Lebreton G, Géminard C, Lapraz F, Pyrpassopoulos S, Cerezo D, Spéder P, Ostap EM, Noselli S. Molecular to organismal chirality is induced by the conserved myosin 1D. Science 2019; 362:949-952. [PMID: 30467170 DOI: 10.1126/science.aat8642] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 10/04/2018] [Indexed: 11/02/2022]
Abstract
The emergence of asymmetry from an initially symmetrical state is a universal transition in nature. Living organisms show asymmetries at the molecular, cellular, tissular, and organismal level. However, whether and how multilevel asymmetries are related remains unclear. In this study, we show that Drosophila myosin 1D (Myo1D) and myosin 1C (Myo1C) are sufficient to generate de novo directional twisting of cells, single organs, or the whole body in opposite directions. Directionality lies in the myosins' motor domain and is swappable between Myo1D and Myo1C. In addition, Myo1D drives gliding of actin filaments in circular, counterclockwise paths in vitro. Altogether, our results reveal the molecular motor Myo1D as a chiral determinant that is sufficient to break symmetry at all biological scales through chiral interaction with the actin cytoskeleton.
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Affiliation(s)
- G Lebreton
- Université Côte D'Azur, CNRS, Inserm, Institut de Biologie Valrose, Nice, France
| | - C Géminard
- Université Côte D'Azur, CNRS, Inserm, Institut de Biologie Valrose, Nice, France
| | - F Lapraz
- Université Côte D'Azur, CNRS, Inserm, Institut de Biologie Valrose, Nice, France
| | - S Pyrpassopoulos
- Pennsylvania Muscle Institute and the Center for Engineering Mechanobiology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - D Cerezo
- Université Côte D'Azur, CNRS, Inserm, Institut de Biologie Valrose, Nice, France
| | - P Spéder
- Université Côte D'Azur, CNRS, Inserm, Institut de Biologie Valrose, Nice, France
| | - E M Ostap
- Pennsylvania Muscle Institute and the Center for Engineering Mechanobiology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - S Noselli
- Université Côte D'Azur, CNRS, Inserm, Institut de Biologie Valrose, Nice, France.
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Coutance G, Lebreton G, Jacob N, Bréchot N, Demondion P, Bouglé A, Nguyen L, Varnous S, Combes A, Leprince P. A Direct Heart-Transplantation Strategy in Selected Patients on Extra-Corporeal Membrane Oxygenation Achieved Favorable Post-Transplant Outcomes. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.261] [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: 11/29/2022] Open
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Jasseron C, Legeai C, Lebreton G, Kindo M, Audry B, Jacquelinet C, Bastien O, Dorent R. Impact of the New Heart Allocation System in France on Candidates’ Profile and Waitlist Outcomes. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.678] [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: 11/30/2022] Open
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Giangreco N, Lebreton G, Restaino S, Farr M, Colombo P, Zorn E, Tatonetti N, Leprince P, Kobashigawa J, Fine B. Exosome Proteomics and Machine Learning Identify Novel Biomarkers of Primary Graft Dysfunction. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Coutance G, Lebreton G, Demondion P, Jacob N, Nguyen L, Combes A, Amour J, Ouldamar S, Varnous S, Leprince P. Survival after heart transplantation in patients on ECMO support at the time of transplant improved over time in a high-volume center. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.312] [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: 11/29/2022]
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Coutance G, Nguyen L, Lebreton G, Ouldamar S, Rouvier P, Saheb S, Bouglé A, Bréchot N, Leprince P, Varnous S. Pre-formed donor specific antibodies > 3000 MFI managed at the time of transplantation predicts early antibody-mediated rejection after heart transplantation in a large cohort of patients. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.313] [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: 10/27/2022]
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Guedeney P, Huchet F, Overtchouk P, Rouanet S, Vicaut E, Manigold T, Letocart V, Balagny P, Leprince P, De Decker L, Lebreton G, Barthelemy O, Montalescot G, Guerin P, Collet JP. P3423Impact of oral anticoagulation on clinical outcomes and hemodynamic parameters after successful transcatheter aortic valve replacement. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3423] [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] [Indexed: 11/14/2022] Open
Affiliation(s)
- P Guedeney
- Hospital Pitie-Salpetriere, Paris, France
| | - F Huchet
- University Hospital of Nantes Nord Laennec, Nantes, France
| | | | | | - E Vicaut
- Lariboisiere hospital, Clinical research unit - ACTION study group, Paris, France
| | - T Manigold
- University Hospital of Nantes Nord Laennec, Nantes, France
| | - V Letocart
- University Hospital of Nantes Nord Laennec, Nantes, France
| | - P Balagny
- Hospital Pitie-Salpetriere, Paris, France
| | - P Leprince
- Hospital Pitie-Salpetriere, Paris, France
| | - L De Decker
- University Hospital of Nantes, Nantes, France
| | - G Lebreton
- Hospital Pitie-Salpetriere, Paris, France
| | | | | | - P Guerin
- University Hospital of Nantes Nord Laennec, Nantes, France
| | - J P Collet
- Hospital Pitie-Salpetriere, Paris, France
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Coutance G, Leprince P, Demondion P, Jacob N, Nguyen L, Combes A, Amour J, Ouldamar S, Varnous S, Lebreton G. P4222Pre-heart transplantation ECMO support achieved favorable post-transplant outcomes in selected patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4222] [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] [Indexed: 11/15/2022] Open
Affiliation(s)
- G Coutance
- Hospital Pitie-Salpetriere, Cardiovascular and Thoracic surgery, Paris, France
| | - P Leprince
- Hospital Pitie-Salpetriere, Cardiovascular and Thoracic surgery, Paris, France
| | - P Demondion
- Hospital Pitie-Salpetriere, Cardiovascular and Thoracic surgery, Paris, France
| | - N Jacob
- Hospital Pitie-Salpetriere, Cardiovascular and Thoracic surgery, Paris, France
| | - L Nguyen
- Hospital Pitie-Salpetriere, Cardiovascular and Thoracic surgery, Paris, France
| | - A Combes
- Hospital Pitie-Salpetriere, Intensive Care Unit, Paris, France
| | - J Amour
- Hospital Pitie-Salpetriere, Anesthesiology, Paris, France
| | - S Ouldamar
- Hospital Pitie-Salpetriere, Cardiovascular and Thoracic surgery, Paris, France
| | - S Varnous
- Hospital Pitie-Salpetriere, Cardiovascular and Thoracic surgery, Paris, France
| | - G Lebreton
- Hospital Pitie-Salpetriere, Cardiovascular and Thoracic surgery, Paris, France
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Cantrelle C, Dorent R, Savoye E, Tuppin P, Lebreton G, Legeai C, Bastien O. Center Characteristics Play a Leading Role in Geographic Disparities in Access to Heart Transplantation in France. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1131] [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: 11/25/2022] Open
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Fine B, Chen E, Lebreton G, Restaino S, Taupin J, Zorn E, Farr M, Colombo P, Leprince P. Pre-Transplant Serum Exosome Proteomics Differentiates Right and Left Ventricular Primary Graft Dysfunction. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.038] [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: 10/17/2022] Open
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31
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Vidal C, Pasqualotto R, James A, Bouglé A, Lebreton G, Varnous S, Leprince P, Amour J. Epidemiology and Risk Factors of Post Operative Pneumonias After Heart Transplantation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.917] [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: 10/17/2022] Open
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32
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Galeone A, Varnous S, Salem J, Lebreton G, Coutance G, Hulot J, Leprince P. ST2 as a Marker of Primary Graft Dysfunction. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.067] [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: 11/24/2022] Open
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Francoual J, Lebreton G, Bazille C, Galais MP, Dupont B, Alves A, Lubrano J, Morello R, Menahem B. Is pathological complete response after a trimodality therapy, a predictive factor of long-term survival in locally-advanced esophageal cancer? Results of a retrospective monocentric study. J Visc Surg 2018; 155:365-374. [PMID: 29501383 DOI: 10.1016/j.jviscsurg.2018.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate long-term (5- and 10-year) survival and recurrence rates on the basis of the pathological complete response (pCR) in the specimens of patients with esophageal carcinoma, treated with trimodality therapy. METHODS Between 1993 and 2014, all consecutives patients with esophageal locally-advanced non-metastatic squamous cell carcinoma (SCC) or adenocarcinoma (ADC) who received trimodality therapy were reviewed. According to histopathological analysis, patients were divided in two groups with pCR and with pathological residual tumor (pRT). The primary endpoint was overall survival (OS). The secondary endpoints included the disease-free survival (DFS), the recurrence rate, and the predictive factors of overall survival and recurrence. RESULTS One hundred and three patients were included: 49 patients with pCR and 54 patients with pRT. The median OS was significantly longer in pCR group than in pRT group (132±22.3 vs. 25.5±4 months), with both 5- and 10-years OS rates of 75.2% vs. 29.1%, and 51.1% vs. 13.6%, respectively (P<0.001). Also, pRT, major postoperative complications (Dindo-Clavien grade>IIIb) and recurrence were the 3 independent predictive factors for worse OS. CONCLUSIONS Patients with locally-advanced oesophageal carcinoma, who responded to trimodality therapy with a pCR, could be achieved a 10-year survival rate of 51%.
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Affiliation(s)
- J Francoual
- Department of digestive surgery, University Hospital of Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France.
| | - G Lebreton
- Department of digestive surgery, University Hospital of Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France
| | - C Bazille
- Department of histopathology, University Hospital of Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France
| | - M P Galais
- Department of oncology and radiotherapy, University Hospital of Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France
| | - B Dupont
- Department of hepatogastroenterology, University Hospital of Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France
| | - A Alves
- Department of digestive surgery, University Hospital of Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France; Inserm UMR 1086, UNICAEN, CEA, CNRS, Centre François Baclesse, CHU de Caen, Normandie University, 3, avenue du Général-Harris, 14045 Caen cedex, France
| | - J Lubrano
- Department of digestive surgery, University Hospital of Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France; Inserm UMR 1086, UNICAEN, CEA, CNRS, Centre François Baclesse, CHU de Caen, Normandie University, 3, avenue du Général-Harris, 14045 Caen cedex, France
| | - R Morello
- Department of biostatistical, Centre Georges-Clemenceau, University Hospital of Caen, 14000 Caen cedex, France
| | - B Menahem
- Department of digestive surgery, University Hospital of Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France; Inserm UMR 1086, UNICAEN, CEA, CNRS, Centre François Baclesse, CHU de Caen, Normandie University, 3, avenue du Général-Harris, 14045 Caen cedex, France
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Cantrelle C, Dorent R, Savoye E, Tuppin P, Lebreton G, Legeai C, Bastien O. Factors contributing to geographic disparities in access to heart transplantation in France. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.080] [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: 11/29/2022]
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35
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D’alessandro C, Badenco N, Duthoit G, Gandjbakhch E, Maupain C, Lebreton G, Hidden-Lucet F, Leprince P. Totally thoracoscopic surgical ablation of stand alone atrial fibrillation and concomitant left appendage exclusion. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.251] [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: 10/18/2022]
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36
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Markar SR, Gronnier C, Pasquer A, Duhamel A, Behal H, Théreaux J, Gagnière J, Lebreton G, Brigand C, Renaud F, Piessen G, Meunier B, Collet D, Mariette C. Discrepancy Between Clinical and Pathologic Nodal Status of Esophageal Cancer and Impact on Prognosis and Therapeutic Strategy. Ann Surg Oncol 2017; 24:3911-3920. [PMID: 28948524 PMCID: PMC5670185 DOI: 10.1245/s10434-017-6088-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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] [Received: 07/02/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND The impact of discrepancies between clinical (c) and pathologic (p) stages of esophageal cancer remains a poorly understood issue. This study aimed to compare the prognosis of patient groups treated by primary surgery including clinical N0/pathologic N0 (cN0pN0), clinical N0/pathologic N+ (cN0pN+), clinical N+/pathologic N0 (cN+pN0), and clinical N+/pathologic N+ (cN+pN+). METHODS Data were collected from 30 European centers during the years 2000 to 2010. Among 2944 recruited patients, 1554 patients receiving primary surgery met the inclusion criteria including 613 cN0pN0, 403 cN0pN+, 220 cN+pN0, and 318 cN+pN+ patients. Analyses with adjustment of the propensity score were used to compensate for differences in baseline characteristics. RESULTS Clinical T stages 3 and 4 were increased in cN+pN+ (73.0%), cN0pN+ (49.6%), and cN+pN0 (51.8%) compared with cN0pN0 (32.8%). Compared with cN0pN0, cN+pN+ and cN0pN+ showed an increase in the proportion of adenocarcinoma histologic subtype, poor tumor differentiation, pathologic T3 and T4 stages, and R1/2 resection margin. Adjusted 5-year overall survival (hazard ratio [HR] 3.12; 95% confidence interval [CI] 2.57-3.78; P < 0.001) and event-free survival (HR 2.87; 95% CI 2.39-3.45; P < 0.001) were significantly reduced in cN0pN+ compared with cN0pN0. No significant differences in 5-year overall survival or event-free survival between cN0pN+ and cN+pN+ were observed. Regression analysis identified an association of distal tumor location, advanced clinical T stage, and poor tumor differentiation with pN+ disease. CONCLUSIONS This large multicenter study showed that cN0pN+ has a prognosis similar to that of cN+pN+ and worse than that of cN0pN0. Patients with clinical N0 disease but risk factors for pathologic N+ disease may benefit from neoadjuvant therapy before surgery.
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Affiliation(s)
- Sheraz R Markar
- Department of Surgery and Cancer, Imperial College, London, UK
| | - Caroline Gronnier
- Department of Digestive and Oncological Surgery, Univ.Lille, Claude Huriez University Hospital, Lille, France.,Univ.Lille, UMR-S 1172 - JPARC - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, Lille, France.,Inserm, UMR-S 1172, Lille, France
| | - Arnaud Pasquer
- Department of Digestive Surgery of Edouard, Herriot University Hospital, Lyon, France
| | - Alain Duhamel
- SIRIC OncoLille, Lille, France.,Department of Biostatistics, Univ.Lille, University Hospital, Lille, France
| | - Hélène Behal
- SIRIC OncoLille, Lille, France.,Department of Biostatistics, Univ.Lille, University Hospital, Lille, France
| | | | | | | | | | - Florence Renaud
- Univ.Lille, UMR-S 1172 - JPARC - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, Lille, France.,Inserm, UMR-S 1172, Lille, France.,Department of Pathology, Univ.Lille, University Hospital, Lille, France
| | - Guillaume Piessen
- Department of Digestive and Oncological Surgery, Univ.Lille, Claude Huriez University Hospital, Lille, France.,Univ.Lille, UMR-S 1172 - JPARC - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, Lille, France.,Inserm, UMR-S 1172, Lille, France
| | | | - Denis Collet
- Haut-Levêque University Hospital, Bordeaux, France
| | - Christophe Mariette
- Department of Digestive and Oncological Surgery, Univ.Lille, Claude Huriez University Hospital, Lille, France. .,Univ.Lille, UMR-S 1172 - JPARC - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, Lille, France. .,Inserm, UMR-S 1172, Lille, France. .,SIRIC OncoLille, Lille, France. .,Department of Digestive and Oncological Surgery, University Hospital Claude Huriez-Regional University Hospital Center, Lille Cedex, France.
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Coutance G, Van Aelst L, Ouldammar S, Rouvier P, Saheb S, Brechot N, Lebreton G, Bouglé A, Combes A, Amour J, Leprince P, Varnous S. Early Acute Humoral Rejection Does Not Alter Prognosis After Heart Transplantation. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.535] [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: 11/25/2022] Open
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Markar SR, Gronnier C, Pasquer A, Duhamel A, Behal H, Théreaux J, Gagnière J, Lebreton G, Brigand C, Meunier B, Collet D, Mariette C. Surgically treated oesophageal cancer developed in a radiated field: Impact on peri-operative and long-term outcomes. Eur J Cancer 2017; 75:179-189. [PMID: 28236769 DOI: 10.1016/j.ejca.2016.12.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 11/21/2016] [Accepted: 12/11/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND The objectives of this study were to compare peri-operative and long-term outcomes from oesophageal cancer (EC) (i) that arose in a previously radiated field (ECRF) versus primary (PEC) and among ECRF patients and (ii) radiotherapy-induced (RIEC) versus non-radiotherapy-induced EC (NRIEC). METHODS Data were collected from 30 European centres from 2000 to 2010. Two thousand four hundred eighty nine EC patients surgically treated were included in the PEC group and 136 in the ECRF group, NRIEC group (n = 61) and RIEC group (n = 75). Propensity score matching analyses were used to compensate for differences in baseline characteristics. RESULTS Compared to the PEC group, the ECRF group was characterised by less use of neoadjuvant chemoradiotherapy (0% versus 29.5%; P < 0.001), less pathological stage III/IV (31.6% versus 39.2%, P = 0.036), greater incidence of R1/2 margins (21.3% versus 10.9%; P < 0.001), increased in-hospital mortality (14.0% versus 7.1%; P = 0.003) and overall morbidity (68.4% versus 56.4%, P = 0.006). After matching, 5-year overall (28.8% versus 50.5%; hazard ratio [HR] = 1.53, 95% confidence interval [CI]: 1.15-2.04; P = 0.003) and event-free (32.2% versus 42.5%; HR = 1.56, 95% CI: 1.18-2.05; P = 0.002) survivals were significantly reduced in the ECRF group. There were no significant differences in incidence or pattern of tumour recurrence. Comparing RIEC and NRIEC groups, there were no significant differences in short- or long-term outcomes before and after matching. CONCLUSIONS ECRF is associated with poorer long-term survival related to a reduced utilisation of neoadjuvant chemoradiotherapy and an increased incidence of tumour margin involvement at surgery. Outcomes appear to be dictated by the limitations related to previous radiotherapy administration more than the radiotherapy-induced carcinogenesis.
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Affiliation(s)
- Sheraz R Markar
- Department of Surgery and Cancer, Imperial College, London, UK
| | - Caroline Gronnier
- Univ. Lille, Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, F-59000 Lille, France; Univ. Lille, UMR-S 1172 - JPARC - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, F-59000 Lille, France; Inserm, UMR-S 1172, F-59000 Lille, France
| | - Arnaud Pasquer
- Department of Digestive Surgery of Edouard Herriot University Hospital, Lyon, France
| | - Alain Duhamel
- SIRIC OncoLille, France; Univ. Lille, Department of Biostatistics, University Hospital, F-59000 Lille, France
| | - Hélène Behal
- SIRIC OncoLille, France; Univ. Lille, Department of Biostatistics, University Hospital, F-59000 Lille, France
| | | | | | | | | | | | - Denis Collet
- Haut-Levêque University Hospital, Bordeaux, France
| | - Christophe Mariette
- Univ. Lille, Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, F-59000 Lille, France; Univ. Lille, UMR-S 1172 - JPARC - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, F-59000 Lille, France; Inserm, UMR-S 1172, F-59000 Lille, France; SIRIC OncoLille, France.
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Mariette C, Markar S, Gronnier C, Pasquer A, Duhamel A, Behal H, Thereaux J, Gagniere J, Lebreton G, Brigand C, Meunier B, Collet D. Surgically treated esophageal cancer developed in a radiated field: Impact on peri-operative and long-term outcomes. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.4_suppl.150] [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: 11/20/2022] Open
Abstract
150 Background: The objectives of this study were to compare peri-operative and long-term outcomes from esophageal cancer (EC) (i) that arose in a previously radiated field (ECRF) versus primary (PEC) and among ECRF patients (ii) radiotherapy-induced (RIEC) versus non radiotherapy-induced EC (NRIEC). Methods: Data was collected from 30 European centers from 2000–2010. 2489 EC patients surgically treated were included in the PEC group and 136 in the ECRF group, including 61 in the NRIEC group and 75 in the RIEC group. Propensity score matching analyses were used to compensate for differences in baseline characteristics. Results: Compared to the PEC group, the ECRF group was characterized by less use of neoadjuvant chemoradiotherapy (0% vs. 29.5%; P < 0.001), less pathological stage III/IV (31.6% vs 39.2%, P = 0.036), greater incidence of R1/2 margins (21.3% vs. 10.9%; P < 0.001), increased in-hospital mortality (14.0% vs. 7.1%; P = 0.003) and overall morbidity (68.4% vs. 56.4%, P = 0.006). After matching, 5-year overall (28.8% vs. 50.5%; HR = 1.53, 95% C.I. 1.15-2.04; P = 0.003) and event-free (32.2% vs. 42.5%; HR = 1.56, 95% C.I. 1.18-2.05; P = 0.002) survivals were significantly reduced in the ECRF group. There were no significant differences in incidence or pattern of tumor recurrence. Comparing RIEC and NRIEC groups, there were no significant differences in short- or long-term outcomes before and after matching. Conclusions: ECRF is associated with poorer long-term survival related to a reduced utilization of neoadjuvant chemoradiotherapy and an increased incidence of tumor margin involvement at surgery. Outcomes are dictated by the limitations related to previous radiotherapy administration more than the radiotherapy-induced carcinogenesis.
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Affiliation(s)
| | - Sheraz Markar
- Department of Surgery and Cancer, Imperial College, London, United Kingdom
| | - Caroline Gronnier
- Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille, France
| | | | - Alain Duhamel
- Department of Biostatistics, University Hospital of Lille, Lille, France
| | | | | | | | | | - Cecile Brigand
- Department of Digestive Surgery, Hautepierre University Hospital, Strasbourg, France
| | - Bernard Meunier
- Department of Digestive Surgery, Pontchaillou University Hospital, Rennes, France
| | - Denis Collet
- Haut-Leveque University Hospital, Bordeaux, France
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Marion Y, Lebreton G, Brévart C, Sarcher T, Alves A, Babin E. Gastric pull-up reconstruction after treatment for advanced hypopharyngeal and cervical esophageal cancer. Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133:397-400. [DOI: 10.1016/j.anorl.2016.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Drouin S, Raux M, Tourret J, Lebreton G, Coffin G, Cohen J, Arzouk N, Ourahma S, Parra J, Riou B, Leprince P, Barrou B. Transplantation rénale issue de donneurs décédés d’arrêt cardiaque de la catégorie III de Maastricht. Résultats après un an d’expérience. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.086] [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: 10/20/2022]
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Zeitoun J, Menahem B, Fohlen A, Lebreton G, Lubrano J, Alves A. Emergency surgery for epidural abcess secondary to sacral fistula after laparoscopic proctectomy. J Surg Case Rep 2016; 2016:rjw108. [PMID: 27421299 PMCID: PMC4946530 DOI: 10.1093/jscr/rjw108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A 61-year-old man presented via the emergency department with a few days history of abdominal and colic occlusion symptoms. He presented signs of sepsis, midline lumbar spine tenderness and reduced hip flexion. Computer tomography of the abdomen and pelvis showed a presacral collection contiguous with the posterior part of the colo-rectal anastomosis, and MRI lumbar spine revealed abscess invation into the epidural space. He underwent a laparotomy with washout of the presacral abscess and a colostomy with a prolonged course of intravenous antibiotic therapy. At 3 weeks after initial presentation he had made a full clinical recovery with progressive radiological resolution of the epidural abscess. The objective of the case report is to highlight a unique and clinically significant complication of a rare post-operative complication after rectal surgery and to briefly discuss other intra-abdominal sources of epidural abscess.
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Affiliation(s)
- Jeremie Zeitoun
- Department of Digestive Surgery, University Hospital of Caen (CHU) Caen, 14032 Caen Cedex, France
| | - Benjamin Menahem
- Department of Digestive Surgery, University Hospital of Caen (CHU) Caen, 14032 Caen Cedex, France
| | - Audrey Fohlen
- Department of Radiology, University Hospital of Caen (CHU) Caen, 14032 Caen Cedex, France
| | - Gil Lebreton
- Department of Digestive Surgery, University Hospital of Caen (CHU) Caen, 14032 Caen Cedex, France
| | - Jean Lubrano
- Department of Digestive Surgery, University Hospital of Caen (CHU) Caen, 14032 Caen Cedex, France
| | - Arnaud Alves
- Department of Digestive Surgery, University Hospital of Caen (CHU) Caen, 14032 Caen Cedex, France
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Le Guennec L, Schmidt M, Bréchot N, Lebreton G, Leprince P, Combes A, Luyt CE. Complications neurologiques de l’assistance circulatoire de courte durée. Réanimation 2016. [DOI: 10.1007/s13546-016-1217-4] [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: 11/29/2022]
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Bekkar S, Gronnier C, Renaud F, Duhamel A, Pasquer A, Théreaux J, Gagnière J, Meunier B, Collet D, Mariette C, Dhahri A, Lignier D, Cossé C, Regimbeau JM, Luc G, Cabau M, Jougon J, Badic B, Lozach P, Bail JP, Cappeliez S, El Nakadi I, Lebreton G, Alves A, Flamein R, Pezet D, Pipitone F, Stan-Iuga B, Contival N, Pappalardo E, Coueffe X, Msika S, Mantziari S, Demartines N, Hec F, Vanderbeken M, Tessier W, Briez N, Fredon F, Gainant A, Mathonnet M, Bigourdan JM, Mezoughi S, Ducerf C, Baulieux J, Mabrut JY, Bigourdan JM, Baraket O, Poncet G, Adam M, Vaudoyer D, Jourdan Enfer P, Villeneuve L, Glehen O, Coste T, Fabre JM, Marchal F, Frisoni R, Ayav A, Brunaud L, Bresler L, Cohen C, Aze O, Venissac N, Pop D, Mouroux J, Donici I, Prudhomme M, Felli E, Lisunfui S, Seman M, Godiris Petit G, Karoui M, Tresallet C, Ménégaux F, Vaillant JC, Hannoun L, Malgras B, Lantuas D, Pautrat K, Pocard M, Valleur P, Lefevre JH, Chafai N, Balladur P, Lefrançois M, Parc Y, Paye F, Tiret E, Nedelcu M, Laface L, Perniceni T, Gayet B, Turner K, Filipello A, Porcheron J, Tiffet O, Kamlet N, Chemaly R, Klipfel A, Pessaux P, Brigand C, Rohr S, Carrère N, Da Re C, Dumont F, Goéré D, Elias D, Bertrand C. Multicentre study of neoadjuvant chemotherapy for stage I and II oesophageal cancer. Br J Surg 2016; 103:855-62. [DOI: 10.1002/bjs.10121] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 11/11/2015] [Accepted: 01/05/2016] [Indexed: 12/28/2022]
Abstract
Abstract
Background
The benefit of neoadjuvant chemotherapy (NCT) for early-stage oesophageal cancer is unknown. The aim of this study was to assess whether NCT improves the outcome of patients with stage I or II disease.
Methods
Data were collected from 30 European centres from 2000 to 2010. Patients who received NCT for stage I or II oesophageal cancer were compared with patients who underwent primary surgery with regard to postoperative morbidity, mortality, and overall and disease-free survival. Propensity score matching was used to adjust for differences in baseline characteristics.
Results
Of 1173 patients recruited (181 NCT, 992 primary surgery), 651 (55·5 per cent) had clinical stage I disease and 522 (44·5 per cent) had stage II disease. Comparisons of the NCT and primary surgery groups in the matched population (181 patients in each group) revealed in-hospital mortality rates of 4·4 and 5·5 per cent respectively (P = 0·660), R0 resection rates of 91·7 and 86·7 per cent (P = 0·338), 5-year overall survival rates of 47·7 and 38·6 per cent (hazard ratio (HR) 0·68, 95 per cent c.i. 0·49 to 0·93; P = 0·016), and 5-year disease-free survival rates of 44·9 and 36·1 per cent (HR 0·68, 0·50 to 0·93; P = 0·017).
Conclusion
NCT was associated with better overall and disease-free survival in patients with stage I or II oesophageal cancer, without increasing postoperative morbidity.
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Affiliation(s)
- S Bekkar
- Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille, France
| | - C Gronnier
- Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille, France
- North of France University, Lille, France
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S1172, Team 5 ‘Mucins, epithelial differentiation and carcinogenesis’, Jean-Pierre Aubert Research Centre, Lille, France
| | - F Renaud
- Department of Pathology, Lille University Hospital, Lille, France
| | - A Duhamel
- Department of Biostatistics, Lille University Hospital, Lille, France
- Site de Recherche Intégré en Cancérologie OncoLille, Lille, France
| | - A Pasquer
- Department of Digestive Surgery, Edouard Herriot University Hospital, Lyon, France
| | - J Théreaux
- Cavale Blanche University Hospital, Brest, France
| | - J Gagnière
- Estaing University Hospital, Clermont-Ferrand, France
| | - B Meunier
- Pontchaillou University Hospital, Rennes, France
| | - D Collet
- Haut-Levêque University Hospital, Bordeaux, France
| | - C Mariette
- Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille, France
- North of France University, Lille, France
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S1172, Team 5 ‘Mucins, epithelial differentiation and carcinogenesis’, Jean-Pierre Aubert Research Centre, Lille, France
- Site de Recherche Intégré en Cancérologie OncoLille, Lille, France
| | - A Dhahri
- Department of Digestive Surgery, Amiens Unievrsity Hospital, Amiens, France
| | - D Lignier
- Department of Digestive Surgery, Amiens Unievrsity Hospital, Amiens, France
| | - C Cossé
- Department of Digestive Surgery, Amiens Unievrsity Hospital, Amiens, France
| | - J-M Regimbeau
- Department of Digestive Surgery, Amiens Unievrsity Hospital, Amiens, France
| | - G Luc
- Department of Digestive Surgery, Pessac University Hospital, Bordeaux, France
| | - M Cabau
- Department of Thoracic Surgery, Pessac University Hospital, Bordeaux, France
| | - J Jougon
- Department of Thoracic Surgery, Pessac University Hospital, Bordeaux, France
| | - B Badic
- Department of Digestive Surgery, Cavale Blanche University Hospital, Brest, France
| | - P Lozach
- Department of Digestive Surgery, Cavale Blanche University Hospital, Brest, France
| | - J P Bail
- Department of Digestive Surgery, Cavale Blanche University Hospital, Brest, France
| | - S Cappeliez
- Department of Digestive Surgery, Brussel ULB Erasme Bordet University, Brussels, Belgium
| | - I El Nakadi
- Department of Digestive Surgery, Brussel ULB Erasme Bordet University, Brussels, Belgium
| | - G Lebreton
- Department of Digestive Surgery, Caen University Hospital, Caen, France
| | - A Alves
- Department of Digestive Surgery, Caen University Hospital, Caen, France
| | - R Flamein
- Department of Digestive Surgery, Estaing University Hospital, Clermont-Ferrand, France
| | - D Pezet
- Department of Digestive Surgery, Estaing University Hospital, Clermont-Ferrand, France
| | - F Pipitone
- Department of Digestive Surgery, Louis Mourier University Hospital, Colombes, France
| | - B Stan-Iuga
- Department of Digestive Surgery, Louis Mourier University Hospital, Colombes, France
| | - N Contival
- Department of Digestive Surgery, Louis Mourier University Hospital, Colombes, France
| | - E Pappalardo
- Department of Digestive Surgery, Louis Mourier University Hospital, Colombes, France
| | - X Coueffe
- Department of Digestive Surgery, Louis Mourier University Hospital, Colombes, France
| | - S Msika
- Department of Digestive Surgery, Louis Mourier University Hospital, Colombes, France
| | - S Mantziari
- Department of Digestive Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - N Demartines
- Department of Digestive Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - F Hec
- Department of Digestive Surgery, Caude Huriez University Hospital, Lille, France
| | - M Vanderbeken
- Department of Digestive Surgery, Caude Huriez University Hospital, Lille, France
| | - W Tessier
- Department of Digestive Surgery, Caude Huriez University Hospital, Lille, France
| | - N Briez
- Department of Digestive Surgery, Caude Huriez University Hospital, Lille, France
| | - F Fredon
- Department of Digestive Surgery, Limoges University Hospital, Limoges, France
| | - A Gainant
- Department of Digestive Surgery, Limoges University Hospital, Limoges, France
| | - M Mathonnet
- Department of Digestive Surgery, Limoges University Hospital, Limoges, France
| | - J M Bigourdan
- Department of Digestive Surgery, Croix Rousse University Hospital, Lyon, France
| | - S Mezoughi
- Department of Digestive Surgery, Croix Rousse University Hospital, Lyon, France
| | - C Ducerf
- Department of Digestive Surgery, Croix Rousse University Hospital, Lyon, France
| | - J Baulieux
- Department of Digestive Surgery, Croix Rousse University Hospital, Lyon, France
| | - J-Y Mabrut
- Department of Digestive Surgery, Croix Rousse University Hospital, Lyon, France
| | - J M Bigourdan
- Department of Digestive Surgery, Croix Rousse University Hospital, Lyon, France
| | - O Baraket
- Department of Digestive Surgery, Edouard Herriot University Hospital, Lyon, France
| | - G Poncet
- Department of Digestive Surgery, Edouard Herriot University Hospital, Lyon, France
| | - M Adam
- Department of Digestive Surgery, Edouard Herriot University Hospital, Lyon, France
| | - D Vaudoyer
- Department of Digestive Surgery, Lyon Sud University Hospital, Lyon, France
| | - P Jourdan Enfer
- Department of Digestive Surgery, Lyon Sud University Hospital, Lyon, France
| | - L Villeneuve
- Department of Digestive Surgery, Lyon Sud University Hospital, Lyon, France
| | - O Glehen
- Department of Digestive Surgery, Lyon Sud University Hospital, Lyon, France
| | - T Coste
- Department of Digestive Surgery, Montpellier, France
| | - J-M Fabre
- Department of Digestive Surgery, Montpellier, France
| | - F Marchal
- Department of Digestive Surgery, Institut de Cancérologie de Lorraine, Nancy, France
| | - R Frisoni
- Department of Digestive Surgery, Nancy University Hospital, Nancy, France
| | - A Ayav
- Department of Digestive Surgery, Nancy University Hospital, Nancy, France
| | - L Brunaud
- Department of Digestive Surgery, Nancy University Hospital, Nancy, France
| | - L Bresler
- Department of Digestive Surgery, Nancy University Hospital, Nancy, France
| | - C Cohen
- Department of Thoracic Surgery, Nice University Hospital, Nice, France
| | - O Aze
- Department of Thoracic Surgery, Nice University Hospital, Nice, France
| | - N Venissac
- Department of Thoracic Surgery, Nice University Hospital, Nice, France
| | - D Pop
- Department of Thoracic Surgery, Nice University Hospital, Nice, France
| | - J Mouroux
- Department of Thoracic Surgery, Nice University Hospital, Nice, France
| | - I Donici
- Department of Digestive Surgery, Nîmes University Hospital, Nîmes, France
| | - M Prudhomme
- Department of Digestive Surgery, Nîmes University Hospital, Nîmes, France
| | - E Felli
- Department of Digestive Surgery, Pitié-Salpétrière University Hospital, Paris, France
| | - S Lisunfui
- Department of Digestive Surgery, Pitié-Salpétrière University Hospital, Paris, France
| | - M Seman
- Department of Digestive Surgery, Pitié-Salpétrière University Hospital, Paris, France
| | - G Godiris Petit
- Department of Digestive Surgery, Pitié-Salpétrière University Hospital, Paris, France
| | - M Karoui
- Department of Digestive Surgery, Pitié-Salpétrière University Hospital, Paris, France
| | - C Tresallet
- Department of Digestive Surgery, Pitié-Salpétrière University Hospital, Paris, France
| | - F Ménégaux
- Department of Digestive Surgery, Pitié-Salpétrière University Hospital, Paris, France
| | - J-C Vaillant
- Department of Digestive Surgery, Pitié-Salpétrière University Hospital, Paris, France
| | - L Hannoun
- Department of Digestive Surgery, Pitié-Salpétrière University Hospital, Paris, France
| | - B Malgras
- Department of Digestive Surgery, Lariboisière University Hospital, Paris, France
| | - D Lantuas
- Department of Digestive Surgery, Lariboisière University Hospital, Paris, France
| | - K Pautrat
- Department of Digestive Surgery, Lariboisière University Hospital, Paris, France
| | - M Pocard
- Department of Digestive Surgery, Lariboisière University Hospital, Paris, France
| | - P Valleur
- Department of Digestive Surgery, Lariboisière University Hospital, Paris, France
| | - J H Lefevre
- Department of Digestive Surgery, Saint-Antoine University Hospital, Paris, France
| | - N Chafai
- Department of Digestive Surgery, Saint-Antoine University Hospital, Paris, France
| | - P Balladur
- Department of Digestive Surgery, Saint-Antoine University Hospital, Paris, France
| | - M Lefrançois
- Department of Digestive Surgery, Saint-Antoine University Hospital, Paris, France
| | - Y Parc
- Department of Digestive Surgery, Saint-Antoine University Hospital, Paris, France
| | - F Paye
- Department of Digestive Surgery, Saint-Antoine University Hospital, Paris, France
| | - E Tiret
- Department of Digestive Surgery, Saint-Antoine University Hospital, Paris, France
| | - M Nedelcu
- Department of Digestive Surgery, Institut Mutualiste Montsouris, Paris, France
| | - L Laface
- Department of Digestive Surgery, Institut Mutualiste Montsouris, Paris, France
| | - T Perniceni
- Department of Digestive Surgery, Institut Mutualiste Montsouris, Paris, France
| | - B Gayet
- Department of Digestive Surgery, Institut Mutualiste Montsouris, Paris, France
| | - K Turner
- Department of Digestive Surgery, Rennes, France
| | - A Filipello
- Department of Digestive Surgery, Saint-Etienne University Hospital, Saint-Etienne, France
| | - J Porcheron
- Department of Digestive Surgery, Saint-Etienne University Hospital, Saint-Etienne, France
| | - O Tiffet
- Department of Digestive Surgery, Saint-Etienne University Hospital, Saint-Etienne, France
| | - N Kamlet
- Department of Digestive Surgery, Strasbourg University Hospital, Strasbourg, France
| | - R Chemaly
- Department of Digestive Surgery, Strasbourg University Hospital, Strasbourg, France
| | - A Klipfel
- Department of Digestive Surgery, Strasbourg University Hospital, Strasbourg, France
| | - P Pessaux
- Department of Digestive Surgery, Strasbourg University Hospital, Strasbourg, France
| | - C Brigand
- Department of Digestive Surgery, Strasbourg University Hospital, Strasbourg, France
| | - S Rohr
- Department of Digestive Surgery, Strasbourg University Hospital, Strasbourg, France
| | - N Carrère
- Department of Digestive Surgery, Toulouse University Hospital, Toulouse, France
| | - C Da Re
- Department of Digestive Surgery, Institut Gustave-Roussy, Villejuif, France
| | - F Dumont
- Department of Digestive Surgery, Institut Gustave-Roussy, Villejuif, France
| | - D Goéré
- Department of Digestive Surgery, Institut Gustave-Roussy, Villejuif, France
| | - D Elias
- Department of Digestive Surgery, Institut Gustave-Roussy, Villejuif, France
| | - C Bertrand
- Mont-Godinne University Hospital, Yvoir, Belgium
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Vidal C, Lebreton G, Djavidi N, Varnous S, Bouglé A, Genton A, Barreda E, Leprince P, Amour J. Heart Transplantation Versus Ventricular Assist Device: Which Therapy for Patient with Refractory Cardiogenic Shock? J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.178] [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: 11/25/2022] Open
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Yssap J, Lebreton G, Hoen B, Larifla L. Infected left ventricular thrombus revealing an unrecognized coronary dissection after blunt chest trauma, treated with emergency heart transplantation. Eur Heart J 2016; 37:318. [PMID: 26093642 DOI: 10.1093/eurheartj/ehv277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J Yssap
- Service de cardiologie, Université des Antilles et de la Guyane, Centre Hospitalier Universitaire de Pointe-à-Pitre, Route de Chauvel, BP 465, Pointe-a-Pitre, Guadeloupe 97159, France
| | - G Lebreton
- Service de chirurgie cardiaque et thoracique, Université Pierre et Marie Curie, Assistance publique des hôpitaux de Paris, Hôpital La Pitié Salpêtrière, Paris, France
| | - B Hoen
- Service de Maladies Infectieuses et Tropicales, Université des Antilles et de la Guyane, Centre Hospitalier Universitaire, Pointe-à-Pitre, Guadeloupe, France
| | - L Larifla
- Service de cardiologie, Université des Antilles et de la Guyane, Centre Hospitalier Universitaire de Pointe-à-Pitre, Route de Chauvel, BP 465, Pointe-a-Pitre, Guadeloupe 97159, France
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Doerfler A, Vaudreuil L, Le Gal S, Lebreton G, Tillou X. Left adrenal tumor extending into the renal vein: surgical management with ipsilateral kidney preservation. J Surg Case Rep 2015; 2015:rjv098. [PMID: 26242191 PMCID: PMC4523813 DOI: 10.1093/jscr/rjv098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 11/14/2022] Open
Abstract
If single adrenal metastasis surgery is well admitted, no recommendation exists about the management of a renal vein tumor thrombus, even though the actual consensual attitude consists in a nephrectomy associated to an adrenalectomy. We report, here, the case of a 74-year-old man with a suspected adrenal metastasis of a lung carcinoma associated with a left adrenal and renal vein tumor thrombus treated by adrenalectomy and renal vein thrombectomy and ipsilateral kidney sparing. The postoperative computed tomography scan showed no thrombus in the left renal vein. Doppler ultrasound performed 1 month after adrenalectomy proved a good left renal vein flux. At 36 months of follow-up, the patient is alive without signs of recurrence.
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Affiliation(s)
- Arnaud Doerfler
- Department of Urology and Transplantation, Caen University Hospital, Caen Cedex, France
| | - Lionel Vaudreuil
- Department of Urology and Transplantation, Caen University Hospital, Caen Cedex, France
| | - Sophie Le Gal
- Department of Urology and Transplantation, Caen University Hospital, Caen Cedex, France
| | - Gil Lebreton
- Department of Abdominal Surgery, Caen University Hospital, Caen Cedex, France
| | - Xavier Tillou
- Department of Urology and Transplantation, Caen University Hospital, Caen Cedex, France Normandie Université UNICAEN, Caen, France
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Luc G, Gronnier C, Lebreton G, Brigand C, Mabrut JY, Bail JP, Meunier B, Collet D, Mariette C. Predictive Factors of Recurrence in Patients with Pathological Complete Response After Esophagectomy Following Neoadjuvant Chemoradiotherapy for Esophageal Cancer: A Multicenter Study. Ann Surg Oncol 2015; 22 Suppl 3:S1357-64. [PMID: 26014152 DOI: 10.1245/s10434-015-4619-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Indexed: 12/23/2022]
Abstract
BACKGROUND Minimal data have previously emerged from studies regarding the factors associated with recurrence in patients with ypT0N0M0 status. The purpose of the study was to predict survival and recurrence in patients with pathological complete response (pCR) following chemoradiotherapy (CRT) and surgery for esophageal cancer (EC). METHODS Among 2944 consecutive patients with EC operations in 30 centers between 2000 and 2010, patients treated with neoadjuvant CRT followed by surgery who achieved pCR (n = 191) were analyzed. The factors associated with survival and recurrence were analyzed using a Cox proportional hazard regression analysis. RESULTS Among 593 patients who underwent neoadjuvant CRT followed by esophagectomy, pCR was observed in 191 patients (32.2 %). Recurrence occurred in 56 (29.3 %) patients. The median time to recurrence was 12 months. The factors associated with recurrence were postoperative complications grade 3-4 [odds ratio (OR): 2.100; 95 % confidence interval (CI) 1.008-4.366; p = 0.048) and adenocarcinoma histologic subtype (OR 2.008; 95 % CI 0.1.06-0.3.80; p = 0.032). The median overall survival was 63 months (95 % CI 39.3-87.1), and the median disease-free survival was 48 months (95 % CI 18.3-77.4). Age (>65 years) [hazard ratio (HR): 2.166; 95 % CI 1.170-4.010; p = 0.014), postoperative complications grades 3-4 [HR 2.099; 95 % CI 1.137-3.878; p = 0.018], and radiation dose (<40 Gy) (HR 0.361; 95 % CI 0.159-0.820; p = 0.015) were identified as factors associated with survival. CONCLUSIONS An intensive follow-up may be beneficial for patients with EC who achieve pCR and who develop major postoperative complications or the adenocarcinoma histologic subtype.
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Affiliation(s)
- Guillaume Luc
- Department of Digestive Surgery, Haut Lévèque University Hospital, Bordeaux, France. .,Inserm, Unit 1026, University of Bordeaux, Bordeaux, France.
| | - Caroline Gronnier
- Department of Digestive and Oncological Surgery, Claude Huriez, University Hospital, Lille, France
| | - Gil Lebreton
- Department of Digestive Surgery, Côte de Nacre University Hospital, Caen, France
| | - Cecile Brigand
- Department of General and Digestive Surgery, Hautepierre University Hospital, Strasbourg, France
| | - Jean-Yves Mabrut
- Department of General and Digestive Surgery and Liver Transplantation, Croix-Rousse University Hospital, Lyon, France
| | - Jean-Pierre Bail
- Department of Digestive Surgery, Cavale Blanche University Hospital, Brest, France
| | - Bernard Meunier
- Department of Hepatic and Digestive Surgery, Pontchaillou University Hospital, Rennes, France
| | - Denis Collet
- Department of Digestive Surgery, Haut Lévèque University Hospital, Bordeaux, France
| | - Christophe Mariette
- Department of Digestive and Oncological Surgery, Claude Huriez, University Hospital, Lille, France
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Lebreton G, Mastroianni C, Demondion P, Genton A, Leprince P. Full Percutaneaous Temporary Right Ventricular Support By a Centrifugal Pump in Right Ventricular Failure After Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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50
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Pontailler M, Demondion P, Lebreton G, Leprince P. Outcomes and Predictors of 30-Day and Long-Term Mortality in Case of Cardiopulmonary Resuscitation Requiring Extracorporeal Life Support in the Elderly. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.629] [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: 10/23/2022] Open
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