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Tabchouri N, Barbier L, Menahem B, Perarnau JM, Muscari F, Fares N, D'Alteroche L, Valette PJ, Dumortier J, Alves A, Lubrano J, Bureau C, Salamé E. Original Study: Transjugular Intrahepatic Portosystemic Shunt as a Bridge to Abdominal Surgery in Cirrhotic Patients. J Gastrointest Surg 2019; 23:2383-2390. [PMID: 30820792 DOI: 10.1007/s11605-018-4053-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 07/18/2018] [Accepted: 11/08/2018] [Indexed: 01/31/2023]
Abstract
BACKGROUND Transjugular intrahepatic portosystemic shunt (TIPS) has been suggested to reduce portal hypertension-associated complications in cirrhotic patients undergoing abdominal surgery. The aim of this study was to compare postoperative outcome in cirrhotic patients with and without specific preoperative TIPS placement, following elective extrahepatic abdominal surgery. METHODS Patients were retrospectively included from 2005 to 2016 in four centers. Patients who underwent preoperative TIPS (n = 66) were compared to cirrhotic control patients without TIPS (n = 68). Postoperative outcome was analyzed using propensity score with inverse probability of treatment weighting analysis. RESULTS Overall, colorectal surgery accounted for 54% of all surgical procedure. TIPS patients had a higher initial Child-Pugh score (6[5-12] vs. 6[5-9], p = 0.043) and received more beta-blockers (65% vs. 22%, p < 0.001). In TIPS group, 56 (85%) patients managed to undergo planned surgery. Preoperative TIPS was associated with less postoperative ascites (hazard ratio = 0.330 [0.140-0.780]). Severe postoperative complications (Clavien-Dindo > 2) and 90-day mortality were similar between TIPS and no-TIPS groups (18% vs. 23%, p = 0.392, and 7.5% vs. 7.8%, p = 0.644, respectively). CONCLUSIONS Preoperative TIPS placement yielded an 85% operability rate with satisfying postoperative outcomes. No significant differences were found between TIPS and no-TIPS groups in terms of severe postoperative complications and mortality, although TIPS patients probably had worse initial portal hypertension.
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Affiliation(s)
- N Tabchouri
- Department of Digestive Surgery, Hepatobiliary Surgery and Liver Transplantation, University Hospital of Tours, CHU Tours, Avenue de la République, F37042, Tours, France.,FHU Support, F37000, Tours, France
| | - L Barbier
- Department of Digestive Surgery, Hepatobiliary Surgery and Liver Transplantation, University Hospital of Tours, CHU Tours, Avenue de la République, F37042, Tours, France.,FHU Support, F37000, Tours, France
| | - B Menahem
- Department of Digestive Surgery, University Hospital of Caen, Caen Cedex, France
| | - J-M Perarnau
- Department of Hepatology, University Hospital of Tours, CHU Tours, F37042, Tours, France
| | - F Muscari
- Department of Surgery, Hôpital Rangueil, Toulouse, France
| | - N Fares
- Department of Hepatology and Gastroenterology, Purpan Hospital, University Hospital of Toulouse, Place du Docteur Baylac TSA 40031, 31059, Toulouse Cedex 9, France
| | - L D'Alteroche
- Department of Hepatology, University Hospital of Tours, CHU Tours, F37042, Tours, France
| | - P-J Valette
- Department of Digestive Diseases, Hospices Civils de Lyon, Hôpital Edouard Herriot, Université Claude Bernard Lyon 1, Lyon, France
| | - J Dumortier
- Department of Digestive Diseases, Hospices Civils de Lyon, Hôpital Edouard Herriot, Université Claude Bernard Lyon 1, Lyon, France
| | - A Alves
- Department of Digestive Surgery, University Hospital of Caen, Caen Cedex, France
| | - J Lubrano
- Department of Digestive Surgery, University Hospital of Caen, Caen Cedex, France
| | - C Bureau
- Department of Hepatology and Gastroenterology, Purpan Hospital, University Hospital of Toulouse, Place du Docteur Baylac TSA 40031, 31059, Toulouse Cedex 9, France
| | - Ephrem Salamé
- Department of Digestive Surgery, Hepatobiliary Surgery and Liver Transplantation, University Hospital of Tours, CHU Tours, Avenue de la République, F37042, Tours, France. .,FHU Support, F37000, Tours, France.
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Vanbrugghe C, Tabchouri N, Louis G, Del Grande J, Lagrange X, Turrini O, Ouaissi M. Hepatobiliary and Pancreatic: A rare form of autoimmune pancreatitis mimicking mixed-type intraductal papillary mucinous neoplasm. J Gastroenterol Hepatol 2018; 33:563. [PMID: 29469233 DOI: 10.1111/jgh.14037] [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: 12/09/2022]
Affiliation(s)
- C Vanbrugghe
- Department of Digestive and Visceral Surgery, Public Assistance-Marseille Hospitals, Timone Hospital, Marseille, France
| | - N Tabchouri
- Digestive, Oncology, Endocrine and Hepatic Transplant Surgery Department, Colorectal Surgery Unit, Regional University Hospital Centers Trousseau, Chambray-lès-Tours, France
| | - G Louis
- Department of Radiology, Public Assistance-Marseille Hospitals, Timone Hospital, Marseille, France
| | - J Del Grande
- Department of Pathology, Public Assistance-Marseille Hospitals, Timone Hospital, Marseille, France
| | - X Lagrange
- Gastroenterology Service, European Hospital, Marseille, France
| | - O Turrini
- Oncology Surgery Service, Paoli Calmette Institute, Marseille, France
| | - M Ouaissi
- Digestive, Oncology, Endocrine and Hepatic Transplant Surgery Department, Colorectal Surgery Unit, Regional University Hospital Centers Trousseau, Chambray-lès-Tours, France
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Peyronnet B, Pradere B, Brichart N, Bodin T, Bertrand P, Bruyère F, Atassi A, Benmeziani R, Bodin T, Breque M, Brichart N, Bron J, Bruyere F, Cloche P, Corbel L, Cormier L, Cuvelier G, Delporte G, Fennouri M, Ferhi K, Fournier G, Gabbay G, Hurtes X, Laplace B, Le Gal S, Lecouteux A, Lesur G, Lokmane M, Mathieu R, Metois P, Miaadi N, Misrai V, Moreau J, Mouly P, Muyshondt C, Obringer L, Perrouin-Verbe M, Peyronnet B, Pradere B, Prezelin Y, Rigaud P, Salin A, Tabchouri N, Tanchoux C, Theveniaud P, Thoulouzan M, Thuillier C, Verhoest G. Complications Associated With Photoselective Vaporization of the Prostate: Categorization by a Panel of GreenLight Users According to Clavien Score and Report of a Single-center Experience. Urology 2014; 84:657-64. [DOI: 10.1016/j.urology.2014.05.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 05/21/2014] [Accepted: 05/23/2014] [Indexed: 11/16/2022]
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Broggi E, May A, Giretti G, Tabchouri N, Lorphelin H, Brichart N, Bruyère F. Long-term outcomes of 80-watt KTP and 120-watt HPS GreenLight photoselective vaporization of the prostate. Urol Int 2014; 93:229-36. [PMID: 24642997 DOI: 10.1159/000356991] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 10/28/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Photoselective vaporization of the prostate (PVP) is becoming a surgical treatment alternative of transurethral resection of the prostate for male lower urinary tract symptoms (LUTS) secondary to benign prostatic obstruction (BPO). We evaluated the outcome and postoperative complications of PVP performed by 80-W KTP and 120-W HPS GreenLight lasers (AMS®) over a 4-year period. MATERIALS AND METHODS This is a prospective monocentric study that included all patients who underwent PVP. They had routine follow-up at 1 month, 3 months, 6 months and every year until the fourth postoperative year. Listed data were maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), post-void residual (PVR) volume, prostate-specific antigen (PSA) and prostate volume. We collected the postoperative complications. RESULTS From September 2005 to May 2008, 77 patients out of a 409 patients cohort underwent surgery and were followed during 4 years. At 4 years mean Qmax increase was 82.5%; mean IPSS, PVR volume, PSA and prostate volume decreases were 79.1, 69.8, 43.8 and 22.9%, respectively. The main side effects observed were storage LUTS. A urinary catheter was replaced after a first withdrawal failure in 10 patients (15.6%) after surgery. CONCLUSIONS PVP showed a sustainable efficacy and an appealing tolerance profile during a 4-year period in patients with LUTS secondary to BPO.
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Affiliation(s)
- E Broggi
- Urology Department, CHRU de Tours, Tours, France
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Roul-Yvonnet F, Tabchouri N, Cassier S, Constantinescu G, Vazquez MP, Picard A, Kadlub N. [Children orbital floor fracture: retrospective study, about 34 cases]. ANN CHIR PLAST ESTH 2012; 57:240-4. [PMID: 22575771 DOI: 10.1016/j.anplas.2012.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 03/27/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Orbital fractures represent 30 % of children facial fractures. Nausea and vomiting are more predictive of entrapment than local trauma stigmatisms. Entrapment and diplopia are more frequent in adults. Delay for surgery is unclear in literature varying from 6 hours to days. The aim of this study is to summarise the aspects of orbital floor fractures in children with regard to clinical and radiological presentation, management, and outcomes. PATIENTS AND METHODS We conducted a retrospective study including 34 children presenting isolated orbital floor fracture. Clinical, radiological, ophthalmological, surgical data and outcomes were analyzed. RESULTS Mean age was 9.4 years. In 15% of cases, no local stigmatism of trauma was present. Entrapment fracture was the most frequent, with 81% of fat or muscles entrapment. In all, 27% of the patient had residual diplopia. Residual diplopia developed after trap-door fracture with muscle entrapment and a more than 24 hours delay for surgery. CONCLUSION Trap-door fracture is frequent in childhood population. Clinical diagnosis can be difficult. However, surgical treatment should be considered before 24 hours to avoid complication as residual diplopia.
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Affiliation(s)
- F Roul-Yvonnet
- Service de chirurgie maxillo-faciale et chirurgie plastique, hôpital d'enfants Armand-Trousseau, groupe hospitalier HUEP, 26 avenue du Docteur-Arnold-Netter, Paris cedex 12, France
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