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Martin X, Terrier JE. The place of Surgical Schools: Their role in training surgeons. J Visc Surg 2020; 157:S87-S91. [PMID: 32444282 DOI: 10.1016/j.jviscsurg.2020.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Surgical Schools have appeared on university campuses as technical learning platforms only fairly recently. They define and assess progressive educational programs in each of the specialties. The students must learn both technical and non-technical acts. The teaching is intended primarily for students during their initial training but also can serve for continuing education in the context of learning new techniques. These technical platforms are expensive, and consideration must be given to pooling of resources at the regional or national levels for the most sophisticated among them. The teaching is carried out with a set of synthetic or organic simulators. In accordance with European regulations, the use of animal models should be kept to a minimum. The use of human anatomical specimens is very useful for certain specialties and justifies the participation of anatomy and pathology laboratories in the training of young surgeons. Certification of these technical simulation platforms should be obtained. Funding for initial surgical training on these high-tech platforms has yet to be resolved.
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Affiliation(s)
- X Martin
- Faculté de médecine of Lyon, The Surgical School of Lyon, Hospices Civils de Lyon, 5, avenue Rockefeller, 69003 Lyon, France.
| | - J-E Terrier
- Faculté de médecine of Lyon, The Surgical School of Lyon, Hospices Civils de Lyon, 5, avenue Rockefeller, 69003 Lyon, France.
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Bodin L, Sécula A, Chapuis H, Cornuez A, Lessire M, Cobo E, Marie-Louise S, Bonnefont CMD, Barrieu J, Mercerand F, Bravo C, Manse H, Le Bourhis MC, Martin X, Pitel F, Brun JM, Morisson M. Dietary methionine deficiency reduces laying performances of female common ducks and impacts traits of interest of their mule ducklings. Poult Sci 2020; 98:5590-5600. [PMID: 31237326 DOI: 10.3382/ps/pez315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 06/04/2019] [Indexed: 12/16/2022] Open
Abstract
The effects of maternal nutrition on offspring phenotypes have been mainly documented over the past years in mammals, and are now studied in poultry as well. In the present study, we investigated the effects of a reduced level of dietary Methionine (Met) on laying performances of common laying ducks and their impacts on the phenotype of their mule ducklings. A total of 60 female laying ducks were divided into 2 dietary treatments at 10 wk of age. The restricted group received Met-restricted diets (R group) containing 0.25% of Met whereas the control group received control diets (C group) containing 0.40% of Met that meets Met requirements. The restriction was applied during the growing and laying periods, from 10 to 51 wk of age and a particular focus was put on female breeder traits that might be affected by the Met restriction. Plasma parameters of hepatic and lipid metabolisms were recorded in ducklings. Total weight (P < 0.001), albumen weight (P < 0.001) and albumen percentage of dry matter (P < 0.01) were decreased for eggs laid by female breeders from the R group. Both male and female ducklings from the R group of female breeders showed a reduced BW at hatching (P < 0.001) and a tendency to an increased proportional liver weight (P = 0.07). Finally, the maternal low dietary Met level modified plasma parameters in newborn ducklings regardless of sex: alkaline phosphatase (ALP) and alanine transaminase (ALT) activities were reduced (P = 0.07 and P = 0.002, respectively), levels of glucose (P = 0.03) and triglycerides (P = 0.01) were higher whereas level of free fatty acids decreased (P = 0.01). It was concluded that feeding female laying ducks with a restricted dietary Met content during the growing and laying periods has a negative effect on egg weight and composition. The ducklings that were restricted in nutrients during their early development, have a reduced BW, and altered lipid and hepatic metabolisms.
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Affiliation(s)
- L Bodin
- GenPhySE, Université de Toulouse, INRA, ENVT, Castanet-Tolosan, France
| | - A Sécula
- GenPhySE, Université de Toulouse, INRA, ENVT, Castanet-Tolosan, France
| | - H Chapuis
- GenPhySE, Université de Toulouse, INRA, ENVT, Castanet-Tolosan, France
| | - A Cornuez
- UEPFG INRA Bordeaux-Aquitaine (Unité Expérimentale Palmipèdes à Foie Gras), Domaine d'Artiguères 1076, route de Haut Mauco, F-40280 Benquet, France
| | - M Lessire
- BOA, INRA, Université de Tours, 37380 Nouzilly, France
| | - E Cobo
- GenPhySE, Université de Toulouse, INRA, ENVT, Castanet-Tolosan, France
| | - S Marie-Louise
- GenPhySE, Université de Toulouse, INRA, ENVT, Castanet-Tolosan, France
| | - C M D Bonnefont
- GenPhySE, Université de Toulouse, INRA, ENVT, Castanet-Tolosan, France
| | - J Barrieu
- UEPFG INRA Bordeaux-Aquitaine (Unité Expérimentale Palmipèdes à Foie Gras), Domaine d'Artiguères 1076, route de Haut Mauco, F-40280 Benquet, France
| | - F Mercerand
- INRA - Unité Expérimentale du Pôle d'Expérimentation Avicole de Tours UEPEAT, Nouzilly, France
| | - C Bravo
- GenPhySE, Université de Toulouse, INRA, ENVT, Castanet-Tolosan, France
| | - H Manse
- GenPhySE, Université de Toulouse, INRA, ENVT, Castanet-Tolosan, France
| | - M C Le Bourhis
- INRA - Unité Expérimentale du Pôle d'Expérimentation Avicole de Tours UEPEAT, Nouzilly, France
| | - X Martin
- UEPFG INRA Bordeaux-Aquitaine (Unité Expérimentale Palmipèdes à Foie Gras), Domaine d'Artiguères 1076, route de Haut Mauco, F-40280 Benquet, France
| | - F Pitel
- GenPhySE, Université de Toulouse, INRA, ENVT, Castanet-Tolosan, France
| | - J M Brun
- GenPhySE, Université de Toulouse, INRA, ENVT, Castanet-Tolosan, France
| | - M Morisson
- GenPhySE, Université de Toulouse, INRA, ENVT, Castanet-Tolosan, France
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Maggio ABR, Martin X, Steiger C, Tabard-Fougère A, Dayer R, Delhumeau C, Ceroni D. Do teenagers return to normal physical activity levels after limb fractures? A longitudinal, accelerometry-based, activity monitoring study. J Child Orthop 2019; 13:575-581. [PMID: 31908674 PMCID: PMC6924123 DOI: 10.1302/1863-2548.13.190082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE This study aimed to elucidate whether levels of physical activity (PA) return to normal after bone healing or whether long-term behavioural changes in PA are to be expected in children and teenagers who have sustained limb fractures. METHODS In all, 100 children and teenagers with a first episode of limb fracture and 100 sex- and age-matched healthy controls (CTRL) were recruited for a prospective study. PA in limb fracture patients was assessed at 18-month follow-up using accelerometer measurements, and values were compared with those of CTRL. Time spent in PA at different levels of intensity was determined for each participant and expressed in minutes and as a percentage of total validly measured time. RESULTS Mean levels of PA at different levels of intensity by previously injured children and teenagers were similar than CTRL (42 sets of paired data). However, time spent in moderate-to-vigorous PA (MVPA) was lower than 60 minutes among limb-fracture patients at 18-month follow-up. CONCLUSION The amount of skeletal loading in children and teenagers returns to normal values by 18 months after limb fracture. Even if time spent in MVPA is not significantly lower in children and teenagers with limb fractures, it no longer reached the international recommendations for school-aged children (MVPA > 60 minutes), which may be interpreted as a lifestyle modification or a behavioural change to avoid new trauma. LEVEL OF EVIDENCE II.
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Affiliation(s)
- A. B. R. Maggio
- Health and movement consultation, Pediatric Cardiology Unit, Department of Child and Adolescent, University of Geneva Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland
| | - X. Martin
- Pediatric Orthopedic Unit, Department of Child and Adolescent, University of Geneva Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland,Clinical Epidemiology Service, Department of Child and Adolescent, University of Geneva Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland
| | - C. Steiger
- Pediatric Orthopedic Unit, Department of Child and Adolescent, University of Geneva Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland
| | - A. Tabard-Fougère
- Pediatric Orthopedic Unit, Department of Child and Adolescent, University of Geneva Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland,Correspondence should be sent to A. Tabard-Fougère, Pediatric Orthopedic Unit, Department of Child and Adolescent, Children’s Hospital, 6 Rue Willy Donzé, 1211 Geneva 14 / Switzerland. E-mail:
| | - R. Dayer
- Pediatric Orthopedic Unit, Department of Child and Adolescent, University of Geneva Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland
| | - C. Delhumeau
- Clinical Epidemiology Service, Department of Child and Adolescent, University of Geneva Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland
| | - D. Ceroni
- Pediatric Orthopedic Unit, Department of Child and Adolescent, University of Geneva Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland
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Codas R, Matillon X, Martin X, Badet L, Fassi-Fehri H. Énucléation prostatique au laser holmium sur sujet anatomique : réalisme, faisabilité et intérêt pédagogique. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.123] [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: 11/16/2022]
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Abid N, Machon C, Dubourg L, Juillard L, Lemoine S, Badet L, Codas R, Fassi Fehri H, Crouzet S, Martin X. Retour sur un an de réunion multidisciplinaire autour de la lithiase urinaire. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.143] [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]
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Duclos A, Peix JL, Piriou V, Occelli P, Denis A, Bourdy S, Carty MJ, Gawande AA, Debouck F, Vacca C, Lifante JC, Colin C, Aegerter P, Aouifi A, Arickx D, Aubart F, Baudrin D, Berry WR, Beuvry C, Bonnet F, Bouveret L, Cabarrot P, Cames E, Carty MJ, Caton J, Chenitz MC, Clergues F, Colin C, Coudray JM, Damiens M, Dauzac C, Debono B, Debouck F, De Germay B, Deleforterie AC, Denis A, Desrousseaux JF, Didelot MP, Doat B, Domingo-Saidji NY, Duclos A, Durieux P, Fessy M, Hardy P, Cariven P, Fontas N, Ganansia P, Gawande AA, Giraud F, Gostiaux G, Habi S, Haga S, Houlgatte A, Jaffe M, Jourdan J, Kaczmarek N, Lamblin S, Level C, Liaras E, Lifante JC, Lipsitz SR, Majchrzak C, Malavaud B, Serres TM, Martin X, Martinet C, Maupetit B, Michel P, Movondo A, Naamani B, Nacry R, Occelli P, Olousouzian S, Papin P, Paquet JC, Parfaite A, Pattou F, Paugam C, Pavy E, Peix JL, Petit H, Pierre S, Piriou V, Poupon Bourdy S, Pradere B, Quesne M, Radola Y, Raould A, Rongieras F, Rouquette I, Sanders V, Sanz F, Sens F, Surmont S, Sicre C, Tabur D, Targosz P, Thery D, Toppan N, Usandizaga G, Vacca C, Verheyde I, Zadegan F. Cluster randomized trial to evaluate the impact of team training on surgical outcomes. Br J Surg 2016; 103:1804-1814. [DOI: 10.1002/bjs.10295] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 05/07/2016] [Accepted: 07/15/2016] [Indexed: 11/10/2022]
Abstract
Abstract
Background
The application of safety principles from the aviation industry to the operating room has offered hope in reducing surgical complications. This study aimed to assess the impact on major surgical complications of adding an aviation-based team training programme after checklist implementation.
Methods
A prospective parallel-group cluster trial was undertaken between September 2011 and March 2013. Operating room teams from 31 hospitals were assigned randomly to participate in a team training programme focused on major concepts of crew resource management and checklist utilization. The primary outcome measure was the occurrence of any major adverse event, including death, during the hospital stay within the first 30 days after surgery. Using a difference-in-difference approach, the ratio of the odds ratios (ROR) was estimated to compare changes in surgical outcomes between intervention and control hospitals.
Results
Some 22 779 patients were enrolled, including 5934 before and 16 845 after team training implementation. The risk of major adverse events fell from 8·8 to 5·5 per cent in 16 intervention hospitals (adjusted odds ratio 0·57, 95 per cent c.i. 0·48 to 0·68; P < 0·001) and from 7·9 to 5·4 per cent in 15 control hospitals (odds ratio 0·64, 0·50 to 0·81; P < 0·001), resulting in the absence of difference between arms (ROR 0·90, 95 per cent c.i. 0·67 to 1·21; P = 0·474). Outcome trends revealed significant improvements among ten institutions, equally distributed across intervention and control hospitals.
Conclusion
Surgical outcomes improved substantially, with no difference between trial arms. Successful implementation of an aviation-based team training programme appears to require modification and adaptation of its principles in the context of the the surgical milieu. Registration number: NCT01384474 (http://www.clinicaltrials.gov).
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Affiliation(s)
- A Duclos
- Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon, France
- Health Services and Performance Research Laboratory, Université Claude Bernard Lyon 1, EA, 7425, Lyon, France
- Center for Surgery and Public Health, Brigham and Women's Hospital – Harvard Medical School, Boston, Massachusetts, USA
| | - J L Peix
- Service de Chirurgie Générale et Endocrinienne, Pierre Bénite, France
| | - V Piriou
- Health Services and Performance Research Laboratory, Université Claude Bernard Lyon 1, EA, 7425, Lyon, France
- Service d'Anesthésie Réanimation Médicale et Chirurgicale, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - P Occelli
- Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon, France
- Health Services and Performance Research Laboratory, Université Claude Bernard Lyon 1, EA, 7425, Lyon, France
| | - A Denis
- Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon, France
| | - S Bourdy
- Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon, France
| | - M J Carty
- Center for Surgery and Public Health, Brigham and Women's Hospital – Harvard Medical School, Boston, Massachusetts, USA
| | - A A Gawande
- Center for Surgery and Public Health, Brigham and Women's Hospital – Harvard Medical School, Boston, Massachusetts, USA
- Ariadne Labs and Harvard Chan School of Public Health, Boston, Massachusetts, USA
| | - F Debouck
- Air France Consulting, AFM42, Chambourcy, France
| | - C Vacca
- Coordination pour l'Evaluation des Pratiques Professionnelles en Santé en Rhône-Alpes, Lyon, France
| | - J C Lifante
- Health Services and Performance Research Laboratory, Université Claude Bernard Lyon 1, EA, 7425, Lyon, France
- Service de Chirurgie Générale et Endocrinienne, Pierre Bénite, France
| | - C Colin
- Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon, France
- Health Services and Performance Research Laboratory, Université Claude Bernard Lyon 1, EA, 7425, Lyon, France
| | | | | | | | | | - D Baudrin
- Agence Régional de Santé de Toulouse
| | | | | | - F Bonnet
- Assistance Publique-Hôpitaux de Paris
| | | | | | - E Cames
- Centre Hospitalier Universitaire de Toulouse
| | - M J Carty
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - J Caton
- Clinique Emile Vialar de Lyon
| | | | | | | | | | | | - C Dauzac
- Assistance Publique-Hôpitaux de Paris
| | - B Debono
- Clinique des Cèdres de Cornebarrieu
| | | | | | | | | | | | | | | | | | | | - P Durieux
- Assistance Publique-Hôpitaux de Paris
| | | | - P Hardy
- Assistance Publique-Hôpitaux de Paris
| | | | - N Fontas
- Centre Hospitalier Universitaire de Toulouse
| | | | - A A Gawande
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | | | - S Habi
- Centre Hospitalier de Vienne
| | - S Haga
- Infirmerie Protestante de Lyon
| | - A Houlgatte
- Hôpital d'Instruction des Armées du Val de Grâce
| | - M Jaffe
- Clinique Ambroise Paré de Toulouse
| | | | | | | | - C Level
- Assistance Publique-Hôpitaux de Paris
| | - E Liaras
- Hôpital Privé de Natécia de Lyon
| | | | - S R Lipsitz
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - B Malavaud
- Centre Hospitalier Régional Universitaire de Toulouse
| | | | | | | | | | | | | | | | | | | | | | - P Papin
- Centre Hospitalier de Villefranche sur Saône
| | | | | | - F Pattou
- Centre Hospitalier Régional Universitaire de Lille
| | - C Paugam
- Assistance Publique-Hôpitaux de Paris
| | - E Pavy
- Hôpital Simone Veil d'Eaubonne
| | | | | | - S Pierre
- Institut Claudius Régaud de Toulouse
| | | | | | - B Pradere
- Centre Hospitalier Régional Universitaire de Lille
| | | | - Y Radola
- Centre Hospitalier Régional Universitaire de Lille
| | - A Raould
- Assistance Publique-Hôpitaux de Paris
| | - F Rongieras
- Hôpital d'Instruction des Armées Desgenettes de Lyon
| | | | - V Sanders
- Centre Hospitalier Régional Universitaire de Lille
| | - F Sanz
- Centre Hospitalier Régional Universitaire de Lille
| | | | | | | | | | | | - D Thery
- Institut Catholique de Lille
| | - N Toppan
- Clinique de l'Union de Saint Jean
| | | | - C Vacca
- Coordination pour l'Evaluation des Pratiques Professionnelles en Santé en Rhône-Alpes de Lyon
| | | | - F Zadegan
- Assistance Publique-Hôpitaux de Paris
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Belot PY, Fassi-Fehri H, Colombel M, Matillon X, Crouzet S, Martin X, Abid N, Badet L. [The W-shaped ileal neobladder: Long term functional outcomes and health-related quality of life]. Prog Urol 2016; 26:367-74. [PMID: 27157921 DOI: 10.1016/j.purol.2016.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 02/26/2016] [Accepted: 03/22/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE To evaluate functional outcomes and patients' health-related quality of life over ten years after a W-shaped ileal neobladder urinary diversion. PATIENTS AND METHODS From 1994 to 2004, 87 patients with bladder cancer underwent a cystoprostatectomy with a W-shaped ileal neobladder. Among them, 31 patients (35.6%) were evaluated. The average follow-up was 158months, average age was 72years. We assessed functional outcomes (use of protections, USP score, uroflowmetry, postvoid residual volume), overall health-related quality of life (SF-36 score), and specific urinary-related quality of life (Ditrovie scale). RESULTS Daytime continence was satisfactory in 29 patients (96.8%). Night-time continence was satisfactory in 27 patients (87.1%). Mean daytime continence, hyperactivity and dysuria scores of the USP were respectively 1.5/9, 3.2/21 and 2/9. Mean value of the maximum flow rate was 18mL/s for an average voiding volume of 324mL and an average postvoid residual volume of 70mL. The 8 dimensions of the SF-36 were all comparable with the French population's values. According to the Ditrovie scale whose average value was 1.83, the health-related quality of life was unchanged or little changed by urinary disorders in 28 patients (90.3%). CONCLUSIONS Our results suggest that voiding status and health-related quality of life remain satisfactory over ten years after an orthotopic ileal neobladder derivation. LEVEL OF EVIDENCE 5.
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Affiliation(s)
- P-Y Belot
- Service d'urologie et de transplantation, pavillon V, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
| | - H Fassi-Fehri
- Service d'urologie et de transplantation, pavillon V, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
| | - M Colombel
- Service d'urologie et de transplantation, pavillon V, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
| | - X Matillon
- Service d'urologie et de transplantation, pavillon V, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
| | - S Crouzet
- Service d'urologie et de transplantation, pavillon V, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
| | - X Martin
- Service d'urologie et de transplantation, pavillon V, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
| | - N Abid
- Service d'urologie et de transplantation, pavillon V, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
| | - L Badet
- Service d'urologie et de transplantation, pavillon V, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
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Lalloué F, Ruffion A, Valette PJ, Crouzet S, Martin X, Rouvière O, Paparel P. Cryothérapie pour les tumeurs rénales : le début d’expérience de notre centre. Prog Urol 2016; 26:310-8. [DOI: 10.1016/j.purol.2016.02.012] [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] [Received: 05/26/2015] [Revised: 01/17/2016] [Accepted: 02/23/2016] [Indexed: 01/20/2023]
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Codas R, Badet L, Ravier E, Abid N, Crouzet S, Colombel M, Martin X, Fassi-fehri H. Vapoénucléation prostatique au laser thulium selon « la mushroom technique ». Prog Urol 2015; 25:864-5. [DOI: 10.1016/j.purol.2015.08.304] [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: 11/28/2022]
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Pierrard V, Abid N, Albert G, Codas R, Fassi-Fehri H, Martin X, Badet L, Crouzet S. L’HIFU : une option dans le traitement des récidives locales des cancers prostatiques après chirurgie et radiothérapie. Prog Urol 2015; 25:835. [DOI: 10.1016/j.purol.2015.08.238] [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]
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Meyer V, Flechon A, Tartas S, Fassi-Fehri H, Ruffion A, Martin X, Colombel M. Impact de la chimiothérapie néoadjuvante sur la prise en charge des tumeurs de vessie infiltrant le muscle. Prog Urol 2015; 25:83-9. [DOI: 10.1016/j.purol.2014.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Revised: 09/29/2014] [Accepted: 11/03/2014] [Indexed: 12/31/2022]
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Ricci E, Cai H, Martin X, Crouzet S, Colombel M. Étude coût-efficacité de la prostatectomie par laparoscopie robot assistée versus prostatectomie par laparoscopie : analyse de cohortes appariées, sur la période périopératoire et à 2 ans de suivi. Prog Urol 2014; 24:866. [DOI: 10.1016/j.purol.2014.08.183] [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]
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Matillon X, Codas R, Danjou F, Petruzzo P, Morelon E, Martin X, Badet L. Valeur pronostique de l’index de résistance lors de la conservation rénale pulsatile hypothermique des greffons prélevés à partir de donneurs décédés après arrêt cardiaque. Prog Urol 2014; 24:803. [DOI: 10.1016/j.purol.2014.08.046] [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]
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Crouzet S, Tonoli Catez H, Rouviere O, Mege Lechevalier F, Martin X, Gelet A. Traitement focal des adénocarcinomes prostatique localisés par HIFU focal : l’échographie de contraste reflète-t-elle bien la zone traitée ? Prog Urol 2014; 24:859. [DOI: 10.1016/j.purol.2014.08.166] [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: 10/24/2022]
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Crouzet S, Meyer V, Matillon X, Forest S, Colombel M, Badet L, Martin X. Première néphrectomie partielle robotique avec utilisation du système Single-Site. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.274] [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: 10/26/2022]
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Meyer V, Fléchon A, Tartas S, Martin X, Fassi-Fehri H, Devonec M, Ruffion A, Colombel M. Impact de la chimiothérapie néoadjuvante sur la prise en charge chirurgicale des tumeurs de vessie infiltrant le muscle. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.169] [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: 10/26/2022]
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Crouzet S, Marechal J, Colombel M, Rouvière O, Chapelon J, Rabilloud M, Belot A, Mège-Lechevallier F, Bouvier R, Tonoli-Catez H, Martin X, Gelet A. Comparaison par paires appariées de la prostatectomie radicale et de l’Ablatherm® (HIFU) dans le traitement du cancer localisé de la prostate. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.234] [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: 11/28/2022]
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Meyer V, Tamarelle B, Amiri A, Pages A, Martin X, Colombel M. Analyse de la tolérance aux instillations intravésicale de BCG par autoquestionnaires. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.163] [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]
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Codas R, Ravier E, Crouzet S, Abid N, Colombel M, Badet L, Martin X, Fassi-Fehri H. Complications de l’énucléation prostatique et de la morcellation pour HBP par laser thulium. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.284] [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]
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Adam E, Martin L, Martin X, Badet L, Haber G, Crouzet S. Prélèvement de rein sur donneur vivant par LESS : technique et résultats. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.225] [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]
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Soria J, Crouzet S, Ardiet J, Chapet O, Pommier P, Tonoli-Catez H, Martin X, Gelet A. Radiothérapie de sauvetage des récidives locales après traitement initial par HIFU : évaluation de l’efficacité et de la tolérance chez 221 patients. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.231] [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]
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22
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Ravier E, Fassi-Fehri H, Gelet A, Abid N, Crouzet S, Martin X. Complications du sphincter artificiel urinaire AMS 800 chez les patients avec versus sans antécédents de radiothérapie. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.123] [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]
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Almaiman H, Serre J, Abid N, Fouque D, Martin X. Approche mini-invasive de l’autotransplantation rénale dans la prise en charge du loin pain hematuria syndrome. Prog Urol 2013; 23:389-93. [PMID: 23628096 DOI: 10.1016/j.purol.2012.11.010] [Citation(s) in RCA: 4] [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] [Received: 06/14/2012] [Revised: 11/29/2012] [Accepted: 11/29/2012] [Indexed: 10/27/2022]
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Roughton M, Campbell JT, Kavanagh SJ, Hoffman AM, Stewart K, Rudd AG, Roffe C, Ali AN, Bailey C, Abdulhafiz AH, Hadbavna A, Coughlan T, Collins DR, O'Neill D, Boyle K, Browne B, Colgan MP, Martin X, O'Neill S, Madhavan P, Moore D, Harbison J, Boyle K, Banghu J, Naureen M, Harbison J, Ryan DJ, Christensen S, Meaney JF, Fagan A, Kenny RA, Harbison JA, Roughton M, Campbell JT, Kavanagh SJ, Hoffman AM, Stewart K, Rudd AG. Stroke. Age Ageing 2013. [DOI: 10.1093/ageing/aft027] [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: 11/14/2022] Open
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25
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Piégay F, Gamondes JP, Martin X, Mornex JF. Métastases pulmonaires d’un adénocarcinome de l’ouraque. Rev Mal Respir 2013. [DOI: 10.1016/j.rmr.2012.10.296] [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]
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Forest S, Polo G, Habchi H, Codas R, Abid N, Fassi-fehri H, Colombel M, Martin X, Badet L, Crouzet S. Néphrectomie partielle cœlioscopique : nouvelle technique de clampage parenchymateux. Prog Urol 2012. [DOI: 10.1016/j.purol.2012.08.258] [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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Crouzet S, Rouvière O, Chapelon JY, Mège-lechevallier F, Abid N, Martin X, Gelet A. HIFU de sauvetage pour récidive locale après curiethérapie. Prog Urol 2012. [DOI: 10.1016/j.purol.2012.08.137] [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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Matillon X, Crouzet S, Murat F, Cherasse A, Gelet A, Martin X. Cryothérapie de rattrapage pour récidive de cancer de prostate après radiothérapie externe. Prog Urol 2012. [DOI: 10.1016/j.purol.2012.08.138] [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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Crouzet S, Marechal JM, Colombel M, Bouvier R, Mège-lechevallier F, Rouvière O, Martin X, Gelet A. Prostatectomie radicale versus HIFU : résultats oncologiques chez 723 patients traites entre juin 2000 et décembre 2005 dans le même service d’urologie. Prog Urol 2012. [DOI: 10.1016/j.purol.2012.08.010] [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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Patard JJ, Bernhard JC, Pignot G, Zini L, Lang H, Crepel M, Rigaud J, Salomon L, Soulie M, Vaessen C, Roupret M, Jung J, Mourey E, Martin X, Bigot P, Bruyère F, Berger J, Ansieau J, Gimel P, Salome F, Hubert J, Pfister C, Mottet N, Baumert H, Mejean A. Chez quels patients et pour quelles tumeurs faisons nous des néphrectomies totales élargies en France ? Données de l’étude Néphron. Prog Urol 2012. [DOI: 10.1016/j.purol.2012.08.027] [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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Codas R, Hanf W, Fassi-Fehri H, Abid N, Crouzet S, Mraiagh F, Petruzzo P, Morelon E, Martin X, Badet L. Expérience lyonnaise de transplantations rénales de blocs pédiatriques réalisées à partir de donneurs de moins de 15kg chez l’adulte. Prog Urol 2012. [DOI: 10.1016/j.purol.2012.08.082] [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: 10/27/2022]
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32
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Bernhard J, Mejean A, Pignot G, Zini L, Lang H, Zerbib M, Crepel M, Rigaud J, Salomon L, Vaessen C, Bellec L, Martin X, Bigot P, Bruyere F, Berger J, Gimel P, Hubert J, Pfister C, Mottet N, Patard J. Quel est l’usage de la néphrectomie partielle en France ? Données de l’étude Néphron. Prog Urol 2012. [DOI: 10.1016/j.purol.2012.08.019] [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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Hanf W, Codas R, Meas-Yedid V, Berthiller J, Buron F, Chauvet C, Brunet M, Giroud A, McGregor BC, Olivo-Marin JC, Hadj-Aissa A, Faure A, Petruzzo P, Martin X, Badet L, Morelon E. Kidney graft outcome and quality (after transplantation) from uncontrolled deceased donors after cardiac arrest. Am J Transplant 2012; 12:1541-50. [PMID: 22390302 DOI: 10.1111/j.1600-6143.2011.03983.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The use of uncontrolled deceased donors after cardiac arrest (uDDCA) has been developed in France to compensate for organ shortage. The quality of these kidneys remains unclear. We analyzed kidney graft function and histology from 27 uDDCA and compared them with kidneys from 30 extended criteria donors (ECD) and from 24 simultaneous pancreas kidney (SPK) donors as a control group of optimal deceased donors. Kidneys from ECD and SPK donors were preserved by static cold storage while kidneys from uDDCA were preserved by pulsatile perfusion. The uDDCA graft function at 3 years posttransplantation (estimated with MDRD and measured with inulin clearance) did not differ from that of the ECD group (eGFR 44.1 vs. 37.4 mL/min/1.73 m(2) , p = 0.13; mGFR 44.6 vs. 36.1 mL/min/1.73 m(2) , p = 0.07 in the uDDCA and ECD groups, respectively). The histological assessment of 3-month and 1-year protocol biopsies did not show differences for interstitial lesions between the uDDCA and ECD grafts (IF score at M3 was 30 vs. 28% and at M12 36 vs. 33%, p = NS). In conclusion, the results at 3 years with carefully selected and machine-perfused uDDCA kidneys have been comparable to ECD kidneys and encourage continuation of this program and development of similar programs.
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Affiliation(s)
- W Hanf
- Service de Néphrologie, Transplantation et Immunologie Clinique, Hôpital Edouard Herriot, Hospices Civils de Lyon, France.
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Polo G, Crouzet S, Poissonnier L, Roux A, Deculier E, Martin X, Badet L. [Partial versus radical nephrectomy for renal cell carcinoma involving peri renal fat. Oncological and functional outcomes]. Prog Urol 2012; 22:388-96. [PMID: 22657258 DOI: 10.1016/j.purol.2012.01.018] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Revised: 01/30/2012] [Accepted: 01/30/2012] [Indexed: 11/19/2022]
Abstract
PURPOSE In the latest guidelines of the European Association of Urology, partial nephrectomy was a reference standard in tumors less than 7cm confined to the kidney. The invasion of the perirenal fat and therefore dissection in a potentially tumor tissue with an increased risk of recurrence. MATERIAL From 1995 to 2009, we retrospectively evaluated the oncological outcomes of partial versus radical nephrectomy in tumors with local extension beyond the boundaries of the kidney, without adrenal involvement or metastatic lymph node extension. We evaluated the histological factors influencing the prognostic. RESULTS A total of 43patients have been included (ten partial and 33radical nephrectomy). We did not found any significant difference in terms of specific and recurrence-free survival between partial and radical nephrectomy in tumor invading the perirenal fat (P=0.739 and P=0.683 respectively). Factors influencing the prognosis were the Fuhrman grade (P=0.010), the invasion of the urinary tract (P=0.017) and the presence of a positive surgical margin (P=0.041). The renal function was better after partial nephrectomy. The complication rate was similar between partial and radical nephrectomy. CONCLUSION The perirenal fat invasion by kidney tumor did not impact the oncological outcomes of partial versus radical nephrectomy with better functional outcomes for partial nephrectomy.
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Affiliation(s)
- G Polo
- Service de chirurgie urologique et transplantation, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
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Petruzzo P, Kanitakis J, Badet L, Pialat JB, Boutroy S, Charpulat R, Mouly J, Gazarian A, Lanzetta M, Brunet M, Devauchelle B, Testelin S, Martin X, Dubernard JM, Morelon E. Long-term follow-up in composite tissue allotransplantation: in-depth study of five (hand and face) recipients. Am J Transplant 2011; 11:808-16. [PMID: 21446980 DOI: 10.1111/j.1600-6143.2011.03469.x] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Composite tissue allotransplantations (CTAs) have clinically shown little, if any, evidence of chronic rejection. Consequently, the effect of chronic rejection on bones, joints, nerves, muscles, tendons and vessels may still have undescribed implications. We thoroughly assessed all allograft structures by histology, magnetic resonance imaging, ultrasonography and high resolution peripheral quantitative computed tomography scan in four bilateral hand-grafted patients (10, 7, 3 and 2 years of follow-up, respectively) and in one facial allotransplantation (5 years of follow-up). All the recipients presented normal skin structure without dermal fibrosis. Vessels were patent, without thrombosis, stenosis or intimal hyperplasia. Tendons and nerves were also normal; muscles showed some changes, such as a variable degree of muscular hypotrophy, particularly of intrinsic muscles, accompanied by fatty degeneration that might be related to denervation. In the majority of hand-grafted patients graft radius and recipient tibia showed a decrease in trabecular density, although in the graft radius the alterations also involved the cortices. No deterioration of graft function was noted. In these cases of CTA no signs of chronic graft rejection have been detected. However, the possibility that chronic rejection may develop in CTA exists, highlighting the necessity of close continuous follow-up of the patients.
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Affiliation(s)
- P Petruzzo
- Department of Transplantation, Hopital Edouard Herriot, Lyon, France.
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Crouzet S, Murat F, Rouviere O, Poissonnier L, Martin X, Colombel M, Chapelon J, Gelet A. 76 ONCOLOGICAL OUTCOMES OF HIGH-INTENSITY FOCUSED ULTRASOUND FOR LOCALIZED PROSTATE CANCER IN 880 CONSECUTIVE PATIENTS. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s1569-9056(11)60080-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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37
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Crouzet S, Poissonnier L, Murat FJ, Pasticier G, Rouvière O, Mège-Lechevallier F, Chapelon JY, Martin X, Gelet A. Traitement du cancer localisé de la prostate avec l’appareil Ablatherm Imagerie Intégrée® : résultats carcinologiques et fonctionnels. Prog Urol 2011; 21:191-7. [DOI: 10.1016/j.purol.2010.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2010] [Revised: 06/26/2010] [Accepted: 07/01/2010] [Indexed: 10/19/2022]
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Sharma H, Mansoor D, Sprunger A, Zalos K, Taylor H, Martin X, Mikhail I. Racial Disparities in the Presentation of Pediatric Eosinophilic Esophagitis. J Allergy Clin Immunol 2011. [DOI: 10.1016/j.jaci.2010.12.440] [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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39
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Dékou A, Vé D, Koffi A, Konan PG, Kouamé B, Badet L, Vodi C, Manzan K, Martin X. L’automutilation génitale : intérêt d’un avis psychiatrique dans la prise en charge urologique. Afr J Urol 2010. [DOI: 10.1007/s12301-009-0041-4] [Citation(s) in RCA: 3] [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: 10/19/2022] Open
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40
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Murat F, Cherasse A, Poissonnier L, Pricaz E, Kulisa M, Chapelon J, Colombel M, Martin X, Gelet A. 854 FOCAL THERAPY OF PROSTATE CANCER (PCA) WITH HIFU: INFLUENCE ON ERECTILE DYSFUNCTION (ED). ACTA ACUST UNITED AC 2009. [DOI: 10.1016/s1569-9056(09)60841-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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41
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Bensouda A, Kulisa M, Poissonnier L, Badet L, Colombel M, Martin X, Gelet A, Fassi-Fehri H. Bandelette sous-urétrale avec ancrage osseux compliquée d’une ostéomyélite pubienne : à propos de deux cas. Prog Urol 2009; 19:145-8. [DOI: 10.1016/j.purol.2008.10.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2008] [Revised: 10/06/2008] [Accepted: 10/22/2008] [Indexed: 11/28/2022]
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Pasticier G, Chapet O, Badet L, Ardiet JM, Poissonnier L, Murat FJ, Martin X, Gelet A. Salvage radiotherapy after high-intensity focused ultrasound for localized prostate cancer: early clinical results. Urology 2008; 72:1305-9. [PMID: 18502487 DOI: 10.1016/j.urology.2008.02.064] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2006] [Revised: 02/24/2008] [Accepted: 02/28/2008] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate the first results of salvage radiotherapy after high-intensity focused ultrasound (HIFU) in terms of feasibility, tolerance, and oncologic control. METHODS From March 1995 to May 2004, 45 patients presenting with local failure after HIFU underwent salvage radiotherapy alone (n = 32) or combined with hormonal therapy (n = 13). The modalities of radiotherapy are described. Tolerance was evaluated using the Radiation Therapy Oncology Group score for urinary and digestive side effects, and incontinence was evaluated using the Ingelman Sundberg score. Patients answered a questionnaire. For the 32 patients who underwent radiotherapy alone, the oncologic early results were given by the disease-free survival rate, defined as no biochemical progression and no androgen suppression therapy. RESULTS The median and mean follow-up were 40 and 46 months, respectively, for the whole series. No additional digestive or urinary toxicity developed with salvage radiotherapy after HIFU. The data from 32 patients were evaluated, with a median follow-up of 37 months after radiotherapy. The 5-year disease-free survival rate was 64% for the 32 patients evaluated. The 5-year disease-free survival rate reached 80% for patients treated for positive biopsy findings and was 44% for those with isolated biochemical failure. CONCLUSIONS Salvage radiotherapy after HIFU for local recurrence is feasible, with no additional toxicity. The early oncologic results are encouraging when isolated local recurrence is proven but longer follow-up is needed.
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Affiliation(s)
- G Pasticier
- Department of Urology, CHU Pellegrin, Bordeaux, France.
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Fassi-Fehri H, Dinia EM, Genevoix S, Murat FJ, Poissonnier L, Badet L, Colombel M, Martin X, Gelet A. [AMS 800 artificial urinary sphincter implantation: can the penoscrotal approach constitute an alternative to the perineal approach?]. Prog Urol 2008; 18:177-82. [PMID: 18472073 DOI: 10.1016/j.purol.2007.12.012] [Citation(s) in RCA: 8] [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: 06/01/2006] [Accepted: 12/01/2007] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare the short-term results of penoscrotal and perineal artificial urinary sphincter implantation. PATIENTS AND METHODS From May 2005 to February 2007, 37 artificial urinary sphincters were implanted successively, via a penoscrotal approach in 16 cases and via a perineal approach in 21 cases. Incontinence was secondary to prostate surgery (n=36) and pelvic trauma (n=1). Seventeen patients had a history of external beam radiotherapy. The times and modalities of activation of the sphincter were identical in the two groups. RESULTS The mean age of the patients, the mean operating time, the mean catheterization duration, the mean hospital stay and the mean postoperative follow-up were equivalent in the two groups. Six urethral erosions (37.5%) and one scrotal erosion due to the pump (6.6%) were observed in the penoscrotal group and infection of the sphincter in two patients (9.5%) and pump migration in another two patients (9.5%), but no urethral erosions were observed in the perineal group. The success rate without revision was 56% in the penoscrotal group and 71.5% in the perineal group. CONCLUSION The perineal approach is the reference incision, as the penoscrotal approach is associated with a high rate of erosion. The penoscrotal urethral approach can constitute an alternative when the bulbar urethra cannot be used.
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Affiliation(s)
- H Fassi-Fehri
- Service d'urologie et de la transplantation, pavillon V, hôpital Edouard-Herriot, hospices civils de Lyon, place d'Arsonval, 69003 Lyon, France.
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Martin X, Rabineau P, Faulborn J. Opération extra-capsulaire de la cataracte avec implant de chambre postérieure: comparaison de deux techniques d'incision. Klin Monbl Augenheilkd 2008. [DOI: 10.1055/s-2008-1050392] [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: 10/21/2022]
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Gazarian A, Abrahamyan DO, Petruzzo P, Kanitakis J, Guigal V, Garret J, Rizzo C, Durand PY, Fredenucci JF, Streichenberger T, Parmentier H, Galewicz T, Guillot M, Sirigu A, Burloux G, Morelon E, Braye F, Badet L, Martin X, Dubernard JM, Eljaafari A. Allogreffe de mains: expérience lyonnaise. ANN CHIR PLAST ESTH 2007; 52:424-35. [PMID: 17905506 DOI: 10.1016/j.anplas.2007.08.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2007] [Accepted: 08/31/2007] [Indexed: 11/15/2022]
Abstract
Hand allograft is a method in the stage of clinical experimentation, which is reserved in France for the treatment of bilateral traumatic amputees. This study reports the Lyon team experience, which is pioneer in this domain. Four patients (3 males and 1 female) underwent seven (one unilateral and three bilateral) hand transplantations from September 1998 to February 2007. The level of amputation was at the wrist or at the mid-forearm. Delay since hand loss ranged from 2.5 to 9 years. The surgical protocol was elaborated and planned case by case. All recipients received the same immunosuppressive treatment. Episodes of acute rejection were observed in the first 3 months after transplantation, which were easily managed after a few days increasing oral prednisone doses and applying topical immunosuppressants. Currently the patients receive the doses of immunosuppressants comparable to those in kidney-grafted patients. We have not registered any severe complication of immunosuppressive treatment up till now (7 years follow-up for the earliest graft). We performed analytical and functional clinical, as well as questionnaire evaluation of patients. The first case (unilateral graft) resulted in graft failure at 2 years due to non-compliance of the patient. The three bilateral graftees demonstrate a favorable evolution despite some immunological (hyperglycemia, serum sickness) and surgical (thrombosis, osteomyelitis, skin loss) complications, which could be managed. The middle and long-term follow-up evaluation revealed good to excellent sensorimotor recovery of 4 hands in both male recipients (4 and 7 years) with satisfactory social adaptation, higher or equal to those expected after post-traumatic replantations at the equivalent level and higher to those obtained with currently available myoelectric prosthesis. The last patient, a young female who has been grafted in February 2007, receives ongoing reeducation course and shows normal progress of functional restoration of both hands. The encouraging results of this clinical experimentation make us currently consider hand allografting as reasonable and useful both for the patients and for evolution of research in composite tissues allotransplantation (CTA). Further long-term careful research and worldwide monitoring of all patients with hand allografts is required to, on the one part, state on the authorization of this surgery, and, on the other part, to better elucidate the mechanisms of successful CTA.
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Affiliation(s)
- A Gazarian
- Chirurgie de la main et du membre supérieur, clinique du Parc, 155, boulevard Stalingrad, 69006 Lyon, France.
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Murat FJ, Chapelon JY, Poissonnier L, Bouvier R, Curiel L, Martin X, Gelet A. Salvage hifu (Sat) for radiorecurrent prostate cancer: factors influencing the outcome. Aktuelle Urol 2006. [DOI: 10.1055/s-2006-947427] [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: 10/19/2022]
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Murat FJ, Lafon C, Cathignol D, Theillère Y, Gelet A, Chapelon JY, Martin X. Bloodless partial nephrectomy with a new high-intensity collimated ultrasonic coagulating applicator in the porcine model. Urology 2006; 68:226-30. [PMID: 16844460 DOI: 10.1016/j.urology.2006.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2005] [Revised: 01/02/2006] [Accepted: 02/01/2006] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To evaluate the long-term hemostatic efficacy of a new high-intensity collimated ultrasonic (HICU) applicator for open subhilar partial nephrectomy (PN) in the porcine model. METHODS An applicator was designed with a planar 3.78-MHz HICU transducer and a reflector to optimize the delivery of acoustic energy to coagulate renal tissue. Six female pigs underwent right PN, followed at day 7 by left PN. The 6 pigs were killed on day 14. The treatment consisted of delivering HICU to a lower pole subhilar location, under a vascular clamp, then releasing the clamp, and cutting the kidney lower pole. The immediate and delayed hemostatic efficacy, treatment parameters, blood loss, complications, and renal function were evaluated at each surgical event and at necropsy. RESULTS Perfect hemostasis was achieved with all 12 kidneys, with a mean treatment time of 7.2 minutes (range 5 to 9.2). The mean proportion of resected parenchyma was 21% (range 14% to 32%). No renal function impairment and no major complications were recorded. At necropsy, no secondary hematoma was observed, and three urinomas (25%) were found. CONCLUSIONS Our HICU applicator has shown promising results during PN in the pig model with no other method of hemostasis. More studies are needed to refine our probe for laparoscopic surgery, improve its ergonomics, and extend our experiments to human laparoscopic nephron-sparing surgery.
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Affiliation(s)
- F-J Murat
- Department of Urology, Edouard Herriot Hospital, Lyon, France.
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Petruzzo P, Badet L, Gazarian A, Lanzetta M, Parmentier H, Kanitakis J, Sirigu A, Martin X, Dubernard JM. Bilateral hand transplantation: six years after the first case. Am J Transplant 2006; 6:1718-24. [PMID: 16827876 DOI: 10.1111/j.1600-6143.2006.01369.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In this study we present our experience concerning bilateral hand transplantation. Two cases were performed: the first in January 2000 and the second in April 2003. Both recipients received the same immunosuppressive treatment, which was similar to those used in solid organ transplantation, including tacrolimus, prednisone and mycophenolate mofetil while antithymocyte globulins were added for induction. Both recipients presented two episodes of acute rejection (maculopapular lesions) in the first 3 months after transplantation; however, these were easily reversed after a few days increasing oral steroid doses and using topical immunosuppressants. The first recipient presented hyperglycemia and serum sickness while the second recipient suffered a thrombosis of the right ulnar artery and an osteomyelitis of left ulna. All the complications were successfully treated. Functional Magnetic Resonance Imaging (fMRI) showed that cortical hand representation progressively shifted from the lateral to the medial region in the motor cortex. After 6 and 2 years respectively, they showed a relevant sensorimotor recovery particularly of sensibility and activity of intrinsic muscles. They were able to perform the majority of daily activities and to lead a normal social life. The first recipient has been working since 2003. They are both satisfied with their grafted hands.
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Affiliation(s)
- P Petruzzo
- Department of Surgery, University of Cagliari, Italy.
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Petruzzo P, Badet L, Lefrançois N, Berthillot C, Dorel SB, Martin X, Laville M. Metabolic consequences of pancreatic systemic or portal venous drainage in simultaneous pancreas-kidney transplant recipients. Diabet Med 2006; 23:654-9. [PMID: 16759308 DOI: 10.1111/j.1464-5491.2006.01891.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIMS The aim was to investigate pancreatic B-cell function and insulin sensitivity in simultaneous pancreas-kidney (SPK) recipients with systemic or portal venous drained pancreas allograft using simple and easy tests. METHODS The study included 44 patients with Type 1 diabetes and end-stage renal disease who had undergone SPK transplantation: 20 recipients received a pancreas allograft with systemic venous drainage (S-SPK) and 24 with portal venous drainage (P-SPK). We studied only recipients with functioning grafts, with normal serum glucose, HbA(1c) and serum creatinine values, on a stable drug regimen. The subjects were studied at 6, 12, 24, 36, 48 and 60 months after transplantation. Insulin sensitivity and B-cell function indices were derived from blood samples and oral glucose tolerance tests. RESULTS All patients from both groups had normal fasting glucose, body mass index and HbA(1c) values by selection. The homeostatic model (HOMA) beta-cell index was significantly lower in P-SPK recipients at several points of the follow-up. HOMA-IR was significantly higher in S-SPK recipients at 6 and 24 months after transplantation and was positively correlated with fasting insulin values, but never exceeded 3.2. There was no significant difference in QUICKI index values between the two groups. Although all patients from both groups always had normal glucose tolerance, the area under the insulin curve was higher in the S-SPK group. Cholesterol, low-density lipoprotein-cholesterol and triglycerides were higher in the P-SPK group. CONCLUSIONS The results suggest sustained long-term endocrine function in both groups and show that portal venous drainage does not offer major metabolic advantages.
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Affiliation(s)
- P Petruzzo
- Department of Surgery, University of Cagliari, Cagliari, Italy.
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Pasticier G, Timsit MO, Badet L, De La Torre Abril L, Halila M, Fassi Fehri H, Colombel M, Martin X. Nephron-Sparing Surgery for Renal Cell Carcinoma: Detailed Analysis of Complications Over a 15-Year Period. Eur Urol 2006; 49:485-90. [PMID: 16443321 DOI: 10.1016/j.eururo.2005.12.049] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2005] [Accepted: 12/07/2005] [Indexed: 01/22/2023]
Abstract
PURPOSE To assess the incidence of complications of conservative renal surgery for renal cell carcinoma in both elective and imperative indications, and its evolution over a 15 year period. PATIENTS AND METHODS From 1988 to 2003, 127 patients underwent partial nephrectomy or tumorectomy for renal cell carcinoma in our department. INDICATIONs were imperative in 42% (n = 53) and elective in 58% (n=74) of cases. Morbidity was retrospectively assessed according to four parameters: 1- Period of surgery: A, from 1988 to 1999 and B, from 2000 to 2003. 2- INDICATION: elective vs. imperative. 3- experience of surgeon: senior vs. junior. 4- Nature of complications: minor or major. Comparative analysis was conducted using Chi-square and Fischer exact tests. RESULTS Global incidence of complications was 30.7% (n = 39) corresponding to 18.1% minor (n = 23) and 12.6% (n = 16) major complications. Results show a moderate decrease of complication rate during Period B: 28.1% versus 32.9% during period A (p = 0.69). Complications occurred more frequently in imperative indications (49.1%) than in elective indications (17.6%) (p = 0.002), mostly regarding major complications (respectively 28.3% and 1.4%. (p < 0.001)). Overall re-intervention rate was 15.7%: 22.6% in imperative and 10.8% in elective indications (p = 0.008). Mean length of hospital stay was 14.1 days and significantly longer during period A (p = 0.003) and in imperative indications (p = 0.009). CONCLUSION In our study, conservative renal surgery has a significant rate of complications which is extremely variable regarding to different parameters. Most discriminating factor was indication: in imperative indications, we observed a high rate of major complications (28.3%) that we consider acceptable to prevent anephria in clearly informed patients. Major complications are exceptional in elective indications. Decreased incidence of complications during the later period (B) is modest, and the role played by systematic pedicular clampage is discussed. As results published in medical literature are difficult to compare, we agree with authors who recently proposed to standardize complications data analysis, using a gravity scale, in order to provide relevant information to patients about statistical risks before surgery.
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Affiliation(s)
- G Pasticier
- Department of Urology and Transplantation, Edouard Herriot Hospital, University of Lyon, France.
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