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Heinz J, Walshaw J, Kwan JY, Long J, Carradice D, Totty J, Kontouli KM, Lainas P, Hitchman L, Smith G, Huo B, Guadalajara H, Garcia-Olmo D, Sharma D, Biyani CS, Tomlinson J, Loubani M, Galli R, Lathan R, Chetter I, Yiasemidou M. PRESS survey: PREvention of surgical site infection-a global pan-specialty survey of practice protocol. Front Surg 2023; 10:1251444. [PMID: 37818209 PMCID: PMC10560728 DOI: 10.3389/fsurg.2023.1251444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 08/15/2023] [Indexed: 10/12/2023] Open
Abstract
Background Surgical site infections (SSI) complicate up to 40% of surgical procedures, leading to increased patient morbidity and mortality. Previous research identified disparities in SSI prevention guidelines and clinical practices across different institutions. The study aims to identify variations in SSI prevention practices within and between specialties and financial systems and provide a representation of existing SSI preventative measures to help improve the standardization of SSI prevention practices. Methods This collaborative cross-sectional survey will be aimed at pan-surgical specialties internationally. The study has been designed and will be reported in line with the CROSS and CHERRIES standards. An international study steering committee will design and internally validate the survey in multiple consensus-based rounds. This will be based on SSI prevention measures outlined in the CDC (2017), WHO (2018), NICE (2019), Wounds UK (2020) and the International Surgical Wound Complications Advisory Panel (ISWCAP) guidelines. The questionnaire will include demographics, SSI surveillance, preoperative, peri-operative and postoperative SSI prevention. Data will be collected on participants' surgical specialty, operative grade, of practice and financial healthcare system of practice. The online survey will be designed and disseminated using QualtricsXM Platform™ through national and international surgical colleges and societies, in addition to social media and snowballing. Data collection will be open for 3 months with reminders, and raking will be used to ascertain the sample. Responses will be analyzed, and the chi-square test used to evaluate the impact of SSI prevention variables on responses. Discussion Current SSI prevention practice in UK Vascular surgery varies considerably, with little consensus on many measures. Given the inconsistency in guidelines on how to prevent SSIs, there is a need for standardization. This survey will investigate the disparity in SSI preventative measures between different surgical fields and countries.
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Affiliation(s)
- J Heinz
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Academic Vascular Surgical Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - J Walshaw
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Academic Vascular Surgical Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
- Department of Health Sciences, University of York, York, United Kingdom
| | - J Y Kwan
- Leeds Vascular Institute, Leeds Teachings Hospitals NHS Trust, Leeds, United Kingdom
| | - J Long
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Academic Vascular Surgical Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - D Carradice
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Academic Vascular Surgical Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - J Totty
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Department of Plastic and Reconstructive Surgery, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - K M Kontouli
- Department of Mathematics, University of Ioannina, Ioannina, Greece
| | - P Lainas
- Department of Digestive Surgery, Metropolitan Hospital, HEAL Academy, Athens, Greece
- Department of Minimally Invasive Digestive Surgery, Antoine-Béclère Hospital, Partis-Saclay University, Clamart, France
| | - L Hitchman
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Academic Vascular Surgical Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - G Smith
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Academic Vascular Surgical Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - B Huo
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - H Guadalajara
- Department of Surgery, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - D Garcia-Olmo
- Department of Surgery, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - D Sharma
- Department of Surgery, Government NSCB Medical College, Jabalpur, India
| | - C S Biyani
- Department of Urology, St James University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - J Tomlinson
- Trauma and Orthopedics, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - M Loubani
- Department of Cardiothoracic Surgery, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - R Galli
- Department of Surgery, Cantonal Hospital Baselland, Liestal, Switzerland
| | - R Lathan
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Academic Vascular Surgical Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
- Department of Health Sciences, University of York, York, United Kingdom
| | - I Chetter
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Academic Vascular Surgical Unit, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - M Yiasemidou
- Clinical Sciences Centre, Hull York Medical School, Hull, United Kingdom
- Department of General Surgery, Bradford Teaching Hospitals NHS Trust, Bradford, United Kingdom
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2
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van der Poel MJ, Barkhatov L, Fuks D, Berardi G, Cipriani F, Aljaiuossi A, Lainas P, Dagher I, D'Hondt M, Rotellar F, Besselink MG, Aldrighetti L, Troisi RI, Gayet B, Edwin B, Abu Hilal M. Multicentre propensity score-matched study of laparoscopic versus open repeat liver resection for colorectal liver metastases. Br J Surg 2019; 106:783-789. [PMID: 30706451 DOI: 10.1002/bjs.11096] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/11/2018] [Accepted: 11/27/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Repeat liver resection is often the best treatment option for patients with recurrent colorectal liver metastases (CRLM). Repeat resections can be complex, however, owing to adhesions and altered liver anatomy. It remains uncertain whether the advantages of a laparoscopic approach are upheld in this setting. The aim of this retrospective, propensity score-matched study was to compare the short-term outcome of laparoscopic (LRLR) and open (ORLR) repeat liver resection. METHODS A multicentre retrospective propensity score-matched study was performed including all patients who underwent LRLRs and ORLRs for CRLM performed in nine high-volume centres from seven European countries between 2000 and 2016. Patients were matched based on propensity scores in a 1 : 1 ratio. Propensity scores were calculated based on 12 preoperative variables, including the approach to, and extent of, the previous liver resection. Operative outcomes were compared using paired tests. RESULTS Overall, 425 repeat liver resections were included. Of 271 LRLRs, 105 were matched with an ORLR. Baseline characteristics were comparable after matching. LRLR was associated with a shorter duration of operation (median 200 (i.q.r. 123-273) versus 256 (199-320) min; P < 0·001), less intraoperative blood loss (200 (50-450) versus 300 (100-600) ml; P = 0·077) and a shorter postoperative hospital stay (5 (3-8) versus 6 (5-8) days; P = 0·028). Postoperative morbidity and mortality rates were similar after LRLR and ORLR. CONCLUSION LRLR for CRLM is feasible in selected patients and may offer advantages over an open approach.
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Affiliation(s)
- M J van der Poel
- Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - L Barkhatov
- Interventional Centre and Department of Hepatopancreatobiliary Surgery, Oslo University Hospital - Rikshospitalet, Oslo, Norway
| | - D Fuks
- Department of Digestive Disease, Institut Mutualiste Montsouris, Université Paris Descartes, Paris, France
| | - G Berardi
- Department of General and Hepatobiliary Surgery, Ghent University Hospital, Ghent, Belgium
| | - F Cipriani
- Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy
| | - A Aljaiuossi
- Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - P Lainas
- Department of Surgery, Antoine Béclère Hospital, Paris, France
| | - I Dagher
- Department of Surgery, Antoine Béclère Hospital, Paris, France
| | - M D'Hondt
- Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium
| | - F Rotellar
- Department of General and Abdominal Surgery, Clinica Universidad de Navarra, Pamplona, Spain
| | - M G Besselink
- Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - L Aldrighetti
- Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy
| | - R I Troisi
- Department of General and Hepatobiliary Surgery, Ghent University Hospital, Ghent, Belgium
| | - B Gayet
- Department of Digestive Disease, Institut Mutualiste Montsouris, Université Paris Descartes, Paris, France
| | - B Edwin
- Interventional Centre and Department of Hepatopancreatobiliary Surgery, Oslo University Hospital - Rikshospitalet, Oslo, Norway
| | - M Abu Hilal
- Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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3
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Lainas P, Ferretti S, Dagher I. Laparoscopic liver resection for segment VII hepatocellular carcinoma in a cirrhotic patient (with video). J Visc Surg 2018; 155:423-425. [DOI: 10.1016/j.jviscsurg.2018.08.004] [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: 11/17/2022]
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4
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Halls MC, Berardi G, Cipriani F, Barkhatov L, Lainas P, Harris S, D'Hondt M, Rotellar F, Dagher I, Aldrighetti L, Troisi RI, Edwin B, Abu Hilal M. Development and validation of a difficulty score to predict intraoperative complications during laparoscopic liver resection. Br J Surg 2018; 105:1182-1191. [DOI: 10.1002/bjs.10821] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 12/04/2017] [Accepted: 12/13/2017] [Indexed: 12/11/2022]
Abstract
Abstract
Background
Previous studies have demonstrated that patient, surgical, tumour and operative variables affect the complexity of laparoscopic liver resections. However, current difficulty scoring systems address only tumour factors. The aim of this study was to develop and validate a predictive model for the risk of intraoperative complications during laparoscopic liver resections.
Methods
The prospectively maintained databases of seven European tertiary referral liver centres were compiled. Data from two-thirds of the patients were used for development and one-third for validation of the model. Intraoperative complications were based on a modified Satava classification. Using the methodology of the Framingham Heart Study, developed to identify risk factors that contribute to the development of cardiovascular disease, factors found to predict intraoperative complications independently were assigned points, and grouped into low-, moderate-, high- and extremely high-risk groups based on the likelihood of intraoperative complications.
Results
A total of 2856 patients were included. Neoadjuvant chemotherapy, lesion type and size, classification of resection and previous open liver resection were found to be independent predictors of intraoperative complications. Patients with intraoperative complications had a longer duration of hospital stay (5 versus 4 days; P < 0·001), higher complication rates (32·5 versus 15·5 per cent; P < 0·001), and higher 30-day (3·0 versus 0·3 per cent; P < 0·001) and 90-day (3·8 versus 0·8 per cent; P < 0·001) mortality rates than those who did not. The model was able to predict intraoperative complications (area under the receiver operating characteristic (ROC) curve (AUC) 0·677, 95 per cent c.i. 0·647 to 0·706) as well as postoperative 90-day mortality (AUC 0·769, 0·681 to 0·858).
Conclusion
This comprehensive scoring system, based on patient, surgical and tumour factors, and developed and validated using a large multicentre European database, helped estimate the risk of intraoperative complications.
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Affiliation(s)
- M C Halls
- Department of Hepato-Biliary and Pancreatic Surgery, University Hospital Southampton, Southampton, UK
| | - G Berardi
- Department of General and Hepatobiliary Surgery, Liver Transplantation, Ghent University Hospital Medical School, Ghent, Belgium
| | - F Cipriani
- Department of Hepato-Biliary and Pancreatic Surgery, University Hospital Southampton, Southampton, UK
- Department of Hepatobiliary Surgery, San Raffaele Hospital, Milan, Italy
| | - L Barkhatov
- Intervention Centre and Department of Hepatopancreatobiliary Surgery, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - P Lainas
- Department of Hepatobiliary Surgery, Antoine-Béclère Hospital, Paris, France
| | - S Harris
- Department of Public Health Sciences and Medical Statistics, Faulty of Medicine, University of Southampton, Southampton, UK
| | - M D'Hondt
- Department of Digestive and Hepatopancreatobiliary Surgery, Groeninge Hospital, Kortrijk, Belgium
| | - F Rotellar
- Department of General Surgery, University of Navarra Hospital, Pamplona, Spain
| | - I Dagher
- Department of Hepatobiliary Surgery, Antoine-Béclère Hospital, Paris, France
| | - L Aldrighetti
- Department of Hepatobiliary Surgery, San Raffaele Hospital, Milan, Italy
| | - R I Troisi
- Department of General and Hepatobiliary Surgery, Liver Transplantation, Ghent University Hospital Medical School, Ghent, Belgium
| | - B Edwin
- Intervention Centre and Department of Hepatopancreatobiliary Surgery, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - M Abu Hilal
- Department of Hepato-Biliary and Pancreatic Surgery, University Hospital Southampton, Southampton, UK
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5
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Lainas P, Fuks D, Gaujoux S, Machroub Z, Fregeville A, Perniceni T, Mal F, Dousset B, Gayet B. Preoperative imaging and prediction of oesophageal conduit necrosis after oesophagectomy for cancer. Br J Surg 2017; 104:1346-1354. [PMID: 28493483 DOI: 10.1002/bjs.10558] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 02/27/2017] [Accepted: 03/07/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Oesophageal conduit necrosis following oesophagectomy is a rare but life-threatening complication. The present study aimed to assess the impact of coeliac axis stenosis on outcomes after oesophagectomy for cancer. METHODS The study included consecutive patients who had an Ivor Lewis procedure with curative intent for middle- and lower-third oesophageal cancer at two tertiary referral centres. All patients underwent preoperative multidetector CT with arterial phase to detect coeliac axis stenosis. The coeliac artery was classified as normal, with extrinsic stenosis due to a median arcuate ligament or with intrinsic stenosis caused by atherosclerosis. RESULTS Some 481 patients underwent an Ivor Lewis procedure. Of these, ten (2·1 per cent) developed oesophageal conduit necrosis after surgery. Coeliac artery evaluation revealed a completely normal artery in 431 patients (91·5 per cent) in the group without conduit necrosis and in one (10 per cent) with necrosis (P < 0·001). Extrinsic stenosis of the coeliac artery due to a median arcuate ligament was found in two patients (0·4 per cent) without conduit necrosis and five (50 per cent) with necrosis (P < 0·001). Intrinsic stenosis of the coeliac artery was found in 11 (2·3 per cent) and eight (80 per cent) patients respectively (P < 0·001). Eight patients without (1·7 per cent) and five (50 per cent) with conduit necrosis had a single and thin left gastric artery (P < 0·001). CONCLUSION This study suggests that oesophageal conduit necrosis after oesophagectomy for cancer may be due to pre-existing coeliac axis stenosis.
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Affiliation(s)
- P Lainas
- Department of Digestive Disease, Institut Mutualiste Montsouris, Paris, France
| | - D Fuks
- Department of Digestive Disease, Institut Mutualiste Montsouris, Paris, France.,Université Paris Descartes, Paris, France
| | - S Gaujoux
- Department of Digestive Surgery, Hôpital Cochin, Paris, France.,Université Paris Descartes, Paris, France
| | - Z Machroub
- Intensive Care Unit, Hôpital Cochin, Paris, France
| | - A Fregeville
- Department of Radiology, Institut Mutualiste Montsouris, Paris, France
| | - T Perniceni
- Department of Digestive Disease, Institut Mutualiste Montsouris, Paris, France
| | - F Mal
- Department of Digestive Disease, Institut Mutualiste Montsouris, Paris, France
| | - B Dousset
- Department of Digestive Surgery, Hôpital Cochin, Paris, France.,Université Paris Descartes, Paris, France
| | - B Gayet
- Department of Digestive Disease, Institut Mutualiste Montsouris, Paris, France.,Université Paris Descartes, Paris, France
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Abstract
INTRODUCTION In order to improve the outcome of classical laparoscopic cholecystectomy (CLC), surgeons have attempted to minimize tissue trauma. The aim of this study is to describe the technique of mini-laparoscopic cholecystectomy (MLC) and to report the outcome of this approach when used as a routine procedure. METHODS Since January 2012, all consecutive patients undergoing MLC were included in this study. Operative and perioperative data were prospectively collected. Additionally, cost analysis was performed. RESULTS From 2012 to 2015, 200 MLC were performed (F/M: 132/68, mean age 45±16 years). Mean operative duration was 97±32min for the first 50 patients and 75±25min for the subsequent 150 patients (P<0.0001). Modifications in the number or size of trocars were necessary in nine of the first 50 procedures and in seven of the subsequent 150 procedures (P=0.003). Perioperative morbidity included gallbladder perforation (n=28) or moderate (<50mL) bleeding (n=6). Postoperative morbidity was 4%. The mean global cost for a MLC procedure was 1757±1855 euros. This cost decreased from 2946±3115 euros in the first 50 patients to 1390±1278 euros in the subsequent 150 patients (P=0.001). CONCLUSION Mini-laparoscopy can be used for routine elective cholecystectomy. This approach is associated with low morbidity and good cosmetic results.
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Affiliation(s)
- C Dammaro
- AP-HP, Antoine-Béclère Hospital, Department of Minimally Invasive Surgery, 92140 Clamart, France; Paris-Saclay University, 91405 Orsay, France
| | - H Tranchart
- AP-HP, Antoine-Béclère Hospital, Department of Minimally Invasive Surgery, 92140 Clamart, France; Paris-Saclay University, 91405 Orsay, France.
| | - M Gaillard
- AP-HP, Antoine-Béclère Hospital, Department of Minimally Invasive Surgery, 92140 Clamart, France; Paris-Saclay University, 91405 Orsay, France
| | - A Debelmas
- AP-HP, Antoine-Béclère Hospital, Department of Minimally Invasive Surgery, 92140 Clamart, France; Paris-Saclay University, 91405 Orsay, France
| | - S Ferretti
- AP-HP, Antoine-Béclère Hospital, Department of Minimally Invasive Surgery, 92140 Clamart, France; Paris-Saclay University, 91405 Orsay, France
| | - P Lainas
- AP-HP, Antoine-Béclère Hospital, Department of Minimally Invasive Surgery, 92140 Clamart, France; Paris-Saclay University, 91405 Orsay, France
| | - I Dagher
- AP-HP, Antoine-Béclère Hospital, Department of Minimally Invasive Surgery, 92140 Clamart, France; Paris-Saclay University, 91405 Orsay, France
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7
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Tranchart H, Koffi GM, Gaillard M, Lainas P, Poüs C, Gonin P, Nguyen TH, Dubart-Kupperschmitt A, Dagher I. Liver regeneration following repeated reversible portal vein embolization in an experimental model. Br J Surg 2016; 103:1209-19. [PMID: 27256140 DOI: 10.1002/bjs.10153] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 01/26/2016] [Accepted: 02/10/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Portal vein embolization (PVE) is used routinely to prevent postoperative liver failure as a result of anticipated insufficient future liver remnant volume following resection. The authors have recently developed a technique for temporary PVE. The aim of this study was to assess the effect of repeated reversible PVE on hepatocyte proliferation and subsequent liver hypertrophy in rodents. METHODS Four treatments were compared (n = 21 rats per group): single reversible PVE, two PVEs separated by 14 days, partial portal vein ligation or sham procedure. The feasibility and tolerance of the procedure were assessed. Volumetric imaging by CT was used to estimate the evolution of liver volumes. After death, the weight of liver lobes was measured and hepatocyte proliferation evaluated by immunostaining. RESULTS Embolization of portal branches corresponding to 70 per cent of total portal flow was performed successfully in all animals. Repeated PVE induced additional hepatocyte proliferation. Repeated embolization resulted in superior hepatocyte proliferation in the non-occluded segments compared with portal vein ligation (31·1 versus 22·2 per cent; P = 0·003). The non-occluded to total liver volume ratio was higher in the repeated PVE group than in the single PVE and sham groups (P = 0·050 and P = 0·001 respectively). CONCLUSION Repeated reversible PVE successfully induced additional hepatocyte proliferation and subsequent liver hypertrophy. Surgical relevance Portal vein embolization (PVE) is used routinely to prevent postoperative liver failure as a result of anticipated insufficient future liver remnant volume following resection. In the present study, a technique of repeated temporary PVE was developed in a rat model; this induced additional hepatocyte proliferation and an increase in liver volume compared with single embolization. This novel approach might help induce major hypertrophy of the future remnant liver, which could increase the rate of patients amenable to major liver resections.
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Affiliation(s)
- H Tranchart
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1193, Villejuif, France.,Departement Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France.,Unité Mixte de Recherche, Paris-Sud University, Villejuif, France.,Departments of Minimally Invasive Surgery, Antoine-Beclere Hospital, Assistance Publique - Hôpitaux de Paris, Paris-Sud University, Clamart, France
| | - G M Koffi
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1193, Villejuif, France.,Departement Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France.,Unité Mixte de Recherche, Paris-Sud University, Villejuif, France
| | - M Gaillard
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1193, Villejuif, France.,Departement Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France.,Unité Mixte de Recherche, Paris-Sud University, Villejuif, France.,Departments of Minimally Invasive Surgery, Antoine-Beclere Hospital, Assistance Publique - Hôpitaux de Paris, Paris-Sud University, Clamart, France
| | - P Lainas
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1193, Villejuif, France.,Departement Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France.,Unité Mixte de Recherche, Paris-Sud University, Villejuif, France.,Departments of Minimally Invasive Surgery, Antoine-Beclere Hospital, Assistance Publique - Hôpitaux de Paris, Paris-Sud University, Clamart, France
| | - C Poüs
- Departments of Biochemistry, Antoine-Beclere Hospital, Assistance Publique - Hôpitaux de Paris, Paris-Sud University, Clamart, France
| | - P Gonin
- Service Commun d'Expérimentation Animale, Gustave Roussy Institut, Villejuif, France
| | - T H Nguyen
- INSERM U1064, Hôtel Dieu Hospital, Nantes, France
| | - A Dubart-Kupperschmitt
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1193, Villejuif, France.,Departement Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France.,Unité Mixte de Recherche, Paris-Sud University, Villejuif, France
| | - I Dagher
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1193, Villejuif, France.,Departement Hospitalo-Universitaire Hepatinov, Paul Brousse Hospital, Villejuif, France.,Unité Mixte de Recherche, Paris-Sud University, Villejuif, France.,Departments of Minimally Invasive Surgery, Antoine-Beclere Hospital, Assistance Publique - Hôpitaux de Paris, Paris-Sud University, Clamart, France
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8
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Affiliation(s)
- P Lainas
- Service de chirurgie digestive minimale invasive, hôpital Antoine-Béclère, 157, rue de la Porte-de-Trivaux, 92141 Clamart cedex, France; Université Paris-Sud, 91405 Orsay, France
| | - H Tranchart
- Service de chirurgie digestive minimale invasive, hôpital Antoine-Béclère, 157, rue de la Porte-de-Trivaux, 92141 Clamart cedex, France; Université Paris-Sud, 91405 Orsay, France
| | - D Tzanis
- Service de chirurgie digestive minimale invasive, hôpital Antoine-Béclère, 157, rue de la Porte-de-Trivaux, 92141 Clamart cedex, France; Université Paris-Sud, 91405 Orsay, France
| | - I Dagher
- Service de chirurgie digestive minimale invasive, hôpital Antoine-Béclère, 157, rue de la Porte-de-Trivaux, 92141 Clamart cedex, France; Université Paris-Sud, 91405 Orsay, France.
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9
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Tranchart H, Lainas P, Tzanis D, Ferretti S, Pourcher G, Devaquet N, Dagher I. Single incision laparoscopic splenectomy with hilar dissection for massive splenomegaly (with video). J Visc Surg 2014; 151:153-4. [DOI: 10.1016/j.jviscsurg.2014.02.002] [Citation(s) in RCA: 3] [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: 10/25/2022]
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10
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Dimitroulis D, Charalampoudis P, Lainas P, Papanikolaou I, Kykalos S, Kouraklis G. Focal nodular hyperplasia and hepatocellular adenoma: current views. Acta Chir Belg 2013; 113:162-9. [PMID: 24941710 DOI: 10.1080/00015458.2013.11680905] [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] [Indexed: 02/07/2023]
Abstract
Focal Nodular Hyperplasia (FNH) is a rare benign hepatic lesion believed to generate upon a hyperplastic response of the hepatocyte. Hepatocellular Adenoma (HA) occurs predominantly in young women receiving oral contraceptive medication. These two lesions have drawn significant attention throughout the recent years due to their specific clinical and pathological features as well as their challenging management. Although Focal Nodular Hyperplasia is managed conservatively in the majority of cases, it can albeit pose a difficult diagnostic dilemma. On the other hand, Hepatocellular Adenoma can be complicated with catastrophic hemorrhage or malignant transformation and therefore mandates surgical excision in many cases. The aim of this work is to review the current literature pertaining to these two clinical entities regarding their pathogenesis, diagnostic approach and genetics, as well as to shed light on specific differential diagnostic issues arising in many cases these lesions are encountered.
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Affiliation(s)
- D. Dimitroulis
- nd Propedeutic Department of Surgery, Athens Medical School, Laiko General Hospital, Athens, Greece
| | - P. Charalampoudis
- nd Propedeutic Department of Surgery, Athens Medical School, Laiko General Hospital, Athens, Greece
| | - P. Lainas
- nd Propedeutic Department of Surgery, Athens Medical School, Laiko General Hospital, Athens, Greece
| | - I.G. Papanikolaou
- nd Propedeutic Department of Surgery, Athens Medical School, Laiko General Hospital, Athens, Greece
| | - S. Kykalos
- nd Propedeutic Department of Surgery, Athens Medical School, Laiko General Hospital, Athens, Greece
| | - G. Kouraklis
- nd Propedeutic Department of Surgery, Athens Medical School, Laiko General Hospital, Athens, Greece
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