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Tendron A, Atallah S, Wagner I, Baujat B, Dauzier E. Varying ENT practices in adult post-intubation laryngotracheal stenosis after the COVID epidemic in France: A CHERRIES analysis. Eur Ann Otorhinolaryngol Head Neck Dis 2024:S1879-7296(24)00025-5. [PMID: 38423860 DOI: 10.1016/j.anorl.2024.02.008] [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: 03/02/2024]
Abstract
AIM The SARS-CoV-2 pandemic may increase the incidence of iatrogenic laryngotracheal stenosis (LTS), whereas management is not well defined. The aim of this study was to survey a panel of French otorhinolaryngologists about their practices and to evaluate their needs. METHOD A national-level survey of the management of iatrogenic LTS was conducted using a 41-item questionnaire, in 4 sections, sent to a panel of French otorhinolaryngologists between July and December 2022. The main endpoint was heterogeneity in responses between 55 proposals on LTS management. RESULTS The response rate was 20% (52/263). The response heterogeneity rate was 69% (38/55). Heterogeneity concerned general questions on diagnosis (7/12, 58%) and management (7/10, 70%), LTS case management (22/27, 81%), and otorhinolaryngologists' expectations (33%, 2/6). Quality of training was considered good or excellent by only 21% of respondents. More than 80% were strongly in favor of creating national guidelines, expert centers and a national database. DISCUSSION This study demonstrated the heterogeneity of adult post-intubation LTS management between otorhinolaryngologists in France. Training quality was deemed poor or mediocre by a majority of respondents. They were in favor of creating national guidelines and expert centers in LTS.
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Affiliation(s)
- A Tendron
- Service d'Oto-rhino-laryngologie et Chirurgie Cervicofaciale, Hôpital Tenon, AP-HP, Université Paris Sorbonne, Paris, France
| | - S Atallah
- Service d'Oto-rhino-laryngologie et Chirurgie Cervicofaciale, Hôpital Tenon, AP-HP, Université Paris Sorbonne, Paris, France
| | - I Wagner
- Service d'Oto-rhino-laryngologie et Chirurgie Cervicofaciale, Hôpital Tenon, AP-HP, Université Paris Sorbonne, Paris, France
| | - B Baujat
- Service d'Oto-rhino-laryngologie et Chirurgie Cervicofaciale, Hôpital Tenon, AP-HP, Université Paris Sorbonne, Paris, France
| | - E Dauzier
- Service d'Oto-rhino-laryngologie et Chirurgie Cervicofaciale, Hôpital Tenon, AP-HP, Université Paris Sorbonne, Paris, France.
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Vinciguerra A, Mattavelli D, Turri-Zanoni M, Ferrari M, Schreiber A, Rampinelli V, Dohin I, Valentini M, Pontillo V, Gaudioso P, Karligkiotis A, Atallah S, Chatelet F, Saccardo T, Piazza C, Verillaud B, Nicolai P, Castelnuovo P, Herman P. Validation of modular endoscopic medial maxillectomies for inverted papilloma of the maxillary sinus. Rhinology 2023:3103. [PMID: 37515817 DOI: 10.4193/rhin23.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2023]
Abstract
BACKGROUND Treatment of inverted papilloma of the maxillary sinus (IPMS) has a lower success rate compared to other IPs. As such, its correct management generally needs trans-nasal endoscopic medial maxillectomy (EMMs) for adequate resection. The aim of this manuscript is to describe outcomes and major prognostic factors of a cohort of patients with IPMS who were treated with EMM. METHODOLOGY In this multicentric study, patients affected with IPMS and treated with EMMs were included. The site of origin of the IPMS were studied as well as the type of EMM performed. The histological features (IP vs dysplasia), type of mucosal resection (total vs. pedicle oriented), and post-operative complications were analyzed. RESULTS 310 patients were included (212 primary and 98 recurrent cases). After a mean follow-up of 45.4 months, 15 patients experienced recurrence (4.8%) due to the application of EMMs tailored to the surgical insertion point. Dysplasia was significantly associated with a higher risk of recurrence. The rates of early and late complications were 11.6% and 11.9%, respectively. CONCLUSIONS IPMS resection via tailored EMM is associated with excellent disease control, thus excluding the systematic use of extended EMMs, which can however be justified in case of dysplastic IPMS given its significant impact on recurrence.
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Affiliation(s)
- A Vinciguerra
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France
| | - D Mattavelli
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - M Turri-Zanoni
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - M Ferrari
- Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - A Schreiber
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - V Rampinelli
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - I Dohin
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - M Valentini
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - V Pontillo
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France
| | - P Gaudioso
- Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - A Karligkiotis
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - S Atallah
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France
| | - F Chatelet
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France
| | - T Saccardo
- Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - C Piazza
- Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - B Verillaud
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France
| | - P Nicolai
- Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - P Castelnuovo
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - P Herman
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France
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Zaborowski AM, Abdile A, Adamina M, Aigner F, d'Allens L, Allmer C, Álvarez A, Anula R, Andric M, Atallah S, Bach S, Bala M, Barussaud M, Bausys A, Beggs A, Bellolio F, Bennett MR, Berdinskikh A, Bevan V, Biondo S, Bislenghi G, Bludau M, Brouwer N, Brown C, Bruns C, Buchanan DD, Buchwald P, Burger JWA, Burlov N, Campanelli M, Capdepont M, Carvello M, Chew HH, Christoforidis D, Clark D, Climent M, Collinson R, Cologne KG, Contreras T, Croner R, Daniels IR, Dapri G, Davies J, Delrio P, Denost Q, Deutsch M, Dias A, D'Hoore A, Drozdov E, Duek D, Dunlop M, Dziki A, Edmundson A, Efetov S, El-Hussuna A, Elliot B, Emile S, Espin E, Evans M, Faes S, Faiz O, Figueiredo N, Fleming F, Foppa C, Fowler G, Frasson M, Forgan T, Frizelle F, Gadaev S, Gellona J, Glyn T, Goran B, Greenwood E, Guren MG, Guillon S, Gutlic I, Hahnloser D, Hampel H, Hanly A, Hasegawa H, Iversen LH, Hill A, Hill J, Hoch J, Hompes R, Hurtado L, Iaquinandi F, Imbrasaite U, Islam R, Jafari MD, Salido AJ, Jiménez Toscano M, Kanemitsu Y, Karachun A, Karimuddin AA, Keller DS, Kelly J, Kennelly R, Khrykov G, Kocian P, Koh C, Kok N, Knight KA, Knol J, Kontovounisios C, Korner H, Krivokapic Z, Kronberger I, Kroon HM, Kryzauskas M, Kural S, Kusters M, Lakkis Z, Lankov T, Larson D, Lázár G, Lee KY, Lee SH, Lefèvre JH, Lepisto A, Lieu C, Loi L, Lynch C, Maillou-Martinaud H, Maroli A, Martin S, Martling A, Matzel KE, Mayol J, McDermott F, Meurette G, Millan M, Mitteregger M, Moiseenko A, Monson JRT, Morarasu S, Moritani K, Möslein G, Munini M, Nahas C, Nahas S, Negoi I, Novikova A, Ocares M, Okabayashi K, Olkina A, Oñate-Ocaña L, Otero J, Ozen C, Pace U, Julião GPS, Panaiotti L, Panis Y, Papamichael D, Patel S, Uriburu JCP, Peng SL, Pera M, Perez RO, Petrov A, Pfeffer F, Phang TP, Poskus T, Pringle H, Proud D, Raguz I, Rama N, Rasheed S, Raval MJ, Rega D, Reissfelder C, Meneses JCR, Ris F, Riss S, Rodriguez-Zentner H, Roxburgh CS, Saklani A, Sammour T, Saraste D, Schneider M, Seishima R, Sekulic A, Seppala T, Sheahan K, Shlomina A, Sigismondo G, Singnomklao T, Siragusa L, Smart N, Solis-Peña A, Spinelli A, Staiger RD, Stamos MJ, Steele S, Tan KK, Tanis PJ, Tekkis P, Teklay B, Tengku S, Tsarkov P, Turina M, Ulrich A, Vailati BB, van Harten M, Verhoef C, Warrier S, Wexner S, de Wilt H, Weinberg BA, Wells C, Wolthuis A, Xynos E, You N, Zakharenko A, Zeballos J, Zhou J, Winter DC. Microsatellite instability in young patients with rectal cancer: molecular findings and treatment response. Br J Surg 2022; 109:251-255. [PMID: 35030243 DOI: 10.1093/bjs/znab437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 11/22/2021] [Indexed: 12/27/2022]
Abstract
In this study of 400 patients with early-onset rectal cancer, 12.5 per cent demonstrated microsatellite instability (MSI). MSI was associated with a reduced likelihood of nodal positivity, an increased rate of pathological complete response, and improved disease-specific survival.
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Huguet F, Durand B, Atallah S, Prébet C, Richard S, Baujat B. Combination of radiation therapy-immunotherapy for head and neck cancers: Promises kept? Cancer Radiother 2021; 25:811-815. [PMID: 34711485 DOI: 10.1016/j.canrad.2021.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 12/24/2022]
Abstract
Chemoradiotherapy with concurrent cisplatin has been the standard treatment for locally advanced head and neck squamous cell carcinoma (HNSCC) for over 20 years. Recently, immunotherapy, a new therapeutic class, has emerged for patients with recurrent or metastatic HNSCC and has significantly extended their survival. Will it bring the same benefit to patients with localized tumors? There is a strong rationale for combining radiation therapy and checkpoint inhibitors for HNSCC. Indeed, radiation therapy can have both immunostimulatory and immunomodulatory effects. This is what explains the famous abscopal effect. The aim of this review is to present the data available on the combination of radiation therapy and immunotherapy for HNSCC.
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Affiliation(s)
- F Huguet
- Service d'Oncologie Radiothérapie, Hôpital Tenon, 4, rue de la Chine, 75020 Paris, France.
| | - B Durand
- Service d'Oncologie Radiothérapie, Hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - S Atallah
- Service d'Oto-Rhino-Laryngologie Chirurgie cervico-faciale, France
| | - C Prébet
- Service d'Oncologie Médicale, Hôpital Tenon, Sorbonne Université, AP-HP, Paris, France
| | - S Richard
- Service d'Oncologie Médicale, Hôpital Tenon, Sorbonne Université, AP-HP, Paris, France
| | - B Baujat
- Service d'Oto-Rhino-Laryngologie Chirurgie cervico-faciale, France
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5
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Zaborowski AM, Abdile A, Adamina M, Aigner F, d'Allens L, Allmer C, Álvarez A, Anula R, Andric M, Atallah S, Bach S, Bala M, Barussaud M, Bausys A, Bebington B, Beggs A, Bellolio F, Bennett MR, Berdinskikh A, Bevan V, Biondo S, Bislenghi G, Bludau M, Boutall A, Brouwer N, Brown C, Bruns C, Buchanan DD, Buchwald P, Burger JWA, Burlov N, Campanelli M, Capdepont M, Carvello M, Chew HH, Christoforidis D, Clark D, Climent M, Cologne KG, Contreras T, Croner R, Daniels IR, Dapri G, Davies J, Delrio P, Denost Q, Deutsch M, Dias A, D'Hoore A, Drozdov E, Duek D, Dunlop M, Dziki A, Edmundson A, Efetov S, El-Hussuna A, Elliot B, Emile S, Espin E, Evans M, Faes S, Faiz O, Fleming F, Foppa C, Fowler G, Frasson M, Figueiredo N, Forgan T, Frizelle F, Gadaev S, Gellona J, Glyn T, Gong J, Goran B, Greenwood E, Guren MG, Guillon S, Gutlic I, Hahnloser D, Hampel H, Hanly A, Hasegawa H, Iversen LH, Hill A, Hill J, Hoch J, Hoffmeister M, Hompes R, Hurtado L, Iaquinandi F, Imbrasaite U, Islam R, Jafari MD, Kanemitsu Y, Karachun A, Karimuddin AA, Keller DS, Kelly J, Kennelly R, Khrykov G, Kocian P, Koh C, Kok N, Knight KA, Knol J, Kontovounisios C, Korner H, Krivokapic Z, Kronberger I, Kroon HM, Kryzauskas M, Kural S, Kusters M, Lakkis Z, Lankov T, Larson D, Lázár G, Lee KY, Lee SH, Lefèvre JH, Lepisto A, Lieu C, Loi L, Lynch C, Maillou-Martinaud H, Maroli A, Martin S, Martling A, Matzel KE, Mayol J, McDermott F, Meurette G, Millan M, Mitteregger M, Moiseenko A, Monson JRT, Morarasu S, Moritani K, Möslein G, Munini M, Nahas C, Nahas S, Negoi I, Novikova A, Ocares M, Okabayashi K, Olkina A, Oñate-Ocaña L, Otero J, Ozen C, Pace U, São Julião GP, Panaiotti L, Panis Y, Papamichael D, Park J, Patel S, Patrón Uriburu JC, Pera M, Perez RO, Petrov A, Pfeffer F, Phang PT, Poskus T, Pringle H, Proud D, Raguz I, Rama N, Rasheed S, Raval MJ, Rega D, Reissfelder C, Reyes Meneses JC, Ris F, Riss S, Rodriguez-Zentner H, Roxburgh CS, Saklani A, Salido AJ, Sammour T, Saraste D, Schneider M, Seishima R, Sekulic A, Seppala T, Sheahan K, Shine R, Shlomina A, Sica GS, Singnomklao T, Siragusa L, Smart N, Solis A, Spinelli A, Staiger RD, Stamos MJ, Steele S, Sunderland M, Tan KK, Tanis PJ, Tekkis P, Teklay B, Tengku S, Jiménez-Toscano M, Tsarkov P, Turina M, Ulrich A, Vailati BB, van Harten M, Verhoef C, Warrier S, Wexner S, de Wilt H, Weinberg BA, Wells C, Wolthuis A, Xynos E, You N, Zakharenko A, Zeballos J, Winter DC. Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review. JAMA Surg 2021; 156:865-874. [PMID: 34190968 DOI: 10.1001/jamasurg.2021.2380] [Citation(s) in RCA: 96] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Importance The incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer. Observations Within the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts. Conclusions and Relevance The clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes.
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Affiliation(s)
| | - Ahmed Abdile
- Department of Surgery, Middlemore Hospital, Auckland, New Zealand
| | - Michel Adamina
- Department of Surgery, Cantonal Hospital, Winterthur, Switzerland
| | - Felix Aigner
- Department of Surgery, Barmherzige Brüder Krankenhaus Graz, Graz, Austria
| | - Laura d'Allens
- Department of Surgery, Cantonal Hospital, Winterthur, Switzerland
| | - Caterina Allmer
- Department of Surgery, Barmherzige Brüder Krankenhaus Graz, Graz, Austria
| | - Andrea Álvarez
- Department of Surgery, Bellvitge University Hospital, Barcelona, Spain
| | - Rocio Anula
- Department of Surgery, Instituto de Investigación Sanitaria San Carlos, Universidad Complutense de Madrid, Hospital Clínico San Carlos, Madrid, Spain
| | - Mihailo Andric
- Department of Surgery, University Hospital Magdeburg, Magdeburg, Germany
| | - Sam Atallah
- Department of Colorectal Surgery, AdventHealth, Orlando, Florida
| | - Simon Bach
- Department of Surgery, Queen Elizabeth Hospital, Birmingham, United Kingdom
| | - Miklosh Bala
- Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Marie Barussaud
- Department of Surgery, University Hospital Poitiers, Poitiers, France
| | - Augustinas Bausys
- Department of Surgery, National Cancer Institute, Vilnius, Lithuania
| | - Brendan Bebington
- Department of Surgery, Wits Donald Gordon Medical Centre, Johannesburg, South Africa
| | - Andrew Beggs
- Department of Surgery, Queen Elizabeth Hospital, Birmingham, United Kingdom
| | - Felipe Bellolio
- Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | | | - Anton Berdinskikh
- Department of Surgery, St-Petersburg Clinical Scientific and Practical Centre, St Petersburg, Russia
| | - Vicki Bevan
- Department of Surgery, Morriston Hospital, Swansea, Wales, United Kingdom
| | - Sebastiano Biondo
- Department of Surgery, Bellvitge University Hospital, Barcelona, Spain
| | | | - Marc Bludau
- Department of Surgery, University Hospital Cologne, Cologne, Germany
| | - Adam Boutall
- Department of Surgery, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Nelleke Brouwer
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carl Brown
- Department of Surgery, St Paul's Hospital, the University of British Columbia, Vancouver, British Columbia, Canada
| | - Christiane Bruns
- Department of Surgery, University Hospital Cologne, Cologne, Germany
| | - Daniel D Buchanan
- Department of Clinical Pathology, the University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Australia
| | - Pamela Buchwald
- Department of Surgery, Skåne University Hospital, Malmö, Sweden
| | | | - Nikita Burlov
- Department of Surgery, Leningrad Regional Clinical Oncology Dispensary, Leningrad, Russia
| | | | - Maylis Capdepont
- Department of Surgery, Bordeaux University Hospital, Bordeaux, France
| | - Michele Carvello
- Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Hwee-Hoon Chew
- Division of Colorectal Surgery, University Surgical Cluster, National University Health System, Singapore, Singapore
| | | | - David Clark
- Department of Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Marta Climent
- Department of Surgery, Bellvitge University Hospital, Barcelona, Spain
| | - Kyle G Cologne
- Department of Surgery, Keck Hospital, University of Southern California, Los Angeles
| | - Tomas Contreras
- Department of Surgery, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Roland Croner
- Department of Surgery, University Hospital Magdeburg, Magdeburg, Germany
| | - Ian R Daniels
- Department of Surgery, Royal Devon and Exeter Hospital, Exeter, United Kingdom
| | - Giovanni Dapri
- Department of Surgery, St-Pierre University Hospital, Brussels, Belgium
| | - Justin Davies
- Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Paolo Delrio
- Colorectal Surgical Oncology, Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, "Fondazione G. Pascale" IRCSS, Naples, Italy
| | - Quentin Denost
- Department of Surgery, Bordeaux University Hospital, Bordeaux, France
| | - Michael Deutsch
- Department of Surgery, Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Andre Dias
- Department of Surgery, Institute of Cancer of São Paulo, São Paulo, Brazil
| | | | - Evgeniy Drozdov
- Department of Surgery, Siberian State Medical University, Tomsk, Russia
| | - Daniel Duek
- Department of Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Malcolm Dunlop
- Department of Surgery, Western General Hospital, Edinburgh, United Kingdom
| | - Adam Dziki
- Department of Surgery, Military Medical Academy University Teaching Hospital, Łódź, Poland
| | - Aleksandra Edmundson
- Department of Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Sergey Efetov
- Department of Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Alaa El-Hussuna
- Department of Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Brodie Elliot
- Department of Surgery, Whangarei Hospital, Whangarei, New Zealand
| | - Sameh Emile
- Department of Surgery, Mansoura University Hospital, Mansoura, Egypt
| | - Eloy Espin
- Colorectal Surgery Unit, General Surgery Service, Hospital Vall de Hebron, Barcelona, Spain
| | - Martyn Evans
- Department of Surgery, Morriston Hospital, Swansea, Wales, United Kingdom
| | - Seraina Faes
- Department of Visceral Surgery, University Hospital Lausanne, Lausanne, Switzerland
| | - Omar Faiz
- Department of Surgery, St Mark's Hospital, London, United Kingdom
| | - Fergal Fleming
- Department of Surgery, University of Rochester, New York
| | - Caterina Foppa
- Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - George Fowler
- Department of Surgery, Royal Devon and Exeter Hospital, Exeter, United Kingdom
| | - Matteo Frasson
- Department of Surgery, University Hospital La Fe, Valencia, Spain
| | - Nuno Figueiredo
- Department of Surgery, Champalimaud Clinical Centre, Lisbon, Portugal
| | - Tim Forgan
- Department of Surgery, Tygerberg Academic Hospital, Cape Town, South Africa
| | - Frank Frizelle
- Department of Surgery, Christchurch Hospital, Christchurch, New Zealand
| | - Shamil Gadaev
- Fourth Coloproctology Department, St Petersburg Oncology Center, St Petersburg, Russia
| | - Jose Gellona
- Department of Colorectal Surgery, Clínica Santa María, Santiago, Chile
- Department of Colorectal Surgery, Hospital Militar de Santiago, Le Reina, Chile
| | - Tamara Glyn
- Department of Surgery, Christchurch Hospital, Christchurch, New Zealand
| | - Jianping Gong
- Department of Surgery, Tongji Hospital, Wuhan, China
| | - Barisic Goran
- Department of Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Emma Greenwood
- Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | | | - Stephanie Guillon
- Department of Surgery, Bordeaux University Hospital, Bordeaux, France
| | - Ida Gutlic
- Department of Surgery, Skåne University Hospital, Malmö, Sweden
| | - Dieter Hahnloser
- Department of Visceral Surgery, University Hospital Lausanne, Lausanne, Switzerland
| | - Heather Hampel
- Division of Human Genetics, The Ohio State University Comprehensive Cancer Center, Columbus
| | - Ann Hanly
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Hirotoshi Hasegawa
- Department of Surgery, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | | | - Andrew Hill
- Department of Surgery, Middlemore Hospital, Auckland, New Zealand
| | - James Hill
- Department of Surgery, Manchester Royal Infirmary, Manchester, United Kingdom
| | - Jiri Hoch
- Department of Surgery, Motol University Hospital, Prague, Czech Republic
| | | | - Roel Hompes
- Department of Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Luis Hurtado
- Department of Surgery, University Hospital La Fe, Valencia, Spain
| | | | | | - Rumana Islam
- Department of Surgery, Austin Hospital, Melbourne, Australia
| | | | - Yukihide Kanemitsu
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Aleksei Karachun
- Surgical Department of Abdominal Oncology, N. N. Petrov National Medical Research Centre of Oncology, St Petersburg, Russia
| | - Ahmer A Karimuddin
- Department of Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - Deborah S Keller
- Division of Colorectal Surgery, Department of Surgery, University of California at Davis Medical Center, Sacramento
| | - Justin Kelly
- Advent Health Colorectal Surgery, Orlando, Florida
| | - Rory Kennelly
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Gleb Khrykov
- Department of Surgery, Leningrad Regional Clinical Oncology Dispensary, Leningrad, Russia
| | - Peter Kocian
- Department of Surgery, Motol University Hospital, Prague, Czech Republic
| | - Cherry Koh
- Department of Surgery, Royal Prince Alfred Hospital, Sydney, Australia
| | - Neils Kok
- Department of Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Joep Knol
- Department of Surgery, Ziekenhuis Oost-Limburg, Belgium
| | | | - Hartwig Korner
- Department of Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Zoran Krivokapic
- Department of Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | | | - Hidde Maarten Kroon
- Department of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, Australia
| | | | - Said Kural
- School of Medicine, Uludag University, Bursa, Turkey
| | - Miranda Kusters
- Department of Surgery, Amsterdam University Medical Centers, location VUmc, Amsterdam, The Netherlands
| | - Zaher Lakkis
- Department of Surgery, University Hospital Besançon, Besançon, France
| | - Timur Lankov
- Surgical Department of Abdominal Oncology, N. N. Petrov National Medical Research Centre of Oncology, St Petersburg, Russia
| | - Dave Larson
- Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - György Lázár
- Department of Surgery, University of Szeged, Szeged, Hungary
| | - Kai-Yin Lee
- Division of Colorectal Surgery, University Surgical Cluster, National University Health System, Singapore, Singapore
| | - Suk Hwan Lee
- Kyung Here University Hospital at Gangdong, Seoul, South Korea
| | - Jérémie H Lefèvre
- Sorbonne Université, Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Hôpital St Antoine, Paris, France
| | - Anna Lepisto
- Department of Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Christopher Lieu
- Division of Medical Oncology, University of Colorado Anschutz Medical Campus, Aurora
| | - Lynette Loi
- University of Glasgow, Glasgow, United Kingdom
| | - Craig Lynch
- Department of Surgery, St Vincent's Hospital, University of Melbourne, Melbourne, Australia
| | | | - Annalisa Maroli
- Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Sean Martin
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Anna Martling
- Department of Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Klaus E Matzel
- Department of Surgery, University Hospital Erlangen, Erlangen, Germany
| | - Julio Mayol
- Department of Surgery, Instituto de Investigación Sanitaria San Carlos, Universidad Complutense de Madrid, Hospital Clínico San Carlos, Madrid, Spain
| | - Frank McDermott
- Department of Surgery, Royal Devon and Exeter Hospital, Exeter, United Kingdom
| | | | - Monica Millan
- Department of Surgery, La Fe University Hospital, Valencia, Spain
| | - Martin Mitteregger
- Department of Surgery, Barmherzige Brüder Krankenhaus Graz, Graz, Austria
| | - Andrei Moiseenko
- Surgical Department of Abdominal Oncology, N. N. Petrov National Medical Research Centre of Oncology, St Petersburg, Russia
| | - John R T Monson
- AdventHealth Medical Group Colorectal Surgery, AdventHealth, Orlando, Florida
| | - Stefan Morarasu
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Konosuke Moritani
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Gabriela Möslein
- Department for Hereditary Tumors, Evangelisches Krankenhaus Bethesda, Duisburg, Germany
| | - Martino Munini
- Department of Surgery, Lugano Regional Hospital, Lugano, Switzerland
| | - Caio Nahas
- Department of Surgery, Institute of Cancer of São Paulo, São Paulo, Brazil
| | - Sergio Nahas
- Department of Surgery, Institute of Cancer of São Paulo, São Paulo, Brazil
| | - Ionut Negoi
- Department of Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Anastasia Novikova
- Department of Surgery, Pavlov First St Petersburg State Medical University's Clinic, St Petersburg, Russia
| | - Misael Ocares
- Department of Surgery, University Hospital Concepción, Concepción, Chile
| | | | - Alexandra Olkina
- Surgical Department of Abdominal Oncology, N. N. Petrov National Medical Research Centre of Oncology, St Petersburg, Russia
| | - Luis Oñate-Ocaña
- Department of Surgery, National Cancer Institute, Mexico City, Mexico
| | - Jaime Otero
- Department of Surgery, Instituto de Investigación Sanitaria San Carlos, Universidad Complutense de Madrid, Hospital Clínico San Carlos, Madrid, Spain
| | - Cihan Ozen
- Department of Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Ugo Pace
- Colorectal Surgical Oncology, Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, "Fondazione G. Pascale" IRCSS, Naples, Italy
| | | | - Lidiia Panaiotti
- Surgical Department of Abdominal Oncology, N. N. Petrov National Medical Research Centre of Oncology, St Petersburg, Russia
| | - Yves Panis
- Department of Surgery, Beaujon Hospital, Paris, France
| | | | - Jason Park
- Department of Surgery, St Boniface General Hospital, Winnipeg, Manitoba, Canada
| | - Swati Patel
- Department of Gastroenterology, University of Colorado Anschutz Medical Campus, Aurora
| | | | - Miguel Pera
- Department of Surgery, Hospital del Mar, Barcelona, Spain
| | - Rodrigo O Perez
- Colorectal Surgery Division, Angelita and Joaquim Gama Institute, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | - Alexei Petrov
- Surgical Department of Abdominal Oncology, N. N. Petrov National Medical Research Centre of Oncology, St Petersburg, Russia
| | - Frank Pfeffer
- Department of Surgery, Haukeland University Hospital, Bergen, Norway
| | - P Terry Phang
- Department of Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - Tomas Poskus
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Heather Pringle
- Department of Surgery, Royal Devon and Exeter Hospital, Exeter, United Kingdom
| | - David Proud
- Department of Surgery, Austin Hospital, Melbourne, Australia
| | - Ivana Raguz
- Department of Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Nuno Rama
- Department of Surgery, Centro Hospitalar de Leiria, Leiria, Portugal
| | - Shahnawaz Rasheed
- Department of Surgery, Royal Marsden Hospital, London, United Kingdom
| | - Manoj J Raval
- Department of Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - Daniela Rega
- Colorectal Surgical Oncology, Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, "Fondazione G. Pascale" IRCSS, Naples, Italy
| | | | | | - Frederic Ris
- Department of Surgery, University Hospital Geneva, Geneva, Switzerland
| | - Stefan Riss
- Department of Surgery, Medical University Vienna, Vienna, Austria
| | | | - Campbell S Roxburgh
- Glasgow Royal Infirmary, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | | | - Tarik Sammour
- Department of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, Australia
| | - Deborah Saraste
- Department of Surgery, Stockholm South General Hospital, Stockholm, Sweden
| | - Martin Schneider
- Department of Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Ryo Seishima
- Department of Surgery, Keio University, Tokyo, Japan
| | | | - Toni Seppala
- Department of Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Kieran Sheahan
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Rebecca Shine
- Department of Surgery, Austin Hospital, Melbourne, Australia
| | - Alexandra Shlomina
- Department of Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
| | | | | | | | - Neil Smart
- Department of Surgery, Royal Devon and Exeter Hospital, Exeter, United Kingdom
| | - Alejandro Solis
- Colorectal Surgery Unit, General Surgery Service, Hospital Vall de Hebron, Barcelona, Spain
| | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Roxane D Staiger
- Department of Surgery, University Hospital Zurich, Zurich, Switzerland
| | | | - Scott Steele
- Department of Surgery, Cleveland Clinic, Cleveland, Ohio
| | | | - Ker-Kan Tan
- Department of Surgery, School of Medicine, National University of Singapore, Singapore, Singapore
| | - Pieter J Tanis
- Department of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam, The Netherlands
| | - Paris Tekkis
- Department of Surgery, Royal Marsden Hospital, London, United Kingdom
| | - Biniam Teklay
- Department of Surgery, Åbenrå Hospital, Åbenrå, Denmark
| | | | | | - Petr Tsarkov
- Department of Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Matthias Turina
- Department of Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Alexis Ulrich
- Department of Surgery, Lukas Hospital, Neuss, Germany
| | - Bruna B Vailati
- Department of Surgery, Angelita and Joaquim Gama Institute, São Paulo, Brazil
| | - Meike van Harten
- Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Cornelis Verhoef
- Department of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Satish Warrier
- Department of Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Steve Wexner
- Department of Surgery, Cleveland Clinic Florida, Weston
| | - Hans de Wilt
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Benjamin A Weinberg
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Cameron Wells
- Department of Surgery, Auckland City Hospital, Auckland, New Zealand
| | | | - Evangelos Xynos
- Department of Surgery, Creta Inter-Clinic Hospital, Heraklion, Crete, Greece
| | - Nancy You
- Department of Surgery, MD Anderson Cancer Center, Houston, Texas
| | - Alexander Zakharenko
- Department of Surgery, Pavlov First St Petersburg State Medical University's Clinic, St Petersburg, Russia
| | | | - Des C Winter
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
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Atallah S, Barbera L, Folwell M, Howell D, Liu A, Jennifer C. PO-1148: Implementation of a cervix cancer specific patient reported outcome measure in clinical practice. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01166-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Atallah S, Bozec A, Ransy P, Davrou J, Longis J, Humbert M, Brenet E, Schultz P, Damecourt A, Lacau Saint Guily J, Baujat B. Functional evaluation of mandibular reconstruction with bone free flap. A GETTEC study. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 138:82-88. [PMID: 32800716 DOI: 10.1016/j.anorl.2020.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To assess the functional results of oromandibular reconstruction by free bone flap, in terms of swallowing, speech and esthetics. MATERIALS AND METHODS A transverse multicenter study included 134 patients reconstructed by free bone flap between 1998 and 2016, with more than 6 months' follow-up, in 9 centers. A standardized questionnaire collected data on patients and treatment. Study endpoints comprised: weight loss, mouth opening, gastrostomy dependence, type of feeding, and DHI score. The impact of patient baseline characteristics on these functional criteria was explored by uni/multivariate analysis. RESULTS Ninety of the 134 patients had cancer. Fibula flap was mainly used (80%). 94% of reconstructions were primary successes. 71% of patients had pre- or post-operative radiation therapy. 88% had less than 50% lingual resection. 97% recovered oral feeding. 89% had intelligible speech. 86% judged their esthetic appearance as good/average. 9% had dental prosthetic rehabilitation. Radiation therapy and extensive lingual resection significantly impacted swallowing function (P=0.04 and P=0.03, respectively). Radiation therapy and oropharyngeal extension significantly increased gastrostomy dependence (P=0.04 and P=0.02, respectively). CONCLUSION Oromandibular reconstruction by free bone flap enabled return to oral feeding in most cases. More than 80% of patients were satisfied with their result in terms of speech and esthetics. However, the rate of dental rehabilitation was low and the rate of complications was high.
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Affiliation(s)
- S Atallah
- Sorbonne Université, Hôpital Tenon, Service d'ORL et Chirurgie Cervico-Faciale, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - A Bozec
- Centre Antoine Lacassagne, département d'ORL et de chirurgie carcinologique de la Tête et du Cou, 33, avenue de Valombrose, 06189 Nice, France
| | - P Ransy
- Service ORL et de chirurgie cervico-faciale, CHU Sart Tilman, Liège, Belgium
| | - J Davrou
- Université Picardie Jules-Verne, CHRU, service de chirurgie maxillo-faciale et stomatologie, Place Victor Pauchet, 80054 Amiens Cedex, France
| | - J Longis
- Clinique de chirurgie maxillo-faciale et stomatologie, CHU Hôtel-Dieu, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - M Humbert
- Service d'ORL, CHU Côte de Nacre/Centre François Baclesse, Service du Dr MY Louis, Caen, France
| | - E Brenet
- CHU de Reims, Hôpital Robert Debré, Service ORL et Chirurgie Cervico-faciale, Reims, France
| | - P Schultz
- Service ORL et Chirurgie Cervico-Faciale, CHU Hautepierre, 1 Avenue Maline, 67098 Strasbourg, France
| | - A Damecourt
- Service d'ORL, CHU Gui de Chauliac, Montpellier, France
| | - J Lacau Saint Guily
- Sorbonne Université, Hôpital Tenon, Service d'ORL et Chirurgie Cervico-Faciale, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - B Baujat
- Sorbonne Université, Hôpital Tenon, Service d'ORL et Chirurgie Cervico-Faciale, AP-HP, 4, rue de la Chine, 75020 Paris, France.
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Abstract
Purpose The purpose of this study was to assess the impact of the COVID-19 pandemic on the surgical volume of three ENT departments in Ile-de-France, a region severely affected by the epidemic. Materials and methods The number and nature of surgeries was collected from three university hospital ENT departments from 17/03/2020 to 17/04/2020 and from 18/03/2019 to 18/04/2019. Centre 1 is a general adult ENT department specialized in otology, centre 2 is a general adult ENT department specialized in cancer and centre 3 is a paediatric ENT department. Comparative analysis of the decreased surgical volume was conducted between 2019 and 2020. Objective To analyse the reduction of ENT surgical volume. Results The three centres operated on 540 patients in 2019, versus 89 in 2020, i.e. an 84% decrease: 89% in Centre 1, 61% in Centre 2, and 95% in the paediatric centre. Otological surgery decreased by 97%, endonasal surgery decreased by 91%, head and neck surgery decreased by 54%, plastic surgery decreased by 82%, and transoral surgery decreased by 85%. The number of surgical operations for skin cancer decreased (24 vs. 9), while the total number of head and neck cancer surgeries remained stable (18 vs. 22). The number of planned tracheostomies increased from 8 to 22. Conclusion The number of ENT surgeries decreased by 84% during the first month of the COVID-19 epidemic. This decreased surgical volume mainly concerned functional surgery, while the level of cancer surgery remained stable. Hospital units will need to absorb a marked excess surgical volume after the epidemic.
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Affiliation(s)
- R Hervochon
- Service d'ORL, GHU Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France.
| | - S Atallah
- Service d'ORL, CHU Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - S Levivien
- Service d'ORL, CHU Robert Debré, Assistance Publique-Hôpitaux de Paris, Université Diderot, Paris, France
| | - N Teissier
- Service d'ORL, CHU Robert Debré, Assistance Publique-Hôpitaux de Paris, Université Diderot, Paris, France
| | - B Baujat
- Service d'ORL, CHU Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - F Tankere
- Service d'ORL, GHU Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
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Laccourreye O, Mirghani H, Evrard D, Bonnefont P, Brugel L, Tankere F, Coste A, Barry B, Baujat B, Atallah S, Kania R. Impact of the first month of Covid-19 lockdown on oncologic surgical activity in the Ile de France region university hospital otorhinolaryngology departments. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:273-276. [PMID: 32565242 PMCID: PMC7293504 DOI: 10.1016/j.anorl.2020.06.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To evaluate the impact of the first month of lockdown related to the Covid-19 epidemic on the oncologic surgical activity in the Ile de France region university hospital otorhinolaryngology departments. MATERIAL AND METHODS A multicenter prospective observational assessment was conducted in 6 university hospital otorhinolaryngology departments (Paris Centre, Nord, Est and Sorbonne) during the 1-month periods before (Month A) and after (Month B) lockdown on March 17, 2020. The main goal was to evaluate lockdown impact on oncologic surgical activity in the departments. Secondary goals were to report population characteristics, surgery conditions, postoperative course, progression of Covid status in patients and surgeons, and adverse events. RESULTS 224 procedures were performed. There was 10.9% reduction in overall activity, without significant difference between departments. Squamous cell carcinoma and larynx, hypopharynx, oropharynx, oral cavity and nasal cavity and sinus locations were predominant, at 79% and 75.8% of cases respectively, with no significant differences between months. T3/4 and N2/3 tumors were more frequent in Month B (P=.002 and .0004). There was no significant difference between months regarding surgical approach, type of reconstruction, postoperative course, tracheotomy and nasogastric feeding-tube time, intensive care stay or hospital stay. None of the Month A patients were Covid-19-positive, versus 3 in Month B, without adverse events. None of the otorhinolaryngologists involved in the procedures developed symptoms suggesting Covid-19 infestation. CONCLUSION The present study underscored the limited impact of the Covid-19 epidemic and lockdown on surgical diagnosis and cancer surgery in the Ile de France university otorhinolaryngology departments, maintaining chances for optimal survival without spreading the virus.
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Affiliation(s)
- O Laccourreye
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Centre, HEGP, AP-HP, 20-40, rue Leblanc, 75015 Paris, France.
| | - H Mirghani
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Centre, HEGP, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
| | - D Evrard
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Centre, Hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France
| | - P Bonnefont
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Nord, Hôpital La Pitié-Salpétrière, AP-HP, 47-83; boulevard de l'Hôpital, 75013 Paris, France
| | - L Brugel
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Est, Centre Hospitalier Intercommunal de Créteil, 40, avenue de Verdun, 94000 Créteil, France
| | - F Tankere
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Nord, Hôpital La Pitié-Salpétrière, AP-HP, 47-83; boulevard de l'Hôpital, 75013 Paris, France
| | - A Coste
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Est, Centre Hospitalier Intercommunal de Créteil, 40, avenue de Verdun, 94000 Créteil, France
| | - B Barry
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Centre, Hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France
| | - B Baujat
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Sorbonne, Hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - S Atallah
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Sorbonne, Hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - R Kania
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Nord, AP-HP, Hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France
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Atallah S. Anatomical Considerations and Procedure-Specific Aspects Important in Preventing Operative Morbidity during Transanal Total Mesorectal Excision. Clin Colon Rectal Surg 2020; 33:157-167. [PMID: 32351339 DOI: 10.1055/s-0040-1701604] [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
As transanal total mesorectal excision (taTME) becomes increasingly utilized, its technical challenges and potential pitfalls have become more clearly appreciated. This chapter explores the differences in how anatomy presents itself from the taTME vantage point as compared with traditional approaches to taTME, and how special problems unique to taTME pose a new set of operative challenges. Morbidity related, specifically, to the technique of taTME is also delineated with particular focus on male urethral injury.
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Affiliation(s)
- Sam Atallah
- Department of Colorectal Surgery, Florida Hospital, Orlando, Florida
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Atallah S, Kural S, Banda N, Banda A, Bawaney F, Cabral F, Neychev V, Patel C, Larach S. Initial clinical experience with a powered circular stapler for colorectal anastomosis. Tech Coloproctol 2020; 24:479-486. [PMID: 32193667 DOI: 10.1007/s10151-020-02162-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 02/05/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND The Echelon circular™ powered stapler (ECP stapler) obviates the need for manual firing of conventional circular staplers during the construction of a colorectal anastomosis, but has not been evaluated clinically. The aim of this study was to perform a clinical evaluation of this stapler. METHODS A retrospective review of the initial clinical experience of a single surgeon using the ECP stapler for left-sided colorectal anastomosis construction during elective colorectal resections for benign and malignant disease was conducted by analyzing results from a prospectively maintained study database. Additionally, four attending colorectal and/or general surgeons who had performed ≥ 5 colorectal operations with the ECP stapler were invited to complete an anonymous online survey to subjectively assess the user experience with the device. Statistical analysis was conducted using Microsoft Excel Version 15.33. RESULTS Seventeen patients underwent left-sided anastomotic reconstruction using the ECP stapler. All donuts (proximal and distal) were intact. Anastomotic integrity was evaluated using the air-leak test utilizing flexible video sigmoidoscopy. No leaks were observed, although one patient (5.9%) developed a postoperative pelvic abscess. The anonymous survey was completed by all four surgeons. Subjective evaluation of the ECP stapler suggests that the overall stapling quality, overall device ease-of-use, and the overall perception of anastomotic quality as above average when compared to manual 'end-to-end anastomosis' (EEA) stapling devices. CONCLUSIONS In an initial clinical evaluation of the ECP stapler, the safety and ease-of-use of the device appears to be satisfactory. Powered stapling and the design of '3D stapling' may provide advantages over manual systems, and may improve the construction quality of left-sided colorectal anastomosis.
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Affiliation(s)
- S Atallah
- University of Central Florida, College of Medicine, Orlando, FL, USA.
- HCA North Florida Division, Winter Park, FL, 32792, USA.
| | - S Kural
- Uludag University, Bursa, Turkey
| | - N Banda
- University of Central Florida, College of Medicine, Orlando, FL, USA
| | - A Banda
- University of Central Florida, College of Medicine, Orlando, FL, USA
| | - F Bawaney
- University of Central Florida, College of Medicine, Orlando, FL, USA
| | - F Cabral
- Instituto Português de Oncologia, Lisbon, Portugal
| | - V Neychev
- University of Central Florida, College of Medicine, Orlando, FL, USA
- HCA North Florida Division, Winter Park, FL, 32792, USA
| | - C Patel
- University of Central Florida, College of Medicine, Orlando, FL, USA
- HCA North Florida Division, Winter Park, FL, 32792, USA
| | - S Larach
- University of Central Florida, College of Medicine, Orlando, FL, USA
- HCA North Florida Division, Winter Park, FL, 32792, USA
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Affiliation(s)
- Liang Kang
- Department of Colorectal Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Patricia Sylla
- Division of Colon and Rectal Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sam Atallah
- The College of Medicine, Endo-Surgical Center of Florida, Department of Colorectal Surgery, Florida Hospital, Orlando, FL, USA
| | - Massaki Ito
- Colorectal and Pelvic Surgery Division, Department of Surgical Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Steven D Wexner
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, USA
| | - Jian-Ping Wang
- Department of Colorectal Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
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Affiliation(s)
- S Atallah
- HCA North Florida Division, Oviedo, FL, USA. .,University of Central Florida, College of Medicine, Orlando, FL, USA. .,AdventHealth Winter Park, Winter Park, FL, USA.
| | - P Sylla
- Mount Sinai Health System, New York, USA
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Atallah S, Oldham A, Kondek A, Larach S. Robotic excision of a colonic neoplasm with ICG as a tumor localizer and colonoscopic assistance. Tech Coloproctol 2019; 23:573-578. [PMID: 31243608 DOI: 10.1007/s10151-019-02032-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 06/20/2019] [Indexed: 10/26/2022]
Affiliation(s)
- S Atallah
- HCA North Florida Division, Oviedo, FL, USA.
| | - A Oldham
- HCA North Florida Division, Oviedo, FL, USA
| | - A Kondek
- HCA North Florida Division, Oviedo, FL, USA
| | - S Larach
- HCA North Florida Division, Oviedo, FL, USA
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Abstract
INTRODUCTION Beside HPV infection, there is currently no evidence of association between head and neck squamous cell carcinomas and microbial infections. We report the case of a cervical squamous cell carcinoma by Mycoplasma hominis. CASE SUMMARY A 20-year-old woman, consulted for a swelling on the left cervical side. Clinical examination found a large fixed mass. Biological tests found no evidence of infection. Biopsies of the cervical lesion diagnosed an HPV negative squamous cell carcinoma. Microbiological tests of 16sRNA identification showed the presence of Mycoplasma hominis in the 3 specimens. The patient was treated by induction chemotherapy associated to antibiotherapy, followed by chemo-radiotherapy. DISCUSSION The present case suggests that oropharyngeal infection by Mycoplasma hominis might be more frequent than expected, that 16sRNA is an efficient technique to isolate this pathogen and finally that further studies are required to document its potential oncogenic role in head and neck squamous cell carcinomas.
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Affiliation(s)
- S Atallah
- Département de chirurgie oncologique cervico-faciale, Institut Curie, Université PSL, 75005 Paris, France
| | - B Berçot
- Département de microbiologie, Hôpital Saint-Louis, Université Paris VII, 75010 Paris, France
| | - V Laurence
- Département d'oncologie médicale, Institut Curie, Université PSL, 75005 Paris, France
| | - C Hoffmann
- Département de chirurgie oncologique cervico-faciale, Institut Curie, Université PSL, 75005 Paris, France; Inserm U932, Immunité et Cancer, Institut Curie, Université PSL, 75005 Paris, France.
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18
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Atallah S, Parra-Davila E, Melani AGF. Assessment of the Versius surgical robotic system for dual-field synchronous transanal total mesorectal excision (taTME) in a preclinical model: will tomorrow's surgical robots promise newfound options? Tech Coloproctol 2019; 23:471-477. [PMID: 31069556 DOI: 10.1007/s10151-019-01992-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 04/15/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the feasibility of the Versius surgical robotic system for transanal total mesorectal excision (taTME) in a preclinical setting. METHODS Dry laboratory and cadaveric sessions were first conducted for three experienced colorectal surgeons in order to gain familiarity with the modular surgical system and the robotic workstation. After introduction, the system was configured to allow for synchronous, totally robotic taTME in a cadaver. RESULTS Using the modular robotic system, one surgeon performed the abdominal portion of the operation, including colonic mobilization and vascular pedicle ligation while simultaneously a second surgeon performed the transanal portion of the operation to the point of rendezvous at the peritoneal reflection, where the operation was completed cooperatively. The operation was successfully completed in 195 min demonstrating preclinical feasibility of this unique approach with an emerging robotic system. CONCLUSIONS This is the first preclinical assessment of the Versius surgical robotic system for taTME. The ability to work simultaneously carries the theoretical advantage of reducing surgical time and thereby reducing overall operative costs. It may also allow surgeons to maintain focus on critical parts of the operation by halving the fatigue associated with long, complex cases such as taTME.
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Affiliation(s)
- S Atallah
- Department of Colorectal Surgery, EndoSurgical Center of Florida, Florida Hospital, 100 N. Dean Road, Orlando, FL, 32825, USA.
| | - E Parra-Davila
- Department of Surgery, Good Samaritan Hospital, West Palm Beach, FL, USA
| | - A G F Melani
- Department of Surgery, IRCAD, Latin America, Rio de Janeiro, Brazil
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Atallah S, Dakermandji M, Larach SW. A new approach to rectal prolapse repair - perineal proctectomy with transanal minimally invasive surgery rectopexy and mesh fixation - a video vignette. Colorectal Dis 2019; 21:609-610. [PMID: 30903730 DOI: 10.1111/codi.14620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 03/16/2019] [Indexed: 02/08/2023]
Affiliation(s)
- S Atallah
- Department of Colorectal Surgery, AdventHealth Orlando, Orlando, Florida, USA.,Department of Surgery, UCF College of Medicine, Orlando, Florida, USA.,Department of Colorectal Surgery, HCA, Oviedo Medical Center, Orlando, Florida, USA
| | - M Dakermandji
- Department of Colorectal Surgery, AdventHealth Orlando, Orlando, Florida, USA
| | - S W Larach
- Department of Surgery, UCF College of Medicine, Orlando, Florida, USA
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20
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De Freitas D, Althoff A, Larach S, Atallah S. Robotic transanal minimally invasive surgery for local repair of acquired rectovaginal and rectourethral fistulas - a video vignette. Colorectal Dis 2019; 21:610-611. [PMID: 30903727 DOI: 10.1111/codi.14619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 03/16/2019] [Indexed: 01/02/2023]
Affiliation(s)
- D De Freitas
- Colorectal Surgery, Florida Hospital, Gainsville, Florida, USA
| | - A Althoff
- Colorectal Surgery, Florida Hospital, Gainsville, Florida, USA
| | - S Larach
- Colorectal Surgery, Florida Hospital, Gainsville, Florida, USA
| | - S Atallah
- Colorectal Surgery, Florida Hospital, Gainsville, Florida, USA
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21
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Affiliation(s)
- R L Shuck
- HCA North Florida Division, Winter Park, FL, USA
| | - S W Larach
- HCA North Florida Division, Winter Park, FL, USA
| | - S Atallah
- HCA North Florida Division, Winter Park, FL, USA.
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22
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Atallah S, Parra-Davila E, Melani AGF, Romagnolo LG, Larach SW, Marescaux J. Robotic-assisted stereotactic real-time navigation: initial clinical experience and feasibility for rectal cancer surgery. Tech Coloproctol 2019; 23:53-63. [PMID: 30656579 DOI: 10.1007/s10151-018-1914-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 12/15/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Real-time stereotactic navigation for transanal total mesorectal excision has been demonstrated to be feasible in small pilot series using laparoscopic techniques. The possibility of real-time stereotactic navigation coupled with robotics has not been previously explored in a clinical setting. METHODS After pre-clinical assessment, and configuration of a robotic-assisted navigational system, two patients with locally advanced rectal cancer were selected for enrollment into a pilot study designed to assess the feasibility of navigation coupled with the robotic da Vinci Xi platform via TilePro interface. In one case, fluorescence-guided surgery was also used as an adjunct for structure localization, with local administration of indocyanine green into the ureters and at the tumor site. RESULTS Each operation was successfully completed with a robotic-assisted approach; image-guided navigation provided computed accuracy of ± 4.5 to 4.6 mm. The principle limitation encountered was navigation signal dropout due to temporary loss of direct line-of-sight with the navigational system's infrared camera. Subjectively, the aid of navigation assisted the operating surgeon in identifying critical anatomical planes. The combination of fluorescence with image-guided surgery further augmented the surgeon's perception of the operative field. CONCLUSIONS The combination of stereotactic navigation and robotic surgery is feasible, although some limitations and technical challenges were observed. For complex surgery, the addition of navigation to robotics can improve surgical precision. This will likely represent the next step in the evolution of robotics and in the development of digital surgery.
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Affiliation(s)
- S Atallah
- Department of Colorectal Surgery, EndoSurgical Center of Florida, Florida Hospital, 100 N. Dean Road, Orlando, FL, 32825, USA.
| | - E Parra-Davila
- Department of Surgery, Good Samaritan Hospital, West Palm Beach, FL, 33401, USA
| | - A G F Melani
- Department of Surgery, IRCAD, Latin America, Rio de Jeneiro, Brazil
| | - L G Romagnolo
- Department of Surgery, IRCAD, Latin America, Barretos, Brazil
| | - S W Larach
- Department of Colorectal Surgery, EndoSurgical Center of Florida, Florida Hospital, 100 N. Dean Road, Orlando, FL, 32825, USA
| | - J Marescaux
- Department of Surgery, IRCAD, France, Strasbourg, France
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23
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Knol J, Bonjer J, Houben B, Wexner SD, Hompes R, Atallah S, Heald RJ, Sietses C, Chadi SA. New Paradigm of Live Surgical Education: Synchronized Deferred Live Surgery. J Am Coll Surg 2018; 227:467-473. [PMID: 30118895 DOI: 10.1016/j.jamcollsurg.2018.07.660] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/23/2018] [Accepted: 07/24/2018] [Indexed: 01/28/2023]
Affiliation(s)
- Joep Knol
- Department of Surgery, Jessa Hospital, Hasselt, Belgium.
| | - Jaap Bonjer
- Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Bert Houben
- Department of Surgery, Jessa Hospital, Hasselt, Belgium
| | - Steven D Wexner
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL
| | - Roel Hompes
- Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Sam Atallah
- Department of Colorectal Surgery, Florida Hospital, Orlando, FL
| | | | - Colin Sietses
- Department of Surgery, Gelderse Vallei Hospital, Ede, The Netherlands
| | - Sami A Chadi
- Department of Surgery, University Health Network and the University of Toronto, Toronto, Ontario, Canada
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24
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Atallah S, Hodges A, Larach SW. Direct target NOTES: prospective applications for next generation robotic platforms. Tech Coloproctol 2018; 22:363-371. [PMID: 29855814 DOI: 10.1007/s10151-018-1788-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 05/04/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND A new era in surgical robotics has centered on alternative access to anatomic targets and next generation designs include flexible, single-port systems which follow circuitous rather than straight pathways. Such systems maintain a small footprint and could be utilized for specialized operations based on direct organ target natural orifice transluminal endoscopic surgery (NOTES), of which transanal total mesorectal excision (taTME) is an important derivative. METHODS During two sessions, four direct target NOTES operations were conducted on a cadaveric model using a flexible robotic system to demonstrate proof-of-concept of the application of a next generation robotic system to specific types of NOTES operations, all of which required removal of a direct target organ through natural orifice access. These four operations were (a) robotic taTME, (b) robotic transvaginal hysterectomy in conjunction with (c) robotic transvaginal salpingo-oophorectomy, and in an ex vivo model, (d) trans-cecal appendectomy. RESULTS Feasibility was demonstrated in all cases using the Flex® Robotic System with Colorectal Drive. During taTME, the platform excursion was 17 cm along a non-linear path; operative time was 57 min for the transanal portion of the dissection. Robotic transvaginal hysterectomy was successfully completed in 78 min with transvaginal extraction of the uterus, although laparoscopic assistance was required. Robotic transvaginal unilateral salpingo-oophorectomy with transvaginal extraction of the ovary and fallopian tube was performed without laparoscopic assistance in 13.5 min. In an ex vivo model, a robotic trans-cecal appendectomy was also successfully performed for the purpose of demonstrating proof-of-concept only; this was completed in 24 min. CONCLUSIONS A flexible robotic system has the potential to access anatomy along circuitous paths, making it a suitable platform for direct target NOTES. The conceptual operations posed could be considered suitable for next generation robotics once the technology is optimized, and after further preclinical validation.
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Affiliation(s)
- S Atallah
- Endo-Surgical Center of Florida, Department of Colorectal Surgery, Florida Hospital, Orlando, FL, USA.
| | - A Hodges
- Nova Southeastern University, Davie, FL, USA
| | - S W Larach
- Endo-Surgical Center of Florida, Department of Colorectal Surgery, Florida Hospital, Orlando, FL, USA
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25
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Yi D, Monson JRT, Stankiewicz CC, Atallah S, Finkler NJ. Impact of colorectal surgeon case volume on outcomes and applications to quality improvement. Int J Colorectal Dis 2018; 33:635-644. [PMID: 29569073 DOI: 10.1007/s00384-018-3018-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/04/2018] [Indexed: 02/04/2023]
Abstract
PURPOSE To evaluate the impact of surgeon case volumes on procedural, financial, and clinical outcomes in colorectal surgery and apply findings to improve hospital care quality. METHODS A retrospective review was performed using 2013-2014 administrative data from a large hospital system in Southeast U.S. region; univariate and multivariable regression analyses were used to explore the impact of surgeon case volume on outcomes. RESULTS One thousand one hundred ninety patients were included in this 2-year study. When compared with low-volume surgeons (LVS) (< 14 cases in 2 years), the high-volume surgeons (HVS) (> 34 cases) were estimated per case to have shorter cut-to-close time in the operation room by 79 min, ([95% CI 58 to 99]), lower total hospitalization cost by $4314, ([95% CI $2261 to $6367]), and shorter post-surgery and overall length of stay by 0.92 days, ([95% CI 0.50 to 1.35]) and 1.27 days ([95% CI 0.56 to 1.98]), respectively. The HVS also showed a higher tendency to choose a laparoscopic approach over an open approach, with an odds ratio of 3.16 ([95% CI 1.23 to 8.07]). When compared with medium-volume surgeons (MVS) (14-34 cases), the HVS were estimated per case to have shorter cut-to-close time in the operation room by 62 min ([95% CI 37 to 87]). Surgeon case volumes had no statistically significant impact on outcomes including in-hospital mortality, 30-day readmission, blood utilization, and surgical site infection (SSI). CONCLUSIONS Surgeon case volume had positive impacts on procedural, financial, and clinical outcomes and this finding may be used to improve hospital's quality of care.
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Affiliation(s)
- David Yi
- Department of Nursing, Florida Hospital, 601 E. Rollins Street, Orlando, FL, 32803, USA.
| | - John R T Monson
- Center for Colon & Rectal Surgery, Florida Hospital Medical Group, 2501 North Orange Avenue, Suite 240, Orlando, FL, 32803, USA
| | - Cathy C Stankiewicz
- Department of Nursing, Florida Hospital, 601 E. Rollins Street, Orlando, FL, 32803, USA
| | - Sam Atallah
- Center for Colon & Rectal Surgery, Florida Hospital Medical Group, 2501 North Orange Avenue, Suite 240, Orlando, FL, 32803, USA
| | - Neil J Finkler
- Executive Office, Florida Hospital, 601 E. Rollins Street, Orlando, FL, 32803, USA
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26
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Silva PA, Goulart A, Sousa M, Rios H, Atallah S, Leão P. Transanal total mesorectal excision with triangle rules: a road map to prevent injuries. Tech Coloproctol 2017; 21:819-820. [DOI: 10.1007/s10151-017-1698-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 09/19/2017] [Indexed: 11/30/2022]
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27
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Atallah S. Assessment of a flexible robotic system for endoluminal applications and transanal total mesorectal excision (taTME): Could this be the solution we have been searching for? Tech Coloproctol 2017; 21:809-814. [PMID: 29063220 DOI: 10.1007/s10151-017-1697-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 09/23/2017] [Indexed: 02/07/2023]
Affiliation(s)
- S Atallah
- Center for Colon and Rectal Surgery, Florida Hospital, Winter Park, FL, USA.
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28
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Alcántara-Quispe C, Xavier JM, Atallah S, Romagnolo LGC, Melani AGF, Jorge E, Muller RL, Machado RD, Faria EF. Laparoscopic left ureteral substitution using the cecal appendix after en-bloc rectosigmoidectomy: a case report and video demonstration. Tech Coloproctol 2017; 21:817-818. [PMID: 28993947 DOI: 10.1007/s10151-017-1694-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 09/06/2017] [Indexed: 11/30/2022]
Affiliation(s)
- C Alcántara-Quispe
- Department of Urology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil.
| | - J M Xavier
- Department of Urology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - S Atallah
- Center for Colon and Rectal Surgery, Florida Hospital, Winter Park, FL, USA
| | - L G C Romagnolo
- Department of Coloproctology, Cancer Hospital of Barretos, Barretos, São Paulo, Brazil
| | - A G F Melani
- Department of Coloproctology, Américas Medical City, Rio de Janeiro, Brazil
| | - E Jorge
- Department of Urology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - R L Muller
- Department of Urology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - R D Machado
- Department of Urology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - E F Faria
- Department of Urology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
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29
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Atallah S, Gaudet M, MacRae R, Cross P, Pantarotto J. Pretreatment PET SUV is Not Correlated With Tumor Growth Rate in Early Stage Non–small Cell Lung Cancer Treated With Stereotactic Radiation Therapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1651] [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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30
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Althoff A, Rowen R, Dakermandji M, Kelly J, Atallah S. Perineal rectosigmoidectomy combined with TAMIS rectopexy: a NOTES operation for rectal procidentia. Tech Coloproctol 2017; 21:815-816. [PMID: 28936765 DOI: 10.1007/s10151-017-1692-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 09/06/2017] [Indexed: 11/25/2022]
Affiliation(s)
- A Althoff
- Florida Hospital, Winter Park, FL, USA
| | - R Rowen
- Florida Hospital, Winter Park, FL, USA
| | | | - J Kelly
- Florida Hospital, Winter Park, FL, USA
| | - S Atallah
- Florida Hospital, Winter Park, FL, USA.
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31
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Brady RRW, Chapman SJ, Atallah S, Chand M, Mayol J, Lacy AM, Wexner SD. #colorectalsurgery. Br J Surg 2017; 104:1470-1476. [PMID: 28881004 DOI: 10.1002/bjs.10615] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 04/21/2017] [Accepted: 05/15/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND The use of social media platforms among healthcare professionals is increasing. A Twitter social media campaign promoting the hashtag #colorectalsurgery was launched with the aim of providing a specialty-specific forum to collate discussions and science relevant to an engaged, global community of coloproctologists. This article reviews initial experiences of the early adoption, engagement and utilization of this pilot initiative. METHODS The hashtag #colorectalsurgery was promoted via the online microblogging service Twitter across a 180-day interval. Data on all tweets containing the #colorectalsurgery hashtag were analysed using online analytical tools. Data included total number of tweets, number of views, and user engagement since registration and launch of the campaign. Content of tweet and user demographic analysis was undertaken. RESULTS The number of tweets using #colorectalsurgery grew rapidly following the launch on 24 April 2016; #colorectalsurgery was used in 15 708 tweets, which resulted in 65 398 696 impressions and involved 1863 individual Twitter accounts. Increased volumes of #colorectalsurgery tweets were noted in association with the timing of three major international colorectal surgical conferences, and geographical trends were noted. Some 88·4 per cent of all posts were by male users. The top 25 users by volume of #colorectalsurgery tweets had considerable influence and posted 8023 tweets (51·1 per cent). CONCLUSION Online global communities formed via healthcare-related hashtags, such as #colorectalsurgery, unify social media posts, scientists, surgeons and authors who have an interest in coloproctology. Furthermore, they facilitate greater connectivity among geographically separate users.
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Affiliation(s)
- R R W Brady
- Department of Colorectal Surgery, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - S J Chapman
- The John Goligher Colorectal Unit, St James's University Hospital, Leeds, UK
| | - S Atallah
- Department of Colon and Rectal Surgery, Florida Hospital, Orlando, Florida, USA
| | - M Chand
- Department of Colorectal Surgery, University College London, London, UK
| | - J Mayol
- Department of Surgery, Hospital Clinico, Instituto de Investigación Sanitaria San Carlos, Universidad Compluntense de Madrid, Madrid, Spain
| | - A M Lacy
- Department of Gastrointestinal Surgery, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - S D Wexner
- Digestive Disease Center, Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida, USA
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Atallah S, Al-Assaf H, Xu Y, El-Sayed S. Adrenocortical carcinoma: patterns of care and role of adjuvant radiation therapy-a population-based study and review of the literature. ACTA ACUST UNITED AC 2017; 24:e316-e322. [PMID: 28874901 DOI: 10.3747/co.24.3533] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE We reviewed the experience of a tertiary cancer centre in the management of adrenocortical carcinoma (acc) treated over 40 years. We also searched the literature for guidelines related to the treatment of acc and for evidence for adjuvant radiation therapy (rt). METHODS In a retrospective chart review, acc patients treated between January 1974 and December 2013 were identified, and patient demographics and tumour characteristics were extracted. Outcomes data, including dates and sites of failure, vital status, and cause of death, were collected. Overall survival was estimated using the Kaplan- Meier method. A medline search using PubMed, Ovid, and embase was used to review the literature about the role of rt and any available management guidelines for acc. RESULTS Of 81 patients identified during the chart review, 39 had confirmed acc. In 32 patients, surgical resection was performed, including in 2 patients with M1 disease. Of those 32 patients, 16 received adjuvant systemic treatment (mitotane or concurrent chemoradiation). Only 6 patients received adjuvant rt, of whom 3 are still alive (2 living with distant failure). At a median follow-up of 3.8 years, 28 patients had died (72%), 10 were living (26%), and 1 had been lost to follow-up. Of the 22 patients for whom failure data were available, 2 experienced local failure, and the rest, distant failure. CONCLUSIONS The current data are insufficient to make treatment recommendations. Use of collaborative databases and consensus about diagnostic and therapeutic guidelines are warranted for better identification of optimum management. Adjuvant rt could be a reasonable option for R1 disease, but further research is needed.
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Affiliation(s)
- S Atallah
- Radiation Medicine Program, The Ottawa Hospital, and.,Division of Radiation Oncology, University of Ottawa, Ottawa, ON
| | - H Al-Assaf
- Radiation Medicine Program, The Ottawa Hospital, and.,Division of Radiation Oncology, University of Ottawa, Ottawa, ON
| | - Y Xu
- Radiation Medicine Program, The Ottawa Hospital, and
| | - S El-Sayed
- Radiation Medicine Program, The Ottawa Hospital, and.,Division of Radiation Oncology, University of Ottawa, Ottawa, ON
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33
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Atallah S, Cook G, MacRae R, Cross P, Bezjak A, Hope A, Pantarotto J. Specific Growth Rate in Stage I Non-Small Cell Lung Cancer Treated With Stereotactic Body Radiation Therapy (SBRT). Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Atallah S, Zenoni S, Kelly J, Tilahun Y, Monson JRT. A blueprint for robotic navigation: pre-clinical simulation for transanal total mesorectal excision (taTME). Tech Coloproctol 2016; 20:653-4. [PMID: 27510523 DOI: 10.1007/s10151-016-1511-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 07/26/2016] [Indexed: 12/23/2022]
Affiliation(s)
- S Atallah
- Florida Hospital, Winter Park, FL, USA.
| | - S Zenoni
- Florida Hospital, Winter Park, FL, USA
| | - J Kelly
- Florida Hospital, Winter Park, FL, USA
| | - Y Tilahun
- Florida Hospital, Winter Park, FL, USA
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Abstract
Application-based technology has emerged as a method of modern information communication, and this has been applied towards surgical training and education. It allows surgeons the ability to obtain portable and instant access to information that is otherwise difficult to deliver. The iLappSurgery Foundation has recently launched the transanal total mesorectal excision educational application (taTME app) which provides a useful adjunct, especially for surgeons interested in mastery of the taTME technique and its principles. The article provides a detailed review of the application, which has achieved a large user-base since its debut in June, 2016.
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Affiliation(s)
- S Atallah
- Florida Hospital, Winter Park, FL, USA.
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36
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Abstract
Stereotactic navigation allows for real-time, image-guided surgery, thus providing an augmented working environment for the operator. This technique can be applied to complex minimally invasive surgery for fixed anatomic targets. Transanal minimally invasive surgery represents a new approach to rectal cancer surgery that is technically demanding and introduces the potential for procedure-specific morbidity. Feasibility of stereotactic navigation for TAMIS-TME has been demonstrated, and this could theoretically translate into improved resection quality by improving the surgeon's spatial awareness. The future of minimally invasive surgery as it relates to augmented reality and image-guided surgery is discussed.
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37
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Burke JP, Martin-Perez B, Khan A, Nassif G, de Beche-Adams T, Larach SW, Albert MR, Atallah S. Transanal total mesorectal excision for rectal cancer: early outcomes in 50 consecutive patients. Colorectal Dis 2016; 18:570-7. [PMID: 26749148 DOI: 10.1111/codi.13263] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 12/22/2015] [Indexed: 02/06/2023]
Abstract
AIM Minimally invasive approaches to proctectomy for rectal cancer have not been widely adopted due to inherent technical challenges. A modification of traditional transabdominal mobilization, termed transanal total mesorectal excision (TaTME), has the potential to improve access to the distal rectum. The aim of the current study is to assess outcomes following TaTME for rectal cancer. METHOD This is a retrospective analysis of a prospectively maintained database of consecutive patients who underwent TaTME for rectal cancer at a single institution. The study period was from 1 March 2012 to 31 July 2015. RESULTS During the study period 50 patients underwent TaTME. The median tumour distance from the anal verge was 4.4 (3.0-5.5) cm. The rate of conversion from a planned minimally invasive approach was 2.2%. The median operative time was 267.0 (227.0-331.0) min. The median lymph node yield was 18.0 (12.0-23.8), the macroscopic quality assessment of the resected specimen was incomplete in 2% and the circumferential resection margin positivity rate was 4%. Intra-operative morbidity occurred in 6% and the 30 day morbidity rate was 36%. The median length of stay was 4.5 (4.0-8.0) days. The median follow-up was 15.1 (7.0-23.2) months; two patients have developed a local recurrence and eight patients have developed distant recurrence. CONCLUSION These data suggest that TaTME for rectal cancer is feasible with an acceptable pathological outcome and morbidity profile. Further data on functional and long-term survival outcomes are required.
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Affiliation(s)
- J P Burke
- Center for Colon and Rectal Surgery, Florida Hospital, Orlando, Florida, USA
| | - B Martin-Perez
- Center for Colon and Rectal Surgery, Florida Hospital, Orlando, Florida, USA
| | - A Khan
- Center for Colon and Rectal Surgery, Florida Hospital, Orlando, Florida, USA
| | - G Nassif
- Center for Colon and Rectal Surgery, Florida Hospital, Orlando, Florida, USA
| | - T de Beche-Adams
- Center for Colon and Rectal Surgery, Florida Hospital, Orlando, Florida, USA
| | - S W Larach
- Center for Colon and Rectal Surgery, Florida Hospital, Orlando, Florida, USA
| | - M R Albert
- Center for Colon and Rectal Surgery, Florida Hospital, Orlando, Florida, USA
| | - S Atallah
- Center for Colon and Rectal Surgery, Florida Hospital, Orlando, Florida, USA
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Atallah S, Albert M, Monson JRT. Critical concepts and important anatomic landmarks encountered during transanal total mesorectal excision (taTME): toward the mastery of a new operation for rectal cancer surgery. Tech Coloproctol 2016; 20:483-94. [PMID: 27189442 DOI: 10.1007/s10151-016-1475-x] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 04/27/2016] [Indexed: 12/15/2022]
Abstract
Over the past 3 years, colorectal surgeons have begun to adapt the technique of transanal total mesorectal excision. As international experience has been quickly forged, an improved recognition of the pitfalls and the practical details of this disruptive technique have been realized. The purpose of this technical note was to express the various nuances of transanal total mesorectal excision as learned during the course of its clinical application and international teaching, so as to rapidly communicate and share important insights with other surgeons who are in the early adoption phase of this approach. The technical points specific to transanal total mesorectal excision are addressed herein. When correctly applied, these will likely improve the quality of surgery and decrease morbidity attributable to inexperience with the transanal approach to total mesorectal excision.
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Affiliation(s)
- S Atallah
- Florida Hospital, Winter Park, FL, USA.
| | - M Albert
- Florida Hospital, Winter Park, FL, USA
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Affiliation(s)
- S Atallah
- Florida Hospital, Winter Park, FL, USA.
| | - A DuBose
- Florida Hospital, Winter Park, FL, USA
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Atallah S, DuBose A. A mechanism for constructing a durable purse-string during transanal total mesorectal excision. Tech Coloproctol 2015; 19:751-2. [PMID: 26546006 DOI: 10.1007/s10151-015-1389-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Accepted: 10/26/2015] [Indexed: 11/24/2022]
Affiliation(s)
- S Atallah
- Florida Hospital, Winter Park, FL, USA.
| | - A DuBose
- Florida Hospital, Winter Park, FL, USA
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Atallah S, Thomas M, AL-Assaf H, Xu Y, El-Sayed S. One Center's Experience: Demographics, Treatment, and Outcome of Patients With Adrenocortical Carcinoma (ACC) Treated During the Past 40 Years. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Atallah S, Guth A, Chabolle F, Bach CA. Supraclavicular artery island flap in head and neck reconstruction. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:291-4. [DOI: 10.1016/j.anorl.2015.08.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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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Shen Z, Ye Y, Atallah S, Xie Q, Jiang K, Wang S. [Three procedures of transanal minimally invasive surgery (TAMIS) for advanced mid-low rectal tumor]. Zhonghua Wei Chang Wai Ke Za Zhi 2015; 18:998-1001. [PMID: 26499144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Transanal minimally invasive surgery (TAMIS) is a novel minimally invasive procedure which is performed by normal laparoscopic instruments through the single port transanally. Three kinds of procedures have been performed based on the TAMIS platform by now, including TAMIS-TME(total mesorectal excision), TAMIS-APE(Abdominoperineal excision) and TAMIS-Hartmann. Transanal total mesorectal excision (taTME) with dissection from bottom to up through the platform of TAMIS is also called TAMIS-TME. The greatest advantage of TAMIS-TME is that it increases the quality of specimen and decrease the adverse injury due to the sufficient vision of lower part of mesorectum in the operation. TAMIS-APE and TAMIS-Hartmann procedures emerge after the experience of TAMIS-TME. TAMIS-APE procedure not only firstly make the dissection of perineal phase minimally invasive, but also make the perineal vision more clear, the resection of levator ani muscle more precise, eventually the tailored APE procedure comes true under the laparoscopy of perineal phase. The dissection of mid-low mesorectum for recurrent tumor is usually difficult just from above, TAMIS facilitates the resection through entering the normal anatomical space under the tumor. If the tumor has the risk of recurrence, distal rectum is closed and proximal colostomy is made, we firstly performed this procedure and name it TAMIS-Hartmann. Therefore, TAMIS is not only a platform for taTME, but also it provides a transanal approach and a "button to up" conception for the mid-low rectal tumor.
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Affiliation(s)
- Zhanlong Shen
- Department of Gastroenterological Surgery, Laboratory of Surgical Oncology, Peking University People's Hospital, Beijing 100044, China. ;
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Atallah S, Thomas M, Al-Assaf H, El-Sayed S. 2235 Adrenocortical carcinoma (ACC), what is the optimum management? A report of single center experience. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31151-0] [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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Affiliation(s)
- S Atallah
- Florida Hospital, Winter Park, FL, USA,
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Atallah S, Drake J, Martin-Perez B, Kang C, Larach S. Robotic transanal total mesorectal excision with intersphincteric dissection for extreme distal rectal cancer: a video demonstration. Tech Coloproctol 2015; 19:435. [PMID: 25962631 DOI: 10.1007/s10151-015-1304-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 04/14/2015] [Indexed: 12/11/2022]
Affiliation(s)
- S Atallah
- Florida Hospital, Winter Park, FL, USA,
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Quddus A, Martin-Perez B, Schoonyoung H, Albert M, Atallah S. Toxic megacolon during pregnancy in ulcerative colitis: A case report. Int J Surg Case Rep 2015; 11:83-86. [PMID: 25942749 PMCID: PMC4446693 DOI: 10.1016/j.ijscr.2015.04.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/06/2015] [Accepted: 04/26/2015] [Indexed: 01/24/2023] Open
Abstract
Ulcerative colitis has a peak incidence which coincides with the childbearing age of females. Acute fulminant colitis during pregnancy is rare, but requires mandatory surgical colectomy which carries a significant risk to both mother and fetus. We recommend that female patients planning to conceive with a known diagnosis of ulcerative colitis have an optimised medical regimen by liaising with their obstetricians and gastroenterologists to prevent exacerbations and the development of toxic megacolon. Should surgical intervention become required, this can be performed with favourable outcomes for mother and child as demonstrated in this report.
Introduction Ulcerative colitis is an idiopathic inflammatory bowel condition whose peak incidence coincides with fertility in female patients. In pregnancy, acute fulminant colitis is rare, and, when it becomes refractory to maximum medical therapy, emergency colectomy is mandated. Over the past quarter century, there have been few reports of this rare event in the literature. Presentation of case We report a 26 year old primigravida female who presented with toxic megacolon during the third trimester of pregnancy, unresponsive to medical therapy. She subsequently underwent an urgent low transverse caesarean section with a total colectomy. Both mother and child made a satisfactory recovery post operatively. Discussion Although the fetus is at higher risk than the mother in such a circumstance, morbidity and mortality rates are still noticeably high for both, and therefore, prompt diagnosis is key. Conclusion It is imperative that female patients planning to conceive with a known diagnosis of ulcerative colitis liaise with their obstetricians and gastroenterologists early to optimise medical treatment to prevent the development of a toxic megacolon and that conception is planned during a state of remission. Should surgical intervention become required, this can be performed with favourable outcomes for mother and child, as demonstrated in this report.
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Affiliation(s)
- Ayyaz Quddus
- Department of Gastroenterology, Royal Free Hospital, London, United Kingdom.
| | | | - Henry Schoonyoung
- Florida Hospital Division of Colon and Rectal Surgery,Orlando, FL, USA
| | - Matthew Albert
- Florida Hospital Division of Colon and Rectal Surgery,Orlando, FL, USA
| | - Sam Atallah
- Florida Hospital Division of Colon and Rectal Surgery,Orlando, FL, USA
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Atallah S, Martin-Perez B, Keller D, Burke J, Hunter L. Natural-orifice transluminal endoscopic surgery. Br J Surg 2015; 102:e73-92. [PMID: 25627137 DOI: 10.1002/bjs.9710] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 10/20/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND Natural-orifice transluminal endoscopic surgery (NOTES) represents one of the most significant innovations in surgery to emerge since the advent of laparoscopy. A decade of progress with this approach has now been catalogued, and yet its clinical application remains controversial. METHODS A PubMed search was carried out for articles describing NOTES in both the preclinical and the clinical setting. Public perceptions and expert opinion regarding NOTES in the published literature were analysed carefully. RESULTS Two hundred relevant articles on NOTES were studied and the outcomes reviewed. A division between direct- and indirect-target NOTES was established. The areas with the most promising clinical application included direct-target NOTES, such as transanal total mesorectal excision and peroral endoscopic myotomy. The clinical experience with distant-target NOTES, such as for appendicectomy and cholecystectomy, showed feasibility; however, NOTES-specific morbidity was introduced and this represents an important limitation. CONCLUSION NOTES experimentation in the preclinical setting has increased substantially. There has also been a significant increase in the application of NOTES in humans in the past decade. Enthusiasm for NOTES should be tempered by the risk of incurring NOTES-specific morbidity. Surgeons should carefully consider patient preferences regarding this new minimally invasive option, as opinions are not unanimously supportive of NOTES. As technical limitations are overcome, the clinical application of NOTES is predicted to increase. It is paramount that, when this complex technique is performed on humans, it is applied judiciously by appropriately trained experts with outcomes recorded in a registry.
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Affiliation(s)
- S Atallah
- Department of Colon and Rectal Surgery, Florida Hospital, Orlando, Florida
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Atallah S, Martin-Perez B, Drake J, Stotland P, Ashamalla S, Albert M. The use of a lighted stent as a method for identifying the urethra in male patients undergoing transanal total mesorectal excision: a video demonstration. Tech Coloproctol 2015; 19:375. [PMID: 25813337 DOI: 10.1007/s10151-015-1297-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Accepted: 03/12/2015] [Indexed: 10/23/2022]
Affiliation(s)
- S Atallah
- Florida Hospital, Winter Park, FL, USA,
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Atallah S, Martin-Perez B, Albert M, Schoonyoung H, Quinteros F, Hunter L, Larach S. Vaginal Access Minimally Invasive Surgery (VAMIS): A New Approach to Hysterectomy. Surg Innov 2014; 22:344-7. [PMID: 25432882 DOI: 10.1177/1553350614560273] [Citation(s) in RCA: 13] [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] [Indexed: 01/08/2023]
Abstract
Vaginal hysterectomy is the original natural orifice operation. Although one of the most common gynecologic operations performed, the surgical approach has not changed significantly during the past century. This article describes a new approach to hysterectomy using vaginal access minimally invasive surgery (VAMIS). VAMIS hysterectomy is successfully performed on a cadaveric model. The step-by-step description of the surgical technique is depicted with video supplement.
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