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Hamel JF, Joris J, Slim K, Régimbeau JM, Cotte E, Léger M, Venara A, Agut E, Alfonsi P, Alili A, Amraoui J, Andre A, Arimon JM, Arnalsteen L, Asztalos R, Audouy C, Aumont O, Auvray S, Baietto H, Balbo G, Aguilera MB, Beaupel N, Beaupel N, Lazreg ZB, Beguinot-Holtzscherer S, Beller JP, Bellouard A, Henda IB, Bentamene M, Bernard P, Berthon N, Biblocque A, Bievre T, Bilosi M, Blanc B, Blatt A, Blehaut D, Bock A, Bongiovanni JP, Bonnet M, Bouarroudj N, Boissier D, Boret H, Borg R, Bouchair Z, Bouchard F, Boumadani M, Bounicaud D, Bourdeix O, Bourseau JC, Bozio G, Brachet D, Brek A, Briez N, Buisset-Subiran C, Calvet B, Cartaux-Taieb A, Castiglioni M, Catinois M, Du Rieu MC, Chalumeau C, Chambrier G, Chamlou R, Chapel N, Chenet P, Chirac P, Chokkairi S, Chopin X, Christou N, Chuffart E, Corfiotti F, Craus C, Cuellar E, Dardenne G, de Angelis N, de Ioro U, Dechanet F, Dellis R, Demasles L, Denet C, Deroo B, Desfourneaux-Denis V, Dileon S, Douard R, Dorado C, Dorscheid E, Dumont F, Durame F, Duchalais E, Dupre A, Dufraisse S, Elghali MA, Hutin E, Emna A, Essome E, Fabre N, Faivre V, Faucheron JL, Favoulet P, Fernou P, Firtion O, Flamein R, Florea S, de la Fontaine C, Forestier D, Fourn E, Frentiu DV, Frisoni R, Frisoni A, Gautier T, Genty F, Georgeanu S, Germain A, Gibert S, Gilbert B, Gignoux B, Goasguen N, Goubault P, Gres P, Guedj J, Guignard B, Gugenheim J, Guaquiere C, Guiot JL, Guinier D, Hail K, Hatwel C, Iatan E, Janecki T, Jany T, Jaspart J, Journe F, Jouffret L, Kassoul A, Kattou F, Keller P, Knepfler T, Khouri T, Kothonidis K, Landreau P, Langlois G, Le Bartz G, Lebas S, Leonard D, Leonard D, Leporrier J, Lescure G, Lewandowski R, Liddo A, Longeville JH, Lucescu I, Mariani A, Mariani P, Martin G, Martinet O, Massalou D, Massard JL, Mauvais F, Mazza D, Katapile JM, Milou F, Mirre F, Martinez CM, Mensier A, Mergui C, Mestrallet JP, Meyer C, Mocellin N, Montagne S, Naseef O, Orville M, Ostermann-Bucher S, Ouaissi M, Paqueron X, Paquet C, Passebois L, Pichot-Delahaye V, Pillet M, Pottie JC, Plard L, Plumereau F, Poincenot J, Poisblanc M, Poupard B, Proske JM, Puche P, Raspado O, Riboud R, Rakotoarisoa B, Raynaud K, Razafindratsira T, Renaud M, Rio D, Rio D, Ripoche J, Roussel B, Denis MS, Salaun P, Sage PY, Scherrer ML, Sirisier F, Smeets B, Smejkal M, Steinmetz JP, Tavernier M, Thievenaz R, Tirca M, Toque L, Triki E, Tzanis D, Vacher B, Vanwymeersch S, Vauclair E, Verhaeghe R, Vetrila V, Vieuille C, Vermeulen F, Vignal JC, Voilin C, de Wailli P, Wolthuis A, Zaepfel S. Transversus Abdominis Block or Wound Infiltration Should be Performed in Colorectal Surgery Patients in an Enhanced Recovery Setting: a Propensity Score Analysis of a National Database. J Gastrointest Surg 2022; 27:798-802. [PMID: 36376728 DOI: 10.1007/s11605-022-05514-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/29/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Jean-Francois Hamel
- Department of Biostatistics, Maison de La Recherche, University Hospital of Angers, 4 Rue Larrey, Cedex 9, 49933, Angers, France.,Faculty of Health, Department of Medicine, Angers, France
| | - Jean Joris
- Department of Anesthesiology, CHU Liège, Liège, Belgium
| | - Karem Slim
- Department of Visceral Surgery, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France
| | - Jean Marc Régimbeau
- Service de Chirurgie Digestive, CHU Amiens Picardie Et Université de Picardie Jules Verne, Amiens, France.,Unité de Recherche Clinique SSPC (Simplifications Des Soins Des Patients Complexes) UR UPJV 7518, Université de Picardie Jules Verne, Amiens, France
| | - Eddy Cotte
- Department of Visceral Surgery, CHU Lyon, Centre Hospitalier Lyon-Sud, 69495, Pierre-Bénite Cedex, France.,Université de Lyon, Lyon, France
| | - Maxime Léger
- Faculty of Health, Department of Medicine, Angers, France.,Department of Anesthesiology, University Hospital of Angers, 4 Rue Larrey, Cedex 9, 49933, Angers, France
| | - Aurélien Venara
- Faculty of Health, Department of Medicine, Angers, France. .,Department of Visceral and Endocrinal Surgery, University Hospital of Angers, 4 Rue Larrey, Cedex 9, 49933, Angers, France. .,IHFIH, UPRES EA 3859, University of Angers, Angers, France.
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Chenevas-Paule Q, Trilling B, Sage PY, Girard E, Faucheron JL. Laparoscopic segmental left colectomy for splenic flexure carcinoma: a single institution experience. Tech Coloproctol 2019; 24:41-48. [PMID: 31834555 DOI: 10.1007/s10151-019-02126-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 01/27/2019] [Accepted: 11/21/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND There is ongoing debate regarding surgical treatment of splenic flexure cancer. The main points of controversy include the appropriate extent of colon resection, either to the right or to the left, and the appropriate extent of lymph-node dissection. The aim of this study was to review our experience in laparoscopic treatment of splenic flexure cancer cases and to compare our data to the recent literature. METHODS Consecutive patients, operated on for splenic flexure colon carcinoma at a single institution between April 2005 and January 2013, were included in the study. Exclusion criteria were a previous history of colorectal cancer, recurrent colonic cancer, emergency cases with an obstructive tumor or a perforated tumor with peritonitis, synchronous cancer, palliative surgery, and a past history of colorectal resection. Patients underwent laparoscopic segmental left colectomy with ligation of the left branch of the middle colic and of the left colic artery. Patient characteristics, operative and postoperative outcomes, and long-term technical, functional, and oncological results from a prospectively maintained database were retrospectively analyzed. After hospital discharge, standardized follow-up was performed at 1 month postoperatively, then every 3 months during the first 2 years, and every 6 months thereafter, for a total of 5 years. RESULTS A total of 28 consecutive patients (16 males) with a median age of 71.8 years (range 42.5-88.8 years) were included. Ninety-day mortality was 3.5% and surgical morbidity was 21.5% with anastomotic leak rate of 10.7%. All survivors experienced good or very good functional results. During a median follow-up period of 50.9 months, eight patients (28.5%) presented with a recurrence. The 5-year overall and disease-free survival rates were 46.3% and 39.2%, respectively. CONCLUSIONS Segmental left colectomy for splenic flexure carcinoma is associated with reasonably low morbidity and very good functional results. However, survival rates are low.
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Affiliation(s)
- Q Chenevas-Paule
- Colorectal Unit, Department of Surgery, Michallon University Hospital, 38000, Grenoble, France
| | - B Trilling
- Colorectal Unit, Department of Surgery, Michallon University Hospital, 38000, Grenoble, France.,University Grenoble Alps, UMR 5525, CNRS, TIMC-IMAG, 38000, Grenoble, France
| | - P Y Sage
- Colorectal Unit, Department of Surgery, Michallon University Hospital, 38000, Grenoble, France
| | - E Girard
- Colorectal Unit, Department of Surgery, Michallon University Hospital, 38000, Grenoble, France.,University Grenoble Alps, UMR 5525, CNRS, TIMC-IMAG, 38000, Grenoble, France
| | - J L Faucheron
- Colorectal Unit, Department of Surgery, Michallon University Hospital, 38000, Grenoble, France. .,University Grenoble Alps, UMR 5525, CNRS, TIMC-IMAG, 38000, Grenoble, France. .,Colorectal Unit, Department of Surgery, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex, France.
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Manceau G, Mege D, Bridoux V, Lakkis Z, Venara A, Voron T, De Angelis N, Ouaissi M, Sielezneff I, Karoui M, Dazza M, Gagnat G, Hamel S, Mallet L, Martre P, Philouze G, Roussel E, Tortajada P, Dumaine AS, Heyd B, Paquette B, Brunetti F, Esposito F, Lizzi V, Michot N, Denost Q, Tresallet C, Tetard O, Regimbeau JM, Sabbagh C, Rivier P, Fayssal E, Collard M, Moszkowicz D, Peschaud F, Etienne JC, loge L, Beyer L, Bege T, Corte H, D'Annunzio E, Humeau M, Issard J, Munoz N, Abba J, Jafar Y, Lacaze L, Sage PY, Susoko L, Trilling B, Arvieux C, Mauvais F, Ulloa‐Severino B, Lefevre JH, Pitel S, Vauchaussade de Chaumont A, Badic B, Blanc B, Bert M, Rat P, Ortega‐Deballon P, Chau A, Dejeante C, Piessen G, Grégoire E, Alfarai A, Cabau M, David A, Kadoche D, Dufour F, Goin G, Goudard Y, Pauleau G, Sockeel P, De la Villeon B, Pautrat K, Eveno C, Brouquet A, Couchard AC, Balbo G, Mabrut JY, Bellinger J, Bertrand M, Aumont A, Duchalais E, Messière AS, Tranchart A, Cazauran JB, Pichot‐Delahaye V, Dubuisson V, Maggiori L, Djawad‐Boumediene B, Fuks D, Kahn X, Huart E, Catheline JM, Lailler G, Baraket O, Baque P, Diaz de Cerio JM, Mariol P, Maes B, Fernoux P, Guillem P, Chatelain E, de Saint Roman C, Fixot K. Thirty-day mortality after emergency surgery for obstructing colon cancer: survey and dedicated score from the French Surgical Association. Colorectal Dis 2019; 21:782-790. [PMID: 30884089 DOI: 10.1111/codi.14614] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 12/09/2018] [Accepted: 02/27/2019] [Indexed: 02/08/2023]
Abstract
AIM The aim was to define risk factors for postoperative mortality in patients undergoing emergency surgery for obstructing colon cancer (OCC) and to propose a dedicated score. METHOD From 2000 to 2015, 2325 patients were treated for OCC in French surgical centres by members of the French National Surgical Association. A multivariate analysis was performed for variables with P value ≤ 0.20 in the univariate analysis for 30-day mortality. Predictive performance was assessed by the area under the receiver operating characteristic curve. RESULTS A total of 1983 patients were included. Thirty-day postoperative mortality was 7%. Multivariate analysis found five significant independent risk factors: age ≥ 75 (P = 0.013), American Society of Anesthesiologists (ASA) score ≥ III (P = 0.027), pulmonary comorbidity (P = 0.0002), right-sided cancer (P = 0.047) and haemodynamic failure (P < 0.0001). The odds ratio for risk of postoperative death was 3.42 with one factor, 5.80 with two factors, 15.73 with three factors, 29.23 with four factors and 77.25 with five factors. The discriminating capacity in predicting 30-day postoperative mortality was 0.80. CONCLUSION Thirty-day postoperative mortality after emergency surgery for OCC is correlated with age, ASA score, pulmonary comorbidity, site of tumour and haemodynamic failure, with a specific score ranging from 0 to 5.
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Affiliation(s)
- G Manceau
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - D Mege
- Department of Digestive Surgery, Timone University Hospital, Marseille, France
| | - V Bridoux
- Department of Digestive Surgery, Charles Nicolle University Hospital, Rouen, France
| | - Z Lakkis
- Department of Digestive Surgery, Besançon University Hospital, Besançon, France
| | - A Venara
- Department of Digestive Surgery, Angers University Hospital, Angers, France
| | - T Voron
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Saint Antoine Hospital, Sorbonne Université, Paris, France
| | - N De Angelis
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Henri Mondor Hospital, Université Paris-Est (UEP), Créteil, France
| | - M Ouaissi
- Department of Digestive Surgery, Tours University Hospital, Tours, France
| | - I Sielezneff
- Department of Digestive Surgery, Timone University Hospital, Marseille, France
| | - M Karoui
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière Hospital, Sorbonne Université, Paris, France
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Abstract
INTRODUCTION Pancreatic trauma (PT) is associated with high morbidity and mortality; the therapeutic options remain debated. MATERIAL AND METHODS Retrospective study of PT treated in the University Hospital of Grenoble over a 22-year span. The decision for initial laparotomy depended on hemodynamic status as well as on associated lesions. Main pancreatic duct lesions were always searched for. PT lesions were graded according to the AAST classification. RESULTS Of a total of 46 PT, 34 were grades II or I. Hemodynamic instability led to immediate laparotomy in 18 patients, for whom treatment was always drainage of the pancreatic bed; morbidity was 30%. Eight patients had grade III injuries, six of whom underwent immediate operation: three underwent splenopancreatectomy without any major complications while the other three who had simple drainage required re-operation for peritonitis, with one death related to pancreatic complications. Four patients had grades IV or V PT: two pancreatoduodenectomies were performed, with no major complication, while one patient underwent duodenal reconstruction with pancreatic drainage, complicated by pancreatic and duodenal fistula requiring a hospital stay of two months. The post-trauma course was complicated for all patients with main pancreatic duct involvement. Our outcomes were similar to those found in the literature. CONCLUSION In patients with distal PT and main pancreatic duct involvement, simple drainage is associated with high morbidity and mortality. For proximal PT, the therapeutic options of drainage versus pancreatoduodenectomy must be weighed; pancreatoduodenectomy may be unavoidable when the duodenum is injured as well. Two-stage (resection first, reconstruction later) could be an effective alternative in the emergency setting when there are other associated traumatic lesions.
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Affiliation(s)
- E Girard
- Service de chirurgie digestive et de l'urgence, hôpital Michallon, CHU, boulevard de la Chantourne, 38700 La Tronche, France
| | - J Abba
- Service de chirurgie digestive et de l'urgence, hôpital Michallon, CHU, boulevard de la Chantourne, 38700 La Tronche, France
| | - C Arvieux
- Service de chirurgie digestive et de l'urgence, hôpital Michallon, CHU, boulevard de la Chantourne, 38700 La Tronche, France
| | - B Trilling
- Service de chirurgie digestive et de l'urgence, hôpital Michallon, CHU, boulevard de la Chantourne, 38700 La Tronche, France
| | - P Y Sage
- Service de chirurgie digestive et de l'urgence, hôpital Michallon, CHU, boulevard de la Chantourne, 38700 La Tronche, France
| | - N Mougin
- Service de chirurgie digestive et de l'urgence, hôpital Michallon, CHU, boulevard de la Chantourne, 38700 La Tronche, France
| | - S Perou
- Service de chirurgie digestive et de l'urgence, hôpital Michallon, CHU, boulevard de la Chantourne, 38700 La Tronche, France
| | - P Lavagne
- Réanimation post-chirurgicale, hôpital Michallon, CHU, boulevard de la Chantourne, 38700 La Tronche, France
| | - C Létoublon
- Service de chirurgie digestive et de l'urgence, hôpital Michallon, CHU, boulevard de la Chantourne, 38700 La Tronche, France.
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