Publications by authors named "Alexandre Challine"
Background: The efficacy of the laparoscopic approach for total gastrectomy(TG) in Western countries remains under discussion. Recently, Textbook Outcome(TO) has gained recognition as a comprehensive measure of care quality in upper gastrointestinal surgery. Although predictive factors for TO after TG are well-documented, the influence of the surgical approach requires further analysis.
View Article and Find Full Text PDFAim: Diverting ileostomy (DS) after restorative proctocolectomy (RPC) can be omitted in selected patients. Its omission could improve functional outcomes and quality of life (QoL), as has been demonstrated in patients after proctectomy. The aim of this study was to report the impact of diverting ileostomy on functional outcomes and QoL after ileal pouch-anal anastomosis (IPAA).
View Article and Find Full Text PDFObjective: To report the 90-day mortality benefit associated with the implementation of the new regulatory reform on oncological surgical digestive authorizations.
Summary Background Data: New thresholds in digestive cancer surgery were applied in 2023, accrediting centers for major interventions. No evidence has been provided to support their justification.
Objective: To clarify the impact of the preoperative time intervals on short-term postoperative and pathologic outcomes in patients with esophageal cancer who underwent neoadjuvant chemoradiotherapy (nCRT) followed by esophagectomy.
Background: The impact of preoperative intervals on patients with esophageal cancer who received multimodality treatment remains unknown.
Methods: Patients (cT1-4aN0-3M0) treated with nCRT plus esophagectomy were included using the Dutch national DUCA database.
Background: For the elderly patients with gastric cancer, it may be more challenging to tolerate complete neoadjuvant therapy (NAT). The impact of discontinued NAT on the surgical safety and pathological outcomes of elderly patients with poor tolerance remains poorly understood.
Methods: Gastric cancer patients received gastrectomy with curative intent from the Dutch upper GI cancer audit (DUCA) database were included in this study.
Article Synopsis
- The study aimed to analyze the rates of definitive stoma and the incidence of follow-up reconstructive surgeries in patients who underwent subtotal colectomy (STC) for inflammatory bowel disease (IBD).
- Conducted as a national retrospective study in France from 2013 to 2021, it included 1,860 patients, with the majority suffering from ulcerative colitis, and assessed the relationship between definitive stoma and various risk factors.
- Results showed that 33% of patients had a definitive stoma, with significant risk factors being older age, Crohn's disease, surgical complications, a situation involving laparotomy, and treatment at low-volume hospitals.
Background: Although numerous treatments exist for the management of rectovaginal fistula, none has demonstrated its superiority. The role of diverting stoma remains controversial. A few series include Martius flap in the armamentarium.
View Article and Find Full Text PDFBackground: Although the incidence of BTC is raising, national healthcare strategies to improve care lack. We aimed to explore patient clinical care pathways and strategies to improve biliary tract cancer (BTC) care.
Methods: We analysed the French National Healthcare database of all BTC inpatients between January 1, 2017 and December 31, 2021.
Background: The aim of our study was to evaluate the external validity of the MIRO randomized controlled trial findings in a similar nationwide setting "real life" population, especially the benefit of a hybrid approach in esophageal resection for pulmonary complication. The external validity of randomized controlled trial findings to the general population with the same condition remains problematic because of the inherent selection bias and rigid inclusion criteria.
Methods: This study was a cohort study from a National Health Database (Programme de Medicalisation des Systemes d'Informations) between 2010 and 2022.
Introduction: Contradictions remain on the impact of interhospital competition on the quality of care, mainly the mortality. The aim of the study is to evaluate the impact of interhospital competition on postoperative mortality after surgery for colorectal cancer in France.
Methods: We conducted a retrospective cross-sectional study from 2015 to 2019.
Surgical resection of adrenocortical carcinoma (ACC) is the only curative treatment. Even in localized (I-II) stages, open adrenalectomy (OA) is the gold standard, though laparoscopic adrenalectomy (LA) can be proposed in selected patients. Despite the postoperative benefits of LA, its role in the surgical management of patients with ACC remains controversial regarding oncologic outcomes.
View Article and Find Full Text PDFBackground: Acute appendicitis represents the leading cause of acute gastrointestinal disorders, but only a small series regarding ambulatory appendectomies are available. The aim of this study was to report the results of ambulatory (day-case) appendectomy for acute appendicitis in a large consecutive cohort and to improve selection criteria in order to extend the indications.
Methods: All appendectomy procedures for acute appendicitis (March 2013 to June 2020) were included retrospectively.
Purpose: The present study assessed the factors associated with the maintenance of a functional anastomosis in a large consecutive series of patients with anastomotic leakage (AL).
Methods: All consecutive patients presenting with AL after colorectal or coloanal anastomosis (2012-2019) were analyzed. The primary end point was a functional anastomosis without a stoma at 1 year.
Purpose: C-reactive protein (CRP) is a useful predictive test to early detect abdominal complication after colorectal surgery. Inflammatory bowel disease (IBD) is responsible for chronic inflammation and abnormal basal CRP that could influence the interest of its management after abdominal surgery. The aim of this study is to evaluate CRP as an indicator of postoperative complication in a specific IBD population.
View Article and Find Full Text PDFArticle Synopsis
- A study investigated successful pregnancy rates among women who had either ileal pouch anal (IPAA) or ileorectal (IRA) surgery for inflammatory bowel disease (IBD) or polyposis in France from 2010 to 2020.
- Out of 1491 women, only 15% achieved successful deliveries, with no significant difference in pregnancy rates between the IPAA and IRA groups after adjustments.
- The laparoscopic surgical method was linked to an increased likelihood of achieving pregnancy compared to the general population, indicating that both IRA and IPAA surgeries generally reduce fertility.
Importance: Caustic ingestion in adults may result in death or severe digestive sequelae. The scarcity of nationwide epidemiological data leads to difficulties regarding the applicability of their analysis to less specialized centers, which are nevertheless largely involved in the emergency management of adverse outcomes following caustic ingestion.
Objective: To assess outcomes associated with caustic ingestion in adults across a nationwide prospective database.
Background: Laparoscopy for gastric cancer has not been as popular compared with other digestive surgeries, with conflicting reports on outcomes. The aim of this study focuses on the surgical techniques comparing open and laparoscopy by assessing the morbi-mortality and long-term complications after gastrectomy.
Methods: A retrospective study (2013-2018) was performed on a prospective national cohort (PMSI).
Background: This paper reports our experience of the perioperative management of patients with sporadic, non-malignant, pancreatic insulinoma.
Methods: A retrospective monocentric cohort study was performed from January 1989 to July 2019, including all the patients who had been operated on for pancreatic insulinoma. The preoperative work-up, surgical management, and postoperative outcome were analyzed.
Background: The outbreak of coronavirus disease 2019 (COVID-19) infection has led to the reorganization of hospital care in several countries. The objective was to report the postoperative mortality after elective digestive resections in a nationwide cohort during the lockdown period.
Methods: This analytic study was performed using a national billing database (the Programme de Médicalisation des Systèmes d'Informations).
Article Synopsis
- - Pancreatic fistula (PF) is a major complication after pancreatic surgery, affecting about 30% of patients, and involves the failure of the pancreas to heal properly after procedures like distal pancreatectomy.
- - The study proposes that using somatostatin-14, a natural hormone with a stronger affinity for somatostatin receptors, may better prevent PF compared to octreotide, a common treatment.
- - The PreFiPS study will compare the effectiveness of somatostatin and octreotide in preventing PF and will also assess other factors like hospital stay duration, readmission rates, and overall quality of life post-surgery.
Background And Objectives: It has been suggested that tumor deposits (TDs) may have a worse prognosis in rectal cancer compared with colonic cancer. The aim of this study was to assess TDs prognosis in rectal cancer.
Methods: Patients who underwent total mesorectum excision for rectal adenocarcinoma (2011-2016) were included.