Publications by authors named "Cotte E"
Background And Aims: Postoperative recurrence requiring medical treatment intensification or redo-surgery is common after ileocolic resection (ICR) for Crohn's disease (CD). This study aimed to identify a subgroup of CD patients for whom ICR could achieve durable remission.
Methods: This retrospective follow-up study analyzed 592 CD patients who underwent ICR (2013-2015) in a nationwide prospective cohort.
Background: This article summarizes the French intergroup guidelines regarding rectal adenocarcinoma (RA) management published in September 2023, available on the French Society of Gastroenterology website.
Methods: This work was supervised by French medical and surgical societies involved in RA management. Recommendations were rated from A to C according to the literature until September 2023.
Background: The OPERA trial has shown that a contact X-ray brachytherapy 50 kV (CXB) boost with neoadjuvant chemoradiotherapy (NCRT) can increase organ preservation (OP) rate for early rectal adenocarcinoma (ADK) of low-mid rectum. We report the results after 5 years of follow-up.
Patients And Methods: OPERA was a multicentre, phase III trial that included operable patients (pts), with cT2-cT3b low-mid rectal ADK, tumours <5 cm, cN0 or cN1 <8 mm.
Background: Acute right colic diverticulitis (ARD) is less frequent in Western countries than acute sigmoid diverticulitis (ASD). We aimed to compare the management of ARD and ASD operated on in emergency.
Methods: All consecutive patients who had emergency surgery for ASD and ARD (2010-2021) were included in a retrospective, multicenter, cohort study.
Background: The potential oncological benefit of extending the waiting period between neoadjuvant radiochemotherapy and surgical resection for rectal cancer is debated.
Objective: To evaluate the impact of prolonging this waiting period on the 5-year oncological prognosis and 2-year functional result of locally advanced rectal adenocarcinoma.
Design: Phase III, multicenter, randomized, open-label, parallel-group, controlled trial.
Article Synopsis
- The study aims to assess how socioeconomic deprivation affects postoperative outcomes in patients who have undergone surgery for sigmoid diverticulitis (SD).
- Conducted across 41 French hospitals from 2010 to 2021, researchers found that 20% of the 6,415 patients experienced severe complications within 90 days post-surgery.
- Results indicated that higher levels of socioeconomic deprivation are linked to an increased risk of severe complications, even after adjusting for factors like age, sex, and surgery type.
Article Synopsis
- High compliance with enhanced recovery programs (ERP) is correlated with better healthcare outcomes, specifically in liver surgery (LS) patients.
- A study analyzed 706 LS patients and found that those with over 70% ERP compliance had significantly higher rates of achieving textbook outcomes (TO) compared to those with lower compliance.
- Key factors negatively affecting TO achievement included having cholangiocarcinoma, undergoing high complexity LS, experiencing intraoperative hypotension, and suffering from postoperative ileus.
Background: Postoperative rectovaginal fistula leads to a loss of patients' quality of life and presents significant challenges to the surgeon. The literature focusing specifically on postoperative rectovaginal fistulas is limited. The objective of the present study is to identify factors that can enhance the success of the management of this postoperative rectovaginal fistula.
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- * In total, 36 patients were treated with a single local injection, and results showed that 47.2% achieved clinical remission at 24 weeks, while 41.6% achieved combined remission.
- * These findings suggest that approximately half of the patients had a successful response to darvadstrocel therapy in a real-world setting, indicating its potential effectiveness for treating this condition.
Article Synopsis
- The study aimed to compare various total mesorectal excision (TME) techniques combined with sphincter-sparing procedures in high-risk rectal cancer patients.
- It involved a multicenter trial with over 1,000 patients, analyzing techniques like laparotomy, laparoscopy, robotic-assisted surgery, and transanal surgery to assess surgical outcomes.
- Results indicated that while all techniques had similar rates of successful resections, none met the anticipated success rate, and the outcomes were comparable among different surgical approaches, especially for minimally invasive methods.
An audit of central venous catheter insertion and management practices in two French university hospitals.
Eur J Clin Microbiol Infect Dis
October 2024
Article Synopsis
- The study aimed to evaluate how well two university hospitals followed French guidelines to prevent infections related to central venous catheters (CVCs).
- An observational audit was carried out in 7 wards using a digital tool to gather data on compliance.
- Results indicated that while hand hygiene practices were generally good (90% compliance), there were notable gaps in glove use and rinsing practices; further investigation is needed to understand the barriers to following these evidence-based recommendations.
Article Synopsis
- The French National Authority for Health (HAS) has released new guidelines for patient blood management (PBM) during surgeries, focusing on three key areas: optimizing red blood cell count, minimizing blood loss, and managing anemia tolerance.
- Preoperative recommendations include identifying anemia and iron deficiency early, especially for surgeries with a higher risk of bleeding.
- Intraoperative strategies involve using tranexamic acid and certain surgical techniques to control bleeding, while postoperative guidance emphasizes reducing blood sampling and monitoring for anemia to determine if treatments like intravenous iron are needed.
Background: Bladder drainage is systematically used in rectal cancer surgery; however, the optimal type of drainage, transurethral catheterization (TUC) or suprapubic catheterization (SPC), is still controversial. The aim was to compare the rates of urinary tract infection on the fourth postoperative day (POD4) between TUC and SPC, after rectal cancer surgery regardless of the day of removal of the urinary drain.
Methods: This randomized clinical trial in 19 expert colorectal surgery centers in France and Belgium was performed between October 2016 and October 2019 and included 240 men (with normal or subnormal voiding function) undergoing mesorectal excision with low anastomosis for rectal cancer.
Aim: The aim of this work was to investigate the association between early postoperative anastomotic leakage or pelvic abscess (AL/PA) and symptomatic anastomotic stenosis (SAS) in patients after surgery for left colonic diverticulitis.
Method: This is a retrospective study based on a national cohort of diverticulitis surgery patients carried out by the Association Française de Chirurgie. The assessment was performed using path analyses.
Article Synopsis
- * A review of 116 patients treated with darvadstrocel showed that 44% achieved clinical remission, while 29% experienced deep remission after a median follow-up of 11 months, with some patients needing further surgery.
- * Factors like higher fistula location and younger age were associated with better treatment outcomes, but overall, complete remission rates remain below 50%, highlighting a notable need for ongoing interventions.
Article Synopsis
- Lateral pelvic node dissection (LPND) is challenging, and this study compares outcomes of robotic vs. laparoscopic surgery for total mesorectal excision (TME) with LPND.
- Using PRISMA and AMSTAR 2 guidelines, a meta-analysis was performed on six studies with 652 patients to evaluate the effectiveness of both surgical approaches.
- The robotic method showed lower morbidity and complications, shorter hospital stays, and more lymph nodes harvested, but at the cost of longer surgery times, while major complications and recurrence rates were similar between the two techniques.
Aim: Although proximal faecal diversion is standard of care to protect patients with high-risk colorectal anastomoses against septic complications of anastomotic leakage, it is associated with significant morbidity. The Colovac device (CD) is an intraluminal bypass device intended to avoid stoma creation in patients undergoing low anterior resection. A preliminary study (SAFE-1) completed in three European centres demonstrated 100% protection of colorectal anastomoses in 15 patients, as evidenced by the absence of faeces below the CD.
View Article and Find Full Text PDFBackground: The observed increase in the incidence of complicated diverticulitis may lead to the performance of more emergency surgeries. This study aimed to assess the rate and risk factors of emergency surgery for sigmoid diverticulitis.
Method: The primary outcomes were the rate of emergency surgery for sigmoid diverticulitis and its associated risk factors.
Background: In the decision to perform elective surgery, it is of great interest to have data about the outcomes of surgery to individualize patients who could safely undergo sigmoid resection. The aim of this study was to provide information on the outcomes of elective sigmoid resection for sigmoid diverticular disease (SDD) at a national level.
Methods: All consecutive patients who had elective surgery for SDD (2010-2021) were included in this retrospective, multicenter, cohort study.
Objective: To analyze the surgical management of sigmoid diverticular disease (SDD) before, during, and after the first containment rules (CR) for the first wave of COVID-19.
Methods: From the French Surgical Association multicenter series, this study included all patients operated on between January 2018 and September 2021. Three groups were compared: A (before CR period: 01/01/18-03/16/20), B (CR period: 03/17/20-05/03/20), and C (post CR period: 05/04/20-09/30/21).
Aim: Robotic-assisted surgery (RAS) is becoming increasingly important in colorectal surgery. Recognition of the short, safe learning curve (LC) could potentially improve implementation. We evaluated the extent and safety of the LC in robotic resection for rectal cancer.
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- The purpose of the study was to create standardized guidelines for using MRI in restaging rectal cancer, emphasizing data collection, image analysis, and reporting.
- Experts combined evidence and opinions to reach a consensus on reporting templates and data acquisition protocols using the RAND-UCLA Appropriateness Method.
- The final outcome included an agreement on patient preparation, MRI sequences, and staging, leading to tailored MRI protocols and a standardized reporting template for clinical use.