Publications by authors named "Etienney I"
We assessed cumulative detection and determinants of anal high-grade squamous intraepithelial lesions (HSILs) in men who have sex with men living with human immunodeficiency virus and who underwent 3 visits over 2 years, with cytology and high-resolution anoscopy, within the ANRS-EP57-APACHES study. The cumulative HSIL detection rate was 33% (134 of 410), of which 48% HSILs were detected at baseline. HSIL detection varied considerably by center (from 13% to 51%).
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- * 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.
In France, about 2000 new cases of anal cancer are diagnosed annually. Squamous cell carcinoma is the most common histological type, mostly occurring secondary to persistent HPV16 infection. Invasive cancer is preceded by precancerous lesions.
View Article and Find Full Text PDFBackground: Non-randomised studies assessing intrarectal botulinum toxin type A (BoNTA) injections for faecal incontinence are promising. We aimed to evaluate the efficacy of BoNTA for the treatment of faecal incontinence in a randomised study.
Methods: In this randomised, double-blind, placebo-controlled study, we included adult patients who had at least one urgency or faecal incontinence episode per week for at least 3 months and who had experienced a failure of conservative or surgical treatment from eight French specialist hospital units with the skills to manage patients with faecal incontinence.
Article Synopsis
- Monkeypox is a zoonotic disease originally from Africa that recently saw a global outbreak starting in April 2022, with limited understanding of its transmission.
- This observational study analyzed anal symptoms in 65 men diagnosed with monkeypox at a proctology unit in Paris during mid-2022, focusing on the association with sexually transmitted infections.
- Key findings revealed that a high percentage of cases involved sexual transmission, primarily among men who have sex with men, with common symptoms being painful anal and perianal ulcerations, and most patients experienced complete symptom resolution within 12 days.
Background: Understanding the natural history of anal high-risk human papillomavirus (hrHPV) infection is key for designing anal cancer prevention programs but has not been systematically characterized.
Methods: We reanalyzed data from 34 studies including 16 164 individuals in 6 risk groups defined by human immunodeficiency virus (HIV) status, sex, and male sexuality: men who have sex with men (MSM) and people with HIV (MSMWH), HIV-negative MSM, women with HIV (WWH), HIV-negative women, men who have sex with women (MSW) with HIV (MSWWH), and HIV-negative MSW. We used Markov models to estimate incidence and clearance of 13 hrHPV types and their determinants.
Article Synopsis
- The study investigates the prevalence of anal HPV and high-grade squamous intraepithelial lesions (HSIL) in men, focusing on factors like HIV status and sexual orientation.
- Researchers conducted a systematic review and pooled individual data from 64 studies involving nearly 29,900 men to analyze type-specific HPV infection and HSIL occurrences.
- Findings showed varying HPV prevalence rates: among HIV-negative MSW, HPV16 was at 1.8%, while HIV-positive MSM had rates as high as 28.5% for HPV16 and 74.3% for high-risk types, suggesting a significant impact of HIV on HPV infection rates.
Article Synopsis
- - The study aimed to evaluate how often severe bleeding occurs after proctological surgery and to identify risk factors, especially in the context of guidelines for anticoagulant treatment.
- - Out of 8,890 patients, only 0.7% required a hemostatic procedure, with a higher risk after hemorrhoidal surgeries, particularly the Milligan-Morgan procedure; blood transfusion was rare (0.1%).
- - Findings indicated that the use of anticoagulants and platelet inhibitors, when managed according to recommendations, did not increase bleeding risk; surprisingly, active smokers had a lower risk of severe bleeding compared to non-smokers.
Introduction: for localized T1N0 squamous cell carcinoma of the anus (SCCA) standard radiotherapy (RT) may result in overtreatment and alternative strategies are debated.
Methods: T1N0M0 SCCA treated between 2015 and 2020 by local excision (LE) or RT were analyzed from the French prospective FFCD ANABASE cohort. Treatment strategies, recurrence-free and colostomy-free survivals (RFS, CFS) and prognostic factors were reported.
Objective: The aim of this study was to assess the effectiveness of sacral nerve modulation (SNM) in a large cohort of patients implanted for at least 10 years, quantify adverse event rates, and identify predictive factors of long-term success.
Summary Background Data: Few studies have evaluated the long-term success of SNM.
Methods: Data collected prospectively from patients implanted for fecal incontinence (FI) in 7 French centers between January 1998 and December 2008 were retrospectively analyzed.
Purpose: Endorectal mucosal advancement flap with muscular plication can ensure complete closure of anovaginal fistulas and preserve continence. The aim of this retrospective study was to show indications might be broadened to include anoperineal fistulas.
Methods: This retrospective study gathered all available data from patients with anovaginal or anterior perineal fistulas who underwent transanal advancement flap repair with muscular plication.
Objective: Endocuff Vision (ECV) is the second generation of a device designed to improve polyp detection. The aim of this study was to evaluate its impact on adenoma detection rate (ADR) in routine colonoscopy.
Design: This cluster-randomised crossover trial compared Endocuff-assisted (ECV+) with standard (ECV-) colonoscopy.
Objective: To assess the efficacy and safety of sacral nerve modulation (SNM) in patients with faecal incontinence (FI) after pelvic radiotherapy in comparison with results of SNM for FI related to other conditions.
Methods: Prospectively collected data from patients who underwent SNM therapy between January 2010 and December 2015 at 7 tertiary colorectal units were reviewed retrospectively. Patients with FI following pelvic radiotherapy were identified and matched (1:2) for age and sex with 38 patients implanted over the same period for FI without previous radiotherapy.
Purpose: Anal fistula is a common condition in proctology, usually requiring surgical treatment. Few risk factors have been clearly identified based on solid evidence. Our research objective was to determine whether history of anal surgery was a risk factor for subsequent anal fistula.
View Article and Find Full Text PDFObjective: Anal high-grade squamous intraepithelial lesion (HSIL) may precede invasive cancer and can be detected clinically or during high-resolution anoscopy (HRA). The aims of this study were to compare the characteristics of HSIL discovered by HRA or in a surgical specimen without clinically visible lesion when diagnosed versus macroscopic HSIL when first diagnosed and then to compare their progression to invasive cancer.
Patients And Methods: Clinical records of all patients with at least one HSIL lesion confirmed by histology and evaluated by HRA in a single center between September 1, 2009, and April 30, 2017, were retrospectively reviewed.
Background: Prospective data on the natural history of anal human papillomavirus (HPV) infection are scarce in human immunodeficiency virus (HIV)-infected men who have sex with men (MSM).
Methods: We analyzed incidence and clearance of HPV-16 and HPV-18 in a French cohort of HIV-infected MSM, aged ≥35 years, followed-up annually (n = 438, 2014-2018).
Results: Human papillomavirus-16 and HPV-18 incidence were similar (~10% incident infections at 24 months).
Numerous systemic diseases (vasculitis, connective tissue disease or sarcoidosis) can display an involvement of the perianal skin, the rectum and/or the anus. Such knowledge is important in order to treat these complications specifically when possible. Lesions of the anorectum arising from systemic diseases can sometimes cause perforations in the peritoneal cavity (if concerning the higher portion of the rectum) and/or fistulization to the anal margin.
View Article and Find Full Text PDFObjective: The objective was to assess the efficacy and the safety of sacral nerve modulation (SNM) in men with fecal incontinence (FI) compared with those of SNM in women.
Method: Prospectively collected data from patients from seven tertiary colorectal units who underwent an implant procedure between January 2010 and December 2015 were reviewed retrospectively. Outcomes and surgical revision and definitive explantation rates were compared between men and women.
Aim: Faecal incontinence is frequent in the elderly. Little is currently known about the efficacy of sacral nerve modulation (SNM) in the elderly. The present study aimed to assess the impact of age on the outcome of SNM and on the surgical revision and explantation rates by comparing the results of a large data set of patients.
View Article and Find Full Text PDFObjective: To assess determinants for histologically proven high-grade anal intraepithelial lesions (hHSIL) in HIV-positive men who have sex with men (MSM), a population at high-risk of HPV-related anal cancer.
Design: APACHES is a prospective study of anal HPV and related-lesions in 513 HIV-positive MSM aged at least 35 years in six centres across France.
Methods: At baseline, participants underwent high-resolution anoscopy (HRA) with biopsy of suspicious lesions, preceded by anal swabs for liquid-based cytology, p16/Ki67 immunostaining, and HPV DNA.
Purpose: Primary anal actinomycosis of cryptoglandular origin, a rare cause of anal suppurative disease, requires specific management to be cured. The aims of this retrospective study were to describe clinical, morphological, and microbiological features of this entity and to evaluate management practices for new cases observed since 2001.
Methods: This was a retrospective case series conducted at the Diaconesses-Croix Saint-Simon Hospital in Paris.
Article Synopsis
- The study investigates anal HPV prevalence and risk factors specifically among HIV-positive men who have sex with men (MSM) aged 35 and older, focusing on their risk of developing anal cancer due to HPV.
- Results show that among 490 participants, 70% were found to have high-risk HPV, with HPV16 being the most common type, especially prevalent in those with severe anal lesions.
- The research highlights that HPV16 is a significant risk factor for high-grade anal lesions in this population, suggesting it should be a primary target for prevention efforts against anal cancer.
Background: Decision-making for pulse generator implantation for sacral nerve stimulation in the management of fecal incontinence is based on the results of a test phase. Its duration is still a matter of debate.
Objective: The purpose of this study was to determine whether an early positive response during the test phase could predict implantation of a permanent sacral nerve pulse generator.
Background: Little is known about the type-specific prevalence of anal human papillomavirus (HPV) infection and risk factors for anal high-risk (HR) HPV infection in human immunodeficiency virus (HIV)-infected women.
Methods: A cross-sectional study of anal and cervical HPV infection was nested within a gynecological cohort of HIV-infected women. Specimens were tested for type-specific DNA using a polymerase chain reaction-based assay.