Rectocele with obstructive defecation syndrome: Laparoscopic rectopexy or vaginal repair?

Introduction: The concomitant presence of a rectocele with obstructive defecation syndrome (ODS) is highly probable. The purpose of this study was to evaluate the effectiveness of native tissue vaginal rectocele repair (VRR) and laparoscopic ventral mesh rectopexy (LVMR) in terms of functional outcome via the medium to long-term ODS score evaluation.

Material: This was a retrospective cohort study.

Systemic causes are important risk factors for failure after unscheduled colorectal revision surgery.

Background: The rates of unscheduled revision surgery (URS) after colorectal surgery and failure to rescue-surgical (FTR-s) are 2.4% and 11-17% respectively. The aim of this study was to evaluate the causes of URS lethality to reduce this rate after colorectal surgery.

Unplanned surgery after colorectal resection: laparoscopy at the index surgery is a protective factor against mortality.

Background: The aim of this study was to assess risk factors of mortality after unplanned surgery following colorectal resection.

Methods: All the consecutive patients who underwent colorectal resection between 2011 and 2020 in a French national cohort were retrospectively included. Perioperative data of the index colorectal resection (indication, surgical approach, pathological analysis, postoperative morbidity), and characteristics of unplanned surgery (indication, time to complication, time to surgical redo) were assessed in order to identify predictive factors of mortality.

SAGES SAFE CHOLE program changes surgeons practice in France-results of the FCVD implementation of SAFE CHOLE in France.

Background: With the Society of Gastrointestinal and Endoscopic Surgeons supervision, the Safe Cholecystectomy Task Force (SAFE CHOLE) was translated into French by the the Federation of Visceral and Digestive Surgery (FCVD) and adopted to run on its national e-learning platform for surgical continuing medical education (CME). The objective of this study was to assess the impact of the SAFE CHOLE (SF) program on the knowledge and practice of French surgeons performing cholecystectomy and participating in the FCVD lead CME activity.

Methods: To obtain CME certification, each participant must fill out three FCVD validated questionnaires regarding (1) the participants' routine practice for cholecystectomy, (2) the participants' knowledge and practice after successful completion of the program, and (3) the educational value of the SC program.

Upfront Laparoscopic Management of Common Bile Duct Stones: What Are the Risk Factors of Failure?

Background: Treatment of common bile duct stones (CBDS) includes laparoscopic cholecystectomy (LC) with either laparoscopic common bile duct exploration (LCBDE) or perioperative endoscopic retrograde cholangiopancreatography (ERCP). The main objective of this study was to identify predictive factors for the failure of upfront and exclusive surgical treatment by LCBDE.

Methods: This is a single-center, retrospective study on patients with CBDS and operated for LC between 2007 and 2019.

Laparoscopic Versus Open Pancreatoduodenectomy: Cost-Effectiveness Analysis.

The role of laparoscopy during a pancreatoduodenectomy (PD) is not clearly defined. The purpose of this study was thus to compare the cost-effectiveness between laparoscopic pancreatoduodenectomy (LPD) and open pancreatoduodenectomy (OPD). From 2010 to 2019, 140 patients underwent PD (60 LPD and 80 OPD).

Impact of recommendations and new therapies on the prognosis of colon cancer with synchronous liver metastasis.

Objective: To assess the prognostic impact of the new therapies recommended over the past twenty years for colonic cancers with synchronous hepatic metastasis (hmCC).

Methods: From 1995 to 2016, 802 hmCC were identified in a tumor registry. An univariate and multivariate analysis looked for the impact of the different recommendations over three periods: chemotherapy without targeted therapy (p1CH), chemotherapy with targeted agent in 2nd line (p2TA2), chemotherapy with TA in 1st line (p3TA1) depending on anatomoclinical criteria and therapeutic sequences: chemotherapy then resection of the primary tumor (CR) (n = 100), resection of the primary tumor then chemotherapy (RC) (n = 541), chemotherapy alone with or without TC (onlyCH) (n = 161).

Pancreatic tuberculosis in an 18-year-old patient.

An 18-year-old male patient presented with abdominal pain, nausea, and diarrhea. Subsequent laboratory investigations involving the patient's blood samples revealed an inflammatory syndrome. Subsequent radiographic investigations (CT scan, MRI, and endoscopic ultrasound with biopsies) led to the discovery of a heterogenic cystic lesion in the tail of the pancreas.

The Cost and the Effectiveness of Cholangiography for the Diagnosis and Treatment of a Bile Duct Injury After Difficult Identification of the Cystic Duct.

Background: This study aims to assess the cost and the effectiveness of intraoperative cholangiography (IOC) for the diagnosis and treatment of a bile duct injury (BDI) after incorrect or difficult identification of the cystic duct (DICD) during a cholecystectomy.

Methods: Between 2009 and 2015, 810 surgeons reported 1161 treatment-related adverse events related to the DICD during cholecystectomy in the French REX database; 623 patients (54%) underwent IOC, and 30% (n = 348) of DICD had a BDI. The therapeutic procedures and the treatment costs have been compared between the IOC group (CG) and the group without IOC (WCG).

Outcome after pancreatectomy for neuroendocrine neoplams according to the WHO 2017 grading system: A retrospective multicentric analysis of 138 consecutive patients.

Aim: The aim of this study was to evaluate the new World Health Organization (WHO) 2017 grading system and the others clinicopathological factors in pancreatic neuroendocrine tumor (panNET) operated patients.

Methods: Histological staging was based on the WHO 2017 grading system. Outcome after surgery and predictors of overall survival (OS) and disease free survival (DFS) were evaluated.

Results of the FUSE Evaluation Project in France.

Background: The Federation of Visceral and Digestive Surgery (FCVD) is in charge in France of the continuing medical education of digestive surgeons. Since 2016 and in collaboration with SAGES, it has offered the Fundamental Use of Surgical Energy (FUSE) program as part of the continuing education for surgeons including eLearning and hands-on workshops.

Methods: The aim of this study was to evaluate the impact of the FUSE program on the participants by participating in a knowledge test and completing a survey.

Level of pancreatic division and postoperative pancreatic fistula after distal pancreatectomy: A retrospective case-control study of 157 patients with non-pancreatic ductal adenocarcinoma lesions.

Background: Several studies have suggested that the level of pancreatic division during distal pancreatectomy (DP) has an impact on postoperative pancreatic fistula (POPF) occurrence. The purpose of this study was thus to investigate the level of pancreatic division as a potential risk factor for POPF after DP for non-pancreatic ductal adenocarcinoma lesions (non-PDAC) in the era of parenchyma-sparing resection.

Methods: Data from 217 patients requiring DP were collected in a prospectively maintained database from January 1997 to December 2017 and analyzed retrospectively.

A retrospective multicenter analysis on redo-laparoscopic anti-reflux surgery: conservative or conversion fundoplication?

Background: Nearly 20% of patients who undergo hiatal hernia (HH) repair and anti-reflux surgery (ARS) report recurrent HH at long-term follow-up and may be candidates for redo surgery. Current literature on redo-ARS has limitations due to small sample sizes or single center experiences. This type of redo surgery is challenging due to rare but severe complications.

Robotic versus laparoscopic distal pancreatectomy: a French prospective single-center experience and cost-effectiveness analysis.

Background: Benefits and cost-effectiveness of robotic approach for distal pancreatectomy (DP) remain debated. In this prospective study, we aim to compare the short-term results and real costs of robotic (RDP) and laparoscopic distal pancreatectomy (LDP).

Methods: From 2011 until 2016, all consecutive patients underwent minimally invasive DP were included and data were prospectively collected.

Impact of laparoscopy in patients aged over 70 years requiring distal pancreatectomy: a French multicentric comparative study.

Background: Few data are available concerning short-term results of minimally invasive surgery in patients > 70 years old requiring distal pancreatectomy. The aim of this study was to compare short-term results after laparoscopic (LDP) versus open distal pancreatectomy (ODP) in this subgroup of patients.

Methods: All patients > 70 years who underwent distal pancreatectomy in 3 expert centers between 1995 and 2017 were included and data were retrospectively analyzed.

Long-term quality of life in gastroesophageal reflux disease after NISSEN fundoplication: does it depend on preoperative responsiveness to proton pump inhibitors?

Purpose: In patients presenting with uncomplicated gastroesophageal reflux disease, nonresponders to medical treatment are not viewed as good candidates for surgical treatment. Considering preoperative response to medical treatment and quality of life, this study aimed to predict outcome following laparoscopic Nissen fundoplication.

Materials And Methods: In an academic center, 35 consecutive patients presenting with a gastroesophageal reflux disease requiring a laparoscopic Nissen fundoplication were prospectively included; 16 patients were nonresponders.

The best surgical approach for left colectomy: a comparative study between transverse laparotomy, midline laparotomy and laparoscopy.

Aim: To compare the early and late complications after left colectomy (LC) by left transverse laparotomy (LTL), midline laparotomy (ML) and laparoscopy (La).

Methods: From 1998 to 2003, 328 patients underwent an LC by LTL, ML or La. After matching patients for age, ASA score and indication, 159 patients were divided into three groups of 53 patients each according to the surgical approach performed.

Laparoscopic ventral rectopexy for the treatment of outlet obstruction associated with recto-anal intussusception and rectocele: a valid alternative to STARR procedure in patients with anal sphincter weakness.

Objective: This study was designed to assess the safety and outcomes achieved with Stapled Trans-Anal Rectal Resection (STARR) vs laparoscopic ventral rectopexy (LVR) in obstructed defecation patients.

Method: From 2002 to 2011, 52 patients (females) had a rectocele with outlet obstruction. After clinical assessment by an Obstructed Defecation Syndrome score (ODS), an anorectal manometry, a defecography and an endoanal ultrasound, the patients underwent either a STARR (n=25) or a LVR (n=27) according to the existence of an asymptomatic anal sphincter injury.

Laparoscopic ampullectomy for an ampullarian adenoma.

Lesions involving the ampulla of Vater are rare entities (0.1-0.2 %) with high malignant potential (90 %) [1].

Does the surgeon's experience influence the outcome of laparoscopic treatment of common bile duct stones?

Background: The aim of this study was to assess laparoscopic treatment of choledocholithiasis with respect to the surgeon's experience.

Methods: From January 1994 to December 2006, 130 patients underwent laparoscopic treatment for common bile duct stones found with intraoperative cholangiography. Two types of surgeons were defined: junior surgeons with fewer than ten laparoscopic common bile duct explorations performed and experienced surgeons with more than ten.

Have French recommendations had an impact on the treatment and survival of middle and lower rectal cancer patients?

Objective: Compare the survival of middle and lower rectal cancer (MLRC) patients before and after the 1994 issue of rectal cancer (RC) consensus conference recommendations.

Methods: Cases of MLRC noted in the Hérault department of France in 1992 (n=58) and 2000 (n=93) yielded exhaustive epidemiological, clinical-pathological and treatment data that were used to compare MLRC patient management and survival in these two periods.

Results: Significantly more lymph nodes (≥ 8) were harvested in 2000 (≥ 8, 47%) than in 1992.

Pelviperitonitis by colorectal perforation in the third trimester of pregnancy after surgery for deep pelvic endometriosis.

Objective: To report a severe complication after colorectal resection for rectovaginal endometriosis.

Design: Case report.

Setting: University hospital.

Primitive liver cancers: epidemiology and geographical study in France.

Objectives: The objectives of this study are, first, to describe the incidence of primary liver cancer (PLC) and, second, to highlight its epidemiological characteristics from a geographical point of view.

Methods: The nine French administrative areas, which are covered by population-based cancer registries, diagnosed a total of 1100 new cases of PLC (of which 898 occurred in males), between 1997 and 1998; 91.5% of these were identified as hepatocellular carcinoma, and 6.