Publications by authors named "Lakkis Z"

Background: Data in the literature suggest that obstruction is an independent predictor of poor prognosis in colon cancer. Of all possible sites of recurrence, peritoneal metastases are associated with worse survival. Our aim was to report the incidence of metachronous peritoneal metastases from a cohort of patients undergoing resection of obstructive colon cancer with curative intent and to identify predictive factors for metachronous peritoneal metastases.

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Purpose: The purpose of this study was to determine whether dual-energy computed tomography (DECT), specifically by measuring bowel wall iodine concentration (BWIC), is superior to monoenergetic reconstructions (MR) for the diagnosis and staging of small bowel ischemia in patients with mechanical small bowel obstruction (SBO).

Materials And Methods: From November 2021 to December 2023, all patients with mechanical SBO who underwent contrast-enhanced DECT of the abdomen and pelvis were evaluated for inclusion. Demographic, clinical and biochemical data were collected.

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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.

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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.
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Solid organ transplantation confronts numerous challenges ranging from donor organ shortage to post-transplant complications. Here, we provide an overview of the latest attempts to address some of these challenges using artificial intelligence (AI). We delve into the application of machine learning in pretransplant evaluation, predicting transplant rejection, and post-operative patient outcomes.

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Article Synopsis
  • - The study investigated the effectiveness of robotic right colectomy (RRC) compared to laparoscopic right colectomy (LRC) for nonmetastatic pT4 colon cancer, focusing on surgical outcomes like cancer removal success, complication rates, and recovery times.
  • - Results showed similar cancer removal rates and lymph node retrieval between RRC and LRC, but RRC had advantages like fewer conversions to open surgery, less blood loss, and fewer postoperative complications.
  • - Both surgical methods had comparable long-term survival rates, indicating that RRC is a viable option for treating pT4 right colon cancer with better short-term results than LRC.
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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.

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Purpose: To evaluate the diagnostic performance of bowel wall enhancement for diagnosing concomitant bowel ischemia in patients with parietal pneumatosis (PI) diagnosed at abdominal CT.

Materials And Methods: From January 1, 2012 to December 31, 2021, 226 consecutive patients who presented with PI on abdominal CT from any bowel segment were included. Variables at the time of the CT were retrospectively extracted from medical charts.

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Background: HER2-targeted therapies have recently emerged as an option in the management of metastatic colorectal cancer (mCRC) overexpressing HER2. However, data regarding HER2 status in primary CRC and its corresponding liver metastases are limited, potentially influencing clinical decisions. Therefore, the aim of this study was to compare the HER2 status in primary CRC and paired liver metastases.

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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.

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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.

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Background: 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.

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Introduction: Nutritional intake and dysregulation of fatty acid metabolism play a role in the progression of various tumors, but the consumption of fatty acids is difficult to assess accurately with dietary questionnaires. Biomarkers can objectively assess intake, storage and bioavailability.

Objective: We studied the association between the polyunsaturated fatty acid (PUFA) composition of abdominal subcutaneous adipose tissue (good indicator of dietary intake over 2-3 years) and all-cause mortality.

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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.

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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).

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Background And Aims: Postoperative recurrence is a major concern in Crohn's disease. The Kono-S anastomosis has been described to reduce the rate of recurrence. However, the level of evidence for its effectiveness remains low.

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Background And Aims: In colorectal cancer (CRC), HER2 targeting is a promising treatment and immune infiltrate is an important area of research and strategy. Data regarding HER2 status and immune infiltrate are lacking. The aim of this study was to compare the immune infiltrate between HER2 amplified and non-amplified categories in proficient MisMatchRepair (pMMR)/microsatellite stable (MSS) CRC.

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Article Synopsis
  • A study was conducted to compare the rates of postoperative recurrence (POR) of Crohn's disease (CD) after two surgical techniques: Kono-S anastomosis and standard ileocolic anastomosis.
  • 85 patients underwent surgery with 30 using Kono-S and 55 using the conventional method, and their endoscopic POR rates were evaluated after 6 to 12 months.
  • The results showed no significant difference in POR rates between the Kono-S group (56.7%) and the control group (49.1%), suggesting that Kono-S does not lead to lower rates of recurrence, although anti-TNF treatment was beneficial.
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  • - Iatrogenic urinary tract injury (IUTI) is a serious complication that can arise from emergency digestive surgery, leading to increased health risks and long-term quality of life issues for patients.
  • - The incidence of IUTIs varies from 0.3% to 1.5%, highlighting the need for clear strategies for prevention and management, especially given the high number of these surgeries done globally.
  • - The World Society of Emergency Surgery (WSES) has developed guidelines based on extensive literature review and expert consultations, focusing on effective prevention measures, detection methods, and management strategies—including antibiotic use—pertaining to IUTIs in emergency settings.
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Purpose: To assess the predictive value of combining CT and clinical findings for predicting 10-day mortality in critically ill patients in shock.

Materials And Methods: From January 1, 2018, to December 31, 2021, 289 consecutives critically ill patients in shock who underwent a contrast enhanced CT were included. Variables at the time of the CT were retrospectively extracted from medical charts.

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  • The study evaluates the outcomes of delayed coloanal anastomosis (DCAA), focusing on its use as both a primary procedure and as a salvage after failed surgery.
  • Among 564 patients, complications occurred at similar rates for both types of DCAA, but anastomotic leakage was more common in salvage DCAA cases.
  • DCAA successfully preserved bowel continuity for 74% of patients after three years, with 75% of those not initially having a stoma avoiding it entirely by the last follow-up.
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Background: Anastomotic leakage presentation after Ivor Lewis esophagectomy may vary on imaging. Such variations may influence anastomotic leakage management and outcomes.

Methods: All consecutive patients who underwent Ivor Lewis esophagectomy for cancer between 2012 and 2019 in 2 referral centers were included.

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Article Synopsis
  • The study looked at how often ureteral injuries happen during colorectal surgery and what problems they can cause later on.* -
  • Researchers found that among 202 patients, 55% had their injuries discovered after surgery, which can lead to more problems like longer hospital stays.* -
  • If these injuries are spotted early, patients generally have fewer issues, but around 36% still end up with ongoing problems, and it can delay important cancer treatments.*
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Background: This study aimed to compare the short- and long-term outcomes of robotic (RRC-IA) versus laparoscopic (LRC-IA) right colectomy with intracorporeal anastomosis using a propensity score matching (PSM) analysis based on a large European multicentric cohort of patients with nonmetastatic right colon cancer.

Methods: Elective curative-intent RRC-IA and LRC-IA performed between 2014 and 2020 were selected from the MERCY Study Group database. The two PSM-groups were compared for operative and postoperative outcomes, and survival rates.

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