Individual learning curve of cytoreductive surgery for peritoneal metastasis from colorectal cancer: A process with an impact on survival.

Background: This study aimed to assess the learning curve (LC) of cytoredutive surgery (CRS) of peritoneal metastasis (PM) from colorectal cancer (CRC). Information about learning curves is important for developing teaching tools and well-structured training programs for the implementation of this complex procedure in new healthcare centers. The aim of this study was to estimate how many procedures an inexperienced surgeon must perform (the length of the learning period) in order to demonstrate an acceptably low rate of locoregional recurrence.

Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus cytoreductive surgery alone for colorectal peritoneal metastases (PRODIGE 7): a multicentre, randomised, open-label, phase 3 trial.

Background: The addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to cytoreductive surgery has been associated with encouraging survival results in some patients with colorectal peritoneal metastases who were eligible for complete macroscopic resection. We aimed to assess the specific benefit of adding HIPEC to cytoreductive surgery compared with receiving cytoreductive surgery alone.

Methods: We did a randomised, open-label, phase 3 trial at 17 cancer centres in France.

French intensive training course in laparoscopic surgery (HUGOFirst) on live porcine models: Validation of a performance assessment scale and residents' satisfaction in a prospective study.

Introduction: Simulation as a method for practical teaching of surgical residents requires objective evaluation in order to measure the student's acquisition of knowledge and skills. The objectives of this article are to publish our evaluation and validation grids and also the measure of student satisfaction.

Method: A teaching platform based on practical exercises with a porcine model was created in 2009 at seven French University Hospitals.

Professional risks when carrying out cytoreductive surgery for peritoneal malignancy with hyperthermic intraperitoneal chemotherapy (HIPEC): A French multicentric survey.

Background: Over the last two decades, many surgical teams have developed programs to treat peritoneal carcinomatosis with extensive cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). Currently, there are no specific recommendations for HIPEC procedures concerning environmental contamination risk management, personal protective equipment (PPE), or occupational health supervision.

Methods: A survey of the institutional practices among all French teams currently performing HIPEC procedures was carried out via the French network for the treatment of rare peritoneal malignancies (RENAPE).

[Sexual functions after treatment for rectal cancer: impact of doses in autonomic pelvic nerves].

Purpose: Prospective evaluation of sexual function after treatment of rectal cancer and identification of predictive factors.

Patients And Methods: Thirty-three patients were treated with curative intent by chemoradiation and surgery for localized rectal adenocarcinoma. Sexual toxicity was assessed four times (before treatment and at 2, 6 and 12 months) using validated questionnaires: QLQ C30 and EORTC CR38 for all, simplified IIEF for men and FSFI for women.

Primary versus delayed repair for bile duct injuries sustained during cholecystectomy: results of a survey of the Association Francaise de Chirurgie.

Background: Bile duct injuries (BDIs) sustained during a cholecystectomy still remain a major surgical problem, and it is still not clear whether the injury should be repaired immediately or a delayed repair is preferred.

Methods: A retrospective national French survey was conducted to compare the results of immediate (at time of cholecystectomy), early (within 45 days after a cholecystectomy) and late (beyond 45 days after a cholecystectomy) surgical repair for BDI sustained during a cholecystectomy.

Results: Forty-seven surgical centres provided 640 cases of bile duct injury sustained during a cholecystectomy of which 543 were analysed for the purpose of the present study.

Prognostic factors of ischemic colitis after infrarenal aortic surgery.

Background: Postoperative ischemic colitis (POIC) remains a frequent and extremely severe complication of infrarenal abdominal aorta surgery. However, its diagnosis and treatment are not always consensual because the incidence is very small. The aim of this retrospective study was to evaluate the prognostic factors of severe colitis after infrarenal aorta surgery.

Incidentally-discovered gallbladder cancer: When, why and which reoperation?

Cancer of the gallbladder, a rare entity with a poor prognosis, is often discovered incidentally during or after cholecystectomy. It tends to disseminate early via lymphatic, peritoneal, endobiliary, and hematogenous pathways. Diagnosis is made intra-operatively in only a quarter of cases, by examination of the opened cholecystectomy specimen in the operating room by the surgeon; this procedure should be routine.

[Cholangiocarcinomas developing on multiple bile duct hamartomas syndrome].

Two cases of cholangiocarcinoma arising in a background of multiple bile duct hamartomas are reported. In each case, the clinical and radiological investigations showed a liver tumor with no other concomitant disease. Tumors were resected, and microscopic examination revealed in one case a hilar cholangiocarcinoma, in the other case a peripheric cholangiocarcinoma, both being well-differentiated.

OPG, RANK and RANK ligand expression in thyroid lesions.

Receptor activator of NF-kappaB (RANK), RANK ligand (RANKL) and osteoprotegerin (OPG) play essential roles in bone metabolism. RANKL binds to RANK, which is expressed by osteoclasts whereas OPG acts as its decoy receptor blocking the RANK-RANKL interaction. OPG/RANK/RANKL are produced by variety of tissues including epithelial and mesenchymal cells.

Repeat hepatectomy for colorectal liver metastases.

This study includes 16 patients (9 men, 7 women; mean age 64 years) who underwent a total of 19 repeat hepatectomies for metastasis after colon (n=7) or rectal (n=9) carcinoma. All patients were reoperated for recurrent liver metastasis after the first resection (mean, 21 months; range, 7-40 months), and three had a third hepatectomy 13, 24, or 65 months after the second. Perioperative mortality was 0% and morbidity was 37%.

[Hepatoid adenocarcinoma of the stomach. A case report].

Hepatoid adenocarcinoma of the stomach is a very rare tumor with a poor prognosis. Lymph nodes involvement and/or liver metastases are frequently observed. Diagnosis should be pointed out if elevated serum level of alpha-fetoprotein (AFP) is detected with gastric tumor.

[Biliary-enteric anastomosis malfunction: retrospective study of 20 surgical cases. Review of literature].

Introduction: This retrospective study of 20 procedures for malfunction of a biliary-enteric anastomosis include 7 choledochoduodenal anastomosis (CD) and 13 choledocho- or hepaticojejunal anastomosis (HJ).

Methods And Results: The malfunctions were revealed by angiocholitis (N=16) jaundice (N=4) acute abdominal syndrome (N=1). Among the 7 CD, the median waiting period before reoperation has been 14 years, the procedures were justified by a biliary disorder in 5 cases (1stricture, 4 stones or food obstruction) or by a duodenal stricture (2 cases).

Up-regulated expression of ADAM17 in human colon carcinoma: co-expression with EGFR in neoplastic and endothelial cells.

The ADAM17 metalloproteinase (a disintegrin and metalloprotease 17) controls epidermal growth factor receptor (EGFR) activation through regulated shedding of EGFR ligands. With the advent of new therapeutic options targeting EGFR signalling in colon carcinoma, it was decided to determine ADAM17 status in relation to clinico-pathological parameters and EGFR status. To this end, a series of 39 colon carcinomas were analysed.

[Bile duct injuries at laparoscopic cholecystectomy: early repair results].

Study Aim: To compare the early repair results in bile duct injuries at laparoscopic cholecystectomy to a later repair and so the early reconstruction by an end-to-end anastomosis to a Roux-en-Y bypass.

Patients And Method: From 1990 to 2003, twelve patients were treated for bile duct injury, not diagnosed at the time of cholecystectomy and had an early repair within 30 days after the cholecystectomy. They had either a duct to duct anastomosis or a Roux-en-Y bypass at the time of the reconstruction.

[Bisegmentectomy 7-8: importance of preoperative diagnosis of a right inferior hepatic vein].

The extent of hepatic resection is often determined by the hepatic veins and their relation to the tumor. A need to transect the right hepatic vein at its entry into the vena cava indicates a need to remove the entire right posterior segment. About six cases, the aim of the study was to remind that under certain circumstances the posteroinferior area may be preserved.

[The importance of lymph node dissection in medullary thyroid macrocarcinomas].

Unlabelled: Medullary thyroid carcinoma (MTC) is often regarded as good medium-term forecast. The 5- and 10-years survival rates are, respectively, appraised at 78-85% and 70-78%. These rates take no care, however, of the fact that 50-56% of the patients keep a pathological calcitonine (CT) level giving evidence of an evolutive disease.

Laparoscopic liver resection of benign liver tumors.

Objective: The objective of this study was to assess the feasibility, safety, and outcome of laparoscopic liver resection for benign liver tumors in a multicenter setting.

Background: Despite restrictive, tailored indications for resection in benign liver tumors, an increasing number of articles have been published concerning laparoscopic liver resection of these tumors.

Methods: A retrospective study was performed in 18 surgical centres in Europe regarding their experience with laparoscopic resection of benign liver tumors.

Percutaneous ethanol injection vs. resection in patients with small single hepatocellular carcinoma: a retrospective case-control study with cost analysis.

Background: Percutaneous ethanol injection and hepatic resection are the most widely used curative therapeutic options for patients with compensated liver disease and small hepatocellular carcinoma.

Aim: To compare percutaneous ethanol injection and hepatic resection in a selected group of consecutive French patients with a single hepatocellular carcinoma, smaller than or equal to 50 mm, in terms of survival, recurrence rate of malignancy and direct costs.

Methods: The analysis of two contemporary cohorts of Child-Pugh A or B patients with a single hepatocellular carcinoma of < or = 50 mm treated by percutaneous ethanol injection (n=55) or hepatic resection (n=50).

[Parathyroid cyst. Report of ten cases].

Aim Of The Study: To evaluate the characteristics of the parathyroid cysts (PC).

Patients And Method: Ten patients with PC were included in this retrospective study. The PC were discovered as follows: cervical mass (n = 3), hyperparathyroidism (n = 3), incidentally during thyroid surgery (n = 3) and screening for obesity (n = 1).

[Locoregional recurrence of differentiated thyroid cancers: diagnosis-treatment].

Aim Of The Study: To evaluate the improvement of the diagnosis and the treatment of local recurrences (LR) in patients with differentiated thyroid carcinoma.

Material And Method: Among a total of 57 patients, two groups were compared: group I: 31 patients operated on from 1974 to 1990; group II: 26 patients operated on from 1991 to 2000. In the group I, the diagnosis of the cervical recurrence was supported by imaging study (ultrasonography, tomodensitometry), in the group II by radioiodinescan and serum thyroglobuline (Tg) measurement.

Resection of hepatic and pulmonary metastases in patients with colorectal cancer.

The resection of liver and lung metastases is now regarded as valid therapy, although the surgical procedure of both metastatic sites has not been clearly defined. Nine consecutive patients who underwent resection of both liver and lung metastases from colorectal cancer (5 Dukes' stage B, 3 C, 1 D) between 1986 and 1999 were studied retrospectively. A total of 19 resections were performed: 8 hepatectomies, 2 liver wedge resections, and 9 lung lobectomies.

[Percutaneous drainage of perisigmoid abscesses of diverticular origin].

Study Aim: The aim of this multicentric retrospective study was to report the results on the percutaneous drainage of perisigmoid abscesses during acute sigmoid diverticulitis in 12 patients.

Patients And Method: Between January 1993 and March 2000. 12 patients with a perisigmoid diverticular abscess were treated by antibiotic therapy and percutaneous drainage of the abscess.

Interruption of the inferior vena cava with azygos termination associated with congenital absence of portal vein.

The authors report an exceptional and well-documented case of interruption of the retrohepatic segment of the inferior vena cava with an "azygos continuation", combined with absence of the portal vein. The only known combination of congenital anomalies of the inferior vena cava and the portal vein was that of an "azygos continuation" and a preduodenal portal vein. The double interruption, portal and inferior caval, may be associated with a disturbance of preferential flows induced by the left umbilical thrust.