Publications by authors named "Rouanet P"

Background: While total mesorectal excision is the gold standard for rectal cancer, the optimal surgical approach to achieve adequate oncological outcomes remains controversial. This network meta-analysis aims to compare the histopathological outcomes of robotic (R-RR), transanal (Ta-RR), laparoscopic (L-RR), and open (O-RR) resections for rectal cancer.

Materials And Methods: MEDLINE, Embase, and the Cochrane Library were screened from inception to June 2024.

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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.

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Article Synopsis
  • This study evaluates the effectiveness of Robot-assisted minimally invasive esophagectomy (RAMIE) for treating esophageal cancer at various centers globally, aiming to pinpoint areas for enhancement in surgical outcomes.
  • Over three time periods (2016-2023), data from 28 centers was analyzed, revealing improvements in textbook outcome rates, lymph node yields, and decreased hospital stays, particularly with McKeown procedures.
  • The results showed varying success rates in surgical outcomes and complications, with a noteworthy decrease in anastomotic leakage rates and hospital stays over time, highlighting advancements in surgical techniques.
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Introduction: Telementoring could increase the quality, reduce the time, and increase cost efficiency of the proctoring program for robot-assisted minimally invasive esophagectomy (RAMIE). However, feasibility is unclear as no studies assessed telementoring for RAMIE.

Methods: The feasibility of telementoring was assessed during the thoracic part of RAMIE procedures in three high-volume centers.

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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.
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Ovarian carcinoma remains the most lethal gynaecologic malignancy. Half of all high-grade serous ovarian cancers (HGSOCs) have a homologous recombination deficiency (HRD) with regard to the repair of double-strand DNA breaks and are candidate to receive maintenance treatment with PARP inhibitors. While a wealth of literature exists regarding the therapeutic guidance of patients from a medical standpoint, the influence of the HRD status on the surgical outlook has been comparatively limited.

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Purpose: Long-term treatment-related toxicities, such as neurologic and metabolic toxicities, are major issues in breast cancer. We investigated the interest of metabolomic profiling to predict toxicities.

Experimental Design: Untargeted high-resolution metabolomic profiles of 992 patients with estrogen receptor (ER)+/HER2- breast cancer from the prospective CANTO cohort were acquired (n = 1935 metabolites).

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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: Socioeconomic status (SES) influences the survival outcomes of patients with early breast cancer (EBC). However, limited research investigates social inequalities in their quality of life (QoL). This study examines the socioeconomic inequalities in QoL after an EBC diagnosis and their time trends.

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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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Article Synopsis
  • A study evaluated the safety and effectiveness of robotic-assisted total mesorectal excision (bTME) for locally advanced rectal tumors, involving a multicenter analysis of 168 patients from July 2015 to November 2020.
  • Most patients were around 60 years old, with a significant portion undergoing neoadjuvant chemoradiotherapy; the procedure had a low conversion rate to laparotomy and a notable instance of postoperative complications.
  • Results showed an R0 resection rate of 92.9%, with overall survival rates of 91.7%, 82.1%, and 76.8% at 1, 3, and 5 years, respectively, suggesting that robotic bTME
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Importance: Younger survivors of breast cancer frequently report more treatment-related symptoms, mostly related to the menopausal transition.

Objective: To assess factors associated with chemotherapy-related amenorrhea (CRA) and to evaluate its association with long-term quality of life (QOL).

Design, Setting, And Participants: The prospective, longitudinal Cancer Toxicities Study, a multicenter French cohort study, includes women with a diagnosis of stage I to III breast cancer and collects data approximately yearly after diagnosis.

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Objective: To gain insight into the global practice of robot-assisted minimally invasive gastrectomy (RAMIG) and evaluate perioperative outcomes using an international registry.

Background: The techniques and perioperative outcomes of RAMIG for gastric cancer vary substantially in the literature.

Methods: Prospectively registered RAMIG cases for gastric cancer (≥10 per center) were extracted from 25 centers in Europe, Asia, and South-America.

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Aim: Total neoadjuvant treatment (TNT) is becoming standard in patients with locally advanced rectal carcinoma (LARC). Preoperative chemoradiotherapy (CRT) has proven side effects on bowel and genitourinary function. An early tumoral response to induction chemotherapy demonstrates its high prognostic value.

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  • The study aimed to create a standardized definition of intersphincteric resection (ISR) for very low-lying rectal cancers by reaching a consensus among international experts in the field.
  • A modified Delphi method involving three rounds of questionnaires was used, with a total of 29 experts participating and achieving high agreement on 36 key statements related to ISR.
  • The study resulted in clear definitions of ISR and related surgical procedures, established specific criteria for when to perform ISR, and created a flowchart and assessment protocol for surgical outcomes.
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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 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: Protective ileostomy (PI) is the current standard of care to protect the anastomosis after low anterior resection (LAR) for rectal cancer, but is associated with significant morbidity. Colovac is an anastomosis protection device designed to shield the anastomosis from fecal content. A second version (Colovac+) was developed to limit the migration risk during the implantation period.

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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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