Publications by authors named "Sebastien Gaujoux"
Objective: Ampullary neoplastic lesions can be resected by endoscopic papillectomy (EP) or transduodenal surgical ampullectomy (TSA) while pancreaticoduodenectomy is reserved for more advanced lesions. We present the largest retrospective comparative study analysing EP and TSA.
Design: Of all patients in the database, lesions with prior interventions, benign histology advanced malignancy (T2 and more), patients with hereditary syndromes and those undergoing pancreatoduodenectomy were excluded.
Article Synopsis
- The study analyzed patients from 2017 to 2022, comparing postoperative serum calcium levels and PTH levels taken shortly after the surgery to create a management algorithm involving calcium and alfacalcidol for those with low intraoperative PTH levels.
- Results showed that using intraoperative PTH levels improved prediction of symptomatic hypocalcemia significantly, identifying 90% of cases, while only 58% could be predicted using postoperative serum calcium levels alone.
Histopathological outcomes of transanal, robotic, open, and laparoscopic surgery for rectal cancer resection. A Bayesian network meta-analysis of randomized controlled trials.
Eur J Surg Oncol
January 2025
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.
Article Synopsis
- - The study investigates the lymphatic network of adrenal glands to improve the lymph node dissection process in adrenocortical carcinoma, as current practices are poorly defined and inconsistent.
- - An anatomical study on cadavers and a systematic review of literature showed a complex, compartmentalized lymphatic network and revealed discrepancies between anatomical studies and clinical cases regarding lymph node involvement.
- - The authors propose a detailed dissection protocol for lymph nodes during surgery for both right and left adrenocortical carcinoma, aiming to standardize the surgical approach and enhance staging accuracy.
Malignant gastric outlet obstruction (mGOO) is a major condition affecting patients with periampullary tumors, including pancreatic cancer. The current treatment options include surgical gastroenterostomy, endoscopic stenting and more recently EUS-guided gastroenterostomy. Most studies comparing the outcomes of the three procedures focus on technical success, clinical success and safety.
View Article and Find Full Text PDFAmpullary tumors: French Intergroup Clinical Practice Guidelines for diagnosis, treatments and follow-up (TNCD, SNFGE, FFCD, UNICANCER, GERCOR, SFCD, SFED, ACHBT, AFC, SFRO, RENAPE, SNFCP, AFEF, SFP, SFR).
Dig Liver Dis
September 2024
Article Synopsis
- Management of ampullary tumors (AT), which include adenomas (AA) and carcinomas (AC), is tough because there's not a lot of solid research on it.
- The French medical community worked together to create guidelines based on recent studies and expert advice, which categorize recommendations by how strong the evidence is.
- Accurate diagnosis requires special tests, and every patient should have their case reviewed by a team of different doctors before deciding on treatment, with a recommended follow-up period of 5 years.
Article Synopsis
- Minimally invasive surgery (MIS) for left pancreatic resections has been increasingly utilized, but its advantages over traditional open surgery for distal pancreatectomy in treating pancreatic neuroendocrine tumors are still debated.
- A retrospective study involving 274 patients across 21 French centers analyzed short and long-term outcomes of MIS versus open surgery, focusing on factors like tumor size and patient characteristics.
- Results showed that MIS reduced major complications and delayed gastric emptying while maintaining comparable survival rates, suggesting it is a safe option for patients with resectable left pancreatic neuroendocrine tumors.
Objective: Pharmacological prevention of postoperative pancreatic fistula (POPF) after pancreatectomy is open to debate. The present study compares clinically significant POPF rates in patients randomized between somatostatin versus octreotide as prophylactic treatment.
Methods: Multicentric randomized controlled open study in patient's candidate for pancreaticoduodenectomy (PD) or distal pancreatectomy (DP) comparing somatostatin continuous intravenous infusion for 7 days versus octreotid 100 μg, every 8 hours subcutaneous injection for 7 days, stratified by procedure (PD vs DP) and size of the main pancreatic duct (>4 mm) on grade B/C POPF rates at 90 days based on an intention-to-treat analysis.
Management of malignant Gastric Outlet Obstruction (mGOO) due to pancreatic cancer in the era of EUS-Gastrojejunostomy: an international practice survey and case vignette study by Pancreas 2000 from the European Pancreatic Club.
Surg Endosc
June 2024
Background: Malignant Gastric Outlet Obstruction (mGOO) has been standardly treated by surgical Gastrojejunostomy (S-GJ) or Endoscopic Stenting (ES). Recently, EUS-Gastrojejunostomy (EUS-GJ) has emerged as an alternative, despite its worldwide diffusion is heterogeneous. The aim of this survey was to assess clinical decision-making around mGOO and to explore current opinions regarding EUS-GJ.
View Article and Find Full Text PDFArticle Synopsis
- International guidelines suggest that monitoring minimally invasive pancreatic surgery (MIPS) is important, but there is a lack of data, particularly on minimally invasive distal pancreatectomy (MIDP).
- This study analyzed data from 1672 patients in 83 European centers to compare robot-assisted distal pancreatectomy (RDP) and laparoscopic distal pancreatectomy (LDP), focusing on intraoperative events, major morbidity, and mortality.
- Findings showed RDP had fewer intraoperative complications but longer surgery times compared to LDP; both procedures had low mortality rates, with LDP still being the more common approach despite the rising use of RDP.
Background: The prognostic value of splenic vessel involvement in distal pancreatic adenocarcinoma remains controversial. The aim of the study was to assess its prognostic relevance in a large multicenter cohort.
Methods: Patients who underwent pancreatosplenectomy for distal pancreatic adenocarcinoma were identified from 5 pancreatic surgical centers.
Purpose: The aims of the study were to evaluate the performance and robustness of [F]fluorocholine PET/CT in detecting hyperfunctioning parathyroid glands in MEN1-related primary hyperparathyroidism (pHPT) at different stages of their disease.
Methods: Retrospective French multicenter study including patients with MEN1 pHPT who underwent [F]fluorocholine PET/CT at initial diagnosis or for evaluation of persistent/recurrent disease. PET/CT were independently reviewed by two readers in a blinded manner.
Background: The impact of lymph node characteristics on mortality and recurrence remains controversial. This study evaluated the prognostic impact of lymph node characteristics in a large, homogenous cohort of patients with therapeutic neck dissection for clinically N1 classic papillary thyroid cancer (PTC).
Methods: All consecutive adult patients with therapeutic central and lateral neck dissection for PTC at a French referral centre were prospectively enrolled from January 2000 until June 2021.
Background: This systematic review and meta-analysis assessed the effectiveness of robotic surgery compared to laparoscopy or open surgery for inguinal (IHR) and ventral (VHR) hernia repair.
Methods: PubMed and EMBASE were searched up to July 2022. Meta-analyses were performed for postoperative complications, surgical site infections (SSI), seroma/hematoma, hernia recurrence, operating time (OT), intraoperative blood loss, intraoperative bowel injury, conversion to open surgery, length of stay (LOS), mortality, reoperation rate, readmission rate, use of opioids, time to return to work and time to return to normal activities.
Background: Data on clinically relevant post-pancreatectomy hemorrhage (CR-PPH) are derived from series mostly focused on pancreatoduodenectomy, and data after distal pancreatectomy (DP) are scarce.
Methods: All non-extended DP performed from 2014 to 2018 were included. CR-PPH encompassed grade B and C PPH.
Background And Aims: Ampullary lesions (ALs) of the minor duodenal papilla are extremely rare. Endoscopic papillectomy (EP) is a routinely used treatment for AL of the major duodenal papilla, but the role of EP for minor AL has not been accurately studied.
Methods: We identified 20 patients with ALs of minor duodenal papilla in the multicentric database from the Endoscopic Papillectomy vs Surgical Ampullectomy vs Pancreatitcoduodenectomy for Ampullary Neoplasm study, which included 1422 EPs.
Response to Letter to the Editor From Jagannath and Mayilvaganan: "FCH-PET/CT in Primary Hyperparathyroidism With Discordant/Negative MIBI Scintigraphy and Ultrasonography".
J Clin Endocrinol Metab
February 2024
French guidelines from the GTE, AFCE and ENDOCAN-RENATEN (Groupe d'étude des Tumeurs Endocrines/Association Francophone de Chirurgie Endocrinienne/Reseau national de prise en charge des tumeurs endocrines) for the screening, diagnosis and management of Multiple Endocrine Neoplasia Type 1.
Ann Endocrinol (Paris)
February 2024
Objective: Describe the diagnostic workup and postoperative results for patients treated by adrenalectomy for primary aldosteronism in France from 2010 to 2020.
Background: Primary aldosteronism (PA) is the underlying cause of hypertension in 6% to 18% of patients. French and international guidelines recommend CT-scan and adrenal vein sampling as part of diagnostic workup to distinguish unilateral PA amenable to surgical treatment from bilateral PA that will require lifelong antialdosterone treatment.