Multicentre experience using daclatasvir and sofosbuvir to treat hepatitis C recurrence - The ANRS CUPILT study.

Background & Aims: HCV recurrence remains a major issue in the liver transplant field, as it has a negative impact on both graft and patient survival. The purpose of this study was to investigate the efficacy and safety of treating HCV recurrence with sofosbuvir (SOF) and daclatasvir (DCV) combination therapy.

Methods: From October 2013 to March 2015, 559 liver recipients were enrolled in the prospective multicentre France REcherche Nord&Sud Sida-hiv Hépatites (ANRS) Compassionate use of Protease Inhibitors in viral C Liver Transplantation cohort.

Salvage reoperation for complications after ileal pouch-anal anastomosis.

Background: Surgical revision may be possible in patients with a poor outcome following ileal pouch-anal anastomosis (IPAA), using either a transanal approach or a combined abdominoperineal approach with pouch revision and reanastomosis.

Methods: Sixty-four patients underwent revisional surgery. The indication for salvage was sepsis in 47 patients, mechanical dysfunction in ten, isolated complications of the residual glandular epithelial cuff in three and previous intraoperative difficulties in four patients.

Primary rectus abdominis myocutaneous flap for repair of perineal and vaginal defects after extended abdominoperineal resection.

Background: Significant morbidity can result from perineal wounds, particularly after radiotherapy and extensive resection for cancer. Myocutaneous flaps have been used to improve healing. The purpose of this study was to evaluate the morbidity and results of primary rectus abdominis myocutaneous flap reconstruction of the vagina and perineum after extended abdominoperineal resection.

[Ampullectomy in benign lesion: indications and results].

Background: Surgical resection remains today the standard treatment of ampullary and papilla tumours. Whether pancreaticoduodenectomy (PD) or ampullectomy is indicated for presumed benign lesions remains debated. The feared potential post-operative morbidity of ampullectomies is balanced by the functional sequelae of PD.

Methods and results of sphincter-preserving surgery for rectal cancer.

Background: Sphincter preservation is the goal in the treatment of rectal cancer and should be considered in all patients with an intact sphincter. Sphincter preservation for tumors of the upper rectum is easily achieved, but surgical management of cancer of the mid and lower third of the rectum continues to evolve. Several recent advances may influence future treatment strategies.

Colonic J-pouch-anal anastomosis for rectal cancer.

Purpose: The purpose of this article is to review the different aspects of the colonic J-pouch reconstruction with special focus on functional results and complications.

Methods: A MEDLINE search from 1965 to the present with manual search for older articles was used as the basis of this review.

Results: Rectal reconstruction using a colonic J-pouch-anal anastomosis after excision of extraperitoneal cancers can be performed with acceptable morbidity and good functional results.

Clinical effects of preoperative radiation therapy on anorectal function after proctectomy and colonic J-pouch-anal anastomosis.

Purpose: Preoperative radiotherapy is increasingly used for certain rectal cancers, although some evidence suggests that it may adversely affect anorectal function. Reconstruction with a colonic J-pouch-anal anastomosis after complete proctectomy is thought to improve function, but few published data on pouch function after radiation exists. The aim of our study was to compare long-term bowel habits in patients receiving preoperative radiation for rectal cancer followed by colonic J-pouch-anal anastomosis with those of patients having similar rectal cancer surgery without radiation.

[Ileal pouch anal-anastomosis without protective ileostomy].

Aim: Ileo-anal anastomosis (IAA) for ulcerative colitis (UC) or familial adenomatous polyposis (FAP) is usually associated with a defunctioning ileostomy, which may in itself cause morbidity. We report the results of a series of patients undergoing IAA without ileostomy.

Methods: Between 1993 and 1998, 84 patients underwent IAA without ileostomy: 51 for FAP, 30 for UC, 2 for non familial colonic polyposis and 1 for indeterminate colitis.

Laparoscopic left colon resection for diverticular disease.

Background: The aim of this study was to review our experience with laparoscopic sigmoid colectomy for diverticular disease.

Methods: All patients presenting with acute or chronic diverticulitis, obstruction, abscess, or fistula were included. Symptomatic diverticular disease was the main surgical indication (95%).

Management and long-term results of surgery for localized gastric lymphomas.

Background: High- and low-grade gastric lymphomas (GL) differ in their behavior and chemosensitivity. Surgery has to be reevaluated according to the histologic grade of malignancy. We aimed to assess the place of surgery in the management of GL and its results after long-term follow-up.

Results of coloanal anastomosis for rectal cancer.

It is now accepted that, in the absence of direct invasion of the anal sphincter, cancers of the middle and lower rectum can be successfully treated with sphincter-preserving surgery. Conservation of the sphincter mechanism should never compromise the oncologic outcome of surgery and the method of neorectum construction must provide acceptable function for patients. This review describes the results of coloanal anastomosis following rectal excision.

Adjuvant intraperitoneal 5-fluorouracil in high-risk colon cancer: A multicenter phase III trial.

Objective: To evaluate the results of a prospective multicenter randomized study of adjuvant intraperitoneal 5-fluorouracil (5-FU) administered during 6 days shortly after resection of stages II and III colon cancers.

Summary Background Data: Systemic adjuvant chemotherapy improves the survival of patients with stage III colon cancer receiving treatment for 6 months. Intraperitoneal chemotherapy theoretically combines peritoneal and hepatic effects.

[Total excision of the mesorectum and preservation of the genitourinary innervation in surgery of rectal cancer].

Locoregional recurrence is one of the most important problems after surgery for rectal cancer. Four to five per cent local recurrence rates have been reported after total mesorectal excision with autonomic nerve preservation. After an anatomic description, the authors describe the surgical technique of total mesorectal excision with nerve preservation.

[Radio- and chemotherapy of cancer of the esophagus].

Surgical resection has been the mainstay of therapy for localised carcinoma of the oesophagus. However, the five-year survival rate after curative resection is only 20 to 30%, and other treatments have been tried to improve these results. Radiotherapy, chemotherapy and sequential or combined chemoradiotherapy have been used, either alone or in combination with surgery.

[Surgical morbidity of segmental colectomy ideally performed via laparotomy for complicated colonic diverticulosis].

Objectives: The appraisal of morbidity and mortality for one stage elective colectomy for complicated diverticulosis is difficult and often overestimated, due to the rarity of reports addressing this question. Our results for 100 patients on a recent 30 month period were studied retrospectively.

Methods: One hundred patients were electively operated in a one-stage procedure for complicated diverticulosis in a single institution from January 1993 to June 1995.

[Treatments for hepatocellular carcinoma in cirrhosis : practical aspects].

Many treatments are able to eradicate or slow the progression of hepatocellular carcinoma in cirrhosis. All are described in this issue of Annales de Chirurgie. These various alternative mean that treatment can be adapted to different clinical situations determined by the patient's general state, the size of the liver tumour, its extrahepatic dissemination and the functional quality of the underlying liver parenchyma.

Long-term functional outcome after low anterior resection: comparison of low colorectal anastomosis and colonic J-pouch-anal anastomosis.

Objective: The purpose of this study was to compare long-term functional results of two methods of reconstruction after anterior rectal resection for cancer: low colorectal anastomosis and colonic J-pouch-anal anastomosis.

Summary Background Data: After anterior resection for mid or low rectal cancer, the decision to perform low colorectal or coloanal anastomosis is made intraoperatively, depending on the distance of the tumor from the anal verge. Functional results of these operations are considered to be similar one to two years after surgery.

[Cancer of the upper third of the bile duct].

Carcinoma of the upper third of the extrahepatic bile ducts (Klatskin's tumors) are difficult to manage and there is still no consensus on the best means of diagnosis and therapy. The objective of this general review was to determine the state of the art about the pathology and the available diagnostic and therapeutic options.

Major extended hepatic resections in diseased livers using hypothermic protection: preliminary results from the first 12 patients treated with this new technique.

Background: Hepatic vascular exclusion allows the performance of major hepatic resections with minimal intraoperative blood loss. We have previously shown that normothermic ischemia can be tolerated by a healthy liver for up to 90 minutes, and this period is increased to 4 hours if the liver is cooled to 4 degrees C using University of Wisconsin solution.

Study Design: This study assessed whether these techniques could be successfully applied for patients requiring resection of a diseased liver, which is more sensitive to ischemic damage.

Prospective randomized trial comparing Billroth I and Billroth II procedures for carcinoma of the gastric antrum.

Background: Controversy persists regarding digestive reconnection following subtotal gastrectomy for carcinoma. A randomized prospective trial comparing Billroth I and Billroth II procedures for mortality, digestive comfort, survival, and patterns of recurrence was conducted.

Study Design: Thirty patients underwent Billroth I and 32 patients underwent Billroth II procedures.