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  1. Article ; Online: Comparison of treatment to improve gastrointestinal functions after colorectal surgery within enhanced recovery programmes

    Jean F. Hamel / Charles Sabbagh / Arnaud Alves / Jean M. Regimbeau / Timothée Vignaud / Aurélien Venara

    Scientific Reports, Vol 11, Iss 1, Pp 1-

    a systematic review and meta-analysis

    2021  Volume 12

    Abstract: Abstract Despite a significant improvement with enhanced recovery programmes (ERP), gastro-intestinal (GI) functions that are impaired after colorectal resection and postoperative ileus (POI) remain a significant issue. In the literature, there is little ...

    Abstract Abstract Despite a significant improvement with enhanced recovery programmes (ERP), gastro-intestinal (GI) functions that are impaired after colorectal resection and postoperative ileus (POI) remain a significant issue. In the literature, there is little evidence of the distinction between the treatment assessed within or outside ERP. The purpose was to evaluate the efficiency of treatments to reduce POI and improve GI function recovery within ERP. A search was performed in PubMed and Scopus on 20 September 2019. The studies were included if they compared the effect of the administration of a treatment aiming to treat or prevent POI or improve the early functional outcomes of colorectal surgery within an ERP. The main outcome measures were the occurrence of postoperative ileus, time to first flatus and time to first bowel movement. Treatments that were assessed at least three times were included in a meta-analysis. Among the analysed studies, 28 met the eligibility criteria. Six of them focused on chewing-gum and were only randomized controlled trials (RCT) and 8 of them focused on Alvimopan but none of them were RCT. The other measures were assessed in less than 3 studies over RCTs (n = 11) or retrospective studies (n = 2). In the meta-analysis, chewing gum had no significant effect on the endpoints and Alvimopan allowed a significant reduction of the occurrence of POI. Chewing-gum was not effective on GI function recovery in ERP but Alvimopan and the other measures were not sufficiently studies to draw conclusion. Randomised controlled trials are needed. Systematic review registration number CRD42020167339.
    Keywords Medicine ; R ; Science ; Q
    Subject code 150
    Language English
    Publishing date 2021-04-01T00:00:00Z
    Publisher Nature Portfolio
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Randomised clinical trial for the cost–utility evaluation of two strategies of perineal reconstruction after abdominoperineal resection in the context of anorectal carcinoma

    Jeremie Lefevre / Eddy Cotte / Nicolas Carrere / Arnaud Alves / Jean-Marc Regimbeau / Anne Dubois / Adeline Germain / Sylvain Kirzin / Etienne Buscail / Cindy Canivet / Laurent Ghouti / Laurent Molinier / Aline Rosillo / Valerie Lauwers-Cances / Nadège Costa / Aurélien Vénara / Zaher Lakkis / Eric Rullier / Guillaue Piessen /
    Bertrand Trilling / Cécilia Ceribelli / Cécile de Chaisemartin / Emilie Duchalais / Mehrdad Jafari / Jean-Jacques Tuech

    BMJ Open, Vol 11, Iss

    biological mesh repair versus primary perineal wound closure, study protocol for the GRECCAR 9 Study

    2021  Volume 4

    Abstract: Introduction Abdominoperineal resections performed for anorectal tumours leave a large pelvic and perineal defect causing a high rate of morbidity of the perineal wound (40%–60%). Biological meshes offer possibilities for new standards of perineal wound ... ...

    Abstract Introduction Abdominoperineal resections performed for anorectal tumours leave a large pelvic and perineal defect causing a high rate of morbidity of the perineal wound (40%–60%). Biological meshes offer possibilities for new standards of perineal wound reconstruction. Perineal fillings with biological mesh are expected to increase quality of life by reducing perineal morbidity.Methods and analysis This is a multicentre, randomised and single-blinded study with a blinded endpoint evaluation, the experimental arm of which uses a biological mesh and the control arm of which is defined by the primary closure after abdominoperineal resection for cancer. Patients eligible for inclusion are patients with a proven history of rectal adenocarcinoma and anal canal epidermoid carcinoma for whom abdominoperineal resection was indicated after a multidisciplinary team discussion. All patients must have social security insurance or equivalent social protection. The main objective is to assess the incremental cost–utility ratio (ICUR) of two strategies of perineal closure after an abdominoperineal resection performed for anorectal cancer treatment: perineal filling with biological mesh versus primary perineal closure (70 patient in each arm). The secondary objectives focus on quality of life and morbidity data during a 1-year follow-up. Deterministic and probabilistic sensitivity analyses will be performed in order to estimate the uncertainty surrounding the ICUR. CIs will be constructed using the non-parametric bootstrap approach. A cost-effectiveness acceptability curve will be built so as to estimate the probability of efficiency of the biological meshes given a collective willingness-to-pay threshold.Ethics and dissemination The study was approved by the Regional Ethical Review Board of ‘Nord Ouest 1’ (protocol reference number: 20.05.14.60714; national number: 2020-A01169-30).The results will be disseminated through conventional scientific channels.Trial registration number ClinicalTrials.gov Registry (NCT02841293).
    Keywords Medicine ; R
    Subject code 610
    Language English
    Publishing date 2021-04-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Diagnosis and Therapeutic Management of Parathyroid Cysts

    Jean-Baptiste Finel / Stéphanie Mucci / Frédéric Branger / Aurélien Venara / Laure Blanchard / Antoine Hamy

    Surgical Science , Vol 03, Iss 10, Pp 479-

    2012  Volume 483

    Abstract: Objectives: The parathyroid cysts (PCs) are rare and their diagnosis and therapeutic management are not clearly established. The aim of the study was to evaluate the characteristics of parathyroid cysts. Methods and Materials: Twenty-five patients with ... ...

    Abstract Objectives: The parathyroid cysts (PCs) are rare and their diagnosis and therapeutic management are not clearly established. The aim of the study was to evaluate the characteristics of parathyroid cysts. Methods and Materials: Twenty-five patients with PC were included in this retrospective study. The PCs were discovered as follows: cervical mass (n = 18), screening for other pathologies (n = 7). Intracystic parathyroid hormone determination was performed in 6 cases. Results: Eight patients presented an hyperparathyroidism. Mean cyst size was 21.1 mm (ext 4 - 70 mm) by 19.8mm (5 - 45 mm). Twenty four cysts were cervical (resection by cervicotomy), and one was mediastinal (resection by sternotomy). In addition to the resection of the PC, 3 adenomas, 1 hyperplasia of the parathyroid glands, 14 benign thyroid diseases and 4 papillary carcinomas were recognized and treated during the cervicotomies. Conclusion: The diagnosis of PC is uncommon and must be based primarily on the study of the cyst liquid obtained by percutaneous puncture (intracystic parathyroid hormone measurement). True PCs are non functional.
    Keywords Hyperparathyroidism ; Cystic Parathyroid ; Intact Parathyroid Hormone ; Surgery ; RD1-811 ; Medicine ; R ; DOAJ:Surgery ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
    Subject code 610
    Language English
    Publishing date 2012-10-01T00:00:00Z
    Publisher Scientific Research Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Analysis of enteric nervous system and intestinal epithelial barrier to predict complications in Hirschsprung’s disease

    Anne Dariel / Lucie Grynberg / Marie Auger / Chloé Lefèvre / Tony Durand / Philippe Aubert / Catherine Le Berre-Scoul / Aurélien Venara / Etienne Suply / Marc-David Leclair / Philine de Vries / Guillaume Levard / Benoit Parmentier / Guillaume Podevin / Françoise Schmitt / Véronique Couvrat / Sabine Irtan / Erik Hervieux / Thierry Villemagne /
    Hubert Lardy / Carmen Capito / Cécile Muller / Sabine Sarnacki / Jean-François Mosnier / Louise Galmiche / Pascal Derkinderen / Hélène Boudin / Charlène Brochard / Michel Neunlist

    Scientific Reports, Vol 10, Iss 1, Pp 1-

    2020  Volume 14

    Abstract: Abstract In Hirschsprung’s disease (HSCR), postoperative course remains unpredictable. Our aim was to define predictive factors of the main postoperative complications: obstructive symptoms (OS) and Hirschsprung-associated enterocolitis (HAEC). In this ... ...

    Abstract Abstract In Hirschsprung’s disease (HSCR), postoperative course remains unpredictable. Our aim was to define predictive factors of the main postoperative complications: obstructive symptoms (OS) and Hirschsprung-associated enterocolitis (HAEC). In this prospective multicentre cohort study, samples of resected bowel were collected at time of surgery in 18 neonates with short-segment HSCR in tertiary care hospitals. OS and HAEC were noted during postoperative follow-up. We assessed the enteric nervous system and the intestinal epithelial barrier (IEB) in ganglionic segments by combining immunohistochemical, proteomic and transcriptomic approaches, with functional ex vivo analysis of motility and para/transcellular permeability. Ten HSCR patients presented postoperative complications (median follow-up 23.5 months): 6 OS, 4 HAEC (2 with OS), 2 diarrhoea (without OS/HAEC). Immunohistochemical analysis showed a significant 41% and 60% decrease in median number of nNOS-IR myenteric neurons per ganglion in HSCR with OS as compared to HSCR with HAEC/diarrhoea (without OS) and HSCR without complications (p = 0.0095; p = 0.002, respectively). Paracellular and transcellular permeability was significantly increased in HSCR with HAEC as compared to HSCR with OS/diarrhoea without HAEC (p = 0.016; p = 0.009) and HSCR without complications (p = 0.029; p = 0.017). This pilot study supports the hypothesis that modulating neuronal phenotype and enhancing IEB permeability may treat or prevent postoperative complications in HSCR.
    Keywords Medicine ; R ; Science ; Q
    Subject code 610
    Language English
    Publishing date 2020-12-01T00:00:00Z
    Publisher Nature Portfolio
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago.

    Perrone, Gennaro / Giuffrida, Mario / Abu-Zidan, Fikri / Kruger, Vitor F / Livrini, Marco / Petracca, Gabriele Luciano / Rossi, Giorgio / Tarasconi, Antonio / Tian, Brian W C A / Bonati, Elena / Mentz, Ricardo / Mazzini, Federico N / Campana, Juan P / Gasser, Elisabeth / Kafka-Ritsch, Reinhold / Felsenreich, Daniel M / Dawoud, Christopher / Riss, Stefan / Gomes, Carlos Augusto /
    Gomes, Felipe Couto / Gonzaga, Ricardo Alessandro Teixeira / Canton, Cassio Alfred Brattig / Pereira, Bruno Monteiro / Fraga, Gustavo P / Zem, Leticia Gonçalves / Cordeiro-Fonseca, Vinicius / de Mesquita Tauil, Renato / Atanasov, Boyko / Belev, Nikolay / Kovachev, Nikola / Meléndez, L Juan José / Dimova, Ana / Dimov, Stefan / Zelić, Zdravko / Augustin, Goran / Bogdanić, Branko / Morić, Trpimir / Chouillard, Elie / Bajul, Melinda / De Simone, Belinda / Panis, Yves / Esposito, Francesco / Notarnicola, Margherita / Lauka, Lelde / Fabbri, Anna / Hentati, Hassen / Fnaiech, Iskander / Aurélien, Venara / Bougard, Marie / Roulet, Maxime / Demetrashvili, Zaza / Pipia, Irakli / Merabishvili, Giorgi / Bouliaris, Konstantinos / Koukoulis, Georgios / Doudakmanis, Christos / Xenaki, Sofia / Chrysos, Emmanuel / Kokkinakis, Stamatios / Vassiliu, Panteleimon / Michalopoulos, Nikolaos / Margaris, Ioannis / Kechagias, Aristotelis / Avgerinos, Konstantinos / Katunin, Jevgeni / Lostoridis, Eftychios / Nagorni, Eleni-Aikaterini / Pujante, Antonio / Mulita, Francesk / Maroulis, Ioannis / Vailas, Michail / Marinis, Athanasios / Siannis, Ioannis / Bourbouteli, Eirini / Manatakis, Dimitrios K / Tasis, Nikolaos / Acheimastos, Vasileios / Maria, Sotiropoulou / Stylianos, Kapiris / Kuzeridis, Harilaos / Korkolis, Dimitrios / Fradelos, Evangelos / Kavalieratos, George / Petropoulou, Thalia / Polydorou, Andreas / Papacostantinou, Ioannis / Triantafyllou, Tania / Kimpizi, Despina / Theodorou, Dimitrios / Toutouzas, Konstantinos / Chamzin, Alexandros / Frountzas, Maximos / Schizas, Dimitrios / Karavokyros, Ioannis / Syllaios, Athanasios / Charalabopoulos, Alexandros / Boura, Maria / Baili, Efstratia / Ioannidis, Orestis / Loutzidou, Lydia / Anestiadou, Elissavet / Tsouknidas, Ioannis / Petrakis, Georgios / Polenta, Eleni / Bains, Lovenish / Gupta, Rahul / Singh, Sudhir K / Khanduri, Archana / Bala, Miklosh / Kedar, Asaf / Pisano, Marcello / Podda, Mauro / Pisanu, Adolfo / Martines, Gennaro / Trigiante, Giuseppe / Lantone, Giuliano / Agrusa, Antonino / Di Buono, Giuseppe / Buscemi, Salvatore / Veroux, Massimiliano / Gioco, Rossella / Veroux, Gastone / Oragano, Luigi / Zonta, Sandro / Lovisetto, Federico / Feo, Carlo V / Pesce, Antonio / Fabbri, Nicolò / Lantone, Giulio / Marino, Fabio / Perrone, Fabrizio / Vincenti, Leonardo / Papagni, Vincenzo / Picciariello, Arcangelo / Rossi, Stefano / Picardi, Biagio / Del Monte, Simone Rossi / Visconti, Diego / Osella, Giulia / Petruzzelli, Luca / Pignata, Giusto / Andreuccetti, Jacopo / D'Alessio, Rossella / Buonfantino, Massimo / Guaitoli, Eleonora / Spinelli, Stefano / Sampietro, Gianluca Matteo / Corbellini, Carlo / Lorusso, Leonardo / Frontali, Alice / Pezzoli, Isabella / Bonomi, Alessandro / Chierici, Andrea / Cotsoglou, Christian / Manca, Giuseppe / Delvecchio, Antonella / Musa, Nicola / Casati, Massimiliano / Letizia, Laface / Abate, Emmanuele / Ercolani, Giorgio / D'Acapito, Fabrizio / Solaini, Leonardo / Guercioni, Gianluca / Cicconi, Simone / Sasia, Diego / Borghi, Felice / Giraudo, Giorgio / Sena, Giuseppe / Castaldo, Pasquale / Cardamone, Eugenia / Portale, Giuseppe / Zuin, Matteo / Spolverato, Ylenia / Esposito, Marialusia / Isernia, Roberta Maria / Di Salvo, Maria / Manunza, Romina / Esposito, Giuseppe / Agus, Marcello / Asti, Emanuele Luigi Giuseppe / Bernardi, Daniele Tiziano / Tonucci, Tommaso Panici / Luppi, Davide / Casadei, Massimiliano / Bonilauri, Stefano / Pezzolla, Angela / Panebianco, Annunziata / Laforgia, Rita / De Luca, Maurizio / Zese, Monica / Parini, Dario / Jovine, Elio / De Sario, Giuseppina / Lombardi, Raffaele / Aprea, Giovanni / Palomba, Giuseppe / Capuano, Marianna / Argenio, Giulio / Orio, Gianluca / Armellino, Mariano Fortunato / Troian, Marina / Guerra, Martina / Nagliati, Carlo / Biloslavo, Alan / Germani, Paola / Aizza, Giada / Monsellato, Igor / Chahrour, Ali Chaouki / Anania, Gabriele / Bombardini, Cristina / Bagolini, Francesco / Sganga, Gabriele / Fransvea, Pietro / Bianchi, Valentina / Boati, Paolo / Ferrara, Francesco / Palmieri, Francesco / Cianci, Pasquale / Gattulli, Domenico / Restini, Enrico / Cillara, Nicola / Cannavera, Alessandro / Nita, Gabriela Elisa / Sarnari, Jlenia / Roscio, Francesco / Clerici, Federico / Scandroglio, Ildo / Berti, Stefano / Cadeo, Alessandro / Filippelli, Alice / Conti, Luigi / Grassi, Carmine / Cattaneo, Gaetano Maria / Pighin, Marina / Papis, Davide / Gambino, Giovanni / Bertino, Vanessa / Schifano, Domenico / Prando, Daniela / Fogato, Luisella / Cavallo, Fabio / Ansaloni, Luca / Picheo, Roberto / Pontarolo, Nicholas / Depalma, Norma / Spampinato, Marcello / D'Ugo, Stefano / Lepre, Luca / Capponi, Michela Giulii / Campa, Rossella Domenica / Sarro, Giuliano / Dinuzzi, Vincenza Paola / Olmi, Stefano / Uccelli, Matteo / Ferrari, Davide / Inama, Marco / Moretto, Gianluigi / Fontana, Michele / Favi, Francesco / Picariello, Erika / Rampini, Alessia / Barberis, Andrea / Azzinnaro, Antonio / Oliva, Alba / Totaro, Luigi / Benzoni, Ilaria / Ranieri, Valerio / Capolupo, Gabriella Teresa / Carannante, Filippo / Caricato, Marco / Ronconi, Maurizio / Casiraghi, Silvia / Casole, Giovanni / Pantalone, Desire / Alemanno, Giovanni / Scheiterle, Maximilian / Ceresoli, Marco / Cereda, Marco / Fumagalli, Chiara / Zanzi, Federico / Bolzon, Stefano / Guerra, Enrico / Lecchi, Francesca / Cellerino, Paola / Ardito, Antonella / Scaramuzzo, Rosa / Balla, Andrea / Lepiane, Pasquale / Tartaglia, Nicola / Ambrosi, Antonio / Pavone, Giovanna / Palini, Gian Marco / Veneroni, Simone / Garulli, Gianluca / Ricci, Claudio / Torre, Beatrice / Russo, Iris Shari / Rottoli, Matteo / Tanzanu, Marta / Belvedere, Angela / Milone, Marco / Manigrasso, Michele / De Palma, Giovanni Domenico / Piccoli, Micaela / Pattacini, Gianmaria Casoni / Magnone, Stefano / Bertoli, Paolo / Pisano, Michele / Massucco, Paolo / Palisi, Marco / Luzzi, Andrea-Pierre / Fleres, Francesco / Clarizia, Guglielmo / Spolini, Alessandro / Kobe, Yoshiro / Toma, Takayuki / Shimamura, Fumihiko / Parker, Robert / Ranketi, Sinkeet / Mitei, Mercy / Svagzdys, Saulius / Pauzas, Henrikas / Zilinskas, Justas / Poskus, Tomas / Kryzauskas, Marius / Jakubauskas, Matas / Zakaria, Andee Dzulkarnaen / Zakaria, Zaidi / Wong, Michael Pak-Kai / Jusoh, Asri Che / Zakaria, Muhammad Nazreen / Cruz, Daniel Rios / Elizalde, Aurea Barbara Rodriguez / Reynaud, Alejandro Bañon / Hernandez, Edgard Efren Lozada / Monroy, Jose Maria Victor Palomo / Hinojosa-Ugarte, Diego / Quiodettis, Martha / Du Bois, María Esther / Latorraca, José / Major, Piotr / Pędziwiatr, Michał / Pisarska-Adamczyk, Magdalena / Walędziak, Maciej / Kwiatkowski, Andrzej / Czyżykowski, Łukasz / da Costa, Silvia Dantas / Pereira, Bela / Ferreira, Ana Rita Oliveira / Almeida, Filipe / Rocha, Ricardo / Carneiro, Carla / Perez, Diego Pita / Carvas, João / Rocha, Catarina / Ferreira, Cátia / Marques, Rita / Fernandes, Urânia / Leao, Pedro / Goulart, André / Pereira, Rita Gonçalves / Patrocínio, Sara Daniela Direito / de Mendonça, Nuno Gonçalo Gonçalves / Manso, Maria Isabel Cerqueira / Morais, Henrique Manuel Cardoso / Cardoso, Paulo Sebastião / Calu, Valentin / Miron, Adrian / Toma, Elena Adelina / Gachabayov, Mahir / Abdullaev, Abakar / Litvin, Andrey / Nechay, Taras / Tyagunov, Alexander / Yuldashev, Anvar / Bradley, Alison / Wilson, Michael / Panyko, Arpád / Látečková, Zuzana / Lacko, Vladimír / Lesko, Dusan / Soltes, Marek / Radonak, Jozef / Turrado-Rodriguez, Victor / Termes-Serra, Roser / Morales-Sevillano, Xavier / Lapolla, Pierfrancesco / Mingoli, Andrea / Brachini, Gioia / Degiuli, Maurizio / Sofia, Silvia / Reddavid, Rossella / de Manzoni Garberini, Andrea / Buffone, Angelica / Del Pozo, Eduardo Perea / Aparicio-Sánchez, Daniel / Dos Barbeito, Sandra / Estaire-Gómez, Mercedes / Vitón-Herrero, Rebeca / de Los Ángeles Gil Olarte-Marquez, Mª / Gil-Martínez, José / Alconchel, Felipe / Nicolás-López, Tatiana / Rahy-Martin, Aida Cristina / Pelloni, María / Bañolas-Suarez, Raquel / Mendoza-Moreno, Fernando / Nisa, Francisca García-Moreno / Díez-Alonso, Manuel / Rodas, María Elisa Valle / Agundez, María Carmona / Andrés, María Inmaculada Pérez / Moreira, Claudia Cristina Lopes / Perez, Aintzane Lizarazu / Ponce, Iñigo Augusto / González-Castillo, Ana María / Membrilla-Fernández, Estela / Salvans, Silvia / Serradilla-Martín, Mario / Pardo, Pablo Sancho / Rivera-Alonso, Daniel / Dziakova, Jana / Huguet, Jose Mugüerza / Valle, Naila Pagès / Ruiz, Enrique Colás / Valcárcel, Cristina Rey / Moreno, Cristina Ruiz / Salazar, Yeniffer Tatiana Moreno / García, Juan Jesús Rubio / Micó, Silvia Sevila / López, Joaquín Ruiz / Farré, Silvia Pérez / Gomez, Maite Santamaria / Petit, Nuria Mestres / Titos-García, Alberto / Aranda-Narváez, Jose Manuel / Romacho-López, Laura / Sánchez-Guillén, Luis / Aranaz-Ostariz, Veronica / Bosch-Ramírez, Marina / Martínez-Pérez, Aleix / Martínez-López, Elías / Sebastián-Tomás, Juan Carlos / Jimenez-Riera, Granada / Jimenez-Vega, Javier / Cuellar, Jose Aurelio Navas / Campos-Serra, Andrea / Muñoz-Campaña, Anna / Gràcia-Roman, Raquel / Alegre, Javier Martínez / Pinto, Francisca Lima / O'Sullivan, Sara Nuñez / Antona, Francisco Blanco / Jiménez, Beatriz Muñoz / López-Sánchez, Jaime / Carmona, Zahira Gómez / Fernández, Rocio Torres / Sierra, Isabel Blesa / de León, Laura Román García / Moreno, Verónica Polaino / Iglesias, Eva / Cumplido, Paola Lora / Bravo, Altea Arango / Simó, Ignacio Rey / Domínguez, Carlota López / Caamaño, Aloia Guerreiro / Lozano, Rafael Calleja / Martínez, Manuel Durán / Torres, Álvaro Naranjo / de Quiros, Javier Tomas Morales Bernaldo / Pellino, Gianluca / Cloquell, Miriam Moratal / Moller, Elsa García / Jalal-Eldin, Sami / Abdoun, Ahmed K / Hamid, Hytham K S / Lohsiriwat, Varut / Mongkhonsupphawan, Aitsariya / Baraket, Oussama / Ayed, Karim / Abbassi, Imed / Ali, Ali Ben / Ammar, Houssem / Kchaou, Ali / Tlili, Ahmed / Zribi, Imen / Colak, Elif / Polat, Suleyman / Koylu, Zehra Alan / Guner, Ali / Usta, Mehmet Arif / Reis, Murat Emre / Mantoglu, Baris / Gonullu, Emre / Akin, Emrah / Altintoprak, Fatih / Bayhan, Zulfu / Firat, Necattin / Isik, Arda / Memis, Ufuk / Bayrak, Mehmet / Altıntaş, Yasemin / Kara, Yasin / Bozkurt, Mehmet Abdussamet / Kocataş, Ali / Das, Koray / Seker, Ahmet / Ozer, Nazmi / Atici, Semra Demirli / Tuncer, Korhan / Kaya, Tayfun / Ozkan, Zeynep / Ilhan, Onur / Agackiran, Ibrahim / Uzunoglu, Mustafa Yener / Demirbas, Eren / Altinel, Yuksel / Meric, Serhat / Hacım, Nadir Adnan / Uymaz, Derya Salim / Omarov, Nail / Balık, Emre / Tebala, Giovanni D / Khalil, Hany / Rana, Mridul / Khan, Mansoor / Florence, Charlotte / Swaminathan, Christie / Leo, Cosimo Alex / Liasis, Lampros / Watfah, Josef / Trostchansky, Ivan / Delgado, Edward / Pontillo, Marcelo / Latifi, Rifat / Coimbra, Raul / Edwards, Sara / Lopez, Ana / Velmahos, George / Dorken, Ander / Gebran, Anthony / Palmer, Amanda / Oury, Jeffrey / Bardes, James M / Seng, Sirivan Suon / Coffua, Lauren S / Ratnasekera, Asanthi / Egodage, Tanya / Echeverria-Rosario, Karla / Armento, Isabella / Napolitano, Lena M / Sangji, Naveen F / Hemmila, Mark / Quick, Jacob A / Austin, Tyler R / Hyman, Theodore S / Curtiss, William / McClure, Amanda / Cairl, Nicholas / Biffl, Walter L / Truong, Hung P / Schaffer, Kathryn / Reames, Summer / Banchini, Filippo / Capelli, Patrizio / Coccolini, Federico / Sartelli, Massimo / Bravi, Francesca / Vallicelli, Carlo / Agnoletti, Vanni / Baiocchi, Gian Luca / Catena, Fausto

    World journal of emergency surgery : WJES

    2024  Volume 19, Issue 1, Page(s) 14

    Abstract: Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute ... ...

    Abstract Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA.
    Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up.
    Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections.
    Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception.
    MeSH term(s) Female ; Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Male ; Emergencies ; Prospective Studies ; Postoperative Complications/etiology ; Anastomosis, Surgical/methods ; Colorectal Neoplasms/surgery
    Language English
    Publishing date 2024-04-16
    Publishing country England
    Document type Observational Study ; Multicenter Study ; Journal Article
    ZDB-ID 2233734-9
    ISSN 1749-7922 ; 1749-7922
    ISSN (online) 1749-7922
    ISSN 1749-7922
    DOI 10.1186/s13017-024-00543-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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