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Article ; Online: The TPA score (total psoas muscle area) is the best marker for preoperative measurement of pre-sarcopenia in pancreatic surgery.

Bougard, M / Barbieux, J / Goulin, J / Parot-Schinkel, E / Vielle, B / Lermite, E

Journal of visceral surgery

2022 Volume 160, Issue 1, Page(s) 4–11

Abstract: Introduction: Pre-sarcopenia, defined by the loss of muscle mass, is significantly associated with an increased risk of postoperative complications in digestive surgery, particularly pancreatic resection. The five predominant markers of sarcopenia are: ... ...

Abstract	Introduction: Pre-sarcopenia, defined by the loss of muscle mass, is significantly associated with an increased risk of postoperative complications in digestive surgery, particularly pancreatic resection. The five predominant markers of sarcopenia are: psoas muscle area (TPA), intramuscular adipose tissue content (IMAC), Average Hounsfield Unit Calculation (HUAC), Skeletal Muscle Mass Index (MMI), and the ratio between visceral adipose tissue area and muscle surface area (VFA/TAMA). No standard reference marker has been determined. Material and methods: This retrospective cohort included patients who underwent pancreatic resection at the University Hospital of Angers between January 2008 and June 2017. The goal was to determine the marker that was most significantly associated with morbidity and mortality in pancreatic surgery. The secondary objective was to determine the characteristics of pre-sarcopenic patients. Results: The TPA score is the most sensitive marker for identifying patients at highest risk for immediate complications (P=0.008), proving far more sensitive than MMI (P=0.02), HUAC (P=0.34), IMAC (P=1), or VFA/TAMA (P=0.42). Postoperative mortality was 3.3% (n=5), morbidity was 63.8% (n=97). Pre-sarcopenic patients, as identified by the TPA index had significantly more immediate complications (71.2% versus 49.5%, P=0.008), in particular, more gastroparesis (P=0.02) and pancreatic fistula (P=0.03). Conclusion: In patients requiring pancreatic surgery, the prevalence of pre-sarcopenia is high and seems to be associated with a greater risk of immediate postoperative complications. The TPA score seems to be the most sensitive marker for detecting pre-sarcopenia. Evaluation of TPA preoperatively would make it possible to identify priority patients a priori who might benefit from pre-habilitation programs.
MeSH term(s)	Humans ; Sarcopenia/diagnosis ; Sarcopenia/diagnostic imaging ; Psoas Muscles/diagnostic imaging ; Retrospective Studies ; Digestive System Surgical Procedures/adverse effects ; Postoperative Complications/etiology ; Risk Factors
Language	English
Publishing date	2022-06-25
Publishing country	France
Document type	Journal Article
ISSN	1878-7886
ISSN (online)	1878-7886
DOI	10.1016/j.jviscsurg.2022.05.009
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Article ; Online: Additional Non-contrast CT to Portal Venous Phase is not Relevant for Patients referred for Colonic Diverticulitis or Sigmoiditis Suspicion.

Dray, Bertille / Aubé, Christophe / Boishardy, Thomas / Besnier, Louis / Darii, Carolina / Bougard, Marie / Paisant, Anita

Current medical imaging

2024

Abstract: Objective: To evaluate the usefulness of unenhanced CT added to the portal venous phase in the diagnostic accuracy of acute colonic diverticulitis/sigmoiditis.: Methods: Between January 1st and December 31st, 2020, all consecutive adult patients ... ...

Abstract	Objective: To evaluate the usefulness of unenhanced CT added to the portal venous phase in the diagnostic accuracy of acute colonic diverticulitis/sigmoiditis. Methods: Between January 1st and December 31st, 2020, all consecutive adult patients referred to the radiology department for clinical suspicion of acute colonic diverticulitis/sigmoiditis were retrospectively screened. To be included, patients must have undergone a CT with both unenhanced (UCT) and contrast-enhanced portal venous phase CT (CECT). CT examinations were assessed for features of diverticulitis, complications, differential diagnosis and incidental findings using UCT + CECT association, medical management, and follow-up as the reference. Radiation doses were recorded on our image archiving system and assessed. Results: Of the 114 patients included (mean age was 67±18 years; 60% were female), 46 had acute colonic diverticulitis/sigmoiditis. No diagnosis of sigmoiditis/diverticulitis, complication or differential diagnosis was missed with the CECT alone. Apart from diverticulitis, only one 2 mm meatal urinary microlithiasis was missed with no impact on patient management. The confidence level in diagnosis was not increased by UCT. The average DLP of CECT was 450 mGy.cm, and 382 mGy.cm for UCT. The use of a single-phase CECT acquisition allowed a reduction of 45.9% of the irradiation. Conclusion: Unenhanced CT is not necessary for patients addressed with clinical suspicion of acute colonic diverticulitis/sigmoiditis, and CECT alone protocol must be used.
Language	English
Publishing date	2024-02-28
Publishing country	United Arab Emirates
Document type	Journal Article
ISSN	1573-4056
ISSN (online)	1573-4056
DOI	10.2174/0115734056259655240103092901
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Article ; Online: Gastrointestinal motility has more of an impact on postoperative recovery than you might expect.

Viannay, P / Hamel, J F / Bougard, M / Barbieux, J / Hamy, A / Venara, A

Journal of visceral surgery

2020 Volume 158, Issue 1, Page(s) 19–26

Abstract: Purpose: While patient's reported autonomy (PRA) may help the physician to adapt the day of discharge, the link between postoperative ileus and length of stay and PRA is not known. The aim of this study was to evaluate the evolution of the PRA score ... ...

Abstract	Purpose: While patient's reported autonomy (PRA) may help the physician to adapt the day of discharge, the link between postoperative ileus and length of stay and PRA is not known. The aim of this study was to evaluate the evolution of the PRA score during the postoperative period and to determine the factors possibly influencing such an evolution. Methods: This retrospective study on a prospective database took place in a single centre over 14 months. PRA was defined by the by using part I of the Groningen Activity Restriction Scale known as activity of daily life [from 9 (best) to 45 (worst)]. Results: Among the 101 patients operated on for elective or emergent colorectal surgery, 80% of the patients had recovered their preoperative PRA (±5 points) before discharge and maintained their PRA during the 2 days preceding discharge. While PRA was significantly decreased by surgery (P<0.0001), each postoperative day allowed for its progressive recovery. Interestingly, the day of recovery of GI transit was associated with a significant increase of PRA (-6.96 points, P<0.0001). Despite high variability of baseline autonomy level, patients presented very similar recovery processes, which were represented by very low slope variability in the linear mixed model. Laparoscopy reduced the decrease of postoperative PRA (P=0.03) while ASA score>2 increased PRA (P=0.03). Age, emergency surgery and the occurrence of postoperative morbidity did not affect postoperative autonomy. Finally, enhanced recovery programs (ERP) tended to improve postoperative autonomy recovery (P=0.09). Conclusion: PRA may be used as a means of optimising a patient's day of discharge following colorectal surgery.
MeSH term(s)	Colorectal Surgery ; Gastrointestinal Motility ; Humans ; Ileus/epidemiology ; Ileus/etiology ; Postoperative Period ; Retrospective Studies
Language	English
Publishing date	2020-07-02
Publishing country	France
Document type	Journal Article
ISSN	1878-7886
ISSN (online)	1878-7886
DOI	10.1016/j.jviscsurg.2020.06.012
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Article ; Online: Modified Appleby Procedure, Distal Splenopancreatectomy with Celiac Axis Resection.

Triki, Haitham / Bergeat, Damien / Bougard, Marie / Robin, Fabien / Sulpice, Laurent

Annals of surgical oncology

2020 Volume 28, Issue 4, Page(s) 2358

Abstract: Background: Modified Appleby procedure could be indicated in stage III locally advanced body pancreatic ductal adenocarcinoma (PDAC) involving the celiac axis after neoadjuvant treatment.: Patients and methods: We report the case of a 38-year-old ... ...

Abstract	Background: Modified Appleby procedure could be indicated in stage III locally advanced body pancreatic ductal adenocarcinoma (PDAC) involving the celiac axis after neoadjuvant treatment. Patients and methods: We report the case of a 38-year-old woman presenting a tumor arising from the body of the pancreas, involving the celiac trunk with the common hepatic artery and having contact with the anterior surface of the superior mesenteric artery. A fine-needle aspirate biopsy confirmed the diagnosis of PADC. Eight cycles of FOLFIRINOX followed by chemoradiotherapy (50.4 Gy) were conducted. After 6 months, the CA19-9 levels were normalized, and the tumor remained stable without local growth or distant metastasis. To reduce the risk of ischemia-related complications and develop the pancreaticoduodenal arcades, a preoperative embolization of the common hepatic artery was performed. Then, surgical resection was considered 4 weeks after embolization. Results: The patient underwent a modified Appleby procedure including distal splenopancreatectomy with en bloc celiac axis resection combined with lateral portal vein resection. Venous reconstruction was carried out using peritoneal patch.1 Pathologic evaluation revealed a 2.5-cm PDAC with negative resection margins. Postoperative course was marked by acute ischemic cholecystitis requiring reoperation at postoperative day 3. The treatment was completed with four cycles of FOLFIRINOX, and she was free of disease 6 months after surgery. Conclusions: Nowadays, modified Appleby procedure is more frequently performed due to improvements in responses to chemotherapy and radiotherapy which have led to better local control and more aggressive approaches in highly selected patients.
MeSH term(s)	Adult ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Carcinoma, Pancreatic Ductal/surgery ; Celiac Artery/diagnostic imaging ; Celiac Artery/surgery ; Female ; Humans ; Pancreatectomy ; Pancreatic Neoplasms/surgery
Language	English
Publishing date	2020-10-21
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-020-09212-z
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Article ; Online: Management of biliary acute pancreatitis.

Bougard, M / Barbier, L / Godart, B / Le Bayon-Bréard, A-G / Marques, F / Salamé, E

Journal of visceral surgery

2018 Volume 156, Issue 2, Page(s) 113–125

Abstract: Acute pancreatitis is a frequent pathology with 11,000 to 13,000 new cases per year in France. A biliary origin (30 to 70% of the cases) should be suspected when alanine amino-transferases are elevated during the first 48 hours, and it is confirmed by ... ...

Abstract	Acute pancreatitis is a frequent pathology with 11,000 to 13,000 new cases per year in France. A biliary origin (30 to 70% of the cases) should be suspected when alanine amino-transferases are elevated during the first 48 hours, and it is confirmed by the presence of gallstones at trans abdominal ultrasound. Abdominal computed-tomography scan is performed around the fifth day, and is repeated according to clinical and biological evolution. Management of acute biliary pancreatitis varies according to its severity, which should be assessed according to systemic inflammatory response syndrome and organ failures. For mild acute pancreatitis, cholecystectomy should be performed during in-hospital stay, before oral feeding. For moderately severe and severe acute pancreatitis, treatment is based on resuscitation, early enteral continuous feeding, and management of complications. Interval cholecystectomy is performed at a later stage. Endoscopic retrograde cholangiopancreatography with sphincterotomy should be performed in emergency when angiocholitis is associated, and in delayed emergency before oral feeding for persistent common bile duct stone. A common bile duct stone should be searched for during cholecystectomy and can be treated during the same surgical procedure if local conditions are adequate. Cholelithiasis is the most frequent cause of acute pancreatitis during pregnancy, and its diagnosis and the treatment have some particularities.
MeSH term(s)	Alanine Transaminase/blood ; Biomarkers/blood ; Cholangiopancreatography, Endoscopic Retrograde/methods ; Choledocholithiasis/complications ; Choledocholithiasis/diagnostic imaging ; Cholelithiasis/complications ; Cholelithiasis/diagnostic imaging ; Drainage ; Enteral Nutrition ; Female ; Gallstones/complications ; Gallstones/diagnostic imaging ; Humans ; Intra-Abdominal Hypertension/diagnosis ; Length of Stay ; Multiple Organ Failure/diagnosis ; Pancreatic Pseudocyst/diagnosis ; Pancreatic Pseudocyst/etiology ; Pancreatic Pseudocyst/therapy ; Pancreatitis/diagnosis ; Pancreatitis/etiology ; Pancreatitis/therapy ; Pancreatitis, Acute Necrotizing/therapy ; Pregnancy ; Pregnancy Complications/diagnosis ; Severity of Illness Index ; Systemic Inflammatory Response Syndrome/diagnosis ; Tomography, X-Ray Computed ; Ultrasonography ; Vascular Diseases/etiology
Chemical Substances	Biomarkers ; Alanine Transaminase (EC 2.6.1.2)
Language	English
Publishing date	2018-10-30
Publishing country	France
Document type	Journal Article ; Review
ISSN	1878-7886
ISSN (online)	1878-7886
DOI	10.1016/j.jviscsurg.2018.08.002
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Article ; Online: Perioperative Transcutaneous Tibial Nerve Stimulation to Reduce Postoperative Ileus After Colorectal Resection: A Pilot Study.

Venara, Aurélien / Bougard, Marie / Mucci, Stéphanie / Lemoult, Annabelle / Le Naoures, Paul / Darsonval, Astrid / Barbieux, Julien / Neunlist, Michel / Hamy, Antoine P

Diseases of the colon and rectum

2018 Volume 61, Issue 9, Page(s) 1080–1088

Abstract: Background: Postoperative ileus involves an inflammatory pathway characterized by an increase of inflammation mediators in the colon wall; this could probably be prevented by sacral nerve neuromodulation. The posterior tibial nerve can be stimulated ... ...

Abstract	Background: Postoperative ileus involves an inflammatory pathway characterized by an increase of inflammation mediators in the colon wall; this could probably be prevented by sacral nerve neuromodulation. The posterior tibial nerve can be stimulated electrically to mimic neuromodulation. Objective: The aims of this study were to assess the efficacy of transcutaneous posterior tibial nerve stimulation in reducing the delay in GI motility recovery, to assess the safety of posterior tibial nerve stimulation in a perioperative setting, and to assess the efficacy of posterior tibial nerve stimulation in reducing the occurrence of postoperative ileus. Design: This was a preliminary randomized controlled study. Settings: This study was conducted in 1 academic hospital in France. Patients: Forty patients undergoing an elective colectomy were included and randomly assigned into 2 groups, posterior tibial nerve stimulation or placebo, according to the side of colectomy and the surgical access size. Intervention: Perioperative posterior tibial nerve stimulation or placebo was performed 3 times per day according to the randomly assigned group. Main outcome measures: Delay in GI motility recovery (passage of stool and tolerance of solid food) was measured. Results: Of the 40 patients included, 34 were included in the final analysis, in which 2 patients in the placebo group were allocated the incorrect device. The 6 other patients were secondarily excluded because of protocol deviation. In the intention-to-treat analysis, the mean delay in GI motility recovery was 3.6 and 3.11 days (in the placebo and tibial nerve stimulation groups; p = 0.60). Occurrence of postoperative ileus was not significantly higher in the placebo group (35.3% vs 17.6%; p = 0.42). In the per-protocol analysis, we observed the same trends except for the occurrence of postoperative ileus, which was significantly higher in the placebo group (p = 0.045). Tolerance to posterior tibial nerve stimulation was good, and all of the patients completed the protocol. Limitations: The amplitude of stimulation is set according to patient sensation, so some patients could have been aware of their group. In addition there were some inherent limitations because of the preliminary nature of the study and several deviations from the protocol. Conclusions: Posterior tibial nerve stimulation was safe in a perioperative setting and had a potential effect on GI motility recovery. The results of this study will be useful for sample size calculations in a larger prospective randomized trial. See Video Abstract at http://links.lww.com/DCR/A708.
MeSH term(s)	Aged ; Colectomy/adverse effects ; Female ; France ; Gastrointestinal Motility/physiology ; Humans ; Ileus/epidemiology ; Ileus/prevention & control ; Intention to Treat Analysis ; Male ; Middle Aged ; Pilot Projects ; Postoperative Complications/prevention & control ; Tibial Nerve/physiology ; Transcutaneous Electric Nerve Stimulation/adverse effects ; Transcutaneous Electric Nerve Stimulation/methods ; Treatment Outcome
Language	English
Publishing date	2018-08-07
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	212581-x
ISSN	1530-0358 ; 0012-3706
ISSN (online)	1530-0358
ISSN	0012-3706
DOI	10.1097/DCR.0000000000001171
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Article ; Online: Liver Venous Deprivation or Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy?: A Retrospective Multicentric Study.

Annals of surgery

2021 Volume 274, Issue 5, Page(s) 874–880

Abstract: Objective: To compare 2 techniques of remnant liver hypertrophy in candidates for extended hepatectomy: radiological simultaneous portal vein embolization and hepatic vein embolization (HVE); namely LVD, and ALPPS.: Background: Recent advances in ... ...

Abstract	Objective: To compare 2 techniques of remnant liver hypertrophy in candidates for extended hepatectomy: radiological simultaneous portal vein embolization and hepatic vein embolization (HVE); namely LVD, and ALPPS. Background: Recent advances in chemotherapy and surgical techniques have widened indications for extended hepatectomy, before which remnant liver augmentation is mandatory. ALPPS and LVD typically show higher hypertrophy rates than portal vein embolization, but their respective places in patient management remain unclear. Methods: All consecutive ALPPS and LVD procedures performed in 8 French centers between 2011 and 2020 were included. The main endpoint was the successful resection rate (resection rate without 90-day mortality) analyzed according to an intention-to-treat principle. Secondary endpoints were hypertrophy rates, intra and postoperative outcomes. Results: Among 209 patients, 124 had LVD 37 [13,1015] days before surgery, whereas 85 underwent ALPPS with an inter-stages period of 10 [6, 69] days. ALPPS was mostly-performed for colorectal liver metastases (CRLM), LVD for CRLM and perihilar cholangiocarcinoma. Hypertrophy was faster for ALPPS. Successful resection rates were 72.6% for LVD ± rescue ALPPS (n = 6) versus 90.6% for ALPPS (P < 0.001). Operative duration, blood losses and length-of-stay were lower for LVD, whereas 90-day major complications and mortality were comparable. Results were globally unchanged for CRLM patients, or after excluding the early 2 years of experience (learning-curve effect). Conclusions: This study is the first 1 comparing LVD versus ALPPS in the largest cohort so far. Despite its retrospective design, it yields original results that may serve as the basis for a prospective study.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/therapy ; Embolization, Therapeutic/methods ; Feasibility Studies ; Female ; Hepatectomy/methods ; Hepatic Veins/surgery ; Humans ; Intention to Treat Analysis/methods ; Ligation/methods ; Liver Neoplasms/therapy ; Male ; Middle Aged ; Portal Vein/surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2021-08-22
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000005121
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Book: La chimie de Nicolas Lemery

Bougard, Michel

(De diversis artibus ; t. 40, n.s. 3)

1999

Author's details	Michel Bougard
Series title	De diversis artibus ; t. 40, n.s. 3
MeSH term(s)	Chemistry/history
Keywords	France
Language	French
Size	524 p. :, ill., port. ;, 25 cm.
Publisher	Brepols
Publishing place	Turnhout
Document type	Book
Note	Commentary on Nicolas Lemery's Cours de chymie.
ISBN	9782503507392 ; 2503507395
Database	Catalogue of the US National Library of Medicine (NLM)

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Conference proceedings ; Online: Greenhouse gas (GHG) Mitigation and Technology Adoption Theory

O'Shea, Robert / Bougard, Maxime / Breen, James / O'Donoghue, Cathal / Ryan, Mary

Extended Grazing as a Case Study

2015

Keywords	Environmental Economics and Policy ; Livestock Production/Industries
Language	English
Publishing country	us
Document type	Conference proceedings ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Myocardial stunning in hypertrophic cardiomyopathy with normal coronary arteries.

Bougard, M / Heuse, D / Friart, A

International journal of cardiology

1996 Volume 56, Issue 1, Page(s) 71–73

Abstract: A patient with an obstructive hypertrophic cardiomyopathy and normal epicardial coronary arteries developed myocardial ischemia accompanied by a transitory apical akinesia. This wall motion dysfunction persisted for hours after the relief of myocardial ... ...

Abstract	A patient with an obstructive hypertrophic cardiomyopathy and normal epicardial coronary arteries developed myocardial ischemia accompanied by a transitory apical akinesia. This wall motion dysfunction persisted for hours after the relief of myocardial ischemia.
MeSH term(s)	Adrenergic beta-Antagonists/administration & dosage ; Cardiomyopathy, Hypertrophic/complications ; Cardiomyopathy, Hypertrophic/diagnosis ; Cardiomyopathy, Hypertrophic/drug therapy ; Coronary Angiography ; Coronary Vessels ; Echocardiography ; Electrocardiography ; Female ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Middle Aged ; Myocardial Stunning/diagnosis ; Myocardial Stunning/drug therapy ; Myocardial Stunning/etiology ; Remission Induction
Chemical Substances	Adrenergic beta-Antagonists
Language	English
Publishing date	1996-09
Publishing country	Netherlands
Document type	Case Reports ; Journal Article
ZDB-ID	779519-1
ISSN	1874-1754 ; 0167-5273
ISSN (online)	1874-1754
ISSN	0167-5273
DOI	10.1016/0167-5273(96)02741-6
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