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Article ; Online: Laparoscopic Complete Mesocolic Excision With Vascular Anatomy.

Popeskou, Sotirios-Georgios / Bernardi, Lorenzo / Christoforidis, Dimitri

2023 Volume 66, Issue 6, Page(s) e299–e300

MeSH term(s)	Humans ; Colonic Neoplasms/surgery ; Lymph Node Excision ; Laparoscopy ; Mesocolon/surgery ; Colectomy
Language	English
Publishing date	2023-03-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	212581-x
ISSN	1530-0358 ; 0012-3706
ISSN (online)	1530-0358
ISSN	0012-3706
DOI	10.1097/DCR.0000000000002667
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Article ; Online: Commentary on 'Changing paradigm of sacral neuromodulation and external anal sphincter repair for faecal incontinence in specialist centres'.

Lehur, Paul A / Christoforidis, Dimitri

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2021 Volume 23, Issue 3, Page(s) 716–717

MeSH term(s)	Anal Canal/surgery ; Electric Stimulation Therapy ; Fecal Incontinence/therapy ; Humans ; Sacrococcygeal Region ; Sacrum
Language	English
Publishing date	2021-03-24
Publishing country	England
Document type	Journal Article
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.15559
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Article ; Online: How best to palliate and treat emergency conditions in geriatric patients with colorectal cancer.

Zattoni, Davide / Christoforidis, Dimitri

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2020 Volume 46, Issue 3, Page(s) 369–378

Abstract: Almost one third of colorectal cancer (CRC) cases are diagnosed in an emergency setting, mostly among geriatric patients. Clinical scenarios are often complex and decision making delicate. Besides the obvious need to consider the patient's and/or family ... ...

Abstract	Almost one third of colorectal cancer (CRC) cases are diagnosed in an emergency setting, mostly among geriatric patients. Clinical scenarios are often complex and decision making delicate. Besides the obvious need to consider the patient's and/or family and care givers' desires, the surgeon should be able to make the best educated guess on future outcomes in three areas: oncological prognosis, morbidity and mortality risk, and long-term functional loss. Using simple and brief tools for frailty screening reasonable treatment goals with curative or palliative intent can be planned. The most frequent clinical scenarios of CRC in emergency are bowel obstruction and perforation. We propose treatment algorithms based on assessment of the patient's overall reserve and discuss the indications, techniques and impact of a stoma in the geriatric patient. Bridge to surgery strategies may be best adapted to help the frail geriatric patient overcome the acute disease and maybe return to previous state of function. Post-operative morbidity and mortality rates are high in emergency surgery for CRC, but if the geriatric patient survives the post-operative period, oncological prognosis seems to be similar to younger patients. Because the occurrence of complications is the strongest predictor of functional decline and death, post-operative care plays a major role to optimize outcomes. Future studies should further investigate emergency surgery of CRC in the older adults focusing in particular on functional outcomes in order to help physicians counsel patients and families for a tailored treatment.
MeSH term(s)	Aged ; Colorectal Neoplasms/therapy ; Emergency Service, Hospital ; Frail Elderly ; Geriatric Assessment/methods ; Humans ; Palliative Care/methods ; Postoperative Care/methods
Language	English
Publishing date	2020-01-02
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2019.12.020
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Zs.A 1149: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Long-term outcomes in elderly patients after elective surgery for colorectal cancer within an ERAS protocol: a retrospective analysis.

Navarra, Andrea / Porcellini, Iride / Mongelli, Francesco / Popeskou, Sotirios Georgios / Grass, Fabian / Christoforidis, Dimitri

Langenbeck's archives of surgery

2023 Volume 408, Issue 1, Page(s) 438

Abstract: Purpose: The number of elderly patients with a diagnosis of colorectal cancer (CRC) is increasing. Considering short life expectancy and multiple comorbidities, surgery may not always be the best treatment option.: Methods: We included all ... ...

Abstract	Purpose: The number of elderly patients with a diagnosis of colorectal cancer (CRC) is increasing. Considering short life expectancy and multiple comorbidities, surgery may not always be the best treatment option. Methods: We included all consecutive patients aged 80 years and older who underwent elective resection for CRC following Enhanced Recovery after Surgery (ERAS) protocol between January 2011 and May 2021. The primary endpoint was overall survival, secondary endpoints were 30-day morbidity, and the rate of return to pre-operative living conditions 3 months after surgery. Results: Ninety-four patients were included. Mean age was 84.6 ± 3.6 years, 49 patients (52%) were female. Most patients (77.6%) were ASA score ≥ 3. Laparoscopic resections were performed in 85 patients (90.4%), involving 69 (73.4%) colonic and 25 (26.6%) rectal resections. A stoma was constructed in 22 patients (23%), and reversed in 12 (54.5%). Twenty-two patients (23.4%) experienced a Clavien-Dindo ≥ 3 complication, and 2 patients (2.1%) died. The median length of hospital stay was 8 (interquartiles: 6-15) days. Sixty-six patients (70.2%) were discharged home directly and 26 (27.7%) to rehabilitation or postacute care institutes. At three months after surgery, eighty-two patients (96.5%) returned to their pre-operative living conditions directly or after short-term rehabilitation. Mean follow-up was 53 ± 33 months, estimated 5-year overall survival was 60.3% (95%CI 49.5-71.1%), and disease-free survival was 86.3% (95%CI 78.1-94.4%). Conclusions: Our study suggests that elderly patients undergoing elective surgery have a high potential to return to preoperative living conditions and good overall- and disease-free survivals, despite significant postoperative morbidity.
MeSH term(s)	Aged ; Humans ; Female ; Aged, 80 and over ; Male ; Enhanced Recovery After Surgery ; Retrospective Studies ; Postoperative Complications/etiology ; Laparoscopy/methods ; Length of Stay ; Colorectal Neoplasms/surgery ; Colorectal Neoplasms/complications
Language	English
Publishing date	2023-11-17
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-023-03179-7
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Article ; Online: Laparoscopic vs. ultrasound-guided transversus abdominis plane (TAP) block in colorectal surgery: a systematic review and meta-analysis of randomized trials.

Iaquinandi, Fabiano / Mongelli, Francesco / Christoforidis, Dimitri / Cianfarani, Agnese / Pini, Ramon / Saporito, Andrea / Popeskou, Sotirios Georgios / La Regina, Davide

Surgical endoscopy

2024 Volume 38, Issue 3, Page(s) 1119–1130

Abstract: Background: The transversus abdominis plane block (TAPB) is effective for postoperative pain management in patients undergoing colorectal surgery. However, evidence regarding the optimal delivery method, either laparoscopic (L-TAPB) or ultrasound-guided ...

Abstract	Background: The transversus abdominis plane block (TAPB) is effective for postoperative pain management in patients undergoing colorectal surgery. However, evidence regarding the optimal delivery method, either laparoscopic (L-TAPB) or ultrasound-guided (U-TAPB) is lacking. Our study aimed to compare the effectiveness of these delivery methods. Methods: We carried out a literature search of PubMed, Cochrane Library, Web of Science, and Google Scholar databases to include randomized studies comparing patients receiving either L-TAPB or U-TAPB during minimally invasive colorectal surgery. The primary endpoint was opioid consumption in the first 24 h after surgery. Risk of bias was assessed with the RoB-2 tool. Effect size was estimated for each study with 95% confidence interval and overall effect measure was estimated with a random effect model. Results: The literature search revealed 294 articles, of which four randomized trials were eligible. A total of 359 patients were included, 176 received a L-TAPB and 183 received a U-TAPB. We established the non-inferiority of L-TAPB, as the absolute difference of - 2.6 morphine-mg (95%CI - 8.3 to 3.0) was below the pooled non-inferiority threshold of 8.1 morphine-mg (low certainty level). No difference in opioid consumption was noted at 2, 6, 12, and 48 h (low to very low certainty level). Postoperative pain, nausea and vomiting were similar between groups at different timepoints (low to very low certainty level). No TAPB-related complications were recorded. Finally, the length of hospital stay was similar between groups. Conclusion: For postoperative multimodal analgesia both L-TAPB and U-TAPB may result in little to no difference in outcome in patients undergoing colorectal surgery. Registration Prospero CRD42023421141.
MeSH term(s)	Humans ; Analgesics, Opioid/therapeutic use ; Anesthetics, Local ; Colorectal Surgery ; Abdominal Muscles/surgery ; Randomized Controlled Trials as Topic ; Laparoscopy/methods ; Pain, Postoperative/etiology ; Pain, Postoperative/prevention & control ; Pain, Postoperative/surgery ; Morphine ; Ultrasonography, Interventional/adverse effects ; Benzamidines
Chemical Substances	Analgesics, Opioid ; Anesthetics, Local ; 1,3-bis(4-amidinophenoxy)-2-(4-amidinophenoxymethyl)ethylpropane (115044-37-6) ; Morphine (76I7G6D29C) ; Benzamidines
Language	English
Publishing date	2024-01-22
Publishing country	Germany
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-023-10658-x
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Article ; Online: Artificial Sphincters to Treat Severe Fecal Incontinence: Currently in a Deadlock.

Lehur, Paul-Antoine / Christoforidis, Dimitri / Meurette, Guillaume

Diseases of the colon and rectum

2020 Volume 63, Issue 8, Page(s) 1017–1019

MeSH term(s)	Anal Canal/surgery ; Artificial Organs ; Fecal Incontinence/therapy ; Humans
Language	English
Publishing date	2020-08-05
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	212581-x
ISSN	1530-0358 ; 0012-3706
ISSN (online)	1530-0358
ISSN	0012-3706
DOI	10.1097/DCR.0000000000001708
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Article ; Online: Ondansetron for Low Anterior Resection Syndrome (LARS): A Double-Blind, Placebo-Controlled, Cross-Over, Randomized Study.

Popeskou, Sotirios Georgios / Roesel, Raffaello / Faes, Seraina / Vanoni, Alice / Galafassi, Jacopo / di Tor Vajana, Antonjacopo Ferrario / Piotet, Laure-Meline / Christoforidis, Dimitri

Annals of surgery

2023 Volume 279, Issue 2, Page(s) 196–202

Abstract: Objective: The aim of the study was to examine the efficacity and safety of ondansetron, a serotonin receptor antagonist, to treat patients with low anterior resection syndrome (LARS).: Background: LARS after rectal resection is common and ... ...

Abstract	Objective: The aim of the study was to examine the efficacity and safety of ondansetron, a serotonin receptor antagonist, to treat patients with low anterior resection syndrome (LARS). Background: LARS after rectal resection is common and debilitating. Current management strategies include behavioral and dietary modifications, physiotherapy, antidiarrheal drugs, enemas, and neuromodulation, but the results are not always satisfactory. Methods: This is a randomized, multicentric, double-blinded, placebo-controlled, and cross-over study. Patients with LARS (LARS score >20) no longer than 2 years after rectal resection were randomized to receive either 4 weeks of ondansetron followed by 4 weeks of placebo (O-P group) or 4 weeks of placebo followed by 4 weeks of ondansetron (P-O group). The primary endpoint was LARS severity measured using the LARS score; secondary endpoints were incontinence (Vaizey score) and irritable bowel syndrome quality of life (IBS-QoL questionnaire). Patients' scores and questionnaires were completed at baseline and after each 4-week treatment period. Results: Of 46 randomized patients, 38 were included in the analysis. From baseline to the end of the first period, in the O-P group, the mean (SD) LARS score decreased by 25% [from 36.6 (5.6) to 27.3 (11.5)] and the proportion of patients with major LARS (score >30) went from 15/17 (88%) to 7/17 (41%), ( P =0.001). In the P-O group, the mean (SD) LARS score decreased by 12% [from 37 (4.8) to 32.6 (9.1)], and the proportion of major LARS went from 19/21 (90%) to 16/21 (76%). After crossover, LARS scores deteriorated again in the O-P group receiving placebo, but further improved in the P-O group receiving ondansetron. Mean Vaizey scores and IBS QoL scores followed a similar pattern. Conclusions: Ondansetron is a safe and simple treatment that appears to improve both symptoms and QoL in LARS patients.
MeSH term(s)	Humans ; Ondansetron/therapeutic use ; Irritable Bowel Syndrome/chemically induced ; Irritable Bowel Syndrome/drug therapy ; Low Anterior Resection Syndrome ; Rectal Neoplasms/surgery ; Quality of Life ; Postoperative Complications/therapy ; Cross-Over Studies
Chemical Substances	Ondansetron (4AF302ESOS)
Language	English
Publishing date	2023-07-13
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000005995
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Article ; Online: Laparoscopic versus ultrasound-guided transversus abdominis plane block in colorectal surgery: a non-inferiority, multicentric randomized double-blinded clinical trial.

La Regina, Davide / Popeskou, Sotirios Georgios / Saporito, Andrea / Gaffuri, Paolo / Tasciotti, Edoardo / Dossi, Roberto / Christoforidis, Dimitri / Mongelli, Francesco

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2023 Volume 25, Issue 9, Page(s) 1921–1928

Abstract: Aim: The aim of this study was to assess if laparoscopic-assisted transversus abdominis plane (TAP) block (L-TAPB) is as efficient as ultrasound-guided TAP block (U-TAPB) in postoperative pain control.: Method: In all, 112 patients scheduled for ... ...

Abstract	Aim: The aim of this study was to assess if laparoscopic-assisted transversus abdominis plane (TAP) block (L-TAPB) is as efficient as ultrasound-guided TAP block (U-TAPB) in postoperative pain control. Method: In all, 112 patients scheduled for elective laparoscopic colon resection from February 2018 to December 2021 at two Swiss hospitals were included and randomized in a 1:1 ratio before surgery with either L-TAPB or U-TAPB. The primary end-point was the non-inferiority of the L-TAPB compared to U-TAPB with regard to the total opioid consumption within the first 24 h after surgery. Data regarding patients' characteristics, opioid consumption, pain on the visual analogue scale, operative and anaesthesia induction time, complications and length of stay were collected and analysed. Results: Fifty-five patients were allocated to the L-TAPB and fifty-seven to the U-TAPB. No significant difference was found in the overall dose of opioids within 24 h, and the non-inferiority of the L-TAPB was confirmed. There were almost twice as many patients in the L-TAPB group requesting opioid reserves compared to the U-TAPB group (54.5% vs. 29.8%, P = 0.008). The anaesthesia induction time was significantly longer in the U-TAPB group (17 ± 11 min vs. 23 ± 12 min, P = 0.014). For all other variables (pain on the visual analogue scale, opioid consumption, need of epidural analgesia, operating time, postoperative complications and hospital stay) no statistically significant difference between the L-TAPB and the U-TAPB groups was noted. Conclusion: Our results showed the non-inferiority of the laparoscopic delivery compared to ultrasound-guided administration of the TAP block, with the advantage of not affecting anaesthesia times. Study registration number: 2017-02017 CE 3294, ClinicalTrials.gov identifier NCT04575233.
MeSH term(s)	Humans ; Abdominal Muscles/diagnostic imaging ; Analgesics, Opioid/therapeutic use ; Colectomy/methods ; Colorectal Surgery ; Laparoscopy/methods ; Pain, Postoperative/drug therapy ; Pain, Postoperative/etiology ; Ultrasonography, Interventional
Chemical Substances	1,3-bis(4-amidinophenoxy)-2-(4-amidinophenoxymethyl)ethylpropane (115044-37-6) ; Analgesics, Opioid
Language	English
Publishing date	2023-07-31
Publishing country	England
Document type	Equivalence Trial ; Journal Article ; Multicenter Study ; Randomized Controlled Trial
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.16689
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Article ; Online: Swiss consensus on the management of acute diverticulitis.

Girardin, Timothée / Martin, David / Lázaro-Fontanet, Enrique / Clerc, Daniel / Hübner, Martin / Brügger, Lukas / Turina, Matthias / Brunner, Walter / Christoforidis, Dimitri / Ris, Frederic / Adamina, Michel / von Strauss, Marco / Hahnloser, Dieter

BJS open

2024 Volume 8, Issue 1

MeSH term(s)	Humans ; Consensus ; Switzerland ; Diverticulitis/surgery ; Acute Disease
Language	English
Publishing date	2024-02-20
Publishing country	England
Document type	Journal Article
ISSN	2474-9842
ISSN (online)	2474-9842
DOI	10.1093/bjsopen/zrad165
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Article ; Online: Bowel function recovery after laparoscopic transverse colectomy within an ERAS program: a comparison to right and left colectomy.

Roesel, Raffaello / Mongelli, Francesco / Ajani, Costanza / Iaquinandi, Fabiano / Celio, Diana / Christoforidis, Dimitri

Langenbeck's archives of surgery

2021 Volume 406, Issue 5, Page(s) 1563–1570

Abstract: Background: It is known that functional recovery of the bowel is slower after right colectomy (RC) compared to left colectomy (LC), but very little has been reported on transverse colectomy (TC).: Objectives: The aim of this study was to compare the ... ...

Abstract	Background: It is known that functional recovery of the bowel is slower after right colectomy (RC) compared to left colectomy (LC), but very little has been reported on transverse colectomy (TC). Objectives: The aim of this study was to compare the clinical and early functional outcomes of TC, a more infrequent operation, to RC, and LC for colorectal cancer. Methods: Between December 2011 and December 2017, all patients undergoing elective colon resection in our institution were treated according to a standardized ERAS protocol and entered in a prospective database. We included in the study patients undergoing laparoscopic TC, RC, or LC for cancer with curative intent. The primary endpoint was prolonged postoperative ileus (PPOI), defined as need to insert a nasogastric tube, or refractory nausea VAS > 4 on or after the third postoperative day. Secondary endpoints were postoperative morbidity and length of hospital stay (LoS). Results: Out of 286 patients, 126 met the inclusion criteria: 20 underwent TC, 65 RC, and 41 LC. Patients in LC group were younger than in TC and RC groups; other baseline demographics were similar. PPOI was observed in 5 (25%), 26 (40%), and 10 (24%) patients in TC, RC, and LC groups, respectively (p = 0.417). In single group comparisons, the incidence of PPOI in the TC group was significantly lower in comparison to the RC group (OR for RC: 4.255, 95% CI 1.092-16.667, p = 0.037) and similar to the LC group. No significant differences in terms of postoperative complications or LoS stay were observed. Conclusion: The incidence of PPOI after segmental laparoscopic colectomy for cancer within an ERAS program appears as infrequent in TC as in LC and lower than after RC. It may be reasonable to consider a slower oral intake after RC, as it represents an independent predictor of PPOI.
MeSH term(s)	Colectomy ; Elective Surgical Procedures ; Humans ; Ileus/epidemiology ; Ileus/etiology ; Laparoscopy ; Length of Stay ; Postoperative Complications/epidemiology ; Recovery of Function
Language	English
Publishing date	2021-01-17
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-021-02082-3
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