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Article ; Online: Outcomes of discoid excision and segmental resection for colorectal endometriosis: robotic versus conventional laparoscopy.

Crestani, Adrien / Le Gac, Marjolaine / de Labrouhe, Éric / Touboul, Cyril / Bendifallah, Sofiane / Ferrier, Clément / Dabi, Yohann / Darai, Emile

Journal of robotic surgery

2024 Volume 18, Issue 1, Page(s) 87

Abstract: Surgery for deep endometriosis with colorectal involvement is an option after medical treatment failure. Over the past decade, robotic laparoscopy has emerged as an alternative to conventional laparoscopy. We aimed to evaluate surgical outcomes of ... ...

Abstract	Surgery for deep endometriosis with colorectal involvement is an option after medical treatment failure. Over the past decade, robotic laparoscopy has emerged as an alternative to conventional laparoscopy. We aimed to evaluate surgical outcomes of robotic versus conventional laparoscopy for discoid excision and segmental resection. From 2019 to 2023, we conducted a retrospective cohort study of 152 consecutive patients with colorectal endometriosis who underwent robotic or conventional laparoscopy for discoid excision and colorectal resection. Ninety of the patients 152 underwent robotic surgery and 62 conventional laparoscopy. The mean total surgical room occupancy and operating times were longer in the robotic group: 270 ± 81 min vs 240 ± 79 min, p = 0.010, and 216 ± 78 min vs 190 ± 76, p = 0.027, respectively. The mean intraoperative blood loss, and the incidence of intra- and postoperative complications (according to Clavien-Dindo classification) were similar in the two groups. The mean hospital stay was greater after conventional laparoscopy (8 ± 5 vs 7 ± 4 days; p = 0.03), and the rate of persistent voiding dysfunction was higher in the conventional group (9/11, 25% vs 2/11, 5%; p = 0.01). A higher incidence of persistent voiding dysfunction was also observed after segmental resection by conventional laparoscopy (25% vs 4.8%, p = 0.01). Our results support the use of robotic surgery as an alternative to conventional laparoscopy for discoid excision and segmental resection for colorectal endometriosis.
MeSH term(s)	Female ; Humans ; Robotic Surgical Procedures/methods ; Endometriosis/surgery ; Retrospective Studies ; Laparoscopy ; Colorectal Neoplasms
Language	English
Publishing date	2024-02-22
Publishing country	England
Document type	Journal Article
ZDB-ID	2268283-1
ISSN	1863-2491 ; 1863-2483
ISSN (online)	1863-2491
ISSN	1863-2483
DOI	10.1007/s11701-024-01854-5
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Article ; Online: Discoid excision for colorectal endometriosis associated infertility: A balance between fertility outcomes and complication rates.

Dabi, Yohann / Ebanga, Lea / Favier, Amélia / Kolanska, Kamila / Puchar, Anne / Jayot, Aude / Ferrier, Clément / Touboul, Cyril / Bendifallah, Sofiane / Darai, Emile

Journal of gynecology obstetrics and human reproduction

2024 Volume 53, Issue 2, Page(s) 102723

Abstract: Objective: The objective of our study was to study the impact of discoid excision for deep endometriosis (DE) with colorectal involvement on fertility outcomes.: Methods: 49 patients with a desire for pregnancy treated with discoid excision for ... ...

Abstract	Objective: The objective of our study was to study the impact of discoid excision for deep endometriosis (DE) with colorectal involvement on fertility outcomes. Methods: 49 patients with a desire for pregnancy treated with discoid excision for colorectal endometriosis in our endometriosis expert center between January 2015 and August 2020 were selected from our prospectively maintained database. Indications for surgery were either infertility and / or pelvic pain. Postoperative complications were graded according to the Clavien-Dindo classification. Fertility outcomes, both spontaneous and post-ART pregnancies, were analyzed. Results: Among the 49 patients who underwent discoid excision exclusively (no other digestive resection) with a desire to conceive, 25 had a pregnancy after surgery and 24 did not. Double discoid excision was performed in 6.1 % of the cases (3/49). A colpectomy was performed in 12.2 % of the patients (6/49), and a protective stoma in 12.2 % (6/49). Fenestration of endometriomas was performed in 28.6 % of the patients (14/49), and parametrectomy in 40.8 % (20/49). The postoperative complication rate was 24.5 % (12/49) including 10.2 % (5/49) grade I, 12.2 % (6/49) grade II, and 2 % (1/49) grade III. Prior to surgery, 28 (57.1 %) patients had infertility including 13 (52 %) that successfully conceived following surgery and 15 (62.5 %) that remain infertile. Spontaneous pregnancy was achieved in 60 % (15/25) of infertile patients' prior surgery. The live-birth rate in patients conceiving spontaneously was 75 % (12/16). Conclusion: Our results support that discoid excision is safe and associated with good fertility outcomes. Whether first-line surgery using discoid excision is superior to first-line ART remains to be determined.
MeSH term(s)	Pregnancy ; Female ; Humans ; Endometriosis/complications ; Endometriosis/surgery ; Rectal Diseases/surgery ; Rectal Diseases/complications ; Fertility ; Infertility, Female/surgery ; Infertility, Female/complications ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Colorectal Neoplasms/complications
Language	English
Publishing date	2024-01-09
Publishing country	France
Document type	Journal Article
ISSN	2468-7847
ISSN (online)	2468-7847
DOI	10.1016/j.jogoh.2024.102723
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Article ; Online: Neglected giant benign phyllode tumor of the breast.

Benderra, Marc-Antoine / Ferrier, Clement / Buob, David / Gligorov, Joseph / Kerrou, Khaldoun

European journal of nuclear medicine and molecular imaging

2022 Volume 49, Issue 11, Page(s) 3954–3955

MeSH term(s)	Breast/diagnostic imaging ; Breast/pathology ; Breast Neoplasms/diagnostic imaging ; Female ; Humans ; Phyllodes Tumor/pathology
Language	English
Publishing date	2022-05-18
Publishing country	Germany
Document type	Journal Article
ZDB-ID	8236-3
ISSN	1619-7089 ; 0340-6997 ; 1619-7070
ISSN (online)	1619-7089
ISSN	0340-6997 ; 1619-7070
DOI	10.1007/s00259-022-05840-7
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Article: Value of non-coding RNAs to assess lymph node status in cervical cancer.

Dabi, Yohann / Favier, Amelia / Razakamanantsoa, Léo / Suisse, Stéphane / Marie, Yannick / Touboul, Cyril / Ferrier, Clément / Bendifallah, Sofiane / Daraï, Emile

Frontiers in oncology

2023 Volume 13, Page(s) 1144672

Abstract: Cervical cancer (CC) is the fourth cancer in women and is the leading cause of cancer death in 42 countries. Lymph node metastasis is a determinant prognostic factor, as underlined in the latest FIGO classification. However, assessment of lymph node ... ...

Abstract	Cervical cancer (CC) is the fourth cancer in women and is the leading cause of cancer death in 42 countries. Lymph node metastasis is a determinant prognostic factor, as underlined in the latest FIGO classification. However, assessment of lymph node status remains difficult, despite the progress of imaging such as PET-CT and MRI. In the specific setting of CC, all data underlined the need for new biomarkers easily available to assess lymph node status. Previous studies have underlined the potential value of ncRNA expression in gynecological cancers. In this review, we aimed to evaluate the contribution of ncRNAs in tissue and biofluid samples to determine lymph node status in CC with potential impact on both surgical and adjuvant therapies. In tissue samples, our analysis found that there are arguments to support the role of ncRNAs in physiopathology, differential diagnosis from normal tissue, preinvasive and invasive tumors. In biofluids, despite small studies especially concerning miRNAs expression, promising data opens up new avenue to establish a non-invasive signature for lymph node status as well as a tool to predict response to neo- and adjuvant therapies, thus improving management algorithm of patients with CC.
Language	English
Publishing date	2023-05-10
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2023.1144672
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Article ; Online: Changes in hospital consumption of opioid and non-opioid analgesics after colorectal endometriosis surgery.

Crestani, Adrien / Bibaoune, Amine / Le Gac, Marjolaine / Dabi, Yohann / Kolanska, Kamila / Ferrier, Clément / Bendifallah, Sofiane / Touboul, Cyril / Darai, Emile

Journal of robotic surgery

2023 Volume 17, Issue 6, Page(s) 2703–2710

Abstract: The aim of this study was to analyze postoperative consumption of analgesics during hospitalization following colorectal surgery for endometriosis. We conducted a retrospective study at Tenon University Hospital, Paris, France from February 2019 to ... ...

Abstract	The aim of this study was to analyze postoperative consumption of analgesics during hospitalization following colorectal surgery for endometriosis. We conducted a retrospective study at Tenon University Hospital, Paris, France from February 2019 to December 2021. One hundred sixty-two patients underwent colorectal surgery: eighty-nine (55%) by robotic and seventy-three (45%) by conventional laparoscopy. The type of procedure had an impact on acetaminophen and nefopam consumed per day: consumption for colorectal shaving, discoid resection, and segmental resection was, respectively, 2(0.5), 2.1(0.6), 2.4(0.6) g/day (p = 10-3), and 25(7), 30(14), 31(11) mg/day (p = 0.03). The total amount of tramadol consumed was greater following robotic surgery compared with conventional laparoscopy (322(222) mg vs 242(292) mg, p = 0.04). We observed a switch in analgesic consumption over the years: tramadol was used by 70% of patients in 2019 but only by 7.1% in 2021 (p < 10-3); conversely, ketoprofen was not used in 2019, but was consumed by 57% of patients in 2021 (p < 10-3). A history of abdominal surgery (OR = 0.37 (0.16-0.78, p = 0.011) and having surgery in 2020 rather than in 2019 (OR = 0.10 (0.04-0.24, p < 10
MeSH term(s)	Female ; Humans ; Analgesics, Non-Narcotic/therapeutic use ; Analgesics, Opioid/therapeutic use ; Endometriosis/surgery ; Nefopam ; Retrospective Studies ; Tramadol/therapeutic use ; Colorectal Surgery ; Rectal Diseases/surgery ; Treatment Outcome ; Robotic Surgical Procedures/methods ; Hospitals, University ; Colorectal Neoplasms ; Pain, Postoperative/drug therapy
Chemical Substances	Analgesics, Non-Narcotic ; Analgesics, Opioid ; Nefopam (4UP8060B7J) ; Tramadol (39J1LGJ30J)
Language	English
Publishing date	2023-08-22
Publishing country	England
Document type	Journal Article
ZDB-ID	2268283-1
ISSN	1863-2491 ; 1863-2483
ISSN (online)	1863-2491
ISSN	1863-2483
DOI	10.1007/s11701-023-01691-y
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Article ; Online: Comparison of robot-assisted and conventional laparoscopy for colorectal surgery for endometriosis: A prospective cohort study.

Ferrier, Clément / Le Gac, Marjolaine / Kolanska, Kamila / Boudy, Anne-Sophie / Dabi, Yohan / Touboul, Cyril / Bendifallah, Sofiane / Daraï, Emile

The international journal of medical robotics + computer assisted surgery : MRCAS

2022 Volume 18, Issue 3, Page(s) e2382

Abstract: Background: Our objective was to evaluate surgical outcomes of robotic compared to conventional laparoscopy for colorectal surgery for endometriosis.: Methods: We conducted a prospective cohort study comparing robotic to conventional laparoscopy for ... ...

Abstract	Background: Our objective was to evaluate surgical outcomes of robotic compared to conventional laparoscopy for colorectal surgery for endometriosis. Methods: We conducted a prospective cohort study comparing robotic to conventional laparoscopy for colorectal endometriosis during an 18-month period. We included 61 patients in the robotic group and 61 patients in the conventional laparoscopy group. Results: Regardless of the colorectal procedure, no differences were found between the groups for complications, blood loss, re-hospitalisation, surgical revision. Robotic surgery was associated with a higher operating time (208 ± 90 min vs. 169 ± 81 min, p = 0.01) and a higher rate of healthy margins (91% vs. 76%; p = 0.01). For the patients undergoing discoid or segmental resections, robotic surgery was associated with a lower intraoperative complication rate (2% vs. 14%; p = 0.04) without difference in operating time or in postoperative complication rates, including voiding dysfunction. Conclusion: Our results suggest that the robotic route confer advantages for discoid and segmental resections.
MeSH term(s)	Colorectal Neoplasms/surgery ; Colorectal Surgery ; Endometriosis/surgery ; Female ; Humans ; Laparoscopy/methods ; Postoperative Complications/etiology ; Prospective Studies ; Retrospective Studies ; Robotic Surgical Procedures/methods ; Robotics ; Treatment Outcome
Language	English
Publishing date	2022-03-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2151860-9
ISSN	1478-596X ; 1478-5951
ISSN (online)	1478-596X
ISSN	1478-5951
DOI	10.1002/rcs.2382
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Zs.A 6382: Show issues

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Article ; Online: Saliva microRNA signature to diagnose endometriosis: A cost-effectiveness evaluation of the Endotest®.

Ferrier, Clement / Bendifallah, Sofiane / Suisse, Stéphane / Dabi, Yohann / Touboul, Cyril / Puchar, Anne / Zarca, Kevin / Durand Zaleski, Isabelle

BJOG : an international journal of obstetrics and gynaecology

2022 Volume 130, Issue 4, Page(s) 396–406

Abstract: Objective: To evaluate a saliva diagnostic test (Endotest®) for endometriosis compared with the conventional algorithm.: Design: A cost-effectiveness analysis with a decision-tree model based on literature data.: Setting: France.: Population: ... ...

Abstract	Objective: To evaluate a saliva diagnostic test (Endotest®) for endometriosis compared with the conventional algorithm. Design: A cost-effectiveness analysis with a decision-tree model based on literature data. Setting: France. Population: Women with chronic pelvic pain. Methods: Strategy I is the French algorithm, representing the comparator. For strategy II, all patients have an Endotest®. For strategy III, patients undergo ultrasonography to detect endometrioma and patients with no endometrioma detected have an Endotest®. For strategy IV, patients with no endometrioma detected on ultrasonography undergo pelvic magnetic resonance imaging (MRI) to detect endometrioma and/or deep endometriosis. An Endotest® is then performed for patients with a negative result on MRI. Main outcomes measures: Costs and accuracy rates and incremental cost-effectiveness ratios (ICERs). Three analyses were performed with an Endotest® priced at €500, €750, and €1000. Probabilistic sensitivity analysis was conducted with Monte Carlo simulations. Results: With an Endotest® priced at €750, the cost per correctly diagnosed case was €1542, €990, €919 and €1000, respectively, for strategies I, II, III and IV. Strategy I was dominated by all other strategies. Strategies IV, III and II were, respectively, preferred for a willingness-to-pay threshold below €473, between €473 and €4670, and beyond €4670 per correctly diagnosed case. At a price of €500 per Endotest®, strategy I was dominated by all other strategies. At €1000, the ICERs of strategies II and III were €724 and €387 per correctly diagnosed case, respectively, compared with strategy I. Conclusion: The present study demonstrates the value of the Endotest® from an economic perspective.
MeSH term(s)	Female ; Humans ; Cost-Benefit Analysis ; Endometriosis/diagnosis ; Endometriosis/genetics ; MicroRNAs/analysis ; Quality-Adjusted Life Years ; Saliva/chemistry ; Ultrasonography ; Diagnostic Techniques, Obstetrical and Gynecological/economics
Chemical Substances	MicroRNAs
Language	English
Publishing date	2022-12-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2000931-8
ISSN	1471-0528 ; 0306-5456 ; 1470-0328
ISSN (online)	1471-0528
ISSN	0306-5456 ; 1470-0328
DOI	10.1111/1471-0528.17348
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Article: Value of 3D MRI and Vaginal Opacification for the Diagnosis of Vaginal Endometriosis.

Bazot, Marc / Beldjord, Selma / Jarboui, Lamia / Ferrier, Clement / Bendifallah, Sofiane / Daraï, Emile

Frontiers in surgery

2020 Volume 7, Page(s) 614989

Abstract: Objective: ...

Abstract	Objective:
Language	English
Publishing date	2020-12-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2020.614989
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Article ; Online: Absenteeism and indirect costs during the year following the diagnosis of an operable breast cancer: A prospective multicentric cohort study.

Ferrier, Clement / Thebaut, Clémence / Levy, Pierre / Baffert, Sandrine / Asselain, Bernard / Rouzier, Roman / Hequet, Delphine

Journal of gynecology obstetrics and human reproduction

2020 Volume 50, Issue 6, Page(s) 101871

Abstract: Background: Diseases consequence on individual work as much as consequences of being absent from work are matters of interest for decision makers.: Methods: We analyzed lengths of absenteeism and related indirect costs for patients with a paid ... ...

Abstract	Background: Diseases consequence on individual work as much as consequences of being absent from work are matters of interest for decision makers. Methods: We analyzed lengths of absenteeism and related indirect costs for patients with a paid activity in the year following the diagnosis of early stage breast cancer, in the prospective OPTISOINS01 cohort. Both human capital and friction costs approach were considered for the valuation of lost working days (LWD). For the analysis, the friction period was estimated from recent French data. The statistical analysis included simple and multiple linear regression to search for the determinants of absenteeism and indirect costs. Results: 93 % of the patients had at least one period of sick leave, with on average 2 period and 186 days of sick leave. 24 % of the patients had a part-time resumption after their sick leave periods, during 114 days on average (i.e. 41 LWD). Estimated indirect costs were 22,722.00 € and 7,724.00 € per patient, respectively for the human capital and the friction cost approach. In the multiple linear regression model, factors associated with absenteeism were: the invasive nature of the tumor (p = .043), a mastectomy (p = .038), a surgery revision (p = .002), a chemotherapy (p = .027), being a manager (p = .025) or a craftsman (p = .005). Conclusion: Breast cancer lead to important lengths of absenteeism in the year following the diagnosis, but almost all patients were able to return to work. Using the friction cost or the human capital approach in the analysis led to an important gap in the results, highlighting the importance of considering both for such studies.
MeSH term(s)	Absenteeism ; Breast Neoplasms/economics ; Breast Neoplasms/therapy ; Chemotherapy, Adjuvant ; Cohort Studies ; Cost of Illness ; Female ; France ; Humans ; Mastectomy ; Middle Aged ; Neoplasm Invasiveness ; Occupations ; Personnel Staffing and Scheduling/economics ; Reoperation ; Return to Work ; Sick Leave/economics
Language	English
Publishing date	2020-07-13
Publishing country	France
Document type	Journal Article ; Multicenter Study
ISSN	2468-7847
ISSN (online)	2468-7847
DOI	10.1016/j.jogoh.2020.101871
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Article: Total Hysterectomy by Low-Impact Laparoscopy to Decrease Opioids Consumption: A Prospective Cohort Study.

Dabi, Yohann / Ouasti, Samia / Didelot, Hélène / Wohrer, Henri / Skalli, Dounia / Miailhe, Gregoire / Uzan, Jennifer / Ferrier, Clément / Bendifallah, Sofiane / Haddad, Bassam / Daraï, Emile / Touboul, Cyril

Journal of clinical medicine

2022 Volume 11, Issue 8

Abstract: Our objective was to evaluate postoperative pain and opioid consumption in patients undergoing hysterectomy by low-impact laparoscopy and compare these parameters with conventional laparoscopy. We conducted a prospective study in two French gynecological ...

Abstract	Our objective was to evaluate postoperative pain and opioid consumption in patients undergoing hysterectomy by low-impact laparoscopy and compare these parameters with conventional laparoscopy. We conducted a prospective study in two French gynecological surgery departments from May 2017 to January 2018. The primary endpoint was the intensity of postoperative pain evaluated by a validated numeric rating scale (NRS) and opioid consumption in the postoperative recovery unit on Day 0 and Day 1. Thirty-two patients underwent low-impact laparoscopy and 77 had conventional laparoscopy. Most of the patients (90.6%) who underwent low-impact laparoscopy were managed as outpatients. There was a significantly higher consumption of strong opioids in the conventional compared to the low-impact group on both Day 0 and Day 1: 26.0% and 36.4% vs. 3.1% and 12.5%, respectively (p = 0.02 and p < 0.01). Over two-thirds of the patients in the low-impact group did not require opioids postoperatively. Two factors were predictive of lower postoperative opioid consumption: low-impact laparoscopy (OR 1.38, 95%CI 1.13−1.69, p = 0.002) and a mean intraoperative peritoneum below 10 mmHg (OR 1.25, 95%CI 1.03−1.51). Total hysterectomy by low-impact laparoscopy is feasible in an outpatient setting and is associated with a marked decrease in opioid consumption compared to conventional laparoscopy.
Language	English
Publishing date	2022-04-13
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11082165
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