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  1. Article ; Online: ASO Author Reflections: Challenges in the Management of Synchronous Prostate Cancer and Rectal Cancer: Towards Double Organ Preservation?

    Doussot, Alexandre / Lakkis, Zaher

    Annals of surgical oncology

    2020  Volume 27, Issue 11, Page(s) 4294–4295

    MeSH term(s) Humans ; Male ; Multicenter Studies as Topic ; Neoplasms, Multiple Primary/therapy ; Organ Sparing Treatments ; Prostatic Neoplasms/therapy ; Rare Diseases ; Rectal Neoplasms/therapy
    Language English
    Publishing date 2020-05-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-020-08685-2
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    Zs.A 4042: Show issues Location:
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  2. Article ; Online: We Asked the Experts: How Do We Maintain Surgical Quality Standards for Enhanced Recovery Programs After Cancer Surgery During the COVID-19 Outbreak?

    Doussot, Alexandre / Heyd, Bruno / Lakkis, Zaher

    World journal of surgery

    2020  Volume 44, Issue 7, Page(s) 2051–2052

    Keywords covid19
    Language English
    Publishing date 2020-04-24
    Publishing country United States
    Document type Editorial
    ZDB-ID 224043-9
    ISSN 1432-2323 ; 0364-2313
    ISSN (online) 1432-2323
    ISSN 0364-2313
    DOI 10.1007/s00268-020-05546-7
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    Zs.A 1336: Show issues Location:
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  3. Article ; Online: Anatomic patterns of anastomotic leaks after Ivor Lewis esophagectomy for cancer: Impact on management and outcomes.

    Laydi, Maxime / Doussot, Alexandre / Lakkis, Zaher / Mathieu, Pierre / Gandon, Anne / Dubois, Clément / Degisors, Sébastien / Martin, Louis / Heyd, Bruno / Piessen, Guillaume

    Surgery

    2023  Volume 174, Issue 2, Page(s) 247–251

    Abstract: Background: Anastomotic leakage presentation after Ivor Lewis esophagectomy may vary on imaging. Such variations may influence anastomotic leakage management and outcomes.: Methods: All consecutive patients who underwent Ivor Lewis esophagectomy for ... ...

    Abstract Background: Anastomotic leakage presentation after Ivor Lewis esophagectomy may vary on imaging. Such variations may influence anastomotic leakage management and outcomes.
    Methods: All consecutive patients who underwent Ivor Lewis esophagectomy for cancer between 2012 and 2019 in 2 referral centers were included. Anatomical patterns of anastomotic leakage were defined on imaging as follows: eso-mediastinal anastomotic leakage was a leak contained in the posterior mediastinum, eso-pleural anastomotic leakage was a leak involving the pleural cavity, and eso-bronchial anastomotic leakage was a leak communicating with the tracheobronchial tract. According to the Esophageal Complications Consensus Group definition, management and 90-day mortality were evaluated according to these patterns.
    Results: Among 731 patients, 111 (15%) developed anastomotic leakage consisting of eso-mediastinal anastomotic leakage (n = 87, 79%), eso-pleural anastomotic leakage (n = 16, 14%) and eso-bronchial anastomotic leakage (n = 8, 7%). There was no difference among these groups regarding preoperative characteristics or time to anastomotic leakage diagnosis. There was a significant difference in initial management according to anastomotic leakage anatomic patterns (P = .001). More than half of patients who experienced eso-mediastinal anastomotic leakage (n = 46, 53%) were initially treated conservatively without requiring intervention (Esophageal Complications Consensus Group type I), whereas most patients with eso-pleural anastomotic leakage (n = 14, 87.5%) and all with eso-bronchial anastomotic leakage (n = 8, 100%) initially required interventional or surgical treatment (Esophageal Complications Consensus Group type II-III). Anastomotic leakage anatomic patterns had a statistically significant impact on 90-day mortality, intensive care unit stay, and total hospital stay (P < .001).
    Conclusion: Anastomotic leakage anatomic patterns after Ivor Lewis esophagectomy influence outcomes. Further studies are warranted to validate it in a prospective setting. Anastomotic leakage anatomic patterns may help in guiding anastomotic leakage management.
    MeSH term(s) Humans ; Anastomotic Leak/diagnosis ; Anastomotic Leak/epidemiology ; Anastomotic Leak/etiology ; Esophagectomy/adverse effects ; Esophagectomy/methods ; Anastomosis, Surgical/adverse effects ; Anastomosis, Surgical/methods ; Prospective Studies ; Esophageal Neoplasms ; Retrospective Studies ; Postoperative Complications/diagnosis ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology
    Language English
    Publishing date 2023-06-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202467-6
    ISSN 1532-7361 ; 0039-6060
    ISSN (online) 1532-7361
    ISSN 0039-6060
    DOI 10.1016/j.surg.2023.04.034
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    Uk I Zs.129: Show issues Location:
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  4. Article ; Online: Short-term mortality prediction using a combination of clinical and CT features: Refining the prognosis of critically ill patients in shock.

    Hassoun, Youness / Konan, Anhum / Simon, Gabriel / Verdot, Pierre / Lakkis, Zaher / Loffroy, Romaric / Besch, Guillaume / Piton, Gael / Delabrousse, Eric / Calame, Paul

    European journal of radiology

    2023  Volume 167, Page(s) 111075

    Abstract: Purpose: To assess the predictive value of combining CT and clinical findings for predicting 10-day mortality in critically ill patients in shock.: Materials and methods: From January 1, 2018, to December 31, 2021, 289 consecutives critically ill ... ...

    Abstract Purpose: To assess the predictive value of combining CT and clinical findings for predicting 10-day mortality in critically ill patients in shock.
    Materials and methods: From January 1, 2018, to December 31, 2021, 289 consecutives critically ill patients in shock who underwent a contrast enhanced CT were included. Variables at the time of the CT were retrospectively extracted from medical charts. CT examinations were blindly analyzed by two independent radiologists. Multivariable analysis was performed, combining clinical and CT features. A simple survival score for 10-day mortality prediction was built and validated in a further independent external cohort of 70 patients.
    Results: 10-day mortality rate was 135/289 (47%) in the study sample. At multivariate analysis, catecholamine infusion (OR = 2.11; 95%CI [1.21-4.18], P = 0.011), lactates level > 5 mmol/l (OR = 3.54; 95%CI [1.94-6.54], P < 0.001); total bilirubin > 50 mg/l (OR = 1.79 CI 95% [1.03-3.13], P = 0.039); small bowel dilation (OR = 1.82; 95%CI [1.01-3.32], P = 0.047); diffuse kidney infarction (OR = 2.76; 95%CI [1.26-6.37], P = 0.013) and superior mesentery artery < 5 mm (OR = 1.96; 95%CI [1.10-3.49], P = 0.021) were associated with 10-days mortality. The AUC of the combined model was 0.79; 95%CI [0.74-0.85] in the study sample and 0.87; 95%CI [0.71-0.91] in the validation cohort.
    Conclusion: The combination of CT imaging features and clinical data should emerge as a novel approach to predict short-term mortality in critically ill patients in shock.
    MeSH term(s) Humans ; Critical Illness ; Retrospective Studies ; Prognosis ; Lactic Acid ; Tomography, X-Ray Computed
    Chemical Substances Lactic Acid (33X04XA5AT)
    Language English
    Publishing date 2023-09-01
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 138815-0
    ISSN 1872-7727 ; 0720-048X
    ISSN (online) 1872-7727
    ISSN 0720-048X
    DOI 10.1016/j.ejrad.2023.111075
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    Zs.A 1630: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  5. Article ; Online: KONO-S Anastomosis Is Not Superior to Conventional Anastomosis for the Reduction of Postoperative Endoscopic Recurrence in Crohn's Disease.

    Tyrode, Gaëlle / Lakkis, Zaher / Vernerey, Dewi / Falcoz, Antoine / Clairet, Valentine / Alibert, Line / Koch, Stéphane / Vuitton, Lucine

    Inflammatory bowel diseases

    2023  

    Abstract: Background: Surgical resection rates remain high in Crohn's disease (CD). Reducing postoperative recurrence (POR) is challenging. Besides drug therapy, the surgical anastomosis technique may reduce POR. We aimed to compare the endoscopic POR rate after ... ...

    Abstract Background: Surgical resection rates remain high in Crohn's disease (CD). Reducing postoperative recurrence (POR) is challenging. Besides drug therapy, the surgical anastomosis technique may reduce POR. We aimed to compare the endoscopic POR rate after Kono-S vs standard ileocolic anastomosis.
    Methods: The study included all consecutive CD patients operated on for ileocolic resection with a Kono-S anastomosis between February 2020 and March 2022. These patients were prospectively followed, and colonoscopy was performed 6 to 12 months after surgery. Patients were compared with a historical cohort of patients operated on with a conventional anastomosis in the same center. The primary end point was endoscopic POR (Rutgeerts score ≥i2). Factors associated with POR were assessed by univariate and multivariable analyses.
    Results: A total of 85 patients were included, 30 in the Kono-S group and 55 in the control group. At baseline, there was no significant difference between the 2 groups regarding CD characteristics or known POR risk factors, including previous exposure to biologics. At 6 to 12 months, endoscopic POR rate did not differ significantly between groups (56.7% in the Kono-S group vs 49.1% in the control group; P = .50), nor did endoscopic POR according to the modified Rutgeerts score ≥i2b (46.7% in the Kono-S group vs 40% in the control group; P = .55). Severe endoscopic POR rates were 23.3% and 18.2% in each group, respectively. Clinical recurrence rate was similar in both groups, and no recurrent surgery occurred. By multivariable analysis, the type of anastomosis was not associated with endoscopic POR (OR, 1.229; 95% CI, 0.461-3.274, P = .68); however, postoperative treatment with anti-TNF was (OR, 0.337; 95% CI, 0.131-0.865 P = .02).
    Conclusions: Kono-S anastomosis was not associated with a reduced rate of endoscopic POR. These results warrant confirmation in prospective, randomized, multicenter studies.
    Language English
    Publishing date 2023-09-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 1340971-2
    ISSN 1536-4844 ; 1078-0998
    ISSN (online) 1536-4844
    ISSN 1078-0998
    DOI 10.1093/ibd/izad214
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    Zs.A 4530: Show issues Location:
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  6. Article: Is There Any Reason Not to Perform Standard Laparoscopic Total Mesorectal Excision?

    Lakkis, Zaher / Panis, Yves

    Clinics in colon and rectal surgery

    2017  Volume 30, Issue 5, Page(s) 333–338

    Abstract: The curative treatment of locally advanced rectal cancer is currently based on chemoradiotherapy and total mesorectal excision (TME). Laparoscopy has developed considerably because of obvious clinical benefits such as reduced pain and shorter hospital ... ...

    Abstract The curative treatment of locally advanced rectal cancer is currently based on chemoradiotherapy and total mesorectal excision (TME). Laparoscopy has developed considerably because of obvious clinical benefits such as reduced pain and shorter hospital stay. Recently, several prospective randomized clinical trials with long-term follow-up have showed that laparoscopy is noninferior to laparotomy with the same oncologic outcomes in terms of survival and local control rate. However, laparoscopic TME remains a challenging procedure requiring a high level of expertise and a long learning curve to ensure an adequate and safe resection. The only relative contraindication of laparoscopic rectal surgery is T4 rectal cancer extended beyond the plane of TME. In this situation, it is reasonable to consider an open resection to avoid an uncomplete resection. In obese and elderly patients, laparoscopic TME also provides the same benefits as in nonobese and younger patients but may be more difficult to achieve. This review summarizes current knowledge on the place of laparoscopic TME in the treatment of rectal cancer.
    Language English
    Publishing date 2017-11-27
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2048635-2
    ISSN 1531-0043
    ISSN 1531-0043
    DOI 10.1055/s-0037-1606110
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    Zs.A 3931: Show issues Location:
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  7. Article ; Online: Low anterior resection syndrome after rectal resection management: multicentre randomized clinical trial of transanal irrigation with a dedicated device (cone catheter) versus conservative bowel management.

    Meurette, Guillaume / Faucheron, Jean-Luc / Cotte, Eddy / Denost, Quentin / Portier, Guillaume / Loriau, Jerôme / Hansen, Andreas Wolff / Vicaut, Eric / Lakkis, Zaher

    The British journal of surgery

    2023  Volume 110, Issue 9, Page(s) 1092–1095

    MeSH term(s) Humans ; Low Anterior Resection Syndrome ; Postoperative Complications/etiology ; Postoperative Complications/therapy ; Rectal Neoplasms/surgery ; Rectum/surgery ; Catheters
    Language English
    Publishing date 2023-03-28
    Publishing country England
    Document type Randomized Controlled Trial ; Multicenter Study ; Journal Article
    ZDB-ID 2985-3
    ISSN 1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
    ISSN (online) 1365-2168
    ISSN 0263-1202 ; 0007-1323 ; 1355-7688
    DOI 10.1093/bjs/znad078
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  8. Article ; Online: Association between polyunsaturated fatty acids in adipose tissue and mortality of colorectal cancer patients.

    Roux-Levy, Cécile / Binquet, Christine / Vaysse, Carole / Scherrer, Marie-Lorraine / Ayav, Ahmet / Ortega-Deballon, Pablo / Lakkis, Zaher / Liu, David / Deguelte, Sophie / Cottet, Vanessa

    Nutrition (Burbank, Los Angeles County, Calif.)

    2024  Volume 121, Page(s) 112358

    Abstract: Introduction: Nutritional intake and dysregulation of fatty acid metabolism play a role in the progression of various tumors, but the consumption of fatty acids is difficult to assess accurately with dietary questionnaires. Biomarkers can objectively ... ...

    Abstract Introduction: Nutritional intake and dysregulation of fatty acid metabolism play a role in the progression of various tumors, but the consumption of fatty acids is difficult to assess accurately with dietary questionnaires. Biomarkers can objectively assess intake, storage and bioavailability.
    Objective: We studied the association between the polyunsaturated fatty acid (PUFA) composition of abdominal subcutaneous adipose tissue (good indicator of dietary intake over 2-3 years) and all-cause mortality.
    Methods: In the multicenter AGARIC study, samples from 203 patients with colorectal cancer (CRC) undergoing curative surgery, were harvested from subcutaneous adipose tissue, which were then analyzed for PUFA composition.
    Results: After a median follow-up of 45 months, 76 patients died. These patients were more often men (72.4% versus 57.5%, P = 0.04), diabetic (32.9% versus 13.4%, P = 0.001), old (median: 74.5 versus 66.6 years, P < 0.001) and with high alcohol consumption (47.4% versus 30.7%, P = 0.005). An increased risk of death was observed with higher levels of 20:2 ω-6 (hazard ratio
    Conclusion: The risk of death was increased in CRC patients with higher concentrations of certain ω-6 PUFAs and lower concentrations of α-linolenic acid in their subcutaneous adipose tissue. These results reflect dietary habits and altered fatty acid metabolism. Our exploratory results warrant confirmation in larger studies with further exploration of the mechanisms involved.
    MeSH term(s) Male ; Humans ; alpha-Linolenic Acid ; Fatty Acids, Unsaturated ; Fatty Acids, Omega-3 ; Fatty Acids ; Adipose Tissue ; Colorectal Neoplasms/surgery
    Chemical Substances alpha-Linolenic Acid (0RBV727H71) ; Fatty Acids, Unsaturated ; Fatty Acids, Omega-3 ; Fatty Acids
    Language English
    Publishing date 2024-01-10
    Publishing country United States
    Document type Multicenter Study ; Journal Article
    ZDB-ID 639259-3
    ISSN 1873-1244 ; 0899-9007
    ISSN (online) 1873-1244
    ISSN 0899-9007
    DOI 10.1016/j.nut.2024.112358
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    Zs.A 2290: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  9. Article ; Online: Fluorescence-based pancreas stump perfusion is associated with postoperative acute pancreatitis after pancreatoduodenectomy a prospective cohort study.

    Doussot, Alexandre / Decrock, Marc / Calame, Paul / Georges, Pauline / Turco, Célia / Lakkis, Zaher / Heyd, Bruno

    Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.

    2021  

    Abstract: Background: Postoperative acute pancreatitis (POAP) emerges as a distinct pancreas-specific complication increasing both the risk and the burden of POPF after pancreatoduodenectomy. Among various risk factors, pancreas stump (PS) hypoperfusion might ... ...

    Abstract Background: Postoperative acute pancreatitis (POAP) emerges as a distinct pancreas-specific complication increasing both the risk and the burden of POPF after pancreatoduodenectomy. Among various risk factors, pancreas stump (PS) hypoperfusion might play a role in POAP occurrence but has never been investigated. The current study aimed at evaluating the feasibility of intraoperative fluorescence angiography (IOFA) of the PS using ICG and its association with POAP.
    Methods: Consecutive patients who underwent pancreatoduodenectomy for a periampullary tumor with pancreatojejunostomy and PS perfusion assessment using IOFA between January 2020 and November 2020 were prospectively included. Perioperative management and surgical strategy were standardized. IOFA of the pancreas stump was performed before fashioning pancreatojejunostomy. POAP was defined according to the Connor definition and was confirmed upon radiological blind review. Outcomes between patients with normally perfused and hypoperfused PS were compared. POAP was the primary endpoint.
    Results: Among 30 patients, nine patients (30%) developed POAP according to the Connor definition, and six patients (20%) had CT-confirmed POAP. Upon IOFA, six patients (20%) presented PS hypoperfusion; of which one patient underwent extended pancreatectomy further to the left. PS hypoperfusion was statistically associated with the occurrence of POAP (80% vs. 16%; p = 0.011) and CT-confirmed POAP (60% vs. 12%; p = 0.041). Clinically relevant POPF rate was 40% in case of PS hypoperfusion and 4% in case of normal PS perfusion (p = 0.064).
    Conclusions: PS perfusion assessment using IOFA seems safe and reliable to anticipate POAP. PS IOFA could be considered as a potential tool for perioperative assessment of surgical risk after pancreatoduodenectomy.
    Language English
    Publishing date 2021-05-18
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2056680-3
    ISSN 1424-3911 ; 1424-3903
    ISSN (online) 1424-3911
    ISSN 1424-3903
    DOI 10.1016/j.pan.2021.05.009
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    Zs.A 5553: Show issues Location:
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  10. Article: Modified DCF (Docetaxel, Cisplatin and 5-fluorouracil) chemotherapy is effective for the treatment of advanced rectal squamous cell carcinoma.

    Hervé, Laure / Kim, Stefano / Boustani, Jihane / Klajer, Elodie / Pernot, Mandy / Nguyen, Thierry / Lakkis, Zaher / Borg, Christophe / Vienot, Angélique

    Frontiers in oncology

    2022  Volume 12, Page(s) 974108

    Abstract: Background: Advanced rectal squamous cell carcinoma (rSCC) is a very rare and aggressive entity, and the best initial management is crucial for long survival as well as organ preservation and quality of life. Whereas local diseases are treated with ... ...

    Abstract Background: Advanced rectal squamous cell carcinoma (rSCC) is a very rare and aggressive entity, and the best initial management is crucial for long survival as well as organ preservation and quality of life. Whereas local diseases are treated with chemo-radiotherapy and salvage surgery, data are scarce on how to treat more advanced diseases, and the role of induction chemotherapy is unknown.
    Methods: We retrospectively analyzed all consecutive patients with advanced rSCC and treated with modified DCF (docetaxel, cisplatin, 5-fluorouracil; mDCF) regimen, from January 2014 and December 2021 in two French centers. Exploratory endpoints were efficacy (overall survival, recurrence-free survival, response rate, organ preservation rate) and safety.
    Results: Nine patients with locally advanced or metastatic diseases received a mDCF regimen and were included for analysis. The median age was 62.0 years, 7 patients (77.8%) were women, and all eight available tumors were positive for HPV, mostly (85.7%) to genotype 16. With a median follow-up of 33.1 months, 77.8% of patients were still alive and disease-free, and the median overall survival was not reached at six years. The objective response rate was 87.5% after mDCF, and the complete response rate was 25.0% after mDCF and was increased to 75.0% after chemoradiotherapy. Only one patient underwent surgery on the primary tumor, with a complete pathological response. The median mDCF cycle was eight over eight scheduled, and all patients received the complete dose of radiotherapy without interruptions.
    Conclusions: Induction mDCF chemotherapy followed by chemoradiotherapy is safe and highly effective in patients with advanced rSCC, and should be considered as an option in metastatic stage or locally advanced disease with an organ-preservation strategy.
    Language English
    Publishing date 2022-11-17
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2649216-7
    ISSN 2234-943X
    ISSN 2234-943X
    DOI 10.3389/fonc.2022.974108
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