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Article ; Online: Ultrasound as a Tool for Initial Diagnosis of Bone Lesions in Children Has Good Predictive Values: A Prospective Study From a University Hospital.

Choukri, Kaoutar / Haddad, Elie / Al Khouri Salem, Hassan / Boutet, Claire / Leveques, Virginie / Mteirek, Ahmad / Philbois, Olivier / Scalabre, Aurélien / Cantais, Aymeric

Clinical pediatrics

2024 , Page(s) 99228241241894

Abstract: Pediatric bone injuries are traditionally diagnosed using radiography. However, ultrasonography is emerging as an alternative due to its speed and minimal invasiveness. This study assessed the diagnostic capabilities of ultrasound before radiography in a ...

Abstract	Pediatric bone injuries are traditionally diagnosed using radiography. However, ultrasonography is emerging as an alternative due to its speed and minimal invasiveness. This study assessed the diagnostic capabilities of ultrasound before radiography in a group of 186 children with suspected long bone fractures at Saint Etienne University Hospital (Saint-Priest-en-Jarez, France). Patients with open trauma and severe deformity were excluded. Ultrasonography demonstrated 88.2% sensitivity and 86.4% specificity, with better results for forearm injuries. Of the 186 cases, 162 were consistent with radiography and 24 varied. Factors influencing an accurate diagnosis included the presence of indirect signs, operator experience, and examination duration, while indirect signs often led to misinterpretation. Although ultrasound cannot completely replace radiography due to its limitations in identifying deeper fractures, this study revealed its substantial efficacy and ease, supporting its potential utility in pediatric trauma emergencies.
Language	English
Publishing date	2024-03-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	207678-0
ISSN	1938-2707 ; 0009-9228
ISSN (online)	1938-2707
ISSN	0009-9228
DOI	10.1177/00099228241241894
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Article ; Online: Pediatric endoscopic subcutaneous mastectomy (pesma) with liposuction in adolescents with gynecomastia.

Varlet, François / Esposito, Ciro / Scalabre, Aurelien / Lepore, Benedetta / Vermersch, Sophie / Escolino, Maria

Surgical endoscopy

2022 Volume 37, Issue 1, Page(s) 766–773

Abstract: Background: Surgical techniques for treatment of gynecomastia are increasingly less invasive. We described technical standardization of pediatric endoscopic subcutaneous mastectomy (PESMA) with liposuction.: Methods: All adolescents with primary ... ...

Abstract	Background: Surgical techniques for treatment of gynecomastia are increasingly less invasive. We described technical standardization of pediatric endoscopic subcutaneous mastectomy (PESMA) with liposuction. Methods: All adolescents with primary gynecomastia, operated using PESMA with liposuction over the period June 2014-July 2021, were included. The video recording of procedures was analyzed to standardize the operative technique. After patient installation, 3 trocars were placed on the mid-axillary line. The technique included 5 steps: (1) subcutaneous injection of lipolysis solution and liposuction; (2) creation of working space using an inflated balloon; (3) gland dissection using 5-mm sealing device; (4) specimen extraction through the largest trocar orifice; and (5) placement of suction drainage tube. Results: Twenty-four male adolescents, operated for Simon's grade 2B and 3 gynecomastia using PESMA with liposuction over the study period, were included. Mean patient age was 16 years (range 15-18). Gynecomastia was bilateral in 19/24 (79.2%) and unilateral in 5/24 (20.8%). One (4.1%) conversion to open was reported. The mean operative time was 87 min (range 98-160) for unilateral and 160 min (range 140-250) for bilateral procedure. The mean length of stay was 2.2 days (range 1-4). Patients wore a thoracic belt for 15 up to 30 days postoperatively. Post-operative complications occurred in 5/24 (20.8%): 2- or 3 mm second-degree burns in 4 (16.7%) and subcutaneous seroma in 1 (4.1%). All complications were Clavien 2 grade and did not require further treatment. Aesthetic outcomes were very good in 21/24 (87.5%). Three (12.5%) boys had persistent minimal breast asymmetry but did never perceive it negatively. Conclusion: PESMA combined with liposuction was feasible and safe for surgical treatment of gynecomastia in this selected cohort of patients. Although challenging, this procedure provided good aesthetic results, with no scars on the anterior thoracic wall. Standardization of the operative technique was a key point for successful outcome.
MeSH term(s)	Humans ; Male ; Adolescent ; Child ; Female ; Gynecomastia/surgery ; Mastectomy, Subcutaneous/methods ; Lipectomy/methods ; Breast Neoplasms/surgery ; Mastectomy ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2022-09-01
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-022-09550-x
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Article ; Online: Early detection of ureteropelvic junction obstruction in neonates with prenatal diagnosis of renal pelvis dilatation using

Scalabre, Aurélien / Clément, Yohann / Guillière, Florence / Ayciriex, Sophie / Gaillard, Ségolène / Demède, Delphine / Bouty, Aurore / Lanteri, Pierre / Mure, Pierre-Yves

Scientific reports

2022 Volume 12, Issue 1, Page(s) 13406

Abstract: Renal pelvis dilatation (RPD) is diagnosed in utero on prenatal ultrasonography (US) and can resolve spontaneously. However, isolated RPD can also reflect ureteropelvic junction obstruction (UPJO), which requires surgical treatment to prevent progressive ...

Abstract	Renal pelvis dilatation (RPD) is diagnosed in utero on prenatal ultrasonography (US) and can resolve spontaneously. However, isolated RPD can also reflect ureteropelvic junction obstruction (UPJO), which requires surgical treatment to prevent progressive renal deterioration. The diagnosis of UPJO can only be confirmed after birth with repeat US and renal isotope studies.
MeSH term(s)	Dilatation ; Female ; Humans ; Hydronephrosis/diagnostic imaging ; Hydronephrosis/surgery ; Infant, Newborn ; Kidney Diseases/pathology ; Kidney Pelvis/pathology ; Pregnancy ; Prenatal Diagnosis ; Prospective Studies ; Proton Magnetic Resonance Spectroscopy ; Tomography, X-Ray Computed ; Ureteral Obstruction/diagnostic imaging
Language	English
Publishing date	2022-08-04
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-022-17664-4
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Article ; Online: Azoospermia: Is it worth waiting for the confirmation of the semen abnormality to start an infertility assessment?

Perouse, Côme / Klein, Jean Philippe / Piqueres, Sylvain / Ghazi, Mohamed / Aknin, Isabelle / Cottier, Michele / Scalabre, Aurélien / Mery, Lionel

Andrologia

2022 Volume 54, Issue 8, Page(s) e14487

Abstract: Azoospermia is found in about 1% of men in the general population and in about 10%-15% of infertile men. Upon discovery of semen analysis abnormality, another test must be performed after an interval of 3 months before any other infertility work-up. This ...

Abstract	Azoospermia is found in about 1% of men in the general population and in about 10%-15% of infertile men. Upon discovery of semen analysis abnormality, another test must be performed after an interval of 3 months before any other infertility work-up. This research aimed at evaluating the benefit of waiting for the control test. This retrospective monocentric descriptive study was carried out in the fertility center of the University Hospital of Saint Etienne. All consecutive azoospermic patients diagnosed between January, 2012 and December, 2019 were included. For each patient, two consecutive semen analyses performed 3 months apart were studied. The main focas was on patients whose second semen analysis would have modified the infertility work-up. Amongst the 172 cases under study, the second semen analysis revealed the presence of sperm for three men. Only one of these 3 modified semen analyses was normal. In the observed azoospermic population, sperm was found on the second test in 1.7%. An infertility assessment is necessary after the discovery of azoospermia in the first semen analysis in 99.5%. These results suggest that it is useless to wait three stressful months before starting an infertility assessment for azoospermic population.
MeSH term(s)	Azoospermia/diagnosis ; Humans ; Infertility, Male/diagnosis ; Male ; Retrospective Studies ; Semen ; Semen Analysis ; Spermatozoa
Language	English
Publishing date	2022-06-20
Publishing country	Germany
Document type	Journal Article
ZDB-ID	7280-1
ISSN	1439-0272 ; 0303-4569
ISSN (online)	1439-0272
ISSN	0303-4569
DOI	10.1111/and.14487
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Article ; Online: Pediatric robot-assisted extravesical ureteral reimplantation (revur) in simple and complex ureter anatomy: Report of a multicenter experience.

Esposito, Ciro / Masieri, Lorenzo / Fourcade, Laurent / Ballouhey, Quentin / Varlet, Francois / Scalabre, Aurelien / Castagnetti, Marco / El Ghoneimi, Alaa / Escolino, Maria

Journal of pediatric urology

2022 Volume 19, Issue 1, Page(s) 136.e1–136.e7

Abstract: Background: Robot-assisted extravesical ureteral reimplantation (REVUR) is a well established approach for surgical treatment of pediatric vesicoureteral reflux (VUR). However, further evidence is needed to confirm its efficacy even in case of complex ... ...

Abstract	Background: Robot-assisted extravesical ureteral reimplantation (REVUR) is a well established approach for surgical treatment of pediatric vesicoureteral reflux (VUR). However, further evidence is needed to confirm its efficacy even in case of complex anatomy. Objective: This study aimed to further confirm the evidence that REVUR is safe and effective in both simple and complex ureter anatomy. Study design: The charts of all patients with VUR, who received REVUR in 6 different institutions over a 5-year period, were retrospectively reviewed. Patients with both simple and complex ureter anatomy were included. Patient demographics, surgical variables, and post-operative results were assessed. VUR resolution was defined as either being resolved VUR on voiding cystourethrogram (VCUG) or clinically without symptoms during the follow-up. Results: Fifty-seven patients with median age of 6.9 years (range 4.5-12), receiving REVUR in the study period, were included. Eighteen (31.6%) patients had complex anatomy and included prior failed endoscopic injection (n = 13), complete ureteral duplication (n = 2), periureteral diverticulum (n = 2), ectopic megaureter requiring dismembering (n = 1). The median operative time was 155 min for unilateral and 211.5 min for bilateral repairs. The clinical + radiographic VUR resolution rate was 96.5%. Post-operative complications (Clavien 2) included urinary retention following bilateral repair (n = 5, 8.7%), febrile urinary tract infection (UTI) (n = 6, 10.5%) and gross hematuria (n = 3, 5.2%). Comparative analysis between simple and complex cases showed that REVUR was faster in simple cases in both unilateral [p = 0.002] and bilateral repair [p = 0.001] and post-operative urinary retention was more frequent in simple cases [p = 0.004] and in patients with pre-operative bowel and bladder dysfunction (BBD) [p = 0.001] (Table). Discussion: This series confirmed that the robot-assisted technique was feasible even in cases with complex anatomy using some technical refinements, that justified the longer operative times in both unilateral and bilateral cases. An interesting finding of this study was the correlation emerged between BBD and risk of post-operative urinary retention and VUR persistence. Our results also excluded any significant correlation between complex cases and risk of post-operative urinary retention. The main study limitations included the retrospective and nonrandomized design, the small number of cases and the arbitrary definition of complex anatomy. Conclusion: REVUR was safe and effective for management of VUR in both simple and complex ureter anatomy. Complex REVUR required slightly longer operative times, without significant differences in post-operative mordidity and success rates. Aside from complex anatomy, BBD emerged as the main risk factor associated with surgical failure and post-operative morbidity.
MeSH term(s)	Humans ; Child ; Child, Preschool ; Ureter/surgery ; Retrospective Studies ; Urinary Retention ; Robotics ; Treatment Outcome ; Robotic Surgical Procedures/methods ; Laparoscopy/methods ; Vesico-Ureteral Reflux/surgery ; Replantation/methods ; Postoperative Complications/epidemiology ; Postoperative Complications/surgery
Language	English
Publishing date	2022-10-22
Publishing country	England
Document type	Multicenter Study ; Journal Article
ZDB-ID	2237683-5
ISSN	1873-4898 ; 1477-5131
ISSN (online)	1873-4898
ISSN	1477-5131
DOI	10.1016/j.jpurol.2022.10.024
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Article ; Online: Visual estimation of postpartum blood loss during a simulation training: A prospective study.

Lemée, Juliette / Scalabre, Aurélien / Chauleur, Céline / Raia-Barjat, Tiphaine

Journal of gynecology obstetrics and human reproduction

2019 Volume 49, Issue 4, Page(s) 101673

Abstract: Objective: The objective of our study was to compare visually estimated blood loss (with collector bags and absorbent pads) during postpartum with the real volume during a simulation training.: Study design: This study was conducted from May 23 to ... ...

Abstract	Objective: The objective of our study was to compare visually estimated blood loss (with collector bags and absorbent pads) during postpartum with the real volume during a simulation training. Study design: This study was conducted from May 23 to December 22, 2017 during training sessions on the theme of postpartum haemorrhage provided by the Elena perinatal network. 137 participants visually estimated the losses contained in 5 graduated collector bags (from 600 to 1800mL) and on 5 absorbent pads (from 200 to 1000mL). Results: The averages of the visual estimated blood loss were significantly different from the real value, except for absorbent pads containing 400mL of losses. The low volumes are better estimated for either the absorbent pads or collector bags (p<0.001). 57% of the volumes were underestimated with collector bags, 33% of the estimates were accurate to ± 50 mL. With absorbent pads, 51% of the estimates were underestimated, compared to 22%, that were accurate. Conclusion: The simulation training allows to test the capacities of visual estimation of blood loss by health professionals in order to improve them and to improve the maternal care during postpartum haemorrhage.
MeSH term(s)	Absorbent Pads ; False Negative Reactions ; Female ; Humans ; Obstetrics/methods ; Postpartum Hemorrhage/diagnosis ; Postpartum Hemorrhage/physiopathology ; Pregnancy ; Prospective Studies ; Simulation Training/methods ; Visual Perception
Language	English
Publishing date	2019-12-06
Publishing country	France
Document type	Journal Article
ISSN	2468-7847
ISSN (online)	2468-7847
DOI	10.1016/j.jogoh.2019.101673
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Article ; Online: Pectus Arcuatum: A Pectus Unlike Any Other.

Abdellaoui, Sarah / Scalabre, Aurélien / Piolat, Christian / Lavrand, Frédéric / Lachkar, Amane-Allah / Lehn, Anne / Klipfel, Clémence / Henry, Brice / Soldea, Valentin / Hameury, Frédéric / Becmeur, François

Journal of pediatric surgery

2023 Volume 58, Issue 9, Page(s) 1679–1685

Abstract: Background: Pectus arcuatum is often mistaken for a type of pectus carinatum. However, pectus arcuatum is a unique clinical form of pectus caused by premature obliteration of the sternal sutures (manubrial sternum, four sternebrae and xiphoïd process), ... ...

Abstract	Background: Pectus arcuatum is often mistaken for a type of pectus carinatum. However, pectus arcuatum is a unique clinical form of pectus caused by premature obliteration of the sternal sutures (manubrial sternum, four sternebrae and xiphoïd process), whereas pectus carinatum is due to abnormal growth of the costal cartilage. In order to better describe pectus arcuatum, we analysed the files of patients with pectus arcuatum followed in our centers. Methods: Multicenter retrospective study of young patients' files diagnosed with pectus arcuatum. Results: The clinical diagnosis of pectus arcuatum was made in 34 patients with a mean age at diagnosis of 10.3 years (4-23 years). A chest profile X-ray or a CT scan was performed in 16 patients (47%) and confirmed the diagnosis of PA by the presence of a sternal fusion. It was complete in 12 patients. A malformation was associated in 35% of cases (Noonan syndrome 33%, scoliosis 25% or cardiopathy 16%). 11 patients (32%) had a family history of skeletal malformation. Orthopedic treatment was initiated in 3 patients without any success. 11 patients underwent surgical correction, which was completed in 7 of them. Conclusion: The diagnosis of pectus arcuatum is based on clinical experience and if necessary, on a profile chest X-ray showing the fusion of the sternal pieces. It implies the search for any associated malformations (musculoskeletal, cardiac, syndromic). Bracing treatment is useless for pectus arcuatum. Corrective surgery, based on a sternotomy associated with a partial chondro-costal resection, can be performed at the end of growth. Level of evidence: IV.
MeSH term(s)	Humans ; Child ; Pectus Carinatum/diagnostic imaging ; Pectus Carinatum/surgery ; Retrospective Studies ; Thoracic Wall/diagnostic imaging ; Thoracic Wall/surgery ; Sternum/diagnostic imaging ; Sternum/surgery ; Musculoskeletal Abnormalities/diagnostic imaging ; Musculoskeletal Abnormalities/surgery ; Funnel Chest/diagnostic imaging ; Funnel Chest/surgery ; Treatment Outcome
Language	English
Publishing date	2023-03-23
Publishing country	United States
Document type	Multicenter Study ; Journal Article
ZDB-ID	80165-3
ISSN	1531-5037 ; 0022-3468
ISSN (online)	1531-5037
ISSN	0022-3468
DOI	10.1016/j.jpedsurg.2023.03.013
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Zs.A 607: Show issues

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Article ; Online: Autonomic cardiac regulation after general anesthesia in children.

Venet, Théa / Pichot, Vincent / Charier, David / Scalabre, Aurélien / Patural, Hugues

Paediatric anaesthesia

2018 Volume 28, Issue 10, Page(s) 881–887

Abstract: Background: General anesthesia dramatically decreases the activity of the autonomic nervous system. Most of the hypnotic agents used to induce anesthesia inhibit sympathetic cardiovascular regulation and baroreflex control in a dose-dependent manner, ... ...

Abstract	Background: General anesthesia dramatically decreases the activity of the autonomic nervous system. Most of the hypnotic agents used to induce anesthesia inhibit sympathetic cardiovascular regulation and baroreflex control in a dose-dependent manner, lowering cardiac adaptability during the operation. The consequence of this effect in children during and after surgery has never been studied to date. Aim: The aim of this study was to follow the variations in autonomic cardiac indices in children younger than 8 years old after general anesthesia (6-24 hours) in programmed surgery. Method: A prospective descriptive monocentric study of 44 children under 8 years old who underwent scheduled surgery at our hospital center (Saint-Étienne University Hospital, France) was performed between June 1, 2016 and November 1, 2016. Heart rate variability was monitored for 24 hours using Holter-ECG devices and the resulting data were interpreted using linear and nonlinear analyses. Results: Compared to baseline thresholds before surgery, all heart rate variability indices decreased dramatically during general anesthesia. After awakening, a slight reduction in sympathetic activity persisted 6 hours after surgery, but all measurements of sympathetic and parasympathetic activity had returned to baseline thresholds 12 hours after the operation. Twenty-four hours after surgery, some parameters had increased above the corresponding baseline levels. Conclusion: Autonomic nervous function normalizes rapidly (within 12 hours) in prepubertal children. This study indicates that general anesthesia does not seem to increase the long-term risk of autonomic dysfunction in these patients.
MeSH term(s)	Anesthesia, General/adverse effects ; Anesthetics, General/administration & dosage ; Anesthetics, General/adverse effects ; Autonomic Nervous System/drug effects ; Autonomic Nervous System/physiopathology ; Child ; Child, Preschool ; Electrocardiography ; Female ; Heart/drug effects ; Heart/physiopathology ; Heart Rate/drug effects ; Humans ; Infant ; Male ; Prospective Studies
Chemical Substances	Anesthetics, General
Language	English
Publishing date	2018-10-10
Publishing country	France
Document type	Journal Article ; Observational Study
ZDB-ID	1086049-6
ISSN	1460-9592 ; 1155-5645
ISSN (online)	1460-9592
ISSN	1155-5645
DOI	10.1111/pan.13468
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Article ; Online: Current trends in 2021 in surgical management of vesico-ureteral reflux in pediatric patients: results of a multicenter international survey on 552 patients.

Esposito, Ciro / Yamataka, Atsuyuki / Varlet, Francois / Castagnetti, Marco / Scalabre, Aurelien / Fourcade, Laurent / Ballouhey, Quentin / Nappo, Simona / Escolino, Maria

Minerva urology and nephrology

2021 Volume 75, Issue 1, Page(s) 106–115

Abstract: Background: The selection of best surgical approach for treatment of vesico-ureteral reflux (VUR) in the pediatric population remains debated. This study aimed to report the results of a multicenter survey about the current trends in surgical management ...

Abstract	Background: The selection of best surgical approach for treatment of vesico-ureteral reflux (VUR) in the pediatric population remains debated. This study aimed to report the results of a multicenter survey about the current trends in surgical management of pediatric VUR. Methods: An online questionnaire-based survey was performed, with participation of six international institutions. All children (age <18 years) affected by primary III-V grade VUR, who were operated over the last 5 years, were included. The incidence of each VUR intervention, patients' demographics and outcomes were analyzed. Results: A total of 552 patients (331 girls), with a median age of 4.6 years (range 0.5-17.6), were included. Deflux Conclusions: This survey confirmed that the choice of the technique remains based on surgeon's preference. Deflux
MeSH term(s)	Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Laparoscopy/methods ; Retrospective Studies ; Treatment Outcome ; Ureter/surgery ; Vesico-Ureteral Reflux/surgery ; Male
Language	English
Publishing date	2021-06-11
Publishing country	Italy
Document type	Multicenter Study ; Journal Article
ZDB-ID	3062840-4
ISSN	2724-6442
ISSN (online)	2724-6442
DOI	10.23736/S2724-6051.21.04430-X
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Article ; Online: Treatment of Gynecomastia by Endoscopic Subcutaneous Mastectomy in Adolescents.

Varlet, François / Raia-Barjat, Tiphaine / Bustangi, Nasser / Vermersch, Sophie / Scalabre, Aurelien

Journal of laparoendoscopic & advanced surgical techniques. Part A

2019 Volume 29, Issue 8, Page(s) 1073–1076

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Adolescent ; Cicatrix ; Drainage ; Endoscopy/methods ; Esthetics ; Gynecomastia/surgery ; Humans ; Male ; Mastectomy, Subcutaneous/methods ; Minimally Invasive Surgical Procedures/methods ; Nipples/surgery ; Postoperative Period ; Retrospective Studies ; Seroma ; Thorax ; Treatment Outcome
Language	English
Publishing date	2019-06-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	1381909-4
ISSN	1557-9034 ; 1092-6429
ISSN (online)	1557-9034
ISSN	1092-6429
DOI	10.1089/lap.2019.0256
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