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1. Randomized clinical trial of sacral nerve stimulation for refractory constipation

Author

F Zerbib, L Siproudhis, P-A Lehur, C Germain, F Mion, A-M Leroi, B Coffin, A Le Sidaner, V Vitton, C Bouyssou-Cellier, G Chene, M Simon, Q Denost, P Lepicard, G Meurette, V Wyart, C Kubis, S Roman, H Damon, X Barth, V Bridoux, G Gourcerol, B Castel, C Gorbatchef, Anne Le Sidaner, M Mathonnet, N Lesavre, P Orsoni, C Brochard, V Desfourneaux, CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Foie, métabolismes et cancer, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), CHU Pontchaillou [Rennes], Institut des Maladies de l'Appareil Digestif, Université de Nantes (UN), CIC CHU Lyon (inserm), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Rouen, Normandie Université (NU), Université Paris Diderot - Paris 7 (UPD7), CHU Limoges, Centre de recherche en neurobiologie - neurophysiologie de Marseille (CRN2M), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), This study was funded by a grant from the French Ministry of Health (PHRC 2011) and promoted by Bordeaux University Hospital (Délégation à la Recherche Clinique, Centre Hospitalier Universitaire de Bordeaux)., CHU Bordeaux [Bordeaux], CHU Rennes - Service gastroentérologie, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre d'Investigation Clinique - Epidemiologie Clinique / Essais Cliniques Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon (HCL), Service de physiologie digestive, urinaire, respiratoire et de l'exercice [CHU Rouen], Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Hôpital Charles Nicolle [Rouen], Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), CHU Marseille, Enjalbert, Alain, and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
Adult, Male, medicine.medical_specialty, Constipation, Adolescent, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, Lumbosacral Plexus, Electric Stimulation Therapy, Stimulation, law.invention, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Hematoma, Double-Blind Method, Randomized controlled trial, Refractory, law, medicine, Humans, ComputingMilieux_MISCELLANEOUS, Aged, Cross-Over Studies, business.industry, [SDV.NEU.NB] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Middle Aged, medicine.disease, Crossover study, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Surgery, Lumbosacral plexus, Implantable Neurostimulators, Treatment Outcome, 030220 oncology & carcinogenesis, Anesthesia, Defecation, Female, 030211 gastroenterology & hepatology, medicine.symptom, business, Follow-Up Studies
Abstract

Background Open studies have reported favourable results for sacral nerve stimulation in the treatment of refractory constipation. Here, its efficacy was assessed in a double-blind crossover RCT. Methods Patients with at least two of the following criteria were included: fewer than three bowel movements per week; straining to evacuate on more than 25 per cent of attempts; or sensation of incomplete evacuation on more than 25 per cent of occasions. Response to therapy was defined as at least three bowel movements per week and/or more than 50 per cent improvement in symptoms. Responders to an initial 3-week peripheral nerve evaluation were offered permanent implantation of a pulse generator and were assigned randomly in a crossover design to two 8-week intervals of active or sham stimulation. At the end of the two trial periods, the patients received active stimulation until the final evaluation at 1 year. Results Thirty-six patients (34 women; mean(s.d.) age 45(14) years) underwent peripheral nerve evaluation. Twenty responded and received a permanent stimulator. A positive response was observed in 12 of 20 and 11 of 20 patients after active and sham stimulation periods respectively (P = 0·746). Pain related to the device occurred in five patients and wound infection or haematoma in three, leading to definitive removal of the pulse generator in two patients. At 1 year, 11 of the 20 patients with an implanted device continued to respond. Stimulation had no significant effect on colonic transit time. Conclusion These results do not support the recommendation of permanent implantation of a pulse generator in patients with refractory constipation who initially responded to temporary nerve stimulation. Registration number: NCT01629303 (http://www.clinicaltrials.gov).

Published
2016
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2. A local structured training program with live pigs allows performing ESD along the gastrointestinal tract with results close to those of Japanese experts

Author

Tessa Tabouret, Virginie Valgueblasse, Romain Legros, Claude-Yves Couquet, Aurélie Charissoux, Jérémie Jacques, Véronique Loustaud-Ratti, Denis Sautereau, Marilyne Debette-Gratien, Anne Le-Sidaner, Paul Carrier, and Laura Mesturoux

Subjects
Adult, Curative resection, medicine.medical_specialty, One year follow up, Sus scrofa, Education, Animal training, 03 medical and health sciences, 0302 clinical medicine, Animals, Humans, Medicine, Intestinal Mucosa, Continuous exposure, Aged, Aged, 80 and over, Hepatology, business.industry, Dissection, General surgery, Significant difference, Gastroenterology, Endoscopy, Middle Aged, Surgery, 030220 oncology & carcinogenesis, Models, Animal, 030211 gastroenterology & hepatology, Clinical Competence, France, business, Training program, Learning Curve
Abstract

Background and aims The high specific skill needed by ESD limit its widespread use in Europe and animal training is recommended in Europe to improve the results of ESD that are far from Japanese at present. We create a local training program using live pigs as models, along with our human cases, to provide continuous exposure to the technique. Methods Between February 2013 and December 2015, two young operators performed 55 pig gastric ESDs in parallel with 62 human cases for large superficial cancerous lesions. The number and training dates of pig cases were adapted to those of the human cases to achieve continuous exposure to ESD cases. Results The en bloc, R0, and curative resection rates were 100%, 85.5% (53/62), and 77.5% (48/62), respectively with no recurrence observed during the one year follow up. There was no statistically significant difference in terms of the R0 or curative resection rates among ESDs performed during 2013–2015 (R0: 80% vs. 86.6% vs. 86.4%; Curative: 80% vs. 86.6% vs. 73%). Conclusion A local structured training program using live pig models was used to train endoscopists for ESD in humans with high safety and efficiency, similar to results published by Japanese experts.

Published
2016
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3. Antireflux versus conventional self-expanding metallic Stents (SEMS) for distal esophageal cancer: results of a multicenter randomized trial

Author

Stéphane Lecleire, D Coumaros, J. Brégeon, Christian Boustière, Philippe Bichard, Jérémie Jacques, C Volteau, B. Vedrenne, G. David, A Le Sidaner, M Le Rhun, Emmanuel Coron, Frédéric Prat, Yann Touchefeu, and T. Barrioz

Subjects
Original article, medicine.medical_specialty, Randomization, medicine.medical_treatment, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, otorhinolaryngologic diseases, medicine, Carcinoma, Pharmacology (medical), lcsh:RC799-869, Adverse effect, business.industry, Reflux, Stent, Esophageal cancer, medicine.disease, Dysphagia, digestive system diseases, Surgery, 030220 oncology & carcinogenesis, lcsh:Diseases of the digestive system. Gastroenterology, 030211 gastroenterology & hepatology, medicine.symptom, business
Abstract

Introduction: Self-expanding metal stents (SEMS) are commonly used in the palliation of dysphagia in patients with inoperable esophageal carcinoma. However, they predispose to gastroesophageal reflux when deployed across the gastroesophageal junction. The aims of this study were to: 1) assess the influence of the antireflux valve on trans-prosthetic reflux (primary outcome); and 2) compare the results of SEMS with and without antireflux valve in terms of reflux symptoms, quality of life (QOL), improvement of dysphagia and adverse events (secondary outcomes). Patients and methods: Thirty-eight patients were enrolled in nine centers. Carcinomas were locally advanced (47 %) or metastatic. After randomization, patients received either a covered SEMS with antireflux valve (n = 20) or a similar type of SEMS with no antireflux device but assigned to standard proton pump inhibitor therapy and postural advice (n = 18). Trans-prosthetic reflux was assessed at day 2 using a radiological score based on barium esophagography performed after Trendelenburg maneuver and graded from 0 (no reflux) to 12 (maximum). Monthly telephone interviews were conducted for Organisation Mondiale de la Santé (OMS) scoring from 0 (excellent) to 5 (poor), QOL assessment (based on the Reflux-Qual Simplifié scoring system) from 0 (poor) to 100 (excellent), dysphagia scoring from 0 (no dysphagia) to 5 (complete dysphagia) and regurgitation scoring from 0 (no regurgitation) to 16 (maximum). Results: No difference was noted in terms of age, sex, size of lesion, prosthesis length or need for dilation prior to SEMS placement. No difficulty in placing SEMS nor complications were noted. Radiological scores of reflux were found to be significantly lower in patients with an antireflux stent compared to the conventional stent and associated measures. The regurgitation scores were significantly decreased in patients with antireflux stents during the first 2 months after stent placement and thereafter, they were similar in the two groups. QOL and dysphagia were improved in both groups. Survival rates were comparable in the two groups. Conclusions: No difference was observed between the two types of SEMS regarding the palliation of dysphagia and improvement of QOL. However, SEMS with an antireflux valve were more effective in preventing trans-prosthetic gastroesophageal reflux but at the cost of an increased likehood of minor adverse events (migrations and/or obstruction of the SEMS).

Published
2016
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4. Adherence to online monitoring of patient-reported outcomes by patients with chronic inflammatory diseases: a feasibility study

Author

Y Jamilloux, M Sarabi, S Kérever, N Boussely, A le Sidaner, V Valgueblasse, P Carrier, V Loustaud-Ratti, D Sautereau, A-L Fauchais, B François, E Vidal, and null Collaborators

Subjects
Adult, Male, medicine.medical_specialty, Future studies, Hospital Anxiety and Depression Scale, Inflammatory bowel disease, Rheumatology, Quality of life, Surveys and Questionnaires, Completion rate, medicine, Humans, Lupus Erythematosus, Systemic, Routine care, Inflammation, Internet, business.industry, Mean age, Middle Aged, Inflammatory Bowel Diseases, medicine.disease, Sjogren's Syndrome, Patient Satisfaction, Chronic Disease, Emergency medicine, Quality of Life, Feasibility Studies, Patient Compliance, Female, Patient Participation, business
Abstract

Objectives The objective of this report is to investigate the feasibility of collecting patient-reported outcomes (PROs) via e-questionnaires delivered to patients with chronic inflammatory diseases (CIDs). Methods Consecutive outpatients with a confirmed diagnosis of systemic lupus erythematosus, primary Sjögren’s syndrome or inflammatory bowel disease were followed at two medical departments. Patients received monthly e-mails containing the SF36, Hospital Anxiety and Depression scale and an analogue symptom scale over a six-month period. Participation rate, socio-demographic characteristics and patients’ satisfaction were analysed. Results A total of 128 patients were included (79% female; mean age: 42 ± 12 years). Eighty-two per cent of questionnaires were returned. The monthly participation rate ranged from 89% to 77%, with a six-month attrition rate of 13%. The mean completion rate of questionnaires was 98%. Factors significantly associated with increased answer rate were: married/couple status, greater number of children at home and previous participation in online surveys. The main reasons for non-response were: ‘too busy to participate’ (35%) and ‘away from home Internet access’ (31%). Overall, 68% of the participants found the study convenient and 96% agreed to continue at a monthly or bimonthly frequency. Conclusion Online home self-assessment of PROs was feasible in the setting of CIDs. Patients were satisfied and willing to continue the survey. The Internet allows immediate and sophisticated presentation of PROs to clinicians. Future studies are warranted to determine how PRO monitoring may contribute to routine care in CIDs and other diseases.

Published
2015
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5. High-pressure injection of glycerol with HybridKnife for ESD is feasible and increases the ease and speed of the procedure: an in vivo study in pigs and first use in human

Author

Claude-Yves Couquet, Paul Carrier, Virginie Valgueblasse, Denis Sautereau, Tessa Tabouret, Jérémie Jacques, Véronique Loustaud-Ratti, Anne Le-Sidaner, Romain Legros, and M. Debette-Gratien

Subjects
Glycerol, medicine.medical_specialty, Sus scrofa, Perforation (oil well), Endoscopy, Gastrointestinal, Injections, chemistry.chemical_compound, In vivo, Outcome Assessment, Health Care, Pressure, medicine, Animals, Humans, Prospective Studies, business.industry, Dissection, Stomach, Endoscopic submucosal dissection, Surgery, chemistry, High pressure, Solvents, Feasibility Studies, business, Biomedical engineering
Abstract

The HybridKnife water-jet system (ERBE, Tubingen, Germany) has been shown to increase dissection speed and decreased the risk of perforation during endoscopic submucosal dissection (ESD). Glycerol mixture is a viscous, long-lasting solution preferentially used by Japanese ESD experts. The combination of the HybridKnife system with a glycerol solution has not been evaluated to date.A prospective non-randomised comparative study of ESD with HybridKnife injecting of either a glycerol mixture or normal saline was performed. Twenty dissections (ten per group) were performed on four anaesthetised domestic mini-pigs. Dissection speed (mm(2)/min), size of the specimen (mm(2)), duration (min), en bloc resection rate, and bleeding and perforation rates were prospectively recorded. An evaluation of operator comfort and perception of safety (dissection score) was performed using a visual analogue scale with 0 being the worst score and 10 the best.High-pressure injection of the glycerol mixture and dissection with the HybridKnife was feasible without complications. Dissection was significantly more rapid (1.67-fold) with glycerol injection than normal saline injection (27.44 vs. 16.44 mm(2)/min; p 0.001). The dissection score was significantly higher in the glycerol group than in the normal saline group (5.9 vs. 2.9; p 0.001). No differences were observed in the rates of en bloc resection, bleeding and perforation. Seven first human cases were also easy without need of preliminary incision and technical complication.High-pressure jet injection of glycerol with HybridKnife for ESD is feasible and increases the speed and safety of the procedure compared with use of normal saline.

Published
2015
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6. High Risk of Anal and Rectal Cancer in Patients With Anal and/or Perianal Crohn’s Disease

Author

Laurent Beaugerie, Fabrice Carrat, Stéphane Nahon, Jean-David Zeitoun, Jean-Marc Sabaté, Laurent Peyrin-Biroulet, Jean-Frédéric Colombel, Matthieu Allez, Jean-François Fléjou, Julien Kirchgesner, Magali Svrcek, Jacques Cosnes, Jean-Pierre Gendre, Marc Lémann, Xavier Hébuterne, Antoine Cortot, Yoram Bouhnik, David Laharie, Jean Louis Dupas, Bernard Flourié, Eric Lerebours, Bernard Messing, Guillaume Cadiot, Philippe Marteau, Jean-Claude Soulé, Jean-Marc Gornet, Michel Veyrac, Bernard Duclos, Philippe Beau, Arnaud Bourreille, Philippe Baumer, Franck Carbonnel, Denis Heresbach, Etienne-Henry Metman, Christian Florent, Antoine Blain, Jean-Luc Faucheron, Bruno Bonaz, Xavier Roblin, Pascal Potier, Christian Boehm, Thierry Kurtz, Hervé Lamouliatte, Isabelle Nion-Larmurier, Jean-Charles Delchier, Stanislas Chaussade, Anne Marie Weiss, Jean Pierre Cézard, Laurent Siproudhis, Daniel Sondag, Raymond Jian, Jean-Christophe Souquet, Pierre Bord, Benoit Coffin, Hélène D’almagne, Patrick Delasalle, Régis Fournier, Maryan Cavicchi, Marc-Henry Souffran, Luc Vandromme, Claire Guedon, Philippe Seksik, Christophe Michiels, Pascal Renard, Patrice Rogier, Sylvie Gouilloud, André Rotenberg, Guillaume Savoye, Alain Thevenin, Laurent Mallet, Franck Brazier, Francois Jean, Anne-Marie Justum, Jean-Paul Latrive, Jean-Luc Gerbal, Robert Pierrugues, Gérard Chardonnal, Laurence Picon, Nicole Reix, Nicolas Drouët D’aubigny, Hervé Uettwiller, Anne Courillon Mallet, Alain Palacci, Raoul-Jacques Bensaude, Pierre Bonniaud, Olivier Empinet, Andrée Nisard, Alain Rudelli, Bernard Tubiana, Philippe Capelle, Alain Dabadie, Daniel Evard, Pierre-Emile Julien, Magali Picon-Coste, Stéphane Schneider, Denis Goldfain, Jérôme Bellanger, Jean-Pierre Blondelot, Philippe Lamy, Sébastien Lemière, Jean Francois Mockly, Benoit Pellat, Gilles Gatineau-Sailliant, Bernard Nalet, Stéphane Nancey, Daniel Kusielewicz, Patrick Loison, Jean-Michel Popot, François Merite, Jean-Pol Roux, Pauline Afchain, Alain Blanquart, Laurent Heyries, Marc Reville, Dominique Viron, Frank Zerbib, Christophe Claviere, Didier Léostic, Philippe Pouderoux, Alain Moitry, Hervé Hagège, Jean-Pierre Hugot, Benoit Humeau, Jean-Marc Sabate, Emmanuel Lederman, Dominique Lescut, Fabrice Luneau, Bruno Mesnard, Lionel Smadja, Michel Steinberg, Marc Brun, Gilles Macaigne, Jean Luc Marchal, Stéphane Ollivier, Dominique Ouvry, Jean Paul Perche, Serge Rambaud, Robert Benamouzig, Jean Louis Cazenave, Jean-Charles Coffin, Martine Blazquez, Marion Lagneau, Bruno Person, Christian Wittersheim, Bertrand Napoleon, Israël Cemachovic, Franck Iglicki, Mehran Howaizi, Eric Leprince, Bruno Leurent, Thierry Morin, Riad Darsouni, Alain Attar, Philippe Baron, Anne Breton, Jean Marie Gillion, Jean-Marc Guemene, Claude Jouffre, Xavier Moreau, Pierre Claude, André Quinton, Vered Abitbol, Jean Michel Brichard, Benoit Desaint, Martin Bouygues, Philippe Chatrenet, Marcelo Salmeron, Jean Silvie, Bruno Waldner, Yves Emery, Armand Moraillon, Daniel Kunkel, Philippe Dubois, Patrick Faure, Christian L'Hirondel, Jean-Eric Labérenne, Pierre Moreau, Adelino Pereira, Genevieve Plihon, Thierry Wolff, Yann Ngo, Arnaud Boruchowicz, Béatrice Jost, Jean Pierre Gotlib, Odile Danne, Philippe Raoux, Marie-José Ramond-Bouhali, Andre Baetz, Bruno Veyres, Christian Chapoutot, Gérard Le Dréau, Jérôme Filippi, Jean Mudry, Philippe Kalt, Sophie Minault, Pierre-André Bounin, Tony Andréani, Jacky Charneau, Didier Reijasse, Jean-Louis Bolze, Jean Luc Thaunat, Christian Le Couteulx, Chantal Maurage, Robert Bader, Philippe Codjovi, Jean-Luc Migairou, Alain Morali, Philippe Rey, Bruno Richard Molard, Richard Petit, Stéphane Koch, Philippe Cassan, Jean-Paul Deschamps, Christine Meicler Caby, Jean-Jacques Meurisse, Philippe Prades, James Boulant, Michel Diacono, Jean-Marie Monsch, J-François Dupuy, Guy Bellaiche, Martine Guegan, Jean-Marc Comte, Jean-Michel Cayla, Francois Le Tallec, Franck Meurisse, Philippe Desurmont, Laurent Roget, Philippe Bouyssou, Bruno Le Gall, Francis Bloch, Loic Larvol, Monique Jullien, Jacques Moreau, Laurent Rebouissoux, Bruno Decroix, Nina Dib, Paul Dieterling, Frédéric Lenormand, Emmanuel Lagier, Philippe Fallourd, Serge Charpin, Hugues Bertrand, Gilles Bommelaer, Daniel Battistelli, Bernard Delon, Lionel Dentant, Etienne Dorval, Jérôme Dumortier, Eric Gaye-Bareyt, Yves Gerosa, Chantal Guez, Martine Mornet, Paul Benfredj, René Piperaud, Noel Stremsdoerfer, Eric Verdier, Alain Grinholtz, Georges Barjonet, Antoine See, Ramuntxo Arotçarena, Anne Baudet, Joel Broyer, Antoine Charachon, Hugues Blondon, Pascal Mouton, Hubert Claudez, Jacques Labat-Labourdette, Jacques Haëm, Patrick Estable, Patrick Levy, Alain Rosenbaum, Yvon Balavoine, Alain Blanchi, Pierre Coutarel, Nadege Delaperriere, Michel Dervichian, Francis Marois, Jacques Seroka, Laurent Michaud, Olivier Leroy, Emmanuel Meyran, Bernard Poilroux, Abdallah Tensaouti, Thierry Paupard, Dominique Agard, Sandrine Beaulieu, Kader Benfiguig, Patrice Capony, Jean Cottereau, Pierre Desreumaux, Jean-Michel Dramard, Mathieu Duché, Patrick Mamou, Isabelle Etienney, Gilles D'Abrigeon, Béatrice Godeberge, Gilbert Tucat, Jean Puech, Jean Roger, Marie-George Lapalus, Paul Bauret, Philippe Houcke, Béatrice Pornin, Bruno Champigneulle, Laurent Cuissard, Xavier-Richard David, Frédéric Lombard, Antoine Granveau, Jean-François Hamon, Olivier Ink, Fabienne Blondel, Alain Namias, Didier Pillon, Antoine Reignier, Gilles Tordjman, Christos Christidis, Simon Zirabe, Michel Audebert, Eric Bion, Claude Bourgeaux, Cécile Poupardin, Philippe Deplaix, Gérard Fratini, Thierry Garnier, Gerard Desseaux, Hervé Magois, Sylvain Lochum, Jean-Francois Vergier, Patrick Texereau, Christel Rat, Francoise Uzzan, Alain Vidal, Nadia Vinante, Bernard Watrin, Cécile Wurtz-Huckert, Bruno Barre, Dominique Chaslin Ferbus, Jean-François Contou, Dominique Coupier, Benoit David, Dany Gargot, Denis Huc, Remy Barraya, Roger Faroux, Jean-Luc Fourgeaud, Hubert Grimprel, Jean Auroux, Jean-François Rey, Jean Pierre Arnoux, Franck Lentini, Ludovic Tardy, Olivier Mouterde, Claire Spyckerelle, Bruno Vacherot, Alain Weissman, Michel Alpérine, Anne Le Sidaner, Pierre-Olivier Bonnet-Eymard, Jean Louis Colson, Daniel Pellet, Bernard Deltombe, André Edouard, Henri Maechel, Jean-Claude Jaillet, Julien Genes, Anne-Marie Leveque, Damien Lucidarme, Philippe Maignan, Nathalie Mallier Gehrke, Jérôme Sanchez, Frank Tusseau, Alban Casteur, Jacques Bottlaender, Denis Constantini, Thierry Coton, Philippe Even, Francois Druart, François Riot, Jean-Michel Gauchet, Geneviève Hecquet, Gerard Henry, Patrick Hochain, Jean Pierre Arpurt, Abdelkrim Medini, Michele Dartois-Hoguin, Henri Moindrot, Philippe Emery, Pierre Periac, Annie Prunier, Pascal Renkes, Christine Tawil-Longreen, Edmond Vincent, René-Louis Vitte, Christian Loeb, Alain Carwana, Didier Barbereau, Philippe Bohon, Céline Corrieri-Baizeau, Daniel Sahy, Philippe Derreveaux, Dominique David, François Desbazeille, Patrick Fontenelle, Jean Luc Slama, Yvon Le Mercier, Michel Certin, Jean Jacques Reig, Isabelle Rosa, Thierry Helbert, Patrick Tounian, Luc Turner, Valéry Perot, Luc Aillet, Arnaud Pauwels, Philippe Barré, Bernard Nury, Claude Cazalbou, Franck Devulder, Alain Durget, Jeanne Dubroca, Daniele Gaudy, Michel Greff, Christian Jacques, Jocelyne Lafarge, Gilles Kezachian, Ronan Le Gall, Alex Pariente, Tiphaine Pinault, Michaël Bismuth, Nathalie Boyer-Darrigrand, Philippe Bretagnolle, Stephane Carpentier, Franck Cholet, Christian Theodore, Rémi Combes, Francois Combet, Christophe Delanoe, Stéphanie De Montigny, Denis Soudan, Olivier Fourdan, Gilles Minier, Jeanne Languepin, Jean Roche, Jean-Louis Ginies, Olivier Nouel, Philippe Petitgars, Edith Robin, Romain Hamm, Jean François Roques, Sylvie Roussin-Bretagne, Agnès Sénéjoux, Sophie Muron, Nicolas Bardoux, Philippe Berthelemy, Patrick Madonia, Bertrand Carles, Catherine Reynier, Emmanuel Cuillerier, Innocenti Dadamessi, Jacques Danis, Bernard Debenes, Nathalie Dubuc-Rey, Gilles Lesur, Pauline Jouet, Catherine Lenaerts, Marc Garret, Alexandra Mineur, Bernard Chabry, Francois Pigot, Valérie Rossi, Ruth Tennenbaum, Julien Salloum, Maurice Hakim Slaoui, Stéphane Mathieu, Valérie Papapietro, Sheila Viola, Alexis Bezet, Claude Altman, Alain Audan, Jean Calabet, Claude Masliah, Laurent Fayemendy, Marc Duruy, Benoit Gauffeny, Ludovic Helie, Kamran Imani, Raoul Janin-Manificat, Jean-Paul Galmiche, Anne Kerlirzin, Laurent Bedenne, Christophe Locher, Gilles Michaudel, Gilles Missonnier, Michel Rinaldi-Dovio, Jean-Michel Rouillon, Stéphane Ecuer, Arnaud Patenotte, Jean Ariel Bronstein, Vincent Baty, Michel Bougnol, Pierre Bourbon, Philippe Cerbelaud, Annick Chavaillon, Franck Boiffin, Béatrice Dubern, Isabelle Duval De Laguierce, Fernand Greco, Florence Bouhot, Philippe Godeberge, Brigitte Grandmaison, Pascal Gros, Guy Targues, Jacques Corallo, Jean Boutin, Jacques Guillan, Jean Pierre Barbieux, Isabelle Loury Lariviere, Henri Le Genissel, Henri Leroi, Marc Bellaiche, Marie-Claire Elie-Legrand, Michel Dapoigny, Philippe Denoyel, Patrice Pienkowski, Philippe Pouche, Marc Michel Saurfelt, Jean Marie Thorel, Thierry Piche, Bruno Travers, Patrick Tuvignon, Marc Zalcberg, Guy Boulay, Christophe Zamora, Joelle Samama, Etienne Ricotie, Patrice De Fleury, Francois Maille, Jean Louis Mougenel, Olivier Gonot, Jean Philippe Menat, Mehdi Kaassis, Francoise Lang, Laurent Abramowitz, Nathalie Ganne, Olivier Pecriaux, Jacques-Arnaud Seyrig, Iradj Sobhani, Thierry Parmentier, Antoine Van Nieuwenhuyse, Francois-Xavier Weber, André Glibert, Catherine Bineau, Bernard Canet, Catherine Collin, Frederic Cordet, David David Parlier, Dominique Carre, Annie Peytier, Francine Fein, Jerome Barouk, Jacques Dewannieux, Johannes Hartwig, Jean-Louis Jouve, Bertrand Laplane, Gilles Lascar, Christophe Legrand, Pierre Le Marchand, Marie Pierre Liebaert, Michele Terdiman-Pire, Naceur Abdelli, Dominique Neveu, Philippe De La Lande, Patrick De Saint Louvent, Cécile Pelatan, Agnès Petit, Martial Richecoeur, Frederic Texier, Jean Brice Cazals, Bertrand Tissot, Christian Mourrut, Marie Doubremelle, Marc Foltz, Florence Gautier-Jubé, Jacques Martin, Elie Khouri, Thierry Lons, Martine Carlier-Bandu, Jean-Luc Monnin, Hervé Roche, Bernard Willemin, Xavier Houard, Abdelaziz Fatisse, Michèle Algard, Kamel Arab, Isabelle Borel, Cécile Lagarrigue, Ariane Chryssostalis, Dominique Boutroux, Jean-Pierre Dupuychaffray, Saïd Khaddari, François Mion, Thierry Puy-Montbrun, Jean-Philippe Girardet, Bruno Gury, Alain Landau, Monique Le Bihan, Sandrine Nieuviarts, Jean Ollivry, Philippe Le Bourgeois, Marie-Astrid Piquet, Michel -Pierre Escartin, Remi Systchenko, Franck Venezia, Michel Wantiez, Xavier Lesage, Elie Zrihen, Philippe Aygalenq, Barbara Dieumegard, Bernard Savarieau, Philippe Bulois, Stéphane Cattan, Jean-Lucien Diez, Olivier Fauchot, Eric Durous, Valérie Gazut, Christian Guilleminet, Jean-Marc Bories, Isabelle Joly Le Floch, Jean-Paul Vove, Stéphane Lelouch, Philippe Lévy, François Lhopital, Norma Marcato, Marianne Mozer-Bernardeau, Jean-Baptiste Nousbaum, Philippe Cattan, Alain Plane, Jean-Michel Raymond, Gilles Roseau, Gerald Rozental, Christian Boustière, Corinne Bonny, Mariepierre Cordier-Collet, Laurent Courat, Bernard Croguennec, Karine Delaunay- Tardy, Damien Labarriere, Edmond Geagea, Frédéric Gottrand, Eve Gelsi, Gerard Thiefin, Eric Wohlschies, Mathieu Miguet, Philippe Ponsot, Jean Suzanne, Yves Teste, Anne-Claire Dupont Gossart, Jean-Luc Baroni, Benabdallah Benchaa, Georges Blanc, Bernard Maroy, Philippe Bonjean, Catherine Brézault, Laure Bridoux-Henno, Claude Chayette, Dominique Auby, Robert Fiorucci, Georges Galindo, Gilles Hubert, Gilles Bonneau, Evelyne Marinier, Michele Pouteau, Afchine Alamdari, Bruno Delbende, Patrick Chamouard, Pascale D'Abravanel, Hélène Dall'Osto, Sophie Hervé, Jean Lefebvre, Damien Levoir, Philippe Lillo, Michel Rouch, Muriel Mathonnet, Mercédes De Lustrac, François-Jean Ramond, Bernard Roupret, and Alain Soupison

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Colorectal cancer, Population, Risk Assessment, Gastroenterology, Inflammatory bowel disease, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Risk Factors, Internal medicine, medicine, Humans, Anal cancer, education, Aged, education.field_of_study, Crohn's disease, Hepatology, Rectal Neoplasms, business.industry, Incidence, Cancer, Odds ratio, Middle Aged, Anus Neoplasms, medicine.disease, Ulcerative colitis, Case-Control Studies, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, France, business, Follow-Up Studies
Abstract

Background & Aims Little is known about the magnitude of the risk of anal and rectal cancer in patients with anal and/or perineal Crohn's disease. We aimed to assess the risk of anal and rectal cancer in patients with Crohn's perianal disease followed up in the Cancers Et Surrisque Associe aux Maladies Inflammatoires Intestinales En France (CESAME) cohort. Methods We collected data from 19,486 patients with inflammatory bowel disease (IBD) enrolled in the observational CESAME study in France, from May 2004 through June 2005; 14.9% of participants had past or current anal and/or perianal Crohn's disease. Subjects were followed up for a median time of 35 months (interquartile range, 29–40 mo). To identify risk factors for anal cancer in the total CESAME population, we performed a case-control study in which participants were matched for age and sex. Results Among the total IBD population, 8 patients developed anal cancer and 14 patients developed rectal cancer. In the subgroup of 2911 patients with past or current anal and/or perianal Crohn's lesions at cohort entry, 2 developed anal squamous-cell carcinoma, 3 developed perianal fistula–related adenocarcinoma, and 6 developed rectal cancer. The corresponding incidence rates were 0.26 per 1000 patient-years for anal squamous-cell carcinoma, 0.38 per 1000 patient-years for perianal fistula–related adenocarcinoma, and 0.77 per 1000 patient-years for rectal cancer. Among the 16,575 patients with ulcerative colitis or Crohn's disease without anal or perianal lesions, the incidence rate of anal cancer was 0.08 per 1000 patient-years and of rectal cancer was 0.21 per 1000 patient-years. Among factors tested by univariate conditional regression (IBD subtype, disease duration, exposure to immune-suppressive therapy, presence of past or current anal and/or perianal lesions), the presence of past or current anal and/or perianal lesions at cohort entry was the only factor significantly associated with development of anal cancer (odds ratio, 11.2; 95% CI, 1.18-551.51; P = .03). Conclusions In an analysis of data from the CESAME cohort in France, patients with anal and/or perianal Crohn's disease have a high risk of anal cancer, including perianal fistula–related cancer, and a high risk of rectal cancer.

Published
2018
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7. Les endoprothèses coliques: évolution du matériel et technique de pose

Author

S. Seillan, Romain Legros, B. Dallaudiere, A. Le Sidaner, D. Sautereau, M. Croguennec, François Cessot, and Leila Kanafi

Subjects
business.industry, Medicine, Radiology, Nuclear Medicine and imaging, Nuclear medicine, business
Abstract

La modification des endoprotheses digestives (catheter d’introduction, ouverture distale, maillage elastique, biocomptabilite des materiaux, facilite d’utilisation) a permis leur diffusion. La technique d’utilisation est bien standardisee et differe selon le type de la prothese. Les indications ont ete elargies du traitement palliatif au traitement d’attente d’une chirurgie d’exerese et enfin, a certaines stenoses benignes.

Published
2009
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9. Intoxication par ingestion de plombs de pêche

Author

Paul Carrier, D. Sautereau, Romain Legros, K.H. Ly, A. Morel, Véronique Loustaud-Ratti, C. Moesch, P. Harry, and A. Le Sidaner

Subjects
Gynecology, medicine.medical_specialty, business.industry, Gastroenterology, Internal Medicine, medicine, business
Abstract

Resume Introduction La colique de plomb est une cause rare de douleur abdominale. Cette presentation symptomatique du saturnisme est evoquee le plus souvent dans des populations a risque (enfants, psychotiques). Observation Nous rapportons l’observation d’un homme de 21 ans hospitalise pour douleurs abdominales avec, pour seule orientation initiale, la presence de corps metalliques intracoliques. Une plombemie et un taux de protoporphyrines zinc fortement eleves confirmaient le diagnostic et l’interrogatoire permettait d’identifier un mâchage d’appâts de peche en plomb lors de leur preparation. L’evolution etait favorable avec les chelateurs du plomb. Conclusion L’intoxication par le plomb resultant de l’ingestion de plombs de peche est rare. La presence de corps etrangers metalliques sur un cliche simple d’abdomen sans preparation peut faire evoquer le diagnostic qui sera confirme par une plombemie elevee. Un traitement rapide associant chelateurs et une eventuelle vidange digestive est le plus souvent efficace.

Published
2012
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10. Gastrostomie percutanée endoscopique

Author

Anne Le Sidaner

Subjects
business.industry, Medicine, Radiology, Nuclear Medicine and imaging, business, Humanities
Abstract

La gastrostomie percutanee endoscopique est actuellement la voie d’abord de reference pour l’alimentation enterale prolongee. La simplicite et la rapidite de la technique, l’evolution du materiel font que les gastro-enterologues sont de plus en plus sollicites et que la pose est accessible a tout endoscopiste. Le respect des contre-indications et la rigueur dans la realisation de la procedure sont la cle de la reussite du geste endoscopique, d’un faible taux de morbidite et de mortalite.

Published
2002
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11. Impact of chromoscopy on adenoma detection in patients with Lynch syndrome: a prospective, multicenter, blinded, tandem colonoscopy study

Author

Stanislas Chaussade, Driffa Moussata, Anne Le Sidaner, Olivier Caron, Elia Samaha, Marianne Gaudric, Karl Barange, Pierre Laurent-Puig, T Maniere, Jean-Christophe Saurin, Thierry Ponchon, Gabriel Rahmi, Marc Le Rhun, Gilles Chatellier, M. G. Lapalus, JP Barbieux, Emmanuel Coron, Christophe Cellier, David Malka, Thierry Lecomte, Rosine Guimbaud, and Denis Sautereau

Subjects
Adenoma, Adult, Male, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Colon, MEDLINE, Coloring agents, Indigo Carmine, law.invention, Randomized controlled trial, law, Medicine, Humans, In patient, Single-Blind Method, Coloring Agents, Early Detection of Cancer, Hepatology, business.industry, General surgery, Carcinoma, Gastroenterology, Rectum, nutritional and metabolic diseases, Colonoscopy, Middle Aged, medicine.disease, Colorectal Neoplasms, Hereditary Nonpolyposis, digestive system diseases, Lynch syndrome, Multicenter study, Female, business, Colorectal Neoplasms, Colonoscopy Study
Abstract

In Lynch syndrome, flat and diminutive adenomas are particularly prone to malignant transformation, but they can be missed by standard colonoscopy. It is not known whether chromocolonoscopy is able to detect more adenomas than standard colonoscopy in patients with Lynch syndrome.We conducted a prospective, multicenter, randomized trial to compare standard colonoscopy with standard colonoscopy followed by pancolonic chromoscopy with indigo carmine in patients with a proven germline mutation in a mismatch-repair gene related to Lynch syndrome and who were undergoing screening or surveillance colonoscopy. Standard colonoscopy was used first to detect visible lesions. Colonoscopy with chromoscopy was then performed by a second gastroenterologist (blinded to the findings of the first colonoscopy) to detect additional lesions. The primary end point was the number of patients in whom at least one adenoma was detected.A total of 78 eligible patients (median age, 45 years) were enrolled at 10 centers from July 2008 to August 2009. Significantly more patients with at least one adenoma were identified by chromocolonoscopy (32/78 (41%)) than by standard colonoscopy (18/78 (23%); P0.001). The percentage of patients in whom at least one additional adenoma was detected during the chromoscopy was 31% (24/78). Overall, chromocolonoscopy plus colonoscopy detected a total of 55 adenomas in 32 patients (mean number of adenomas detected per patient: 0.7 vs. standard colonoscopy alone: 0.3; P0.001).The results support the proposition that chromocolonoscopy may significantly improve the detection rate of colorectal adenomas in patients undergoing screening or surveillance colonoscopy for Lynch syndrome.

Published
2014

12. [Untitled]

Author

C. Moesch, B. Desaint, V. de Ledinghen, Jean-Louis Legoux, G. Grollier, B. Person, Pierre Ingrand, A. Le Sidaner, D. Sautereau, M. Greff, and Michel Beauchant

Subjects
medicine.medical_specialty, Physiology, business.industry, medicine.medical_treatment, Gastroenterology, Stent, medicine.disease, Ursodeoxycholic acid, Surgery, law.invention, Cholestasis, Randomized controlled trial, Biliary tract, law, Multicenter trial, medicine, business, Norfloxacin, medicine.drug, Antibacterial agent
Abstract

We report a prospective randomized multicenter trial that tested the efficacy of combining ursodeoxycholic acid and norfloxacin in the prevention of polyethylene stent clogging in patients with obstructive jaundice due to an unresectable malignancy at the level of the common bile duct. After insertion of a 10-Fr straight polyethylene stent, patients were allocated to receive oral treatment with ursodeoxycholic acid and norfloxacin, or conservative treatment. The primary outcome measure was stent blockage within six months. Thirty-three patients (group I) received ursodeoxycholic acid and norfloxacin, and 29 received conservative treatment (group II). At six months, cumulative stent patency rate did not differ significantly between group I (47 ± 11%, mean ± se, median 149 days) and group II patients (24 ± 10%, mean ± se, median 100 days, P = 0.23, log-rank test). Four stents were clogged by ursodeoxycholic acid. Survival did not differ between the two groups. Combined therapy with ursodeoxycholic acid and norfloxacin failed to improve stent patency. Moreover, ursodeoxycholic acid can cause stent obstruction.

Published
2000
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13. Value of MR cholangiography in the diagnosis of obstructive diseases of the biliary tree: a study of 58 cases

Author

D. Sautereau, B Pillegand, Michel-Henry Mendler, Anne Le Sidaner, Pierre Chaumerliac, François Cessot, and Philippe Bouillet

Subjects
Adult, Male, medicine.medical_specialty, Bile Duct Diseases, Gallstones, Cholangiography, Cholestasis, Reference Values, medicine, Humans, Prospective Studies, Aged, Ultrasonography, Aged, 80 and over, Cholangiopancreatography, Endoscopic Retrograde, Endoscopic retrograde cholangiopancreatography, Hepatology, medicine.diagnostic_test, Bile duct, business.industry, Ultrasound, Gastroenterology, Magnetic resonance imaging, Middle Aged, medicine.disease, Magnetic Resonance Imaging, medicine.anatomical_structure, Bile Duct Neoplasms, Biliary tract, Etiology, Female, Radiology, Tomography, X-Ray Computed, business
Abstract

Objective: The aim of this study was to evaluate magnetic resonance cholangiography (MRC) in the diagnosis of biliary tree obstruction. Methods: Fifty-eight consecutive patients underwent MRC (GYROSCAN ACS II 1.5 Tesla, TSE T2 axial/coronal-MIP sequences) for clinical and biochemical signs of main bile duct obstruction. MRC images were interpreted by two radiologists and consensus was established according to presence or absence of main bile duct dilation, choledocholithiasis, and malignant or benign stricture. MRC was compared to a final diagnosis established by ultrasound and CT in 19 cases, endoscopic retrograde cholangiopancreatography (ERCP) in 25, intraoperative cholangiography and exploration in 14, and clinical, biochemical, and histological presentation when relevant. Included were single or multiple choledocholithiasis (28, including 11 ≤ 3 mm), malignant (10) and benign (12) strictures, and intrahepatic cholestasis (9). Results: Overall, MRC was sensitive (94%) and specific (92%) in detecting main bile duct dilation and choledocholithiasis (86% and 97%), but was less sensitive (64%) for small stones ≤ 3 mm. Sensitivity for stones > 3 mm was 100%. For benign and malignant strictures, MRC was less sensitive (67% and 80%) but remained specific (98% and 96%). In the detection of normal main bile duct, MRC was highly sensitive (100%) and specific (94%). Diagnostic accuracy ranged from 91% to 98%. Conclusion: MRC appears to be specific for choledocholithiasis and sensitive except for small stones. Results for biliary stricture are less satisfactory, but remain specific. Our data confirm that MRC can be useful in the diagnostic workup of main bile duct obstruction.

Published
1998
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15. Accuracy of computed tomographic colonography in a nationwide multicentre trial, and its relation to radiologist expertise

Author

M Boudiaf, Philippe Bouillet, S Hamonic, M Tissier, M A Pierredon-Foulogne, C Marcus, J M Josselin, C Ridereau-Zins, H Laumonier, J Keruhel, F Riou, A L Pelletier, Thierry Ponchon, Antoine Charachon, A Le Sidaner, B Diris, M Djabbari, J A Seyrig, S Ficarelli, M Giraud-Cohen, M Veyrac, H Lamouliatte, F Ramaholimihaso, A M Zagdanski, Yoram Bouhnik, K Vahedi, Denis Heresbach, D Luet, Y Gandon, Centre de recherche en économie et management (CREM), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS), Service d'hépato-gastro-entérologie [Rennes] = Gastroenterology [Rennes], CHU Pontchaillou [Rennes], and Normandie Université (NU)-Normandie Université (NU)-Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, medicine.medical_specialty, Multivariate analysis, Colorectal cancer, Population, education, Video Recording, Colonic Polyps, Colonoscopy, radiologist expertise, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Positive predicative value, Humans, Medicine, Computed Tomographic Colonography, neoplasms, Aged, Univariate analysis, education.field_of_study, medicine.diagnostic_test, business.industry, Gastroenterology, Middle Aged, medicine.disease, [SHS.ECO]Humanities and Social Sciences/Economics and Finance, computed tomographic colonography, digestive system diseases, 3. Good health, Clinical trial, Occult Blood, Education, Medical, Continuing, Female, 030211 gastroenterology & hepatology, Clinical Competence, France, Radiology, Colorectal Neoplasms, Epidemiologic Methods, business, Colonography, Computed Tomographic
Abstract

Impact factor : 9.357; International audience; Objective Reports on the accuracy of computed tomographic colonography (CTC) mainly involve series from expert institutions. The aims of this study were to assess CTC accuracy in a nationwide population and to relate it to radiologist performance in their initial training. Design Nationwide multicentre trial. Setting Twenty-eight radiologists, working in 26 mostly academic clinical units, were involved in the study after having attended a formal specialised 2-day training session on CTC. They worked through a training set of 52 cases with automatic feedback after an attempt at each case. Patients The study enrolled 845 patients with average and high risk of colorectal cancer, 737 of whom had both complete CTC and videocolonoscopy data, which constituted the dataset. Interventions Patients underwent same-day CTC followed by videocolonoscopy with segmental unblinding of CTC results. Main outcome measures Sensitivity, specificity and positive and negative predictive values for detection of polyps ≥6 mm in per-patient and per-lesion analyses of CTC without computer-aided detection. Results Sensitivity, specificity and positive and negative predictive values for patients with polyps ≥6 mm were 69% (95% CI 61% to 77%), 91% (95% CI 89% to 94%), 67% (95% CI 59% to 74%) and 92% (95% CI 90% to 94%), respectively. Univariate analysis showed that the detection rate for polyps ≥6 mm was linked to neither radiologist case volume nor number of polyps, but was related to sensitivity achieved in the training set. Pooled sensitivity was 72% (95% CI 63% to 80%) versus 51% (95% CI 40% to 60%) for radiologists achieving above and below median sensitivity in the training set (61%), respectively. Multivariate analysis showed that sensitivity for polyps ≥6 mm in the training set was the only remaining significant predictive factor for subsequent performance. Conclusions Radiologist sensitivity CTC for detection of polyps ≥6 mm in training was the sole independent predictor for subsequent sensitivity in detection of such polyps.

Published
2011
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16. Etude multicentrique prospective de la coloscopie virtuelle comparée à la vidéocoloscopie

Author

H Laumonier, T. Ponchon, Antoine Charachon, Philippe Bouillet, J A Seyrig, Pascal Burtin, M A Pierredon-Foulogne, C Ridereau-Zins, J Keruhel, D. Heresbach, A Le Sidaner, M Boudiaf, A M Zagdanski, M Giraud-Cohen, S Ficarelli, M Veyrac, F Ramaholimihaso, F Riou, M Djabbari, Kouroche Vahedi, Yoram Bouhnik, Thierry Vallot, Y Gandon, H Lamouliatte, and C Marcus

Subjects
Gynecology, medicine.medical_specialty, business.industry, Gastroenterology, medicine, business
Published
2010
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19. La coloscopie avec chromo-endoscopie à l'indigo carmin détecte deux fois plus d'adénomes que la coloscopie standard chez les patients HNPCC: étude prospective, randomisée, multicentrique française

Author

Marianne Gaudric, A Le Sidaner, T Maniere, B. Landi, T. Ponchon, Karl Barange, D. Sautereau, Emmanuel Coron, M. G. Lapalus, P Zimmermann, Christophe Cellier, Driffa Moussata, Jean-Christophe Saurin, B. Boboc, Rosine Guimbaud, M Lerun, Stanislas Chaussade, Thierry Lecomte, JP Barbieux, and David Malka

Subjects
Gynecology, medicine.medical_specialty, business.industry, Gastroenterology, medicine, business
Published
2008
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21. Sa1630 Safe and Efficient ESD for Large Lateral Spreading Tumors of the Rectum in a French Center Thanks to a Rigorous Training Program

Author

Paul Carrier, Marilyne Debette-Gratien, Laura Mesturoux, Françoise Boulanger, Romain Legros, Denis Sautereau, Claude-Yves Couquet, Jérémie Jacques, Tessa Tabouret, Véronique Loustaud-Ratti, Virginie Valgueblasse, Anne Le-Sidaner, and Roger Daloko

Subjects
medicine.medical_specialty, medicine.anatomical_structure, business.industry, Gastroenterology, medicine, Rectum, Radiology, Nuclear Medicine and imaging, Center (algebra and category theory), Medical physics, Training program, business, Surgery
Published
2015
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22. Similar performance but higher cholecystitis rate with covered biliary stents: results from a prospective multicenter evaluation

Author

Frédéric Prat, T Yzet, H Lamouliatte, B. Napoléon, Fabien Fumex, J-M Canard, D Coumaros, Marc Barthet, Société Française d'Endoscopie Digestive, P Desurmont, R. Laugier, T. Ponchon, J-F Rey, A Le Sidaner, and J-C Letard

Subjects
Male, medicine.medical_specialty, Abdominal pain, Time Factors, medicine.medical_treatment, Biliary Stenting, medicine, Cholecystitis, Humans, Prospective Studies, Prospective cohort study, Aged, Cholestasis, business.industry, Gallbladder, Gastroenterology, Stent, equipment and supplies, medicine.disease, Surgery, surgical procedures, operative, medicine.anatomical_structure, Biliary tract, Pancreatitis, Female, Stents, Radiology, medicine.symptom, business, Follow-Up Studies
Abstract

Background and study aims Endoscopic biliary stenting is now a well-established treatment method in patients with unresectable malignant biliary obstruction. Despite advances with metal stents, the problem of stent occlusion has not yet been resolved. Covered metal stents could reduce the occlusion rate by preventing tumor ingrowth, but have not been well evaluated. A prospective multicenter study was therefore conducted to evaluate the efficacy and disadvantages of covered Wallstents. Patients and methods Covered Wallstents were implanted endoscopically in 62 patients with inoperable distal malignant biliary obstruction. Complications, stent patency, and patient survival were analyzed. Results Stent insertion was achieved in 61 of the 62 patients (98.4 %). Procedure-related complications were observed in four patients, consisting of minor pancreatitis (n = 2) and abdominal pain due to stent expansion (n = 2). There was no procedure-related mortality. Seven patients died too early for proper assessment, so that a total of 54 patients were ultimately evaluated. Stent dysfunction occurred in 17 of the 54 patients (31.5 %). The reasons for dysfunction were proximal tumor overgrowth (n = 5), migration (n = 3), lithiasis or food impaction (n = 3), cholangitis without the need for a repeat biliary intervention (n = 5), and unknown (n = 1). The median period of stent patency was 142 days. No tumor ingrowth was observed. Acute cholecystitis was diagnosed in five patients (10 %) and was responsible for one death. Three stents were successfully removed. Conclusions Covered biliary metal stents are effective for the drainage of distal malignant biliary obstruction, with a dysfunction rate apparently similar to that of uncovered stents. However, the risk of acute cholecystitis appears to be a major concern with this type of stent in patients with gallbladder in situ. Further comparative studies are needed.

Published
2006

24. Obscure bleeding from gastrointestinal metastases of a head and neck squamous cell carcinoma

Author

Romain Legros, Sophie Geyl, Jérémie Jacques, Denis Sautereau, Paul Carrier, Fabrice Projetti, and Anne Le-Sidaner

Subjects
Male, medicine.medical_specialty, Anemia, MEDLINE, Colonoscopy, Cecal Neoplasms, Stomach Neoplasms, Gastroscopy, Carcinoma, medicine, Humans, Aged, Anemia, Iron-Deficiency, Jejunal Neoplasms, medicine.diagnostic_test, business.industry, General surgery, Gastroenterology, medicine.disease, Head and neck squamous-cell carcinoma, Oropharyngeal Neoplasms, Carcinoma, Squamous Cell, Radiology, Gastrointestinal Hemorrhage, business
Published
2014
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25. Su1536 Validation of a French Training Program of Endoscopic Submucosal Dissection (ESD) in Live Pigs Aiming to Start Efficient and Safe Human Rectal ESD

Author

Roger Daloko, A. Bouygues, Claude-Yves Couquet, Anne Le-Sidaner, Françoise Boulanger, Tessa Tabouret, Jérémie Jacques, Véronique Loustaud-Ratti, Virginie Valgueblasse, Romain Legros, Denis Sautereau, Marilyne Debette-Gratien, and Paul Carrier

Subjects
medicine.medical_specialty, business.industry, Gastroenterology, medicine, Radiology, Nuclear Medicine and imaging, Endoscopic submucosal dissection, Training program, business, Surgery
Published
2014
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26. Value of magnetic resonance cholangiography in the preoperative diagnosis of common bile duct stones

Author

B Pillegand, Philippe Bouillet, Aklesso Laokpessi, François Cessot, Anne Le Sidaner, Jean-Claude Desport, and D. Sautereau

Subjects
medicine.medical_specialty, medicine.medical_treatment, Intraoperative cholangiography, Gallstones, Preoperative care, Sensitivity and Specificity, Cholangiography, Preoperative Care, medicine, Humans, Cholangiopancreatography, Endoscopic Retrograde, Hepatology, medicine.diagnostic_test, Common bile duct, business.industry, Significant difference, Gastroenterology, Magnetic resonance imaging, medicine.disease, Magnetic Resonance Imaging, Surgery, medicine.anatomical_structure, Cholecystectomy, Radiology, business
Abstract

OBJECTIVE: The aim of this study was to assess the performance of magnetic resonance cholangiography (MRC) in the preoperative diagnosis of choledocholithiasis. METHODS: A total of 147 consecutive patients underwent MRC for clinical and biological signs of common bile duct stones. ERCP was then carried out in 101 patients in whom there was a past history of cholecystectomy. The remaining 46 patients without a past history of biliary surgery underwent cholecystectomy and intraoperative cholangiography (IOC). The diagnosis obtained by MRC was compared with the final diagnosis established after endoscopic or surgical removal of calculi. RESULTS: A total of 113 patients had choledocholithiasis (single or multiple, including 15 cases of microlithiasis). There were no false-positive results with MRC. The false-negative results were caused mainly by small stones

Published
2001

27. Indications, Efficacy, Complications and Outcome of Colorectal Stenting for Colonic Obstruction: Six Years Experience At a Single Center Consecutive Study Involving 135 Patients

Author

François Cessot, Denis Sautereau, Leila Kanafi, Benjamin Dallaudiere, Romain Legros, and Anne Le Sidaner

Subjects
Colonic obstruction, medicine.medical_specialty, business.industry, Gastroenterology, Medicine, Radiology, Nuclear Medicine and imaging, business, Single Center, Outcome (game theory), Surgery
Published
2009
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28. Dual-energy CT in the diagnosis and quantification of fatty liver: limited clinical value in comparison to ultrasound scan and single-energy CT, with special reference to iron overload

Author

D. Sautereau, Philippe Bouillet, B Pillegand, Eric Lavoine, François Labrousse, Michel-Henry Mendler, and Anne Le Sidaner

Subjects
Adult, Male, medicine.medical_specialty, Radiography, Radiography, Dual-Energy Scanned Projection, chemistry.chemical_compound, Reference Values, Biopsy, medicine, Humans, Obesity, Aged, Ultrasonography, Hepatology, medicine.diagnostic_test, Triglyceride, business.industry, Ultrasound, Fatty liver, Biopsy, Needle, Reproducibility of Results, Middle Aged, medicine.disease, Fatty Liver, chemistry, Liver, Liver biopsy, Regression Analysis, Female, Radiology, Tomography, Steatosis, business, Tomography, X-Ray Computed, Spleen, Fatty Liver, Alcoholic
Abstract

It has been suggested that dual-energy CT could differentiate irregular fatty liver from other hypodense lesions. We compared dual-energy CT to ultrasound scan and single-energy CT in the diagnosis and quantification of fatty liver, with special reference to iron overload.Twenty-seven patients were included according to ultrasound: fatty liver (n=16) and normal liver (n=11). Single and dual-energy CT were performed. Attenuation measurements of hepatic lobes and control tissues were taken at 140 kV and 80 kV CT-guided liver biopsy was done in fatty liver patients, the degree of infiltration was estimated, and the histologic iron overload determined (iron overload, n=11; iron-free, n=5).The mean changes in attenuation for the right hepatic lobe were: normal liver: -0.8 (ns); iron overloaded fatty liver: 1.5 (ns); and iron-free fatty liver: 7.7 (p0.0053). A spleen-liver attenuation differential threshold of 12H (140 kV, single-energy CT) and a right hepatic lobe 140 kV to 80 kV attenuation differential threshold of 9 H (dual-energy CT) were specific for fatty liver. Histology confirmed all cases of fatty liver diagnosed by ultrasound, independently of iron overload. Ultrasound did not differentiate cases of irregular from diffuse fatty liver detected on CT. Iron overload produced a masking effect in CT, decreasing its sensitivity: fatty liver was diagnosed in 67% of cases by single-energy CT and in 20% by dual-energy CT. Degree of fatty infiltration correlated with single-energy CT.Ultrasound diagnosed fatty liver best. Single-energy CT quantifies fatty infiltration, and best differentiates the irregular from the diffuse forms. Dual-energy CT is limited by poor sensitivity, especially in iron overload.

Published
1998

29. S1279 Treatment of Neoplastic Stenosis of the Biliary Tract With Self Expandable Metal Stents: A Retrospective Study of 211 Consecutive Procedures Comparaison of Percutaneous Versus Endoscopic Drainage

Author

Alexandre Giraud, Denis Sautereau, Sébastien Seillan, Paul Carrier, Anne Le Sidaner, Romain Legros, François Cessot, Virginie Valgueblasse, and Leila Kanafi

Subjects
medicine.medical_specialty, Percutaneous, Hepatology, business.industry, Gastroenterology, Retrospective cohort study, medicine.disease, Surgery, Self Expandable Metal Stents, Endoscopic drainage, Stenosis, Biliary tract, medicine, Radiology, business
Published
2010
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31. P.259 Endoprothèses coliques dans le traitement des obstructions coliques néoplasiques : indications, efficacité, complications, et suivi : à propos de 135 patients consécutifs

Author

Romain Legros, M. Picard-Croguennec, JB Ngomirakiza, Leila Kanafi, François Cessot, B. Dallaudiere, A. Le Sidaner, and D. Sautereau

Subjects
Gynecology, medicine.medical_specialty, business.industry, Gastroenterology, Medicine, General Medicine, business
Abstract

Introduction Le stent auto-extensible metallique a modifie la prise en charge des occlusions neoplasiques colorectales. Le stent colique est indique en preparation a la chirurgie ou comme traitement palliatif. Patients et Methodes Cette etude retrospective monocentrique a ete realisee en CHU par trois gastroenterologues seniors et quatre internes. Les patients presentaient un tableau d’occlusion colo-rectale plus ou moins complet. Un total de 135 protheses colorectales ont ete posees sur une periode de 6 ans (juillet 2001 a fevrier 2008). Le resultat a ete mesure par le succes technique et clinique sur l’ensemble de la population et a ete precise selon des sous-groupes de patients (carcinose peritoneale ; indications ; intensite des signes cliniques ; controle endoscopique seul ou associe a un controle radiologique). D’autres caracteristiques ont ete relevees tels que les particularites anatomiques endoscopiques, la longueur de la stenose et la survie. Resultats L’âge median des patients etait de 78 ans (27 a 98 ans). Le sex ratio etait 60 % d’hommes et 40 % de femmes. La longueur mediane de la stenose etait de 5 cm. Le site tumoral etait le rectum dans 21 % des cas, le recto-sigmoide dans 61 % des cas, l’angle splenique dans 6 % des cas, le colon transverse dans 6 % des cas et et le colon droit dans 6 % des cas. La pose a ete realisee avec succes technique pour 123 patients (91,1 %) et obtenu une decompression colique (succes clinique) pour 118 patients (87,4 %). Des differences ont ete observees selon plusieurs sous-groupes : le succes clinique etait moindre chez les patients presentant une carcinose peritoneale (67 %), et pour des patients avec des symptomes d’occlusion complete (78,9 % versus 89,3 % avec des symptomes d’occlusion partielle). Le stent a ete pose sous controle endoscopique seul dans 66,7 % versus 33,3 % par controle endoscopique et radiologique. Le succes clinique pour le sous-groupe controle par endoscopie et radiologie etait de 93,2 % versus 84,1 % sous controle endoscopique seul. La prothese a ete posee en attente a la chirurgie dans 31 % des cas et dans 69 % en traitement palliatif. On ne notait pas de difference d’efficacite quand le stent a ete insere avant la chirurgie (89 %) ou comme traitement palliatif (90 %). Le delai median avant la chirurgie etait de 7,5 jours. La complication principale etait la perforation pour 5 patients (4 %) dont 2 etaient lethales (1,6 %) et 3 asymptomatiques (decouverts lors de la chirurgie). Le siege de la perforation etait au pole superieur du stent pour 3 patients, pour 1 patient au pole inferieur enfin une perforation diastatique d’amont. La migration a ete observee chez 8 patients (6,4 %). La duree mediane de survie apres la pose du stent etait de 69 jours (un jour a 3 ans). Conclusion Ce travail est caracterise par l’importance de cette serie monocentrique ainsi que par la recherche de differences d’efficacite selon les sous groupes analyses. Il semble que l’efficacite du stenting colique est majoree chez un patient sans carcinose peritoneale, presentant des signes d’occlusion partielle et quand la pose est realisee sous controle endoscopique et radiologique.

Published
2009
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32. P.267 Evaluation du traitement par coagulation au plasma argon (CPA) des rectites radiques chroniques hémorragiques (RRC) au CHU de LIMOGES

Author

François Cessot, Alexandre Giraud, Virginie Valgueblasse, A. Cypierre, A. Le Sidaner, D. Sautereau, A. Bouygues, S. Seillan, and Romain Legros

Subjects
Gynecology, medicine.medical_specialty, business.industry, Gastroenterology, Medicine, General Medicine, business
Abstract

Objectif Notre etude a pour objectif d’evaluer notre prise en charge des RRC par CPA [1, 2] et de proposer une nouvelle echelle d’evaluation des lesions endoscopiques et sa correlation therapeutique afin d’optimiser la procedure. Patients et Methodes 34 patients ont ete inclus de facon retrospective entre 2002 et 2008 dans notre service d’endoscopie digestive. La CPA etait realisee en per endoscopique avec ou sans anesthesie apres preparation par voie haute de type PEG, puis un suivi clinique et endoscopique systematique etait mis en place. Resultats Le score clinique de Chutkan initial de 3,09 etait de 0,57 apres CPA, le taux d’hemoglobine a augmente de 1,7 g/dL et aucun patient n’a eu besoin de transfusion apres notre prise en charge. Le score endoscopique est ameliore de 2,3 points (p Discussion Nos resultats, conformes a la litterature, confirment l’efficacite de la CPA sur les lesions de RRC. Elle permet de traiter tous les stades de lesions de RRC par spotting ou par balayage, en vision directe ou retro bequillage. Nous n’avons pas retrouve de facteur predictif d’efficacite ou d’echec de la CPA, lie aux antecedents cardiovasculaires, a la prise d’un traitement anti-hemostatique, ni a la prise en charge princeps du cancer (radiotherapie, chirurgie, chimiotherapie ou hormonotherapie). Le risque de complications est augmente si D > 0,8 L/mn ou P > 50 W, sans modification d’efficacite. Conclusion L’utilisation prospective, a chaque seance, de cette nouvelle echelle des lesions endoscopiques de RRC pourrait permettre de juger, selon des criteres objectifs, du stade initial et de l’amelioration des lesions. L’application de la CPA se ferait en fonction du stade endoscopique trouve, minimisant ainsi la survenue de complications (ulcere, microrectie) en optimisant le traitement.

Published
2009
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33. Self Expending Metallic Stents (SEMS) with Antireflux Valve for Distal Esophageal Carcinoma: Results of a Randomized Trial

Author

Jean-Michel Nguyen, T. Barrioz, Emmanuel Coron, Marc Le Rhun, Emmanuel Ben Soussan, Bertrand Vedrenne, Frédéric Prat, Dimitri Coumaros, Christian Boustière, Philippe Bichard, and Anne Le Sidaner

Subjects
medicine.medical_specialty, Randomization, business.industry, Gastroenterology, Reflux, medicine.disease, Dysphagia, digestive system diseases, law.invention, Surgery, Randomized controlled trial, Quality of life, law, Regurgitation (digestion), otorhinolaryngologic diseases, medicine, Carcinoma, Radiology, Nuclear Medicine and imaging, medicine.symptom, business, Complication
Abstract

Self Expending Metallic Stents (SEMS) with Antireflux Valve for Distal Esophageal Carcinoma: Results of a Randomized Trial Marc Le Rhun, Emmanuel Ben Soussan, Emmanuel Coron, Anne Le Sidaner, Thierry Barrioz, Dimitri Coumaros, Jean-Michel Nguyen, Bertrand Vedrenne, Philippe Bichard, Christian Boustiere, Frederic Prat D’Endoscopie Digestive Societe Francaise Aims: SEMS are commonly used in the palliation of dysphagia in patients with inoperable esophageal carcinoma. However they predispose to gastroesophageal reflux when deployed across the gastroesophageal junction. The aims of this study were 1) to assess the influence of the antireflux valve on trans-prothetic reflux (primary outcome) and 2) to compare the results of SEMS with and without antireflux valve in terms of reflux symptoms, quality of life (QOL), improvement of dysphagia and complications (secondary outcomes). Patients and Methods: Thirty eight patients (age 71 G 12 years ; sex ratio 5) with malignant strictures of the distal esophagus or gastric cardia (53% adenocarcinomas) were enrolled in 9 centers. Carcinomas were locally advanced (47%) or generalized. After randomization, patients received either a covered SEMS without antireflux valve (CHOOSTENT , Life Europe) associated to standard PPI therapy and postural advice (n Z 19) or a similar type of SEMS including an antireflux device (DOSTENT , Life Europe) (n Z 19). Trans-prosthetic reflux was assessed at day 2 using a radiological score based on barium esophagography performed after Trendelenburg maneuver and graded from 0 (no reflux) to 12 (maximum). Monthly telephone interviews were conducted for: a) OMS scoring from 0 (excellent) to 5 (poor) b) QOL assessment (based on the Reflux-Qual Simplifie scoring system) from 0 (poor) to 100 (excellent) c) dysphagia scoring from 0 (no dysphagia) to 5 (complete dysphagia) and d) regurgitation scoring from 0 (no regurgitation) to 16 (maximum). Results :No difference was noted in terms of age, sex, size of lesion, prosthesis length (12 G 2.5 cm) and need for dilation (30%) prior to SEMS placement. No difficulty to place SEMS nor complication were noted. QOL and dysphagia were improved in both groups. Mean survival was similar in both groups (180 days). Results according to the type of SEMS were as follows: (table 1) Conclusions: These two types of SEMS are equally effective on the palliation of dysphagia and improvement of QOL. However, SEMS with antireflux valve are more efficient to prevent trans-prosthetic gastroesophageal reflux but at the cost of an increased likehood of migrations.

Published
2006
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34. Results of an internal audit of the practice of in-hospital colonoscopy: The patients, information provided prior to colonoscopy, methods of bowel preparation, and patient evaluation of the procedure

Author

Laokpessi Aklesso, Anivel Ramos, Jean Claude Desport, Laurent Courat, Anne Le Sidaner, Eric Barrière, N. Pichon, Bernard Pillegand, Denis Sautereau, and François Cessot

Subjects
medicine.medical_specialty, Hepatology, medicine.diagnostic_test, Internal audit, business.industry, General surgery, Gastroenterology, medicine, Bowel preparation, Colonoscopy, Patient evaluation, Radiology, business
Published
2000
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35. Résultats d'un audit sur la pratique des coloscopies en centre hospitalier: Le patient, son information, sa préparation et son vécu

Author

Anivel Ramos, Laurent Courat, Aklesso Laokpessi, B Pillegand, François Cessot, Jean Claude Desport, A. Le Sidaner, D. Sautereau, and N. Pichon

Subjects
Gynecology, medicine.medical_specialty, medicine.diagnostic_test, business.industry, medicine, Radiology, Nuclear Medicine and imaging, Interventional radiology, business
Abstract

L'hopital de jour etait utilise par des patients plus jeunes. On notait l'importance de la consultation aupres d'un gastro-enterologue qui permettait une meilleure information et une meilleure preparation des patients, meme de ceux qui avaient deja beneficie de cet examen.

Published
1999
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36. Résultats d'un audit intepim sur la pratique des coloscopies en centre hospitalier: Médecin prescripteur, type d'hospitalisation, indications et résultats

Author

A. Le Sidaner, D. Sautereau, François Cessot, B Pillegand, Anivel Ramos, Jean Claude Desport, Eric Barrière, Aklesso Laokpessi, and Laurent Courat

Subjects
Gynecology, medicine.medical_specialty, medicine.diagnostic_test, business.industry, medicine, Radiology, Nuclear Medicine and imaging, Interventional radiology, business
Abstract

Les medecins prescripteurs de coloscopies etaient essentiellement des gastro-enterologues et des medecins generalistes. La moitie des examens etait realisee chez des patients ayant deja subi une coloscopie generalement pour controle d'adenome ou de cancer.

Published
1999
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37. Gallbladder lithiasis in patients with alcoholic cirrhosis of the liver: Prospective study of aetiologic and pathogenic factors in 56 cases

Author

B Pillegand, François Cessot, Michel-Henry Mendler, MC Cazelles-Boudier, J L Parneix, MP Liebaert-Bories, J Venot, A. Le Sidaner, and D. Sautereau

Subjects
medicine.medical_specialty, Alcoholic liver disease, Hepatology, business.industry, Gallbladder, Gastroenterology, medicine.disease, medicine.anatomical_structure, Internal medicine, Medicine, In patient, business, Prospective cohort study
Published
1995
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39. Rhumatisme palindromique révélateur d'une maladie de whipple

Author

Ph. Loget, Gérard Chalès, R Leblay, J.P. Blanquet, Bernard Grosbois, and R. Le Sidaner

Subjects
Abdominal pain, medicine.medical_specialty, Lamina propria, medicine.diagnostic_test, business.industry, Gastroenterology, medicine.disease, Endoscopy, Diarrhea, medicine.anatomical_structure, Internal medicine, Internal Medicine, medicine, Upper gastrointestinal, In patient, Palindromic rheumatism, medicine.symptom, business
Abstract

A 42 year-old man first developed a palindromic rheumatism on november 1988. We noted an hepatomegaly, a weight loss and lymphadenopathies on april 1990. Abdominal pain, fever and diarrhea occured on novembrer 1990. Intestinal biopsies showed infiltration of the lamina propria by PAS positive macrophages. In patients presenting with palindromic rheumatism, diagnosis of Whipple's disease must be considered and an upper gastrointestinal tract endoscopy with intestinal biopsies must be performed.

Published
1991
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40. The effects of aminosalicylates or thiopurines on the risk of colorectal cancer in inflammatory bowel disease

Author

STEPHANE NANCEY, Francois MION, Nathalie Ganne-Carrié, ANTOINE CORTOT, Laurent Siproudhis, Bernard FLOURIE, ROBERT BENAMOUZIG, Isabelle Rosa, Jean-Ariel BRONSTEIN, Matthieu Allez, Frederic Gottrand, Guillaume Savoye, Gerard Thiefin, Xavier Roblin, Fabrice Carrat, Jean-Pierre Hugot, Bertrand Napoleon, Pierre DESREUMAUX, Laurent Peyrin-biroulet, Laurent Michaud, Christos CHRISTIDIS, Stéphane Nahon, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 (UPMC), Icahn School of Medicine at Mount Sinai [New York] (MSSM), Service d'Hépato-gastro-entérologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), CESAME Study Group: Jean-Frédéric Colombel, Jacques Cosnes, Jean-Pierre Gendre, Marc Lémann, Xavier Hébuterne, Antoine Cortot, Yoram Bouhnik, David Laharie, Jean Louis Dupas, Bernard Flourié, Eric Lerebours, Laurent Beaugerie, Laurent Peyrin-Biroulet, Matthieu Allez, Bernard Messing, Guillaume Cadiot, Philippe Marteau, Jean-Claude Soulé, Jean-Marc Gornet, Michel Veyrac, Bernard Duclos, Philippe Beau, Arnaud Bourreille, Philippe Baumer, Franck Carbonnel, Denis Heresbach, Etienne-Henry Metman, Christian Florent, Antoine Blain, Jean-Luc Faucheron, Bruno Bonaz, Xavier Roblin, Pascal Potier, Christian Boehm, Thierry Kurtz, Hervé Lamouliatte, Isabelle Nion-Larmurier, Jean-Charles Delchier, Stanislas Chaussade, Anne Marie Weiss, Jean Pierre Cézard, Laurent Siproudhis, Stéphane Nahon, Daniel Sondag, Raymond Jian, Jean-Christophe Souquet, Pierre Bord, Benoit Coffin, Hélène D'almagne, Patrick Delasalle, Régis Fournier, Maryan Cavicchi, Marc-Henry Souffran, Luc Vandromme, Claire Guedon, Philippe Seksik, Christophe Michiels, Pascal Renard, Patrice Rogier, Sylvie Gouilloud, André Rotenberg, Guillaume Savoye, Alain Thevenin, Laurent Mallet, Franck Brazier, Francois Jean, Anne-Marie Justum, Jean-Paul Latrive, Jean-Luc Gerbal, Robert Pierrugues, Gérard Chardonnal, Laurence Picon, Nicole Reix, Nicolas Drouët D'aubigny, Hervé Uettwiller, Anne Courillon Mallet, Alain Palacci, Raoul-Jacques Bensaude, Pierre Bonniaud, Olivier Empinet, Andrée Nisard, Alain Rudelli, Bernard Tubiana, Philippe Capelle, Alain Dabadie, Daniel Evard, Pierre-Emile Julien, Magali Picon-Coste, Stéphane Schneider, Denis Goldfain, Jérôme Bellanger, Jean-Pierre Blondelot, Philippe Lamy, Sébastien Lemière, Jean Francois Mockly, Benoit Pellat, Gilles Gatineau-Sailliant, Bernard Nalet, Stéphane Nancey, Daniel Kusielewicz, Patrick Loison, Jean-Michel Popot, François Merite, Jean-Pol Roux, Pauline Afchain, Alain Blanquart, Laurent Heyries, Marc Reville, Dominique Viron, Frank Zerbib, Christophe Claviere, Didier Léostic, Philippe Pouderoux, Alain Moitry, Hervé Hagège, Jean-Pierre Hugot, Benoit Humeau, Jean-Marc Sabate, Emmanuel Lederman, Dominique Lescut, Fabrice Luneau, Bruno Mesnard, Lionel Smadja, Michel Steinberg, Marc Brun, Gilles Macaigne, Jean Luc Marchal, Stéphane Ollivier, Dominique Ouvry, Jean Paul Perche, Serge Rambaud, Robert Benamouzig, Jean Louis Cazenave, Jean-Charles Coffin, Martine Blazquez, Marion Lagneau, Bruno Person, Christian Wittersheim, Bertrand Napoleon, Israël Cemachovic, Franck Iglicki, Mehran Howaizi, Eric Leprince, Bruno Leurent, Thierry Morin, Riad Darsouni, Alain Attar, Philippe Baron, Anne Breton, Jean Marie Gillion, Jean-Marc Guemene, Claude Jouffre, Xavier Moreau, Pierre Claude, André Quinton, Vered Abitbol, Jean Michel Brichard, Benoit Desaint, Martin Bouygues, Philippe Chatrenet, Marcelo Salmeron, Jean Silvie, Bruno Waldner, Yves Emery, Armand Moraillon, Daniel Kunkel, Philippe Dubois, Patrick Faure, Christian L'Hirondel, Jean-Eric Labérenne, Pierre Moreau, Adelino Pereira, Genevieve Plihon, Thierry Wolff, Yann Ngo, Arnaud Boruchowicz, Béatrice Jost, Jean Pierre Gotlib, Odile Danne, Philippe Raoux, Marie-José Ramond-Bouhali, Andre Baetz, Bruno Veyres, Christian Chapoutot, Gérard Le Dréau, Jérôme Filippi, Jean Mudry, Philippe Kalt, Sophie Minault, Pierre-André Bounin, Tony Andréani, Jacky Charneau, Didier Reijasse, Jean-Louis Bolze, Jean Luc Thaunat, Christian Le Couteulx, Chantal Maurage, Robert Bader, Philippe Codjovi, Jean-Luc Migairou, Alain Morali, Philippe Rey, Bruno Richard Molard, Richard Petit, Stéphane Koch, Philippe Cassan, Jean-Paul Deschamps, Christine Meicler Caby, Jean-Jacques Meurisse, Philippe Prades, James Boulant, Michel Diacono, Jean-Marie Monsch, J-François Dupuy, Guy Bellaiche, Martine Guegan, Jean-Marc Comte, Jean-Michel Cayla, Francois Le Tallec, Franck Meurisse, Philippe Desurmont, Laurent Roget, Philippe Bouyssou, Bruno Le Gall, Francis Bloch, Loic Larvol, Monique Jullien, Jacques Moreau, Laurent Rebouissoux, Bruno Decroix, Nina Dib, Paul Dieterling, Frédéric Lenormand, Emmanuel Lagier, Philippe Fallourd, Serge Charpin, Hugues Bertrand, Gilles Bommelaer, Daniel Battistelli, Bernard Delon, Lionel Dentant, Etienne Dorval, Jérôme Dumortier, Eric Gaye-Bareyt, Yves Gerosa, Chantal Guez, Martine Mornet, Paul Benfredj, René Piperaud, Noel Stremsdoerfer, Eric Verdier, Alain Grinholtz, Georges Barjonet, Antoine See, Ramuntxo Arotçarena, Anne Baudet, Joel Broyer, Antoine Charachon, Hugues Blondon, Pascal Mouton, Hubert Claudez, Jacques Labat-Labourdette, Jacques Haëm, Patrick Estable, Patrick Levy, Alain Rosenbaum, Yvon Balavoine, Alain Blanchi, Pierre Coutarel, Nadege Delaperriere, Michel Dervichian, Francis Marois, Jacques Seroka, Laurent Michaud, Olivier Leroy, Emmanuel Meyran, Bernard Poilroux, Abdallah Tensaouti, Thierry Paupard, Dominique Agard, Sandrine Beaulieu, Kader Benfiguig, Patrice Capony, Jean Cottereau, Pierre Desreumaux, Jean-Michel Dramard, Mathieu Duché, Patrick Mamou, Isabelle Etienney, Gilles D'Abrigeon, Béatrice Godeberge, Gilbert Tucat, Jean Puech, Jean Roger, Marie-George Lapalus, Paul Bauret, Philippe Houcke, Béatrice Pornin, Bruno Champigneulle, Laurent Cuissard, Xavier-Richard David, Frédéric Lombard, Antoine Granveau, Jean-François Hamon, Olivier Ink, Fabienne Blondel, Alain Namias, Didier Pillon, Antoine Reignier, Gilles Tordjman, Christos Christidis, Simon Zirabe, Michel Audebert, Eric Bion, Claude Bourgeaux, Cécile Poupardin, Philippe Deplaix, Gérard Fratini, Thierry Garnier, Gerard Desseaux, Hervé Magois, Sylvain Lochum, Jean-Francois Vergier, Patrick Texereau, Christel Rat, Francoise Uzzan, Alain Vidal, Nadia Vinante, Bernard Watrin, Cécile Wurtz-Huckert, Bruno Barre, Dominique Chaslin Ferbus, Jean-François Contou, Dominique Coupier, Benoit David, Dany Gargot, Denis Huc, Remy Barraya, Roger Faroux, Jean-Luc Fourgeaud, Hubert Grimprel, Jean Auroux, Jean-François Rey, Jean Pierre Arnoux, Franck Lentini, Ludovic Tardy, Olivier Mouterde, Claire Spyckerelle, Bruno Vacherot, Alain Weissman, Michel Alpérine, Anne Le Sidaner, Pierre-Olivier Bonnet-Eymard, Jean Louis Colson, Daniel Pellet, Bernard Deltombe, André Edouard, Henri Maechel, Jean-Claude Jaillet, Julien Genes, Anne-Marie Leveque, Damien Lucidarme, Philippe Maignan, Nathalie Mallier Gehrke, Jérôme Sanchez, Frank Tusseau, Alban Casteur, Jacques Bottlaender, Denis Constantini, Thierry Coton, Philippe Even, Francois Druart, François Riot, Jean-Michel Gauchet, Geneviève Hecquet, Gerard Henry, Patrick Hochain, Jean Pierre Arpurt, Abdelkrim Medini, Michele Dartois-Hoguin, Henri Moindrot, Philippe Emery, Pierre Periac, Annie Prunier, Pascal Renkes, Christine Tawil-Longreen, Edmond Vincent, René-Louis Vitte, Christian Loeb, Alain Carwana, Didier Barbereau, Philippe Bohon, Céline Corrieri-Baizeau, Daniel Sahy, Philippe Derreveaux, Dominique David, François Desbazeille, Patrick Fontenelle, Jean Luc Slama, Yvon Le Mercier, Michel Certin, Jean Jacques Reig, Isabelle Rosa, Thierry Helbert, Patrick Tounian, Luc Turner, Valéry Perot, Luc Aillet, Arnaud Pauwels, Philippe Barré, Bernard Nury, Claude Cazalbou, Franck Devulder, Alain Durget, Jeanne Dubroca, Daniele Gaudy, Michel Greff, Christian Jacques, Jocelyne Lafarge, Gilles Kezachian, Ronan Le Gall, Alex Pariente, Tiphaine Pinault, Michaël Bismuth, Nathalie Boyer-Darrigrand, Philippe Bretagnolle, Stephane Carpentier, Franck Cholet, Christian Theodore, Rémi Combes, Francois Combet, Christophe Delanoe, Stéphanie De Montigny, Denis Soudan, Olivier Fourdan, Gilles Minier, Jeanne Languepin, Jean Roche, Jean-Louis Ginies, Olivier Nouel, Philippe Petitgars, Edith Robin, Romain Hamm, Jean François Roques, Sylvie Roussin-Bretagne, Agnès Sénéjoux, Sophie Muron, Nicolas Bardoux, Philippe Berthelemy, Patrick Madonia, Bertrand Carles, Catherine Reynier, Emmanuel Cuillerier, Innocenti Dadamessi, Jacques Danis, Bernard Debenes, Nathalie Dubuc-Rey, Gilles Lesur, Pauline Jouet, Catherine Lenaerts, Marc Garret, Alexandra Mineur, Bernard Chabry, Francois Pigot, Valérie Rossi, Ruth Tennenbaum, Julien Salloum, Maurice Hakim Slaoui, Stéphane Mathieu, Valérie Papapietro, Sheila Viola, Alexis Bezet, Claude Altman, Alain Audan, Jean Calabet, Claude Masliah, Laurent Fayemendy, Marc Duruy, Benoit Gauffeny, Ludovic Helie, Kamran Imani, Raoul Janin-Manificat, Jean-Paul Galmiche, Anne Kerlirzin, Laurent Bedenne, Christophe Locher, Gilles Michaudel, Gilles Missonnier, Michel Rinaldi-Dovio, Jean-Michel Rouillon, Stéphane Ecuer, Arnaud Patenotte, Jean Ariel Bronstein, Vincent Baty, Michel Bougnol, Pierre Bourbon, Philippe Cerbelaud, Annick Chavaillon, Franck Boiffin, Béatrice Dubern, Isabelle Duval De Laguierce, Fernand Greco, Florence Bouhot, Philippe Godeberge, Brigitte Grandmaison, Pascal Gros, Guy Targues, Jacques Corallo, Jean Boutin, Jacques Guillan, Jean Pierre Barbieux, Isabelle Loury Lariviere, Henri Le Genissel, Henri Leroi, Marc Bellaiche, Marie-Claire Elie-Legrand, Michel Dapoigny, Philippe Denoyel, Patrice Pienkowski, Philippe Pouche, Marc Michel Saurfelt, Jean Marie Thorel, Thierry Piche, Bruno Travers, Patrick Tuvignon, Marc Zalcberg, Guy Boulay, Christophe Zamora, Joelle Samama, Etienne Ricotie, Patrice De Fleury, Francois Maille, Jean Louis Mougenel, Olivier Gonot, Jean Philippe Menat, Mehdi Kaassis, Francoise Lang, Laurent Abramowitz, Nathalie Ganne, Olivier Pecriaux, Jacques-Arnaud Seyrig, Iradj Sobhani, Thierry Parmentier, Antoine Van Nieuwenhuyse, Francois-Xavier Weber, André Glibert, Catherine Bineau, Bernard Canet, Catherine Collin, Frederic Cordet, David David Parlier, Dominique Carre, Annie Peytier, Francine Fein, Jerome Barouk, Jacques Dewannieux, Johannes Hartwig, Jean-Louis Jouve, Bertrand Laplane, Gilles Lascar, Christophe Legrand, Pierre Le Marchand, Marie Pierre Liebaert, Michele Terdiman-Pire, Naceur Abdelli, Dominique Neveu, Philippe De La Lande, Patrick De Saint Louvent, Cécile Pelatan, Agnès Petit, Martial Richecoeur, Frederic Texier, Jean Brice Cazals, Bertrand Tissot, Christian Mourrut, Marie Doubremelle, Marc Foltz, Florence Gautier-Jubé, Jacques Martin, Elie Khouri, Thierry Lons, Martine Carlier-Bandu, Jean-Luc Monnin, Hervé Roche, Bernard Willemin, Xavier Houard, Abdelaziz Fatisse, Michèle Algard, Kamel Arab, Isabelle Borel, Cécile Lagarrigue, Ariane Chryssostalis, Dominique Boutroux, Jean-Pierre Dupuychaffray, Saïd Khaddari, François Mion, Thierry Puy-Montbrun, Jean-Philippe Girardet, Bruno Gury, Alain Landau, Monique Le Bihan, Sandrine Nieuviarts, Jean Ollivry, Philippe Le Bourgeois, Marie-Astrid Piquet, Michel-Pierre Escartin, Remi Systchenko, Franck Venezia, Michel Wantiez, Xavier Lesage, Elie Zrihen, Philippe Aygalenq, Barbara Dieumegard, Bernard Savarieau, Philippe Bulois, Stéphane Cattan, Jean-Lucien Diez, Olivier Fauchot, Eric Durous, Valérie Gazut, Christian Guilleminet, Jean-Marc Bories, Isabelle Joly Le Floch, Jean-Paul Vove, Stéphane Lelouch, Philippe Lévy, François Lhopital, Norma Marcato, Marianne Mozer-Bernardeau, Jean-Baptiste Nousbaum, Philippe Cattan, Alain Plane, Jean-Michel Raymond, Gilles Roseau, Gerald Rozental, Christian Boustière, Corinne Bonny, Mariepierre Cordier-Collet, Laurent Courat, Bernard Croguennec, Karine Delaunay-Tardy, Damien Labarriere, Edmond Geagea, Frédéric Gottrand, Eve Gelsi, Gerard Thiefin, Eric Wohlschies, Mathieu Miguet, Philippe Ponsot, Jean Suzanne, Yves Teste, Anne-Claire Dupont Gossart, Jean-Luc Baroni, Benabdallah Benchaa, Georges Blanc, Bernard Maroy, Philippe Bonjean, Catherine Brézault, Laure Bridoux-Henno, Claude Chayette, Dominique Auby, Robert Fiorucci, Georges Galindo, Gilles Hubert, Gilles Bonneau, Evelyne Marinier, Michele Pouteau, Afchine Alamdari, Bruno Delbende, Patrick Chamouard, Pascale D'Abravanel, Hélène Dall'Osto, Sophie Hervé, Jean Lefebvre, Damien Levoir, Philippe Lillo, Michel Rouch, Muriel Mathonnet, Mercédes De Lustrac, François-Jean Ramond, Bernard Roupret, Alain Soupison, Djamila Ait-Ouadda, Yves Barbaza, Brice Bayart, Thomas Bottini, Franck Cochet, Isabelle Goderel, Orélien Maury, Léa Mbonyingo, Vanessa Pourtau, Elise Rasoanarivo, Laure Romain-Huttin, Anne-Violaine Sallé, Jonathan Trang, Hakeem Admane, Elodie Drouet, Service de santé publique [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Gastroentérologie et nutrition [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Herrada, Anthony

Subjects
Adult, Male, medicine.medical_specialty, Colorectal cancer, Inflammatory bowel disease, Gastroenterology, Primary sclerosing cholangitis, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, Pharmacology (medical), Prospective Studies, Prospective cohort study, Mesalamine, Aged, Retrospective Studies, Hepatology, business.industry, Anti-Inflammatory Agents, Non-Steroidal, Case-control study, Cancer, Retrospective cohort study, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Middle Aged, medicine.disease, Colitis, Inflammatory Bowel Diseases, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, digestive system diseases, 3. Good health, Aminosalicylic Acids, Treatment Outcome, [SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, 030220 oncology & carcinogenesis, Case-Control Studies, Cohort, Multivariate Analysis, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, 030211 gastroenterology & hepatology, Female, business, Colorectal Neoplasms
Abstract

SummaryBackground Whether aminosalicylates or thiopurines reduce the risk of colorectal cancer (CRC) in inflammatory bowel (IBD) disease is controversial. Aim To assess simultaneously the chemopreventive effect of aminosalicylates or thiopurines in a case–control study nested in the CESAME observational cohort that enrolled consecutive patients with IBD between May 2004 and June 2005. Patients were followed up to December 2007. Methods Study population comprised 144 case patients who developed CRC from the diagnosis of IBD (65 and 79 cases diagnosed, respectively, before and from 2004, starting year of the prospective observational period of CESAME) and 286 controls matched for gender, age, IBD subtype and year of diagnosis, and cumulative extent of colitis. Exposure to aminosalicylates or thiopurines was defined by an exposure to the treatment during the year of the diagnosis of cancer. The propensity of receiving 5-ASA and thiopurines was quantified by a composite score taking into account patient and IBD characteristics. The role of aminosalicylates or thiopurines was assessed by multivariate analysis. Propensity scores and the history of primary sclerosing cholangitis were entered into the multivariate model for adjustment. Results By multivariate analysis adjusted for propensity, a significant protective effect of exposure to drugs during the year of cancer was found for aminosalicylates (OR = 0.587, 95% CI: 0.367–0.937, P = 0.0257), but not for thiopurines (OR = 0.762, 95% CI: 0.432–1.343, P = 0.3468). Conclusion In a case–control study nested in the CESAME cohort, a significant decrease in the risk of colorectal cancer in IBD was associated with exposure to aminosalicylates, not to thiopurines.

Published
2017
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