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1. Adenocarcinoma of the oesophagogastric junction Siewert II: An oesophageal cancer better cured with total gastrectomy

Author

Benjamin Mathieu, Renaud Flamein, Fédérique Peschaud, Kevin Kraft, Diane Goéré, Sylvain Fabre, Basile Tsilividis, Frederic Borie, Florence Vandois, Jean Pierre Arnaud, Damien Louis, Virginie Pichot-Delahaye, Manuel Fernandez, Frank Bonnetain, Marie Guilbert, Sophie Michalak, Marc Pocard, Denis Pezet, Bertrand Millat, Thibault Voron, Brigitte Gillet, Jeremie Thereaux, Jean Yves Mabrut, Emmanuelle Leteurtre, Xavier B. D’Journo, Nicolas Carrere, Michel Prudhomme, Olivier Glehen, Gil Lebreton, Jean-Marc Regimbeau, Arnaud Pasquer, Pascal Thomas, Jean Robert Delpero, Johan Gagnière, Timothée Thiébot, Denis Collet, Aude Glaise, N. Huten, Guillaume Piessen, Ariane Poisson, Cécile Brigand, Mohamed Hebbar, Bernard Meunier, Pierre Dechelotte, Caroline Gronnier, Dorothée Brachet, Jérôme Guiramand, Abdenaceur Dhari, Francis Michot, François Paye, Jean Michel Balon, Jérémie H. Lefevre, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), Hôpital Claude Huriez [Lille], CHU Lille, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO), Chirurgie digestive et hépatobiliaire, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Peuplements végétaux et bioagresseurs en milieu tropical (UMR PVBMT), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut de Recherche pour le Développement (IRD)-Institut National de la Recherche Agronomique (INRA)-Université de La Réunion (UR), Laboratoire de chimie de coordination (LCC), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie de Toulouse (ICT-FR 2599), Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), Service de chirurgie digestive, CHU Bordeaux [Bordeaux], Université de Lille, Service de chirurgie générale et digestive [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), Service de Chirurgie Digestive et Endocrinienne [CHU Angers], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Service Chirurgie Digestive et Endocrinienne [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Service Biostatistiques et Informatique Médicale (CHU de Dijon) (DIM), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Département de chirurgie générale et digestive [CHU Strasbourg], Centre Hospitalier Universitaire de Strasbourg (CHU de Strasbourg ), Département de chirurgie digestive, [CHU Toulouse], Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), 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), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Chirurgie digestive [CHU Amiens], CHU Amiens-Picardie, Éducation et scolarisation (ESCOL), Centre interdisciplinaire de recherche, culture, éducation, formation, travail (CIRCEFT), Université Paris 8 Vincennes-Saint-Denis (UP8)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Université Paris 8 Vincennes-Saint-Denis (UP8)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut de Recherche juridique de la Sorbonne André Tunc (IRJS), Université Paris 1 Panthéon-Sorbonne (UP1), Département de chirurgie digestive, CHU Clermont-Ferrand, Institut de Chimie des Substances Naturelles (ICSN), Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC), Département de chirurgie digestive, [CHU Montpellier], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Département de chirurgie générale [Gustave Roussy], Institut Gustave Roussy (IGR), Service de Chirurgie Générale et Digestive[Lille], Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre de Recherche en Cancérologie de Marseille (CRCM), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Aix Marseille Université (AMU), Inserm UMR837 Team 5, Service d'oncologie médicale, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U1172 Inserm - U837 (JPArc), Université Lille Nord de France (COMUE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Université Lille Nord de France (COMUE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Service de Chirurgie Digestive et Endocrinienne, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Biologie-Pathologie, Département de chirurgie digestive, [CHU Tours], Université d'Orléans (UO), Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH), Université d'Angers (UA), Department of Digestive Surgery, Rouen University Hospital, CHU de Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre de Recherche Saint-Antoine (UMRS893), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de chirurgie générale, digestive et oncologique [CHU Ambroise-Paré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Centre Hospitalier Lyon Sud, Service de Chirurgie Digestive, Hôpital Lariboisière, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Service de Chirurgie Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes], CHU Pontchaillou [Rennes], AP-HM, Department of General and Digestive Surgery, North Hospital, Marseille, France, parent, Service de chirurgie digestive [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Institut de Chimie de Toulouse (ICT), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Centre National de la Recherche Scientifique (CNRS), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service Chirurgie viscérale et digestive [CHU Toulouse], Pôle Maladies de l'appareil digestif [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 (JPArc), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Institut de Chimie de Toulouse (ICT-FR 2599), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire Estaing, Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie de Toulouse (ICT-FR 2599), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Lille Nord de France (COMUE)-Université de Lille-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Lille Nord de France (COMUE)-Université de Lille, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Université Paris Diderot - Paris 7 (UPD7)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Hépatobiliaire et Digestive [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), and CCSD, Accord Elsevier

Subjects
Male, medicine.medical_specialty, Esophageal Neoplasms, medicine.medical_treatment, 030230 surgery, Adenocarcinoma, [SDV.BBM.BM] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, 03 medical and health sciences, 0302 clinical medicine, Oesophagogastric junction, Gastrectomy, Medicine, Humans, In patient, ComputingMilieux_MISCELLANEOUS, Neoplasm Staging, Retrospective Studies, Surgical approach, business.industry, Cancer, Retrospective cohort study, Cardia, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, General Medicine, Middle Aged, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Neoadjuvant Therapy, 3. Good health, Surgery, Survival Rate, Oncology, 030220 oncology & carcinogenesis, Female, Esophagogastric Junction, France, [SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, business, Median survival
Abstract

Introduction Type II AEG is now considered as oesophageal cancer in the seventh and eighth edition of TNM classification but optimal surgical approach for these tumors remains debated. The objective of the study is to assess and compare surgical and oncological outcomes of two surgical approaches: superior polar oesogastrectomy (SPO) or total gastrectomy (TG) in patients with type II adenocarcinoma of the oesophagogastric junction (AEG). Material and methods 183 patients with type II AEG treated from 1997 to 2010 in 21 French centers by SPO or TG were included in a multicenter retrospective study. The surgical and oncological outcomes were compared between these two surgical approaches. Results A TG was performed in 64 (35%) patients whereas 119 (65%) patients were treated by SPO with transthoracic approach in 100 of them (83.2%) and transhiatal approach with cervicotomy in 19 (16.8%). Surgical outcomes were comparable between the two approaches with a postoperative mortality rate of 4.9% and a severe operative morbidity rate within 30 days of 15.3%. Median survival in patients operated on by TG was of 46 months compared to 27 months in patients treated by SPO (p = 0.118). At multivariate analysis, TG appears to be an independent good prognostic factor compared to SPO (HR = 1.847; p = 0.008). However, TG was also associated with a higher rate of incomplete resection, (12.5% vs 5.9%; p = 0.120). Conclusion When TG allows obtaining tumor-free resection margins, this approach should be preferred to SPO.

Published
2019
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2. The Impact of Perioperative Chemotherapy on Survival in Patients With Gastric Signet Ring Cell Adenocarcinoma

Author

Mathieu Messager, Jérémie H. Lefevre, Virginie Pichot-Delahaye, Amine Souadka, Guillaume Piessen, Christophe Mariette, Jean Pierre Arnaud, Jean Michel Balon, Frank Bonnetain, Frédéric Borie, Dorothée Brachet, Cécile Brigand, Nicolas Carrere, Xavier Benoit D'Journo, Pierre Dechelotte, Jean Robert Delpero, Abdenaceur Dhari, Sylvain Fabre, Manuel Fernandez, Renaud Flamein, Brigitte Gillet, Aude Glaise, Olivier Glehen, Diane Goéré, Marie Guilbert, Jérôme Guiramand, Mohamed Hebbar, Noël Huten, Kevin Kraft, Emmanuelle Leteurtre, Damien Louis, Jean Yves Mabrut, Benjamin Mathieu, Bernard Meunier, Sophie Michalak, Francis Michot, Bertrand Millat, François Paye, Frédérique Peschaud, Denis Pezet, Marc Pocard, Ariane Poisson, Michel Prudhomme, Jean Marc Regimbeau, Timothée Thiébot, Pascal-Alexandre Thomas, Basile Tsilividis, and Florence Vandois

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Gastroenterology, Perioperative Care, Stomach Neoplasms, Internal medicine, medicine, Carcinoma, Humans, Stage (cooking), Retrospective Studies, Chemotherapy, Signet ring cell, business.industry, Standard treatment, Retrospective cohort study, Middle Aged, Prognosis, medicine.disease, Intention to Treat Analysis, Surgery, Regimen, Treatment Outcome, Chemotherapy, Adjuvant, Multivariate Analysis, Adenocarcinoma, Female, business, Carcinoma, Signet Ring Cell, hormones, hormone substitutes, and hormone antagonists
Abstract

The aim of this retrospective study was to evaluate the survival impact of perioperative chemotherapy (PCT) in patients with gastric signet ring cell (SRC) adenocarcinoma.PCT is a standard treatment for advanced resectable gastric adenocarcinoma (GA). SRC has a worse prognosis compared to non-SRC and the chemosensitivity of SRC is uncertain.Among 3010 patients registered in 19 French centers between January 1997 and January 2010, 1050 (34.9%) were diagnosed with SRC. Of those treated with curative intent (n = 924), 171 (18.5%) received PCT with surgery (PCT group), whereas 753 (81.5%) were treated with primary surgery (S group). PCT was based mainly on a fluorouracil-platinum doublet or triplet regimen.The groups were comparable regarding age, gender, American Society of Anesthesiologists (ASA) score, malnutrition, tumor location and cTNM stage. 60 patients did not undergo resection because of tumor progression (10) or metastases (50) found at operation. The R0 resection rates were 65.9% and 62.3% in the S and PCT groups, respectively (P = 0.308). Fewer patients received adjuvant chemotherapy in the S group than in the PCT group (35.2% vs. 66.5%, P0.001). At a median follow-up of 31.5 months, the median survival was shorter in the PCT group (12.8 vs. 14.0 months, P = 0.043). On multivariate analysis, PCT was found to be an independent predictor of poor survival (HR = 1.4, 95% CI 1.1-1.9, P = 0.042).PCT provides no survival benefit in patients with gastric SRC. Clinical Trial.gov record: ADCI001, Clinical Trial.gov identifier NCT01249859.

Published
2011
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3. Intravitreal Triamcinolone Prior to Laser Treatment of Diabetic Macular Edema

Author

Wan-Ling Wong, Meidong Zhu, Mark C Gillies, Ian L. McAllister, Tien Yin Wong, Damien Louis, and Jennifer J. Arnold

Subjects
medicine.medical_specialty, Triamcinolone acetonide, Visual acuity, genetic structures, business.industry, Eye disease, medicine.medical_treatment, Diabetic retinopathy, medicine.disease, Acetonide, eye diseases, Surgery, Ophthalmology, medicine, sense organs, medicine.symptom, business, Macular edema, Laser coagulation, medicine.drug, Retinopathy
Abstract

Purpose To report the 24 months outcomes from a clinical trial of intravitreal triamcinolone acetonide (IVTA) plus laser versus laser treatment only in eyes with diabetic macular edema (DME). Design Prospective, double-masked, randomized, placebo-controlled study. Participants Eighty-four eyes of 54 participants were entered into the study, with 42 eyes randomly assigned to receive IVTA plus laser and 42 randomly assigned to receive laser treatment alone. Primary end point data were available for 71 (84.5%) eyes at 24 months, with last visual acuity observation carried forward for the remaining eyes. Methods Best-corrected logarithm of minimum angle of resolution (logMAR) visual acuity and central macular thickness (CMT) by optical coherence tomography were measured after laser treatment preceded by either IVTA or sham. Main Outcomes Measures The primary outcome was the proportion of eyes with improvement in visual acuity of 10 letters or more at 24 months. The secondary outcomes were mean visual acuity, requirement for further treatment, change in CMT, and adverse events. Results At 24 months, improvement of 10 logMAR letters or more was seen in 15 (36%) of 42 eyes treated with IVTA plus laser compared with 7 (17%) of 42 eyes treated with laser only ( P = 0.047; odds ratio, 2.79; 95% confidence interval, 1.01–7.67). There was no difference in the mean CMT or mean logMAR visual acuity between 2 groups. At least 1 retreatment was required in the second year of the study in 29 (69%) of 42 IVTA plus laser-treated eyes compared with 19 (45%) of 42 laser only eyes ( P = 0.187). Cataracts were removed from 17 (61%) of 28 phakic IVTA plus laser-treated eyes versus 0 (0%) of 27 laser only eyes ( P P Conclusions Treatment with IVTA plus laser resulted in a doubling of improvement in vision by 10 letters or more compared with laser only over 2 years in eyes with DME, but is associated with cataract and raised intraocular pressure. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references.

Published
2011
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4. Cataract extraction in a major ophthalmic hospital: Day-case or overnight stay?

Author

Kristen Wells, Daniel J. McCarty, Qing Yi, Damien Louis, Hugh R. Taylor, Nicole Peucker, and Maged L Atalla

Subjects
medicine.medical_specialty, Univariate analysis, business.industry, Medical record, medicine.medical_treatment, Retrospective cohort study, Cataract surgery, medicine.disease, Obstructive lung disease, Surgery, Ophthalmology, Ambulatory care, Emergency medicine, Health care, medicine, business, Asthma
Abstract

Purpose: Cataract surgery is increasing in Australia and represents a significant burden on limited health resources. This study examines the frequency and outcomes of cataract surgery for patients who were hospitalized overnight compared with those treated as day surgery cases. Methods: Medical records of 671 consecutive admissions for cataract surgery at the Royal Victorian Eye and Ear Hospital were reviewed. Data analysed included demographic features, insurance status, length of hospitalization, ophthalmic conditions, medical conditions, social problems and planned surgical technique. Ophthalmic and anaesthetic complications, active ophthalmic and medical interventions were also studied. Results: Of the 671 patient admissions for cataract during the study period, 226 (33.4%) were hospitalized overnight. Factors significantly associated with overnight hospitalization in univariate analyses include older age, female sex, country residence, Veterans’ Affairs insurance, monocular vision status, pre-existing ischaemic heart disease, pre-existing asthma/chronic obstructive lung disease, absence of carer, transportation problems, planned extra-capsular cataract extraction technique, ophthalmic complications and active ophthalmic and/or medical interventions. After adjusting for possible confounding factors using backwards stepwise multivariate logistic regression models all except pre-existing ischaemic heart disease and opthalmic complications were significantly associated with overnight admission for cataract surgery. In total, 14 cases (2.1%) needed active ophthalmic and/or medical interventions, 13 overnight cases and one day case. Conclusions: These data suggest that many patients who are hospitalized overnight for cataract surgery could be safely treated as day cases. Such a shift in the pattern of care for cataract surgery could provide a significant potential for health care savings.

Published
2000
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5. Is the negative prognostic impact of signet ring cell histology maintained in early gastric adenocarcinoma?

Author

Timothée Thiebot, Mathieu Messager, William B Robb, Caroline Gronnier, Guillaume Luc, Guillaume Piessen, Damien Louis, and Christophe Mariette

Subjects
Adult, Male, medicine.medical_specialty, Pathology, Gastroenterology, Young Adult, Stomach Neoplasms, Internal medicine, Carcinoma, medicine, Humans, Young adult, Survival rate, Aged, Retrospective Studies, Aged, 80 and over, Signet ring cell, business.industry, Retrospective cohort study, Histology, Middle Aged, medicine.disease, Prognosis, Early Diagnosis, Cohort, Surgery, Female, Neoplasm Recurrence, Local, business, Carcinoma, Signet Ring Cell, Proto-oncogene tyrosine-protein kinase Src
Abstract

Although the signet ring cell histologic subtype (SRC) is an independent predictor of poor prognosis in advanced gastric adenocarcinomas (GA), its prognostic value in early GA remains highly controversial. The aim of the study was to evaluate the prognostic impact of SRC in mucosal and submucosal GAs.Based on a multicenter cohort of 3,010 patients operated on for GA between January 1997 and January 2010, patients with pTis or pT1 tumors were extracted and analyzed comparatively between the SRC and non-SRC groups. The primary objective was to compare the 5-year survival rate between groups.Among 421 patients with a pTis or pT1 tumor, 104 (25%) were SRC and 317 (75%) were non-SRC. Demographic variables were comparable between groups, except median age, which was less in the SRC group (59.6 vs 68.8 years; P.001). Submucosal involvement was more frequent in the SRC group (94% vs 85%; P = .043), whereas lymph node involvement and number of invaded nodes were comparable between the 2 groups. When comparing SRC and non-SRC, recurrence rates (6% vs 9%; P = .223) and sites of recurrence were similar. The 5-year overall survival benefit in SRC patients (85% vs 76%, respectively; P = .035), was not evident when considering exclusively disease-specific survival or in multivariable analysis.Contrary to more advanced GA, SRC morphologic subtype is not a negative prognostic factor in early GA. Better survival identified in some reports may be related to the younger age in SRC patients.

Published
2013

6. Arthroscopic release for shoulder internal rotation contracture secondary to brachial plexus birth palsy: clinical and magnetic resonance imaging results on glenohumeral dysplasia

Author

Damien Louis, Jean Philippe Cahuzac, Franck Accadbled, Jérôme Sales de Gauzy, Jorge Knorr, Abdelaziz Abid, and Jean Kany

Subjects
Male, medicine.medical_specialty, Contracture, education, Physical examination, Outcome Assessment, Health Care, medicine, Brachial Plexus Neuritis, Humans, Orthopedics and Sports Medicine, Range of Motion, Articular, Brachial Plexus Neuropathies, Palsy, medicine.diagnostic_test, business.industry, Shoulder Joint, Shoulder Dislocation, Internal rotation, Infant, Magnetic resonance imaging, medicine.disease, Magnetic Resonance Imaging, Joint Capsule Release, Arthroscopic release, Treatment Outcome, Dysplasia, Pediatrics, Perinatology and Child Health, Female, Radiology, medicine.symptom, business, Brachial plexus
Abstract

Internal rotation contracture of the shoulder in brachial plexus birth palsy frequently leads to shoulder dysplasia. Six children underwent anterior arthroscopic release sparing the subscapularis. Clinical examination and MRI were performed preoperatively and repeated at the 5-year follow-up. MRI was carried out for assessment of glenohumeral dysplasia. Passive external rotation was improved by 63.3° without any limitation of active internal rotation. Active antepulsion/abduction was improved by 90°. Remodeling of the glenoid and improved coverage of the humeral head were observed in all cases. Shoulder arthroscopic release sparing the subscapularis seems to be an efficient procedure to restore external rotation without affecting active internal rotation.

Published
2012

7. Predictive Factors of Postoperative Mortality After Junctional and Gastric Adenocarcinoma Resection

Author

Jérémie H. Lefevre, Diane Goéré, Kevin Kraft, Jérôme Guiramand, Virginie Pichot-Delahaye, Christophe Mariette, William B. Robb, Damien Louis, and Mathieu Messager

Subjects
Adult, Male, medicine.medical_specialty, Multivariate analysis, medicine.medical_treatment, Adenocarcinoma, Preoperative care, Gastroenterology, Risk Factors, Stomach Neoplasms, Internal medicine, Humans, Medicine, Neoadjuvant therapy, Aged, Neoplasm Staging, Retrospective Studies, Aged, 80 and over, business.industry, Surrogate endpoint, Radiotherapy Dosage, Retrospective cohort study, Chemoradiotherapy, Adjuvant, Odds ratio, Middle Aged, Neoadjuvant Therapy, Surgery, Logistic Models, Multivariate Analysis, Cohort, Female, Esophagogastric Junction, business, Chemoradiotherapy
Abstract

Importance Postoperative mortality after junctional and gastric adenocarcinoma resection remains a significant issue. Objective To identify factors predictive of mortality within 30 days of junctional and gastric adenocarcinoma resection in a large national multicenter cohort. Design A retrospective study collecting data from a multicenter database of patients who underwent resection for junctional and gastric adenocarcinoma from January 1, 1997, through January 31, 2010. A stepwise logistic regression model was built to identify, by multivariate analysis, variables independently predictive of 30-day postoperative mortality (POM). Setting Nineteen university teaching hospitals in France. Participants Two thousand six hundred seventy patients with available data. Main Outcome Measures The primary end point was POM. Secondary end points included (1) late mortality (30-90 days after resection) and (2) postoperative morbidity. Results One thousand eight hundred ninety-six patients (71.01%) had gastric adenocarcinoma and 774 (28.99%) had junctional tumors. Neoadjuvant treatment was given to 655 patients (24.53%), and 114 patients (4.27%) died within 30 days of surgery. Postoperative mortality was higher in patients who experienced grades III and IV toxic effects during neoadjuvant treatment compared with those who did not (8.7% vs 2.9%, respectively; P = .007). Multivariate analysis revealed metastatic disease at diagnosis (odds ratio, 9.13 [95% CI, 3.29-25.35]; P P = .02) as being independently predictive of POM. Centers performing at least 10 resections per year were found to be protective against POM (odds ratio, 0.29 [95% CI, 0.12-0.72]; P = .008). Conclusions and Relevance This large national cohort study confirms that advanced disease heightens the risk of POM; centralization of junctional and gastric adenocarcinoma resection is warranted. The novel finding that grades III to IV toxic effects during neoadjuvant therapy increase POM has significant implications for decision making in this subgroup of patients. Trial Registration clinicaltrials.gov Identifier:NCT01249859

Published
2013
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