133 results on '"Rullier A"'
Search Results
2. Omentoplasty versus cecal mobilization after abdominoperineal resection: A propensity score matching analysis
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Boubaddi, Mehdi, Eude, Audrey, Marichez, Arthur, Amintas, Samuel, Boissieras, Lara, Celerier, Bertrand, Rullier, Eric, and Fernandez, Benjamin
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- 2024
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3. The Crying Need for a Better Response Assessment in Rectal Cancer
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Amintas, Samuel, Giraud, Nicolas, Fernandez, Benjamin, Dupin, Charles, Denost, Quentin, Garant, Aurelie, Frulio, Nora, Smith, Denis, Rullier, Anne, Rullier, Eric, Vuong, Te, Dabernat, Sandrine, and Vendrely, Véronique
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- 2023
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4. Effects of neoadjuvant chemotherapy plus chemoradiotherapy on lymph nodes in rectal adenocarcinoma
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Chotard, Guillaume, Capdepont, Maylis, Denost, Quentin, Smith, Denis, Vendrely, Véronique, Rullier, Eric, and Rullier, Anne
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- 2021
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5. TAilored SToma policY after TME for rectal cancer: The TASTY approach.
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Boissieras, Lara, Harji, Deena, Celerier, Bertrand, Rullier, Eric, and Denost, Quentin
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DISEASE risk factors ,RECTAL cancer ,RECEIVER operating characteristic curves ,SURGICAL stomas ,REFERENCE values ,RECTAL surgery - Abstract
Aim: Diverting stomas are routinely used in restorative surgery following total mesorectal exicision (TME) for rectal cancer to mitigate the clinical risks of anastomotic leakage (AL). However, routine diverting stomas are associated with their own complication profile and may not be required in all patients. A tailored approach based on personalized risk of AL and selective use of diverting stoma may be more appropriate. The aim of the TAilored SToma policY (TASTY) project was to design and pilot a standardized, tailored approach to diverting stoma in low rectal cancer. Method: A mixed‐methods approach was employed. Phase I externally validated the anastomotic failure observed risk score (AFORS). We compared the observed rate of AL in our cohort to the theoretical, predicted risk of the AFORS score. To identify the subset of patients who would benefit from early closure of the diverting stoma using C‐reactive protein (CRP) we calculated the Youden index. Phase II designed the TASTY approach based on the results of Phase I. This was evaluated within a second prospective cohort study in patients undergoing TME for rectal cancer between April 2018 and April 2020. Results: A total of 80 patients undergoing TME surgery for rectal cancer between 2016 and 2018 participated in the external validation of the AFORS score. The overall observed AL rate in this cohort of patients was 17.5% (n = 14). There was a positive correlation between the predicted and observed rates of AL using the AFORS score. Using ROC curves, we calculated a CRP cutoff value of 115 mg/L on postoperative day 2 for AL with a sensitivity of 86% and a negative predictive value of 96%. The TASTY approach was designed to allocate patients with a low risk AFORS score to primary anastomosis with no diverting stoma and high risk AFORS score patients to a diverting stoma, with early closure at 8–14 days, if CRP values and postoperative CT were satisfactory. The TASTY approach was piloted in 122 patients, 48 (39%) were identified as low risk (AFORS score 0–1) and 74 (61%) were considered as high risk (AFORS score 2–6). The AL rate was 10% in the low‐risk cohort of patient compared to 23% in the high‐risk cohort of patients, p = 0.078 The grade of Clavien‐Dindo morbidity was equivalent. The incidence of major LARS was lowest in the no stoma cohort at 3 months (p = 0.014). Conclusion: This study demonstrates the feasibility and safety of employing a selective approach to diverting stoma in patients with a low anastomosis following TME surgery for rectal cancer. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Suprapubic versus transurethral catheterization for bladder drainage in male rectal cancer surgery (GRECCAR10), a randomized clinical trial.
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Trilling, B., Tidadini, F., Lakkis, Z., Jafari, M., Germain, A., Rullier, E., Lefevre, J., Tuech, J. J., Kartheuser, A., Leonard, D., Prudhomme, M., Piessen, G., Regimbeau, J. M., Cotte, E., Duprez, D., Badic, B., Panis, Y., Rivoire, M., Meunier, B., and Portier, G.
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RECTAL cancer ,RECTAL surgery ,URINARY catheterization ,ONCOLOGIC surgery ,MEDICAL drainage ,CLINICAL trials ,CATHETERIZATION - Abstract
Background: Bladder drainage is systematically used in rectal cancer surgery; however, the optimal type of drainage, transurethral catheterization (TUC) or suprapubic catheterization (SPC), is still controversial. The aim was to compare the rates of urinary tract infection on the fourth postoperative day (POD4) between TUC and SPC, after rectal cancer surgery regardless of the day of removal of the urinary drain. Methods: This randomized clinical trial in 19 expert colorectal surgery centers in France and Belgium was performed between October 2016 and October 2019 and included 240 men (with normal or subnormal voiding function) undergoing mesorectal excision with low anastomosis for rectal cancer. Patients were followed at postoperative days 4, 30, and 180. Results: In 208 patients (median age 66 years [IQR 58–71]) randomized to TUC (n = 99) or SPC (n = 109), the rate of urinary infection at POD4 was not significantly different whatever the type of drainage (11/99 (11.1%) vs. 8/109 (7.3%), 95% CI, − 4.2% to 11.7%; p = 0.35). There was significantly more pyuria in the TUC group (79/99 (79.0%) vs. (60/109 (60.9%), 95% CI, 5.7–30.0%; p = 0.004). No difference in bacteriuria was observed between the groups. Patients in the TUC group had a shorter duration of catheterization (median 4 [2–5] vs. 4 [3–5] days; p = 0.002). Drainage complications were more frequent in the SPC group at all followup visits. Conclusions: TUC should be preferred over SPC in male patients undergoing surgery for mid and/or lower rectal cancers, owing to the lower rate of complications and shorter duration of catheterization. Trial registration: ClinicalTrials.gov identifier NCT02922647. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Multicentre cohort study evaluating clinical, oncological and functional outcomes following robotic rectal cancer surgery—the EUREKA collaborative: trial protocol.
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Fleming, Christina A, Duhoky, Rauand, Geitenbeek, Ritchie T J, Moussion, Aurore, Bouazza, Nabila, Khan, Jim, Cotte, Eddy, Dubois, Anne, Rullier, Eric, Hompes, Roel, Denost, Quentin, Rouanet, Philippe, Consten, Esther C J, and collaborative, EUREKA
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RECTAL surgery ,RECTAL cancer ,ONCOLOGIC surgery ,FUNCTIONAL status - Abstract
This article discusses a multicenter cohort study that examines the outcomes of robotic rectal cancer surgery. The study compares different surgical techniques and evaluates the safety and effectiveness of robotic surgery for rectal cancer. The article provides information on the study's design, eligibility criteria, surgical interventions, and data management. The study aims to collect international outcome data on complex high-risk cases and will include patient-reported outcome measures. The results of the study will be shared through scientific meetings and peer-reviewed journals. [Extracted from the article]
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- 2024
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8. IDEAL Stage 2a/b prospective cohort study of transanal transection and single‐stapled anastomosis for rectal cancer.
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Harji, Deena, Fernandez, Benjamin, Boissieras, Lara, Celerier, Bertrand, Rullier, Eric, and Denost, Quentin
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RECTAL cancer ,RECTAL surgery ,SURGICAL anastomosis ,COHORT analysis ,ONCOLOGIC surgery ,LONGITUDINAL method - Abstract
Aim: There are several anastomotic techniques available to facilitate restorative rectal cancer surgery after total mesorectal excision (TME), including double‐stapled anastomosis (DST) and handsewn coloanal anastomosis (CAA). However, to date no one technique is superior with regard to anastomotic leakage (AL) or functional outcomes. Transanal transection single‐stapled anastomosis (TTSS) aims to overcome some of the technical challenges and offer comparable clinical and functional outcomes to traditional anastomotic techniques. The aim of this study was to explore the role of TTSS in modern rectal cancer surgery and to provide comparative clinical and functional outcome data with DST and CAA. Method: A prospective cohort study was undertaken to assess the safety and clinical and patient‐reported outcomes associated with the TTSS procedure. All patients undergoing sphincter‐preserving surgery for rectal cancer with an anastomosis performed within 6 cm of the anal verge between January 2016 and April 2021 were prospectively enrolled into this study. Clinical and patient‐reported outcome data, including low anterior resection syndrome (LARS) assessment, were collected. The primary endpoint was anastomotic leakage within 30 days. Results: A total of 275 patients participated in this study, with 70 (25%) patients undergoing a TTSS, 110 (40%) undergoing a DST and 95 (35%) undergoing a CAA. Patients undergoing a CAA had more distal tumours than those having a TTSS or DST, with a median tumour height of 5, 7 and 9 cm (p < 0.001), respectively. We observed a statistically significant reduction in AL in the TTSS group compared with the DST group, with rates of 8.6% versus 20.9% (p = 0.028). There was no difference in LARS scores between patients undergoing TTSS and DST (p = 0.228), while patients with a CAA had worse LARS scores than TTSS patients (p = 0.002). Conclusion: TTSS is a technically safe and feasible anastomotic technique in rectal cancer surgery as an alternative to DST and CAA. Its advantages over DST are a reduced AL rate and, over CAA, improved function. It should therefore be considered as an alternative technique to improve clinical and patient‐reported outcomes in restorative rectal cancer surgery. [ABSTRACT FROM AUTHOR]
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- 2023
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9. Laparoscopic Surgical Management of Rectal Cancer
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Denost, Quentin, Adam, Jean-Philippe, Rullier, Eric, Patel, Hitendra R.H., editor, Mould, Tim, editor, Joseph, Jean V., editor, and Delaney, Conor P., editor
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- 2015
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10. St.Gallen consensus on safe implementation of transanal total mesorectal excision
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Adamina, Michel, Buchs, Nicolas C., Penna, Marta, Hompes, Roel, Adamina, Michel, Aigner, Felix, Albert, Matthew, Bell, Stephen, Bemelman, Willem, Boni, Luigi, Brown, Carl J., Brown, Gina, Buchs, Nicolas C., Grieder, Felix, Güller, Ulrich, Hompes, Roel, d’Hoore, André, Huscher, Cristiano, Ito, Masaaki, Kneist, Werner, Knol, Joep, Lacy, Antonio, Maykel, Justin, Merrie, Arend, Oh, Jae Hwan, Panis, Yves, Penna, Marta, Perez, Rodrigo Oliva, Pfeffer, Frank, Quirke, Philip, Rouanet, Philippe, Rullier, Eric, Seitinger, Gerald, Sietses, Colin, Spinelli, Antonino, Stevenson, Andrew R. L., Sylla, Patricia, Tekkis, Paris, Tuech, Jean-Jacques, Tuynman, Jurriaan, Warusavitarne, Janindra, Whiteford, Mark, Winter, Des, Wolthuis, Albert, and on behalf of the St.Gallen Colorectal Consensus Expert Group
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- 2017
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11. Is Delaying a Coloanal Anastomosis the Ideal Solution for Rectal Surgery? Analysis of a Multicentric Cohort of 564 Patients From the GRECCAR.
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Collard, Maxime K., Rullier, Eric, Tuech, Jean-Jacques, Sabbagh, Charles, Souadka, Amine, Loriau, Jérome, Faucheron, Jean-Luc, Benoist, Stéphane, Dubois, Anne, Dumont, Frédéric, Germain, Adeline, Manceau, Gilles, Marchal, Frédéric, Sourrouille, Isabelle, Lakkis, Zaher, Lelong, Bernard, and Derieux, Simon
- Abstract
Objectives: To assess the specific results of delayed coloanal anastomosis (DCAA) in light of its 2 main indications. Background: DCAA can be proposed either immediately after a low anterior resection (primary DCAA) or after the failure of a primary pelvic surgery as a salvage procedure (salvage DCAA). Methods: All patients who underwent DCAA intervention at 30 GRECCAR-affiliated hospitals between 2010 and 2021 were retrospectively included. Results: Five hundred sixty-four patients (male: 63%; median age: 62 years; interquartile range: 53--69) underwent a DCAA: 66% for primary DCAA and 34% for salvage DCAA. Overall morbidity, major morbidity, and mortality were 57%, 30%, and 1.1%, respectively, without any significant differences between primary DCAA and salvage DCAA (P = 0.933; P = 0.238, and P = 0.410, respectively). Anastomotic leakage was more frequent after salvage DCAA (23%) than after primary DCAA (15%), (P = 0.016). Fifty-five patients (10%) developed necrosis of the intra-abdominal colon. In multivariate analysis, intra-abdominal colon necrosis was significantly associated with male sex [odds ratio (OR) = 2.67 95% CI: 1.22--6.49; P= 0.020], body mass index > 25 (OR = 2.78 95% CI: 1.37--6.00; P = 0.006), and peripheral artery disease (OR = 4.68 95% CI: 1.12--19.1; P = 0.030). The occurrence of this complication was similar between primary DCAA (11%) and salvage DCAA (8%), (P = 0.289). Preservation of bowel continuity was reached 3 years after DCAA in 74% of the cohort (primary DCAA: 77% vs salvage DCAA: 68%, P = 0.031). Among patients with a DCAA mannered without diverting stoma, 75% (301/403) have never required a stoma at the last follow-up. Conclusions: DCAA makes it possible to definitively avoid a stoma in 75% of patients when mannered initially without a stoma and to save bowel continuity in 68% of the patients in the setting of failure of primary pelvic surgery. [ABSTRACT FROM AUTHOR]
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- 2023
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12. Implémentation d'une intervention psychosociale StomieCare auprès de patients opérés d'un cancer du rectum avec stomie temporaire: une étude pilote de faisabilité, d'acceptabilité et d'efficacité.
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Faury, Stéphane, M'Bailara, Katia, Rullier, Eric, Denost, Quentin, and Quintard, Bruno
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PREVENTION of mental depression ,ANXIETY prevention ,ABDOMINOPERINEAL resection ,PSYCHOTHERAPY ,PATIENT education ,SURGERY ,PATIENTS ,PSYCHOLOGICAL distress ,SURGICAL stomas ,STATISTICAL sampling ,PILOT projects ,TREATMENT effectiveness ,RANDOMIZED controlled trials ,CANCER patients ,BODY image ,PROBLEM solving ,RECTUM tumors ,CONTROL groups ,PRE-tests & post-tests ,QUALITY of life ,EVALUATION - Abstract
Copyright of Psycho-Oncologie is the property of Tech Science Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2023
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13. Learning curve for robotic‐assisted total mesorectal excision: a multicentre, prospective study.
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Arquillière, J., Dubois, A., Rullier, E., Rouanet, P., Denost, Q., Celerier, B., Pezet, D., Passot, G., Aboukassem, A., Colombo, P. E., Mourregot, A., Carrere, S., Vaudoyer, D., Gourgou, S., Gauthier, L., and Cotte, E.
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LYMPHADENECTOMY ,RECTAL cancer ,RECTAL surgery ,SURGICAL margin ,ABDOMINAL surgery ,LONGITUDINAL method - Abstract
Aim: Robotic‐assisted surgery (RAS) is becoming increasingly important in colorectal surgery. Recognition of the short, safe learning curve (LC) could potentially improve implementation. We evaluated the extent and safety of the LC in robotic resection for rectal cancer. Method: Consecutive rectal cancer resections (January 2018 to February 2021) were prospectively included from three French centres, involving nine surgeons. LC analyses only included surgeons who had performed more than 25 robotic rectal cancer surgeries. The primary endpoint was operating time LC and the secondary endpoint conversion rate LC. Interphase comparisons included demographic and intraoperative data, operating time, conversion rate, pathological specimen features and postoperative morbidity. Results: In 174 patients (69% men; mean age 62.6 years) the mean operating time was 334.5 ± 92.1 min. Operative procedures included low anterior resection (n = 143) and intersphincteric resection (n = 31). For operating time, there were two or three (centre‐dependent) LC phases. After 12–21 cases (learning phase), there was a significant decrease in total operating time (all centres) and an increase in the number of harvested lymph nodes (two centres). For conversion rate, there were two or four LC phases. After 9–14 cases (learning phase), the conversion rate decreased significantly in two centres; in one centre, there was a nonsignificant decrease despite the treatment of significantly more obese patients and patients with previous abdominal surgery. There were no significant differences in interphase comparisons. Conclusion: The LC for RAS in rectal cancer was achieved after 12–21 cases for the operating time and 9–14 cases for the conversion rate. RAS for rectal cancer was safe during this time, with no interphase differences in postoperative complications and circumferential resection margin. [ABSTRACT FROM AUTHOR]
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- 2023
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14. An International Multicenter Prospective Study Evaluating the Long-term Oncological Impact of Adjuvant Chemotherapy in ypN+ Rectal Cancer
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Denost, Quentin, Fleming, Christina A., Burghgraef, Thijs, Celerier, Bertrand, Geitenbeek, Ritchie, Rullier, Eric, Tuynman, Jurriaan, Consten, Esther, Hompes, Roel, Surgery, CCA - Cancer Treatment and Quality of Life, CCA - Cancer Treatment and quality of life, CCA - Imaging and biomarkers, Amsterdam Gastroenterology Endocrinology Metabolism, and VU University medical center
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adjuvant chemotherapy ,rectal cancer ,survival ,lymph node positive - Abstract
Objective: To assess the oncological benefit of adjuvant chemotherapy (AC) in node positive (ypN+) rectal cancer after neoadjuvant chemoradiotherapy and radical surgery. Background: The evidence for AC after total mesorectal excision for locally advanced rectal cancer is conflicting and the net survival benefit is debated. Methods: An international multicenter comparative cohort study was performed comparing oncological outcomes in tertiary rectal cancer centers from the Netherlands and France. Patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy followed by total mesorectal excision surgery and with positive lymph nodes on histologic examination (ypN+) were included for analysis. Kaplan-Meier curves were generated to compare disease-free (DFS) and overall survival in AC and non-AC groups. Results: Of 1265 patients screened, a total of 239 rectal cancer patients with ypN+ disease were included. Demographic and clinical characteristics were similar in both groups. Higher systemic recurrence rates were observed in the non-AC group compared with those who received AC [32.0% (n=40) vs 17.5% (n=11), respectively, P=0.034]. DFS at 1 and 5 years postoperatively were significantly better in the AC group (92% vs 80% at 1 year; 72% vs 51% at 5 years, P=0.024), whereas no difference in overall survival was observed. Conclusions: In this multicenter comparative cohort study, we identified an oncological benefit of AC in both systemic recurrence and DFS in ypN+ rectal cancer patients. From this data, systemic chemotherapy continues to confer oncological benefit in locally advanced ypN+ rectal cancer.
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- 2023
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15. Quelles représentations les hommes opérés d’un cancer du rectum ont-ils de la stomie temporaire ? Une étude exploratoire
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Faury, S., Rullier, E., and Quintard, B.
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- 2017
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16. Transanal versus abdominal low rectal dissection for rectal cancer: long-term results of the Bordeaux’ randomized trial
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Denost, Quentin, Loughlin, Paula, Chevalier, Remy, Celerier, Bertrand, Didailler, Romain, and Rullier, Eric
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- 2017
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17. A concept of sphincter salvage in low rectal cancer
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Rullier, Eric, Denost, Quentin, Laurent, Christophe, Schiessel, Rudolf, editor, and Metzger, Peter, editor
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- 2012
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18. Comparison between preoperative chemoradiotherapy and lateral pelvic lymph node dissection in clinical T3 low rectal cancer without enlarged lateral lymph nodes.
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Tsukada, Yuichiro, Rullier, Eric, Shiraishi, Takuya, Capdepont, Maylis, Sasaki, Takeshi, Celerier, Bertrand, Denost, Quentin, and Ito, Masaaki
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RECTAL cancer , *CHEMORADIOTHERAPY , *LYMPH nodes , *LYMPHADENECTOMY , *PROGRESSION-free survival , *NERVOUS system injuries ,WESTERN countries - Abstract
Aim: The standard strategy for clinical T3 rectal cancer without enlarged lateral lymph nodes is preoperative chemoradiotherapy (CRT) followed by total mesorectal excision (TME) in Western countries and TME with bilateral lateral pelvic lymph node dissection (LPLND) in Japan. This study compared surgical, pathological and oncological results of these two strategies. Method: Patients who underwent preoperative CRT followed by TME in France (CRT + TME group) and those who underwent TME with LPLND in Japan (TME + LPLND group) for clinical T3 rectal adenocarcinoma without enlarged lateral lymph nodes from 2010 to 2016 were retrospectively analysed. Results: In total, 439 patients were included in this study. The estimated local recurrence rate (LRR), disease‐free survival and overall survival at 5 years post‐surgery was 4.9%, 71% and 82% in the CRT + TME group, and 8.6%, 75% and 90% in the TME + LPLND group, respectively. Lateral LRR versus non‐lateral LRR was 0.5% versus 4.2% in the CRT + TME group and 1.8% versus 6.2% in the TME + LPLND group. Obturator nerve injury and isolated pelvic abscess were shown only in the TME + LPLND group. Urinary complications were more frequent in the TME + LPLND group than in the CRT + TME group. Conclusion: Disease‐free survival was not significantly different after TME with LPLND and after CRT followed by TME. LRR was not significantly different after both strategies; however, there was a trend for higher LRR after TME with LPLND than after CRT followed by TME. Obturator nerve injury, isolated lateral pelvic abscess and urinary complications should be noted when TME with LPLND is applied. [ABSTRACT FROM AUTHOR]
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- 2023
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19. Potential sexual function improvement by using transanal mesorectal approach for laparoscopic low rectal cancer excision
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Pontallier, Arnaud, Denost, Quentin, Van Geluwe, Bart, Adam, Jean-Philippe, Celerier, Bertrand, and Rullier, Eric
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- 2016
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20. International expert consensus guidance on indications, implementation and quality measures for transanal total mesorectal excision
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Mark Katory, Teresa deBeche-Adams, Danilo Miskovic, Hongwei Yao, Mark Whiteford, Shady Ashamalla, Elena Vikis, Willem A. Bemelman, Tsuyoshi Konishi, Nicola Fearnhead, Sergio Araujo, Walter Brunner, Antonino Spinelli, Ichiro Takemasa, Eric Rullier, Quentin Denost, Jae Hwan Oh, Andrew Stevenson, Stephen Bell, Masaaki Ito, N. C. Buchs, Jos Kleijnen, Bert Houben, Patricia Sylla, Frederic Ris, Gabriela Möslein, Elisabeth McLemore, Michel Adamina, Janindra Warusavitarne, Alexander Heriot, Nader Francis, Zhongtao Zhang, Justin Maykel, Roel Hompes, Felix Aigner, Gustavo Rossi, Marta Penna, Alberto Arezzo, Park Sung Chan, André D'Hoore, J. Knol, Jared Torkington, Isacco Montroni, Gerald Seitinger, Minhua Zheng, John Marks, Werner Kneist, Eelco J. R. de Graaf, Sami A Chadi, Antonio Caycedo, Julian Hayes, Seong Hyeon Yun, Pieter J. Tanis, David Clark, Jurriaan B. Tuynman, Suguru Hasegawa, Rodrigo Oliva Perez, Carl J. Brown, Beatriz Martin-Perez, Buchs, Nicolas, Ris, Frédéric, Surgery, CCA - Cancer Treatment and Quality of Life, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism
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medicine.medical_specialty ,Consensus ,health care facilities, manpower, and services ,media_common.quotation_subject ,Best practice ,education ,Delphi method ,Rectal surgery ,030230 surgery ,03 medical and health sciences ,0302 clinical medicine ,rectal surgery ,Humans ,Medicine ,Quality (business) ,Medical physics ,Rectal cancer ,rectal cancer ,health care economics and organizations ,Quality Indicators, Health Care ,Transanal Endoscopic Surgery ,media_common ,computer.programming_language ,ddc:617 ,Rectal Neoplasms ,business.industry ,TME ,Rectum ,Gastroenterology ,Expert consensus ,TaTME ,consensus ,guidance ,Total mesorectal excision ,Focus group ,Guidance ,Laparoscopy ,030211 gastroenterology & hepatology ,business ,computer ,Delphi round ,Delphi - Abstract
Aim To provide dynamic guidance from a rigorous and up-to-date consensus on the safe implementation and application of transanal total mesorectal excision (TaTME) from an international panel of expert surgeons and educationalists supported by 14 international surgical societies. Method An adapted Delphi method and focus group discussion approach was implemented for this consensus process, with expert advice from a guidelines methodologist. Statements were generated focusing on three main topics relating to the safe implementation of TaTME: (1) indications, (2) quality and outcome measures, (3) training and implementation of TaTME. Results Five rounds of the Delphi consensus process were completed over a 13-month period. A total of 56 surgeons experienced in TaTME and surgical education participated in this project. By Delphi round four, 80.0% or greater agreement was reached for all statements except for two, which were further reviewed during a fifth round. More complex cases that are likely to benefit from TaTME were identified, with the recommendation that they should be referred to TaTME expert centres. The most agreed upon definition of expert centres is outlined. Conclusion We have provided a current framework of best practice related to implementation of TaTME. The statements are not indefinite and will continue to be 'dynamic' and updated as new evidence emerges.
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- 2020
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21. Feasibility study of a Response Surveillance Program in locally advanced mid and low rectal cancer to increase organ preservation.
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Boubaddi, Mehdi, Fleming, Christina, Vendrely, Veronique, Frulio, Nora, Salut, Cécile, Rullier, Eric, and Denost, Quentin
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RECTAL cancer ,PRESERVATION of organs, tissues, etc. ,PROGRESSION-free survival ,NEOADJUVANT chemotherapy ,OVERALL survival ,FEASIBILITY studies - Abstract
Assessment of tumor response in rectal cancer after neoadjuvant treatment by MRI (Tumour Regression Grade, TRG 1–5) is well standardized. The overall timing and method of defining complete response (cCR) remain controversial. The aim of this work was to evaluate the feasibility of a defined Response Surveillance Program (RSP) to increase organ preservation for locally advanced rectal cancer after neoadjuvant treatment. A standardized program of clinical (CR), radiological (RR) and metabolic (MR) assessment of tumor response is defined over a 6 month period from completion of NACRT with formal assessment performed every 2 months (M). Patients with TRG1-3 at M2 and TRG1-2 at M4 continue in the program up to M6 assessment. Patients managed with this protocol from 2016 to 2020 were analyzed. The primary endpoint was rectal preservation rate. Secondary endpoints included disease-free survival and overall survival at 3 years. 314 potentially suitable patients were enrolled in the RSP and 50 patients completed the six month program and were successfully enrolled into watch and wait. Fourteen (28%) were T2 tumor stage, 27 (54%) T3 and nine (18%) were T4. During watch and wait, patients with locoregional recurrence (n = 11) were treated with local excision (n = 3), endocavitary radiotherapy (n = 1), TME (n = 5) and APR (n = 2). With a median follow-up of 32 months, the rectal preservation rate was 88%, with a 3-year disease-free survival of 67% and an overall survival of 98%. This study validates the feasibility of the practical implementation of a Response Surveillance Program to increase organ preservation rates without compromising oncological outcomes in rectal cancer. [ABSTRACT FROM AUTHOR]
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- 2023
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22. Laparoscopic surgery for rectal cancer: preoperative radiochemotherapy versus surgery alone
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Denost, Quentin, Laurent, Christophe, Paumet, Thomas, Quintane, Laurence, Martenot, Mathieu, and Rullier, Eric
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- 2012
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23. Est-il raisonnable de proposer un traitement local après radiochimiothérapie néoadjuvante ?: Question 4
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Laurent, C., Denost, Q., and Rullier, E.
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- 2012
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24. Oncological strategy following R1 sphincter-saving resection in low rectal cancer after chemoradiotherapy.
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Denost, Quentin, Assenat, Vincent, Vendrely, Veronique, Celerier, Bertrand, Rullier, Anne, Laurent, Christophe, and Rullier, Eric
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RECTAL cancer ,PROGRESSION-free survival ,SURGICAL margin ,CHEMORADIOTHERAPY ,ABDOMINOPERINEAL resection ,ADJUVANT chemotherapy - Abstract
Sphincter-saving resection (SSR) for low rectal cancer remains challenging due to the high risk of positive resection margin (R1). Long-term outcomes and the dedicated oncological strategy are not well established in this situation. The aim of this study was to define the more appropriate strategy according to the patterns of recurrence. Between 1994 and 2014, patients treated by SSR for low rectal cancer with preoperative chemoradiotherapy were included. Three types of recurrences were defined: local (LR), distant (DR) and mixed (MR). Recurrences and survival after R0 and R1 resection were analysed by Kaplan-Meier and compared with the log-rang test. Among 394 patients receiving SSR, 42 (10.6%) had R1 resection. Independent factors of R1 resection were EMVI (OR2.24,95%IC1.10–4.53,p = 0.025) and no tumor downstaging (OR8.41,95%IC2.50–8.32,p = 0.001). Both 5-year disease free and overall survival, and 5-year distant and local recurrence, were significantly worse after R1 resection. The overall recurrence after R1 resection was 57% (24/42), 7% had LR, 36% DR and 14% MR. Time to DR was shorter than time to LR (11.1 vs. 34.3) months. In all cases of MR, DR occurred before LR (12.1 vs. 34.3) months, meaning that after R1 resection, the first concern was DR. R1 resection after SSR for low rectal cancer reflects a more aggressive and systemic disease. Prognosis depends on DR in about 90% of cases, suggesting that pelvic control should not be the priority in the oncological strategy after R1. Adjuvant systemic chemotherapy ought to be preferred to salvage abdominoperineal resection. [ABSTRACT FROM AUTHOR]
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- 2021
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25. A phase III randomized trial evaluating chemotherapy followed by pelvic reirradiation versus chemotherapy alone as preoperative treatment for locally recurrent rectal cancer – GRECCAR 15 trial protocol.
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Denost, Quentin, Frison, Eric, Salut, Cécile, Sitta, Remy, Rullier, Anne, Harji, Deena, Maillou‐Martinaud, Helene, Rullier, Eric, Smith, Denis, and Vendrely, Veronique
- Subjects
RECTAL cancer ,NEOADJUVANT chemotherapy ,COMBINATION drug therapy ,CANCER chemotherapy ,CHEMORADIOTHERAPY - Abstract
Aim: Treatment strategies in locally recurrent rectal cancer (LRRC) are complex and need to be balanced against previous treatments received for the primary rectal cancer. Radiotherapy is an important component of treatment in LRRC. However, there is little high‐quality evidence on the role of reirradiation in this cohort. Therefore, the aim of this trial is to assess the efficacy of neoadjuvant chemotherapy followed by pelvic reirradiation versus neoadjuvant chemotherapy alone on the rate of curative surgery (R0) in previously irradiated patients with LRRC. Method: GRECCAR 15 is a prospective, multicentre, open‐label, outcome assessor‐blinded, superiority randomized controlled phase III clinical trial comparing neoadjuvant chemotherapy followed by pelvic reirradiation versus neoadjuvant chemotherapy alone in patients with LRRC previously irradiated for the primary cancer. Adult patients (>18 years old) with a histologically proven resectable LRRC, who have previously received pelvic radiotherapy for their primary rectal cancer at a dose of 25–50.4 Gy, and an Eastern Cooperative Oncology Group performance status of <2 will be eligible to participate. The pelvic reirradiation will consist of conformational intensity‐modulated external irradiation, delivering a dose of 30.6 Gy with concomitant chemotherapy using capecitabine. The primary outcome of this trial is the R0 resection rate. Overall, GRECCAR 15 aims to recruit 186 patients to detect an absolute difference of 20% in the R0 resection rate with 80% power and 5% two‐sided significance level. Conclusion: The GRECCAR 15 trial is the first, definitive, phase III trial to investigate reirradiation in LRRC. The results of this trial will inform definitively the neoadjuvant treatment strategy in previously irradiated patients and assess whether there is any associated benefit of reirradiation in combination with induction chemotherapy in improving R0 resection rates. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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26. An international multicentre prospective audit of elective rectal cancer surgery; operative approach versus outcome, including transanal total mesorectal excision (TaTME)
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Bhangu, Aneel, Minaya-Bravo, Ana María, Gallo, Gaetano, Glasbey, James C., Kamarajah, Sivesh, Pinkney, Thomas, El-Hussuna, Alaa, Battersby, Nick J., Buchs, Nicolas C., Buskens, Christianne, Chaudri, Sanjay, Frasson, Matteo, Glasbey, James, Morton, Dion, Negoi, Ionut, Nepogodiev, Dmitri, Pata, Francesco, Sánchez-Guillén, Luis, Singh, Baljit, Zmora, Oded, Perry, Rita, Magill, Laura, Altomare, Donato, Bemelman, Willem, Brown, Steven, Denost, Quentin, Knowles, Charles, Laurberg, Søren, Lefevre, Jérémie H., Möeslein, Gabriela, Pinkney, Tom, Vaizey, Carolynne, Bilali, S., Bilali, V., Salomon, M., Cillo, M., Estefania, D., Patron Uriburu, J., Ruiz, H., Farina, P., Carballo, F., Guckenheimer, S., Proud, D., Brouwer, R., Bui, A., Nguyen, B., Smart, P., Warwick, A., Theodore, J. E., Herbst, F., Birsan, T., Dauser, B., Ghaffari, S., Hartig, N., Stift, A., Argeny, S., Unger, L., Strouhal, R., Heuberger, A., Varabei, A., Lahodzich, N., Makhmudov, A., Selniahina, L., Feryn, T., Leupe, T., Maes, L., Reynvoet, E., Van Langenhove, K., Nachtergaele, M., Monami, B., Francart, D., Jehaes, C., Markiewicz, S., Weerts, J., Van Belle, K., Bomans, B., Cavenaile, V., Nijs, Y., Vertruyen, M., Pletinckx, P., Claeys, D., Defoort, B., Muysoms, F., Van Cleven, S., Lange, C., Vindevoghel, K., Wolthuis, A., Todorovic, M., Dabic, S., Kenjic, B., Lovric, S., Vidovic, J., Delibegovic, S., Mehmedovic, Z., Christiano, A., Lombardi, B., Marchiori, M., Tercioti, V., Dardanov, D., Petkov, P., Simonova, L., Yonkov, A., Zhivkov, E., Maslyankov, S., Pavlov, V., Sokolov, M., Todorov, G., Stoyanov, V., Batashki, I., Iarumov, N., Lozev, I., Moshev, B., Slavchev, M., Atanasov, B., Belev, N., Krstev, P., Penkov, R., Šantak, G., Ćosić, J., Previšić, A., Vukušić, L., Zukanović, G., Zelić, M., Kršul, D., Lekić Vitlov, V., Mendrila, D., Orhalmi, J., Dusek, T., Maly, O., Paral, J., Sotona, O., Skrovina, M., Bencurik, V., Machackova, M., Kala, Z., Farkašová, M., Grolich, T., Procházka, V., Hoch, J., Kocian, P., Martinek, L., Antos, F., Pruchova, V., Ceccotti, A., Madsbøll, T., Straarup, D., Uth Ovesen, A., Christensen, P., Bondeven, P., Edling, P., Elfeki, H., Alexandrovich Gameza, V., Michelsen Bach, S., Zheltiakova, I., Krarup, P. M., Krogh, A., Rolff, H. -C., Lykke, J., Juvik, A. F., Lóven, H. H. K., Marckmann, M., Osterkamp, J. T. F., Madsen, A. H., Worsøe, J., Ugianskis, A., Kjær, M. D., Youn Cho Lee, B., Khalid, A., Kristensen, M. H., El Sorogy, M., Elgeidie, A., Elhemaly, M., El Nakeeb, A., Elrefai, M., Shalaby, M., Emile, S., Omar, W., Sakr, A., Thabet, W., Awny, S., Metwally, I., Refky, B., Shams, N., Zuhdy, M., Lepistö, A., Keränen, I., Kivelä, A., Lehtonen, T., Siironen, P., Rautio, T., Ahonen-Siirtola, M., Klintrup, K., Paarnio, K., Takala, H., Hyöty, M., Haukijärvi, E., Kotaluoto, S. -M., Lehto, K., Tomminen, T., Huhtinen, H., Carpelan, A., Karvonen, J., Rantala, A., Varpe, P., Cotte, E., Francois, Y., Glehen, O., Passot, G., D'Alessandro, A., Chouillard, E., Etienne, J. C., Ghilles, E., Vinson-Bonnet, B., Germain, A., Ayav, A., Bresler, L., Chevalier, R., Denost, Q., Didailler, R., Rullier, E., Tiret, E., Chafai, N., Lefevre, J. 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R., Rubbini, M., Anania, G., Carcoforo, P., Cavallesco, G., Feo, C., Yamamoto, T., Sivins, A., Ancans, G., Gerkis, S., Lunis, R., Pcolkins, A., Venskutonis, D., Bradulskis, S., Dainius, E., Subocius, A., Vencius, J., Zeromskas, P., Eismontas, V., Nutautiene, V., Simcikas, D., Tamosiunas, A., Svagzdys, S., Latkauskas, T., Lizdenis, P., Saladzinskas, Z., Tamelis, A., Dulskas, A., Kuliavas, J., Samalavicius, N. E., Poskus, T., Jotautas, V., Mikalauskas, S., Poskus, E., Strupas, K., Zakaria, A. D., Lah, N. N., Wong, M., Zain, W. Z., Zakaria, Z., Mazlan, L., Mohd Azman, Z. A., Sagap, I., Psaila, J., Andrejevic, P., Cini, C., Ellul, S., Pace, K., Ahallat, M., Hamid, M., Hrora, A., Majbar, M. A., Raiss, M., Westerduin, E., Bemelman, W., Buskens, C., Tanis, P., van der Sluis, P. C., Davids, P. H., Pronk, A., Schiphorst, A. H. W., Smakman, N., Zimmerman, D., Koeter, T., Stijns, J., van Loon, Y. -T., Vermaas, M., de Graaf, E., Doornebosch, P., van Hagen, P., van Ruler, O., Toorenvliet, B., Nonner, J., van den Berg, I., van Steensel, L., Vles, W., Melenhorst, J., Orsini, R., Visschers, R., Hoff, C., Blom, R., Marsman, H., Mulder, I., Cense, H., de Castro, S., Demirkiran, A., Hunfeld, M., van Geloven, A., de Groof, J., Hendriks, E., Leeuwenburg, M., van Oorschot, N., Wit, F., Rupert, C., Veldman, P., Keijzers, M., Konsten, J., Den Boer, F., Corver, M., Boerma, E. G., Koolen, L., Martens, M., Van Wijck, K., Ignjatovic, D., Breuer, R., Gurpreet, B., Oresland, T., Tetens Moe, T., Nesbakken, A., Flaaten Backe, I., Wik, T. -A., Radiya, K., Dehli, T., Gjessing, P., Norderval, S., Woll, K., Anwer, M., Qureshi, M. S., Qureshi, A. U., Billah, M., Jawad, M. Y., Raza, A., Urooj, N., Wang, X., Li, L., Jajtner, D., Gasinski, B., Kabiesz, W., Walega, P., Romaniszyn, M., Zawadzki, M., Czarnecki, R., Obuszko, Z., Rzaca, M., Sitarska, M., Silva, P., Duarte, A., Gonçalves, D., Morais, M., Rama, N., Nobre, J., Sales, I., Costa Pereira, J., Costa, S., Costa Pereira, C., Insua, C., Romero, I., Figueiredo, N., Cunha, J., Domingos, H., Vieira, P., Cunha, M., Americano, M., Amorim, E., Rachadell, J., Carvas, J. M., Armas, I., Fernandes, P., Pires, C., Reis, R., Martins, R., Dos Santos, M., Henriques, P., Oliveira, O., Duarte, M., Ferreira, L., Miranda, J., Vilela, N., Corte Real, J., Carlos, S., Frois Borges, M., Moniz Pereira, P., Simões, J., Silva-vaz, P., Bettencourt, V., Gouveia, A., Perez, H., Rainho, R., Bintintan, V., Ciuce, C., Dindelegan, G., Scurtu, R., Seicean, R., Cristian, D., Burcos, T., Grama, F., Mandi, D. M., Richiteanu, G., Miron, A., Calu, V., Enciu, O., Nadragea, M., Parvuletu, R., Mogoanta, S. 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U., Kara, Y., Agcaoglu, O., Balik, E., Bayram, O., Özbalcı, G. S., Özkan, B. B., Karabacak, U., Sungurtekin, U., Ozgen, U., Demirbas, S., Öztürk, E., Isik, O., Yilmazlar, T., Colak, E., Karagul, S., Kinas, V., Fearnhead, N., Lord, I., Stewart, P., Zammit, M., Arnold, S., Battersby, N. J., Broadhurst, J., Moran, S., Seretis, F., Shabbir, J., Jones, C., Kynaston, J., Vimalachandran, D., Blower, E., Mcfaul, C., Mcwhirter, D., Pilkington, J., Wilson, T., Chowdhary, M., Stubbs, B., Abdalkoddus, M., Lai, C., Thavanesan, N., Yao, C., Agarwal, T., Dindyal, S., Hill, R. M. C., Reade, S., Slesser, A., Paterson, H., Balfour, A., Boland, M., Geraghty, A., O'Kelly, J., Patel, P., Tezas, S., Yahia, S., Jadhav, V., Marimuthu, K., Narayanan, A., Piramanayagam, B., Bradley, N., Buchanan, F., Paul, K., Singh, J., Thomson, K., Korsgen, S., Bedford, M., Lee, K., Leong, K., Mcarthur, D., Bhangu, A., Malik, S., Mohamed, I., Cunha, P., Pilavas, A., Reddy, A., Ahmed, S., Ahmed, A., Voll, J., Velchuru, V., Lal, R., Mirshekar-Syahkal, B., Kassai, M., Aleem, M., Keogh-Bootland, S., Sarmah, P., Brown, S., Keegan, R., Kelkar, A., Sen, P., Oliveira-Cunha, M., Chaudhri, S., Fares, R., Singh, B., Thomas, W. M., Aslam, M. I., Boyle, K., Hemingway, D., Miller, A., Norwood, M., Gurjar, S., Al-Saeedi, M., Anandan, L., Sudlow, A., Zampitis, N., Malik, K., Bogdan, M., Smart, C., Iqbal, M. R., Bailey, S., Lawes, D., Omar, G., Tamhane, R., Evans, M., Ather, S., Lim, J., Nageswaran, H., Taylor, G., Hunt, L., Nicholls, J., Shaikh, I., Muscara, F., O'Brien, J., Photi, E., Stearns, A., Meylemans, D., Cunningham, C., Hompes, R., Tennakoon, A., Kumarasinghe, N., Rao, M., Upanishad, I., Khan, J., Ahmad, N., Shweejawee, Z., Stefan, S., Smart, N., Daniels, I., Gregoir, T., Longstaff, L., Mcdermott, F., Varcada, M., Drami, I., Gala, T., Moggia, E., Ratnatunga, K., Harries, R., Hayes, J., Williams, G., Raymond, T., Bronder, C., Davies, E., Hawkin, P., Ryska, O., Ayral, K., Beveridge, A., Bhowmik, A., Gill, M., Simpson, R., Schofield, A., Mcardle, K., Parmar, M., Williamson, M., Burton, H., Courtney, E., Grant, C., Saracino, A., Newton, K., Epstein, J., Branagan, G., Bignell, M., Symankewicz, M., Zaman, S., Mankotia, R., Siddiqui, Z., Torrance, A., Artioukh, D., Eggleston, M., Gokul, K., Selwyn, D., Warusavitarne, J., Chandrasinghe, P., Grainger, J., Leo, C. A., Vaizey, C. J., Harris, G., Levy, B., Skull, A., Thaha, M., Garg, A., Patel, H., Ramsanahie, A., Mondragon-Pritchard, M., Cuinas Leon, K., Shukla, A., Brewer, H., Fitzgerald, J., Kho, H., Torkington, J., Tate, S., Wheat, J., Smolarek, S., Platt, E., Rossi, B., Tham, J. C., Knight, J., Richardson, J., Tzivanakis, A., Gregori, M., Ashraf, M. A., Atif, M., Santos, J., Saffaf, N., Canning, L., Chandratreya, N., Bowen, M., Graham, B., Hamad, Y., Kaubrys, M., Chaudhry, Z. U., Bhan, C., Mukhtar, H., Oshowo, A., Wilson, J., Gouvas, N., Nicol, D., Pandey, S., Zilvetti, M., Sharma, A., Fatayer, T., Mothe, S., Rahman, M., Curtis, N., Allison, A., Dalton, R., Francis, N., Ockrim, J., Psaras, G., Dudarovaska, H., Marharint, T., Mostovoy, E., Voloshin, S., Kolesnik, O., Makhmudov, D., Altinel, Y., Iqbal, A., Cunningham, L., Go, K., Tan, S., R. Tutino, G. salamone, L. Licari, G. Cocorullo, G. Gulotta, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, and CCA - Cancer Treatment and Quality of Life
- Subjects
Male ,Laparoscopic surgery ,medicine.medical_specialty ,Colorectal cancer ,medicine.medical_treatment ,Operative Time ,Anastomosis ,Malignancy ,rectal cancer ,laparoscopic surgery ,TME ,transanal TME ,TaTME ,robotic surgery ,randomized clinical-trial ,short-term outcomes ,laparoscopic-assisted resection ,pathological outcomes ,anastomotic leakage ,initial-experience ,risk ,NO ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Robotic Surgical Procedures ,Humans ,Medicine ,Robotic surgery ,Prospective Studies ,Rectal cancer ,Gastroenterology ,Aged ,Transanal Endoscopic Surgery ,ta3126 ,Medical Audit ,Univariate analysis ,Proctectomy ,Rectal Neoplasms ,business.industry ,Rectum ,Margins of Excision ,Middle Aged ,medicine.disease ,Total mesorectal excision ,Surgery ,Treatment Outcome ,Elective Surgical Procedures ,030220 oncology & carcinogenesis ,Rectal cancer surgery ,Female ,Laparoscopy ,030211 gastroenterology & hepatology ,business - Abstract
Introduction: Transanal total mesorectal excision (TaTME) has rapidly emerged as a novel approach for rectal cancer surgery. Safety profiles are still emerging and more comparative data is urgently needed. This study aimed to compare indications and short-term outcomes of TaTME, open, laparoscopic, and robotic TME internationally. Methods: A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 audit was performed. Patients undergoing elective total mesorectal excision (TME) for malignancy between 1 January 2017 and 15 March 2017 by any operative approach were included. The primary outcome measure was anastomotic leak. Results: Of 2579 included patients, 76.2% (1966/2579) underwent TME with restorative anastomosis of which 19.9% (312/1966) had a minimally invasive approach (laparoscopic or robotic) which included a transanal component (TaTME). Overall, 9.0% (175/1951, 15 missing outcome data) of patients suffered an anastomotic leak. On univariate analysis both laparoscopic TaTME (OR 1.61, 1.02–2.48, P=0.04) and robotic TaTME (OR 3.05, 1.10–7.34, P=0.02) were associated with a higher risk of anastomotic leak than non-transanal laparoscopic TME. However this association was lost in the mixed-effects model controlling for patient and disease factors (OR 1.23, 0.77–1.97, P=0.39 and OR 2.11, 0.79–5.62, P=0.14 respectively), whilst low rectal anastomosis (OR 2.72, 1.55–4.77, P 
- Published
- 2018
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27. Evaluating the incidence of pathological complete response in current international rectal cancer practice: the barriers to widespread safe deferral of surgery
- Author
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Battersby, Nick, Glasbey, James C., Neary, Peter, Negoi, Ionut, Kamarajah, Sivesh, Sgro, Alessandro, Bhangu, Aneel, Pinkney, Thomas, Frasson, Matteo, El-Hussuna, Alaa, Battersby, Nick J., Buchs, Nicolas C., Buskens, Christianne, Chaudri, Sanjay, Gallo, Gaetano, Glasbey, James, Minaya-Bravo, Ana María, Morton, Dion, Nepogodiev, Dmitri, Pata, Francesco, Sánchez-Guillén, Luis, Singh, Baljit, Zmora, Oded, Perry, Rita, Magill, Laura, Altomare, Donato, Bemelman, Willem, Brown, Steven, Denost, Quentin, Knowles, Charles, Laurberg, Søren, Lefevre, Jérémie H., Möeslein, Gabriela, Pinkney, Tom, Vaizey, Carolynne, Bilali, S., Bilali, V., Salomon, M., Cillo, M., Estefania, D., Patron Uriburu, J., Ruiz, H., Farina, P., Carballo, F., Guckenheimer, S., Proud, D., Brouwer, R., Bui, A., Nguyen, B., Smart, P., Warwick, A., Theodore, J. 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C, Romero de Diego, A, Cordoba Diaz de Laspra, E, Echazarreta Gallego, E, Elia Guedea, M, Escola, D, Martinez, S, Primo Romaguera, V, Parreno, R, Pastor, L, Rosell, E, Lozoya Trujillo, R, Alos Company, R, Ruiz Carmona, M, Solana Bueno, A, Salvans Ruiz, S, Alonso Goncalves, S, Jimenez- Toscano, M, Pascual Damieta, M, Pera Roman, M, Pellicer-Franco, E, Garcia-Marin, J, Mengual-Ballester, M, Soria-Aledo, V, Valero-Navarro, G, Vicente-Ruiz, M, Garcia-Zamora, C, Gonzalez-Gil, A, Montoya-Tabares, M, Paredes-Quiles, M, Die Trill, J, Abadia, P, Moreno, I, Pina, J, Ramos Rubio, D, Escartin, J, Blas, J, Fernando, J, Ferrer, R, Garcia Egea, J, Pros, I, Martinez, W, Rius, J, Socias, M, Sabia, D, Castellvi Valls, J, Gonzalez Santin, V, Mompart Garcia, S, Viso Pons, L, Julia, D, Codina-Cazador, A, Farres, R, Gomez, N, Planellas, P, Cuadrado, M, Camps, I, Rufas, M, Escoll, J, Ferminan, A, Muriel, P, Sierra, E, Alvarez-Laso, C, Lora, P, Padin, H, Garcia-Septiem, J, Bustamante, C, Jimenez, V, 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Ochogavia Segui, A, Ibanez, N, Abrisqueta, J, Lujan, J, Gomez Perez, R, Corrales Valero, E, Monje Salazar, C, Sanchiz Cardenas, E, Soler Humanes, R, Jimenez-Rodriguez, R, De la Portilla, F, Diaz Pavon, J, Garcia Cabrera, A, Reyes Diaz, M, Espin, E, Marinello, F, Marti, M, Vallribera, F, Orts Mico, F, Ortin Navarro, M, Perez Climent, M, Serra Diaz, C, Millan, M, Caro, A, Escuder, J, Espina, B, Feliu, F, Climent Aira, A, Estevez Diz, A, Moreno Asencio, M, Varela Mato, A, Vazquez Bouzan, R, Diez-Alonso, M, Villeta-Plaza, R, Guadalajara, H, Alias, D, Garcia Olmo, D, Pastor, C, Valverde, I, Sanchez Romero, A, Gardea, A, Gil Santos, M, Nimmersgern, T, Serrano Paz, P, Romero-Simo, M, Blasco-Segura, T, Caravaca-Garcia, I, Costa-Navarro, D, Zarco-Pleguezuelos, A, Flor-Lorente, B, Garcia-Granero, A, Garcia-Granero, E, Arencibia, B, Alonso, J, Febles, G, Nogues, E, Roque, C, Segelman, J, Nygren, J, Nestler, G, Abraham-Nordling, M, Egenvall, M, Myrelid, P, Jung, B, Loftas, P, Lydrup, M, Azahr, N, 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Nageswaran, H, Taylor, G, Hunt, L, Nicholls, J, Shaikh, I, Muscara, F, O'Brien, J, Photi, E, Stearns, A, Meylemans, D, Cunningham, C, Hompes, R, Tennakoon, A, Kumarasinghe, N, Rao, M, Upanishad, I, Khan, J, Ahmad, N, Shweejawee, Z, Stefan, S, Smart, N, Daniels, I, Gregoir, T, Longstaff, L, Mcdermott, F, Varcada, M, Drami, I, Gala, T, Moggia, E, Ratnatunga, K, Harries, R, Hayes, J, Williams, G, Raymond, T, Bronder, C, Davies, E, Hawkin, P, Ryska, O, Ayral, K, Beveridge, A, Bhowmik, A, Gill, M, Simpson, R, Schofield, A, Mcardle, K, Parmar, M, Williamson, M, Burton, H, Courtney, E, Grant, C, Saracino, A, Newton, K, Epstein, J, Branagan, G, Bignell, M, Symankewicz, M, Zaman, S, Mankotia, R, Siddiqui, Z, Torrance, A, Artioukh, D, Eggleston, M, Gokul, K, Selwyn, D, Warusavitarne, J, Chandrasinghe, P, Grainger, J, Leo, C, Harris, G, Levy, B, Skull, A, Thaha, M, Garg, A, Patel, H, Ramsanahie, A, Mondragon-Pritchard, M, Cuinas Leon, K, Shukla, A, Brewer, H, Fitzgerald, J, Kho, H, Torkington, J, Tate, S, Wheat, J, Smolarek, S, Platt, E, Rossi, B, Tham, J, Knight, J, Richardson, J, Tzivanakis, A, Gregori, M, Ashraf, M, Atif, M, Santos, J, Saffaf, N, Canning, L, Chandratreya, N, Bowen, M, Graham, B, Hamad, Y, Kaubrys, M, Chaudhry, Z, Bhan, C, Mukhtar, H, Oshowo, A, Wilson, J, Gouvas, N, Nicol, D, Pandey, S, Zilvetti, M, Sharma, A, Fatayer, T, Mothe, S, Rahman, M, Curtis, N, Allison, A, Dalton, R, Francis, N, Ockrim, J, Psaras, G, Dudarovaska, H, Marharint, T, Mostovoy, E, Voloshin, S, Kolesnik, O, Makhmudov, D, Altinel, Y, Iqbal, A, Cunningham, L, Go, K, Tan, S, R. Tutino, G. Salamone, L. Licari, G. Cocorullo, and G. Gulotta
- Subjects
Male ,Colorectal cancer ,deferral of surgery ,neoadjuvant therapy ,pathology ,radiology ,rectal cancer ,Rectal surgery ,surgical oncology ,Gastroenterology ,0302 clinical medicine ,Prospective Studies ,Prospective cohort study ,Complete response ,Medical Audit ,integumentary system ,Incidence (epidemiology) ,Incidence ,Remission Induction ,Middle Aged ,Magnetic Resonance Imaging ,Europe ,Treatment Outcome ,Response Evaluation Criteria in Solid Tumors ,030220 oncology & carcinogenesis ,Preoperative Period ,030211 gastroenterology & hepatology ,Female ,Adult ,medicine.medical_specialty ,NO ,03 medical and health sciences ,medicine ,Humans ,Intensive care medicine ,Deferral ,Pathological ,Aged ,Neoplasm Staging ,ta3126 ,business.industry ,Rectal Neoplasms ,Reproducibility of Results ,Chemoradiotherapy, Adjuvant ,medicine.disease ,Rectal Neoplasms/diagnostic imaging ,Neoplasm Staging/methods ,business - Abstract
INTRODUCTION: The mainstay of management for locally advanced rectal cancer is chemoradiotherapy followed by surgical resection. Following chemoradiotherapy, a complete response may be detected clinically and radiologically (cCR) prior to surgery or pathologically after surgery (pCR). We aim to report the overall complete pathological response (pCR) rate and the reliability of detecting a cCR by conventional pre-operative imaging.METHODS: A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 audit was performed. Patients treated by elective rectal resection were included. A pCR was defined as a ypT0 N0 EMVI negative primary tumour; a partial response represented any regression from baseline staging following chemoradiotherapy. The primary endpoint was the pCR rate. The secondary endpoint was agreement between post-treatment MRI restaging (yMRI) and final pathological staging.RESULTS: Of 2572 patients undergoing rectal cancer surgery in 277 participating centres across 44 countries, 673 (26.2%) underwent chemoradiotherapy and surgery. The pCR rate was 10.3% (67/649), with a partial response in 35.9% (233/649) patients. Comparison of AJCC stage determined by post-treatment yMRI with final pathology showed understaging in 13% (55/429) and overstaging in 34% (148/429). Agreement between yMRI and final pathology for T-stage, N-stage, or AJCC status were each graded as 'fair' only (n = 429, Kappa 0.25, 0.26 and 0.35 respectively).CONCLUSION: The reported pCR rate of 10% highlights the potential for non-operative management in selected cases. The limited strength of agreement between basic conventional post-chemoradiotherapy imaging assessment techniques and pathology suggest alternative markers of response should be considered, in the context of controlled clinical trials.
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- 2018
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28. Local Therapy for Rectal Cancer: Still Controversial?
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Bretagnol, F., Rullier, E., George, B., Warren, B. F., and Mortensen, N. J.
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- 2007
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29. Is it safe to perform an anastomosis for rectal cancer after prostate cancer? A multicentre study of 126 patients from the GRECCAR group.
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Lakkis, Zaher, Doussot, Alexandre, Manfredelli, Simone, Vernerey, Dewi, Meillat, Hélène, Ouaissi, Mehdi, Cotte, Eddy, Faucheron, Jean‐Luc, Piessen, Guillaume, Tuech, Jean‐Jacques, Lefevre, Jérémie H., Panis, Yves, Beyer, Laura, Brouquet, Antoine, Dumont, Frédéric, Meurisse, Aurélia, Rullier, Eric, and Heyd, Bruno
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RECTAL cancer ,PROSTATE cancer ,PROSTATECTOMY ,SURGICAL anastomosis ,RECTAL surgery ,SURGICAL stomas - Abstract
Aim: To determine the safety of performing an anastomosis after rectal cancer (RC) resection in patients with a previously treated prostate cancer (PC). Methods: Patients with a previously treated PC who underwent rectal resection from 2008 to 2018 were retrospectively included. Outcomes were compared between patients who underwent rectal resection with anastomosis (restorative surgery, RS+ group) and those with a definitive stoma (RS− group). In the RS+ group, anastomotic leak (AL) rates were assessed according to the type of reconstruction. Results: A total of 126 patients underwent rectal surgery for mid‐low RC after a previous PC treated by radiotherapy (RT) and/or radical prostatectomy. Overall, 80 patients (63%) underwent a RS and 46 patients (37%) underwent rectal surgery with a definitive stoma. There was no statistical difference between the two groups in terms of intraoperative data, except for the type of resection with more multivisceral resection in the RS‐ group (p < 0.01). In the RS+group, a diverting stoma was performed in 74% of cases. No difference between the two groups in terms of overall morbidity was found. In the RS+group (n = 80), 17 patients (21%) experienced AL. Of these, none was observed when delayed coloanal anastomosis was performed (p = 0.16). Long‐term permanent stoma in the RS+ group was 16% (n = 13). Conclusion: Restorative surgery after resection for RC in patients with a previous history of RT and/or radical prostatectomy for PC is safe without additional morbidity. In selected patients for restorative surgery, performing delayed coloanal anastomosis may represent a promising option. [ABSTRACT FROM AUTHOR]
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- 2022
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30. Intersphincteric resection with excision of internal anal sphincter for conservative treatment of very low rectal cancer
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Rullier, Eric, Zerbib, Frank, Laurent, Christophe, Bonnel, Catherine, Caudry, Michel, Saric, Jean, and Parneix, Michel
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- 1999
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31. Total anorectal and partial vaginal reconstruction with dynamic graciloplasty and colonic vaginoplasty after extended abdominoperineal resection: Report of a case
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Rullier, Eric, McBride, Tarun, Zerbib, Frank, Caudry, Michel, and Saric, Jean
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- 1999
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32. The impact of conversion on the risk of major complication following laparoscopic colonic surgery: an international, multicentre prospective audit
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van der Pool, Anne, Rawlings, Alexandra, Sánchez-Guillén, Luis, Kuiper, Sara, Negoi, Ionut, Buchs, Nicolas, El-Hussuna, Alaa, Battersby, Nick J., Buchs, Nicolas C., Buskens, Christianne, Chaudri, Sanjay, Frasson, Matteo, Gallo, Gaetano, Minaya-Bravo, Ana María, Morton, Dion, Nepogodiev, Dmitri, Pata, Francesco, Singh, Baljit, Zmora, Oded, Perry, Rita, Magill, Laura, Altomare, Donato, Bemelman, Willem, Brown, Steven, Denost, Christianne Buskens Quentin, Knowles, Charles, Laurberg, Søren, Lefevre, Jérémie H., Möeslein, Gabriela, Pinkney, Tom, Vaizey, Carolynne, Bilali, S., Bilali, V., Salomon, M., Cillo, M., Estefania, D., Patron Uriburu, J., Ruiz, H., Farina, P., Carballo, F., Guckenheimer, S., Proud, D., Brouwer, R., Bui, A., Nguyen, B., Smart, P., Warwick, A., Theodore, J. E., Herbst, F., Birsan, T., Dauser, B., Ghaffari, S., Hartig, N., Stift, A., Argeny, S., Unger, L., Strouhal, R., Heuberger, A., Varabei, A., Lahodzich, N., Makhmudov, A., Selniahina, L., Feryn, T., Leupe, T., Maes, L., Reynvoet, E., Van Langenhove, K., Nachtergaele, M., Monami, B., Francart, D., Jehaes, C., Markiewicz, S., Weerts, J., Van Belle, K., Bomans, B., Cavenaile, V., Nijs, Y., Vertruyen, M., Pletinckx, P., Claeys, D., Defoort, B., Muysoms, F., Van Cleven, S., Lange, C., Vindevoghel, K., Wolthuis, A., Todorovic, M., Dabic, S., Kenjic, B., Lovric, S., Vidovic, J., Delibegovic, S., Mehmedovic, Z., Christiano, A., Lombardi, B., Marchiori, M., Tercioti, V., Dardanov, D., Petkov, P., Simonova, L., Yonkov, A., Zhivkov, E., Maslyankov, S., Pavlov, V., Sokolov, M., Todorov, G., Stoyanov, V., Batashki, I., Iarumov, N., Lozev, I., Moshev, B., Slavchev, M., Atanasov, B., Belev, N., Krstev, P., Penkov, R., Šantak, G., Ćosić, J., Previšić, A., Vukušić, L., Zukanović, G., Zelić, M., Kršul, D., Lekić Vitlov, V., Mendrila, D., Orhalmi, J., Dusek, T., Maly, O., Paral, J., Sotona, O., Skrovina, M., Bencurik, V., Machackova, M., Kala, Z., Farkašová, M., Grolich, T., Procházka, V., Hoch, J., Kocian, P., Martinek, L., Antos, F., Pruchova, V., El-Hussuna, A., Ceccotti, A., Madsbøll, T., Straarup, D., Uth Ovesen, A., Christensen, P., Bondeven, P., Edling, P., Elfeki, H., Alexandrovich Gameza, V., Michelsen Bach, S., Zheltiakova, I., Krarup, P. M., Krogh, A., Rolff, H. -C., Lykke, J., Juvik, A. F., Lóven, H. H. K., Marckmann, M., Osterkamp, J. T. F., Madsen, A. H., Worsøe, J., Ugianskis, A., Kjær, M. D., Youn Cho Lee, B., Khalid, A., Kristensen, M. H., El Sorogy, M., Elgeidie, A., Elhemaly, M., El Nakeeb, A., Elrefai, M., Shalaby, M., Emile, S., Omar, W., Sakr, A., Thabet, W., Awny, S., Metwally, I., Refky, B., Shams, N., Zuhdy, M., Lepistö, A., Keränen, I., Kivelä, A., Lehtonen, T., Siironen, P., Rautio, T., Ahonen-Siirtola, M., Klintrup, K., Paarnio, K., Takala, H., Hyöty, M., Haukijärvi, E., Kotaluoto, S. -M., Lehto, K., Tomminen, T., Huhtinen, H., Carpelan, A., Karvonen, J., Rantala, A., Varpe, P., Cotte, E., Francois, Y., Glehen, O., Passot, G., D'Alessandro, A., Chouillard, E., Etienne, J. C., Ghilles, E., Vinson-Bonnet, B., Germain, A., Ayav, A., Bresler, L., Chevalier, R., Denost, Q., Didailler, R., Rullier, E., Tiret, E., Chafai, N., Lefevre, J. H., Parc, Y., Sielezneff, I., Mege, D., Lakkis, Z., Barussaud, M., Krones, C., Bock, B., Webler, R., Baral, J., Lang, T., Münch, S., Pullig, F., Schön, M., Hinz, S., Becker, T., Möller, T., Richter, F., Schafmayer, C., Hardt, J., Kienle, P., Crescenti, F., Ahmad, M., Soleiman, Y., Papaconstantinou, I., Gklavas, A., Nastos, K., Theodosopoulos, T., Vezakis, A., Stamou, K., Saridaki, A., Xynos, E., Paraskakis, S., Zervakis, N., Skroubis, G., Amanatidis, T., Germanos, S., Maroulis, I., Papadopoulos, G., Dimitriou, N., Alexandrou, A., Felekouras, E., Griniatsos, J., Karavokyros, I., Papadopoulos, A., Chouliaras, C., Ioannidis, P., Katsounis, D., Kefalou, E., Katsoulis, I. E., Balalis, D., Korkolis, D. 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R., Dorot, S., Edden, Y., Halfteck, G., Reissman, P., Pery, R., Tulchinsky, H., Weizman, A., Agresta, F., Curinga, R., Finotti, E., Savino, G., Verza, L. A., Asteria, C. R., Boccia, L., Pascariello, A., Tamini, N., Bugatti, A., Gianotti, L., Totis, M., Vincenti, L., Andriola, V., Giannini, I., Travaglio, E., Balestri, R., Buccianti, P., Roffi, N., Rossi, E., Urbani, L., Mellano, A., Cinquegrana, A., Lauretta, A., Belluco, C., Mistrangelo, M., Allaix, M. 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G., Picarella, P., Porfidia, R., Tugnoli, G., Bondurri, A., Cavallo, D., Maffioli, A., Pertusati, A., Pulighe, F., Balestra, F., De Nisco, C., Podda, M., Opocher, E., Longhi, M., Mariani, N. M., Maroni, N., Pisani Ceretti, A., Galleano, R., Aonzo, P., Curletti, G., Reggiani, L., Marconi, M., Del Prete, L., Oldani, M., Pappalardo, R., Zaccone l, S., Scatizzi, M., Baraghini, M., Cantafio, S., Feroci, F., Giani, I., Tutino, R., Cocorullo, G., Gulotta, G., Licari, L., Salamone, G., Sileri, P., Saraceno, F., La Torre, F., Chirletti, P., Coletta, D., De Toma, G., Mingoli, A., Papandrea, M., De Luca, E., Sacco, R., Sammarco, G., Vescio, G., Tonini, V., Bianchini, S., Cervellera, M., Vaccari, S., Cracco, N., Barugola, G., Bertocchi, E., Rossini, R., Ruffo, G., Sartori, A., Clemente, N., De Luca, M., De Luca, A., Scaffidi, G., Lorenzon, L., Balducci, G., Bocchetti, T., Ferri, M., Mercantini, P., Pata, F., Bauce, S., Benevento, A., Bottini, C., Crapa, P. R., Rubbini, M., Anania, G., Carcoforo, P., Cavallesco, G., Feo, C., Yamamoto, T., Sivins, A., Ancans, G., Gerkis, S., Lunis, R., Pcolkins, A., Venskutonis, D., Bradulskis, S., Dainius, E., Subocius, A., Vencius, J., Zeromskas, P., Eismontas, V., Nutautiene, V., Simcikas, D., Tamosiunas, A., Svagzdys, S., Latkauskas, T., Lizdenis, P., Saladzinskas, Z., Tamelis, A., Dulskas, A., Kuliavas, J., Samalavicius, N. E., Poskus, T., Jotautas, V., Mikalauskas, S., Poskus, E., Strupas, K., Zakaria, A. D., Lah, N. N., Wong, M., Zain, W. Z., Zakaria, Z., Mazlan, L., Mohd Azman, Z. A., Sagap, I., Psaila, J., Andrejevic, P., Cini, C., Ellul, S., Pace, K., Ahallat, M., Hamid, M., Hrora, A., Majbar, M. A., Raiss, M., Westerduin, E., Bemelman, W., Buskens, C., Tanis, P., van der Sluis, P. C., Davids, P. H., Pronk, A., Schiphorst, A. H. W., Smakman, N., Zimmerman, D., Koeter, T., Stijns, J., van Loon, Y. -T., Vermaas, M., de Graaf, E., Doornebosch, P., van Hagen, P., van Ruler, O., Toorenvliet, B., Nonner, J., van den Berg, I., van Steensel, L., Vles, W., Melenhorst, J., Orsini, R., Visschers, R., Hoff, C., Blom, R., Marsman, H., Mulder, I., Cense, H., de Castro, S., Demirkiran, A., Hunfeld, M., van Geloven, A., de Groof, J., Hendriks, E., Leeuwenburg, M., van Oorschot, N., Wit, F., Rupert, C., Veldman, P., Keijzers, M., Konsten, J., Den Boer, F., Corver, M., Boerma, E. G., Koolen, L., Martens, M., Van Wijck, K., Ignjatovic, D., Breuer, R., Gurpreet, B., Oresland, T., Tetens Moe, T., Nesbakken, A., Flaaten Backe, I., Wik, T. -A., Radiya, K., Dehli, T., Gjessing, P., Norderval, S., Woll, K., Anwer, M., Qureshi, M. S., Qureshi, A. U., Billah, M., Jawad, M. 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Alonso-Hernandez, N, Fernandez Isart, M, Gamundi Cuesta, M, Ochogavia Segui, A, Ibanez, N, Abrisqueta, J, Lujan, J, Gomez Perez, R, Corrales Valero, E, Monje Salazar, C, Sanchiz Cardenas, E, Soler Humanes, R, Jimenez-Rodriguez, R, De la Portilla, F, Diaz Pavon, J, Garcia Cabrera, A, Reyes Diaz, M, Espin, E, Marinello, F, Marti, M, Vallribera, F, Orts Mico, F, Ortin Navarro, M, Perez Climent, M, Serra Diaz, C, Millan, M, Caro, A, Escuder, J, Espina, B, Feliu, F, Climent Aira, A, Estevez Diz, A, Moreno Asencio, M, Varela Mato, A, Vazquez Bouzan, R, Diez-Alonso, M, Villeta-Plaza, R, Guadalajara, H, Alias, D, Garcia Olmo, D, Pastor, C, Valverde, I, Sanchez Romero, A, Gardea, A, Gil Santos, M, Nimmersgern, T, Serrano Paz, P, Romero-Simo, M, Blasco-Segura, T, Caravaca-Garcia, I, Costa-Navarro, D, Zarco-Pleguezuelos, A, Flor-Lorente, B, Garcia-Granero, A, Garcia-Granero, E, Arencibia, B, Alonso, J, Febles, G, Nogues, E, Roque, C, Segelman, J, Nygren, J, Nestler, G, Abraham-Nordling, M, 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P, Zammit, M, Arnold, S, Broadhurst, J, Moran, S, Seretis, F, Shabbir, J, Jones, C, Kynaston, J, Vimalachandran, D, Blower, E, Mcfaul, C, Mcwhirter, D, Pilkington, J, Wilson, T, Chowdhary, M, Stubbs, B, Abdalkoddus, M, Lai, C, Thavanesan, N, Yao, C, Agarwal, T, Dindyal, S, Hill, R, Reade, S, Slesser, A, Paterson, H, Balfour, A, Boland, M, Geraghty, A, O'Kelly, J, Patel, P, Tezas, S, Yahia, S, Jadhav, V, Marimuthu, K, Narayanan, A, Piramanayagam, B, Bradley, N, Buchanan, F, Paul, K, Singh, J, Thomson, K, Korsgen, S, Bedford, M, Lee, K, Leong, K, Mcarthur, D, Malik, S, Mohamed, I, Cunha, P, Pilavas, A, Reddy, A, Ahmed, S, Ahmed, A, Voll, J, Velchuru, V, Lal, R, Mirshekar-Syahkal, B, Kassai, M, Aleem, M, Keogh-Bootland, S, Sarmah, P, Keegan, R, Kelkar, A, Sen, P, Oliveira-Cunha, M, Chaudhri, S, Fares, R, Thomas, W, Aslam, M, Boyle, K, Hemingway, D, Miller, A, Norwood, M, Gurjar, S, Al-Saeedi, M, Anandan, L, Sudlow, A, Zampitis, N, Malik, K, Bogdan, M, Smart, C, Iqbal, M, Bailey, S, Lawes, D, Omar, G, Tamhane, R, Evans, M, Ather, S, Lim, J, Nageswaran, H, Taylor, G, Hunt, L, Nicholls, J, Shaikh, I, Muscara, F, O'Brien, J, Photi, E, Stearns, A, Meylemans, D, Cunningham, C, Hompes, R, Tennakoon, A, Kumarasinghe, N, Rao, M, Upanishad, I, Khan, J, Ahmad, N, Shweejawee, Z, Stefan, S, Smart, N, Daniels, I, Gregoir, T, Longstaff, L, Mcdermott, F, Varcada, M, Drami, I, Gala, T, Moggia, E, Ratnatunga, K, Harries, R, Hayes, J, Williams, G, Raymond, T, Bronder, C, Davies, E, Hawkin, P, Ryska, O, Ayral, K, Beveridge, A, Bhowmik, A, Gill, M, Simpson, R, Schofield, A, Mcardle, K, Parmar, M, Williamson, M, Burton, H, Courtney, E, Grant, C, Saracino, A, Newton, K, Epstein, J, Branagan, G, Bignell, M, Symankewicz, M, Zaman, S, Mankotia, R, Siddiqui, Z, Torrance, A, Artioukh, D, Eggleston, M, Gokul, K, Selwyn, D, Warusavitarne, J, Chandrasinghe, P, Grainger, J, Leo, C, Harris, G, Levy, B, Skull, A, Thaha, M, Garg, A, Patel, H, Ramsanahie, A, Mondragon-Pritchard, M, Cuinas Leon, K, Shukla, A, Brewer, H, Fitzgerald, J, Kho, H, Torkington, J, Tate, S, Wheat, J, Smolarek, S, Platt, E, Rossi, B, Tham, J, Knight, J, Richardson, J, Tzivanakis, A, Gregori, M, Ashraf, M, Atif, M, Santos, J, Saffaf, N, Canning, L, Chandratreya, N, Bowen, M, Graham, B, Hamad, Y, Kaubrys, M, Chaudhry, Z, Bhan, C, Mukhtar, H, Oshowo, A, Wilson, J, Gouvas, N, Nicol, D, Pandey, S, Zilvetti, M, Sharma, A, Fatayer, T, Mothe, S, Rahman, M, Curtis, N, Allison, A, Dalton, R, Francis, N, Ockrim, J, Psaras, G, Dudarovaska, H, Marharint, T, Mostovoy, E, Voloshin, S, Kolesnik, O, Makhmudov, D, Altinel, Y, Iqbal, A, Cunningham, L, Go, K, Tan, S, R. Tutino, G. Salamone, L. Licari, G. Cocorullo, G. Gulotta, AGEM - Digestive immunity, Surgery, AGEM - Re-generation and cancer of the digestive system, CCA - Cancer Treatment and Quality of Life, RS: NUTRIM - R2 - Liver and digestive health, and 2017 and 2015 European Society of Coloproctology (ESCP) collaborating, Group
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Laparoscopic surgery ,Male ,Colorectal cancer ,medicine.medical_treatment ,surgery ,0302 clinical medicine ,Postoperative Complications ,Medicine ,Major complication ,Prospective Studies ,Laparoscopy ,SHORT-TERM OUTCOMES ,Colectomy ,Medical Audit ,medicine.diagnostic_test ,Prospective audit ,Gastroenterology ,Middle Aged ,laparoscopic surgery ,Conversion to Open Surgery ,Colon cancer ,Treatment Outcome ,Elective Surgical Procedures ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,Colonic surgery ,Adult ,medicine.medical_specialty ,CLINICAL-TRIAL ,NO ,OPEN COLECTOMY ,03 medical and health sciences ,COLORECTAL SURGERY ,Case mix index ,gastrointestinal surgery ,Humans ,rectal cancer ,RECTAL-CANCER ,Aged ,ta3126 ,business.industry ,Elective resection ,medicine.disease ,RANDOMIZED-TRIAL ,OPEN RESECTION ,Surgery ,business - Abstract
BACKGROUND: Laparoscopy has now been implemented as a standard of care for elective colonic resection around the world. During the adoption period, studies showed that conversion may be detrimental to patients, with poorer outcomes than both laparoscopic completed or planned open surgery. The primary aim of this study was to determine whether laparoscopic conversion was associated with a higher major complication rate than planned open surgery in contemporary, international practice.METHODS: Combined analysis of the European Society of Coloproctology 2017 and 2015 audits. Patients were included if they underwent elective resection of a colonic segment from the caecum to the rectosigmoid junction with primary anastomosis. The primary outcome measure was the 30-day major complication rate, defined as Clavien-Dindo grade III-V.RESULTS: Of 3980 patients, 64% (2561/3980) underwent laparoscopic surgery and a laparoscopic conversion rate of 14% (359/2561). The major complication rate was highest after open surgery (laparoscopic 7.4%, converted 9.7%, open 11.6%, P < 0.001). After case mix adjustment in a multilevel model, only planned open (and not laparoscopic converted) surgery was associated with increased major complications in comparison to laparoscopic surgery (OR 1.64, 1.27-2.11, P < 0.001).CONCLUSIONS: Appropriate laparoscopic conversion should not be considered a treatment failure in modern practice. Conversion does not appear to place patients at increased risk of complications vs planned open surgery, supporting broadening of selection criteria for attempted laparoscopy in elective colonic resection.
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- 2018
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33. Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit
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Gallego, E, Elia Guedea, M, Escola, D, Martinez, S, Primo Romaguera, V, Parreno, R, Pastor, L, Rosell, E, Lozoya Trujillo, R, Alos Company, R, Ruiz Carmona, M, Solana Bueno, A, Salvans Ruiz, S, Alonso Goncalves, S, Jimenez-Toscano, M, Pascual Damieta, M, Pera Roman, M, Pellicer-Franco, E, Garcia-Marin, J, Mengual-Ballester, M, Soria-Aledo, V, Valero-Navarro, G, Vicente-Ruiz, M, Garcia-Zamora, C, Gonzalez-Gil, A, Montoya-Tabares, M, Paredes-Quiles, M, Die Trill, J, Abadia, P, Moreno, I, Pina, J, Ramos Rubio, D, Escartin, J, Blas, J, Fernando, J, Ferrer, R, Garcia Egea, J, Pros, I, Martinez, W, Rius, J, Socias, M, Sabia, D, Castellvi Valls, J, Gonzalez Santin, V, Mompart Garcia, S, Viso Pons, L, Julia, D, Codina-Cazador, A, Farres, R, Gomez, N, Planellas, P, Cuadrado, M, Camps, I, Rufas, M, Escoll, J, Ferminan, A, Muriel, P, Sierra, E, Alvarez-Laso, C, Lora, P, Padin, H, Garcia-Septiem, J, Bustamante, C, Jimenez, V, Jimenez-Miramon, J, Ramos, J, Gallardo, A, Benito, P, Colao, L, Galindo, P, Garcia, C, Forero-Torres, A, Alonso Poza, A, Dieguez Fernandez, B, Gilsanz Martin, C, Hernandez Garcia, M, Rojo Lopez, J, Gil Lopez, J, Gonzalez Zunzarren, M, Martinez Alegre, J, Zorrilla Matilla, J, Navarro-Sanchez, A, Alcala Serrano, F, Lopez-Fernandez, J, Montesdeoca Cabrera, D, Alvarez-Gallego, M, Guevara, J, Pascual Miguelanez, I, Rubio-Perez, I, Gomez Ruiz, M, Alonso Martin, J, Cagigas Fernandez, C, Castillo Diego, J, Pando, J, Maristany, C, Munoz-Duyos, A, Rada-Palomino, A, Vargas-Pierola, H, Pena Ros, E, Benavides Buleje, J, Munoz Camarena, J, Parra Banos, P, Ramirez Faraco, M, Arenal, J, Citores, M, Marcos, J, Sanchez, J, Tinoco, C, Garcia Florez, L, Arias Pacheco, R, Minguez Ruiz, G, Rodriguez Corral, N, Rodriguez Infante, A, Carrillo Lopez, M, Carrasco Prats, M, Lage Laredo, A, Martinez Manzano, A, Rodriguez Garcia, P, Segura-Sampedro, J, Alonso-Hernandez, N, Fernandez Isart, M, Gamundi Cuesta, M, Ochogavia Segui, A, Ibanez, N, Abrisqueta, J, Lujan, J, Gomez Perez, R, Corrales Valero, E, Monje Salazar, C, Sanchiz Cardenas, E, Soler Humanes, R, Jimenez-Rodriguez, R, De la Portilla, F, Diaz Pavon, J, Garcia Cabrera, A, Reyes Diaz, M, Espin, E, Marinello, F, Marti, M, Vallribera, F, Orts Mico, F, Ortin Navarro, M, Perez Climent, M, Serra Diaz, C, Millan, M, Caro, A, Escuder, J, Espina, B, Feliu, F, Climent Aira, A, Estevez Diz, A, Moreno Asencio, M, Varela Mato, A, Vazquez Bouzan, R, Minaya-Bravo, A, Diez-Alonso, M, Villeta-Plaza, R, Guadalajara, H, Alias, D, Garcia Olmo, D, Pastor, C, Valverde, I, Sanchez Romero, A, Gardea, A, Gil Santos, M, Nimmersgern, T, Serrano Paz, P, Romero-Simo, M, Blasco-Segura, T, Caravaca-Garcia, I, Costa-Navarro, D, Zarco-Pleguezuelos, A, Flor-Lorente, B, Garcia-Granero, A, Garcia-Granero, E, Arencibia, B, Alonso, J, Febles, G, Nogues, E, Roque, C, Segelman, J, Nygren, J, Nestler, G, Abraham-Nordling, M, Egenvall, M, Myrelid, P, Jung, B, Loftas, P, Lydrup, M, Azahr, N, Buchwald, P, Mangell, P, Syk, I, Nikberg, M, Carlander, J, Chabok, A, Smedh, K, Tiselius, C, Haapaniemi, S, Benckert, A, Adamina, M, Freil-Lanter, C, Gingert, C, Muller, P, Schafli, J, Regusci, L, Brenna, M, Fasolini, F, Misteli, H, Kirchhoff, P, Oertli, D, Hahnloser, D, Clerc, D, Hubner, M, Ris, F, Chevallay, M, Morel, P, Schiltz, B, Wang, J, Su, W, Huang, C, Ma, C, Tsai, H, Ozbalci, G, Ozkan, B, Karabacak, U, Bugra, D, Agalar, F, Baloglu, H, Basoglu, I, Okkabaz, N, Binboga, E, Biricik, A, Celik, A, Yavuz, E, Canda, A, Agalar, C, Fuzun, M, Sokmen, S, Terzi, C, Isik, A, Karip, B, Bilgili, A, Leventoglu, S, Aytac, B, Yildiz, A, Yuksel, O, Sinan, H, Hancerliogullari, O, Kaymak, S, Kozak, O, Ozer, M, Sarici, I, Akca, O, Kalayci, M, Kara, Y, Agcaoglu, O, Balik, E, Bayram, O, Sungurtekin, U, Ozgen, U, Demirbas, S, Ozturk, E, Isik, O, Yilmazlar, T, Colak, E, Karagul, S, Kinas, V, Fearnhead, N, Lord, I, Stewart, P, Zammit, M, Arnold, S, Battersby, N, Broadhurst, J, Mehta, A, Seretis, F, Shabbir, J, Jones, C, Kynaston, J, Vimalachandran, D, Blower, E, Mcfaul, C, Mcwhirter, D, Pilkington, J, Wilson, T, Chowdhary, M, Stubbs, B, Abdalkoddus, M, Lai, C, Thavanesan, N, Yao, C, Agarwal, T, Dindyal, S, Hill, R, Reade, S, Slesser, A, Paterson, H, Balfour, A, Boland, M, Geraghty, A, O'Kelly, J, Patel, P, Tezas, S, Yahia, S, Jadhav, V, Marimuthu, K, Narayanan, A, Piramanayagam, B, Bradley, N, Buchanan, F, Paul, K, Singh, J, Thomson, K, Korsgen, S, Bedford, M, Lee, K, Leong, K, Mcarthur, D, Malik, S, Mohamed, I, Cunha, P, Pilavas, A, Reddy, A, Ahmed, S, Ahmed, A, Voll, J, Velchuru, V, Lal, R, Mirshekar-Syahkal, B, Kassai, M, Aleem, M, Keogh-Bootland, S, Sarmah, P, Keegan, R, Kelkar, A, Sen, P, Oliveira-Cunha, M, Chaudhri, S, Fares, R, Thomas, W, Aslam, M, Boyle, K, Hemingway, D, Miller, A, Norwood, M, Gurjar, S, Al-Saeedi, M, Anandan, L, Sudlow, A, Zampitis, N, Malik, K, Bogdan, M, Smart, C, Iqbal, M, Bailey, S, Lawes, D, Omar, G, Tamhane, R, Evans, M, Ather, S, Lim, J, Nageswaran, H, Taylor, G, Hunt, L, Nicholls, J, Shaikh, I, Muscara, F, 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J, Richardson, J, Tzivanakis, A, Gregori, M, Ashraf, M, Atif, M, Santos, J, Saffaf, N, Canning, L, Chandratreya, N, Bowen, M, Graham, B, Hamad, Y, Kaubrys, M, Chaudhry, Z, Bhan, C, Mukhtar, H, Oshowo, A, Wilson, J, Gouvas, N, Nicol, D, Pandey, S, Zilvetti, M, Sharma, A, Fatayer, T, Mothe, S, Rahman, M, Curtis, N, Allison, A, Dalton, R, Francis, N, Ockrim, J, Psaras, G, Dudarovaska, H, Marharint, T, Mostovoy, E, Voloshin, S, Kolesnik, O, Makhmudov, D, Altinel, Y, Iqbal, A, Cunningham, L, Go, K, Tan, S, Surgery, R. Tutino, G. Salamone, L. Licari, G. Cocorullo, G. Gulotta, European Society of Coloproctology (ESCP) Cohort Studie, and Tonini V, Cervellera M, Vaccari S
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Male ,Medical audit ,Treatment outcome ,anastomotic leak ,030230 surgery ,0302 clinical medicine ,Postoperative Complications ,Prospective Studies ,Multi centre ,emergency surgery ,Prospective cohort study ,Colectomy ,Medical Audit ,Proctectomy ,Proctectomy/adverse effects ,Prospective audit ,Primary anastomosis ,Anastomosis, Surgical ,Gastroenterology ,Middle Aged ,surgical complications ,Europe ,Treatment Outcome ,colon cancer ,gastrointestinal surgery ,rectal cancer ,Surgery ,surgical outcomes ,030220 oncology & carcinogenesis ,Postoperative Complications/etiology ,Female ,Colectomy/adverse effects ,Emergency Treatment/adverse effects ,Adult ,medicine.medical_specialty ,Adolescent ,surgical outcome ,Left sided ,NO ,03 medical and health sciences ,Young Adult ,surgical complication ,medicine ,Humans ,Emergency Treatment ,Colorectal resection ,Aged ,ta3126 ,Anastomosis, Surgical/methods ,business.industry ,General surgery ,Surgical Stomas ,Surgical Stomas/statistics & numerical data ,Settore MED/18 - Chirurgia Generale ,Multivariate Analysis ,business - Abstract
Introduction: Some evidence suggests that primary anastomosis following left sided colorectal resection in the emergency setting may be safe in selected patients, and confer favourable outcomes to permanent enterostomy. The aim of this study was to compare the major postoperative complication rate in patients undergoing end stoma vs primary anastomosis following emergency left sided colorectal resection. Methods: A pre-planned analysis of the European Society of Coloproctology 2017 audit. Adult patients (>16years) who underwent emergency (unplanned, within 24h of hospital admission) left sided colonic or rectal resection were included. The primary endpoint was the 30-day major complication rate (Clavien-Dindo grade 3 to 5). Results: From 591 patients, 455 (77%) received an end stoma, 103 a primary anastomosis (17%) and 33 primary anastomosis with defunctioning stoma (6%). In multivariable models, anastomosis was associated with a similar major complication rate to end stoma (adjusted odds ratio for end stoma 1.52, 95%CI 0.83–2.79, P=0.173). Although a defunctioning stoma was not associated with reduced anastomotic leak (12% defunctioned [4/33] vs 13% not defunctioned [13/97], adjusted odds ratio 2.19, 95%CI 0.43–11.02, P=0.343), it was associated with less severe complications (75% [3/4] with defunctioning stoma, 86.7% anastomosis only [13/15]), a lower mortality rate (0% [0/4] vs 20% [3/15]), and fewer reoperations (50% [2/4] vs 73% [11/15]) when a leak did occur. Conclusions: Primary anastomosis in selected patients appears safe after left sided emergency colorectal resection. A defunctioning stoma might mitigate against risk of subsequent complications.
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- 2018
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34. Intersphincteric resection for low rectal cancer: the risk is functional rather than oncological. A 25‐year experience from Bordeaux.
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Denost, Q., Moreau, J.‐B., Vendrely, V., Celerier, B., Rullier, A., Assenat, V., and Rullier, E.
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RECTAL cancer ,RECTAL surgery ,ANUS ,ABDOMINOPERINEAL resection ,ONCOLOGIC surgery ,TREATMENT programs ,PROGRESSION-free survival - Abstract
Aim: There are few data evaluating the long‐term outcomes of intersphincteric resection (ISR), especially the impact of inclusion of more juxtapositioned and intra‐anal tumours on oncological and functional outcomes. We compared the oncological and functional results of patients treated by total mesorectal excision and ISR for low rectal cancer over a 25‐year period. Method: This is a retrospective study from a single institution evaluating results of ISR over three periods: 1990–1998, 1999–2006 and 2007–2014. Patients treated by partial or total ISR, with or without neoadjuvant chemoradiotherapy, for low rectal cancer (≤ 6 cm from the anal verge) were included. We compared postoperative morbidity, quality of surgery and oncological and functional outcomes in the time periods studied. Results: Of 813 patients operated on for low rectal cancer, 303 had ISR. Tumour stage did not differ; however, the distance of the tumour from the anorectal junction decreased from 1 to 0 cm (P < 0.001) and the distal resection margin shortened from 25 to 10 mm (P < 0.001) from 1990 to 2014. The postoperative morbidity and quality of surgery did not change significantly over time. The 5‐year local recurrence (4.3% vs 5.9% vs 3.5%; P = 0.741) and disease‐free survival (72% vs 71% vs 75%; P = 0.918) did not differ between the three time periods. Functional results improved during the last period; however, overall 42% of patients experienced major bowel dysfunction. Conclusion: Pushing the envelope of sphincter‐saving resection in ultra‐low rectal cancer reaching or invading the anal sphincter did not compromise oncological and functional outcomes. The main limitation of the ISR procedure appears to be functional rather than oncological, suggesting that bowel rehabilitation programmes should be developed. [ABSTRACT FROM AUTHOR]
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- 2020
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35. National multicentric evaluation of quality of pathology reports for rectal cancer in France in 2016
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Anne Rullier, Céline Bazille, M. Desrousseaux, A. Daubech, Catherine Julie, F. Thélu, F. Le Pessot, B. Turlin, S. Stanislas, M.-S. Bordier, Armelle Bardier, C. Boutanos, Marie-Hélène Laverriere, R.-P. Eyremandi, A. Rousseau, T. Lazure, Janick Selves, Frédéric Bibeau, Nathalie Guedj, Magali Svrcek, M. Capdepont, Flora Poizat, B. Bonhomme, A. Demoures, Service de pathologie [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service de Pathologie [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), Pathologie Nord Unilabs, Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Service de Pathologie [Rennes] = Pathology [Rennes], CHU Pontchaillou [Rennes], Service d'Anatomie et cytologie pathologiques = Service de Pathologie [CHU Pitié-Salpêtrière] (ACP), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Pathologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Institut Bergonié [Bordeaux], UNICANCER, CHU Grenoble, Service de pathologie [CHU Ambroise Paré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Centre hospitalier de Pau, Département de Pathologie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Hôpital Bicêtre, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Centre Hospitalier Libourne, Hopital de Périgueux, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Service de pathologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)
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Male ,0301 basic medicine ,Pathology ,medicine.medical_specialty ,Colorectal cancer ,medicine.medical_treatment ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Routine practice ,Pathology and Forensic Medicine ,03 medical and health sciences ,Quality report ,0302 clinical medicine ,Pathology report ,medicine ,Rectal Adenocarcinoma ,Humans ,Venous Invasion ,Rectal cancer ,Molecular Biology ,Aged ,Neoplasm Staging ,Rectal Neoplasms ,business.industry ,Chemoradiotherapy ,Cell Biology ,General Medicine ,Pathology Report ,Middle Aged ,medicine.disease ,Neoadjuvant Therapy ,3. Good health ,Radiation therapy ,Treatment Outcome ,030104 developmental biology ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Concomitant ,Neoadjuvant radiochemotherapy ,Lymph Node Excision ,Female ,Radiotherapy, Adjuvant ,France ,Lymph Nodes ,business - Abstract
International audience; The quality of pathologic assessment of rectal cancer specimens is crucial for treatment efficiency and survival. The Royal College of Pathologists (RCP) recommends evaluating the quality of the pathology report in routine practice using three quality indicators (QIs): the number of lymph nodes (LNs) analyzed (≥ 12), the rate of venous invasion (VI ≥ 30%), and peritoneal involvement (pT4a ≥ 10%). In this study, we evaluated the three QIs of the French national pathology reports and compared them with British guidelines and assessed the influence of neoadjuvant radiochemotherapy on QIs. From January 1 to December 31, 2016, all pathology reports for rectal adenocarcinoma were collected from French departments. Neoadjuvant radiochemotherapy included long-course radiotherapy with concomitant 5-FU-based chemotherapy. A total of 983 rectal cancer pathology reports were evaluated. A median of 15 LNs were analyzed and 81% of centers had ≥ 12 LNs. The rate of VI was 30% and 41% of centers had ≥ 30% VI. The rate of pT4a was 4% and 18% of centers reported ≥ 10% pT4a. None of the centers reached the threshold for the three QIs. All three QIs were lower after radiochemotherapy compared to surgery alone. In conclusion, in French routine practice, the values of two of the three QIs (LNs analyzed and VI) were globally in line with RCP guidelines. However, the rate of pT4a was very low, particularly after radiochemotherapy, suggesting its low value in rectal cancer.
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- 2019
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36. A novel bowel rehabilitation programme after total mesorectal excision for rectal cancer: the BOREAL pilot study.
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Harji, Deena, Fernandez, Benjamin, Boissieras, Lara, Berger, Arthur, Capdepont, Maylis, Zerbib, Frank, Rullier, Eric, and Denost, Quentin
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RECTAL cancer ,TREATMENT programs ,RECTAL surgery ,ONCOLOGIC surgery ,FECAL incontinence ,PILOT projects ,SACRAL nerves - Abstract
Aim: Low anterior resection syndrome (LARS) following sphincter‐preserving surgery for rectal cancer has a high prevalence, with an impact on long‐term bowel dysfunction and quality of life. We designed the bowel rehabilitation programme (BOREAL) as a proactive strategy to assess and treat patients with LARS. The BOREAL programme consists of a stepwise approach of escalating treatments: medical management (steps 0–1), pelvic floor physiotherapy, biofeedback and transanal irrigation (step 2), sacral nerve neuromodulation (step 3), percutaneous endoscopic caecostomy and anterograde enema (step 4) and definitive colostomy (step 5). Methods: A pilot study was undertaken to assess the feasibility of collecting LARS data routinely with the parallel implementation of the BOREAL programme. All patients who underwent total mesorectal excision for rectal cancer between February 2017 and March 2019 were included. LARS was assessed using the LARS score and the Wexner Faecal Incontinence score at 30 days and 3, 6, 9 and 12 months postoperatively. A good functional result was considered to be a combined LARS score <20 and/or a Wexner score <4. Results: In all, 137 patients were included. Overall compliance with the BOREAL programme was 72.9%. Major LARS decreased from 48% at 30 days postoperatively to 12% at 12 months, with a concomitant improvement in overall good function from 33% to 77%, P < 0.001. The majority of patients (n = 106, 77%) required medical management of their LARS. Conclusion: The BOREAL programme demonstrates the acceptability, feasibility and effectiveness of implementing a responsive, stepwise programme for detecting and treating LARS. [ABSTRACT FROM AUTHOR]
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- 2021
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37. Local Recurrence After Transanal Total Mesorectal Excision for Rectal Cancer: A Multicenter Cohort Study.
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Roodbeen, Sapho Xenia, Spinelli, Antonino, Bemelman, Willem A., Di Candido, Francesca, Cardepont, Maylis, Denost, Quentin, D'Hoore, Andre, Houben, Bert, Knol, Joep J., Martín-Pérez, Beatriz, Rullier, Eric, Sands, Dana, Setton, Ilana, Van de Steen, Katrien, Tanis, Pieter J., Wexner, Steven D., Hompes, Roel, and Wolthuis, Albert M.
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Objective: This study aimed to determine local recurrence (LR) rate and pattern after transanal total mesorectal excision (TaTME) for rectal cancer. Background: TaTME for mid- and low rectal cancer has known a rapid and worldwide adoption. Recently, concerns have been raised on the oncological safety in light of reported high LR rates with a multifocal pattern. Methods: This was a multicenter observational cohort study in 6 tertiary referral centers. All consecutive TaTME cases for primary rectal adenocarcinoma from the first TaTME case in every center until December 2018 were included for analysis. Patients with benign tumors, malignancies other than adenocarcinoma and recurrent rectal cancer, as well as exenterative procedures, were excluded. The primary endpoint was 2-year LR rate. Secondary endpoints included patterns and treatment of LR and histopathological characteristics of the primary surgery. Results: A total of 767 patients were identified and eligible for analysis. Resection margins were involved in 8% and optimal pathological outcome (clear margins, (nearly) complete specimen, no perforation) was achieved in 86% of patients. After a median follow-up of 25.5 months, 24 patients developed LR, with an actuarial cumulative 2-year LR rate of 3% (95% CI 2-5). In none of the patients, a multifocal pattern of LR was observed. Thirteen patients had isolated LR (without systemic disease) and 10/13 could be managed by salvage surgery of whom 8 were disease-free at the end of follow-up. Conclusions and relevance: This study shows good loco regional control after TaTME in selected cases from tertiary referral centers and does not indicate an inherent oncological risk of the surgical technique. [ABSTRACT FROM AUTHOR]
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- 2021
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38. Impact of early biochemical diagnosis of anastomotic leakage after rectal cancer surgery: long-term results from GRECCAR 5 trial.
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Denost, Q., Rouanet, P., Faucheron, J.-L., Panis, Y., Meunier, B., Cotte, E., Meurette, G., Portier, G., Sabbagh, C., Loriau, J., Benoist, S., Piessen, G., Sielezneff, I., Lelong, B., Mauvais, F., Romain, B., Barussaud, M.-L., Capdepont, M., Laurent, C., and Rullier, E.
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ONCOLOGIC surgery ,RECTAL cancer ,EARLY diagnosis ,RECTAL surgery ,LEAKAGE - Published
- 2021
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39. Sphincter-saving surgery after neoadjuvant therapy for ultra-low rectal cancer where abdominoperineal resection was indicated: 10-year results of the GRECCAR 1 trial.
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Rouanet, P., Rivoire, M., Gourgou, S., Lelong, B., Rullier, E., Jafari, M., Mineur, L., Pocard, M., Faucheron, J. L., Dravet, F., Pezet, D., Fabre, J. M., Bresler, L., Balosso, J., and Lemanski, C.
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RECTAL cancer ,ABDOMINOPERINEAL resection ,ONCOLOGIC surgery ,SURGERY - Published
- 2021
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40. International variation in managing locally advanced or recurrent rectal cancer: prospective benchmark analysis.
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Denost, Q., Solomon, M., Tuech, J.‐J., Ghouti, L., Cotte, E., Panis, Y., Lelong, B., Rouanet, P., Faucheron, J.‐L., Jafari, M., Lefevre, J. H., Rullier, E., Heriot, A., Austin, K., Lee, P., Brown, W., Maillou‐Martinaud, H., Savel, H., Quintard, B., and Broc, G.
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RECTAL cancer ,SURGICAL excision ,PELVIC exenteration ,INTRAOPERATIVE radiotherapy ,RECTAL surgery ,MAGNETIC resonance imaging ,PSYCHOSOCIAL factors - Abstract
Copyright of British Journal of Surgery is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2020
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41. Delayed coloanal anastomosis: an alternative option for restorative rectal cancer surgery after high‐dose pelvic radiotherapy for prostate cancer.
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François, M.‐O., Buscail, E., Vendrely, V., Célérier, B., Assénat, V., Moreau, J.‐B., Rullier, E., and Denost, Q.
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RECTAL cancer ,PROSTATE cancer ,RECTAL surgery ,ONCOLOGIC surgery ,CANCER radiotherapy ,CHEMORADIOTHERAPY ,SEPSIS - Abstract
Aim: Restorative total mesorectal excision (TME) for rectal cancer after high‐dose pelvic radiotherapy for prostate cancer has been reported to provide an unacceptable rate of pelvic sepsis. In a previous publication we proposed that delayed coloanal anastomosis (DCAA) should be performed in this situation. The present study aimed to assess the feasibility and outcomes of this strategy. Method: Between 2000 and 2018, 1094 men were operated on for rectal cancer in our institution. All men with T2/T3 mid and low rectal cancer with preoperative radiotherapy and restorative TME were considered for this study (n = 416). Patients with external‐beam high‐dose radiotherapy (EBHRT) for prostate cancer (70–78 Gy) were identified and compared with patients with conventional long‐course chemoradiotherapy (CRT) followed by TME. We compared our already published historical cohort (2000–2012), including arm A (CRT + TME; n = 236) and arm B (EBHRT + TME; n = 12), with our early cohort (2013–2018), including arm C (CRT + TME; n = 158) and arm D (EBHRT + TME‐DCAA; n = 10). The end‐points were morbidity, pelvic sepsis, reoperation rate and quality of the specimen. Results: Overall morbidity was not significantly different between groups. Pelvic sepsis decreased from 50% (arm B) to 10% (arm D) with the use of DCAA (P = 0.074), and was similar between arms A, C and D. Quality of the specimen was not significantly different between the four groups. Conclusion: Our results suggest that TME with DCAA in patients with previous EBHRT is feasible, with the same postoperative pelvic sepsis rate as conventional CRT. [ABSTRACT FROM AUTHOR]
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- 2020
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42. Early MRI predictors of disease‐free survival in locally advanced rectal cancer from the GRECCAR 4 trial.
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Nougaret, S., Castan, F., Forges, H., Vargas, H. A., Gallix, B., Gourgou, S., Rouanet, P., Rullier, E., Lelong, B., Maingon, P., Tuech, J.‐J., Pezet, D., Rivoire, M., Meunier, B., Loriau, J., Valverde, A., Fabre, J.‐M., Prudhomme, M., Cotte, E., and Portier, G.
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PROGRESSION-free survival ,RECTAL cancer ,ONCOLOGY ,TUMORS ,SPHINCTERS ,VOLUME (Cubic content) - Abstract
Copyright of British Journal of Surgery is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2019
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43. Morbidity and oncological outcomes of rectal cancer impaired by previous prostate malignancy.
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Lakkis, Z., Vernerey, D., Mege, D., Faucheron, J.‐L., Panis, Y., Tuech, J.‐J., Lefevre, J. H., Brouquet, A., Dumont, F., Borg, C., Woronoff, A.‐S., Meurisse, A., Heyd, B., and Rullier, E.
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RECTAL cancer ,PROPENSITY score matching ,PROSTATE cancer ,PROSTATE ,DISEASES - Abstract
Background: Specific surgical and oncological outcomes in patients with rectal cancer surgery after a previous diagnosis of prostate cancer have not been well described. The aim of this study was to compare surgical outcomes in patients with rectal cancer with or without a history of prostate cancer. Methods: Patients who had surgery for rectal cancer with (PC group) or without (no‐PC group) previous curative treatment for prostate cancer were enrolled between January 2001 and December 2015. Comparisons between the two groups were performed by multivariable Cox analysis, and after propensity score matching in a 3 : 1 ratio for demographic and tumour characteristics, and surgical and oncological outcomes. Results: A total of 944 patients with rectal cancer were enrolled, of whom 10·8 per cent had a history of prostate cancer. After matching, 83 patients who had received treatment for prostate cancer were compared with 249 who had not. The PC and no‐PC groups were similar regarding patient characteristics. Extended total mesorectal excision, conversion to open surgery, transfusion and tumour perforation were more frequent in the PC group than in the no‐PC group. Major surgical morbidity (28 versus 17·2 per cent; P = 0·036), anastomotic leakage (25 versus 13·7 per cent; P = 0·019) and permanent stoma (41 versus 12·4 per cent; P < 0·001) occurred more frequently in the PC group. Local recurrence was increased significantly in the PC group (17 versus 8·0 per cent; P = 0·019), and resulted in a significant decrease in disease‐free and overall survival. Conclusion: Prostate cancer treatment increases short‐ and long‐term surgical morbidity in patients with rectal cancer, and impairs oncological outcomes. [ABSTRACT FROM AUTHOR]
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- 2019
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44. Anastomotic leakage and functional outcomes following total mesorectal excision with delayed and immediate colo-anal anastomosis for rectal cancer: Two single-arm phase II trials.
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Evrard, Serge, Bellera, Carine, Desolneux, Gregoire, Cantarel, Coralie, Toulza, Emilie, Faucheron, Jean-Luc, Rivoire, Michel, Dupré, Aurélien, Mabrut, Jean-Yves, Bresler, Laurent, Marchal, Frédéric, Bouriez, Damien, and Rullier, Eric
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RECTAL cancer ,ABDOMINOPERINEAL resection ,SURGICAL complications ,FUNCTIONAL status ,ILEOSTOMY ,PROGRESSION-free survival ,LEAKAGE - Abstract
Anastomotic leakage (AL) remains a major cause of morbidity following total mesorectal excision (TME). A diverting ileostomy reduces the risk of AL but impairs quality of life (QoL). Delayed colo-anal anastomosis (DCAA) may be an alternative to immediate colo-anal anastomosis (ICAA) without creation of a diverting ileostomy. Patients with T3 or N+ rectal tumours were treated with neoadjuvant chemoradiation and TME. To evaluate DCAA or ICAA with diverting ileostomy, a two multicenter single-arm phase II trials was designed. The primary endpoint was the rate of AL requiring a diverting ileostomy up to 30 days postoperatively. Secondary endpoints were 30-day postoperative complications, 1- and 2-year disease-free survival; QoL at baseline, 6 months and anorectal function measured by the low anterior resection syndrome questionnaire and Wexner score at baseline, 6 months and a late assessment at median 8 years following surgery. AL requiring diverting ileostomy occurred in one patient (2.1%; 95% confidence interval (CI) [0; 11.1]) in the DCAA group and in five patients (8.6%; 95%CI [3.2; 21.0]) in the ICAA group. Thirty-day postoperative complications occurred in 13 patients (27.1%) in the DCAA group and in 10 patients (19.2%) in the ICAA group. Short and long-term functional outcomes showed similar patterns. These two single-arm phase II trials showed that DCAA has low rates of AL requiring a diverting ileostomy and acceptable long-term functional results. DCAA seems a good choice to restore bowel continuity. [ABSTRACT FROM AUTHOR]
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- 2023
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45. Transanal versus abdominal low rectal dissection for rectal cancer: long-term results of the Bordeaux' randomized trial.
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Denost, Quentin, Loughlin, Paula, Chevalier, Remy, Celerier, Bertrand, Didailler, Romain, and Rullier, Eric
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RECTAL cancer ,HEALTH outcome assessment ,LAPAROSCOPIC surgery ,KAPLAN-Meier estimator ,LOG-rank test ,SURGERY - Abstract
Aim: The aim of the current study is to report long-term outcomes after transanal low rectal dissection compared with the conventional laparoscopic approach within the context of the Bordeaux' randomized trial. Results from this randomized trial have indicated that transanal approach was more effective than laparoscopic dissection regarding the rate of negative circumferential resection margin (CRM). Despite a high number of publications regarding the transanal approach for TME, there were no long-term data on survival and local recurrence which are now required.Methods: One hundred patients with low rectal cancer suitable for laparoscopic TME with handsewn coloanal anastomosis were randomized in transanal versus laparoscopic low rectal dissection from 2008 to 2012. The randomization ratio was 1:1. All patients included in the trial were considered for long-term assessment. Local recurrence, overall- and disease-free survival were assessed by Kaplan-Meier and compared with Log-rank test.Results: The follow up was 60.2 months, similar in both group (p = 0.321). Overall, there were no differences of long-term outcomes. There was a significant association between CRM involvement and local recurrence (p = 0.011), however, the 5-year local recurrence rate was 4%, without any significant difference between transanal and laparoscopic dissection: 3% vs. 5%; p = 0.300. The 5-year disease-free survival was 73%: 72% vs. 74; p = 0.351.Conclusion: Lower positivity of the circumferential resection margin was reported after transanal low rectal dissection, but it did not translate into a decreased incidence of local recurrence. Further investigations are necessary to demonstrate advantages of this new procedure. [ABSTRACT FROM AUTHOR]- Published
- 2018
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46. Organ preservation in rectal cancer: a synopsis of current guidelines.
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Borstlap, W. A. A., Van Oostendorp, S. E., Klaver, C. E. L., Hahnloser, D., Cunningham, C., Rullier, E., Bemelman, W. A., Tuynman, J. B., Tanis, P. J., and The Research Committee Of The European Society Of Coloproctology
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PRESERVATION of organs, tissues, etc. ,RECTAL cancer ,DISEASES & society ,CHEMORADIOTHERAPY ,CLINICAL trials ,PREVENTION - Abstract
Abstract: Aim: The high morbidity associated with radical resection for rectal cancer is an incentive for surgeons to adopt strategies aimed at organ preservation, particularly for early disease. There are a number of different approaches to achieve this. In this study we have collated current national and international guidelines to produce a synopsis to support this changing practice. Method: The PubMed, Embase, Trip, National Guideline Clearinghouse and BMJ Best Practice databases were interrogated. Guidelines published before 2010 were excluded. The AGREE‐II tool was used for quality assessment. Results: Twenty‐four guidelines were drawn from 2278 potential publications. A consensus exists for local excision for ‘low‐risk’ T1 rectal cancer but there is no agreement on how to stratify the risk of treatment failure. There is a low level of agreement for rectal preservation for more advanced disease, but when mentioned it is recommended for unfit patients or in the context of a clinical trial. Guidelines are inconsistent with respect to surveillance in node‐negative disease and after complete response to chemoradiotherapy. Conclusion: According to current guidelines and consensus statements, organ preservation for rectal cancer beyond low‐risk T1 is still considered experimental and only indicated in patients who are unsuitable for radical surgery. Follow‐up strategies and cN0 staging deserve attention, highlighting the need for high‐quality clinical trials. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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47. The effect of adjuvant chemotherapy on survival and recurrence after curative rectal cancer surgery in patients who are histologically node negative after neoadjuvant chemoradiotherapy.
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Baird, D. L. H., Denost, Q., Simillis, C., Pellino, G., Rasheed, S., Kontovounisios, C., Tekkis, P. P., and Rullier, E.
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ADJUVANT treatment of cancer ,RECTAL cancer treatment ,CANCER relapse ,CANCER chemotherapy ,RECTAL cancer patients ,TREATMENT effectiveness ,PROGRESSION-free survival ,CHEMORADIOTHERAPY - Abstract
Aim The aim of this study was to evaluate whether adjuvant chemotherapy will affect recurrence rate or disease-free and overall survival in patients with rectal adenocarcinoma who were staged with MRI node-positive disease (mrN+) preoperatively. These patients underwent neoadjuvant chemoradiotherapy with curative rectal cancer surgery and their pathological staging was negative for nodal disease (ypN0). There is no consensus on the role of adjuvant chemotherapy in such patients. Method Patients who received neoadjuvant chemoradiotherapy and underwent curative rectal cancer surgery for rectal adenocarcinoma staged as [mrTxN+M0] on MRI staging and who on pathological staging were found to be [ypTxN0M0] were retrospectively identified from January 2008 December 2012 from two tertiary referral centres (Royal Marsden Hospital, London and Saint-Andre Hospital, Bordeaux). Results One hundred and sixty-three patients were recruited and, after propensity matching at a ratio of 2:1, n = 80 patients were divided to receive adjuvant ( n = 28) or no adjuvant treatment ( n = 52). A comparison of adjuvant chemotherapy vs no adjuvant therapy showed that the mean overall survival was 2.67 vs 3.60 years ( P = 0.42) and disease-free survival was 2.27 vs 3.32 years ( P = 0.14). Conclusion This study found no significant difference in survival or disease recurrence between patients who received adjuvant chemotherapy and patients who did not. There is no clear evidence to support or dismiss the use of adjuvant chemotherapy for patients who were node positive on preoperative MRI and node negative on histopathological staging. Further multicentre prospective randomized trials are needed to identify the appropriate treatment regime for this group of patients. [ABSTRACT FROM AUTHOR]
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- 2017
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48. Intersphincteric Resection Pushing the Envelope for Sphincter Preservation.
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Denost, Quentin and Rullier, Eric
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During the last 15 years, a significant evolution has emerged in the surgical treatment of rectal cancer and restoration of bowel continuity has been one of the main goals. For many years the treatment of distal rectal cancer would necessarily require an abdominoperineal resection and end colostomy. The surgical procedure of intersphinctericresectionhasbeenproposedtooffersphincterpreservationinpatientswithlow rectal cancer and has been legitimized if executed according to adequate oncologic criteria. This article will discuss the best indications, technical aspects, functional, and oncological outcomes of intersphicteric resection in the management of rectal cancer. [ABSTRACT FROM AUTHOR]
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- 2017
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49. To Drain or Not to Drain Infraperitoneal Anastomosis After Rectal Excision for Cancer.
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Denost, Quentin, Rouanet, Philippe, Faucheron, Jean-Luc, Panis, Yves, Meunier, Bernard, Cotte, Eddy, Meurette, Guillaume, Kirzin, Sylvain, Sabbagh, Charles, Loriau, Jèrôme, Benoist, Stèphane, Mariette, Christophe, Sielezneff, Igor, Lelong, Bernard, Mauvais, François, Romain, Benoit, Barussaud, Marie-Line, Germain, Christine, Picat, Marie-Quitterie, and Rullier, Eric
- Abstract
Objective: To assess the effect of pelvic drainage after rectal surgery for cancer. Background: Pelvic sepsis is one of the major complications after rectal excision for rectal cancer. Although many studies have confirmed infectiveness of drainage after colectomy, there is still a controversy after rectal surgery. Methods: This multicenter randomized trial with 2 parallel arms (drain vs no drain) was performed between 2011 and 2014. Primary endpoint was postoperative pelvic sepsis within 30 postoperative days, including anastomotic leakage, pelvic abscess, and peritonitis. Secondary endpoints were overall morbidity and mortality, rate of reoperation, length of hospital stay, and rate of stoma closure at 6 months. Results: A total of 494 patients were randomized, 25 did not meet the criteria and 469 were analyzed: 236 with drain and 233 without. The anastomotic height was 3.5 ± 1.9 cm from the anal verge. The rate of pelvic sepsis was 17.1% (80/469) and was similar between drain and no drain: 16.1% versus 18.0% (P = 0.58). There was no difference of surgical morbidity (18.7% vs 25.3%; P = 0.83), rate of reoperation (16.6% vs 21.0%; P = 0.22), length of hospital stay (12.2 vs 12.2; P = 0.99) and rate of stoma closure (80.1% vs 77.3%; P = 0.53) between groups. Absence of colonic pouch was the only independent factor of pelvic sepsis (odds ratio = 1.757; 95% confidence interval 1.078-2.864; P = 0.024). Conclusions: This randomized trial suggests that the use of a pelvic drain after rectal excision for rectal cancer did not confer any benefit to the patient. [ABSTRACT FROM AUTHOR]
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- 2017
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50. Individualizing surgical treatment based on tumour response following neoadjuvant therapy in T4 primary rectal cancer.
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Denost, Q., Kontovounisios, C., Rasheed, S., Chevalier, R., Brasio, R., Capdepont, M., Rullier, E., and Tekkis, P.P.
- Subjects
ADJUVANT treatment of cancer ,RECTAL cancer treatment ,CANCER relapse ,RECTAL cancer patients ,CANCER chemotherapy ,PROGRESSION-free survival - Abstract
Background Rectal cancer involving at least one adjacent organ (mrT4b) requires multi-visceral resection to achieve clear resection margin (R0). Performing pelvic compartment preservation according to the tumour response has not been considered. This study assesses the impact of changing the surgical strategy according to tumour response in rectal cancer mrT4b. Methods Patients with non-metastatic T4b rectal cancer at two tertiary referral centres between 2008 and 2013 were grouped as “Responders” ypT0-3abNx versus “Non-responders” ypT3cd-4Nx and divided into three surgical procedures: total mesorectal excision (TME), extended-TME (eTME) and beyond-TME (b-TME). End-points were circumferential resection margin, postoperative morbidity, definitive stoma formation, 3-years local recurrence (3y-LR) and 3-years disease-free survival (3y-DFS) according to both tumours' response and surgical procedures. Results Among 883 patients with rectal cancer, 101 were included. Responders had a higher rate of induction chemotherapy (59.7% vs. 38.2%; p = 0.04). Morbidity and definitive stoma formation were significantly higher in Non-responders. R0 was not impacted by either the tumour response or the surgical procedures. The 3y-LR was lower in Responders (14%) compared to Non Responders (32%) (HR 1.6; 95% CI: 1.02–2.59; p = 0.041), and was two-fold higher in e-TME compared to b-TME in Non-responders, whereas no difference was found in Responders. The 3y-DFS was higher in Responders irrespective to the surgery (71% vs. 47%; p = 0.07). Conclusion In Responders, TME or e-TME are technically and oncollogically feasible and should be considered in preferrence to b-TME. In Non-responders, allowing for high rates of morbidity and local recurrence in patients with e-TME, b-TME procedures should be preferred. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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