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7. 46th Medical Maghrebian Congress. November 9-10, 2018. Tunis

Author

Alami Aroussi, A., Fouad, A., Omrane, A., Razzak, A., Aissa, A., Akkad, A., Amraoui, A., Aouam, A., Arfaoui, A., Belkouchi, A., Ben Chaaben, A., Ben Cheikh, A., Ben Khélifa, A., Ben Mabrouk, A., Benhima, A., Bezza, A., Bezzine, A., Bourrahouat, A., Chaieb, A., Chakib, A., Chetoui, A., Daoudi, A., Ech-Chenbouli, A., Gaaliche, A., Hassani, A., Kassimi, A., Khachane, A., Labidi, A., Lalaoui, A., Masrar, A., Mchachi, A., Nakhli, A., Ouakaa, A., Siati, A., Toumi, A., Zaouali, A., Condé, A. Y., Haggui, A., Belaguid, A., abdelkader jalil el hangouche, Gharbi, A., Mahfoudh, A., Bouzouita, A., Aissaoui, A., Ben Hamouda, A., Hedhli, A., Ammous, A., Bahlous, A., Ben Halima, A., Belhadj, A., Blel, A., Brahem, A., Banasr, A., Meherzi, A., Saadi, A., Sellami, A., Turki, A., Ben Miled, A., Ben Slama, A., Daib, A., Zommiti, A., Chadly, A., Jmaa, A., Mtiraoui, A., Ksentini, A., Methnani, A., Zehani, A., Kessantini, A., Farah, A., Mankai, A., Mellouli, A., Touil, A., Hssine, A., Ben Safta, A., Derouiche, A., Jmal, A., Ferjani, A., Djobbi, A., Dridi, A., Aridhi, A., Bahdoudi, A., Ben Amara, A., Benzarti, A., Ben Slama, A. Y., Oueslati, A., Soltani, A., Chadli, A., Aloui, A., Belghuith Sriha, A., Bouden, A., Laabidi, A., Mensi, A., Sabbek, A., Zribi, A., Green, A., Ben Nasr, A., Azaiez, A., Yeades, A., Belhaj, A., Mediouni, A., Sammoud, A., Slim, A., Amine, B., Chelly, B., Jatik, B., Lmimouni, B., Daouahi, B., Ben Khelifa, B., Louzir, B., Dorra, A., Dhahri, B., Ben Nasrallah, C., Chefchaouni, C., Konzi, C., Loussaief, C., Makni, C., Dziri, C., Bouguerra, C., Kays, C., Zedini, C., Dhouha, C., Mohamed, C., Aichaouia, C., Dhieb, C., Fofana, D., Gargouri, D., Chebil, D., Issaoui, D., Gouiaa, D., Brahim, D., Essid, D., Jarraya, D., Trad, D., Ben Hmida, E., Sboui, E., Ben Brahim, E., Baati, E., Talbi, E., Chaari, E., Hammami, E., Ghazouani, E., Ayari, F., Ben Hariz, F., Bennaoui, F., Chebbi, F., Chigr, F., Guemira, F., Harrar, F., Benmoula, F. Z., Ouali, F. Z., Maoulainine, F. M. R., Bouden, F., Fdhila, F., Améziani, F., Bouhaouala, F., Charfi, F., Chermiti Ben Abdallah, F., Hammemi, F., Jarraya, F., Khanchel, F., Ourda, F., Sellami, F., Trabelsi, F., Yangui, F., Fekih Romdhane, F., Mellouli, F., Nacef Jomli, F., Mghaieth, F., Draiss, G., Elamine, G., Kablouti, G., Touzani, G., Manzeki, G. B., Garali, G., Drissi, G., Besbes, G., Abaza, H., Azzouz, H., Said Latiri, H., Rejeb, H., Ben Ammar, H., Ben Brahim, H., Ben Jeddi, H., Ben Mahjouba, H., Besbes, H., Dabbebi, H., Douik, H., El Haoury, H., Elannaz, H., Elloumi, H., Hachim, H., Iraqi, H., Kalboussi, H., Khadhraoui, H., Khouni, H., Mamad, H., Metjaouel, H., Naoui, H., Zargouni, H., Elmalki, H. O., Feki, H., Haouala, H., Jaafoura, H., Drissa, H., Mizouni, H., Kamoun, H., Ouerda, H., Zaibi, H., Chiha, H., Saibi, H., Skhiri, H., Boussaffa, H., Majed, H., Blibech, H., Daami, H., Harzallah, H., Rkain, H., Ben Massoud, H., Jaziri, H., Ben Said, H., Ayed, H., Harrabi, H., Chaabouni, H., Ladida Debbache, H., Harbi, H., Yacoub, H., Abroug, H., Ghali, H., Kchir, H., Msaad, H., Manai, H., Riahi, H., Bousselmi, H., Limem, H., Aouina, H., Jerraya, H., Ben Ayed, H., Chahed, H., Snéne, H., Lahlou Amine, I., Nouiser, I., Ait Sab, I., Chelly, I., Elboukhani, I., Ghanmi, I., Kallala, I., Kooli, I., Bouasker, I., Fetni, I., Bachouch, I., Bouguecha, I., Chaabani, I., Gazzeh, I., Samaali, I., Youssef, I., Zemni, I., Bachouche, I., Bouannene, I., Kasraoui, I., Laouini, I., Mahjoubi, I., Maoudoud, I., Riahi, I., Selmi, I., Tka, I., Hadj Khalifa, I., Mejri, I., Béjia, I., Bellagha, J., Boubaker, J., Daghfous, J., Dammak, J., Hleli, J., Ben Amar, J., Jedidi, J., Marrakchi, J., Kaoutar, K., Arjouni, K., Ben Helel, K., Benouhoud, K., Rjeb, K., Imene, K., Samoud, K., El Jeri, K., Abid, K., Chaker, K., Bouzghaîa, K., Kamoun, K., Zitouna, K., Oughlani, K., Lassoued, K., Letaif, K., Hakim, K., Cherif Alami, L., Benhmidoune, L., Boumhil, L., Bouzgarrou, L., Dhidah, L., Ifrine, L., Kallel, L., Merzougui, L., Errguig, L., Mouelhi, L., Sahli, L., Maoua, M., Rejeb, M., Ben Rejeb, M., Bouchrik, M., Bouhoula, M., Bourrous, M., Bouskraoui, M., El Belhadji, M., Essakhi, M., Essid, M., Gharbaoui, M., Haboub, M., Iken, M., Krifa, M., Lagrine, M., Leboyer, M., Najimi, M., Rahoui, M., Sabbah, M., Sbihi, M., Zouine, M., Chefchaouni, M. C., Gharbi, M. H., El Fakiri, M. M., Tagajdid, M. R., Shimi, M., Touaibia, M., Jguirim, M., Barsaoui, M., Belghith, M., Ben Jmaa, M., Koubaa, M., Tbini, M., Boughdir, M., Ben Salah, M., Ben Fraj, M., Ben Halima, M., Ben Khalifa, M., Bousleh, M., Limam, M., Mabrouk, M., Mallouli, M., Rebeii, M., Ayari, M., Belhadj, M., Ben Hmida, M., Boughattas, M., Drissa, M., El Ghardallou, M., Fejjeri, M., Hamza, M., Jaidane, M., Jrad, M., Kacem, M., Mersni, M., Mjid, M., Serghini, M., Triki, M., Ben Abbes, M., Boussaid, M., Gharbi, M., Hafi, M., Slama, M., Trigui, M., Taoueb, M., Chakroun, M., Ben Cheikh, M., Chebbi, M., Hadj Taieb, M., Ben Khelil, M., Hammami, M., Khalfallah, M., Ksiaa, M., Mechri, M., Mrad, M., Sboui, M., Bani, M., Hajri, M., Mellouli, M., Allouche, M., Mesrati, M. A., Mseddi, M. A., Amri, M., Bejaoui, M., Bellali, M., Ben Amor, M., Ben Dhieb, M., Ben Moussa, M., Chebil, M., Cherif, M., Fourati, M., Kahloul, M., Khaled, M., Machghoul, M., Mansour, M., Abdesslem, M. M., Ben Chehida, M. A., Chaouch, M. A., Essid, M. A., Meddeb, M. A., Gharbi, M. C., Elleuch, M. H., Loueslati, M. H., Sboui, M. M., Mhiri, M. N., Kilani, M. O., Ben Slama, M. R., Charfi, M. R., Nakhli, M. S., Mourali, M. S., El Asli, M. S., Lamouchi, M. T., Cherti, M., Khadhraoui, M., Bibi, M., Hamdoun, M., Kassis, M., Touzi, M., Ben Khaled, M., Fekih, M., Khemiri, M., Ouederni, M., Hchicha, M., Ben Attia, M., Yahyaoui, M., Ben Azaiez, M., Bousnina, M., Ben Jemaa, M., Ben Yahia, M., Daghfous, M., Haj Slimen, M., Assidi, M., Belhadj, N., Ben Mustapha, N., El Idrissislitine, N., Hikki, N., Kchir, N., Mars, N., Meddeb, N., Ouni, N., Rada, N., Rezg, N., Trabelsi, N., Bouafia, N., Haloui, N., Benfenatki, N., Bergaoui, N., Yomn, N., Maamouri, N., Mehiri, N., Siala, N., Beltaief, N., Aridhi, N., Sidaoui, N., Walid, N., Mechergui, N., Mnif, N., Ben Chekaya, N., Bellil, N., Dhouib, N., Achour, N., Kaabar, N., Mrizak, N., Chaouech, N., Hasni, N., Issaoui, N., Ati, N., Balloumi, N., Haj Salem, N., Ladhari, N., Akif, N., Liani, N., Hajji, N., Trad, N., Elleuch, N., Marzouki, N. E. H., Larbi, N., M Barek, N., Rebai, N., Bibani, N., Ben Salah, N., Belmaachi, O., Elmaalel, O., Jlassi, O., Mihoub, O., Ben Zaid, O., Bouallègue, O., Bousnina, O., Bouyahia, O., El Maalel, O., Fendri, O., Azzabi, O., Borgi, O., Ghdes, O., Ben Rejeb, O., Rachid, R., Abi, R., Bahiri, R., Boulma, R., Elkhayat, R., Habbal, R., Tamouza, R., Jomli, R., Ben Abdallah, R., Smaoui, R., Debbeche, R., Fakhfakh, R., El Kamel, R., Gargouri, R., Jouini, R., Nouira, R., Fessi, R., Bannour, R., Ben Rabeh, R., Kacem, R., Khmakhem, R., Ben Younes, R., Karray, R., Cheikh, R., Ben Malek, R., Ben Slama, R., Kouki, R., Baati, R., Bechraoui, R., Fradi, R., Lahiani, R., Ridha, R., Zainine, R., Kallel, R., Rostom, S., Ben Abdallah, S., Ben Hammamia, S., Benchérifa, S., Benkirane, S., Chatti, S., El Guedri, S., El Oussaoui, S., Elkochri, S., Elmoussaoui, S., Enbili, S., Gara, S., Haouet, S., Khammeri, S., Khefecha, S., Khtrouche, S., Macheghoul, S., Mallouli, S., Rharrit, S., Skouri, S., Helali, S., Boulehmi, S., Abid, S., Naouar, S., Zelfani, S., Ben Amar, S., Ajmi, S., Braiek, S., Yahiaoui, S., Ghezaiel, S., Ben Toumia, S., Thabeti, S., Daboussi, S., Ben Abderahman, S., Rhaiem, S., Ben Rhouma, S., Rekaya, S., Haddad, S., Kammoun, S., Merai, S., Mhamdi, S., Ben Ali, R., Gaaloul, S., Ouali, S., Taleb, S., Zrour, S., Hamdi, S., Zaghdoudi, S., Ammari, S., Ben Abderrahim, S., Karaa, S., Maazaoui, S., Saidani, S., Stambouli, S., Mokadem, S., Boudiche, S., Zaghbib, S., Ayedi, S., Jardek, S., Bouselmi, S., Chtourou, S., Manoubi, S., Bahri, S., Halioui, S., Jrad, S., Mazigh, S., Ouerghi, S., Toujani, S., Fenniche, S., Aboudrar, S., Meriem Amari, S., Karouia, S., Bourgou, S., Halayem, S., Rammeh, S., Yaïch, S., Ben Nasrallah, S., Chouchane, S., Ftini, S., Makni, S., Miri, S., Saadi, S., Manoubi, S. A., Khalfallah, T., Mechergui, T., Dakka, T., Barhoumi, T., M Rad, T. E. B., Ajmi, T., Dorra, T., Ouali, U., Hannachi, W., Ferjaoui, W., Aissi, W., Dahmani, W., Dhouib, W., Koubaa, W., Zhir, W., Gheriani, W., Arfa, W., Dougaz, W., Sahnoun, W., Naija, W., Sami, Y., Bouteraa, Y., Elhamdaoui, Y., Hama, Y., Ouahchi, Y., Guebsi, Y., Nouira, Y., Daly, Y., Mahjoubi, Y., Mejdoub, Y., Mosbahi, Y., Said, Y., Zaimi, Y., Zgueb, Y., Dridi, Y., Mesbahi, Y., Gharbi, Y., Hellal, Y., Hechmi, Z., Zid, Z., Elmouatassim, Z., Ghorbel, Z., Habbadi, Z., Marrakchi, Z., Hidouri, Z., Abbes, Z., Ouhachi, Z., Khessairi, Z., Khlayfia, Z., Mahjoubi, Z., and Moatemri, Z.

11. Abstracts of the 40th National Congress of Medicine Tunis, 19-20 October 2017

Author

Abdallah, M., Abdelaziz, A., Abdelaziz, O., Abdelhedi, N., Abdelkbir, A., Abdelkefi, M., Abdelmoula, L., Abdennacir, S., Abdennadher, M., Abidi, H., Abir Hakiri, A., Abou El Makarim, S., Abouda, M., Achour, W., Aichaouia, C., Aissa, A., Aissa, Y., Aissi, W., Ajroudi, M., Allouche, E., Aloui, H., Aloui, D., Amdouni, F., Ammar, Y., Ammara, Y., Ammari, S., Ammous, A., Amous, A., Amri, A., Amri, M., Amri, R., Annabi, H., Antit, S., Aouadi, S., Arfaoui, A., Assadi, A., Attia, L., Attia, M., Ayadi, I., Ayadi Dahmane, I., Ayari, A., Azzabi, S., Azzouz, H., B Mefteh, N., B Salah, C., Baccar, H., Bachali, A., Bahlouli, M., Bahri, G., Baïli, H., Bani, M., Bani, W., Bani, M. A., Bassalah, E., Bawandi, R., Bayar, M., Bchir, N., Bechraoui, R., Béji, M., Beji, R., Bel Haj Yahia, D., Belakhel, S., Belfkih, H., Belgacem, O., Belgacem, N., Belhadj, A., Beltaief, N., Ben Abbes, M., Ben Abdelaziz, A., Ben Ahmed, I., Ben Aissia, N., Ben Ali, M., Ben Ammar, H., Ben Ammou, B., Ben Amor, A., Ben Amor, M., Benatta, M., Ben Ayed, N., Ben Ayoub, W., Ben Charrada, N., Ben Cheikh, M., Ben Dahmen, F., Ben Dhia, M., Ben Fadhel, S., Ben Farhat, L., Ben Fredj Ismail, F., Ben Hamida, E., Ben Hamida Nouaili, E., Ben Hammamia, M., Ben Hamouda, A., Ben Hassine, L., Ben Hassouna, A., Ben Hasssen, A., Ben Hlima, M., Ben Kaab, B., Ben Mami, N., Ben Mbarka, F., Ben Mefteh, N., Ben Kahla, N., Ben Mrad, M., Ben Mustapha, N., Ben Nacer, M., Ben Neticha, K., Ben Othmen, E., Ben Rhouma, S., Ben Rhouma, M., Ben Saadi, S., Ben Safta, A., Ben Safta, Z., Ben Salah, C., Ben Salah, N., Ben Sassi, S., Ben Sassi, J., Ben Tekaya, S., Ben Temime, R., Ben Tkhayat, A., Ben Tmim, R., Ben Yahmed, Y., Ben Youssef, S., Ben Atta, M., Ben Salah, M., Berrahal, I., Besbes, G., Bezdah, L., Bezzine, A., Bokal, Z., Borsali, R., Bouasker, I., Boubaker, J., Bouchekoua, M., Bouden, F., Boudiche, S., Boukhris, I., Bouomrani, S., Bouraoui, S., Bourgou, S., Boussabeh, E., Bouzaidi, K., Chaker, K., Chaker, L., Chaker, A., Chaker, F., Chaouech, N., Charfi, M., Charfi, M. R., Charfi, F., Chatti, L., Chebbi, F., Chebbi, W., Cheikh, R., Cheikhrouhou, S., Chekir, J., Chelbi, E., Chelly, I., Chelly, B., Chemakh, M., Chenik, S., Cheour, M., Cherif, E., Cherif, Y., Cherif, W., Cherni, R., Chetoui, A., Chihaoui, M., Chiraz Aichaouia, C., Dabousii, S., Daghfous, A., Daib, A., Daib, N., Damak, R., Daoud, N., Daoud, Z., Daoued, N., Debbabi, H., Demni, W., Denguir, R., Derbel, S., Derbel, B., Dghaies, S., Dhaouadi, S., Dhilel, I., Dimassi, K., Dougaz, A., Dougaz, W., Douik, H., Douik El Gharbi, L., Dziri, C., El Aoud, S., El Hechmi, Z., El Heni, A., Elaoud, S., Elfeleh, E., Ellini, S., Ellouz, F., Elmoez Ben, O., Ennaifer, R., Ennaifer, S., Essid, M., Fadhloun, N., Farhat, M., Fekih, M., Fourati, M., Fteriche, F., G Hali, O., Galai, S., Gara, S., Garali, G., Garbouge, W., Garbouj, W., Ghali, O., Ghali, F., Gharbi, E., Gharbi, R., Ghariani, W., Gharsalli, H., Ghaya Jmii, G., Ghédira, F., Ghédira, A., Ghédira, H., Ghériani, A., Gouta, E. L., Guemira, F., Guermazi, E., Guesmi, A., Hachem, J., Haddad, A., Hakim, K., Hakiri, A., Hamdi, S., Hamed, W., Hamrouni, S., Hamza, M., Haouet, S., Hariz, A., Hendaoui, L., Hfaidh, M., Hriz, H., Hsairi, M., Ichaoui, H., Issaoui, D., Jaafoura, H., Jazi, R., Jazia, R., Jelassi, H., Jerraya, H., Jlassi, H., Jmii, G., Jouini, M., Kâaniche, M., Kacem, M., Kadhraoui, M., Kalai, M., Kallel, K., Kammoun, O., Karoui, M., Karouia, S., Karrou, M., Kchaou, A., Kchaw, R., Kchir, N., Kchir, H., Kechaou, I., Kerrou, M., Khaled, S., Khalfallah, N., Khalfallah, M., Khalfallah, R., Khamassi, K., Kharrat, M., Khelifa, E., Khelil, M., Khelil, A., Khessairi, N., Khezami, M. A., Khouni, H., Kooli, C., Korbsi, B., Koubaa, M. A., Ksantini, R., Ksentini, A., Ksibi, I., Ksibi, J., Kwas, H., Laabidi, A., Labidi, A., Ladhari, N., Lafrem, R., Lahiani, R., Lajmi, M., Lakhal, J., Laribi, M., Lassoued, N., Lassoued, K., Letaif, F., Limaïem, F., Maalej, S., Maamouri, N., Maaoui, R., Maâtallah, H., Maazaoui, S., Maghrebi, H., Mahfoudhi, S., Mahjoubi, Y., Mahjoubi, S., Mahmoud, I., Makhlouf, T., Makni, A., Mamou, S., Mannoubi, S., Maoui, A., Marghli, A., Marrakchi, Z., Marrakchi, J., Marzougui, S., Marzouk, I., Mathlouthi, N., Mbarek, K., Mbarek, M., Meddeb, S., azza mediouni, Mechergui, N., Mejri, I., Menjour, M. B., Messaoudi, Y., Mestiri, T., Methnani, A., Mezghani, I., Meziou, O., Mezlini, A., Mhamdi, S., Mighri, M., Miled, S., Miri, I., Mlayeh, D., Moatemri, Z., Mokaddem, W., Mokni, M., Mouhli, N., Mourali, M. S., Mrabet, A., Mrad, F., Mrouki, M., Msaad, H., Msakni, A., Msolli, S., Mtimet, S., Mzabi, S., Mzoughi, Z., Naffeti, E., Najjar, S., Nakhli, A., Nechi, S., Neffati, E., Neji, H., Nouira, Y., Nouira, R., Omar, S., Ouali, S., Ouannes, Y., Ouarda, F., Ouechtati, W., Ouertani, J., Ouertani, H., Oueslati, A., Oueslati, J., Oueslati, I., Rabai, B., Rahali, H., Rbia, E., Rebai, W., Regaïeg, N., Rejeb, O., Rhaiem, W., Rhimi, H., Riahi, I., Ridha, R., Robbena, L., Rouached, L., Rouis, S., Safer, M., Saffar, K., Sahli, H., Sahraoui, G., Saidane, O., Sakka, D., Salah, H., Sallami, S., Salouage, I., Samet, A., Sammoud, K., Sassi Mahfoudh, A., Sayadi, C., Sayhi, A., Sebri, T., Sedki, Y., Sellami, A., Serghini, M., Sghaier, I., Skouri, W., Slama, I., Slimane, H., Slimani, O., Souhail, O., Souhir, S., Souissi, A., Souissi, R., Taboubi, A., Talbi, G., Tbini, M., Tborbi, A., Tekaya, R., Temessek, H., Thameur, M., Touati, A., Touinsi, H., Tounsi, A., Tounsia, H., Trabelsi, S., Triki, A., Triki, M., Turki, J., Turki, K., Twinsi, H., Walha, Y., Wali, J., Yacoub, H., Yangui, F., Yazidi, M., Youssef, I., Zaier, A., Zainine, R., Zakhama, L., Zalila, H., Zargouni, H., Zehani, A., Zeineb, Z., Zemni, I., Zghal, M., Ziadi, J., Zid, Z., Znagui, I., Zoghlami, C., Zouaoui, C., Zouari, B., Zouiten, L., and Zribi, H.

12. Predictive factors of major low anterior resection syndrome after surgery for rectal tumors.

Author

Trabelsi M, Samaali I, Kammoun N, Ben Safta A, Oueslati A, Dougaz W, Khalfallah M, Jerraya H, Bouasker I, Nouira R, and Dziri C

Subjects
Humans, Male, Female, Retrospective Studies, Middle Aged, Syndrome, Aged, Risk Factors, Adult, Proctectomy adverse effects, Rectum surgery, Rectum pathology, Neoadjuvant Therapy statistics & numerical data, Low Anterior Resection Syndrome, Rectal Neoplasms surgery, Rectal Neoplasms pathology, Rectal Neoplasms epidemiology, Postoperative Complications epidemiology, Postoperative Complications diagnosis, Postoperative Complications etiology
Abstract

Aim: To describe the epidemiological and clinical data of impaired functional outcome secondary to anterior resection of the rectum and to identify the predictive factors of major low anterior resection syndrome (LARS) Methods: This retrospective study considered patients operated on for rectal tumors in surgical department in our hospital, between January 1st,2009 and December 31st, 2021. The primary outcome measure was the development of a major LARS immediately or after stoma closure. In order to identify independent predictors of major LARS, patients were divided into two groups: the "Major LARS" group and the "No Major LARS" group, and then we carried out a descriptive study, followed by an analytical study with logistic regression., Results: We enrolled 42 patients operated for rectal tumor and had an anterior resection. Half of our patients developed LARS of which 14 developed major LARS. The median time to onset of LARS symptoms was 9 [2 -24] months. At the end of this study, 2 factors were retained: age (OR=2.48; CI95% [1.2- 5.10], p=0.012) and pT3T4 stage (OR=5.95; CI95% [1.07- 33.33], p=0.041) as independent predictive factors of a major LARS. Neoadjuvant therapy was also a risk factor for major LARS in our study with a statistically significant difference (p=0.025) between the two groups "Major LARS" and "No major LARS"., Conclusion: LARS should be appropriately considered in the management of rectal cancer. Based on our results and data from the literature, age and mesorectal invasion were found to be independent predictors of major LARS.

Published
2024
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13. Biosimilar versus branded enoxaparin to prevent postoperative venous thromboembolism after surgery for digestive tract cancer: Randomized trial.

Author

Dziri C, Ben Hmida W, Dougaz W, Khalfallah M, Samaali I, Jerraya H, Bouasker I, and Nouira R

Subjects
Humans, Enoxaparin adverse effects, Anticoagulants therapeutic use, Postoperative Complications prevention & control, Postoperative Complications drug therapy, Venous Thromboembolism etiology, Venous Thromboembolism prevention & control, Venous Thromboembolism drug therapy, Biosimilar Pharmaceuticals adverse effects, Venous Thrombosis prevention & control, Thrombosis drug therapy, Gastrointestinal Neoplasms drug therapy
Abstract

Cancer and/or major surgery are two factors that predispose to post-operative thrombosis. The annual incidence of venous thromboembolic disease (VTED) in cancer patients was estimated at 0.5%-20%. Surgery increases the risk of VTED by 29% in the absence of thromboprophylaxis. Enoxaparin is a low molecular weight heparin that is safe and effective. Branded Enoxaparin and biosimilar Enoxaparin are two enoxaparin treatments. This study aimed to compare Branded Enoxaparin with biosimilar Enoxaparin in patients operated on for digestive cancer regarding the prevention of postoperative thrombosis event, to compare the tolerance of the two treatments and to identify independent predictive factors of thromboembolic incident. A randomized controlled trial conducted in a single-centre, surgical department B of Charles Nicolle Hospital, over a 5-year period from October 12th, 2015, to July 08th, 2020. We included all patients over 18 who had cancer of the digestive tract newly diagnosed, operable and whatever its nature, site, or stage, operated on in emergency or elective surgery. The primary endpoint was any asymptomatic thromboembolic event, demonstrated by systematic US Doppler of the lower limbs on postoperative day 7 to day 10. The sonographer was unaware of the prescribed treatment (Branded Enoxaparin [BE] or biosimilar Enoxaparin [BSE]). Of one hundred sixty-eight enrolled patients, six patients (4.1%) had subclinical venous thrombosis. Among those who had subclinical thrombosis, four patients (5.6%) were in the Branded Enoxaparin group and two patients (2.7%) in the Biosimilar Enoxaparin group without statistically significant difference (p = 0.435). Analysis of the difference in means using Student's t test demonstrated the equivalence of the two treatments. Our study allowed us to conclude that there was no statistically significant difference between Branded Enoxaparin and Biosimilar Enoxaparin regarding the occurrence of thromboembolic accidents postoperatively. BE and BSE are equivalent. Trial registration. Trial registration: The trial was registered on CLINICALTRIALS.GOV under the number NCT02444572., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Dziri et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Published
2023
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14. A Giant Anorectal Condyloma Is Not Synonym of Malignancy.

Author

El Bessi M, Dougaz W, Jones M, Jerraya H, and Dziri C

Subjects
Adult, Anal Canal diagnostic imaging, Anal Canal pathology, Anal Canal surgery, Anus Neoplasms pathology, Anus Neoplasms surgery, Biopsy, Buschke-Lowenstein Tumor pathology, Buschke-Lowenstein Tumor surgery, Diagnosis, Differential, Humans, Male, Tumor Burden, Anus Neoplasms diagnosis, Buschke-Lowenstein Tumor diagnosis, Carcinoma, Squamous Cell diagnosis
Published
2019
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16. Endogenous hyperinsulinism: diagnostic and therapeutic difficulties.

Author

Gouta EL, Jerraya H, Dougaz W, Chaouech MA, Bouasker I, Nouira R, and Dziri C

Subjects
Adult, Aged, 80 and over, Blood Glucose analysis, Female, Humans, Hyperinsulinism etiology, Hyperinsulinism surgery, Insulinoma complications, Magnetic Resonance Imaging, Male, Middle Aged, Pancreaticoduodenectomy methods, Retrospective Studies, Splenectomy methods, Tomography, X-Ray Computed, Hyperinsulinism diagnosis, Insulinoma diagnosis, Pancreatectomy methods
Abstract

Endogenous hyperinsulinism is an abnormal clinical condition that involves excessive insulin secretion, related in 55% of cases to insulinoma. Other causes are possible such as islet cell hyperplasia, nesidioblastosis or antibodies to insulin or to the insulin receptor. Differentiation between these diseases may be difficult despite the use of several morphological examinations. We report six patients operated on for endogenous hyperinsulinism from 1 st January 2000 to 31 st December 2015. Endogenous hyperinsulinism was caused by insulinoma in three cases, endocrine cells hyperplasia in two cases and no pathological lesions were found in the last case. All patients typically presented with adrenergic and neuroglycopenic symptoms with a low blood glucose level concomitant with high insulin and C-peptide levels. Computed tomography showed insulinoma in one case out of two. MRI was carried out four times and succeeded to locate the lesion in the two cases of insulinoma. Endoscopic ultrasound showed one insulinoma and provided false positive findings three times out of four. Intra operative ultrasound succeeded to localize the insulinoma in two cases but was false positive in two cases. Procedures were one duodenopancreatectomy, two left splenopancreatectomy and two enucleations. For the sixth case, no lesion was radiologically objectified. Hence, a left blind pancreatectomy was practised but the pathological examination showed normal pancreatic tissue. Our work showed that even if morphological examinations are suggestive of insulinoma, other causes of endogenous hyperinsulinism must be considered and therefore invasive explorations should be carried out., Competing Interests: The authors declare no competing interests.

Published
2019
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17. Predictive factor of recurrence after curative resection for stage I-II colon cancer.

Author

Dougaz W, Bouasker I, Gouta EL, Khalfallah M, Oueslati A, Samaali I, Ghariani W, Jerraya H, Nouira R, and Dziri C

Subjects
Adult, Aged, Aged, 80 and over, Cohort Studies, Colonic Neoplasms pathology, Female, Humans, Male, Middle Aged, Neoplasm Staging, Prognosis, Retrospective Studies, Colonic Neoplasms epidemiology, Colonic Neoplasms surgery, Neoplasm Recurrence, Local epidemiology
Abstract

Background: Colon cancer has become a common malignant neoplasm in Tunisia. Patients with negative lymph node have a 5 years recurrence rate of 21.1%. Studies reporting the prognostic factors of recurrence for patients with stage I-II colon cancer are limited., Aim: This study aimed to determine factors predicting recurrence for patients with stage I-II colon cancer after curative resection., Methods: This was a retrospective cohort study. Were included patients who underwent curative surgery for stage I or II colon cancer. Enrolled variables were subdivided into: Pre-operative, Intraoperative and Post-operative variables. Main outcome measures were local recurrence and distant metastasis detected during follow-up., Results: Eighteen men and 17 women with median age of 61 years, ranging from 33 to 89, were enrolled in this study. Twenty-eight patients out of 35 were classified T3 and T4 colon cancer. The mean number of lymph nodes harvested was 16.23 (median= 17; range: 4-44). Ten patients (28%) had colloid component in the tumor. At a median follow-up of 23 months (range: 6-56 months), recurrence was observed in five cases (14%). Variables associated to recurrence were Carcinoembryonic antigen level (p= 0.03), serum albumin level (p=0.029) and the presence of colloid component (0.02). Multivariate logistic regression retained colloid component as the only predictive factor of recurrence (OR=1.2, 95%CI [1.019-1.412], p=0.028)., Conclusions: This study showed that the percentage of mucinous component equal or greater than 25% was the only predictive factor of recurrence for curatively resected, stages I and II, colon cancer.

Published
2019

18. Self-directed learning digital tool versus tutorials under the guidance of an educator: Randomized trial.

Author

Khalfallah M, Dougaz W, Jerraya H, Samaali I, Mazigh S, Loueslati MH, Nouira R, Bou Asker I, and Dziri C

Subjects
Adult, Clinical Competence, Education, Distance methods, Educational Measurement, Humans, Personal Satisfaction, Self Efficacy, Students, Medical, Tunisia, Computer-Assisted Instruction methods, Education, Medical methods, Faculty, Medical, Self-Directed Learning as Topic
Abstract

Introduction: Self-directed learning digital tool aims to enable students to acquire skills in an autonomous way. The aim of this work was to compare a self-directed learning digital tool in non-traumatic abdominal emergencies with tutorials under the guidance of the educator in two parallel groups of second-year of second-cycle of medical students selected by means of a draw., Methods: We performed a controlled trial with draw comparing the self-directed learning digital tool and tutorials under the guidance of a teacher. Second-year of second-cycle medical students under training in general surgery from February, 20, 2017 to May, 7, 017 were included. Main judgment criterion was the assessment of the skills gained by students by means of the total score got at the objective structured clinical examination. We have carried out a descriptive survey, kappa statistics to study agreement between examiners, followed by an ANOVA test. We have compared the total score for the self-directed learning digital tool group with the total score of the tutorials group by using the « t » test of Student and the « U » test of Mann-Whitney. We performed a ROC curve for the total score. We have also achieved a satisfaction survey., Results: Twenty seven students were enrolled: 14 in the « self-directed learning digital tool » group and 13 in the « tutorials » group. The average total score for all the students was 230 ± 52 points [extremes: 71,5 - 318,5]. There was no difference between examiners (kappa test and ANOVA test). The univariate analysis showed a total score and a score by examiner higher in a statistically significant way for the « self-directed learning digital teaching tool » group. The ROC curve allowed us to conclude that the self-directed learning digital tool had an important discriminating power[an area under the curve equal to 0,791, (CI95%: 0,616-0,966) with p=0,010]., Conclusion: Self-directed learning digital tool has allowed second-year of second-cycle medical students to acquire skills in matters of interpretation of medical imaging in non-traumatic abdominal emergency with a higher rate compared with tutorials.

Published
2019

19. 46th Medical Maghrebian Congress. November 9-10, 2018. Tunis.

Author

Alami Aroussi A, Fouad A, Omrane A, Razzak A, Aissa A, Akkad A, Amraoui A, Aouam A, Arfaoui A, Belkouchi A, Ben Chaaben A, Ben Cheikh A, Ben Khélifa A, Ben Mabrouk A, Benhima A, Bezza A, Bezzine A, Bourrahouat A, Chaieb A, Chakib A, Chetoui A, Daoudi A, Ech-Chenbouli A, Gaaliche A, Hassani A, Kassimi A, Khachane A, Labidi A, Lalaoui A, Masrar A, McHachi A, Nakhli A, Ouakaa A, Siati A, Toumi A, Zaouali A, Condé AY, Haggui A, Belaguid A, El Hangouche AJ, Gharbi A, Mahfoudh A, Bouzouita A, Aissaoui A, Ben Hamouda A, Hedhli A, Ammous A, Bahlous A, Ben Halima A, Belhadj A, Bezzine A, Blel A, Brahem A, Banasr A, Meherzi A, Saadi A, Sellami A, Turki A, Ben Miled A, Ben Slama A, Daib A, Zommiti A, Chadly A, Jmaa A, Mtiraoui A, Ksentini A, Methnani A, Zehani A, Kessantini A, Farah A, Mankai A, Mellouli A, Zaouali A, Touil A, Hssine A, Ben Safta A, Derouiche A, Jmal A, Ferjani A, Djobbi A, Dridi A, Aridhi A, Bahdoudi A, Ben Amara A, Benzarti A, Ben Slama AY, Oueslati A, Soltani A, Chadli A, Aloui A, Belghuith Sriha A, Bouden A, Laabidi A, Mensi A, Ouakaa A, Sabbek A, Zribi A, Green A, Ben Nasr A, Azaiez A, Yeades A, Belhaj A, Mediouni A, Sammoud A, Slim A, Amine B, Chelly B, Jatik B, Lmimouni B, Daouahi B, Ben Khelifa B, Louzir B, Dorra A, Dhahri B, Ben Nasrallah C, Chefchaouni C, Konzi C, Loussaief C, Makni C, Dziri C, Bouguerra C, Kays C, Zedini C, Dhouha C, Mohamed C, Aichaouia C, Dhieb C, Fofana D, Gargouri D, Chebil D, Issaoui D, Gouiaa D, Brahim D, Essid D, Jarraya D, Trad D, Ben Hmida E, Sboui E, Ben Brahim E, Baati E, Talbi E, Chaari E, Hammami E, Ghazouani E, Ayari F, Ben Hariz F, Bennaoui F, Chebbi F, Chigr F, Guemira F, Harrar F, Benmoula FZ, Ouali FZ, Maoulainine FMR, Bouden F, Fdhila F, Améziani F, Bouhaouala F, Charfi F, Chermiti Ben Abdallah F, Hammemi F, Jarraya F, Khanchel F, Ourda F, Sellami F, Trabelsi F, Yangui F, Fekih Romdhane F, Mellouli F, Nacef Jomli F, Mghaieth F, Draiss G, Elamine G, Kablouti G, Touzani G, Manzeki GB, Garali G, Drissi G, Besbes G, Abaza H, Azzouz H, Said Latiri H, Rejeb H, Ben Ammar H, Ben Brahim H, Ben Jeddi H, Ben Mahjouba H, Besbes H, Dabbebi H, Douik H, El Haoury H, Elannaz H, Elloumi H, Hachim H, Iraqi H, Kalboussi H, Khadhraoui H, Khouni H, Mamad H, Metjaouel H, Naoui H, Zargouni H, Elmalki HO, Feki H, Haouala H, Jaafoura H, Drissa H, Mizouni H, Kamoun H, Ouerda H, Zaibi H, Chiha H, Kamoun H, Saibi H, Skhiri H, Boussaffa H, Majed H, Blibech H, Daami H, Harzallah H, Rkain H, Ben Massoud H, Jaziri H, Ben Said H, Ayed H, Harrabi H, Chaabouni H, Ladida Debbache H, Harbi H, Yacoub H, Abroug H, Ghali H, Kchir H, Msaad H, Ghali H, Manai H, Riahi H, Bousselmi H, Limem H, Aouina H, Jerraya H, Ben Ayed H, Chahed H, Snéne H, Lahlou Amine I, Nouiser I, Ait Sab I, Chelly I, Elboukhani I, Ghanmi I, Kallala I, Kooli I, Bouasker I, Fetni I, Bachouch I, Bouguecha I, Chaabani I, Gazzeh I, Samaali I, Youssef I, Zemni I, Bachouche I, Youssef I, Bouannene I, Kasraoui I, Laouini I, Mahjoubi I, Maoudoud I, Riahi I, Selmi I, Tka I, Hadj Khalifa I, Mejri I, Béjia I, Bellagha J, Boubaker J, Daghfous J, Dammak J, Hleli J, Ben Amar J, Jedidi J, Marrakchi J, Kaoutar K, Arjouni K, Ben Helel K, Benouhoud K, Rjeb K, Imene K, Samoud K, El Jeri K, Abid K, Chaker K, Abid K, Bouzghaîa K, Kamoun K, Zitouna K, Oughlani K, Lassoued K, Letaif K, Hakim K, Cherif Alami L, Benhmidoune L, Boumhil L, Bouzgarrou L, Dhidah L, Ifrine L, Kallel L, Merzougui L, Errguig L, Mouelhi L, Sahli L, Maoua M, Rejeb M, Ben Rejeb M, Bouchrik M, Bouhoula M, Bourrous M, Bouskraoui M, El Belhadji M, El Belhadji M, Essakhi M, Essid M, Gharbaoui M, Haboub M, Iken M, Krifa M, Lagrine M, Leboyer M, Najimi M, Rahoui M, Sabbah M, Sbihi M, Zouine M, Chefchaouni MC, Gharbi MH, El Fakiri MM, Tagajdid MR, Shimi M, Touaibia M, Jguirim M, Barsaoui M, Belghith M, Ben Jmaa M, Koubaa M, Tbini M, Boughdir M, Ben Salah M, Ben Fraj M, Ben Halima M, Ben Khalifa M, Bousleh M, Limam M, Mabrouk M, Mallouli M, Rebeii M, Ayari M, Belhadj M, Ben Hmida M, Boughattas M, Drissa M, El Ghardallou M, Fejjeri M, Hamza M, Jaidane M, Jrad M, Kacem M, Mersni M, Mjid M, Sabbah M, Serghini M, Triki M, Ben Abbes M, Boussaid M, Gharbi M, Hafi M, Slama M, Trigui M, Taoueb M, Chakroun M, Ben Cheikh M, Chebbi M, Hadj Taieb M, Kacem M, Ben Khelil M, Hammami M, Khalfallah M, Ksiaa M, Mechri M, Mrad M, Sboui M, Bani M, Hajri M, Mellouli M, Allouche M, Mesrati MA, Mseddi MA, Amri M, Bejaoui M, Bellali M, Ben Amor M, Ben Dhieb M, Ben Moussa M, Chebil M, Cherif M, Fourati M, Kahloul M, Khaled M, Machghoul M, Mansour M, Abdesslem MM, Ben Chehida MA, Chaouch MA, Essid MA, Meddeb MA, Gharbi MC, Elleuch MH, Loueslati MH, Sboui MM, Mhiri MN, Kilani MO, Ben Slama MR, Charfi MR, Nakhli MS, Mourali MS, El Asli MS, Lamouchi MT, Cherti M, Khadhraoui M, Bibi M, Hamdoun M, Kassis M, Touzi M, Ben Khaled M, Fekih M, Khemiri M, Ouederni M, Hchicha M, Kassis M, Ben Attia M, Yahyaoui M, Ben Azaiez M, Bousnina M, Ben Jemaa M, Ben Yahia M, Daghfous M, Haj Slimen M, Assidi M, Belhadj N, Ben Mustapha N, El Idrissislitine N, Hikki N, Kchir N, Mars N, Meddeb N, Ouni N, Rada N, Rezg N, Trabelsi N, Bouafia N, Haloui N, Benfenatki N, Bergaoui N, Yomn N, Ben Mustapha N, Maamouri N, Mehiri N, Siala N, Beltaief N, Aridhi N, Sidaoui N, Walid N, Mechergui N, Mnif N, Ben Chekaya N, Bellil N, Dhouib N, Achour N, Kaabar N, Mrizak N, Mnif N, Chaouech N, Hasni N, Issaoui N, Ati N, Balloumi N, Haj Salem N, Ladhari N, Akif N, Liani N, Hajji N, Trad N, Elleuch N, Marzouki NEH, Larbi N, M'barek N, Rebai N, Bibani N, Ben Salah N, Belmaachi O, Elmaalel O, Jlassi O, Mihoub O, Ben Zaid O, Bouallègue O, Bousnina O, Bouyahia O, El Maalel O, Fendri O, Azzabi O, Borgi O, Ghdes O, Ben Rejeb O, Rachid R, Abi R, Bahiri R, Boulma R, Elkhayat R, Habbal R, Rachid R, Tamouza R, Jomli R, Ben Abdallah R, Smaoui R, Debbeche R, Fakhfakh R, El Kamel R, Gargouri R, Jouini R, Nouira R, Fessi R, Bannour R, Ben Rabeh R, Kacem R, Khmakhem R, Ben Younes R, Karray R, Cheikh R, Ben Malek R, Ben Slama R, Kouki R, Baati R, Bechraoui R, Fakhfakh R, Fradi R, Lahiani R, Ridha R, Zainine R, Kallel R, Rostom S, Ben Abdallah S, Ben Hammamia S, Benchérifa S, Benkirane S, Chatti S, El Guedri S, El Oussaoui S, Elkochri S, Elmoussaoui S, Enbili S, Gara S, Haouet S, Khammeri S, Khefecha S, Khtrouche S, Macheghoul S, Mallouli S, Rharrit S, Skouri S, Helali S, Boulehmi S, Abid S, Naouar S, Zelfani S, Ben Amar S, Ajmi S, Braiek S, Yahiaoui S, Ghezaiel S, Ben Toumia S, Thabeti S, Daboussi S, Ben Abderahman S, Rhaiem S, Ben Rhouma S, Rekaya S, Haddad S, Kammoun S, Merai S, Mhamdi S, Ben Ali R, Gaaloul S, Ouali S, Taleb S, Zrour S, Hamdi S, Zaghdoudi S, Ammari S, Ben Abderrahim S, Karaa S, Maazaoui S, Saidani S, Stambouli S, Mokadem S, Boudiche S, Zaghbib S, Ayedi S, Jardek S, Bouselmi S, Chtourou S, Manoubi S, Bahri S, Halioui S, Jrad S, Mazigh S, Ouerghi S, Toujani S, Fenniche S, Aboudrar S, Meriem Amari S, Karouia S, Bourgou S, Halayem S, Rammeh S, Yaïch S, Ben Nasrallah S, Chouchane S, Ftini S, Makni S, Manoubi S, Miri S, Saadi S, Manoubi SA, Khalfallah T, Mechergui T, Dakka T, Barhoumi T, M'rad TEB, Ajmi T, Dorra T, Ouali U, Hannachi W, Ferjaoui W, Aissi W, Dahmani W, Dhouib W, Koubaa W, Zhir W, Gheriani W, Arfa W, Dougaz W, Sahnoun W, Naija W, Sami Y, Bouteraa Y, Elhamdaoui Y, Hama Y, Ouahchi Y, Guebsi Y, Nouira Y, Daly Y, Mahjoubi Y, Mejdoub Y, Mosbahi Y, Said Y, Zaimi Y, Zgueb Y, Dridi Y, Mesbahi Y, Gharbi Y, Hellal Y, Hechmi Z, Zid Z, Elmouatassim Z, Ghorbel Z, Habbadi Z, Marrakchi Z, Hidouri Z, Abbes Z, Ouhachi Z, Khessairi Z, Khlayfia Z, Mahjoubi Z, and Moatemri Z

Subjects
Africa, Northern epidemiology, Anatomy education, Education, Medical history, Education, Medical methods, Education, Medical organization & administration, History, 21st Century, Humans, Internship and Residency standards, Internship and Residency trends, Job Satisfaction, Pathology, Clinical education, Tunisia epidemiology, Education, Medical trends, Medicine methods, Medicine organization & administration, Medicine trends
Published
2019

20. Morbidity and mortality of infected diabetic foot managed in general surgical department.

Author

Gouta EL, Khalfallah M, Dougaz W, Samaali I, Nouira R, Bouasker I, and Dziri C

Subjects
Aged, Amputation, Surgical mortality, Amputation, Surgical statistics & numerical data, Debridement mortality, Debridement statistics & numerical data, Diabetic Foot complications, Diabetic Foot mortality, Female, Heart Failure epidemiology, Heart Failure mortality, Hospital Departments, Hospital Mortality, Humans, Length of Stay statistics & numerical data, Male, Middle Aged, Morbidity, Mortality, Multiple Organ Failure epidemiology, Multiple Organ Failure mortality, Retrospective Studies, Tunisia epidemiology, Wound Infection complications, Wound Infection mortality, Diabetic Foot epidemiology, Diabetic Foot surgery, Surgical Procedures, Operative methods, Surgical Procedures, Operative mortality, Surgical Procedures, Operative statistics & numerical data, Wound Infection epidemiology, Wound Infection surgery
Abstract

Background: Foot ulcers are diabetes-related complications which occur in 10%-25% in diabetic patients. They are an important cause of morbidity and mortality in diabetes. This retrospective study aimed to assess, using an administrative database, the morbidity and the mortality risk of infected diabetic ulcers., Methods: It's a retrospective study enrolling 644 patients operated on for a diabetic foot between January 1st, 2012 and December 31st, 2016 in the surgical department B of Charles Nicolle's Hospital. Logistic regression identified independent predictive factors of major amputation, morbidity and mortality., Results: This retrospective study showed that "Cardiac failure" (OR=5.00, 95%CI [1.08  23.25], p=0.039), "Admission in the ICU in the first 48h" (OR=12.76, 95%CI [4.92  33.33], p<0.001) and "Major amputation" (OR=6.40, 95%CI [2.41  16.94], p<0.001) were considered as independent predictive factors of mortality. As concerns morbidity, Cardiac failure (OR=0.163, 95%CI [0.055  0.479], p=0.001) and organ failure at admission (OR=0.017, 95%CI [0.004  0.066], p=0.017) were predictive factors of admission in the ICU during the first 48 hours. Besides, advanced age (OR=1.033, 95%CI [1.014  1.052], p=0.001), Pre-operative stay (OR=1.093, 95%CI [1.039  1.151], p=0.001) and admission in the ICU during the first 48 hours (OR=0.142, 95%CI [0.071  0.285], p<0.001) were predictive factors of major amputation. Moreover, Cardiac failure (OR=0.517, 95%CI [0.298  0.896], p=0.019), admission in the ICU during the first 48 hours (OR=0.176, 95%CI [0.088  0.354], p<0.001)  and Pre-operative stay (OR=1.083, 95%CI [1.033  1.134], p=0.001) were predictive variables of complicated post-operative course. Admission in the ICU during the first 48h (OR=0.140, 95%CI [0.48  0.405], p<0.001), major amputation (OR=0.170, 95%CI [0.76  0.379], p<0.001), and number of ICU stays (OR=3.341, 95%CI [1.558  7.164], p=0.002) were predictive factors of medical complications. Preoperative stay (OR=1.091, 95%CI [1.038  1.147], p=0.001) was predictive of reintervention., Conclusions: Our retrospective study assessed that mortality rate was inferior when the patient didn't have amputation, no post-operative complications and no reintervention. The main limitation of our study was the retrospective design.

Published
2018

21. Management of perforated duodenal peptic ulcer treated by suture.

Author

Gouta EL, Dougaz W, Khalfallah M, Bouasker I, and Dziri C

Subjects
Adult, Aged, Duodenal Ulcer epidemiology, Duodenum pathology, Duodenum surgery, Female, Humans, Laparoscopy methods, Length of Stay statistics & numerical data, Male, Middle Aged, Peptic Ulcer Perforation epidemiology, Postoperative Complications epidemiology, Postoperative Complications etiology, Retrospective Studies, Suture Techniques adverse effects, Treatment Outcome, Young Adult, Digestive System Surgical Procedures adverse effects, Digestive System Surgical Procedures methods, Duodenal Ulcer complications, Duodenal Ulcer surgery, Peptic Ulcer Perforation surgery, Sutures adverse effects
Abstract

Background: Laparoscopic surgery has become the gold standard for many procedures owing to its advantages such as a shorter post-operative stay, a faster recovery and less postoperative pain. However, choosing laparoscopic approach in an emergency situationsuch as in the management of a perforated duodenal peptic ulcer is still debated because of the absence of significant benefits. This study aimed to assess the management of perforated duodenal peptic ulcer treated by suture., Methods: It's a retrospective study enrolling 81 patients operated on for duodenal perforated peptic ulcer between June 1st, 2012 and December 31st, 2016 who underwent surgery in the surgical department B of Charles Nicolle's Hospital., Results: Our retrospective study showed that laparoscopic approach had shorter post-operative duration (3 [1-5] versus 4 [1-16] days, respectively, p< 0.001), shorter mortality rate (3% versus 19%, p=0.032) and more uneventful post-operative course (97% versus 74%, p=0.004) comparing to the open approach. Patients who were not admitted in the intensive care unit during the first 48 hours had 9.901 more chance to be operated by laparoscopic approach. Patients who were operated on by a senior had 3.240 times more chance to be operated by laparoscopic approach. There was no predictive variable for conversion. Mortality rate was 11%. Age was the only predictive independent factor of mortality with a cut-off point of 47 years., Conclusions: Laparoscopic approach is routinely practised in the perforated duodenal ulcer. In our study, we showed that laparoscopic approach had less post-operative complications, a lower rate of mortality and a shorter post-operative duration comparing to the open approach. The main limitation of our study was non-randomization and lack of laparoscopic expertise. The decision for either open or laparoscopic approach was then dependent on senior surgeon's availability.

Published
2018

22. Atypical form of peritoneal tuberculosis.

Author

Dougaz W, Khalfallah M, Jerraya H, Nouira R, Bouasker I, and Dziri C

Subjects
Biopsy methods, Female, Humans, Middle Aged, Peritonitis, Tuberculous drug therapy, Peritonitis, Tuberculous pathology, Antitubercular Agents therapeutic use, Peritonitis, Tuberculous diagnosis, Tomography, X-Ray Computed methods
Abstract

It was a 48-year-old woman with a right flank mass. On examination there was a hard and painful mass of the right side, centered by a fistula orifice with a diameter of 5 mm. Abdominal computed tomography showed an intraperitoneal tissue structure in relation to the parietal peritoneum in the left hypochondria. A scanno-guided biopsy was performed. Pathological examination revealed non-specific inflammatory lesions. The evolution was marked by the appearance of a purulent fistula in the puncture site. A biopsy of the margins of the fistulous orifice of the left hypochondria was performed. Pathological examination found a granular infiltrate with caseous necrosis confirming the diagnosis of tuberculosis. The patient was put under anti-tuberculosis treatment with a good clinical and radiological evolution.

Published
2018

23. Predictive factors for major amputation of lower limb in diabetic foot: about 430 patients.

Author

Khalfallah M, Gouta EL, Dougaz W, Jerraya H, Samaali I, Nouira R, Bouasker I, and Dziri C

Subjects
Adult, Age Factors, Aged, Aged, 80 and over, Female, Humans, Intensive Care Units statistics & numerical data, Length of Stay, Lower Extremity pathology, Male, Middle Aged, Multivariate Analysis, Patient Readmission statistics & numerical data, Retrospective Studies, Risk Factors, Sensitivity and Specificity, Time Factors, Tunisia, Young Adult, Amputation, Surgical statistics & numerical data, Diabetic Foot surgery, Lower Extremity surgery
Abstract

Background: Major amputation of the lower limb is defined by a leg or thigh amputation. The aim of our work was identifying predictive factors for lower limb major amputation in patients with diabetes admitted on for foot lesions through using an administrative data base., Methods: It was a retrospective study ranging from June 1st, 2008 to December 31st, 2011, which included all the patients admitted on for an infected diabetic foot to the surgery unit B of Charles Nicolle hospital in Tunis. The main judgement criterion was the major amputation of the lower limb. We have done a descriptive and a comparative study, with univariate and multivariate analysis., Results: We have enrolled 319 men and 111 women. The average age was 60.5 ± 12 years. Ninety five patients (24%) had a major amputation. Former inpatient, patient readmitted within one month post-operatively, stay in intensive care, admission in intensive care within 48hours after admission, age ≥ 65 years, presence of kidney problem, preoperative stay and length of intervention were identified as predictive factors of major amputation in the univariate analysis. Age was the only independent variable predictive for major amputation which appeared from the multivariate analysis (p=0.004).  The age cut-off ≥ 65 years has a specificity of 69 % and a sensitivity of 47% [p=0.004, OR=1.971, IC 95% : 1.239-3.132]., Conclusions: Age was the only independent predictive factor for major amputation of the lower limb in the diabetic foot with a threshold value higher or equal to 65 years. Patients aged more than 65 had 1.9 time more risk to undergo major amputation of the lower limb.

Published
2018

24. Surgery of the pancreatic cystic echinococcosis: systematic review.

Author

Dziri C, Dougaz W, and Bouasker I

Abstract

The prevalence of pancreatic cystic echinococcosis (PCE) in the world is low ranging between 0.2% and 0.6%. The diagnosis of PCE is easy when it is associated to other location such as liver, it became difficult when PCE was isolated simulating other diagnosis such as pseudocyst, a choledochal cyst, serous or mucinous cystadenoma and cystadenocarcinoma. This systematic review aimed to provide evidence-based answer to the following questions: (I) what are the efficient tools to affirm the diagnosis of isolated PCE and (II) what are the best therapeutic strategy for the PCE? An electronic search was performed by two authors (W Dougaz, I Bouasker). Medline, Scopus, Embase, Web of Science, Google Scholar and Cochrane collaboration were consulted. The keywords used were "cyst", "echinococcosis", "hydatid cyst" and "pancreas". All abstracts were analyzed followed by extraction of the full text by the same two authors (W Dougaz, I Bouasker), all divergences were resolved by discussion with C Dziri. Recommendations were based on Oxford's classification: (I) what are the efficient tools to affirm the diagnosis of PCE? -ultrasound remains the cornerstone of diagnosis. Magnetic resonance imaging (MRI) reproduces the ultrasound defined features of CE better than computed tomography (CT). MRI with heavily T2-weighted series is preferable to CT. Pancreatic duct MRI should be promising to identify a fistula between PCE and pancreatic duct (level of evidence 3-recommendation B); (II) what are the best therapeutic strategy for the PCE? -surgery is the main treatment of PCE. Open approach is validated. The decision depends of the location of PCE: head versus body and/or tail of the pancreas (level of evidence 5-recommendation D): for the head of the pancreas, the tendency is toward conservative surgery. For body and/or tail of the pancreas, the tendency is toward radical surgery. Medical treatment (albendazole) should be prescribed 1 week before surgery and 2 months during postoperative period (level II evidence and grade C recommendation)., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.

Published
2017
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25. Pseudo papillary and solid tumor of the pancreas: a rare tumor and a difficult diagnosis.

Author

Gouta EL, Khalfallah M, Jerraya H, Dougaz W, Nouira R, and Dziri C

Subjects
Adolescent, Female, Humans, Carcinoma, Papillary diagnosis, Pancreatic Neoplasms diagnosis
Abstract

The pseudopapillary and solid tumor of the pancreas is a rare disease that accounts for 2% of pancreatic tumors. It affects mainly young, female adults. The clinical features are not specific, hence the diagnostic difficulty and the importance of imaging. The diagnosis is based on pathological examination coupled with immunohistochemistry. The aim of our work was to report the difficulty of the diagnostic procedure in a patient with a pancreatic cystic tumor.

Published
2017

26. Prognostic factors in rectal cancer: where is the evidence?

Author

Khalfallah M, Dougaz W, Jerraya H, Nouira R, Bouasker I, and Dziri C

Subjects
Adenocarcinoma pathology, Adenocarcinoma surgery, Biomarkers, Tumor analysis, Digestive System Surgical Procedures, Disease-Free Survival, Humans, Neoplasm Staging, Prognosis, Rectal Neoplasms pathology, Rectal Neoplasms surgery, Risk Factors, Adenocarcinoma diagnosis, Adenocarcinoma epidemiology, Evidence-Based Practice methods, Evidence-Based Practice trends, Rectal Neoplasms diagnosis, Rectal Neoplasms epidemiology
Abstract

Background: In rectal cancer, the 5 years survival is about 53 % for all stages: it remains low in spite of the progress of diagnostic and therapeutic tools. The aim of this work was to provide evidence based answers to the following question: what are the pre, intra and post operative prognostic factors in rectal cancer?, Methods: We have carried out a search in the following data bases: Pubmed, Embase, Cochrane and Scopus. The key words used were: « rectal cancer », « adenocarcinoma », « overall survival », « disease-free survival », « prognosis » and « evidence-based medicine ». The overall 5 years survival rate has been retained as primary outcome measure. Recurrence-free survival has been retained as secondary endpoint. Were included meta-analyses and systematic reviews of clinical trials dating back to less than six years., Results:   We retrieved 270 publications, 27 articles only met the above-mentioned eligibility criteria and thereof have been retained in this work. A high operating volume, a specialized surgeon in colorectal surgery, a total mesorectal excision, an adjuvant chemotherapy given within no more than 8 weeks following the curative resection improve prognosis in rectal cancer with level I of evidence. Anastomotic leak and diabetes worsen prognosis in rectal cancer with level I of evidence. Margin of surgical resection must be RO to improve prognosis in rectal cancer with level I of evidence., Conclusion: The main prognostic factors found in literature which we should keep in mind are those on which surgeons can  act:  neoadjuvant treatment,  high operating volume of the surgeon,  high tie of the inferior mesenteric  artery,  mesorectal excision , RO resection,  improvement of the techniques of intersphincteric resection and techniques of anastomosis   and adjuvant chemotherapy within less than 8 weeks when appropriate.

Published
2017

27. Abstracts of the 40th National Congress of Medicine Tunis, 19-20 October 2017.

Author

Abdallah M, Abdelaziz A, Abdelaziz O, Abdelhedi N, Abdelkbir A, Abdelkefi M, Abdelmoula L, Abdennacir S, Abdennadher M, Abidi H, Abir Hakiri A, Abou El Makarim S, Abouda M, Achour W, Aichaouia C, Aissa A, Aissa Y, Aissi W, Ajroudi M, Allouche E, Aloui H, Aloui D, Amdouni F, Ammar Y, Ammara Y, Ammari S, Ammous A, Amous A, Amri A, Amri M, Amri R, Annabi H, Antit S, Aouadi S, Arfaoui A, Assadi A, Attia L, Attia M, Attia L, Ayadi I, Ayadi Dahmane I, Ayari A, Azzabi S, Azzouz H, B Mefteh N, B Salah C, Baccar H, Bachali A, Bahlouli M, Bahri G, Baïli H, Bani M, Bani W, Bani MA, Bassalah E, Bawandi R, Bayar M, Bchir N, Bechraoui R, Béji M, Beji R, Bel Haj Yahia D, Belakhel S, Belfkih H, Belgacem O, Belgacem N, Belhadj A, Beltaief N, Beltaief N, Ben Abbes M, Ben Abdelaziz A, Ben Ahmed I, Ben Aissia N, Ben Ali M, Ben Ammar H, Ben Ammou B, Ben Amor A, Ben Amor M, Benatta M, Ben Ayed N, Ben Ayoub W, Ben Charrada N, Ben Cheikh M, Ben Dahmen F, Ben Dhia M, Ben Fadhel S, Ben Farhat L, Ben Fredj Ismail F, Ben Hamida E, Ben Hamida Nouaili E, Ben Hammamia M, Ben Hamouda A, Ben Hassine L, Ben Hassouna A, Ben Hasssen A, Ben Hlima M, Ben Kaab B, Ben Mami N, Ben Mbarka F, Ben Mefteh N, Ben Kahla N, Ben Mrad M, Ben Mustapha N, Ben Nacer M, Ben Neticha K, Ben Othmen E, Ben Rhouma S, Ben Rhouma M, Ben Saadi S, Ben Safta A, Ben Safta Z, Ben Salah C, Ben Salah N, Ben Sassi S, Ben Sassi J, Ben Tekaya S, Ben Temime R, Ben Tkhayat A, Ben Tmim R, Ben Yahmed Y, Ben Youssef S, Ben Ali M, Ben Atta M, Ben Safta Z, Ben Salah M, Berrahal I, Besbes G, Bezdah L, Bezzine A, Bezzine A, Bokal Z, Borsali R, Bouasker I, Boubaker J, Bouchekoua M, Bouden F, Boudiche S, Boukhris I, Bouomrani S, Bouraoui S, Bouraoui S, Bourgou S, Boussabeh E, Bouzaidi K, Chaker K, Chaker L, Chaker A, Chaker F, Chaouech N, Charfi M, Charfi MR, Charfi F, Chatti L, Chebbi F, Chebbi W, Cheikh R, Cheikhrouhou S, Chekir J, Chelbi E, Chelly I, Chelly B, Chemakh M, Chenik S, Cheour M, Cheour M, Cherif E, Cherif Y, Cherif W, Cherni R, Chetoui A, Chihaoui M, Chiraz Aichaouia C, Dabousii S, Daghfous A, Daib A, Daib N, Damak R, Daoud N, Daoud Z, Daoued N, Debbabi H, Demni W, Denguir R, Derbel S, Derbel B, Dghaies S, Dhaouadi S, Dhilel I, Dimassi K, Dougaz A, Dougaz W, Douik H, Douik El Gharbi L, Dziri C, El Aoud S, El Hechmi Z, El Heni A, ELaoud S, Elfeleh E, Ellini S, Ellouz F, Elmoez Ben O, Ennaifer R, Ennaifer S, Essid M, Fadhloun N, Farhat M, Fekih M, Fourati M, Fteriche F, G Hali O, Galai S, Gara S, Garali G, Garbouge W, Garbouj W, Ghali O, Ghali F, Gharbi E, Gharbi R, Ghariani W, Gharsalli H, Ghaya Jmii G, Ghédira F, Ghédira A, Ghédira H, Ghériani A, Gouta EL, Guemira F, Guermazi E, Guesmi A, Hachem J, Haddad A, Hakim K, Hakiri A, Hamdi S, Hamed W, Hamrouni S, Hamza M, Haouet S, Hariz A, Hendaoui L, Hfaidh M, Hriz H, Hsairi M, Ichaoui H, Issaoui D, Jaafoura H, Jazi R, Jazia R, Jelassi H, Jerraya H, Jlassi H, Jmii G, Jouini M, Kâaniche M, Kacem M, Kadhraoui M, Kalai M, Kallel K, Kammoun O, Karoui M, Karouia S, Karrou M, Kchaou A, Kchaw R, Kchir N, Kchir H, Kechaou I, Kerrou M, Khaled S, Khalfallah N, Khalfallah M, Khalfallah R, Khamassi K, Kharrat M, Khelifa E, Khelil M, Khelil A, Khessairi N, Khezami MA, Khouni H, Kooli C, Korbsi B, Koubaa MA, Ksantini R, Ksentini A, Ksibi I, Ksibi J, Kwas H, Laabidi A, Labidi A, Ladhari N, Lafrem R, Lahiani R, Lajmi M, Lakhal J, Laribi M, Lassoued N, Lassoued K, Letaif F, Limaïem F, Maalej S, Maamouri N, Maaoui R, Maâtallah H, Maazaoui S, Maghrebi H, Mahfoudhi S, Mahjoubi Y, Mahjoubi S, Mahmoud I, Makhlouf T, Makni A, Mamou S, Mannoubi S, Maoui A, Marghli A, Marrakchi Z, Marrakchi J, Marzougui S, Marzouk I, Mathlouthi N, Mbarek K, Mbarek M, Meddeb S, Mediouni A, Mechergui N, Mejri I, Menjour MB, Messaoudi Y, Mestiri T, Methnani A, Mezghani I, Meziou O, Mezlini A, Mhamdi S, Mighri M, Miled S, Miri I, Mlayeh D, Moatemri Z, Mokaddem W, Mokni M, Mouhli N, Mourali MS, Mrabet A, Mrad F, Mrouki M, Msaad H, Msakni A, Msolli S, Mtimet S, Mzabi S, Mzoughi Z, Naffeti E, Najjar S, Nakhli A, Nechi S, Neffati E, Neji H, Nouira Y, Nouira R, Omar S, Ouali S, Ouannes Y, Ouarda F, Ouechtati W, Ouertani J, Ouertani J, Ouertani H, Oueslati A, Oueslati J, Oueslati I, Oueslati A, Rabai B, Rahali H, Rbia E, Rebai W, Regaïeg N, Rejeb O, Rhaiem W, Rhimi H, Riahi I, Ridha R, Robbena L, Rouached L, Rouis S, Safer M, Saffar K, Sahli H, Sahraoui G, Saidane O, Sakka D, Salah H, Sallami S, Salouage I, Samet A, Sammoud K, Sassi Mahfoudh A, Sayadi C, Sayhi A, Sebri T, Sedki Y, Sellami A, Serghini M, Sghaier I, Skouri W, Skouri W, Slama I, Slimane H, Slimani O, Souhail O, Souhir S, Souissi A, Souissi R, Taboubi A, Talbi G, Tbini M, Tborbi A, Tekaya R, Temessek H, Thameur M, Touati A, Touinsi H, Tounsi A, Tounsia H, Trabelsi S, Trabelsi S, Triki A, Triki M, Turki J, Turki K, Twinsi H, Walha Y, Wali J, Yacoub H, Yangui F, Yazidi M, Youssef I, Zaier A, Zainine R, Zakhama L, Zalila H, Zargouni H, Zehani A, Zeineb Z, Zemni I, Zghal M, Ziadi J, Zid Z, Znagui I, Zoghlami C, Zouaoui C, Zouari B, Zouiten L, and Zribi H

Published
2017

28. Treatment of inguinal hernia by lichtenstein technique: an open prospective study.

Author

Samaali I, Zenaidi HH, Dougaz W, Khalfallah M, Jarraya H, Nouira R, Bouasker I, and Dziri C

Subjects
Adult, Aged, Aged, 80 and over, Analysis of Variance, Female, Herniorrhaphy adverse effects, Humans, Male, Middle Aged, Pain, Postoperative, Postoperative Complications, Prospective Studies, Recurrence, Surgical Wound complications, Treatment Outcome, Young Adult, Hernia, Inguinal surgery, Herniorrhaphy methods
Abstract

Background: Treatment of inguinal hernia is still a challenge for the surgeon. The multitude of surgical techniques attests of the difficulty of choosing the best procedure. In the surgical B department of the Charles Nicolle Hospital we have chosen the Lichtenstein technique since 2008. The aim of this study was to evaluate the immediate and long-term results of this technique and to identify the predictive factors of recurrence., Methods: This open prospective study included all patients who underwent an elective inguinal hernia repair in the surgical B department of the Charles Nicolle Hospital between June 1st 2008 and December 31st 2009. These patients were regularly followed for at least three years. Hernia's recurrence was the primary study endpoint. Postoperative pain, wound complications, urinary complications were secondary endpoints.  An univariate and multivariate analysis were performed to identify predictive factor of hernia recurrence., Results: 256 men and eight women were involved in this study with a sex ratio to 32. The average age was 54 years, ranging from 18 to 85 years. we identified seven cases of recurrent hernia (2,6%) with a risk of recurrence at five years equal to 4.9%, 95%CI[4,5 - 5,3].Wound complications were present in 90 patients (34%), dominated by serums seen in 12.1% of cases. The scrotal edema was found in 32 patients (12%). Eight patients kept a postoperative pain after three years of follow-up (3%). The presence of coagulation disorders in pre-operative check-up ( OR 32.25, 95% CI [3.33- 333.3], p = 0.003) and the persistence of pain after one year of intervention ( OR 16.12,95% CI [2.68 -100], p = 0.01) were two predictive factors of hernia recurrence., Conclusion: The Lichtenstein technique remains the gold standard technique in the treatment of inguinal hernias by open surgery. It is a safe, simple, reproducible procedure with a low recurrence rate.

Published
2016

29. Prognostic Nutritional Index score is useful to predict post-operative mortality and morbidity in gastric cancer.

Author

Khalfallah M, Jerraya H, Sbai A, Dougaz W, Changuel A, Nouira R, Bouasker I, and Dziri C

Subjects
Analysis of Variance, Female, Gastrectomy, Humans, Lymphocyte Count, Male, Middle Aged, Nutritional Status, Outcome Assessment, Health Care, Prognosis, Retrospective Studies, Sensitivity and Specificity, Serum Albumin, Stomach Neoplasms blood, Stomach Neoplasms surgery, Nutrition Assessment, Postoperative Complications mortality, Stomach Neoplasms mortality
Abstract

Background - The Prognostic Nutritional Index (PNI) score is based on the level of lymphocytes and albuminemia. The aim of this study was to validate the pre-operative PNI score for predicting post-operative mortality and morbidity of patients operated on for gastric cancer. Methods - This retrospective study collected data from patients operated on for a gastric cancer at the surgical unit B of Charles Nicolle's hospital in Tunis between January 1st, 2008 and December 31, 2012. The main outcome measure was post-operative death within 30 days. The secondary outcome was post-operative morbidity (within 30 days). We have performed a descriptive analysis, a univariate and multivariate analysis with logistic regression and a ROC curve analysis. Results - 14 women and 26 men were enrolled, with a sex ratio of 1,85. The mean age was 63 ± 15. Post-operative mortality and morbidity rate were respectively 18% and 28%. The ROC curve allowed us to validate the PNI for predicting post-operative mortality in gastric cancer with a threshold level of 38 with sensitivity 100% and specificity 64%. PNI was also validated for post-operative morbidity with a threshold level of 38 with sensitivity 82% and specificity 66%. Conclusion - PNI was validated for predicting post-operative mortality and post-operative morbidity in gastric cancer.

Published
2016

30. Predictive factors of failure and mortality after CT-Guided percutaneous drainage of infected pancreatic necrosis.

Author

Dougaz W, Bouasker I, Ben Osman S, Nouira R, and Dziri C

Subjects
Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Pancreatitis, Acute Necrotizing diagnostic imaging, Radiography, Interventional, Retrospective Studies, Tomography, X-Ray Computed, Drainage, Pancreatitis, Acute Necrotizing mortality, Pancreatitis, Acute Necrotizing therapy
Abstract

Background: The traditional approach to the drainage of infected pancreatic necrosis (IPN) is open necrosectomy. As an alternative to open necrosectomy, percutaneous drainage is the first-line treatment of IPN. This study is aimed to identify predictive factor of failure after CT-guided percutaneous catheter drainage (PCD) of IPN., Methods: Between June 1st 1988 and October 31th 2011, 26 patients with IPN were treated by PCD. The outcome measures were the failure of the PCD and/or death. A descriptive analysis was performed followed by a comparative analysis of alive versus deceased patients and success group versus failure group. Univariate and multivariate analysis were performed to determine predictive factors of failure after percutaneous drainage or death., Results: The failure and mortality rates were respectively 38% and 34%. The size of catheter inferior to 10 French was the only variable associated with the percutaneous drainage failure (OR=27, CI95% [2.5-284.6], p=0.006]. The collection number on CT scan was associated with mortality (OR=2.2, IC95% [1-5.1], p=0.050)., Conclusion: PCD with catheter size equal or greater than 10 French is efficient tool for the treatment of IPN. Collection number on CT scan is an independent predictive factor of mortality.

Published
2016

31. Mesh repair versus non-mesh repair for strangulated inguinal hernia: systematic review with meta-analysis.

Author

Hentati H, Dougaz W, and Dziri C

Subjects
Adult, Female, Hernia, Inguinal complications, Humans, Recurrence, Surgical Wound Infection epidemiology, Hernia, Inguinal surgery, Surgical Mesh
Abstract

Background: The optimal technique to cure strangulated inguinal hernia remains controversial. The use of mesh in cases of strangulated hernia is still debated due to the potential risk of infection., Objective: This systematic review aimed to determine whether or not the mesh repair technique is associated with a higher risk of surgical site infection than non-mesh techniques for strangulated inguinal hernias in adults., Methods: An electronic search of the relevant literature was performed on 15 December 2012 using the following databases: MEDLINE, the Cochrane Library, Scopus, Embase, and the Web of Science. Articles reporting a comparison between the mesh repair technique and a non-mesh technique to treat strangulated inguinal hernias in adults, and published in the English or French language in a peer-reviewed journal, were considered for analysis. The quality of randomized controlled trials (RCTs) was assessed using the Jadad scoring system. To assess the quality of non-randomized trials, we used the Methodological Index for Non-Randomized Studies (MINORS)., Results: A total of 232 papers was found in the initial search; nine were included in the meta-analysis. The wound infection rate in the mesh repair technique group was lower than in the control group, with a trend towards significance (odds ratio [OR] 0.46, 95 % confidence interval [CI] 0.20-1.07; p = 0.07). The hernia recurrence rate was lower in the mesh repair group (OR 0.2, 95 % CI 0.05-0.78; p = 0.02)., Conclusion: The mesh repair technique is a good option for the treatment of strangulated inguinal hernias in adults, giving an acceptable wound infection rate and fewer recurrences than non-mesh repair. Our study does not allow us to recommend the use of mesh in cases of bowel resection. We emphasize that, except the two RCTs, the results are predicated on patient selection bias by careful surgeons. Further RCTs are required to obtain more powerful evidence-based data.

Published
2014
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32. [Colonovesical fistula complicating colonic diverticulitis].

Author

Bedoui R, Maghrebi H, Dougaz W, Chaker Y, Nouira R, and Dziri C

Subjects
Aged, Colon, Sigmoid surgery, Diverticulitis, Colonic diagnostic imaging, Female, Humans, Intestinal Fistula diagnostic imaging, Radiography, Diverticulitis, Colonic complications, Intestinal Fistula complications
Published
2012

33. Gastrointestinal stromal tumor mimicking peritoneal hydatid cyst.

Author

Bedoui R, Nouira R, Maghrebi H, Dougaz W, and Dziri C

Subjects
Diagnosis, Differential, Female, Humans, Middle Aged, Echinococcosis diagnostic imaging, Gastrointestinal Stromal Tumors diagnostic imaging, Peritoneal Diseases diagnostic imaging, Peritoneal Diseases parasitology, Tomography, X-Ray Computed
Published
2010

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