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J L Faucheron - One of the best experts on this subject based on the ideXlab platform.
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prospective evaluation of functional outcomes after laparoscopic sigmoidectomy with high tie of the Inferior Mesenteric Artery for diverticular disease in consecutive male patients
Techniques in Coloproctology, 2020Co-Authors: M Jolivet, Bertrand Trilling, P Y Sage, B Boussat, Edouard Girard, J L FaucheronAbstract:To date, there has been no consensus concerning the vascular approach during sigmoid colectomy for diverticular disease. The aim of this study was to determine the functional impact of elective laparoscopic sigmoidectomy performed with high ligation of the Inferior Mesenteric Artery for diverticulitis in consecutive male patients. Twenty-five consecutive patients of median age 53 years were enrolled in a prospective single-centre pilot study at a tertiary teaching hospital. Main outcome measures were functional results. Patients were asked to complete standardized, validated questionnaires to evaluate preoperative and 6 months postoperative bowel symptomatology (Jorge–Wexner Incontinence Score and KESS score), urinary function (IPSS), and sexual function (IIEF). Secondary outcomes were surgical data, morbidity, and quality of life (SF-36). There were no significant differences between preoperative and 6 months postoperative total scores for bowel symptomatology, urinary function, and sexual function. There were no perioperative deaths. The morbidity rate was 12% including three minor and no major events. Quality of life demonstrated statistically better general health (p < 0.01) and better medical status over the prior 4 weeks at 6 months after surgery, compared to baseline. This single-centre prospective study has a limited number of patients, relatively short follow-up time, and includes only male patients. Laparoscopic sigmoidectomy with high tie of the Inferior Mesenteric Artery for diverticular disease does not induce functional disorders at 6 months after surgery. The benefit of the operation for quality of life is even greater for general health and medical status.
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level of Inferior Mesenteric Artery ligation in low rectal cancer surgery high tie preferred over low tie
Techniques in Coloproctology, 2019Co-Authors: Edouard Girard, Bertrand Trilling, P Y Sage, J L Faucheron, Pierreyves Rabattu, Nicolas Taton, Yohann Robert, Philippe ChaffanjonAbstract:There is no demonstrated benefit of high-tie versus low-tie vascular transections in low rectal cancer surgery. The aim of this study was to compare the effects of high tie and low tie of the Inferior Mesenteric Artery on colonic length. This study was conducted in a surgical anatomy research laboratory. Anatomical dissections were performed on 11 human cadavers. We performed full left colonic mobilization, section of the descending-sigmoid junction, and high and low ligation of the Inferior Mesenteric Artery. Distance from the proximal colon limb to the lower edge of the pubis symphysis was recorded after each step of vascular division. Three measurements were successively performed: before vascular section, after Inferior Mesenteric Artery ligation, and after Inferior Mesenteric Artery and vein section. Before vascular section, the mean distance between colonic end and lower edge of the symphysis pubis was − 1.9 ± 3.5 cm. After combined Artery and vein section, the mean distance was + 10.7 ± 4.6 cm for high tie and + 1.5 ± 3 cm for low tie. A limitation of this study is the use of embalmed anatomical specimens, rather than live patients, and the small number of specimens. This study also does not evaluate colon limb vascularization or the impact of proximal lymph node dissection on survival rates. High tie of the Inferior Mesenteric Artery at its aortic origin allows a gain of extra length of about 9 cm over low tie.
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level of Inferior Mesenteric Artery ligation in low rectal cancer surgery high tie preferred over low tie
Techniques in Coloproctology, 2019Co-Authors: Edouard Girard, P Y Sage, Pierreyves Rabattu, Nicolas Taton, Yohann Robert, Philippe Chaffanjon, B Trilling, J L FaucheronAbstract:Background There is no demonstrated benefit of high-tie versus low-tie vascular transections in low rectal cancer surgery. The aim of this study was to compare the effects of high tie and low tie of the Inferior Mesenteric Artery on colonic length.
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energy vessel sealing systems versus mechanical ligature of the Inferior Mesenteric Artery in laparoscopic sigmoidectomy
International Journal of Colorectal Disease, 2016Co-Authors: Bertrand Trilling, Edouard Girard, Romain Riboud, J Abba, J L FaucheronAbstract:With the development of new devices, our ligation technique of the Inferior Mesenteric Artery changed from mechanical ligature (ML) to energized vessel sealing systems (EVSS) ligature. The aim of this study was to determine if EVSS could be considered as safe and effective as the more convention ML of the Inferior Mesenteric vessels division during elective laparoscopic left colectomy. Between 2001 and 2014, 200 consecutive patients (111 males) of mean age 54.1 years were operated laparoscopically for a symptomatic sigmoid diverticulitis. Vascular interruptions were performed using mechanical ligatures including double clipping, staples or surgical thread (100 patients) or, starting from 2006, with EVSS thereafter (100 patients). Section of the Inferior Mesenteric Artery is performed systematically at its origin in our institution for teaching purposes. Technical results were prospectively collected perioperatively and postoperatively. There was no mortality. Mean operating time was 253.7 and 200.7 min in the ML and EVSS groups, respectively (p < 0.001). Mean hospital stay was 10.4 and 8.1 days (p < 0.001). Thirty-day complications occurred in 31 versus 25 % of patients (p = 0.26). Leakage with peritonitis occurred in 3 patients in the ML group. Hemorrhagic events occurred in both groups (2 in ML group versus 1 in EVSS group). Limitations of the study are its retrospective design and the bias due to the comparison of two historical cohorts. EVSS for the Inferior Mesenteric Artery are as safe and effective as ML in elective sigmoidectomy for diverticular disease with lower operative time and hospital stay.
Edouard Girard - One of the best experts on this subject based on the ideXlab platform.
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prospective evaluation of functional outcomes after laparoscopic sigmoidectomy with high tie of the Inferior Mesenteric Artery for diverticular disease in consecutive male patients
Techniques in Coloproctology, 2020Co-Authors: M Jolivet, Bertrand Trilling, P Y Sage, B Boussat, Edouard Girard, J L FaucheronAbstract:To date, there has been no consensus concerning the vascular approach during sigmoid colectomy for diverticular disease. The aim of this study was to determine the functional impact of elective laparoscopic sigmoidectomy performed with high ligation of the Inferior Mesenteric Artery for diverticulitis in consecutive male patients. Twenty-five consecutive patients of median age 53 years were enrolled in a prospective single-centre pilot study at a tertiary teaching hospital. Main outcome measures were functional results. Patients were asked to complete standardized, validated questionnaires to evaluate preoperative and 6 months postoperative bowel symptomatology (Jorge–Wexner Incontinence Score and KESS score), urinary function (IPSS), and sexual function (IIEF). Secondary outcomes were surgical data, morbidity, and quality of life (SF-36). There were no significant differences between preoperative and 6 months postoperative total scores for bowel symptomatology, urinary function, and sexual function. There were no perioperative deaths. The morbidity rate was 12% including three minor and no major events. Quality of life demonstrated statistically better general health (p < 0.01) and better medical status over the prior 4 weeks at 6 months after surgery, compared to baseline. This single-centre prospective study has a limited number of patients, relatively short follow-up time, and includes only male patients. Laparoscopic sigmoidectomy with high tie of the Inferior Mesenteric Artery for diverticular disease does not induce functional disorders at 6 months after surgery. The benefit of the operation for quality of life is even greater for general health and medical status.
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level of Inferior Mesenteric Artery ligation in low rectal cancer surgery high tie preferred over low tie
Techniques in Coloproctology, 2019Co-Authors: Edouard Girard, Bertrand Trilling, P Y Sage, J L Faucheron, Pierreyves Rabattu, Nicolas Taton, Yohann Robert, Philippe ChaffanjonAbstract:There is no demonstrated benefit of high-tie versus low-tie vascular transections in low rectal cancer surgery. The aim of this study was to compare the effects of high tie and low tie of the Inferior Mesenteric Artery on colonic length. This study was conducted in a surgical anatomy research laboratory. Anatomical dissections were performed on 11 human cadavers. We performed full left colonic mobilization, section of the descending-sigmoid junction, and high and low ligation of the Inferior Mesenteric Artery. Distance from the proximal colon limb to the lower edge of the pubis symphysis was recorded after each step of vascular division. Three measurements were successively performed: before vascular section, after Inferior Mesenteric Artery ligation, and after Inferior Mesenteric Artery and vein section. Before vascular section, the mean distance between colonic end and lower edge of the symphysis pubis was − 1.9 ± 3.5 cm. After combined Artery and vein section, the mean distance was + 10.7 ± 4.6 cm for high tie and + 1.5 ± 3 cm for low tie. A limitation of this study is the use of embalmed anatomical specimens, rather than live patients, and the small number of specimens. This study also does not evaluate colon limb vascularization or the impact of proximal lymph node dissection on survival rates. High tie of the Inferior Mesenteric Artery at its aortic origin allows a gain of extra length of about 9 cm over low tie.
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level of Inferior Mesenteric Artery ligation in low rectal cancer surgery high tie preferred over low tie
Techniques in Coloproctology, 2019Co-Authors: Edouard Girard, P Y Sage, Pierreyves Rabattu, Nicolas Taton, Yohann Robert, Philippe Chaffanjon, B Trilling, J L FaucheronAbstract:Background There is no demonstrated benefit of high-tie versus low-tie vascular transections in low rectal cancer surgery. The aim of this study was to compare the effects of high tie and low tie of the Inferior Mesenteric Artery on colonic length.
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energy vessel sealing systems versus mechanical ligature of the Inferior Mesenteric Artery in laparoscopic sigmoidectomy
International Journal of Colorectal Disease, 2016Co-Authors: Bertrand Trilling, Edouard Girard, Romain Riboud, J Abba, J L FaucheronAbstract:With the development of new devices, our ligation technique of the Inferior Mesenteric Artery changed from mechanical ligature (ML) to energized vessel sealing systems (EVSS) ligature. The aim of this study was to determine if EVSS could be considered as safe and effective as the more convention ML of the Inferior Mesenteric vessels division during elective laparoscopic left colectomy. Between 2001 and 2014, 200 consecutive patients (111 males) of mean age 54.1 years were operated laparoscopically for a symptomatic sigmoid diverticulitis. Vascular interruptions were performed using mechanical ligatures including double clipping, staples or surgical thread (100 patients) or, starting from 2006, with EVSS thereafter (100 patients). Section of the Inferior Mesenteric Artery is performed systematically at its origin in our institution for teaching purposes. Technical results were prospectively collected perioperatively and postoperatively. There was no mortality. Mean operating time was 253.7 and 200.7 min in the ML and EVSS groups, respectively (p < 0.001). Mean hospital stay was 10.4 and 8.1 days (p < 0.001). Thirty-day complications occurred in 31 versus 25 % of patients (p = 0.26). Leakage with peritonitis occurred in 3 patients in the ML group. Hemorrhagic events occurred in both groups (2 in ML group versus 1 in EVSS group). Limitations of the study are its retrospective design and the bias due to the comparison of two historical cohorts. EVSS for the Inferior Mesenteric Artery are as safe and effective as ML in elective sigmoidectomy for diverticular disease with lower operative time and hospital stay.
P Y Sage - One of the best experts on this subject based on the ideXlab platform.
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prospective evaluation of functional outcomes after laparoscopic sigmoidectomy with high tie of the Inferior Mesenteric Artery for diverticular disease in consecutive male patients
Techniques in Coloproctology, 2020Co-Authors: M Jolivet, Bertrand Trilling, P Y Sage, B Boussat, Edouard Girard, J L FaucheronAbstract:To date, there has been no consensus concerning the vascular approach during sigmoid colectomy for diverticular disease. The aim of this study was to determine the functional impact of elective laparoscopic sigmoidectomy performed with high ligation of the Inferior Mesenteric Artery for diverticulitis in consecutive male patients. Twenty-five consecutive patients of median age 53 years were enrolled in a prospective single-centre pilot study at a tertiary teaching hospital. Main outcome measures were functional results. Patients were asked to complete standardized, validated questionnaires to evaluate preoperative and 6 months postoperative bowel symptomatology (Jorge–Wexner Incontinence Score and KESS score), urinary function (IPSS), and sexual function (IIEF). Secondary outcomes were surgical data, morbidity, and quality of life (SF-36). There were no significant differences between preoperative and 6 months postoperative total scores for bowel symptomatology, urinary function, and sexual function. There were no perioperative deaths. The morbidity rate was 12% including three minor and no major events. Quality of life demonstrated statistically better general health (p < 0.01) and better medical status over the prior 4 weeks at 6 months after surgery, compared to baseline. This single-centre prospective study has a limited number of patients, relatively short follow-up time, and includes only male patients. Laparoscopic sigmoidectomy with high tie of the Inferior Mesenteric Artery for diverticular disease does not induce functional disorders at 6 months after surgery. The benefit of the operation for quality of life is even greater for general health and medical status.
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level of Inferior Mesenteric Artery ligation in low rectal cancer surgery high tie preferred over low tie
Techniques in Coloproctology, 2019Co-Authors: Edouard Girard, Bertrand Trilling, P Y Sage, J L Faucheron, Pierreyves Rabattu, Nicolas Taton, Yohann Robert, Philippe ChaffanjonAbstract:There is no demonstrated benefit of high-tie versus low-tie vascular transections in low rectal cancer surgery. The aim of this study was to compare the effects of high tie and low tie of the Inferior Mesenteric Artery on colonic length. This study was conducted in a surgical anatomy research laboratory. Anatomical dissections were performed on 11 human cadavers. We performed full left colonic mobilization, section of the descending-sigmoid junction, and high and low ligation of the Inferior Mesenteric Artery. Distance from the proximal colon limb to the lower edge of the pubis symphysis was recorded after each step of vascular division. Three measurements were successively performed: before vascular section, after Inferior Mesenteric Artery ligation, and after Inferior Mesenteric Artery and vein section. Before vascular section, the mean distance between colonic end and lower edge of the symphysis pubis was − 1.9 ± 3.5 cm. After combined Artery and vein section, the mean distance was + 10.7 ± 4.6 cm for high tie and + 1.5 ± 3 cm for low tie. A limitation of this study is the use of embalmed anatomical specimens, rather than live patients, and the small number of specimens. This study also does not evaluate colon limb vascularization or the impact of proximal lymph node dissection on survival rates. High tie of the Inferior Mesenteric Artery at its aortic origin allows a gain of extra length of about 9 cm over low tie.
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level of Inferior Mesenteric Artery ligation in low rectal cancer surgery high tie preferred over low tie
Techniques in Coloproctology, 2019Co-Authors: Edouard Girard, P Y Sage, Pierreyves Rabattu, Nicolas Taton, Yohann Robert, Philippe Chaffanjon, B Trilling, J L FaucheronAbstract:Background There is no demonstrated benefit of high-tie versus low-tie vascular transections in low rectal cancer surgery. The aim of this study was to compare the effects of high tie and low tie of the Inferior Mesenteric Artery on colonic length.
Bertrand Trilling - One of the best experts on this subject based on the ideXlab platform.
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prospective evaluation of functional outcomes after laparoscopic sigmoidectomy with high tie of the Inferior Mesenteric Artery for diverticular disease in consecutive male patients
Techniques in Coloproctology, 2020Co-Authors: M Jolivet, Bertrand Trilling, P Y Sage, B Boussat, Edouard Girard, J L FaucheronAbstract:To date, there has been no consensus concerning the vascular approach during sigmoid colectomy for diverticular disease. The aim of this study was to determine the functional impact of elective laparoscopic sigmoidectomy performed with high ligation of the Inferior Mesenteric Artery for diverticulitis in consecutive male patients. Twenty-five consecutive patients of median age 53 years were enrolled in a prospective single-centre pilot study at a tertiary teaching hospital. Main outcome measures were functional results. Patients were asked to complete standardized, validated questionnaires to evaluate preoperative and 6 months postoperative bowel symptomatology (Jorge–Wexner Incontinence Score and KESS score), urinary function (IPSS), and sexual function (IIEF). Secondary outcomes were surgical data, morbidity, and quality of life (SF-36). There were no significant differences between preoperative and 6 months postoperative total scores for bowel symptomatology, urinary function, and sexual function. There were no perioperative deaths. The morbidity rate was 12% including three minor and no major events. Quality of life demonstrated statistically better general health (p < 0.01) and better medical status over the prior 4 weeks at 6 months after surgery, compared to baseline. This single-centre prospective study has a limited number of patients, relatively short follow-up time, and includes only male patients. Laparoscopic sigmoidectomy with high tie of the Inferior Mesenteric Artery for diverticular disease does not induce functional disorders at 6 months after surgery. The benefit of the operation for quality of life is even greater for general health and medical status.
-
level of Inferior Mesenteric Artery ligation in low rectal cancer surgery high tie preferred over low tie
Techniques in Coloproctology, 2019Co-Authors: Edouard Girard, Bertrand Trilling, P Y Sage, J L Faucheron, Pierreyves Rabattu, Nicolas Taton, Yohann Robert, Philippe ChaffanjonAbstract:There is no demonstrated benefit of high-tie versus low-tie vascular transections in low rectal cancer surgery. The aim of this study was to compare the effects of high tie and low tie of the Inferior Mesenteric Artery on colonic length. This study was conducted in a surgical anatomy research laboratory. Anatomical dissections were performed on 11 human cadavers. We performed full left colonic mobilization, section of the descending-sigmoid junction, and high and low ligation of the Inferior Mesenteric Artery. Distance from the proximal colon limb to the lower edge of the pubis symphysis was recorded after each step of vascular division. Three measurements were successively performed: before vascular section, after Inferior Mesenteric Artery ligation, and after Inferior Mesenteric Artery and vein section. Before vascular section, the mean distance between colonic end and lower edge of the symphysis pubis was − 1.9 ± 3.5 cm. After combined Artery and vein section, the mean distance was + 10.7 ± 4.6 cm for high tie and + 1.5 ± 3 cm for low tie. A limitation of this study is the use of embalmed anatomical specimens, rather than live patients, and the small number of specimens. This study also does not evaluate colon limb vascularization or the impact of proximal lymph node dissection on survival rates. High tie of the Inferior Mesenteric Artery at its aortic origin allows a gain of extra length of about 9 cm over low tie.
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energy vessel sealing systems versus mechanical ligature of the Inferior Mesenteric Artery in laparoscopic sigmoidectomy
International Journal of Colorectal Disease, 2016Co-Authors: Bertrand Trilling, Edouard Girard, Romain Riboud, J Abba, J L FaucheronAbstract:With the development of new devices, our ligation technique of the Inferior Mesenteric Artery changed from mechanical ligature (ML) to energized vessel sealing systems (EVSS) ligature. The aim of this study was to determine if EVSS could be considered as safe and effective as the more convention ML of the Inferior Mesenteric vessels division during elective laparoscopic left colectomy. Between 2001 and 2014, 200 consecutive patients (111 males) of mean age 54.1 years were operated laparoscopically for a symptomatic sigmoid diverticulitis. Vascular interruptions were performed using mechanical ligatures including double clipping, staples or surgical thread (100 patients) or, starting from 2006, with EVSS thereafter (100 patients). Section of the Inferior Mesenteric Artery is performed systematically at its origin in our institution for teaching purposes. Technical results were prospectively collected perioperatively and postoperatively. There was no mortality. Mean operating time was 253.7 and 200.7 min in the ML and EVSS groups, respectively (p < 0.001). Mean hospital stay was 10.4 and 8.1 days (p < 0.001). Thirty-day complications occurred in 31 versus 25 % of patients (p = 0.26). Leakage with peritonitis occurred in 3 patients in the ML group. Hemorrhagic events occurred in both groups (2 in ML group versus 1 in EVSS group). Limitations of the study are its retrospective design and the bias due to the comparison of two historical cohorts. EVSS for the Inferior Mesenteric Artery are as safe and effective as ML in elective sigmoidectomy for diverticular disease with lower operative time and hospital stay.
Pierreyves Rabattu - One of the best experts on this subject based on the ideXlab platform.
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level of Inferior Mesenteric Artery ligation in low rectal cancer surgery high tie preferred over low tie
Techniques in Coloproctology, 2019Co-Authors: Edouard Girard, Bertrand Trilling, P Y Sage, J L Faucheron, Pierreyves Rabattu, Nicolas Taton, Yohann Robert, Philippe ChaffanjonAbstract:There is no demonstrated benefit of high-tie versus low-tie vascular transections in low rectal cancer surgery. The aim of this study was to compare the effects of high tie and low tie of the Inferior Mesenteric Artery on colonic length. This study was conducted in a surgical anatomy research laboratory. Anatomical dissections were performed on 11 human cadavers. We performed full left colonic mobilization, section of the descending-sigmoid junction, and high and low ligation of the Inferior Mesenteric Artery. Distance from the proximal colon limb to the lower edge of the pubis symphysis was recorded after each step of vascular division. Three measurements were successively performed: before vascular section, after Inferior Mesenteric Artery ligation, and after Inferior Mesenteric Artery and vein section. Before vascular section, the mean distance between colonic end and lower edge of the symphysis pubis was − 1.9 ± 3.5 cm. After combined Artery and vein section, the mean distance was + 10.7 ± 4.6 cm for high tie and + 1.5 ± 3 cm for low tie. A limitation of this study is the use of embalmed anatomical specimens, rather than live patients, and the small number of specimens. This study also does not evaluate colon limb vascularization or the impact of proximal lymph node dissection on survival rates. High tie of the Inferior Mesenteric Artery at its aortic origin allows a gain of extra length of about 9 cm over low tie.
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level of Inferior Mesenteric Artery ligation in low rectal cancer surgery high tie preferred over low tie
Techniques in Coloproctology, 2019Co-Authors: Edouard Girard, P Y Sage, Pierreyves Rabattu, Nicolas Taton, Yohann Robert, Philippe Chaffanjon, B Trilling, J L FaucheronAbstract:Background There is no demonstrated benefit of high-tie versus low-tie vascular transections in low rectal cancer surgery. The aim of this study was to compare the effects of high tie and low tie of the Inferior Mesenteric Artery on colonic length.