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Recent trends in the treatment of well-differentiated endocrine carcinoma of the small bowel

World Journal of Gastroenterology 2010年第14期16卷 1696-1706页

作者： Gilles Poncet jean-luc faucheron Thomas Walter Department of Digestive Surgery Edouard Herriot Hospital 69437 Lyon cedex 03 France Department of Colorectal Surgery Michallon Hospital 38043 Grenoble cedex France Department of Medical Oncology Pavillon H Edouard Herriot Hospital 69437 Lyon Cedex 03 France

Well-differentiated endocrine carcinomas of the small bowel are fairly rare neoplasms that present many clinical challenges. They secrete peptides and neuroamines that may cause carcinoid syndrome. However, many are clinically silent until late presentation with major effects. Initial treatment aims to control carcinoid syndrome with somatostatin analogs. Even if there is metastatic spread, surgical resection of the primitive tumor should be discussed in cases of retractile mesenteritis, small bowel ischemia or subocclusive syndrome in order to avoid any acute complication, in particular at the beginning of somatostatin analog treatment. The choice of treatment depends on the symptoms, general health of the patient, tumor burden, degree of uptake of radionuclide, histological features of the tumor, and tumor growth. Management strategies include surgery for cure (which is rarely achieved) or for cytoreduction, radiological interventions (transarterial embolization or radiofrequency ablation), and chemotherapy (interferon and somatostatin analogs). New biological agent and radionuclide targeted therapies are under investigation. Diffuse and non-evolving lesions should also be simplymonitored. Finally, it has to be emphasized that it is of the utmost importance to enroll these patients with a rare disease in prospective clinical trials assessing new therapeutic strategies.

关键词： Gastrointestinal neoplasms Neuroendocrine carcinoma Carcinoid tumor Somatostatin analogs Therapeutic chemoembolization Surgery

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Anterior rectopexy for full-thickness rectal prolapse: Technical and functional results

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World Journal of Gastroenterology 2015年第16期21卷 5049-5055页

作者： jean-luc faucheron Bertrand Trilling Edouard Girard Pierre-Yves Sage Sandrine Barbois Fabian Reche Colorectal Unit Department of SurgeryUniversity Hospital

AIM:To assess effectiveness, complications, recurrence rate, and recent improvements of the anterior rectopexy procedure for treatment of total rectal ***:MEDLINE, Pub Med, EMBASE, and other relevant database were searched to identify *** controlled trials, non-randomized studies and original articles in English language, with more than 10 patients who underwent laparoscopic ventral rectopexy for full-thickness rectal prolapse, with a follow-up over 3 mo were considered for the ***:Twelve non-randomized case series studies with 574 patients were included in the *** surgical mortality was *** was needed in 17 cases(2.9%), most often due to difficult *** eight patients(4.8%) presented with major ***(1.2%) mesh-related complications were *** frequent complications were urinary tract infection and urinary *** recurrence rate was 4.7% with a median follow-up of 23 *** of constipation ranged from 3%-72% of the patients and worsening or new onset occurred in 0%-20%.Incontinence improved in 31%-84% patients who presented fecal incontinence at various *** of functional score was disparate between ***:Based on the low long-term recurrence rate and favorable outcome data in terms of low de novo constipation rate, improvement of anal incontinence, and low complications rate, laparoscopic anterior rectopexy seems to emerge as an efficient procedure for the treatment of patients with total rectal prolapse.

关键词： Total rectal prolapse Laparoscopy Anteriorrectopexy Ventral rectopexy Results Recurrence Systematic review

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痔结扎切除术后并发症:一项在法国进行的多中心研究

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世界核心医学期刊文摘（胃肠病学分册） 2005年第9期1卷 25-26页

作者： Oughriss M. Yver R. faucheron J.-L. 翟惠虹 Unité de Chirurgie Colrectale Département de Chirurgie Digestive et de l'Urgence Hpital Michallon BP 2/7 3804 Grenobe Cedex 09 France

Objectives-The aim of this retrospective multicentric study was to assess the complications of the Longo technique for the treatment of haemorrhoidal disease. Methods-From March 1999 to April 2003, 550 patients underwent a stapled hemorrhoidectomy following Longo’s technique in 12 surgical units in the Rhne-Alpes Region. The operative indications were the same as for conventional hemorrhoidectomy. Complications were divided into early or late complications depending on whether they occurred before or after the 7 th day. For each patient, the most serious complication was retained for analysis. Results-One hundred and five patients (19%), mean age 51 years, experienced complications. The early complications were bleeding (1.8%), severe anal pain (2.3%), urinary retention (0.9%) and sepsis (0.5%). Late complicationswere chronic anal pain (1.6%), suture dehiscence (1.6%), anal stricture (1.6%) , anal fissure (0.9%), ex- ternal thrombosis (0.9%), fistulae and intramural abscesses (0.9%), anal incontinence (0.3%), haemorrhoidal disease symptoms persistence or recurrence (3.2%). Strictures were successfully dilated, fissures were treated by sphincterotomy, external thromboses were excised and fistulae were laid open. Most of the recurrences were treated with the Milligan-Morgan hemorroidectomy technique. Conclusion-Complications may occur after stapled hemorrhoidopexy, some are particularly serious, especially bleeding and sepsis.

关键词：术后并发症晚期并发症切除术肛周脓肿括约肌切开术 ligan 痔切除脓毒症手术指征大便失禁

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骶神经调节治疗重症肛门失禁:40例连续病例独家机构报道

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世界核心医学期刊文摘（胃肠病学分册） 2006年第11期2卷 19-19页

作者： faucheron J.-L. Bost R. Duffournet V. 纪泛扑 Unitéde Chirurgie Colorectale Département de Chirurgie Digestive et de l'Urgence BP 217 38043 Grenoble

Introduction -Sacral neuromodulation is a recognized therapeutic option in severe anal incontinence from neurogenic origins, when medical treatment has failed. Methods -We report the results of this procedure applied in 40 consecutive patients operated on by a single surgeon from August 2001 to June 2004. Mean duration of incontinence was 5 years. There were 33 women and 7 men of mean age 59 (range 29-89). All patients had had medical treatment, 26 had had physiotherapy and 9 had been previously operated on for that problem. Neuromodulation consisted in a temporary electrical stimulation test followed by implantation of a stimulator in case of efficacy. Results -Twenty nine patients had a positive test and were implanted. Ten had a negative test and one is waiting for implantation. From the 29 patients, 23 had uneventful postoperative course. Incontinence score varied from 17 before neuromodulation to 6 after in the 24 patients who were improved. Mean resting pressure, mean maximum squeeze pressure and mean duration of squeeze pressure did not change from pre to postoperative period. Conclusion -Sacral neuromodulation is a safe and efficacious procedure in properly selected anal incontinent patients. However, we observed no correlation between clinical and manometric data.

关键词：肛门失禁骶神经平均持续时间刺激反应大便失禁电刺激神经调节刺激物一名

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