The influence of obesity and body mass index on the outcome of laparoscopic colorectal surgery: a systematic literature review

AIM: The relationship between obesity, body-mass index (BMI) and laparoscopic colorectal resection is unclear. Our object was to assess systematically the available evidence to establish the influence of obesity and BMI on the outcome of laparoscopic colorectal resection. METHOD: A search of PubMed/Medline databases was performed in May 2015 to identify all studies investigating the impact of BMI and obesity on elective laparoscopic colorectal resection performed for benign or malignant bowel disease. Clinical end points examined included operation time, conversion rate to open surgery, post-operative complications including anastomotic leakage, length of hospital stay, readmission rate, reoperation rate and mortality. For patients who underwent an operation for cancer, the harvested number of lymph nodes and long-term oncological data were also examined. RESULTS: 45 studies were analysed, the majority of which were Level IV with only four level III case-controlled studies. Thirty comparative studies containing 23649 patients including 17895 non-obese and 5754 obese showed no significant differences between the two groups with respect to intraoperative blood loss, overall postoperative morbidity, anastomotic leakage, reoperation rate, mortality and the number of retrieved lymph nodes in patients operated on for malignancy. Most studies, including 15 non-comparative studies, reported a longer operation time in patients who underwent a laparoscopic procedure with the BMI being an independent predictor in multivariate analyses for the operation time. CONCLUSION: Laparoscopic colorectal resection is safe and technically and oncologically feasible in obese patients. These results, however, may be different outside high volume centres of expertise. This article is protected by copyright. All rights reserved

La source de la pensée juridique de Montesquieu : la logique « d'association » : Kingston (Rebecca), Montesquieu and the Parlement of Bordeaux, Genève, Droz, 1996

Bège-Seurin Denise. La source de la pensée juridique de Montesquieu : la logique « d'association » : Kingston (Rebecca), Montesquieu and the Parlement of Bordeaux, Genève, Droz, 1996. In: Annales du Midi : revue archéologique, historique et philologique de la France méridionale, Tome 110, N°223, 1998. pp. 407-410

Un panorama institutionnel du mouvement corporatif bordelais au XVIIIe siècle : Gallinato (Bernard), Les corporations à Bordeaux à la fin de l'Ancien Régime : vie et mort d'un mode d'organisation du travail, Presses universitaires de Bordeaux, 1992

Bège-Seurin Denise. Un panorama institutionnel du mouvement corporatif bordelais au XVIIIe siècle : Gallinato (Bernard), Les corporations à Bordeaux à la fin de l'Ancien Régime : vie et mort d'un mode d'organisation du travail, Presses universitaires de Bordeaux, 1992. In: Annales du Midi : revue archéologique, historique et philologique de la France méridionale, Tome 106, N°207, 1994. pp. 383-385

Un panorama institutionnel du mouvement corporatif bordelais au XVIIIe siècle : Gallinato (Bernard), Les corporations à Bordeaux à la fin de l'Ancien Régime : vie et mort d'un mode d'organisation du travail, Presses universitaires de Bordeaux, 1992

Bège-Seurin Denise. Un panorama institutionnel du mouvement corporatif bordelais au XVIIIe siècle : Gallinato (Bernard), Les corporations à Bordeaux à la fin de l'Ancien Régime : vie et mort d'un mode d'organisation du travail, Presses universitaires de Bordeaux, 1992. In: Annales du Midi : revue archéologique, historique et philologique de la France méridionale, Tome 106, N°207, 1994. pp. 383-385

Dynamic-MRI quantification of abdominal wall motion and deformation during breathing and muscular contraction

International audienc

Semiautomatic quantification of abdominal wall muscles deformations based on dynamic MRI image registration

International audiencein the diagnosis of abdominal muscle deficiency. Here, wepresent a dedicated semiautomatic dynamic MRI postprocessing method enablingthe quantification of spatial and temporal deformations of the antero-lateral abdominalwall muscles. Ten healthy participants were imaged during a controlled breathingsession at the L3–L4 disc level using real-time dynamic MRI at 3 T. A coarse featuretrackingstep allowed the selection of the inhalation cycle of maximum abdominalexcursion. Over this image series, the described method combines (1) a supervised2D+t segmentation procedure of the abdominal wall muscles, (2) the quantificationof muscle deformations based on masks registration, and (3) the mapping of deformationswithin muscle subzones leveraging a dedicated automatic parcellation. Thesupervised 2D+t segmentation (1) provided an accurate segmentation of the abdominalwall muscles throughout maximum inhalation with a 0.95 ± 0.03 Dice similaritycoefficient (DSC) value and a 2.3 ± 0.7 mm Hausdorff distance value while requiringonly manual segmentation of 20% of the data. The robustness of the deformationquantification (2) was indicated by high indices of correspondence between the registeredsource mask and the target mask (0.98 ± 0.01 DSC value and 2.1 ± 1.5 mmHausdorff distance value). Parcellation (3) enabled the distinction of muscle substructuresthat are anatomically relevant but could not be distinguished based on imagecontrast. The present genuine postprocessing method provides a quantitative analyticalframe that could be used in further studies for a better understanding of abdominalwall deformations in physiological and pathological situations