2 research outputs found

    Analyse écorégionale marine de Nouvelle-Calédonie : atelier d'identification des aires de conservation prioritaires

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    Dans le cadre de l'initiative pour les rĂ©cifs coralliens du Pacifique sud (CRISP), le WWF-France a souhaitĂ© dĂ©velopper un projet pour la protection des rĂ©cifs et des lagons nĂ©o-calĂ©doniens. L'atelier, qui s'est dĂ©roulĂ© les 10 et 11 aoĂ»t Ă  NoumĂ©a, avait pour objectif de rassembler les scientifiques et les experts du lagon nĂ©ocalĂ©donien pour identifier, sur la base de leur connaissance experte, les zones les plus remarquables du lagon (richesse, endĂ©misme, originalitĂ© des faunes et flores, espĂšces emblĂ©matiques, zones d'intĂ©rĂȘt fonctionnel) sur lesquelles doivent porter en prioritĂ© les efforts de conservation. Il a permis d'identifier 20 aires prioritaires pour la conservation, parmi lesquelles 6 ont un intĂ©rĂȘt mondial, 4 ont un intĂ©rĂȘt sur le plan rĂ©gional, les autres ayant un intĂ©rĂȘt local

    Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit

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    Aim The anastomosis technique used following right-sided colonic resection is widely variable and may affect patient outcome. This study aimed to assess the association between leak and anastomosis technique (stapled vs handsewn). Method This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a 2-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, determined using a prespecified definition. Mixed effects logistic regression models were used to assess the association between leak and anastomosis method, adjusting for patient, disease and operative cofactors, with centre included as a random-effect variable. Results This study included 3208 patients, of whom 78.4\% (n = 2515) underwent surgery for malignancy and 11.7\% (n = 375) underwent surgery for Crohn's disease. An anastomosis was performed in 94.8\% (n = 3041) of patients, which was handsewn in 38.9\% (n = 1183) and stapled in 61.1\% (n = 1858). Patients undergoing hand-sewn anastomosis were more likely to be emergency admissions (20.5\% handsewn vs 12.9\% stapled) and to undergo open surgery (54.7\% handsewn vs 36.6\% stapled). The overall anastomotic leak rate was 8.1\% (245/3041), which was similar following handsewn (7.4\%) and stapled (8.5\%) techniques (P = 0.3). After adjustment for cofactors, the odds of a leak were higher for stapled anastomosis (adjusted OR = 1.43; 95\% CI: 1.04-1.95; P = 0.03). Conclusion Despite being used in lower-risk patients, stapled anastomosis was associated with an increased anastomotic leak rate in this observational study. Further research is needed to define patient groups in whom a stapled anastomosis is safe
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