TRAITEMENT CHIRURGICAL DES OCCLUSIONS NEOPLASIQUES DU COLON GAUCHE ET DU RECTUM (ETUDE RETROSPECTIVE)

LIMOGES-BU Médecine pharmacie (870852108) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Man With Joint Pain and Abdominal Pain

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Management of mucocele of the appendix with peritoneal dissemination in pregnant women: a case report and literature review

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Acute intestinal ischaemia due to a foramen of Winslow hernia

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Effect of 5-Fluoro-Uracile + Oxaliplatin chemotherapy on the histological response of PEritoneal and hePatIc corectal metasTases in a mOuse model: PEPITO experimental study

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Découverte fortuite de micro-adénome endocrine pancréatique : à propos de deux cas

International audienceA 59-year-old male, was admitted to our hospital for a tumor of the pancreatic tail. Serum CEA and CA 19-9 levels were normal. Splenopancreasectomy found a desmoid tumour. A 69-year-old male was referred to our institution for chronic anemia and inflammatory syndrome with splenomegaly. Splenectomy showed an important splenic congestion and siderosis. Both patients had a type 2 diabetes mellitus. Furthermore, histological examination revealed pancreatic endocrine microadenomas. The two patients' postoperative course was unremarkable. Eleven and 24 months respectively after the diagnosis, the patients are alive and well, with no tumor recurrence.Un patient âgé de 59 ans a été hospitalisé pour prise en charge d’une tumeur de la queue du pancréas. Les taux sériques d’ACE et de CA 19-9 étaient normaux. La spléno-pancréatectomie caudale a révélé une tumeur desmoïde. Le second patient, âgé de 69 ans, a été hospitalisé pour prise en charge d’une anémie chronique inexpliquée associée à un syndrome inflammatoire et à une splénomégalie. La splénectomie a montré une importante congestion associée à une sidérose. L’examen histologique a conduit, dans ces deux observations de patients diabétiques de type 2, à la découverte fortuite de micro-adénomes endocrines pancréatiques. Les deux patients ne présentent pas de récidive respectivement à 11 et à 24 mois après l’intervention et bénéficient d’une simple surveillance clinique et radiologique

Generation of a syngeneic orthotopic graft murine model of peritoneal carcinomatosis for studying in vivo nsPEF anticancerous effects

International audienceCarcinoma of the colon and rectum known as colorectal cancer (CRC) is a common cancer that causes around 700 000 deaths from CRC annually and more than 3.5 millions of patients living with it [1]. In addition to the liver, which is the most commonly affected organ, the peritoneum (the membrane that covers the entire abdominal cavity and viscera) is another common metastatic site. Indeed, peritoneal metastases are found in 10 to 25% of cases of CRC [2,3]. The localization remains only peritoneal in about 25% of these cases. Until recently, oncologists and digestive surgeons have considered peritoneal carcinomatosis (CPc, the implantation of tumor cells throughout the peritoneal cavity) as an incurable disease [4]. Currently, the only treatment for validated CPc is based on a complete cytoreduction associated with intraperitoneal hyperthermia chemotherapy (CHIP), supervised by systemic chemotherapy [5]. This treatment has improved the long-term survival of these highly selected patients with a median survival of between 22 and 60 months [6,7]. However, this curative surgical treatment is only available to patients with resectable CPc. The majority of patients with CPc is considered unresectable at the time of diagnosis [8] and will not be able to access this curative treatment despite systemic neoadjuvant chemotherapy. In addition, this surgical treatment is associated with a morbidity of 30% in these already fragile patients [9] and any complication may delay the introduction of post-operative systemic chemotherapy which is equally important in their management.It is for these reasons that it is imperative to work on therapeutic alternatives to treat these many patients with unresectable peritoneal carcinomatosis. High-intensity pulsed electric fields with nanosecond durations (3-300ns; nsPEFs) have emerged as a promising tool for tumor ablation [10-12]. The physical mechanisms and specific type of cell death that occurs following the application of nsPEFs is under investigation by several groups and initial studies have shown effects on cell signaling through calcium and cell death pathways [13-14], mitochondria [15] and cytoskeleton [17-19].In order to develop a new model of peritoneal colorectal cancer in mouse suitable for studies on nsPEF treatment, we grafted murine colon carcinoma CT-26 cells expressing luciferase in immunocompetent BALB-c mice by intravenous, subcutaneous, intraperitoneal or laparotomy injection and followed the tumoral growth by bioluminescence over 15 days post-grafting. In vitro CT-26 cells were analyzed by flow cytometry for their sensitivity to nsPEFs (survival, mitochondrial potential and permeabilization). In parallel, human and mice peritoneal tumoral tissue were observed by multiphoton microscopy in order to evaluate the tumor microenvironment

Predictive value of C-reactive protein levels for the early and later detection of postoperative complications after cytoreductive surgery and HIPEC

International audienceSynopsis C-reactive protein (CRP), white blood cells and procalcitonin (PCT) participate in the systemic response to inflammation and increase after postoperative infective complications. Postoperative complications after CRS and HIPEC could be predicted using the CRP cut-off value (169 mg/L at PODs 3-5 and 62 mg/L at PODs 7-10). Background Postoperative elevation of C-reactive protein (CRP) can be used in order to predict the postoperative complications in many indications. Cytoreduction surgery (CRS) associated with hyperthermic intraperitoneal chemotherapy (HIPEC) is associated with high morbidity. Objectives The aim of the study was to demonstrate the CRP predictive value for the occurrence of complications. Methods All patients who had CRS and HIPEC, regardless of the origin of peritoneal metastasis, were included in this retrospective study. Postoperative complications and CRP and white blood cell (WBC) counts were recorded from postoperative day (POD) 1 through 10. Results Among the 127 patients included, 58 (45.7%) had no complications (NCs), 53 (41.7%) had infective complications (ICs), and 16 (12.6%) had non-infective complications (NICs). The IC group had a higher CRP value than the NC group, which was statistically significant from POD7 to POD10 (41.1 versus 107.5 p = 0.023 and 77.8 versus 140 p = 0.047, respectively). A cut-off CRP value was 169 mg/L at PODs 3-5 and 62 mg/L at PODs 7-10. The area under the curve (AUC) at POD5 was 0.56 versus 0.76 at POD7, p=0.007. The sensibility, specificity, positive and negative predictive values of these cut-offs were 55%, 83%, 74% and 67%, respectively. Moreover, 17 patients (32%) with ICs had a CRP value higher than these cut-offs before the diagnosis was made by the medical team. Conclusion This study suggested that postoperative complications could be predicted using the CRP cut-off value on PODs 3-5 (169 mg/l) and PODs 7-10 (62 mg/l) after CRS and HIPEC

Effects of HyaRegen® Gel on tumour proliferation of colorectalperitoneal metastases

International audiencePressurized intraperitoneal aerosol chemotherapy (PIPAC) is a valuabletherapeutic alternative for patients with peritoneal metastases. PIPAC uses ahyaluronic acid-based gel to reduce surgically induced adhesions.Hyaluronic acid (HA) is a natural disaccharide polymer composed of Dglucuronicacid and D-N-acetylglucosamine monomers linked by alternatingβ-1,4 and β-1,3 glycosidic bonds. HA is present in large quantities in thehuman body; more than half of all HA is located in the skin, particularly in thedermis. HyaRegen® Gel (BioRegen Laboratory) is a sterile, transparentviscous gel; its active component is cross-linked HA molecules. The gelcreates a barrier preventing tissue adhesion during healing after surgery.The aim of this study was to evaluate the effects of the hyaluronic acidbasedgel on tumor dissemination

Stepwise management of hepatocellular carcinoma associated with Abernethy syndrome

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