Colorectal screening following appendectomy in adult patients: a systematic review.

Purpose: Although the association between appendicitis and colorectal cancer in older patients has received attention, postoperative colorectal screening through endoscopy is not currently recommended. This study conducted a systematic review of the literature on colorectal screening following appendectomy in adult patients. Methods: A literature search was performed using online databases. Studies reporting colorectal surveillance after appendectomy in adult patients were retrieved for assessment. Results: Eight articles including a total of 3,995 patients were published between 2013 and 2023. An age of 40 years was the lower threshold in 6 of the 8 articles. Postoperative colorectal screening occurred in 771 patients (19.3%). Endoscopy was performed in 95.2% of cases and computed tomography-colonography in 4.8%. During endoscopic examinations, a lesion was discovered in 184 of 771 patients (24.0%), and an adenomatous polyp was found in 154 of 686 patients (22.5%). The overall cancer rate was 3.9% (30 of 771 patients). The tumor was located in the right-sided colon in 46.7% of the patients, in the cecum in 20.0%, in the rectum in 16.7%, in the left-sided colon in 10.0%, and in the sigmoid colon in 6.7%. Conclusion: Performing post-appendectomy colorectal screening in patients >40 years of age could allow early detection of an underlying lesion.

Influence of mesh type on the quality of early outcomes after inguinal hernia repair in ambulatory setting controlled study: Glucamesh® vs Polypropylene®.

BACKGROUND: Early post-operative pain after inguinal hernia repair delays management in ambulatory setting. The type of mesh used for repair appears to influence their incidence. AIMS: The aim of this randomized, prospective study using the alternation principle was to compare post-operative early pain and the quality of life of patients operated on for inguinal hernia depending on the type of mesh used and their impact on management in ambulatory setting. PATIENTS AND METHODS: Fifty successive patients were included prospectively. Hernia repair was performed using the Lichtenstein procedure with two types of mesh, namely standard polypropylene 100 g/m² (Prolène®) or light polypropylene (55 g/m²) with a natural beta-D-glucan coating (Glucamesh®). The main assessment criterion was post-operative pain evaluated twice daily by the patient for 7 days, using the visual analogue scale (VAS) and their use of analgesics. The secondary assessment criteria were the rate of unscheduled admissions the evening of the intervention and the hospital length of stay and the quality of life evaluated by the SF12 questionnaire at pre-operative stage and on days 7 and 30. RESULTS: The two groups were comparable. The operative durations were identical (38.8±10.2 vs 48±15.4 min). On the evening of the intervention before discharge, the pain was less intense in the Glucamesh® group (mean VAS score 21.6±2.4 vs 31.7±6.2, p=0.02). On day 4, 20% of patients from the Glucamesh® group and none of the patients from the Prolène® group had a VAS score of 0 (p=0.02). There were no unscheduled admissions in either group, but the hospital stay was significantly shorter in the Glucamesh® group compared with the Prolène® group (288±35 vs 360±48 min, p=0.02). The post-operative quality of life evaluated by the SF12 questionnaire from day 7 to day 30 was the same in both groups (38±4.8 vs 37±5.2) and altered as at pre-operative stage compared with a control population (normal=50). CONCLUSIONS: This randomized, prospective study showed that the use of a self-adhesive, light mesh, reducing the fixation sutures and coated with factors favouring tissue integration, such as the Glucamesh® prosthesis, significantly reduced early post-operative pain compared with conventional prostheses and could increase the percentage of patients likely to undergo an ambulatory hernia repair.

Papillary carcinoma of the thyroglossal duct cyst: report of two cases.

AIM: To present two cases of papillary carcinoma of the thyroglossal duct cyst (TDC) and to report their management. PATIENTS AND METHODS: Two patients, a 47-year-old woman and a 60-year-old man, were operated in 2006 and 2008 in the Department of Digestive and Metabolic Surgery of the "Jean Verdier" Hospital. RESULTS: The diagnosis of papillary carcinoma was established after the pathological examination carried out on the thyroglossal duct cyst, after its complete surgical excision. A total thyroidectomy followed by a treatment by radioactive iodine and a substitutive hormonal therapy were carried out in the second time for one of the two patients. For the other patient, a total thyroidectomy followed by a substitute hormonal therapy, were achieved. The evolution was favorable, with a follow-up of four years for the first patient and two years for the second one. DISCUSSION: Total thyroidectomy after the complete excision of the cyst is currently the recommended treatment for the papillary carcinoma of the TDC. It was shown that a latent thyroid cancer could develop even 15 years after the initial excision of the thyroglossal cyst. The treatment is curative in 95% of the cases. CONCLUSIONS: Current treatment of papillary carcinoma of the thyroglossal duct cyst is well codified, allowing an excellent prognostic.

Acute glycemic and blood lipid response to the ingestion of a candy bar-like protein supplement compared with its candy bar counterpart.

Candy bar-like protein supplements are sometimes consumed for their sugar alcohol content, which lowers the glycemic response. The purpose of this study was to determine the acute glycemic and blood lipid response to the ingestion of a candy bar-like protein supplement compared with its candy bar counterpart. In a crossover design, 5 males and 5 females (N = 10; age, 24 ± 5.5 years; height, 174 ± 8.3 cm; weight, 80 ± 21.9 kg) consumed a candy bar (CBR) or a similar protein bar (PBR) after a 10-h fast. Blood draws occurred at baseline and at 15, 30, 45, and 60 min after consumption and were analyzed for blood glucose, insulin, and lipid profiles. A 2×5 ANOVA was used, with Student's t tests for significant interactions. A significant (p < 0.05) blood glucose time effect occurred in both groups, with a more profound glucose response from the CBR at 15 min (CBR: 6.2 ± 0.8 mmol·L(-1); PBR: 4.9 ± 0.5 mmol·L(-1)). Triglycerides increased significantly (p < 0.05), independent of group, peaking at 60 min (Δ CBR: 0.8 ± 0.3 mmol·L(-1); Δ PBR: 1.3 ± 0.3 mmol·L(-1)). Insulin increased significantly (p < 0.05), independent of group, peaking at 15 min (Δ CBR: 42 ± 27 µIU·mL(-1); Δ PBR: 25 ± 11 µIU·mL(-1)). No significant change (p > 0.05) was observed in total cholesterol. Blood glucose, triglycerides, and insulin all increased significantly in response to both CBR and PBR consumption. The CBR elicited a greater effect on blood glucose; however, the PBR had a strong impact on serum triglycerides and insulin.

The trans-metastasis hepatectomy (through metastases previously ablated with radiofrequency): results of a 13-case study of colorectal cancer.

BACKGROUND: Curative trans-metastasis liver resection immediately following radiofrequency (RF) destruction is a new technique that enables the proposition of a curative approach to patients with bilateral, unresectable liver metastases (LM), when the only possible future hepatectomy plane passes through a LM. Firstly, the ill-sited LM, which is located in the only feasible future hepatectomy plane, is ablated using RF; the hepatectomy is then performed through this ablated LM. AIM: The aim of this study is to report the feasibility and efficacy of this new approach, known as post-RF-trans-metastasis-hepatectomy (PRFTMH). MATERIALS AND METHODS: Thirteen patients with colorectal primary cancer were treated with PRFTMPH between January 2000 and May 2004. The mean number of LMs per patient was 10.7. Preoperative hypertrophy of the future remaining liver was achieved by selective portal vein embolization in eight patients. RESULTS: The mortality rate was 7.6% (one death), and morbidity was 24%. No local recurrence was observed at the PRTMPH site after a mean follow-up of 19.4 months (range: 47-10), demonstrating the efficacy of this technique. All patients, except those who died postoperatively, are currently alive; the median survival has not yet been attained after a mean follow-up of 19.4 months. CONCLUSION: TMPRFH is a new and safe technique, combining RF ablation and trans-RF-hepatectomy, which makes it possible to propose a curative approach in certain patients with non-resectable bilateral LMs.