{"title":"Efficacy of CycloMesh™+Ropivacaine in the treatment of uncomplicated inguinal hernia after the Lichtenstein procedure: Results of a prospective multicentric double-blind study.","authors":"Frank-Olivier Breleur, Haitham Khalil, André Dabrowski, Francois Mauvais, Phiphia Pipia, Mathieu Messager, Mégane Homa, Jean-Marc Regimbeau","doi":"10.1016/j.jviscsurg.2024.11.006","DOIUrl":"https://doi.org/10.1016/j.jviscsurg.2024.11.006","url":null,"abstract":"<p><strong>Background: </strong>Twenty to 30% of patients undergoing inguinal hernia surgery (20 million patients per year worldwide) present early postoperative pain. The aim of this study was to assess the interest of a mesh (CycloMesh™, Cousin Biotech) soaked with ropivacaine for managing early postoperative pain.</p><p><strong>Materials and methods: </strong>This was a randomized, phase III, comparative superiority, double-blind, international multicenter study. From October 2019 to February 2022, 290 patients underwent surgery for uncomplicated inguinal hernia, under general anesthesia, using the Liechtenstein technique. Each patient was randomly assigned to either the experimental group (mesh soaked in ropivacaine hydrochloride 10mg/mL) or the control group (mesh soaked in physiological saline solution). The primary endpoint was the pain at cough assessment with the visual analogue scale (VAS) at H6 after the surgery. The secondary endpoints were the global pain assessment at H2, H4, H6, day 1, day 2, day 3, day 7, 1month, 1year, and 2years after the surgery, assessment of antalgic consumption, description of the surgical procedure and postoperative complications rate, hospitalization and post-hospital discharge data (number of conversions from outpatient to inpatient care), and recurrence.</p><p><strong>Results: </strong>Of the 290 patients included in the study, 150 and 140 patients were in the experimental or control group respectively. The per-protocol (PP) population (240 patients) comprised 125 patients in the ropivacaine group and 115 in the control group. The mesh soaking solution had no significant effect on the pain at cough at H6, either in the intention-to-treat population (3.3 vs 3.2, P=0.12) or in the PP population (3.3 vs 3.7, P=0.15). The ropivacaine-soaked prosthesis resulted in a reduction in overall pain at H2 (2.3 vs 3.2, P<0.0001), H4 (2.3 vs 3.1, P<0.0001) and H6 (2.3 vs 2.7, P=0.0039). There was no difference between the two groups in terms of antalgic consumption, postoperative complications, or the number of ambulatory conversions.</p><p><strong>Conclusion: </strong>The placement of CycloMesh™ soaked with ropivacaine did not reduce the pain at cough at H6 but did reduce overall pain in the first 6hours after surgery and could simplify patient management.</p>","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Construction of J-shaped ileal reservoir and manual or stapled ileo-anal anastomosis.","authors":"Maxime K Collard, Jérémie H Lefèvre, Yann Parc","doi":"10.1016/j.jviscsurg.2024.09.009","DOIUrl":"10.1016/j.jviscsurg.2024.09.009","url":null,"abstract":"","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":" ","pages":"382-390"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Left hepatectomy extended to segments 1, 5 and 8 with reconstruction of the right branch of the hepatic artery for Rennes type X perihilar cholangiocarcinoma.","authors":"Heithem Jeddou, Stylianos Tzedakis, Karim Boudjema","doi":"10.1016/j.jviscsurg.2024.10.003","DOIUrl":"10.1016/j.jviscsurg.2024.10.003","url":null,"abstract":"","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":" ","pages":"391-398"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hilaire de Malleray, Henri de Lesquen, Guillaume Boddaert, Mathieu Raux, Valentin Lefrançois, Nathalie Delhaye, Pauline Ponsin, Anaïs Cordorniu, Thierry Floch, Fanny Bounes, Elisabeth Gaertner, Alexia Hardy, Julien Bordes, Éric Meaudre, Michael Cardinale
{"title":"French practice of emergency resuscitative thoracotomy. A study based on the Traumabase Registry.","authors":"Hilaire de Malleray, Henri de Lesquen, Guillaume Boddaert, Mathieu Raux, Valentin Lefrançois, Nathalie Delhaye, Pauline Ponsin, Anaïs Cordorniu, Thierry Floch, Fanny Bounes, Elisabeth Gaertner, Alexia Hardy, Julien Bordes, Éric Meaudre, Michael Cardinale","doi":"10.1016/j.jviscsurg.2024.07.002","DOIUrl":"10.1016/j.jviscsurg.2024.07.002","url":null,"abstract":"<p><strong>Aim of the study: </strong>Emergency resuscitative thoracotomy (ERT) has been described as a potentially life-saving procedure for trauma patients who have been admitted in refractory shock or with recent loss of sign of life (SOL). This nationwide registry analysis aimed to describe the French practice of ERT.</p><p><strong>Patients and methods: </strong>From 2015 to 2021, all severe trauma patients who underwent ERT were extracted from the TraumaBase→ registry. Demographic data, prehospital management and in-hospital outcomes were recorded to evaluate predictors of success-to rescue after ERT at 24-hour and 28-day.</p><p><strong>Results: </strong>Only 10/26 Trauma centers have an effective practice of ERT, three of them perform more than 1 ERT/year. Sixty-six patients (74% male, 49/66) with a median age of 37 y/o [26-51], mostly with blunt trauma (52%, 35/66) were managed with ERT. The median pre-hospital time was 64mins [45-89]. At admission, the median injury severity score was 35 [25-48], and 51% (16/30) of patients have lost SOL. ERT was associated with a massive transfusion protocol including 8 RBCs [6-13], 6 FFPs [4-10], and 0 PCs [0-1] in the first 6h. The overall success-to-rescue after ERT at 24-h and 28-d were 27% and 15%, respectively. In case of refractory shock after penetrating trauma, survival was 64% at 24-hours and 47% at 28-days.</p><p><strong>Conclusions: </strong>ERT integrated into the trauma protocol remains a life-saving procedure that appears to be underutilized in France, despite significant success-to-rescue observed by trained teams for selected patients.</p>","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":" ","pages":"356-363"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}