Benjamin Darnis, Louise Tedeschi, Marie-Cécile Blanchet, Vincent Frering, Jessica Crozet, Benoit Gignoux, Christophe Duchamp
{"title":"Management of pilonidal sinus and recurrences in 2025","authors":"Benjamin Darnis, Louise Tedeschi, Marie-Cécile Blanchet, Vincent Frering, Jessica Crozet, Benoit Gignoux, Christophe Duchamp","doi":"10.1016/j.jviscsurg.2024.12.005","DOIUrl":"10.1016/j.jviscsurg.2024.12.005","url":null,"abstract":"<div><div>Pilonidal sinus is a common pathology of the intergluteal cleft that can develop into abscess or suppuration. This lesion corresponds histologically to a granuloma that organizes around foreign bodies, most often hairs, and fistulizes to the skin through partially epithelialized orifices. If suppuration and abscess develop, treatment is based either on medical treatment combining analgesics, local antiseptics and sometimes antibiotics, or on emergency incision and drainage in the operating room. This is performed in more than 10,000 patients per year in France. Outside of emergencies, elective surgery for pilonidal sinus is indicated to treat bothersome symptoms or to avoid the risk of recurrent abscess. The surgical indication must take into account the patient's risk factors, particularly active smoking, that increase the risk of postoperative complications and recurrence. Elective intervention is performed on more than 30,000 patients per year in France. Radical excision followed by secondary healing is the most commonly performed option. This strategy carries a risk of failure or recurrence for at least 10% of patients. Primary closure after excision can reduce the time for healing and convalescence, but at the cost of more frequent infectious complications. Midline closure should be avoided, in favor of paramedian or flap closure. Minimally invasive techniques are being developed that combine the extraction of foreign bodies and mechanical debridement or thermal or chemical cautery of the granulomatous walls. They avoid complex and unpleasant nursing care of secondarily healing wounds, at the cost of a recurrence rate equivalent to that from excision techniques. They have the merit of avoiding difficult situations of failure to heal or recurrence after radical excision that are associated with a clear deterioration in the quality of life. The treatment of surgical failures is complex, and combines comprehensive patient care (smoking cessation, anti-infectious treatments, treatment of excess weight, avoidance of a sedentary lifestyle) and often a repeat operation. Minimally invasive treatments, particularly laser treatments, have their place in these difficult situations.</div></div>","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":"162 2","pages":"Pages 117-127"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059677","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}
Julien Epailly , Olivier Georges , Florence de Dominicis
{"title":"RE: RE : Traumatic diaphragmatic wound repair","authors":"Julien Epailly , Olivier Georges , Florence de Dominicis","doi":"10.1016/j.jviscsurg.2024.12.002","DOIUrl":"10.1016/j.jviscsurg.2024.12.002","url":null,"abstract":"","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":"162 2","pages":"Page 163"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833844","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":"Will today's (scientific) truth be tomorrow's?","authors":"Karem Slim , Arnaud Alves","doi":"10.1016/j.jviscsurg.2025.01.011","DOIUrl":"10.1016/j.jviscsurg.2025.01.011","url":null,"abstract":"","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":"162 2","pages":"Pages 89-92"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460372","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}
Laura Beyer-Berjot , Alain Valverde , Jérémie H. Lefevre , on behalf of the Executive Board and 3CVD's Organisation and Scientific Committees
{"title":"The advent of the 3CVD Congress – A new era for visceral and digestive surgery in France","authors":"Laura Beyer-Berjot , Alain Valverde , Jérémie H. Lefevre , on behalf of the Executive Board and 3CVD's Organisation and Scientific Committees","doi":"10.1016/j.jviscsurg.2025.02.001","DOIUrl":"10.1016/j.jviscsurg.2025.02.001","url":null,"abstract":"","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":"162 2","pages":"Pages 93-95"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450790","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}
Dahbia Djelil , Ulrich Clarac , Daniel Eyrauld , Solene Doat , Olivier Lucidarne , Marc Pocard
{"title":"Abdominal and concomitant thoracic HIPEC, named HITAC : Technique and post-operative courses","authors":"Dahbia Djelil , Ulrich Clarac , Daniel Eyrauld , Solene Doat , Olivier Lucidarne , Marc Pocard","doi":"10.1016/j.jviscsurg.2025.01.002","DOIUrl":"10.1016/j.jviscsurg.2025.01.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is the preferred treatment for selected patients with carcinomatosis. When diaphragmatic involvement occurs, partial diaphragm resection (DR) is necessary to achieve complete cytoreduction (CC-0). In cases of macroscopic pleural invasion detected during CRS, abdominal and intrathoracic HIPEC (HITAC) through the diaphragm may be considered if pleural and peritoneal CC0 can be obtained.</div></div><div><h3>Objectives</h3><div>To report the combined procedure technique, postoperative course, morbidity, and long-term outcomes.</div></div><div><h3>Methods</h3><div>A monocentric database was used to identify cases.</div></div><div><h3>Results</h3><div>Seven synchronous HITAC cases were identified. Median PCI was 12 (3–39). Inflow catheter placement was behind the spleen, with outflow in the right thorax. Four patients had anastomosis and two splenectomy. Oxaliplatin was used in 4 HITAC, mitomycin in 1, and cisplatin in 2. Surgery lasted a median of 580<!--> <!-->mins (300–720), with extubation 2–4<!--> <!-->h post-op, or on day 1. Median thoracic drainage on day 1 was 657<!--> <!-->mL (300–1600), decreasing by day 3. Median drain removal was on day 8 (7–17), with hospital stay of 12 days (8–16). One patient had a postoperative pancreatic fistula and pneumonia, while the remaining 6 had no major complications. One-month residual pleural effusion was noted in one case. No pleural recurrence was observed for PMP, with a median follow-up of 88 months (30–166).</div></div><div><h3>Conclusions</h3><div>Combined HIPEC and intrathoracic chemotherapy is feasible without major risks. Thoracic drainage can produce high volumes postoperatively. Favorable long-term outcomes are observed in low-grade PMP.</div></div>","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":"162 2","pages":"Pages 96-101"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833845","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}