Witry-lès-Reims, France
Witry-lès-Reims, France

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Rhaiem R.,Robert Debre University Hospital | Rhaiem R.,University of Tunis | Rhaiem R.,University of Champagne Ardennes | Piardi T.,Robert Debre University Hospital | And 10 more authors.
Surgery Today | Year: 2017

Purpose: Laparoscopic surgery has gained the acceptance of the hepatobiliary surgical community and expert teams are now advocating major laparoscopic liver resections (LLRs). In this setting, the liver hanging maneuver (LHM) has been described in numerous series. We conducted a systematic review to investigate the effectiveness of the LHM in LLR. Methods: We performed an electronic literature search using PubMed, EMBASE, and COCHRANE databases. The final search was carried out in December, 2015. Results: We found 11 articles describing a collective total of 104 surgical procedures that were eligible for this study. Laparoscopic LHM was used in LLR for both benign and malignant conditions, and also in living donor liver transplantation (LDLT). The LHM was used mainly in right hepatectomy and only two authors reproduced the original LHM. We investigated the intraoperative parameters, preservation of postoperative liver function, and oncological outcomes. The clear benefit of using the LHM in LLR is for better identification of the parenchymal transection plane with less blood loss. The other benefits of LHM could not be corroborated by solid data on its positive value. Conclusions: In view of the data published in the literature, our findings are not strong enough to support the systematic use of LHM in LLR. © 2017 Springer Japan


Tronquoy A.-F.,University of Rouen | De Quatrebarbes J.,University of Rouen | Picard D.,University of Rouen | Courville P.,University of Rouen | And 5 more authors.
Journal of the American Academy of Dermatology | Year: 2011

Background: Skin manifestations of relapsing polychondritis (RP) are usually nonspecific. Objective: We report a series of patients with RP who presented with annular skin lesions. Methods: The clinical and histologic features and follow-up data of patients with RP and an annular urticarial eruption were retrospectively reviewed. Results: Ten patients (9 male, 1 female) (mean age 63.7 years) were included. All patients had tense, fixed, urticarial papules with an annular configuration predominantly located on the upper part of the trunk. Skin lesions occurred before the chondritis in 7 of 10 cases with a mean delay of 23 ± 13 months. Histologic examination consistently showed a lymphocytic vasculitis with no leukocytoclastic vasculitis, even when biopsies were repeated during the evolution (n = 7). Hematologic abnormalities were found in all cases. A myelodysplastic syndrome was found in 4 patients. Oral corticosteroids were effective in all cases, although skin lesions recurred during the decrease of corticosteroid doses in 4 cases. Five patients died during the evolution. Limitation: Retrospective case series design is a limitation. Conclusion: Annular and papular fixed urticarial eruption may represent a characteristic skin manifestation of RP. It is frequently associated with hematologic abnormalities and may auger a poor prognosis. © 2010 by the American Academy of Dermatology, Inc.

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