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1. Region-specific remodeling of the enteric nervous system and enteroendocrine cells in the colon of spinal cord injury patients

Author: Chloë Lefèvre, Camille Le Roy, Anne Bessard, Catherine Le Berre-Scoul, Justine Marchix, Emmanuel Coron, Marc Le Rhun, Charlène Brochard, Brigitte Perrouin-Verbe, and Michel Neunlist
Subjects: Medicine, Science
Abstract: Abstract Patients with spinal cord injury (SCI) suffer from major bowel dysfunction, whose exact pathophysiology, particularly the involvement of the enteric nervous system or epithelial dysfunction is poorly understood. Herein, we aimed to characterize the mucosal biopsies of the right and left colon in SCI patients vs controls (CT): (1) remodeling of key enteric neurotransmitters, (2) remodeling of enteroendocrine cells, and (3) mucosal inflammation compared to those in controls. In SCI, mucosal ACh concentration was lower in the right colon as compared to CT, but no change was observed in the left colon, and AChE expression was lower in both the right and left colons than in CT. While the VIP concentration was similar in the right and left colons, VIP mRNA expression was increased in the right colon and decreased in the left colon, in SCI patients as compared to CT. Interestingly, 5-HT concentration was reduced in the left colon but not in the right colon in SCI patients. Moreover, in SCI patients, as compared to CT, SERT mRNA expression was selectively increased in the left colon while TPH1 mRNA expression was increased in the right and left colons. Although mucosal TNFα and IL-1β mRNA expression did not significantly differ between SCI and CT groups, we identified a significant positive correlation between TNFα and IL-1β mRNA expression and left colon transit time in the SCI group. In conclusion, region-specific changes occur in the enteric neurotransmitter, serotonergic, and inflammatory pathways in the colon of SCI patients. The significant correlations between these pathways and clinical parameters in the left colon further set a scientific basis for designing therapeutic targets to improve colonic motor dysfunction in patients. Biobank information: Spinal cord injury patients: PHRC ConstiCAPE—clinical trial NCT02566746. Controls: Anosain—clinical trial NCT03054415 and biobank of the “Institut des Maladies de l’Appareil Digestif (IMAD)” registered under number DC-2008-402.
Published: 2023
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2. Altered epithelial barrier functions in the colon of patients with spina bifida

Author: Charlène Brochard, Guillaume Bouguen, Raphael Olivier, Tony Durand, Sébastien Henno, Benoît Peyronnet, Mael Pagenault, Chloé Lefèvre, Gaëlle Boudry, Mikael Croyal, Alain Fautrel, Maxime Esvan, Alain Ropert, Anne Dariel, Laurent Siproudhis, and Michel Neunlist
Subjects: Medicine, Science
Abstract: Abstract Our objectives were to better characterize the colorectal function of patients with Spina Bifida (SB). Patients with SB and healthy volunteers (HVs) completed prospectively a standardized questionnaire, clinical evaluation, rectal barostat, colonoscopy with biopsies and faecal collection. The data from 36 adults with SB (age: 38.8 [34.1–47.2]) were compared with those of 16 HVs (age: 39.0 [31.0–46.5]). Compared to HVs, rectal compliance was lower in patients with SB (p = 0.01), whereas rectal tone was higher (p = 0.0015). Ex vivo paracellular permeability was increased in patients with SB (p = 0.0008) and inversely correlated with rectal compliance (r = − 0.563, p = 0.002). The expression of key tight junction proteins and inflammatory markers was comparable between SB and HVs, except for an increase in Claudin-1 immunoreactivity (p = 0.04) in SB compared to HVs. TGFβ1 and GDNF mRNAs were expressed at higher levels in patients with SB (p = 0.02 and p = 0.008). The levels of acetate, propionate and butyrate in faecal samples were reduced (p = 0.04, p = 0.01, and p = 0.02, respectively). Our findings provide evidence that anorectal and epithelial functions are altered in patients with SB. The alterations in these key functions might represent new therapeutic targets, in particular using microbiota-derived approaches. Clinical Trials: NCT02440984 and NCT03054415.
Published: 2022
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3. Analysis of enteric nervous system and intestinal epithelial barrier to predict complications in Hirschsprung’s disease

Author: Anne Dariel, Lucie Grynberg, Marie Auger, Chloé Lefèvre, Tony Durand, Philippe Aubert, Catherine Le Berre-Scoul, Aurélien Venara, Etienne Suply, Marc-David Leclair, Philine de Vries, Guillaume Levard, Benoit Parmentier, Guillaume Podevin, Françoise Schmitt, Véronique Couvrat, Sabine Irtan, Erik Hervieux, Thierry Villemagne, Hubert Lardy, Carmen Capito, Cécile Muller, Sabine Sarnacki, Jean-François Mosnier, Louise Galmiche, Pascal Derkinderen, Hélène Boudin, Charlène Brochard, and Michel Neunlist
Subjects: Medicine, Science
Abstract: Abstract In Hirschsprung’s disease (HSCR), postoperative course remains unpredictable. Our aim was to define predictive factors of the main postoperative complications: obstructive symptoms (OS) and Hirschsprung-associated enterocolitis (HAEC). In this prospective multicentre cohort study, samples of resected bowel were collected at time of surgery in 18 neonates with short-segment HSCR in tertiary care hospitals. OS and HAEC were noted during postoperative follow-up. We assessed the enteric nervous system and the intestinal epithelial barrier (IEB) in ganglionic segments by combining immunohistochemical, proteomic and transcriptomic approaches, with functional ex vivo analysis of motility and para/transcellular permeability. Ten HSCR patients presented postoperative complications (median follow-up 23.5 months): 6 OS, 4 HAEC (2 with OS), 2 diarrhoea (without OS/HAEC). Immunohistochemical analysis showed a significant 41% and 60% decrease in median number of nNOS-IR myenteric neurons per ganglion in HSCR with OS as compared to HSCR with HAEC/diarrhoea (without OS) and HSCR without complications (p = 0.0095; p = 0.002, respectively). Paracellular and transcellular permeability was significantly increased in HSCR with HAEC as compared to HSCR with OS/diarrhoea without HAEC (p = 0.016; p = 0.009) and HSCR without complications (p = 0.029; p = 0.017). This pilot study supports the hypothesis that modulating neuronal phenotype and enhancing IEB permeability may treat or prevent postoperative complications in HSCR.
Published: 2020
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4. Interferential therapy for chronic constipation in adults: The CON‐COUR randomizedcontrolled trial

Author: Veronique Vitton, François Mion, Anne‐Marie Leroi, Charlène Brochard, Benoit Coffin, Frank Zerbib, Henri Damon, Chloé Melchior, Henri Duboc, Michel Queralto, Karine Baumstarck, Assistance Publique - Hôpitaux de Marseille (APHM), Hospices Civils de Lyon (HCL), Application des ultrasons à la thérapie (LabTAU), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Inflammation et axe Microbiote-Intestin-Cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Normandie Université (NU), Service de physiologie digestive, urinaire, respiratoire et de l'exercice [CHU Rouen], Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Centre d'Investigation Clinique [CHU Rouen] (CIC Rouen), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Service d'Hépato-Gastroentérologie [CHU Rouen], and Service de Colo-proctologie, Clinique des Cèdres, Cornebarrieu, France
Subjects: Oncology, [SDV]Life Sciences [q-bio], Gastroenterology
Published: 2023
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5. Peroral endoscopic myotomy: is it better to perform it in naive patients or as second-line therapy? Results of an open-label-controlled study in 105 patients

Author: Raphael Olivier, Charlène Brochard, Stanislas Bruley des Varannes, Alain Ropert, Timothée Wallenhorst, Noémi Reboux, Lucille Quénéhervé, Emmanuel Coron, Centre hospitalier universitaire de Nantes (CHU Nantes), Institut des Maladies de l'Appareil Digestif, Université de Nantes (UN), Centre hospitalier universitaire de Poitiers (CHU Poitiers), CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Hôpital Universitaire de Genève = University Hospitals of Geneva (HUG), and Open access funding provided by University of Geneva. None.
Subjects: Oesophagus, [SDV]Life Sciences [q-bio], Achalasia, Endoscopy, Surgery, Symptom score or index
Abstract: Background Whether Peroral Endoscopic Myotomy (POEM) can be proposed as a second-line treatment in patients with achalasia remains to be confirmed in real-life series. Objective This study aimed to compare the efficacy, feasibility and safety of POEM between treatment-naïve patients and patients who had prior endoscopic or surgical therapies for achalasia. Methods All consecutive patients who underwent a POEM procedure for achalasia in our centre from June 2015 to September 2018 were included in this retrospective study. They were classified into treatment-naïve patients (POEM1) and patients who had at least one previous endoscopic and/or surgical treatment for achalasia (POEM2). Results A total of 105 patients were included, 52 in the POEM1 group and 53 in the POEM2 group. Clinical success (defined as an Eckardt score ≤ 3) at 6 months was observed in 93% of POEM1 patients and 84% of POEM2 patients (p = 0.18). Technical success rate was not significantly different between the two groups (100% vs 96%, respectively; p = 0.50). No significant difference was noted in terms of adverse event rate (19% vs 19%, respectively; p = 1.00). Post-procedure pain occurred in 12% of treatment-naive and 9% of non-naïve patients (p = 0.76). The median length of hospital stay was 3 days in both groups (p = 0.17). Symptomatic gastroesophageal reflux occurred in 25% of POEM1 patients and 16% of POEM2 patients (p = 0.24). Conclusion Efficacy, feasibility and safety of POEM are not different between treatment-naïve and non-naïve patients. POEM is a valuable second-line approach in patients with persistent symptoms of achalasia after surgical or endoscopic treatments.
Published: 2023
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6. Impact of antibiotic prophylaxis and conditioning modalities in per-oral endoscopic myotomy for esophageal motor disorders

Author: Audrey Hastier-De Chelle, Philippe Onana-Ndong, Raphaël Olivier, Imad Bentellis, Mathieu Pioche, Jérôme Rivory, Jean Michel Gonzalez, Laurent Bailly, Thierry Piche, Thierry Ponchon, Charlène Brochard, Emmanuel Coron, Marc Barthet, and Geoffroy Vanbiervliet
Subjects: Adult, Natural Orifice Endoscopic Surgery, Adolescent, Motor Disorders, Gastroenterology, Middle Aged, Esophageal Sphincter, Lower, Esophageal Achalasia, Treatment Outcome, Humans, Female, Esophageal Motility Disorders, Aged, Retrospective Studies, Myotomy
Abstract: No recommendation regarding antibiotic prophylaxis and preparation modalities are available for patients with esophageal motor disorders who benefit from Per-Oral Endoscopic Myotomy (POEM). The aim of our study was to evaluate their impact on the POEM's safety.This study was a comparative and multicentric retrospective analysis of a database prospectively collected. Patients over 18 years old with esophageal motor disorders confirmed by prior manometry, who underwent POEM were included. The primary endpoint was the occurrence of adverse events, as classified by Cotton, based on whether or not antibiotic prophylaxis was administered.A total of 226 patients (median age 52.9 ± 19.12 years [18-105], 116 women [51.3%]) were included. The indication for POEM was mainly type 2 achalasia (The antibiotic prophylaxis during POEM does not prevent adverse events, had no impact on their severity and the efficacy of the procedure. A liquid diet before the procedure should be systematically proposed.
Published: 2022
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7. Allogenic stem cells for anal Crohn’s fistula: treating early improves the deep response rate

Author: Nadia Fathallah, Laurent Siproudhis, Mélissa Akaffou, Mohamed Amine Haouari, Amandine Landemaine, Elise Pommaret, Lucas Spindler, Charlène Brochard, Guillaume Bouguen, and Vincent Parades
Abstract: Purpose: The aim of this study was to evaluate the real-life clinical and radiological efficacy of darvadstrocel injection into complex perianal fistulas in Crohn’s disease. Secondary endpoints were to assess symptomatic efficacy, outcomes and factors associated with complete combined clinical-radiological response (deep response). Methods: After marketing the product in France, all patients treated consecutively were included. A complete clinical response was defined by a complete closure of all external openings with no discharge on pressure. A partial response was defined by closure of ≥ 50% of external openings with no discharge on pressure. A complete radiological response (MRI), evaluated at least after six months of follow-up, was defined by a completely fibrotic sequela without abscess. Results: Forty-three patients were included (M/F: 22/21, median age 37 [26-45] years). The fistulas of all patients were already drained with seton(s) and were on biologic treatment. After a median follow-up of 383 [359-505] days, 28 (65%) patients showed a clinical response (22 complete and 6 partial). Only 16 (37%) achieved a deep response. The PDAI decreased significantly after treatment: 39 (91%) patients reported symptomatic improvement in terms of discharge, pain, and induration, and 28 (65%) no longer had any perineal symptoms. Only a short history of Crohn’s disease < 3 years was significantly associated with deep response (OD 4.5 [1.0-19.1], p = 0.04). Conclusion: Darvadstrocel injection resulted in a clinical response for two thirds of patients and deep response for one third. A shorter duration of Crohn’s disease was associated with deep response.
Published: 2023
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8. Transanal irrigation is a better choice for bowel dysfunction in adults with spina bifida: a randomized controlled trial

Author: Charlène Brochard, Magali Jezequel, Anne Blanchard‐Dauphin, Jacques Kerdraon, Brigitte Perrouin‐Verbe, Anne‐Marie Leroi, Jean Michel Reymann, Benoît Peyronnet, Jeff Morçet, Laurent Siproudhis, CHU Pontchaillou [Rennes], The Enteric Nervous System in gut and brain disorders [U1235] (TENS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), CHU Lille, Centre Mutualiste de Kerpape, Ploemeur, Centre hospitalier universitaire de Nantes (CHU Nantes), Nutrition, Inflammation et axe Microbiote-Intestin-Cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de physiologie digestive, urinaire, respiratoire et de l'exercice [CHU Rouen], Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service des Maladies de l'Appareil Digestif [CHU Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and French Ministry of Health. Grant Number: 2013-A01520-45
Subjects: transanal irrigation, faecal incontinence, [SDV]Life Sciences [q-bio], Gastroenterology, bowel dysfunction, conservative treatment, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Spina bifida, randomised controlled trial
Abstract: International audience; Aim: To compare transanal irrigation with conservative bowel management for the treatment of bowel dysfunction in Spina bifida (SB) patients.Methods: Patients with SB and bowel dysfunction were randomly assigned to receive either transanal irrigation or conservative bowel management. The effectiveness of the treatment was defined as a decrease of 4 points in the neurogenic bowel dysfunction (NBD) score at week 10. Data on incontinence (Cleveland scores; Jorge-Wexner [JW]) and constipation (Knowles-Eccersley-Scott Symptom Constipation Score [KESS]) were recorded at 10 and 24 weeks after inclusion. Data were analysed on an intention-to-treat basis.Results: A total of 34 patients were randomised: 16 patients to conservative bowel management and 18 patients to transanal irrigation. A total of 19/31 (61%) patients improved at week 10, 13 (76%) in the transanal irrigation group versus six (43%) in the conservative group (p = 0.056). In the irrigation group, the decrease in NBD score was -6.9 (-9.9 to -4.02) versus -1.9 (-6.5 to -2.8) in the conservative group (p = 0.049 in univariate and p = 0.004 in multivariate analysis). The NBD, Cleveland (JW and KESS) and Rosenberg scores were significantly lower in the transanal irrigation group than in the conservative bowel management group at week 10.Conclusions: This prospective, randomised, controlled, multicentre study in adult patients with SB suggests that transanal irrigation may be more effective than conservative bowel management.
Published: 2023
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9. Identification of the optimal medical and surgical management for patients with perianal fistulising Crohn’s disease

Author: Mathilde Laland, Marie François, Ferdinando D'Amico, Camille Zallot, Charlène Brochard, Marie Dewitte, Laurent Siproudhis, Laurent Peyrin‐Biroulet, Guillaume Bouguen, CHU Pontchaillou [Rennes], Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Humanitas University [Milan] (Hunimed), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Jonchère, Laurent
Subjects: [SDV] Life Sciences [q-bio], Crohn’s disease, medical and surgical management, [SDV]Life Sciences [q-bio], Gastroenterology, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, perianal fistula, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, combination therapy
Abstract: International audience; AIMS: The aims of our study were to assess the best medical and surgical approaches for Perianal Crohn’s Disease (PCD) in order to identify an optimal combined medical and surgical treatment. METHODS: Medical records of all patients with PCD treated with TNFα antagonists in two referral centers between 1998 and 2018 were reviewed. Predictors of long-term outcomes were identified using a Cox proportional hazard model. RESULTS: A total of 200 patients were included. Fifty-three patients (26.5%) were treated with adalimumab and 147 (73.5%) with infliximab. Combination of TNFα antagonist with an immunosuppressant and presence of proctitis were independently associated with fistula closure. Seton was placed in 127 patients (63.5%) before starting biological therapy. Eighty patients (40%) underwent additional perineal surgery. Prior PCD surgery, seton positioning, additional perineal surgery, and additional surgery within 52 weeks of anti-TNFα treatment were associated with an increased rate of fistula closure. Finally, medical combination therapy (anti-TNFα plus immunosuppressant) along with seton placement and additional surgery within one year was the best management for PCD patients (p=0,02). CONCLUSION: Combined medical and surgical management is required for the treatment of PCD patients. Medical combination therapy associated with seton placement and additional surgery within one year is the best management for PCD patients.
Published: 2023
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10. Long-term outcomes and predictors of disabling disease in a population-based cohort of patients with incident Crohn's disease diagnosed between 1994 and 1997

Author: Marie-Laure, Rabilloud, Emma, Bajeux, Laurent, Siproudhis, Stéphanie, Hamonic, Maël, Pagenault, Charlène, Brochard, Agathe, Gerfaud, Alain, Dabadie, Jean-François, Viel, Isabelle, Tron, Michel, Robaszkiewicz, Jean-François, Bretagne, Guillaume, Bouguen, CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Observatoire régional de la santé Bretagne, This work received a grant from ABBVIE, Rungis, France, and Jonchère, Laurent
Subjects: Hepatology, [SDV]Life Sciences [q-bio], Gastroenterology, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Outcomes, Population-based, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Cohort Studies, Intestines, [SDV] Life Sciences [q-bio], Crohn's disease, Treatment Outcome, Crohn Disease, Disease Progression, Humans, Immunosuppressive Agents
Abstract: International audience; Background: The identification of early prognostic factors during Crohn's disease (CD) remains needed for physician decision-making to minimize structural bowel damage, which this study aimed to assess in a population-based setting. Methods: All incident cases of CD were prospectively registered from 1994 to 1997 in Brittany, a limited area of France. All charts of patients were reviewed from the diagnosis to the last clinic visit in 2015. Disabling CD course was defined according to the Saint-Antoine criteria. Results: Among the 331 incident cases of CD, 272 (82%) were followed-up for a median time of 12.8 years. The cumulative probability of developing stricturing or fistulizing CD was 66% at 15 years, and 107 (39%) patients underwent surgery. The cumulative probabilities of immunosuppressant and TNF antagonist use at 15 years were 37% and 22%, respectively. The cumulative risks for disabling disease and bowel damage were 74% and 71% at 15 years, respectively. Systemic symptoms and perianal lesions at diagnosis were independently associated with a disabling disease course. Perianal disease and short disease extension were associated with the onset of bowel damage. Deep ulcers was not predictive of any outcome. Conclusions: A disabling disease course and bowel damage occurred early in the course of CD, which suggests the need for early diagnosis and early treatment, particularly for patients with systematic symptoms and perianal disease.
Published: 2022
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11. Prospective and multicentre study of radiofrequency treatment in anal fistula

Author: Marie Sautereau, Dominique Bouchard, Charlène Brochard, François Pigot, Laurent Siproudhis, Jean Marie Fayette, Cécile Train, Anne Laurain, Charlotte Favreau, Laurent Abramowitz, CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Ramsay Santé
Subjects: Crohn’s disease, radiofrequency, anal incontinence, [SDV]Life Sciences [q-bio], sphincter-sparing, Gastroenterology, fistula-in-ano
Abstract: International audience; BACKGROUND: The most effective treatment for anal fistula is fistulotomy, but it involves a risk of anal incontinence. To reduce this morbidity, sphincter-sparing treatments have been developed, but their success in real life is often less than 50%. The aim is to determine clinical healing rate 6 months after radiofrequency treatment. PATIENTS AND METHODS: We planned to evaluate 50 patients from 3 French proctology centres. Treatment efficacy was evaluated at 6 and 12 months by means of clinical and magnetic resonance imaging examination. We evaluated morbidity and healing prognostic factors. RESULTS: Fifty patients with a mean age of 51years [22-82] were included. Eleven patients had a low transsphincteric fistula(LTS), 21 high transsphincteric fistula(HTS), 8 complex fistula and 9 Crohn’s disease fistula. After 6 months, 17 patients (34.7%) had a clinically healed fistula, including 5 (45.5%) with LTS fistula, 7 (33.3%) with HTS fistula, 1 (12.5%) with complex fistula, 4 (44.4%) with Crohn’s disease, with no significant difference between these fistula types (p:0.142). At 12 months, the healing rate was identical. MRI in 15 out of 17 clinically healed patients showed a deep remission of 73.3% at 12 months. Energy power was associated with the success of the treatment. There was an 8.2% incidence of post-surgical complications with 4.1% being abscesses (one required surgical management). Postoperative pain was minor. No new cases or deterioration of continence have been shown. CONCLUSION: Radiofrequency is effective in less than 50% of the cases as an anal fistula treatment in this first prospective study, with low morbidity and no effect on continence. Clinical healing was deep (MRI) in ¾ at 1 year. The increase in energy power during the procedure seems to be a key point to be analysed to optimise results.
Published: 2022
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12. Assessment of sexual dysfunction in patients with perianal Crohn's disease

Author: David Laharie, Pauline Rivière, R. Boudiaf, Charlène Brochard, Laurent Abramowitz, Dominique Bouchard, and François Pigot
Subjects: medicine.medical_specialty, Multivariate analysis, business.industry, Fistula, Gastroenterology, Disease, medicine.disease, Inflammatory bowel disease, 03 medical and health sciences, 0302 clinical medicine, Erectile dysfunction, Sexual dysfunction, 030220 oncology & carcinogenesis, Internal medicine, Cohort, medicine, Clinical endpoint, 030211 gastroenterology & hepatology, medicine.symptom, business
Abstract: Introduction Over the past 10 years, several studies have focused on sexuality in patients with Crohn's disease. Very few of them specifically focused on perianal disease (PD). This study aimed to compare the prevalence of sexual dysfunction (SD) in Crohn's disease patients with active PD versus controls without active PD. Methods Patients from 14 French centers with active PD, defined by the presence of symptomatic ulceration, fistula, or stenosis, were arbitrarily included. They were compared to controls from the existing SEXIA cohort. Men completed the International Index of Erectile Function (IIEF) and women, the Female Sexual Function Index (FSFI). The primary endpoint was SD defined by an FSFI Results Ninety-seven patients (64 women, 33 men) and 238 controls (131 women, 107 men) were included. SD was found in 66% of the female patients versus 50% of the controls (p = 0.04). In the male population, SD was found in 30% of the cases versus 16% of the controls (p = 0.06). Erectile dysfunction affected 46% of the male patients and 43% of the controls (p = 0.8). On multivariate analysis, the predictive factor most strongly associated with SD in women was severely active anal-PD defined by a perineal disease activity index >4 (OR = 13.05 [2.32-73.44]). Conclusion Women with active PD had an increased prevalence of SD compared to controls without active PD. In the male population, the study was unable to determine if there was a difference as it was underpowered.
Published: 2020
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13. Management of solitary rectal ulcer syndome: Results of a french national survey

Author: Marion Chambaz, Guillaume Meurette, Aurélien Venara, Laurent Siproudhis, Charlène Brochard, Alain Ropert, Guillaume Bouguen, and Claire Gouriou
Subjects: medicine.medical_specialty, Rehabilitation, Hepatology, Medical treatment, business.industry, medicine.medical_treatment, General surgery, Gastroenterology, Laxative, Biofeedback, Solitary rectal ulcer syndrome, 3. Good health, 03 medical and health sciences, Solitary rectal ulcer, 0302 clinical medicine, Quality of life, 030220 oncology & carcinogenesis, Intervention (counseling), medicine, 030211 gastroenterology & hepatology, business
Abstract: There is no consensus on the treatment for solitary rectal ulcer syndrome (SRUS). This study aimed to obtain information from physicians treating patients with SRUS in a French medical surgical society to facilitate management plans and to develop a support algorithm. Members of the French National Society of Coloproctology (SNFCP) were invited to complete a survey that included twenty items about therapeutic management and healing criteria. Overall, 91 practitioners (median age: 52 [42-59] years) responded to the questionnaire; 64/91 (70.3%) were proctologists, and 27/91 (29.7%) were colorectal surgeons. Only 15 members (16.5%) followed more than 5 patients with SRUS per year. The therapeutic objectives were to improve both patient symptoms (100%) and quality of life (98.9%). Laxative treatment and first-line rehabilitation were agreed upon by 83.5% and 73% of the respondents, respectively. Surgery, mainly rectopexy, was offered after failed medical treatment by 81.1% of the practitioners (79.1%). The first-line strategy preferred by the professionals included laxatives and biofeedback rehabilitation. Surgical treatment, preferably rectopexy, was proposed as a second intervention. No consensus was reached regarding other therapeutic alternatives, and additional studies are required to clarify their indications.
Published: 2020
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14. Ten-year Evaluation of a Large Retrospective Cohort Treated by Sacral Nerve Modulation for Fecal Incontinence

Author: Vincent Wyart, Laurent Siproudhis, Guillaume Meurette, Henri Damon, François Mion, Elsa Lambrescak, Charlotte Desprez, Paul-Antoine Lehur, Anne-Marie Leroi, Club Nemo, Isabelle Etienney, Igor Sielezneff, Thomas Duflot, Guillaume Gourcerol, Diane Mege, Jean-Luc Faucheron, Charlène Brochard, Nadine Ajamie, and Valérie Bridoux
Subjects: Male, medicine.medical_specialty, Lumbosacral Plexus, Electric Stimulation Therapy, Internal medicine, medicine, Humans, Fecal incontinence, Favorable outcome, Adverse effect, Aged, Retrospective Studies, business.industry, Background data, Retrospective cohort study, Middle Aged, 3. Good health, Treatment Outcome, Increased risk, Multicenter study, Sacral nerve, Female, Surgery, France, medicine.symptom, business, Fecal Incontinence
Abstract: OBJECTIVE The aim of this study was to assess the effectiveness of sacral nerve modulation (SNM) in a large cohort of patients implanted for at least 10 years, quantify adverse event rates, and identify predictive factors of long-term success. SUMMARY BACKGROUND DATA Few studies have evaluated the long-term success of SNM. METHODS Data collected prospectively from patients implanted for fecal incontinence (FI) in 7 French centers between January 1998 and December 2008 were retrospectively analyzed. Patient FI severity scores were assessed before and 10 years after implantation. The main evaluation criterion was the success of SNM defined by the continuation of the treatment without additional therapies. The secondary evaluation criteria were the rate of device revisions and explantations. Preoperative predictors of success at 10 years were sought. RESULTS Of the 360 patients (27 males, mean age: 59 ± 12 years) implanted for FI, 162 (45%) had a favorable outcome 10 years post-implantation, 115 (31.9%) failed, and 83 (23.1%) were lost to follow-up. The favorable outcome derived from the time-to-event Kaplan-Meier curve at 10 years was 0.64 (95% CI 0.58-0.69). FI severity scores were significantly better 10 years post-implantation compared to preimplantation (7.4 ± 4.3 vs 14.0 ± 3.2; P < 0.0001). During the 10-year follow-up, 233 patients (64.7%) had a surgical revision and 94 (26.1%) were explanted. A history of surgery for FI and sex (male) were associated with an increased risk of an unfavorable outcome. CONCLUSIONS Long-term efficacy was maintained in approximately half of the FI patients treated by SNM at least 10 years post-implantation.
Published: 2020
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15. Natural History of Perianal Crohn's Disease: Long-term Follow-up of a Population-Based Cohort

Author: Charlène Brochard, Marie-Laure Rabilloud, Stéphanie Hamonic, Emma Bajeux, Maël Pagenault, Alain Dabadie, Agathe Gerfaud, Jean-François Viel, Isabelle Tron, Michel Robaszkiewicz, Jean-François Bretagne, Laurent Siproudhis, Guillaume Bouguen, Etienne Cruchant, Jean-Luc Alexandre, Jacques Arnaud Seyrig, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Observatoire Régional de Santé (ORS Bretagne), ORS Bretagne, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), AbbVie, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and Jonchère, Laurent
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], Disease, outcomes, population based, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Internal medicine, medicine, Humans, Rectal Fistula, Proctitis, Retrospective Studies, Crohn's disease, Hepatology, business.industry, Incidence (epidemiology), Hazard ratio, Gastroenterology, Retrospective cohort study, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, medicine.disease, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, 3. Good health, Natural history, [SDV] Life Sciences [q-bio], natural history, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, business, Perianal Crohn’s disease, Anal stricture, Follow-Up Studies
Abstract: International audience; BACKGROUND AND AIMS: The natural history of perianal Crohn’s disease (PCD) remains poorly described and is mainly based on retrospective studies from referral centres. The aim of this study was to assess the incidence, outcomes and predictors of the onset of PCD. METHODS: All incident cases of patients diagnosed with possible CD were prospectively registered from 1994 to 1997 in Brittany, a limited area in France. At diagnosis, the clinical features of perianal disease were recorded. All patient charts were reviewed from the diagnosis to the last clinic visit in 2015. RESULTS: Among the 272 out of 331 incident CD patients followed up, 51 (18.7%) patients had PCD at diagnosis. After a mean follow-up of 12.8 years, 93 (34%) patients developed PCD. The cumulative probabilities of perianal CD occurrence were 22%, 29%, and 32% after 1 year, 5 years, and 10 years, respectively. The cumulative probabilities of anal ulceration were 14%, and 19% after 1 year and 10 years, respectively. Extraintestinal manifestations were associated with the occurrence of anal ulceration. The cumulative probabilities of fistulizing PCD were 11%, 16%, and 19% after 1 year, 5 years, and 10 years, respectively. Extraintestinal manifestations, rectal involvement and anal ulceration were predictors of fistulizing PCD. The cumulative probability of developing anal stricture was 4% after 10 years. CONCLUSIONS: PCD is frequently observed during CD, in approximately one-third of patients. These data underline the need for targeted therapeutic research on primary perianal lesions (proctitis, anal ulceration) to avoid the onset of fistulizing perianal disease.
Published: 2022
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16. Risk factors for upper urinary tract deterioration in adult patients with spina bifida

Author: Camille Haudebert, Juliette Hascoet, Emmanuelle Samson, Magali Jezequel, Caroline Voiry, Charlène Brochard, Claire Richard, Jacques Kerdraon, Laurent Siproudhis, Andréa Manunta, and Benoit Peyronnet
Subjects: Urology
Published: 2023
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17. Prevalence and risk factors for scoliosis in adults with closed and open spina bifida: A large, cross-sectional study

Author: Marine Cacioppo, Hélène Menard, Camille Olivari Philiponnet, Estelle Le Pabic, Charlène Brochard, Benoit Peyronnet, Philippe Violas, Laurent Riffaud, Isabelle Bonan, CHU Pontchaillou [Rennes], Laboratoire de Traitement de l'Information Medicale (LaTIM), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-IMT Atlantique (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-Institut National de Recherche en Informatique et en Automatique (Inria)-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-IMT Atlantique (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Neuroimagerie: méthodes et applications (EMPENN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Inria Rennes – Bretagne Atlantique, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-SIGNAL, IMAGE ET LANGAGE (IRISA-D6), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université de Rennes (UR)-Institut National des Sciences Appliquées - Rennes (INSA Rennes), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Institut de Recherche en Informatique et Systèmes Aléatoires (IRISA), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Bretagne Sud (UBS)-École normale supérieure - Rennes (ENS Rennes)-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS)-IMT Atlantique (IMT Atlantique), and This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Subjects: Spinal deformity, Scoliosis, Rehabilitation, Neural tube defect, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Orthopedics and Sports Medicine, Myelomeningocele, Spinal dysraphism, Spina bi fida
Abstract: International audience; Background: Scoliosis develops in a proportion of children with myelomeningocele; however, little is known about scoliosis in adulthood and in other forms of spina bifida (SB). Objectives: The aims of this study were to describe the prevalence of scoliosis and identify risk factors for its development in a large cohort of adults with open and closed SB. Methods: This was a cross-sectional study of data from 580 adults with SB attending their first consultation at a French multidisciplinary referral centre for SB. Sex, anatomical location and type of SB (open or closed), neurological level, back pain and ambulatory status (new Functional Ambulation Classification [new FAC]) were compared in adults with and without scoliosis. These characteristics were used to determine scoliosis risk factors. Results: In total, 331 adults fulfilled the inclusion criteria: 221 had open and 110 had closed SB. Of these, 176 (53%) had scoliosis: 57% open and 45% closed SB. As compared with individuals without scoliosis, those with scoliosis more frequently had open SB (p=0.03), more cranially located SB (p
Published: 2021
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18. Surgical closure, mainly with glue injection and anti-tumour necrosis factor alpha, in fistulizing perianal Crohn's disease: A multicentre randomized controlled trial

Author: Dominique Bouchard, Béatrice Vinson Bonnet, Guillaume Meurette, Cécile Train, Charlène Brochard, Pauline Roumeguère, Laurent Siproudhis, Laurent Abramowitz, Jean Marie Fayette, François Pigot, Ghislain Staumont, Hélène Pillant, Guillaume Bonnaud, A. Senéjoux, Jean Luc Faucheron, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Maison de Santé Protestante de Bordeaux-Bagatelle (MSPB), Clinique Tivoli Ducos [Bordeaux], Hôpital Léopold-Bellan, CHI Poissy-Saint-Germain, Centre Hospitalier Universitaire [Grenoble] (CHU), CHP Saint Grégoire, Hôpital Ambroise Paré [AP-HP], Centre hospitalier universitaire de Nantes (CHU Nantes), ClinSearch [Malakoff, France], Clinique Saint-Jean Languedoc [Toulouse] (CSJL), Abbvie Laboratory AbbVie, and Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, Fistula, [SDV]Life Sciences [q-bio], fistulizing perianal, law.invention, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Randomized controlled trial, law, medicine, Adalimumab, Humans, Rectal Fistula, Abscess, GLUE, Perianal Crohn's disease, Crohn's disease, business.industry, Anti tumour necrosis factor, Gastroenterology, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, medicine.disease, surgical closure, 3. Good health, Surgery, seton removal, Treatment Outcome, 030220 oncology & carcinogenesis, Drainage, 030211 gastroenterology & hepatology, business, medicine.drug
Abstract: Clinical trial registration: ClinicalTrials.gov Identifier NCT01388257; International audience; Aim In patients with fistulizing perianal Crohn's disease (CD), the need for a secondary surgical step is not defined. The aim was to assess the efficacy of surgical closure compared to a single seton removal in patients with drained fistulizing perianal CD treated with adalimumab. Methods This was a multicentre, randomized controlled trial, comparing seton removal + surgical closure (closure group) to seton removal alone (control group) with a stratification according to the American Gastroenterological Association classification. The primary end-point was fistula closure at month 12 defined by the association of the following criteria: no seton, absence of a visible external opening, absence of discharge from the tract after finger compression, absence of an internal opening, absence of perianal pain/abscess and absence of fistula-related abnormalities. Results Among the 64 included patients (262 expected) (48 complex fistula, 75%), 33 were randomized to the closure group and 31 to the control group. In the closure group, 26 patients (78.8%) had glue. At month 12, overall fistula closure was achieved in 35 of the evaluable 58 patients (60%): 18/32 (56%) in the surgery group and 17/26 (65%) in the control group (P = 0.479). In the closure group, fistula closure was observed in 13/25 (52%) and 5/7 (71%) patients with complex and simple fistula respectively (P = 0.426), compared with 12/18 (67%) and 5/8 (63%), respectively in the control group (P = 1.000). Conclusions Seton removal alone seems to be no more effective than a secondary surgical step (in particular glue injection) in patients having fistulizing perianal CD controlled by an initial drainage combined with adalimumab. The results should be interpreted with caution.
Published: 2021
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19. PD36-05 URINARY MMP-2 IS SIGNIFICANTLY ASSOCIATED WITH THE RISK OF INTRADETRUSOR TOXIN INJECTIONS FAILURE IN PATIENTS WITH SPINA BIFIDA

Author: Juliette Hascoet, Xavier Gamé, Charlène Brochard, Andrea Manunta, C. Voiry, C. Richard, Emmanuelle Samson, Jacques Kerdraon, M. Jezequel, Claude Bendavid, Guillaume Bouguen, and Benoit Peyronnet
Subjects: congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, business.industry, Spina bifida, Toxin, Urology, Urinary system, Matrix metalloproteinase, medicine.disease, medicine.disease_cause, complex mixtures, Gastroenterology, nervous system diseases, Botulinum toxin a, Internal medicine, Medicine, In patient, business
Abstract: INTRODUCTION AND OBJECTIVE:Several studies have suggested that spina bifida patients may have a poorer response to intradetrusor botulinum toxin A (BTX-A) injections than other neurological populat...
Published: 2021
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20. Urinary biomarkers profiles in patients with neurogenic detrusor overactivity according to their neurological condition

Author: C. Voiry, C. Richard, Laurent Siproudhis, Benoit Peyronnet, Quentin Alimi, Zine-Eddine Khene, Charlène Brochard, Juliette Hascoet, Andrea Manunta, Claude Bendavid, Jacques Kerdraon, Xavier Gamé, and Guillaume Bouguen
Subjects: Adult, Male, Nephrology, medicine.medical_specialty, Multiple Sclerosis, Urology, Urinary system, 030232 urology & nephrology, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, medicine, Humans, Prospective Studies, Urinary Bladder, Neurogenic, Spinal Dysraphism, Spinal cord injury, Spinal Cord Injuries, Aged, Creatinine, Urinary bladder, Urinary Bladder, Overactive, business.industry, Spina bifida, Multiple sclerosis, Middle Aged, medicine.disease, Pathophysiology, medicine.anatomical_structure, chemistry, 030220 oncology & carcinogenesis, Female, business, Biomarkers
Abstract: The aim of this study was to investigate the disease-specific urinary levels variations of neurotrophins (NGF, BDNF), mediators of inflammation (TGFβ-1, PGE-2) and markers of extracellular matrix alterations (TIMP-2) in patients with multiple sclerosis (MS) spinal cord injury (SCI), or spina bifida (SB), and neurogenic detrusor overactivity (NDO). A prospective single-center study was conducted between March 2015 and March 2017. Patients aged over 18 years old, with neurological disease, with a urodynamic diagnosis of NDO were included. The urinary levels of NGF, BDNF, TIMP-2, PGE 2, and TGF-β1 were measured using dedicated ELISA kits. Forty-one patients were included: 6 with MS, 20 with SCI, and 15 with spina bifida. The average urinary level of NGF/Cr was significantly higher in MS patients compared to other neurologic populations (8 vs. 0.56 vs. 1.25 pg/mg of creatinine; p = 0.001) as well for the average urinary level of BDNF (88.3 vs. 5 vs. 4.8 pg/mg of creatinine; p
Published: 2019
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21. How to manage anal ulcerations and anorectal stenosis in Crohn’s disease: algorithm-based decision making

Author: F. Pigot, Yves Panis, B. Vinson-Bonnet, Charlène Brochard, Nadia Fathallah, Paul Benfredj, Laurent Siproudhis, Laurent Abramowitz, Dominique Bouchard, T. Higuero, Jean-Luc Faucheron, David Laharie, Ghislain Staumont, and V. de Parades
Subjects: medicine.medical_specialty, Consensus, Clinical Decision-Making, education, Disease, Proctocolitis, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Humans, Medicine, Crohn's disease, business.industry, Gastroenterology, Disease Management, medicine.disease, Anorectal Malformations, Colorectal surgery, Anorectal stenosis, 030220 oncology & carcinogenesis, Treatment strategy, 030211 gastroenterology & hepatology, Surgery, France, business, Colorectal Surgery, Algorithm, Algorithms
Abstract: The French National Society of Coloproctology established national recommendations for the treatment of anoperineal lesions associated with Crohn's disease. Treatment strategies for anal ulcerations and anorectal stenosis are suggested. Recommendations have been graded following international recommendations, and when absent professional agreement was established. For each situation, practical algorithms have been drawn.
Published: 2019
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22. Cumulative Exposure to Infliximab, But Not Trough Concentrations, Correlate With Rate of Infection

Author: Laurent Siproudhis, Eric Bellissant, Thomas Grainville, Guillaume Bouguen, Amandine Landemaine, Antoine Petitcollin, Eric Le Balch, Céline Miard, Marie Dewitte, Charlène Brochard, CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: Adult, Male, medicine.medical_specialty, tumor necrosis factor, [SDV]Life Sciences [q-bio], Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Gastrointestinal Agents, Internal medicine, medicine, Humans, Trough Concentration, Crohn's disease, Hepatology, treatment, business.industry, Area under the curve, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Odds ratio, anti-TNF, Inflammatory Bowel Diseases, medicine.disease, Ulcerative colitis, Infliximab, 3. Good health, CD, Regimen, Area Under Curve, 030220 oncology & carcinogenesis, Trough level, 030211 gastroenterology & hepatology, France, business, medicine.drug
Abstract: Background & Aims Infliximab increases the risk of infection in patients with inflammatory bowel diseases (IBD), but there is controversy over the relationship between drug concentration and infections. We aimed to assess factors associated with infection in infliximab-treated patients, including pharmacokinetic features. Methods We collected data from 209 patients with IBD (102 men; mean age, 39 y; 159 with Crohn’s disease; 54 received combination therapy) who received an infliximab maintenance regimen from November 2016 through April 2017 in France. Data were collected from each infusion visit (total of 640 infusions). Infliximab exposure was estimated based on the area under the curve (AUC) of drug concentration in pharmacokinetic models; individual exposures over the 6-month period were estimated based on the sum of the AUC (ΣAUC). Results The mean infliximab trough level was 5.46 mg/L, and the mean ΣAUC was 3938 ± 1427 mg.d/L. A total of 215 infections were collected from the 640 infusion visits; 123 patients (59%) had at least 1 infection. Factors independently associated with infection after multivariate analysis were smoking (odds ratio [OR], 2.05; P = .046), IBD flare (OR, 2.71; P = .006), and a high ΣAUC of infliximab (above 3234 mg x d/L) (OR, 2.02; P = .02). The ΣAUC was higher in patients with an occurrence of infection (P = .04) and correlated with the number of infections (P = .04). Trough concentration of infliximab alone was not associated with infection. Conclusions Almost two-thirds of patients treated with infliximab developed an infection; risk was individually correlated with cumulative increase in drug exposure, but not infliximab trough level.
Published: 2021
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23. Solitary rectal ulcer syndrome in 102 patients: Do different phenotypes make sense?

Author: Charlène Brochard, Laurent Siproudhis, Alain Ropert, Aurore Carlo, Timothée Wallenhorst, Alexandre Merlini-l’Heritier, Marion Chambaz, Claire Gouriou, Guillaume Bouguen, CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: Adult, Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Anal Canal, Solitary rectal ulcer syndrome, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Defecography, Ulcer, Aged, Retrospective Studies, Hepatology, medicine.diagnostic_test, Obstructed defecation, business.industry, Rectal Ulcer, Anorectal manometry, Faecal incontinence, Rectal Prolapse, Syndrome, Middle Aged, Hypotonia, 3. Good health, Endoscopy, Phenotype, Rectal Diseases, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, medicine.symptom, business, Constipation, Fecal Incontinence, Procidentia
Abstract: International audience; Background - Little is known about the pathophysiological mechanisms of solitary rectal ulcer syndrome (SRUS). Aims - We aim to identify the different phenotypes, taking into account complaints, anatomy and anorectal physiology. Methods - Complaints, endoscopy results, and physiology data of patients with histologically proven SRUS were collected and analysed. The associated anorectal diseases were faecal incontinence and obstructed defecation. The clinical aspects of SRUS were compared, and factors associated with anorectal diseases were identified. Results - Overall, 102 consecutive patients were included. The predominant lesion was a rectal ulcer (66%), and inflammation of the rectal wall was present in 42% of patients. Abnormal rectal capacities and/or rectal perception was observed in more than half. Nearly half (52%) of the patients met the criteria for obstructed defecation and they tended to more frequently have psychiatric disease (66.7% vs 33.3%; p=0.07). Patients with faecal incontinence (17%) reported more self-perception of anal procidentia (p=0.01) and were more likely to have inflammation of the rectal wall (p=0.02), high-grade internal rectal procidentia (p=0.06) and anal hypotonia (p=0.004); their maximum tolerable volume was lower (p=0.004). Conclusion - The characteristics of patients with SRUS suggest different phenotypes. This may be a way to develop a comprehensive treatment strategy.
Published: 2021
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24. Successful closure of a rectovesical fistula after radical prostatectomy using endoscopic submucosal dissection combined with an over-the-scope clip

Author: Mathieu Pioche, Guillaume Bouguen, Thomas Lambin, Charlène Brochard, Mael Pagenault, Timothée Wallenhorst, and Laurent Siproudhis
Subjects: Male, Prostatectomy, medicine.medical_specialty, Rectovesical fistula, Endoscopic Mucosal Resection, business.industry, medicine.medical_treatment, Treatment outcome, Gastroenterology, Closure (topology), Over the scope clip, Endoscopic submucosal dissection, Surgical Instruments, Surgery, Treatment Outcome, medicine, Humans, Rectal Fistula, business
Published: 2020

25. Ileocecal valve opening with double clip and rubber band for countertraction facilitates R0 en bloc resection of laterally spreading tumors

Author: Sylvain Mottais, Jérémie Jacques, Mathieu Pioche, Guillaume Bouguen, Timothée Wallenhorst, David Cocaign, Charlène Brochard, CHU Pontchaillou [Rennes], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, business.product_category, Endoscopic Mucosal Resection, [SDV]Life Sciences [q-bio], Treatment outcome, Colonoscopy, Endoscopic mucosal resection, 03 medical and health sciences, Ileocecal valve, 0302 clinical medicine, Neoplasms, medicine, Humans, ComputingMilieux_MISCELLANEOUS, Ileocecal Valve, medicine.diagnostic_test, business.industry, Gastroenterology, En bloc resection, Surgical Instruments, Surgery, medicine.anatomical_structure, Treatment Outcome, 030220 oncology & carcinogenesis, Rubber band, 030211 gastroenterology & hepatology, business
Abstract: International audience
Published: 2020
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26. Improving the screening of precancerous anal lesions in high-risk subjects with normal cytology: A longitudinal cohort study using simple tests

Author: Charlène Brochard, Laurent Siproudhis, Aurore Carlo, Claire Gouriou, Emeric Boisteau, Sébastien Henno, Johanna Moreau, Astrid Lièvre, Vincent Thibault, Annie Lion, Guillaume Bouguen, CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CCSD, Accord Elsevier, Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Adult, Male, HPV16, medicine.medical_specialty, Anal Carcinoma, Biopsy, Cytodiagnosis, [SDV]Life Sciences [q-bio], Human immunodeficiency virus (HIV), Anal Canal, HIV Infections, medicine.disease_cause, Proctoscopy, 03 medical and health sciences, 0302 clinical medicine, Anal carcinoma, Internal medicine, medicine, Humans, Mass Screening, Anal cancer, Longitudinal Studies, Pap test, Longitudinal cohort, Normal cytology, Anal intraepithelial neoplasm, Retrospective Studies, Hepatology, medicine.diagnostic_test, business.industry, Papillomavirus Infections, Gastroenterology, Anoscopy, HIV, Middle Aged, Anus Neoplasms, medicine.disease, Annual Screening, 3. Good health, [SDV] Life Sciences [q-bio], 030220 oncology & carcinogenesis, Screening, Female, 030211 gastroenterology & hepatology, France, business, Precancerous Conditions, Carcinoma in Situ
Abstract: International audience; Unlabelled - For patients at high risk of anal cancer, annual screening strategies using invasive evaluation methods are stressful. According to a normal examination at baseline using simple and non invasive tests, the aim of the work was to quantify neoplastic events. Patients and method - Data from patients with a normal evaluation at the first visit were retrospectively extracted from a prospective database. The individual follow-up period was at least two years and three evaluations. Patients with abnormal cytology were assessed using high-resolution anoscopy and targeted biopsies. Results - A total of 182 subjects (F/M: 10/90, aged 48.1(10.6) years, HIV: 81%) were followed for 41(11) months. Anal cytology remained normal in 94 patients (52%), but high-grade anal neoplasms occurred in 28 patients (15%). Patients with a negative HPV16 status at baseline had cumulative probabilities of high-grade AIN of 0.4%(0.1%-1.9%), 2.6%(1.2%-5.9%) and 7.5%(4.5%-12.2%) after 1 year, 2 years and 3 years of follow-up, respectively. These probabilities were lower than those of patients with a positive HPV16 at baseline and those with a previous history of AIN. Conclusion - In patients with normal cytology and negative HPV16 at baseline, a three-year interval screening may be a less cumbersome alternative to traditional annual screening.
Published: 2020
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27. Le MMP-2 urinaire est significativement associé à l’échec de la toxine botulique intradétrusorienne chez les patients spina bifida

Author: Bruno Clément, C. Anne, C. Richard, E. Samson, C. Bendavid, Jacques Kerdraon, C. Voiry, M. Jezequel, X. Gamé, B. Peyronnet, Charlène Brochard, G. Bouguen, Andrea Manunta, Juliette Hascoet, CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre d'investigation clinique de Toulouse (CIC 1436), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Pôle Santé publique et médecine publique [CHU Toulouse], and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, business.industry, 030220 oncology & carcinogenesis, Urology, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, medicine, business, ComputingMilieux_MISCELLANEOUS, 3. Good health
Abstract: National audience
Published: 2020
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28. Management of solitary rectal ulcer syndome Results of a french national survey Société Nationale Française de Coloproctologie SNFCP, France

Author: Claire, Gouriou, Marion, Chambaz, Alain, Ropert, Guillaume, Bouguen, Aurélien, Venara, Guillaume, Meurette, Laurent, Siproudhis, Charlène, Brochard, CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Centre hospitalier universitaire de Nantes (CHU Nantes), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: Adult, Male, Consensus, Therapeutic management, [SDV]Life Sciences [q-bio], Syndrome, Middle Aged, Solitary rectal ulcer syndrome, Rectal Diseases, Laxatives, Surveys and Questionnaires, Quality of Life, Humans, Female, France, Practice Patterns, Physicians', Colorectal Surgery, Ulcer
Abstract: International audience; There is no consensus on the treatment for solitary rectal ulcer syndrome (SRUS). This study aimed to obtain information from physicians treating patients with SRUS in a French medical surgical society to facilitate management plans and to develop a support algorithm. Members of the French National Society of Coloproctology (SNFCP) were invited to complete a survey that included twenty items about therapeutic management and healing criteria. Overall, 91 practitioners (median age 52 [42-59] years) responded to the questionnaire; 64/91 (70.3%) were proctologists, and 27/91 (29.7%) were colorectal surgeons. Only 15 members (16.5%) followed more than 5 patients with SRUS per year. The therapeutic objectives were to improve both patient symptoms (100%) and quality of life (98.9%). Laxative treatment and first-line rehabilitation were agreed upon by 83.5% and 73% of the respondents, respectively. Surgery, mainly rectopexy, was offered after failed medical treatment by 81.1% of the practitioners (79.1%). The first-line strategy preferred by the professionals included laxatives and biofeedback rehabilitation. Surgical treatment, preferably rectopexy, was proposed as a second intervention. No consensus was reached regarding other therapeutic alternatives, and additional studies are required to clarify their indications.
Published: 2020
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29. Long-term outcomes of artificial urinary sphincter in female patients with spina bifida

Author: B. Peyronnet, J. Hascoet, Isabelle Bonan, M. Jezequel, Charlène Brochard, S. Odent, L. Siproudhis, A. Manunta, Xavier Gamé, and Jacques Kerdraon
Subjects: medicine.medical_specialty, business.industry, Spina bifida, Urology, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, lcsh:RC870-923, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, lcsh:RC254-282, Surgery, Artificial urinary sphincter, Female patient, Long term outcomes, Medicine, business
Published: 2020

30. Sexual dysfunction in adult women with spina bifida

Author: C. Voiry, J. Hascoet, J. Kerdraon, Charlène Brochard, C. Richard, Lucas Freton, B. Peyronnet, M. Jezequel, L. Siproudhis, A. Manunta, and Isabelle Bonan
Subjects: medicine.medical_specialty, business.industry, Obstetrics, Spina bifida, Urology, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, lcsh:RC870-923, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, lcsh:RC254-282, Adult women, Sexual dysfunction, Medicine, medicine.symptom, business
Published: 2020

31. Efficacy and safety of sacral nerve modulation for faecal incontinence after pelvic radiotherapy

Author: Paul-Antoine Lehur, Laurent Siproudhis, François Mion, Guillaume Meurette, Elsa Lambrescak, Vincent Wyart, Jean-Luc Faucheron, Charlène Brochard, Valérie Bridoux, Igor Sielezneff, Bertrand Trilling, Diane Mege, Henri Damon, Anne-Marie Leroi, Isabelle Etienney, Hôpital de la Timone [CHU - APHM] (TIMONE), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Neuropathies du système nerveux entérique et pathologies digestives, implication des cellules gliales entériques, Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM), Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-GMCAO), Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), Centre Hospitalier Universitaire [Grenoble] (CHU), Centre hospitalier universitaire de Nantes (CHU Nantes), Service de chirurgie digestive [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Groupe Hospitalier Diaconesses Croix Saint-Simon, Application des ultrasons à la thérapie (LabTAU), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de physiologie digestive, urinaire, respiratoire et de l'exercice [CHU Rouen], Hôpital Charles Nicolle [Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Charles Nicolle [Rouen]-CHU Rouen, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: medicine.medical_specialty, Sacral nerve modulation, Success rate, medicine.medical_treatment, Electric Stimulation Therapy, Age and sex, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, Medicine, Radiology, Nuclear Medicine and imaging, In patient, Retrospective Studies, Outcome, Radiotherapy, business.industry, Faecal incontinence, Hematology, Electrodes, Implanted, 3. Good health, Surgery, Radiation therapy, Treatment Outcome, Increased risk, Oncology, 030220 oncology & carcinogenesis, Sacral nerve, Implant, business, Complication, Pelvic radiotherapy, Fecal Incontinence
Abstract: International audience; Objective: To assess the efficacy and safety of sacral nerve modulation (SNM) in patients with faecal incontinence (FI) after pelvic radiotherapy in comparison with results of SNM for FI related to other conditions.Methods: Prospectively collected data from patients who underwent SNM therapy between January 2010 and December 2015 at 7 tertiary colorectal units were reviewed retrospectively. Patients with FI following pelvic radiotherapy were identified and matched (1:2) for age and sex with 38 patients implanted over the same period for FI without previous radiotherapy. The treatment was considered favourable if the patient reported any therapeutic benefit from SNM, had no further complaints or interventions and did not consider stopping the treatment. Long-term results, surgical revision and definitive explantation rates were compared.Results: Among 352 patients who received a permanent SNM implant, 19 (5.4%) had FI following pelvic radiotherapy. After a mean follow-up of 3.5 ± 1.9 years, the cumulative successful treatment rates were similar between the groups (p = 0.60). For patients with FI following pelvic radiotherapy, the cumulative success rates were 99.4% [85.4-99.8], 96.7% [78.1-99.6], 91.7% [70.4-98.1] and 74.6% [48.4-94.8] at 1, 2, 3 and 5 years respectively. The revision and definitive explantation rates for infection did not differ significantly.Conclusion: The long-term success rate of SNM for FI after pelvic radiotherapy is similar to that of SNM for FI related to other more frequent conditions. Our study suggests that FI after pelvic radiotherapy could be improved with SNM without an increased risk of complication.
Published: 2020
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32. MP30-07 MIDURETHRAL SLINGS ARE ASSOCIATED WITH POOR FUNCTIONAL OUTCOMES IN FEMALE PATIENTS WITH SPINA BIFIDA

Author: Benoit Peyronnet, Charlène Brochard, Isabelle Bonan, M. Jezequel, C. Voiry, Laurent Siproudhis, Quentin Alimi, Andrea Manunta, Jacques Kerdraon, and Juliette Hascoet
Subjects: Midurethral Slings, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Spina bifida, business.industry, Urology, Urinary incontinence, medicine.disease, nervous system diseases, Surgery, Female patient, medicine, medicine.symptom, business, Surgical treatment
Abstract: INTRODUCTION AND OBJECTIVE:Stress urinary incontinence (SUI) is relatively common in women with spina bifida. However, there is very little data available on the outcomes of surgical treatment of S...
Published: 2020
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33. MP48-14 URINARY TIMP-2 AND MMP-2 ARE SIGNIFICANTLY ASSOCIATED WITH POOR BLADDER COMPLIANCE IN ADULT PATIENTS WITH SPINA BIFIDA

Author: Zineddine Khene, Andrea Manunta, Claude Bendavid, Quentin Alimi, M. Jezequel, Juliette Hascoet, Jacques Kerdraon, Guillaume Bouguen, Xavier Gamé, Charlène Brochard, C. Richard, and Benoit Peyronnet
Subjects: medicine.medical_specialty, Adult patients, business.industry, Spina bifida, Bladder compliance, Urology, Urinary system, Medicine, Matrix metalloproteinase, business, medicine.disease
Published: 2020
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34. THE OPENING OF THE ILEOCAECAL VALVE THANKS TO COUNTERTRACTION USING A DOUBLE CLIP AND RUBBER BAND FACILITATES R0 EN BLOC RESECTION OF ILEOCAECAL LSTS

Author: Charlène Brochard, M Pagenault, J Jacques, M Pioche, D Cocaign, Guillaume Bouguen, Timothée Wallenhorst, and S Mottais
Subjects: medicine.medical_specialty, Materials science, business.product_category, Rubber band, medicine, En bloc resection, business, Surgery
Published: 2020
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35. Full-field optical coherence tomography: novel imaging technique for extemporaneous high-resolution analysis of mucosal architecture in human gut biopsies

Author: Emilie Benoit a la Guillaume, Raphael Olivier, Michel Neunlist, Céline Bossard, Jean-François Mosnier, Claude Boccara, Lucille Quénéhervé, Charlène Brochard, Michalina Gora, Emmanuel Coron, The Enteric Nervous System in gut and brain disorders [U1235] (TENS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Institut des Maladies de l'Appareil Digestif, Université de Nantes (UN), Service d’hépato-gastro-entérologie et assistance nutritive [CHU de Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Anti-Tumor Immunosurveillance and Immunotherapy (CRCINA-ÉQUIPE 3), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), LLTech SAS Paris, Institut Langevin - Ondes et Images (UMR7587) (IL), Ecole Superieure de Physique et de Chimie Industrielles de la Ville de Paris (ESPCI Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), CHU Pontchaillou [Rennes], Bernardo, Elizabeth, Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Réseau nanophotonique et optique, Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Matériaux et nanosciences d'Alsace (FMNGE), Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA), Sorbonne Université (SU)-Ecole Superieure de Physique et de Chimie Industrielles de la Ville de Paris (ESPCI Paris), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université de Paris (UP)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Pathology, medicine.medical_specialty, Biopsy, [SDV.CAN]Life Sciences [q-bio]/Cancer, 01 natural sciences, 010309 optics, 03 medical and health sciences, 0302 clinical medicine, Human gut, [SDV.CAN] Life Sciences [q-bio]/Cancer, Optical coherence tomography, gastrointesinal endoscopy, 0103 physical sciences, Medicine, Humans, High resolution analysis, Lamina propria, Mucous Membrane, medicine.diagnostic_test, business.industry, Gastroenterology, Endoscopy, Biological tissue, Full field, Gastrointestinal Tract, medicine.anatomical_structure, Gastric pits, 030220 oncology & carcinogenesis, histopathology, epithelial barrier, Imaging technique, business, Tomography, Optical Coherence
Abstract: International audience; Full-field optical coherence tomography (FFOCT) is an imaging technique of biological tissue based on tissue light reflectance analysis. We evaluated the feasibility of imaging fresh digestive mucosal biopsies after a quick mounting procedure (5 min) using two distinct modalities of FFOCT. In static FFOCT mode, we gained high-resolution images of general gut tissue-specific architecture, such as oesophageal papillae, gastric pits, duodenal villi and colonic crypts. In dynamic FFOCT mode, we imaged individual epithelial cells of the mucosal lining with a cellular or subcellular resolution and identified cellular components of the lamina propria. FFOCT represents a promising dye-free imaging tool for on-site analysis of gut tissue remodelling.
Published: 2020
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36. Risk of prolapse and urinary complications in adult spina bifida patients with neurogenic acontractile detrusor using clean intermittent catheterization versus Valsalva voiding

Author: C. Richard, Charlène Brochard, Jacques Kerdraon, Laurent Siproudhis, Xavier Gamé, Zine-Eddine Khene, Isabelle Bonan, Quentin Alimi, M. Jezequel, Andrea Manunta, Juliette Hascoet, Mehdi El Akri, B. Peyronnet, CHU Pontchaillou [Rennes], Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Mutualiste de Rééducation et de Réadaptation Fonctionnelles de Kerpape, CHU Toulouse [Toulouse], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: Adult, Male, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Urology, Urinary system, 030232 urology & nephrology, acontractile, urologic and male genital diseases, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Uterine Prolapse, Intussusception (medical disorder), Urinary Bladder, Underactive, Clinical endpoint, Humans, Medicine, Intermittent Urethral Catheterization, Urinary Complication, Urinary Bladder, Neurogenic, Spinal Dysraphism, Retrospective Studies, valsalva pelvic organ prolapse, 030219 obstetrics & reproductive medicine, Urinary bladder, business.industry, Spina bifida, clean-intermittent catheterization, medicine.disease, spina bifida, body regions, Rectal prolapse, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Relative risk, Urinary Tract Infections, Female, Neurology (clinical), urinary tract infection, business, urinary bladder, rectal prolapse
Abstract: International audience; Aims - To assess the relative risks of pelvic organ prolapse (POP) and urinary complications in adult spina bifida patients with neurogenic acontractile detrusor voiding with Valsalva versus those using clean-intermittent catheterization (CIC). Methods - We conducted a retrospective analysis including all spina bifida patients with neurogenic acontractile detrusor with a minimum follow-up of 12 months. Patients were then divided in two groups according to their bladder management: voiding with Valsalva versus CIC. The primary endpoint was any de novo or worsened rectal and/or pelvic organ prolapse (POP) diagnosed during follow-up. The secondary outcome was urinary complications defined as febrile urinary tract infections (UTI) and/or urolithiasis and/or renal failure. Results - Fifty-five patients (50.9% were males) met the inclusion/exclusion criteria: 28 voiding with Valsalva and 27 performing CIC. At baseline, the rates of vaginal prolapse (44.4% vs 50%; P = 0.99), and rectal prolapse/intussusception (25.9% vs 21.4%; P = 0.76) were similar in both groups. After a median follow-up of 80.6 and 65.6 months, respectively (P = 0.29), the rate of de novo or worsened rectal prolapse/intussusception was higher in the Valsalva voiding group than in the CIC group (32.1% vs 3.7%; P = 0.01). De novo or worsened vaginal prolapses were also more common in the Valsalva voiding group, but it did not reach statistical significance (33.3% vs 11.1%; P = 0.29). Conclusions - Valsalva voiding might be harmful in adult spina bifida patients with neurogenic acontractile detrusor as it may increase the risk of rectal prolapse/intussusception. Overall, the prevalence of POP and rectal prolapse was high in both groups.
Published: 2018
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37. Effets cardio-vasculaires des traitements anticholinergiques à visée vésicale chez la personne âgée : une revue

Author: J. Kerdraon, B. Peyronnet, Rebecca Haddad, Camille Chesnel, C. Jeandel, J M Soler, Grégoire Capon, C. Thuillier, X. Gamé, P Mongiat-Artus, Claire Hentzen, Brigitte Fatton, A. Charlanes, X. Deffieux, Pierre Marès, Charlène Brochard, Gérard Amarenco, M. Mezzadri, J.-M. Vetel, G. Robain, Xavier Biardeau, Nicolas Turmel, P. Manceau, S. Campagne, and A.-C. Petit
Subjects: Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, business.industry, Urology, 030232 urology & nephrology, medicine, 030212 general & internal medicine, business, 3. Good health
Abstract: Resume Objectif L’objectif de cet article etait d’effectuer une revue des donnees de la litterature concernant les effets cardiovasculaires des traitements anticholinergiques a visee urinaire chez la personne âgee. Methodes Une revue de la litterature a ete effectuee en octobre 2017 a l’aide de la base de donnees Medline/Pubmed en limitant la recherche aux travaux en anglais ou en francais. Resultats Au total, 602 articles de mars 1964 a octobre 2017 ont ete releves, 60 articles ont ete analyses et 19 essais prospectifs ont ete selectionnes. Plus de 20 % de la population geriatrique presente une hyperactivite vesicale dont 41,4 % serait traite par anticholinergiques. La prevalence des comorbidites cardiovasculaires est elevee avec 24,4 % de cardiopathies chez les 65–74 ans et 36,9 % chez les ≥ 75 ans. L’evaluation des effets cardiovasculaires des anticholinergiques dans la population geriatrique est rendue difficile par l’exclusion dans cette population au cours des essais des comorbidites cardiovasculaires. Neanmoins, certains evenements cardiovasculaires severes sont rapportes comme la survenue d’une fibrillation auriculaire, d’un bloc auriculo-ventriculaire ou de syncopes sur torsades de pointe. Des etudes complementaires semblent necessaires tout particulierement dans la « vraie vie » avec suivi longitudinal des patients âges traites par anticholinergiques pour preciser l’impact cardiovasculaire de ces prescriptions. Conclusion En l’absence de donnees d’evidence, et compte tenu du tropisme cardiovasculaire des anticholinergiques, meme a visee specifiquement vesicale en raison de leur manque de selectivite, il semble raisonnable d’introduire avec precaution un traitement anticholinergique dans la population geriatrique, et ce au-dela des effets indesirables notamment cognitifs deja connus.
Published: 2018
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38. Long-term functional outcomes of perineal gangrene: worse than expected?—an observational retrospective study

Author: J. Barbieux, Aurélien Venara, A. Hamy, Charlène Brochard, P. Bigot, A. Le Fouler, V. Souday, P. Le Naoures, R. Jaouen, Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH), Université d'Angers (UA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)
Subjects: Quality of life, Male, medicine.medical_specialty, Time Factors, Constipation, [SDV]Life Sciences [q-bio], Urinary system, medicine.medical_treatment, 030232 urology & nephrology, Urinary incontinence, Perineum, Gangrene, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Fecal incontinence, Dysuria, Retrospective Studies, business.industry, Gastroenterology, Colostomy, Middle Aged, medicine.disease, 3. Good health, Surgery, Treatment Outcome, medicine.anatomical_structure, Female, 030211 gastroenterology & hepatology, medicine.symptom, business, Fecal Incontinence
Abstract: International audience; Purpose - For survivors of perineal gangrene (PG), quality of life and functional prognosis of pelvic functions are probably overestimated. The aim of this study was to report long-term anal and urinary sphincter dysfunctions, sexual sequelae, and patients' quality of life after treatment of perineal gangrene. Methods - This retrospective observational study was conducted in one university hospital over 16 years. Seventy-three patients experienced PG; 22 were subject to long-term follow-up. Three questionnaires were sent to patients to assess pelvic dysfunction and quality of life: the GIQLI, the Cleveland Incontinence Score, and the USP score for urinary dysfunction. Sexual sequelae were considered if orchiectomy or penile resection for male patients and vulvar resection for female patients were performed. Results - Of the 72 patients included, seven died before discharge (9.7%) and at least 14 died during follow-up (19.4%), despite a mean age of 62 years (± 13). Among the surviving patients, seven experienced an alteration of their quality of life (44%) (GIQLI
Published: 2018
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39. Le pas de valse à trois temps de l’enseignement de la proctologie : entre opportunisme, manque de considération et déception…*

Author: F. Pigot, Laurent Siproudhis, Charlène Brochard, Guillaume Bouguen, V. de Parades, and Laurent Abramowitz
Subjects: Gastroenterology, Internal Medicine
Published: 2019
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40. Endoscopic resection of a rectal gastrointestinal stromal tumor using the submucosal tunneling endoscopic resection (STER) technique

Author: Mathieu Pioche, Guillaume Bouguen, Mael Pagenault, Jérémie Jacques, Charlène Brochard, Astrid Lièvre, and Timothée Wallenhorst
Subjects: 2019-20 coronavirus outbreak, medicine.medical_specialty, Endoscopic Mucosal Resection, Esophageal Neoplasms, Coronavirus disease 2019 (COVID-19), Gastrointestinal Stromal Tumors, business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Gastroenterology, Treatment Outcome, Text mining, Gastric Mucosa, Stomach Neoplasms, Gastroscopy, Humans, Medicine, Endoscopic resection, Radiology, Stromal tumor, business, Retrospective Studies
Published: 2021
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41. Bowel Dysfunction Related to Spina Bifida: Keep It Simple

Author: Guillaume Bouguen, Charlène Brochard, H. Menard, Laurent Siproudhis, Michel Neunlist, Andrea Manunta, Alain Ropert, Anne Dariel, Benoit Peyronnet, CHU Pontchaillou [Rennes], Institut des Maladies de l'Appareil Digestif, Université de Nantes (UN), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Foie, métabolismes et cancer, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), The Enteric Nervous System in gut and brain disorders [U1235] (TENS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: Adult, Male, congenital, hereditary, and neonatal diseases and abnormalities, Pediatrics, medicine.medical_specialty, Constipation, [SDV]Life Sciences [q-bio], Population, 030232 urology & nephrology, complication, Urinary incontinence, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Neurogenic Bowel, Risk Factors, Severity of illness, Prevalence, medicine, Humans, Fecal incontinence, human, Prospective Studies, education, Prospective cohort study, Spinal Dysraphism, education.field_of_study, Spina bifida, business.industry, Gastroenterology, General Medicine, medicine.disease, 3. Good health, Intestinal Diseases, risk factor, Female, 030211 gastroenterology & hepatology, France, medicine.symptom, business, Fecal Incontinence, prospective study
Abstract: International audience; BACKGROUND: Although care of urological disorders in spina bifida is well established, there is yet no agreement on a standardized approach to bowel dysfunction in this population.OBJECTIVE: The purpose of this study was to assess bowel dysfunction using validated instruments and the risk factors in adults with spina bifida.DESIGN: A multidisciplinary team prospectively collected patient data, focusing on anorectal and urological symptoms.SETTINGS: The study was conducted with data from a French referral center for spina bifida.PATIENTS: A total of 228 adults with spina bifida (sex ratio men:women, 92 (40%):136 (60%)) with a median age of 34.7 years (range, 26.8-44.7 y) were assessed.MAIN OUTCOMES MEASURES: Factors associated with severe fecal incontinence (Cleveland Clinic Incontinence Score ≥9) and severe bowel dysfunction (Neurogenic Bowel Dysfunction score ≥14) were assessed in a multivariate analysis model.RESULTS: The prevalence rates of severe fecal incontinence and severe bowel dysfunction were 60% (130/217) and 42% (71/168). Bowel dysfunction was the second most common major concern of patients after lower urinary tract dysfunction. Male sex, obesity, urinary incontinence, and a Knowles-Eccersley-Scott symptom constipation score ≥10 were independently associated with severe fecal incontinence. Patients with soft stools had significantly less severe bowel dysfunction. Neither neurologic level nor other neurologic features of spina bifida were associated with severe fecal incontinence or severe bowel dysfunction.LIMITATIONS: The recruitment of patients with spina bifida through a national referral center might have resulted in selection bias, and some data were missing especially regarding BMI and Neurogenic Bowel Dysfunction score (21% and 26% of missing data).CONCLUSIONS: The prevalence rates of severe fecal incontinence and severe bowel dysfunction in adults with spina bifida were high and were adequately perceived by the patients. The present study emphasized the association of bowel dysfunction and fecal incontinence with obesity, urologic disorders, and stool consistency rather than neurologic features. See Video Abstract at http://links.lww.com/DCR/A394.
Published: 2017
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42. Fecal incontinence in patients with spina bifida: The target is the rectum

Author: Guillaume Bouguen, Laurent Siproudhis, Alain Ropert, Andrea Manunta, Michel Neunlist, Charlène Brochard, H. Menard, Benoit Peyronnet, Service des Maladies de l'Appareil Digestif, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], U1235, Neuropathies du système nerveux entérique et pathologies digestives (TENS), Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Service des Maladies de l'Appareil Digestif [CHU Rennes], Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), The Enteric Nervous System in gut and brain disorders [U1235] (TENS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), and Institut National de la Recherche Agronomique (INRA)-Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Adult, Male, medicine.medical_specialty, Multivariate analysis, Manometry, [SDV]Life Sciences [q-bio], Urology, Sensation, 030232 urology & nephrology, Prevalence, Anal Canal, Rectum, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Humans, Medicine, Fecal incontinence, Spinal Dysraphism, Gynecology, rectal sensitivity, business.industry, Spina bifida, Anorectal manometry, Middle Aged, Anal canal, medicine.disease, spina bifida, fecal incontinence, medicine.anatomical_structure, Latex allergy, Female, 030211 gastroenterology & hepatology, Neurology (clinical), medicine.symptom, business
Abstract: International audience; Aims - The prevalence rate of severe fecal incontinence (FI) in adults with spina bifida (SB) is high. The physiological basis of FI in SB has not been clearly established, which contributes to inadequate care. The aim was to better characterize a large cohort of adults with special consideration of anorectal physiology.Methods - A multidisciplinary team from a French referral centre for SB prospectively collected data on patients who had an anorectal manometry. Factors associated with severe FI (Cleveland clinical incontinence score ≥ 9) were assessed in a multivariate analysis model.Results - A total of 132 adults with SB (sex ratio M/F: 55 [41.7%]/77 [58.3%]; mean age of 38.2 [11.6] years old) were assessed. Among these patients, 83/132 (62.9%) suffered from severe FI. Rectal perception was not evaluable among 17 patients who had a latex allergy. Overall, 29/115 (25.2%) had maximal tolerable volume (MTV) > 330 mL or no sensation. The absence of anal canal sensitivity, MVT > 330 mL and the amplitude of the recto-anal inhibitory reflex (RAIR) >75% after a rectal isovolumic inflation of 50 mL were significantly associated with severe FI in the multivariate analysis model. Neither neurological level nor other neurological features were associated with severe FI.Conclusions - This study showed that FI in patients with SB is mainly associated with rectal abnormalities. This should be taken into consideration to improve incontinence management of patients with SB.
Published: 2017
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43. Human papillomavirus does not play a role in the Barrett esophagus: a French cohort

Author: Sandrine Bertrais, M. Le Rhun, Françoise Lunel-Fabiani, Nina Dib, Adeline Pivert, Dominique Luet, E. Cesbron-Metivier, Emmanuel Coron, C. Couffon, Sophie Michalak, Charlène Brochard, André Ricard, Alexandra Ducancelle, F.-X. Caroli Bosc, M. Bodin, Nicolas Musquer, CHU Pontchaillou [Rennes], Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Neuropathies du système nerveux entérique et pathologies digestives, implication des cellules gliales entériques, Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH), Université d'Angers (UA), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: Male, medicine.medical_specialty, Biopsy, [SDV.CAN]Life Sciences [q-bio]/Cancer, Real-Time Polymerase Chain Reaction, Gastroenterology, Virus, Barrett's esophagus, Barrett Esophagus, 03 medical and health sciences, Esophagus, 0302 clinical medicine, Internal medicine, Prevalence, medicine, Humans, Prospective Studies, Human papillomavirus, human papillomavirus, HPV DNA, Papillomaviridae, Aged, Hyperplasia, business.industry, Papillomavirus Infections, HPV infection, General Medicine, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, Middle Aged, medicine.disease, humanities, 3. Good health, medicine.anatomical_structure, Dysplasia, Case-Control Studies, 030220 oncology & carcinogenesis, Cohort, Etiology, Female, 030211 gastroenterology & hepatology, France, business, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition
Abstract: International audience; The role of human papillomavirus (HPV) in Barrett's esophagus (BE) has been examined but remains unclear. The purpose of the study is to dispute the connection between HPV and BE in a prospective case-control study. Biopsies were performed above and inside the Barrett's segment for BE patients and in the distal third of the esophagus for control patients for histological interpretation and for virological analysis. Biopsies for virological analysis were placed in a virus transport medium and immediately frozen in liquid nitrogen. Virological analysis involved real-time PCR using the SyBr® green protocol with modified SPF10 general primers. A total of 180 patients (119 control and 61 BE, respectively) were included. In BE patients, 31, 18, and 12 patients had, respectively, no dysplasia, low-grade dysplasia, and high grade dysplasia. Overall, nine were found to be HPV positive: five were control patients and four BE patients. HPV positive status was not associated with BE. No factors were associated with HPV, in particular the degree of BE dysplasia. HPV infection appears unlikely to be significant in the etiology of BE compared with control patients. (ClinicalTrials.gov, Number NCT02549053).
Published: 2017
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44. Hypermétabolisme anal de découverte fortuite à la TEP au 18F-FDG : un examen proctologique doit-il être proposé ?

Author: Laurent Siproudhis, Etienne Garin, E. Le Balc'h, A. Merlini l'Héritier, Thomas Grainville, Charlène Brochard, Astrid Lièvre, Timothée Wallenhorst, Xavier Palard, and A.S. Moussaddaq
Subjects: Radiological and Ultrasound Technology, Biophysics, Radiology, Nuclear Medicine and imaging
Abstract: Introduction Les objectifs de ce travail ont ete d’evaluer la prevalence des hypermetabolismes anaux de decouverte fortuite, leurs etiologies et l’existence d’une eventuelle correlation entre les parametres metaboliques et la prise en charge proctologique. Materiels et methodes Les donnees cliniques (âge, sexe, principaux antecedents, motif de realisation de la TEP au 18F-FDG, realisation ou non d’un examen proctologique, presence ou non d’un diagnostic proctologique et proposition ou non d’un traitement proctologique) des patients ayant un hypermetabolisme anal de decouverte fortuite ont ete analysees retrospectivement. Les TEP au 18F-FDG ont ete relues en aveugle des donnees de l’examen proctologique pour confirmer l’hypermetabolisme anal et extraire la SUVmax, SUVmean et plusieurs volumes metaboliques (MV50, MV41 et MV30). Les parametres cliniques et metaboliques des patients ayant ete explores ont ete compares a ceux ne l’ayant pas ete, et de ceux ayant eu une proposition therapeutique a l’issue de cet examen ont ete compares aux autres. Resultats Parmi les 43 020 compte-rendus de TEP au 18F-FDG realisees entre janvier 2005 et decembre 2018, un hypermetabolisme anal de decouverte fortuite a ete retenu chez 134 patients. Quarante-huit patients (36 %) ont eu un examen proctologique, parmi lesquels 33 (69 %) ont eu un diagnostic proctologique pose au decours. Les diagnostics etaient les suivants : une maladie hemorroidaire (n = 22), une fissure anale (n = 5), une recidive d’adenocarcinome sur anastomose colo-anale (n = 1), des condylomes (n = 3), un fecalome (n = 1), une suppuration (n = 2) et un syndrome de l’ulcere solitaire du rectum (n = 1). Aucun parametre metabolique n’etait associe significativement au fait qu’un diagnostic ait ete pose. Un traitement a ete propose pour 18 (38 %) patients dont 5 (28 %) un traitement chirurgical. Le SUVmax, le SUVmoyen, le MV41 et le MV30 differaient significativement entre les patients ayant une pathologie accessible a un traitement et ceux sans. Conclusion L’hypermetabolisme anal de decouverte fortuite est peu explore. Toutefois, lorsqu’un examen proctologique est realise, un diagnostic est pose dans plus de deux tiers des cas et un traitement est propose dans plus d’un tiers des cas. Les parametres metaboliques sont associes a l’existence de pathologies anorectales accessibles a un traitement. Ces donnees devraient encourager les praticiens a explorer systematiquement un hypermetabolisme anal de decouverte fortuite.
Published: 2020
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45. Incidental anal 18fluorodeoxyglucose uptake: Should we further examine the patient?

Author: Thomas Grainville, Laurent Siproudhis, Eric Le Balch, Etienne Garin, Alexandre Merlini l’Héritier, Anne-Sophie Moussaddaq, Timothée Wallenhorst, Astrid Lièvre, Charlène Brochard, Xavier Palard-Novello, Centre Hospitalier Universitaire [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CRLCC Eugène Marquis (CRLCC), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Jonchère, Laurent, Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: [SDV.IB] Life Sciences [q-bio]/Bioengineering, medicine.medical_specialty, Anorectal disease, medicine.diagnostic_test, business.industry, Computed tomography, Standardized uptake value, General Medicine, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Rare, Retrospective Study, 030220 oncology & carcinogenesis, medicine, 030211 gastroenterology & hepatology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Radiology, 18fdg pet, business, Incidental anal 18fluorodeoxyglucose uptake
Abstract: International audience; Background - There are no studies on incidental anal F-fluorodeoxyglucose (FDG) uptake. Aim - To assess the rate and aetiologies of incidental anal FDG uptake and to evaluate the correlation between FDG positron-emission tomography/computed tomography (PET/CT) parameters and the diagnosis of an anorectal disease. Methods - The data from patients with incidental anal FDG uptake were retrospectively analysed. Patients who underwent anorectal examinations were identified and compared to those who did not undergo examinations. Patients who were offered treatment were then identified and compared to those who did not receive treatment. Results - Among the 43020 FDG PET/CT scans performed, 197 FDG PET/CT scans of 146 patients (0.45%) reported incidental anal uptake. Among the 134 patients included, 48 (35.8%) patients underwent anorectal examinations, and anorectal diseases were diagnosed in 33 (69.0%) of these patients and treated in 18/48 (37.5%) patients. Among the examined patients, those with a pathology requiring treatment had significantly smaller metabolic volumes (MV) 30 and MV41 values and higher maximal and mean standardized uptake value measurements than those who did not require treatment. Conclusion - Incidental anal FDG uptake is rare, but a reliable anorectal diagnosis is commonly obtained when an anorectal examination is performed. The diagnosis of an anorectal disease induces treatment in more than one-third of the patients. These data should encourage practitioners to explore incidental anal FDG uptake systematically.
Published: 2020
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46. Pharmacokinetic parameters of infliximab influence the rate of relapse after de-escalation in adults with inflammatory bowel diseases

Author: Camille Tron, Charlène Brochard, Guillaume Bouguen, Marie-Clémence Verdier, Florian Lemaitre, Laurent Siproudhis, Antoine Petitcollin, Eric Bellissant, Camille Lucidarme, CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 - Faculté de Médecine (UR1 Médecine), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes - Faculté de Médecine (UR Médecine), Université de Rennes (UR), and Institut National de la Recherche Agronomique (INRA)-Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Time Factors, 030226 pharmacology & pharmacy, Gastroenterology, Inflammatory bowel disease, Tobacco Use, 0302 clinical medicine, Dose tapering, Recurrence, Pharmacology (medical), Prospective cohort study, ComputingMilieux_MISCELLANEOUS, biology, medicine.diagnostic_test, Remission Induction, Therapeutic Drug Monitoring, Middle Aged, Ulcerative colitis, De-escalation, 3. Good health, Population Pharmacokinetics, C-Reactive Protein, 030220 oncology & carcinogenesis, Female, medicine.drug, Adult, medicine.medical_specialty, Metabolic Clearance Rate, 03 medical and health sciences, Pharmacokinetics, Gastrointestinal Agents, Internal medicine, medicine, Humans, Proportional Hazards Models, Pharmacology, Proportional hazards model, business.industry, C-reactive protein, [SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy, medicine.disease, Inflammatory Bowel Diseases, Real-World Data, Infliximab, Therapeutic drug monitoring, biology.protein, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Colitis, Ulcerative, business
Abstract: This study aimed at exploring the link among individual concentrations, pharmacokinetic parameters, and the probability of relapse after de-escalation in a real-world prospective cohort of patients with inflammatory bowel disease (IBD) who underwent infliximab treatment de-escalation. Ninety-one patients were included. A time-varying compartment model was used to estimate individual pharmacokinetic parameters and trough concentrations. A Cox model was implemented to explore the parameters influencing the probability of relapse after de-escalation. Volume, clearance, and trough before and after de-escalation were linked to the relapse risk at the univariate step. Independent predictors of relapse were tobacco use and/or ulcerative colitis (P = 0.0093), a higher C-reactive protein (CRP; P = 0.00064), and an infliximab trough 2.4 μg/mL after de-escalation (P = 0.0001). Patients with trough 5.7 μg/mL are eligible to de-escalation, but infliximab pharmacokinetics is highly variable in time. Therefore, drug monitoring is mandatory after de-escalation to maintain trough 2.4 μg/mL. Clearance monitoring seems an appealing approach for patient selection and relapse prediction.
Published: 2019
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47. Sacral nerve modulation for faecal incontinence influence of age on outcomes and complications. A multicentre study

Author: Paul-Antoine Lehur, Guillaume Meurette, Diane Mege, Estelle Houivet, Vincent Wyart, Isabelle Etienney, Valérie Bridoux, Anne-Marie Leroi, Elsa Lambrescak, Jean-Luc Faucheron, Charlène Brochard, Henri Damon, François Mion, Igor Sielezneff, Laurent Siproudhis, Assistance Publique - Hôpitaux de Marseille (APHM), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Groupe Hospitalier Diaconesses Croix Saint-Simon, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre d'Investigation Clinique [CHU Rouen] (CIC Rouen), Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de chirurgie digestive [CHU Rouen], CHU Rouen, Normandie Université (NU), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Service de physiologie digestive, urinaire, respiratoire et de l'exercice [CHU Rouen], Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA)-Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Charles Nicolle [Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, and Jonchère, Laurent
Subjects: Adult, Male, medicine.medical_specialty, complications, faecal incontinence, Population, Lumbosacral Plexus, Surgical Revision, Electric Stimulation Therapy, elderly, 03 medical and health sciences, 0302 clinical medicine, sacral nerve modulation, Age groups, Medicine, Humans, In patient, Revision rate, education, ComputingMilieux_MISCELLANEOUS, Aged, Retrospective Studies, Aged, 80 and over, education.field_of_study, [SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, business.industry, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, Gastroenterology, Age Factors, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Middle Aged, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, 3. Good health, Surgery, Electrodes, Implanted, age, 030220 oncology & carcinogenesis, Sacral nerve, outcome, 030211 gastroenterology & hepatology, Female, Implant, France, business, explantation, Fecal Incontinence
Abstract: AIM Faecal incontinence is frequent in the elderly. Little is currently known about the efficacy of sacral nerve modulation (SNM) in the elderly. The present study aimed to assess the impact of age on the outcome of SNM and on the surgical revision and explantation rates by comparing the results of a large data set of patients. METHOD Prospectively collected data from patients who underwent an implant procedure between January 2010 and December 2015 in seven French centres were retrospectively evaluated. In total, 352 patients [321 women; median age (range): 63 (24-86) years] were included. Clinically favourable and unfavourable outcomes, and surgical revision and explantation rates, were compared according to the age of the patients. RESULTS A similar outcome was observed when comparing patients
Published: 2019
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48. Sphincter-sparing surgery for complex anal fistulas: radiofrequency-thermo-coagulation of the tract is of no help

Author: E. Le Balc'h, A. Merlini l'Héritier, Timothée Wallenhorst, G. Bessi, Charlène Brochard, Guillaume Bouguen, Laurent Siproudhis, CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut National de la Recherche Agronomique (INRA)-Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Adult, Male, Anal fistula, medicine.medical_specialty, Drainage procedure, Databases, Factual, medicine.medical_treatment, Fistula, Anal Canal, Surgical Flaps, 03 medical and health sciences, 0302 clinical medicine, Radiofrequency thermocoagulation, radiofrequency, Crohn Disease, Cox proportional hazards regression, Electrocoagulation, Humans, Rectal Fistula, Medicine, Prospective Studies, Abscess, ComputingMilieux_MISCELLANEOUS, Proportional Hazards Models, business.industry, Clinical events, Rectum, Gastroenterology, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Middle Aged, Radiofrequency Therapy, medicine.disease, Surgery, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Sphincter, Female, 030211 gastroenterology & hepatology, business, rectal flap, Organ Sparing Treatments
Abstract: Aim To compare the rate of failure of radiofrequency thermocoagulation for anal fistula with that of rectal advancement flap in a case-matched study. Method Patients who underwent radiofrequency treatment were compared with age- and sex-matched patients with Crohn's disease (CD) who underwent a rectal flap procedure. Fistula features, general characteristics and the main clinical events were recorded in a prospective database. Failure was defined by at least one of following: abscess, purulent discharge, visible external opening or further drainage procedure. Results A total of 62 patients [median age 45 (range 36.8-57.5) years; 22 women, 40 men; 22 with CD] were analysed. The failure rate of radiofrequency treatment was higher than that of rectal flap treatment (74.2% vs 32.2%; P = 0.004). The cumulative probabilities of failure of the radiofrequency treatment were 53.8% (38.8-68.3), 71.8% (55.3-84.0) and 87.4% (70.6-95.3) at 3, 6 and 12 months, respectively. Three patients in the radiofrequency group required drainage for an abscess and one had severe thermal ulceration. The Cox proportional hazards regression model (surgical procedure, obesity, CD) showed rectal flap treatment [3.48 (1.60-8.07); P = 0.001] and CD [2.60 (1.16-6.41); P = 0.02] to be the main independent predictors of healing. Conclusion Radiofrequency thermocoagulation is a less satisfactory sphincter-sparing treatment for the management of anal fistula than a rectal flap procedure.
Published: 2019
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49. Is Sacral Nerve Modulation a Good Option for Fecal Incontinence in Men?

Author: B. Trilling, Anne-Marie Leroi, Guillaume Meurette, Laurent Siproudhis, Charlène Brochard, Paul-Antoine Lehur, Valérie Bridoux, Elsa Lambrescak, Jean-Luc Faucheron, Vincent Wyart, Isabelle Etienney, Henri Damon, Igor Sielezneff, Diane Mege, François Mion, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance Publique - Hôpitaux de Marseille (APHM), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Normandie Université (NU), Service de chirurgie digestive [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Centre hospitalier universitaire de Nantes (CHU Nantes), Hospices Civils de Lyon (HCL), Groupe Hospitalier Diaconesses Croix Saint-Simon, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre Hospitalier Universitaire [Grenoble] (CHU), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Centre d'Investigation Clinique [CHU Rouen] (CIC Rouen), Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de physiologie digestive, urinaire, respiratoire et de l'exercice [CHU Rouen], Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Charles Nicolle [Rouen], and Normandie Université (NU)-Normandie Université (NU)-CHU Rouen
Subjects: Male, medicine.medical_specialty, Permanent implant, [SDV]Life Sciences [q-bio], Lumbosacral Plexus, men, Surgical Revision, Electric Stimulation Therapy, 03 medical and health sciences, 0302 clinical medicine, sacral nerve modulation, Fecal incontinence, Medicine, Humans, Revision rate, Prospective Studies, Aged, Sex Characteristics, business.industry, Mean age, General Medicine, Middle Aged, 3. Good health, Surgery, Electrodes, Implanted, Anesthesiology and Pain Medicine, Neurology, 030220 oncology & carcinogenesis, Sacral nerve, 030211 gastroenterology & hepatology, Female, Neurology (clinical), Implant, medicine.symptom, business, Follow-Up Studies
Abstract: International audience; Objective - The objective was to assess the efficacy and the safety of sacral nerve modulation (SNM) in men with fecal incontinence (FI) compared with those of SNM in women. Method - Prospectively collected data from patients from seven tertiary colorectal units who underwent an implant procedure between January 2010 and December 2015 were reviewed retrospectively. Outcomes and surgical revision and definitive explantation rates were compared between men and women. Results - A total of 469 patients (60 men [12.8%]; mean age = 61.4 ± 12.0 years) were included in the study, 352 (78.1%) (31 men [8.8%]) of whom received a permanent implant. The ratio of implanted/tested men was significantly lower than the ratio of implanted/tested women (p = 0.0004). After a mean follow-up of 3.4 ± 1.9 years, the cumulative successful treatment rates tended to be less favorable in men than in women (p = 0.0514): 88.6% (75.6-95.1), 75.9% (60.9-86.4), 63.9% (48.0-77.3), and 43.9% (26.7-62.7) at one, two, three, and five years, respectively, in men; 92.0% (89.1-94.2), 84.2% (80.3-87.4), 76.8% (72.3-80.7), and 63.6% (57.5-69.3) at one, two, three, and five years, respectively, in women. The revision rate for infection and the definitive explantation rate for infection were higher in men than in women (p = 0.0001 and p = 0.0024, respectively). Conclusion - Both short- and long-term success rates of SNM for FI were lower in men than in women. The revision and definitive explantation for long-term infection rates were significantly higher in men.
Published: 2019
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50. Urologic Disorders are Still the Leading Cause of In-hospital Death in Patients With Spina Bifida

Author: Jacques Kerdraon, B. Peyronnet, F. Gao, Quentin Alimi, Camille Olivari, Xavier Gamé, Emmanuel Oger, Laurent Siproudhis, Sahar Bayat, Lucie-Marie Scailteux, Zine-Eddine Khene, Juliette Hascoet, Charlène Brochard, Guillaume Bouguen, C. Voiry, Frédéric Balusson, Andrea Manunta, M. Jezequel, CHU Pontchaillou [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), École des Hautes Études en Santé Publique [EHESP] (EHESP), Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP), Département Méthodes quantitatives en santé publique (METIS), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Jonchère, Laurent, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP), and CHU Toulouse [Toulouse]
Subjects: Adult, Male, Urologic Diseases, congenital, hereditary, and neonatal diseases and abnormalities, Pediatrics, medicine.medical_specialty, Cross-sectional study, Epidemiology, Urology, Bladder, [SDV]Life Sciences [q-bio], Population, 030232 urology & nephrology, MEDLINE, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 03 medical and health sciences, 0302 clinical medicine, Cause of Death, Medicine, Humans, Urinary, Hospital Mortality, Longitudinal Studies, Mortality, education, Spina bifida, Spinal Dysraphism, Cause of death, education.field_of_study, business.industry, medicine.disease, Urological disorder, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, nervous system diseases, 3. Good health, Hydrocephalus, Death, [SDV] Life Sciences [q-bio], Hospitalization, Cross-Sectional Studies, 030220 oncology & carcinogenesis, Needs assessment, Observational study, Female, France, business, Needs Assessment
Abstract: International audience; Objective - To assess and analyze the contemporary causes of in-hospital deaths of spina bifida patients. Methods - It was a cross-sectional observational study of the longitudinal national cohort of all patients hospitalized in French public and private hospitals. We analyzed the data from the French hospital discharge database (Programme de Médicalisation des Systemes d'Information, PMSI) from 2009 to 2014. The number of in-hospital deaths was extracted using the combination of the ICD-10 codes "Q05" or "Q760" and a discharge code = 9. Results - There were 138 in-hospital deaths of spina bifida patients over the 6-year study period. The median age at death was 41 years (IQR: 25-52). The median age at death was significantly lower in patients with vs without hydrocephalus (26.6 vs 45.5 years; P
Published: 2019
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