Publications by authors named "Claire Nominé-Criqui"

17 Publications

  • Page 1 of 1

Somatostatin analogue pasireotide (SOM230) inhibits catecholamine secretion in human pheochromocytoma cells.

Cancer Lett 2021 Oct 9. Epub 2021 Oct 9.

Centre National de la Recherche Scientifique, Université de Strasbourg, Institut des Neurosciences Cellulaires et Intégratives, F-67000, Strasbourg, France. Electronic address:

Increasingly common, neuroendocrine tumors (NETs) are regarded nowadays as neoplasms potentially causing debilitating symptoms and life-threatening medical conditions. Pheochromocytoma is a NET that develops from chromaffin cells of the adrenal medulla, and is responsible for an excessive secretion of catecholamines. Consequently, patients have an increased risk for clinical symptoms such as hypertension, elevated stroke risk and various cardiovascular complications. Somatostatin analogues are among the main anti-secretory medical drugs used in current clinical practice in patient with NETs. However, their impact on pheochromocytoma-associated catecholamine hypersecretion remains incompletely explored. This study investigated the potential efficacy of octreotide and pasireotide (SOM230) on human tumor cells directly cultured from freshly resected pheochromocytomas using an implemented catecholamine secretion measurement by carbon fiber amperometry. SOM230 treatment efficiently inhibited nicotine-induced catecholamine secretion both in bovine chromaffin cells and in human tumor cells whereas octreotide had no effect. Moreover, SOM230 specifically decreased the number of exocytic events by impairing the stimulation-evoked calcium influx as well as the nicotinic receptor-activated inward current in human pheochromocytoma cells. Altogether, our findings indicate that SOM230 acts as an inhibitor of catecholamine secretion through a mechanism involving the nicotinic receptor and might be considered as a potential anti-secretory treatment for patients with pheochromocytoma.
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http://dx.doi.org/10.1016/j.canlet.2021.10.009DOI Listing
October 2021

Impact of rocuronium on intraoperative neuromonitoring vagal amplitudes during thyroidectomy.

Langenbecks Arch Surg 2021 Sep 12;406(6):2019-2025. Epub 2021 Jun 12.

Department of Surgery (CVMC), Unit of Metabolic, Endocrine, and Thyroid Surgery, Université de Lorraine, CHRU Nancy-Brabois (7Eme Étage), Vandœuvre-lès-Nancy, France.

Purpose: Neuromuscular blocking agents (NMBA) facilitate endotracheal intubation and reduce related laryngeal morbidity. However, NMBA interfere with intraoperative neuromonitoring amplitudes during thyroidectomy. The goal of this study was to evaluate the impact of rocuronium used for tracheal intubation on early intraoperative neuromonitoring vagal amplitudes observed during first thyroid lobe dissection.

Methods: This is an observational pharmacoepidemiological study with prospective data collection and retrospective analysis. During the study period, all consecutive patients who underwent thyroid surgery with neuromonitoring were included. Patients underwent endotracheal intubation either using a single dose of rocuronium (NMBA group) or without NMBA (NMBA-free group) according to the anesthesiologist's preference.

Results: Six hundred six patients were included (213 NMBA and 393 NMBA-free group patients). At V1, 39 patients (18%) in the NMBA group had an amplitude < 100 µV (need for curarization reversal in 30 patients) and 13 patients (3.3%) in the NMBA-free group (p < 0.001). In the remaining 554 patients, the mean V1 amplitude was significantly decreased in the NMBA group (544 versus 685 µV; p < 0.001). After exclusion of 25 patients with loss of signal types 1 and 2 during dissection, the difference between mean V1 and mean V2 was significantly lower in NMBA group patients (- 22 versus - 86 µV; p = 0.016).

Conclusion: This study provides new data showing how NMBA used for tracheal intubation significantly decrease V1 amplitude baseline and modify amplitude variations from V1 to V2 values during the first thyroid lobe dissection.

Level Of Evidence: Pharmacoepidemiological study.
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http://dx.doi.org/10.1007/s00423-021-02234-5DOI Listing
September 2021

Evaluation of diagnostic laparoscopy for penetrating abdominal injuries: About 131 anterior abdominal stab wound.

Surg Endosc 2021 Jun 2. Epub 2021 Jun 2.

Department of Gastrointestinal, Metabolic and Surgical Oncology, University Hospital Nancy Brabois, Rue du Morvan, 54511, Vandoeuvre-Les-Nancy, France.

Background: The management of hemodynamically stable patients with anterior abdominal stab wounds (AASW) is debated. Mini-invasive techniques using laparoscopy and non-operative management (NOM) have reduced the rate of nontherapeutic laparotomies after AASW leading to unnecessary morbidity. The aim of this study was to determine with a systematic diagnostic laparoscopy of peritoneal penetration (PP), patients who do not require abdominal exploration in the management of stable patient with an AASW.

Methods: All patients with AASW were retrospectively recorded from 2006 to 2018. Criteria of inclusion were AASW patients who underwent a systematic diagnostic laparoscopy. Criteria of exclusion were patients with an evisceration, impaling, clinical peritonitis, and hemodynamic instability. If no PP was detected, laparoscopy was terminated. If defects of peritoneum were found, a laparotomy was performed looking for diagnosis and treatment of intra-abdominal injuries.

Results: On 131 AASW patients, 35 underwent immediate emergency laparotomy, 96 underwent diagnostic laparoscopy, 47 were positive (PP) and had an intra-abdominal exploration by laparotomy, 32 (68.1%) had intra-abdominal injuries which required treatment. All patients with an intra-abdominal injury had a positive diagnostic laparoscopy. For the 49 patients with a negative laparoscopy, the mean hospital stay was 1.6 days with ambulatory care for some patients. No patient presented a delayed injury. Non-therapeutic laparotomy rate was 15.6%. For patients who did not have an intra-abdominal injury the morbidity rate was low (3%).

Conclusion: Our study shows that diagnostic laparoscopy was safe, with a low duration of hospitalization, a possible ambulatory care and had an excellent ability to screen the patients who did not need a abdominal exploration. This management can avoid many unnecessary laparotomies with an acceptable rate of negative laparotomy, without any delayed diagnosis of intra-abdominal injuries and with a low morbidity rate.
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http://dx.doi.org/10.1007/s00464-021-08566-zDOI Listing
June 2021

Robotic approach for partial adrenalectomy.

Updates Surg 2021 Jun 7;73(3):1147-1154. Epub 2021 Jan 7.

Département de Chirurgie Viscérale, Métabolique et Cancérologique (CVMC), CHRU Nancy, Hôpital de Brabois, Université de Lorraine, (7(ème) étage), Vandeuvre-lès-Nancy, France.

Although safe and feasible, partial adrenalectomy is not a widespread procedure. Endorsement of robotic technologies and fluorescence techniques in adrenal surgery might help develop partial adrenalectomy and could avoid unnecessary total adrenalectomies. When performed in selected cases, partial adrenalectomy is associated with good postoperative outcomes comparable with those reported after total adrenalectomy. It has been hypothesized that one of the advantages of the robotic approach in adrenal-sparing surgery is to reduce manipulation of the gland allowing preservation of the vascularization of the residual adrenal, overcoming some limits when performing a laparoscopic conventional approach. A major drawback of the robotic surgery is its cost, but the overcost due to the use of the robotic system could be balanced by the execution of a high number of partial adrenalectomies leading to fewer life-long replacement steroid treatment. Partial adrenalectomy could become the recommended management for small benign and hormonal active adrenal tumors. Indocyanine green fluorescence (IGF) also seems to be a useful technique to help surgeons identify the adrenal gland and to locate small tumors from the normal adrenal tissue in difficult patients. It is likely that the use of a robotic approach associated with IGF may extend indications of partial adrenalectomy in the years to come.
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http://dx.doi.org/10.1007/s13304-020-00957-6DOI Listing
June 2021

Robotic adrenalectomy in patients with pheochromocytoma: a systematic review.

Gland Surg 2020 Jun;9(3):844-848

Département de Chirurgie Viscérale, Métabolique et Cancérologique (CVMC), Unité multidisciplinaire de chirurgie métabolique, endocrinienne et thyroïdienne (UMET), CHRU Brabois, Université de Lorraine, Nancy, France.

Pheochromocytomas (PHEOs) are neural crest cell tumors producing catecholamines. PHEOS need to be early diagnosed and adequately managed. Adrenalectomy is the gold standard treatment of these type of tumors. There has been major improvement of surgical technologies with the development of laparoscopic and robotic systems these past several years. We conducted a review of the literature to evaluate the robotic approach for adrenalectomy for patients with PHEO.
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http://dx.doi.org/10.21037/gs-2019-ra-05DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7347808PMC
June 2020

What is the impact of continuous neuromonitoring on the incidence of injury to the recurrent laryngeal nerve during total thyroidectomy?

Surgery 2021 01 12;169(1):63-69. Epub 2020 May 12.

Université de Lorraine, Département de Chirurgie Viscérale, Métabolique et Cancérologique (CVMC), CHRU Nancy, Hopital de Brabois (7(ème) étage), Vandoeuvre-les-Nancy, France; Université de Lorraine, INSERM U1256, « Nutrition, Genetics, Environmental Risks », Faculté de Médecine, Vandoeuvre-les-Nancy, France. Electronic address:

Background: Continuous intraoperative neuromonitoring may facilitate reversal of intraoperative injurious operative maneuvers in comparison with intermittent intraoperative neuromonitoring. The aim of this study was to evaluate the impact of the routine use of continuous intraoperative neuromonitoring on intraoperative injuries to the recurrent laryngeal nerve.

Method: This study was a prospective case series with retrospective analysis of consecutive patients undergoing total thyroidectomy from August 2013 to August 2019. During this period, intermittent intraoperative neuromonitoring (before Mar 2016) and continuous intraoperative neuromonitoring (after Mar 2016) were used in all patients.

Results: We reviewed the outcomes of 603 patients (466 female patients) comprising 236 who underwent intermittent intraoperative neuromonitoring and 367 who underwent continuous intraoperative neuromonitoring. Intraoperative adverse electromyography events (>50% decrease in amplitude between VN1 and VN2) were observed in 87 patients (14.5%) and were less frequent in the continuous intraoperative neuromonitoring group (10.6 vs 20.3%, P = .001). Intraoperative loss of signal (electromyography events with VN2 ≤100μV) were observed in 35 patients (5.8%) without any difference between the 2 groups of patients (5.2 vs 6.8%, P = .415). Postoperative recurrent laryngeal nerve palsies were observed in 36 patients (5.9%) without any difference between the 2 groups of patients (4.9 vs 7.6%, P = .168).

Conclusion: The routine use of continuous intraoperative neuromonitoring improves the rate of intraoperative adverse electromyography events but does not impact significantly the rates of loss of signal and recurrent laryngeal nerve palsy.
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http://dx.doi.org/10.1016/j.surg.2020.03.029DOI Listing
January 2021

Robotic adrenalectomy: when and how?

Gland Surg 2020 Feb;9(Suppl 2):S166-S172

Unit of Metabolic, Endocrine, and Thyroid Surgery (UMET), Department of Visceral and Metabolic Surgery, Hospital Brabois Adultes, CHRU Nancy, University of Lorraine, Nancy, France.

Currently, laparoscopic adrenalectomy is considered as the preferred technique to manage adrenal tumors. However, there are no prospective randomized studies evaluating this strategy. With the recent advances in surgical equipment and the widespread of robotic technology, a robotic approach is considered as an interesting option in some medical centers. This approach seems to be feasible and safe but high-level evidence of its benefits is still lacking. This review summarizes indications, advantages and drawbacks of robotic adrenalectomy and describes its surgical technique.
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http://dx.doi.org/10.21037/gs.2019.12.11DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044087PMC
February 2020

Needle electrodes inserted in the thyroid cartilage may provide better neuromonitoring signals during thyroidectomy.

Gland Surg 2019 Oct;8(5):583-584

Department of Surgery, Unit of Metabolic, Endocrine, and Thyroid Surgery, University of Lorraine, CHRU Nancy, Brabois Hospital, Nancy, France.

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http://dx.doi.org/10.21037/gs.2019.07.07DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842763PMC
October 2019

Coronary artery disease is more severe in patients with primary hyperparathyroidism.

Surgery 2020 01 24;167(1):149-154. Epub 2019 Oct 24.

Department of Surgery, Section of Endocrine, Thyroid and Metabolic Surgery, University of Lorraine, CHU Nancy, Brabois Hospital, France; Nutrition, Genetics, Environmental Risks, Faculty of Medicine, University of Lorraine, INSERM U1256, Nancy, France. Electronic address:

Background: Primary hyperparathyroidism is associated with an increased cardiovascular mortality, but mechanisms underlying this association are unclear. The goal of this study was to evaluate coronary artery calcifications via the coronary calcification score in primary hyperparathyroidism patients, to compare with control subjects, and to identify risk factors for high to intermediate risk coronary calcification scores (coronary calcification score >100).

Method: Cross-sectional study of primary hyperparathyroidism patients without a history of coronary artery disease, diabetes, or severe, chronic kidney disease. Coronary calcification scores were compared with a cohort of population-based control subjects.

Results: The mean coronary calcification score was 120 ± 344 in 130 primary hyperparathyroidism patients. The coronary calcification score was >100 in 27 patients (21%). When compared with control subjects, the percentage of positive coronary calcification scores was similar in primary hyperparathyroidism patients (53% vs 50%); however, positive coronary calcification scores were at the 67 percentile of the control subjects cohort (P < .001). In multivariable regression, patient age (1.1; 1.1-1.2; P < .001), patients in the mild normocalcemic primary hyperparathyroidism group (5.1; 1.1-22.6; P = .037), and the need for antihypertensive medications (6.1; 1.8-20.9; P < .001) remained independent predictors for a coronary calcification score >100.

Conclusion: Positive coronary calcification scores were greater in primary hyperparathyroidism patients than in population-based control subjects. These study data may provide new criteria for parathyroidectomy in patients with primary hyperparathyroidism.
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http://dx.doi.org/10.1016/j.surg.2019.05.094DOI Listing
January 2020

When a Pathological Forearm Fracture Led to Explore the Neck: About a Case.

Head Neck Pathol 2020 Sep 12;14(3):828-832. Epub 2019 Oct 12.

Department of Digestive, Hepato-Biliary and Endocrine Surgery, University Hospital Nancy Brabois, Rue du Morvan, 54511, Vandoeuvre-Les-Nancy, Grand Est, France.

The majority of patients with parathyroid carcinoma (PC) have significant clinical signs and simultaneous symptoms related to the unregulated hypersecretion of parathyroid hormone (PTH) by the tumor. The aim of this case was to report a patient presenting an isolated bone fracture leading to the diagnosis of PC. A 20-years-old female patient presenting a fracture of both bones of the forearm following a fall from her own height. Imageries showed diffuse bone demineralization. Biology revealed malignant hypercalcemia at 4.1 mmol/L and PTH at 1331 pg/mL. Bone densitometry showed severe osteoporosis with a femoral and lumbar T-score < - 3DS. Imageries showed a right parathyroid mass of 32 mm. An one-piece excision of the pathological gland, right thyroid lobectomy and ipsilateral central lymph node dissection were performed. Postoperatively, the patient presented a hungry bone syndrome with severe hypocalcemia and required substitutive treatment. PTH on day 1 was normal. Pathology analysis found a PC with Ki67 at 3%, lymph node removal was negative. Complete one-piece surgical excision is the only potentially curative treatment for PC. Preoperative suspicion and intraoperative recognition of malignant features is important in order to propose an appropriate compartmental surgery, which can provide the lowest possible recurrence rate.
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http://dx.doi.org/10.1007/s12105-019-01085-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413925PMC
September 2020

Deep neuromuscular blockade improves surgical conditions during gastric bypass surgery for morbid obesity: A randomised controlled trial.

Eur J Anaesthesiol 2019 07;36(7):486-493

From the Department of Anesthesiology & Critical Care, Brabois University Hospital, University de Lorraine, CHRU Nancy (TF-B, DS, LH, CM), the Clinical Research Support Facility PARC, Brabois University Hospital (CB), the Multidisciplinary Unit of Bariatric Surgery, UMCO, Brabois University Hospital, University de Lorraine, CHRU Nancy (CN-C, LB), University de Lorraine, INSERM U954, Faculty of Medicine, Nancy, France (LB), and Department of Anesthesiology, Université Libre de Bruxelles, CHU Brugmann, Bruxelles, Belgium (DS).

Background: There is a controversy in the literature whether deep compared with moderate neuromuscular block (NMB) improves surgical conditions for laparoscopic surgery.

Objectives: The primary outcome measure was to examine whether switching from moderate to deep NMB improves surgical conditions for laparoscopic surgery in the obese; secondary outcome measures were changes in intra-abdominal pressure, time required to perform the gastrojejunal anastomosis and peri-operative surgical complications.

Design: A single-centre, randomised controlled study. Each patient was taken as their own control and examined twice: at the first evaluation (E1), all patients had a moderate NMB, thereafter patients were randomised to deep or moderate block and a second evaluation (E2) was performed within 10 min. Patients with excellent rating at E1 were excluded from E2, as their surgical condition could not be further improved.

Setting: University Hospital France.

Patients: Patients undergoing laparoscopic gastric bypass surgery under general anaesthesia were included. Main exclusion criteria were hypersensitivity to the drugs used and absence of written informed consent.

Interventions: According to the group assignment, patients received bolus doses of rocuronium or 0.9% saline.

Main Outcome Measures: Surgical conditions were assessed with a 4-point rating scale. Intra-operative adverse events were assessed with the Kaafarani-classification and postoperative complications with the Clavien-Dindo classification.

Results: Eighty-nine patients were initially included and data from 85 could be assessed at E1; surgical rating was excellent in 20, good in 35, acceptable in 18, poor in 12. After excluding those with an excellent rating, the remaining 65 patients were randomly assigned to deep or moderate block. At E2, an improvement of surgical conditions was observed in 29 out of 34 patients with deep block and in four out of 31 with moderate block; P < 0.0001. Poor surgical conditions were more frequently associated with surgical complications (61.5 versus 15.3%; P < 0.001).

Conclusion: Switching from moderate to deep block improves surgical conditions. Poor surgical conditions were associated with a higher incidence of surgical complications.

Trial Registration: ClinicalTrials.gov identifier: NCT02118844.
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http://dx.doi.org/10.1097/EJA.0000000000000996DOI Listing
July 2019

Robotic-assisted unilateral adrenalectomy: risk factors for perioperative complications in 303 consecutive patients.

Surg Endosc 2019 03 11;33(3):802-810. Epub 2018 Jul 11.

Université de Lorraine, Service de Chirurgie Digestive, Hépatobiliaire, Pancréatique, Endocrinienne et Cancérologique, Centre Hospitalier Régional Universitaire (CHRU) Nancy-Brabois, Rue du Morvan, 54511, Vandoeuvre-Les-Nancy, France.

Background: There is no consensus about the utility of using the robotic platform to perform a unilateral lateral transabdominal adrenalectomy in comparison with conventional laparoscopy. In some groups, obese patients (Body Mass Index > 30 kg/m) and patients with tumor size > 5 cm have been considered as good candidates for robotic adrenalectomy. However, evaluation of incidence and risk factors for perioperative complications is currently lacking in large series of patients. The aim of this study was to evaluate incidence and predictive factors for intraoperative (conversion and capsular rupture) and postoperative complications (morbidity) after unilateral robotic-assisted transabdominal lateral adrenalectomy.

Methods: From 2001 to 2016, consecutive patients undergoing unilateral lateral transabdominal robotic adrenalectomy were included in a prospectively maintained database and analyzed retrospectively (clinicaltrials.gov NCT03410394).

Results: A total of 303 consecutive patients were analyzed. Between the first and last 100 of patients, mean tumor size increased from 2.9 to 4.2 cm (p < 0.001) and mean operating time decreased from 99 to 77 min (p < 0.001). Postoperative complications occurred in 28 patients (9.2%) and no postoperative death was observed. Nine patients (3%) were converted to open laparotomy and capsular rupture was observed in nine patients (3%). BMI was not a significant risk factor for conversion, capsular rupture, or postoperative complication. Tumor size > 5 cm remained the only predictive factor for conversion to laparotomy (OR 7.47, 95% CI 1.81-30.75; p = 0.005). History of upper gastrointestinal surgery was the only predictive factor for capsular rupture (OR 13.6, 95% CI 2.33-80.03; p = 0.004). Conversion to laparotomy (OR 8.35, 95% CI 1.99-35.05; p = 0.003) and patient age (OR 1.039, 95% CI 1.006-1.072; p = 0.019) remained independent predictive factors for postoperative complications.

Conclusions: This study identified independent risk factors for perioperative complications after robotic-assisted unilateral adrenalectomy. These factors should be taken into account when evaluating robotic-assisted transabdominal lateral adrenalectomy.
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http://dx.doi.org/10.1007/s00464-018-6346-2DOI Listing
March 2019

[Bariatric surgical procedures].

Presse Med 2018 May 3;47(5):447-452. Epub 2018 May 3.

Université de Lorraine, CHU Nancy-Brabois, unité multidisciplinaire de la chirurgie de l'obésité du CHU de Nancy, 11, allée du Morvan, 54500 Vandoeuvre-les-Nancy, France; Université de Lorraine, unité Inserm U954, faculté de médecine, 9, avenue de la Forêt-de-Haye, 54500 Vandoeuvre-les-Nancy, France.

Obesity physioptahology is complex and involves several factors (genetic, behavioral, psychological…). In this still undefined context, bariatric surgery modifies gastrointestinal tract anatomy, reduces the caloric intake and modifies gastrointestinal hormonal secretions for some of them. Aim of this work was to describe bariatric surgical procedures (sleeve, gastric band, short-gastric gastric, biliopancreatic diversion), specifying their historical context and considering possible evolutions.
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http://dx.doi.org/10.1016/j.lpm.2018.03.022DOI Listing
May 2018

[Complications after bariatric surgery].

Presse Med 2018 May 25;47(5):464-470. Epub 2018 Apr 25.

Université de Montpellier, CHRU de Montpellier, hôpital St-Éloi, département de chirurgie digestive A, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France. Electronic address:

Bariatric surgery became consensual after the NIH consensus of 1991 and the appearance of laparoscopic approach. This type of operation has a functional role (improvement of quality of life, locomotion and digestive symptoms as gastro-esophageal reflux disease), a prevention role (increase in life expectancy, reduction of risk of cancer and cardiovascular disease) and a curative role (remission of diabetes mellitus, obstructive sleep apnea syndrome and arterial hypertension). The laparoscopic approach for bariatric surgery led to a major reduction of postoperative morbi-mortality. Types and rates of complications after bariatric surgery vary according to the procedure. The efficiency of each technique is closely related to its morbi-mortality rate. This concept explains the disparity concerning the choice of the adequate procedure for the patient according to the bariatric team. The risk/benefits balance evaluation must be analyzed case-by-case by each specialist of the multidisciplinary bariatric staff and explained to the patients before final decision. This preoperative period (6 to 12 months) is crucial to select good candidates for bariatric surgery and contributes to the reduction of postoperative complications. A multidisciplinary surveillance for life is mandatory to prevent and treat late complications of bariatric surgery.
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http://dx.doi.org/10.1016/j.lpm.2018.03.024DOI Listing
May 2018

Comments on: Clinical predictors of prolonged postresection hypotension after laparoscopic adrenalectomy for pheochromocytoma.

Surgery 2016 07 25;160(1):250. Epub 2016 Mar 25.

Department of Digestive, Hepato-Biliary, and Endocrine Surgery, Hospital Brabois Adultes, University of Lorraine, Vandoeuvre-les-Nancy, France.

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http://dx.doi.org/10.1016/j.surg.2016.02.013DOI Listing
July 2016

Minimal impact of calcimimetics on the management of hyperparathyroidism in chronic dialysis.

Surgery 2016 Jan 21;159(1):183-91. Epub 2015 Oct 21.

University de Lorraine, CHU Nancy, Pôle S2R, Epidémiologie et Evaluation Cliniques, INSERM, CIC-EC1433, Nancy, France; University de Lorraine, CHU Nancy, Department of Nephrology, Nancy, France.

Background: The calcimimetic drug cinacalcet has changed the prescription patterns in patients with secondary hyperparathyroidism, despite the lack of randomized studies that compare cinacalcet with conventional treatment, including parathyroidectomy. The aim of this study was to evaluate current management of patients on chronic dialysis with incidental and parathyroid hormone (PTH) levels ≥ 500 ng/L.

Methods: Prospective pharmacoepidemiologic study of chronic dialysis patients with PTH level ≥ 500 ng/L.

Results: We studied 269 patients. Among the 186 patients who had 2-year follow-up, 125 (67%) were managed using cinacalcet. At 2 years, when comparing the cinacalet with the noncinacalet groups, we found that mean PTH values were 400 ± 318 versus 388 ± 251 ng/L (P = ns) and the percentage of patients following 2009 PTH Kidney Disease Improving Global Outcomes (KDIGO) guidelines were 79 versus 85% (P = ns). Eight patients (4%) underwent parathyroidectomy. On multivariate analysis, the use of cinacalcet was not a predictor for PTH within KDIGO guidelines at 2-year follow-up.

Conclusion: Cinacalcet was used in the majority (67%) of patients on chronic dialysis with secondary hyperparathyroidism, but the use of cinacalcet did not affect mean PTH values nor the proportion of patients following KDIGO guidelines compared with patients not using calcimimetics.
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http://dx.doi.org/10.1016/j.surg.2015.06.058DOI Listing
January 2016

Robotic lateral transabdominal adrenalectomy.

J Surg Oncol 2015 Sep 15;112(3):305-9. Epub 2015 Jul 15.

Department of Digestive, Université de Lorraine, CHU Nancy (Hopital Brabois Adultes), Hepato-Biliary, Endocrine Surgery, and Surgical Oncology, France.

Laparoscopic transabdominal adrenalectomy is considered to be the standard of care for adrnalectomy. Widespread adoption of robotic technology has positioned robotic adrenalectomy as an option in some medical centers. Many studies have compared laparoscopic versus robotic approaches to perform adrenalectomy and evaluated potential advantages to balance higher costs. This review summarizes current available data regarding the use of the robotic system to perform adrenalectomy (RA) and its comparison with laparoscopic adrenalectomy (LA).
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http://dx.doi.org/10.1002/jso.23960DOI Listing
September 2015
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