Extensive suppuration and being overweight are factors associated with the failure of laser treatment for pilonidal disease: lessons from the first French retrospective cohort

Techniques in Coloproctology - The aim of our study was to assess the efficacy of sinus laser therapy (SiLaT) for the treatment of pilonidal disease. All adult patients treated with SiLaT in our...     

La technique de la LIFT. Traiter une fistule anale en ligaturant le trajet fistuleux à travers l’espace intersphinctérien. Une technique d’épargne sphinctérienne intéressante,mais qui a ses limites…

The ligation of the intersphincteric tract or LIFT is a fashionable, little expensive, and simple sphincter-sparing technique with a rate of often attractive success. The technique is described stage by stage with a review of the literature. The limits of this technique will be discussed in this article.     

Traitement des fistules anales par laser Filac™ (Fistula Laser Closure): un nouvel espoir ...

FiLaC? (Fistula Laser Closure) is a new sphincter-saving technique, which appears to be both safe and easy to apply. It consists of closing the fistula track by using laser energy emitted by a radial fibre connected to a diode laser. First results from uncontrolled reports are interesting with high success rate of at least 70% without negative impact on fecal incontinence. In addition, it can be carried out in an outpatient clinic. Before use, the most important precaution is to ensure an adequate fistula drainage. This technique can be applied to all fistula types, even if Crohn’s fistulas were excluded from publications. Comparative studies with long follow-up are clearly needed to clarify its position in the management of complex fistula, once there is still no consensus on the correct approach of such pathology.     

Surveillance in Barrett's esophagus

Barrett's esophagus (BE) is a consequence of chronic gastroesophageal reflux. Barrett's esophagus is a well-established risk factor for adenocarcinoma. There is no effective method available to prevent the malignant transformation of Barrett's esophagus. Endoscopy is therefore the only means of patients' screening and monitoring. Endoscopic surveillance is recommended to detect precancerous or cancerous lesions at an early stage, where curative treatment can be proposed.     

Helpfulness of the combination of acetic acid and FICE in the detection of Barrett's epithelium and Barrett's associated neoplasias

AIM: To investigate the mucosal morphology in Barrett’s oesophagus by chromo and magnifying endoscopy.METHODS: A prospective pilot study at a tertiary medical centre was conducted to evaluate the use of acetic acid pulverisation combined with virtual chromoendoscopy using Fujinon intelligent chromoendoscopy (FICE) for semiological characterization of the mucosal morphology in Barrett’s oesophagus and its neoplastic complications. Upper endoscopy using high definition white light, 2% acid acetic pulverisation and FICE with high definition videoendoscopy were performed in 20 patients including 18 patients who presented with aspects of Barrett’s oesophagus at endoscopy examination. Two patients used as controls had normal endoscopy and histological results. Prospectively, videos were watched blind from histological results by three trained FICE technique endoscopists.RESULTS: The videos of patients with high-grade dysplasia showed an irregular mucosal pattern in 14% using high definition white light endoscopy and in 100% using acid acetic-FICE combined. Videos did not identify irregular vascular patterns using high definition white light endoscopy, while acid acetic-FICE combined visualised one in 86% of cases.CONCLUSION: Combined acetic acid and FICE is a promising method for screening high-grade dysplasia and early cancer in Barrett’s oesophagus.