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Dive into the research topics where Stefano Ferretti is active.

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Featured researches published by Stefano Ferretti.


Hpb | 2013

Single incision laparoscopic cholecystectomy: for what benefit?

Hadrien Tranchart; Serge Ketoff; Panagiotis Lainas; Guillaume Pourcher; Giuseppe Di Giuro; D. Tzanis; Stefano Ferretti; Antoine Dautruche; Niaz Devaquet; Ibrahim Dagher

BACKGROUND A single-incision laparoscopic cholecystectomy (SILC) was developed to improve outcomes as compared with the four-port classic laparoscopic cholecystectomy (CLC). Any potential benefits associated with a SILC have been suggested by previous studies reporting few patients with different surgical techniques. The aim of this study was to describe the experience with a standardized SILC as compared with CLC. METHODS From June 2010 to January 2012, 40 patients underwent a SILC [median age: 47.5 years (25-92)] and operative and peri-operative data were prospectively collected. Over the same period, 37 patients underwent a CLC. A 10-point visual analogue scale (VAS) was used for qualitative data. The costs of SILC and CLC were also compared. RESULTS For those patients undergoing a SILC the median operating time was 70 min (24-110). There were no conversions. An additional trocar was necessary in 16 patients. Four patients developed post-operative complications. The median immediate post-operative pain score was 5 (0-10). The median quality of life and cosmetic satisfaction at the initial post-operative visit were 10 (6-10) and 10 (5-10), respectively (VAS). Although the surgical results of both groups were similar, post-operative complications were exclusively reported in the SILC group (two incisional hernias). CONCLUSION Standardization of SILC is possible but associated with an important rate of additional trocar placement and a disturbing rate of incisional hernias.


Surgery for Obesity and Related Diseases | 2016

Single-port laparoscopic sleeve gastrectomy as a routine procedure in 1000 patients

Martin Gaillard; Hadrien Tranchart; Panagiotis Lainas; Stefano Ferretti; Gabriel Perlemuter; Ibrahim Dagher

BACKGROUND Single-port laparoscopic sleeve gastrectomy (SPSG) is performed routinely in our department as an alternative to a conventional laparoscopic approach. OBJECTIVES The aim of this study was to report our surgical results and follow-up outcome after SPSG. SETTING Department of Digestive Minimally Invasive Surgery, Antoine Béclère Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Saclay University, France. METHODS Data from consecutive patients who underwent SPSG in our institution between August 2010 and July 2015 were prospectively collected and retrospectively analyzed. Patients with more than 1-year follow-up were included in our analysis for weight loss and co-morbidity. RESULTS A total of 1000 patients underwent SPSG during the study period. Median body mass index was 42.6 kg/m² (range: 33.8-84.6 kg/m²). Median operative time was 112 minutes (range: 50-360 min) and decreased over the years. Completion of the procedure required introduction of an extraport in 78 patients (7.8%). Postoperative mortality and morbidity rates were .1% and 8.1%, respectively. Relaparoscopy and/or endoscopic treatment were required to treat intra-abdominal bleeding in 24 patients (2.4%) and staple-line leakage in 28 patients (2.8%). Five hundred forty-six patients were considered for 1-year follow-up evaluation. Mean excess weight loss was 69% after 1 year and 62.2% after 2 years. Incisional hernia from the trocar site occurred in 20 (3.7%) patients. CONCLUSION Sleeve gastrectomy can be routinely performed using a single-incision laparoscopic technique with equivalent outcomes of surgical morbidity and weight loss compared with conventional laparoscopic surgery. Prospective comparative studies are necessary to assess the potential benefits of this minimally-invasive approach.


Surgery for Obesity and Related Diseases | 2016

Prospective evaluation of routine early computed tomography scanner in laparoscopic sleeve gastrectomy.

Panagiotis Lainas; Hadrien Tranchart; Martin Gaillard; Stefano Ferretti; Gianfranco Donatelli; Ibrahim Dagher

BACKGROUND Prompt management of laparoscopic sleeve gastrectomy (LSG) complications is essential in avoiding prolonged hospital stay and associated mortality. The value of routine computed tomography (CT) scan examination in early diagnosis of postoperative complications after LSG has not been studied. OBJECTIVES To prospectively assess the impact of postoperative day (POD) 2 CT scan after LSG. SETTING Department of Minimally Invasive Digestive Surgery, Antoine-Beclere Hospital, AP-HP, Paris-Saclay University, France. METHODS Data were prospectively gathered for 1000 patients undergoing single-incision LSG and POD 2 CT scan. Complications were identified and treatment modalities decided according to the severity of complications. Sensitivity, specificity, and positive and negative predictive values were calculated for the diagnosis of surgical complications on POD 2 CT scan. RESULTS Mean age was 40.1 years and median BMI 42.6 kg/m². Early postoperative surgical complications occurred in 66 patients (6.6%). Intraabdominal bleeding/hematoma occurred in 38 patients, with 3 requiring emergent reoperation on POD 1. POD 2 CT scan detected this complication in 32 patients (sensitivity: 91.4%). Twenty-four (63.1%) patients were treated with relaparoscopy and drainage while 14 (36.9%) received conservative management. Postoperative transfusion was required in 7 patients. Twenty-eight patients suffered a gastric staple line leak, 13 (sensitivity: 46.4%) detected on POD 2 CT scan. Three patients (10.7%) received pure surgical treatment, 16 (57.1%) combined relaparoscopy and endoscopic treatment, and 9 (32.2%) had pure endoscopic treatment. CONCLUSION POD 2 abdominal CT scan is an efficient diagnostic tool for detecting active bleeding/hematoma, but shows less impressive results with gastric staple line leak detection. A combination of clinical surveillance and early imaging allowed prompt management of complicated cases, avoiding further morbidity.


Surgery for Obesity and Related Diseases | 2016

Single-port sleeve gastrectomy for super-obese patients

Guillaume Pourcher; Stefano Ferretti; William Akakpo; Panagiotis Lainas; Hadrien Tranchart; Ibrahim Dagher

BACKGROUND Laparoscopic sleeve gastrectomy, which has become a primary bariatric procedure in super-obese patients (SOPs), is associated with considerable weight loss. Traditionally, laparoscopic sleeve gastrectomy requires 4-7 skin incisions. Single-port laparoscopic surgery is now feasible for bariatric surgery. OBJECTIVES To evaluate the feasibility and safety of single-port sleeve gastrectomy (SPSG) for SOPs. SETTING Department of Abdominal and Minimally Invasive Surgery, Antoine Beclere Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Sud University, France. METHODS Evaluation of the outcomes on patients who underwent surgery consecutively from June 2010 to June 2013 with follow-up of>1 year. RESULTS In total, 62 patients (46 women, 16 men) underwent SPSG. The median age was 41 years (range 19-67), median preoperative body mass index was 52.2 kg/m(2) (range 50-87), median operative time was 89 minutes (range 42-212). Twelve patients required additional trocars, and 4.8 % developed complications. The median postoperative stay was 4 days (range 3-9 days) and median follow-up period was 21 months (range 12-48 months) with no loss of follow-up. The median percentage of excess weight loss was 69.7% (range 52%-100%) and percentage of weight loss was 36% (28%-56%) for the same period. CONCLUSION SPSG for SOPs was found to be technically feasible, reproducible, and safe in this series.


European Journal of Gastroenterology & Hepatology | 2016

Adaptation of liver stiffness measurement depth in bariatric surgery candidates with suspected nonalcoholic fatty liver disease.

Dragos Ciocan; Amandine Lebrun; Karima Lamouri; Guillaume Pourcher; Cosmin Sebastian Voican; Micheline Njiké-Nakseu; Stefano Ferretti; Rodi Courie; Hadrien Tranchart; Axel Balian; Sophie Prévot; Gabriel Perlemuter; Ibrahim Dagher; Sylvie Naveau

Background and aims A thick layer of subcutaneous adipose tissue may lead to an overestimation of liver stiffness by transient elastography. The aim of this study was to assess whether liver stiffness measurement (LSM) was overestimated using an XL probe in patients with severe obesity and, if so, to reprocess the data to the adapted depth to obtain the appropriate LSM (LSMa). Methods A total of 152 obese patients prospectively underwent bariatric surgery and needle liver biopsy. Liver stiffness was measured by transient elastography 15 days before. To determine whether the LSM was overestimated, an expert operator retrospectively determined whether the skin-to-capsula distance was greater than 35 mm by analyzing the hyperechogenicity of ultrasound signals and the measured slope between 35 and 75 mm. In the case of an overestimation, a deeper measurement depth was selected to calculate the LSMa. Results There was an overestimation of the LSM obtained between 35 and 75 mm in 76 patients (50%). Among these patients, the LSMa was obtained between 40 and 75 mm in 49 patients and between 45 and 80 mm in 27 patients. Only the percentage of steatosis was independently and positively correlated with LSM overestimation. The areas under receiver operating characteristic of LSMa was 0.82±0.04 for predicting fibrosis stage F3. The Obuchowski measure was 0.85±0.02. Conclusion The LSM was overestimated in severely obese patients obtained between 35 and 75 mm using an XL probe in 76 patients (50%), but LSM can be performed correctly in these patients after adapting the measurement depth to deeper beneath the patients’ skin.


Obesity Surgery | 2015

Treatment of Leaks Following Sleeve Gastrectomy by Endoscopic Internal Drainage (EID)

Gianfranco Donatelli; Jean-Loup Dumont; Fabrizio Cereatti; Stefano Ferretti; Bertrand Marie Vergeau; Thierry Tuszynski; Guillaume Pourcher; Hadrien Tranchart; Mariani P; Meduri A; Jean-Marc Catheline; Ibrahim Dagher; Fausto Fiocca; Jean-Pierre Marmuse; Bruno Meduri


World Journal of Surgery | 2014

Traditional versus Robot-Assisted Full Laparoscopic Liver Resection: A Matched-Pair Comparative Study

Hadrien Tranchart; Cecilia Ceribelli; Stefano Ferretti; Ibrahim Dagher; Alberto Patriti


Obesity Surgery | 2014

Endoscopic Internal Drainage with Enteral Nutrition (EDEN) for Treatment of Leaks Following Sleeve Gastrectomy

Gianfranco Donatelli; Stefano Ferretti; Bertrand Marie Vergeau; Parag Dhumane; Jean-Loup Dumont; Serge Derhy; Thierry Tuszynski; Stavros Dritsas; Alessio Carloni; Jean-Marc Catheline; Guillaume Pourcher; Ibrahim Dagher; Bruno Meduri


Obesity Surgery | 2014

The Diagnostic Accuracy of Transient Elastography for the Diagnosis of Liver Fibrosis in Bariatric Surgery Candidates with Suspected NAFLD

Sylvie Naveau; Karima Lamouri; Guillaume Pourcher; Micheline Njiké-Nakseu; Stefano Ferretti; Rodi Courie; Hadrien Tranchart; Mariana Ghinoiu; Axel Balian; Sophie Prévot; Gabriel Perlemuter; Ibrahim Dagher


Surgical Endoscopy and Other Interventional Techniques | 2015

Multivariate analysis of risk factors for postoperative complications after laparoscopic liver resection.

Hadrien Tranchart; Martin Gaillard; Mircea Chirica; Stefano Ferretti; Gabriel Perlemuter; Sylvie Naveau; Ibrahim Dagher

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Hadrien Tranchart

Paris Descartes University

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Brice Gayet

Paris Descartes University

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Catherine Piquard

Paris Descartes University

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D. Tzanis

University of Paris-Sud

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Go Wakabayashi

Iwate Medical University

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