Georges Audry

Polytech Paris-UPMC, Lutetia Parisorum, Île-de-France, France

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Publications (10)10.26 Total impact

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    ABSTRACT: The umbilical hernia is common in the pediatric population. Most of the cases have a spontaneous regression around the age of 3 years. Complications are very rare, and thus surgery is not routinely indicated before the age of 3 years We report an exceptional case of spontaneous rupture of an umbilical hernia in a 3-year-old girl with an emphasis on the management of this rare complication and a literature review of similar cases
    Full-text · Article · Oct 2015 · Journal of Pediatric Surgery Case Reports
  • Matthieu Peycelon · Georges Audry · Sabine Irtan
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    ABSTRACT: Introduction Minimally invasive surgery (MIS) has emerged as an alternative to open approach for cancer diagnosis in children ∼20 years ago, but only recently for tumor resection. The purpose of this review is to update the use of MIS in pediatric oncological surgery over the past five years. Methods The authors conducted a systematic review of papers published between 2009 and 2014 focusing on indications and results of the technique. Results New indications in Wilms tumor, pheochromocytoma, and lung nodules have emerged, thanks to the growing use of MIS in benign urological and thoracic surgery with satisfactory results. Case control studies comparing MIS to open approach have been published for the first time in more classical indications such as neurogenic tumors, while robot-assisted procedure has shown concern in results about its early experience in solid tumors. Conclusion MIS is a promising method for removal of thoracic and abdominal malignancies as long as oncological principles are strictly followed. Long-term follow-up is mandatory to further delineate objective indications. Georg Thieme Verlag KG Stuttgart · New York.
    No preview · Article · Dec 2014 · European Journal of Pediatric Surgery
  • Jan Godzinski · Norbert Graf · Georges Audry
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    ABSTRACT: This article describes the current status of surgical approach to Wilms tumor. Combined multimodal treatment including classical open nephrectomy is still the most recommended and offers excellent survivals. Patients suffering from Wilms tumor as potentially very long-term survivors also need great care of quality of their further life. Nephron-sparing surgery seems an important step in this regard; however, selection of patients is necessary to avoid failures and decreasing survival rate. A new method of describing this kind of procedure developed within the SIOP Renal Tumours Study Group (RTSG) offers an opportunity for further comparisons and assessment. Minimally invasive nephrectomy is not recommended in the treatment of Wilms tumor; however, in experienced hands and correctly selected (rare) cases, minimally invasive nephrectomy may offer the same outcome as the classical open approach. Lymph nodes sampling, essential for reliable staging, appeared rarely correct in children operated by this technique. Any competition with partial nephrectomy should be avoided in favor of the nephron-sparing approach. A small proportion of patients still create surgical difficulties and this is in fact the target group for further surgical reviews. Their prognosis seems at least in part surgeon-dependent. Few clinical factors available preoperatively (tumor side, age, and tumor volume) were detected as influencing potential risk of surgical failures. Once identified, this needs increased attention from the surgical point of view. Georg Thieme Verlag KG Stuttgart · New York.
    No preview · Article · Dec 2014 · European Journal of Pediatric Surgery
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    ABSTRACT: Background Total nephrectomy (TN) remains the standard treatment of unilateral Wilms tumors (uWT). The SIOP WT-2001 protocol allowed Nephron Sparing Surgery (NSS) for polar or peripherally non-infiltrating tumors. Aim: Inventory of the current SIOP NSS-experience.Procedures2,800 patients with a unilateral, localized or metastatic and an unequivocal surgical technique recorded were included. All had neo-adjuvant chemotherapy and delayed surgery. In 91 (3%) NSS was performed and in 2709 TN. Data was retrieved from the SIOP WT 2001 database.ResultsNSS group contained 65% stage I tumours and the TN group 48%. Tumor volume (at diagnosis and surgery) was significantly smaller in the NSS group. Within stage III, after NSS, 7/12 (58%) had positive margins (M +), 5 with tumor negative lymph nodes (LN-). After TN, 355/712 (55%) had M + , 182 were LN-. Treatment of M+ in the NSS group resulted in two conversions to TN (one combined with radiotherapy), three patients had radiotherapy only and in two patients local therapy, if given, was not recorded. After NSS, four recurrences occurred. For localized disease the 5-year overall (OS) and event free survival (EFS) in NSS group was 100 and 94.8 (95% CI:89.9-99.9), respectively, while OS and EFS in the TN group were 94.4 (95% CI: 93.2-95.5, log-rank test P = 0.06) and 86.5 (95% CI:85.0-88.1, log-rank test P = 0.06), respectively.ConclusionsNSS was only performed in 3% of patients with uWT. Despite excellent survival with few relapses, the gain of nephrons needs to be weighed against the risk to induce stage III with intensified therapy. Pediatr Blood Cancer © 2014 Wiley Periodicals, Inc.
    Full-text · Article · Dec 2014 · Pediatric Blood & Cancer

  • No preview · Article · May 2014 · Archives de Pédiatrie

  • No preview · Article · May 2014 · Archives de Pédiatrie
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    ABSTRACT: This review presents the evidence of video-assisted surgery in the pediatric population and discusses future progress in this field. Videosurgery minimizes the cosmetic impact and the pain induced by open procedures and has been in constant development in adults and children. Earlier training of surgeons and residents combined with advances in anesthetics and technology have expanded the use of videosurgery for more complex interventions. Although most feasible surgical procedures have been performed by laparoscopy, the literature has not yet defined it as the gold standard for most interventions, especially because of the lack of evidence for many of them. However, laparoscopy for cholecystectomy is now the preferred approach with excellent postoperative outcomes and few complications. Although no evidence has been demonstrated in children, laparoscopy has been shown to be superior in adults for gastroesophageal reflux disease and splenectomy. Laparoscopic appendectomy remains controversial. Nevertheless, meta-analyses have concluded in moderate but significant advantages in terms of pain, cosmetic considerations, and recovery for the laparoscopic approach. Laparoscopy is now adopted for undescended testes and allows both localization and surgical treatment if necessary. For benign conditions, videosurgery can be an excellent tool for nephrectomy and adrenalectomy. However, laparoscopy remains controversial in pediatric surgical oncology.
    No preview · Article · Apr 2013 · Archives de Pédiatrie
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    ABSTRACT: Abnormalities of the male genitalia have increased in the last 2 decades in numerous developed countries and remain a frequent reason of consultation in pediatric surgery. The diagnostic spectrum is wide, and surgeons should pay particular attention to these abnormalities because of their potential psychological effect. Anatomically, these abnormalities can affect one of three parts of the penis. First, the foreskin may not be fully retracted. This is normal at birth and can be caused by prepuce adherents that can continue until adolescence. Today, true phimosis is treated with topical corticoids from the age of 3years. If medical treatment fails, a surgical procedure is required. Second, the urethra can be affected by hypospadia, which is the most frequent abnormality of the urethra. It is associated with ectopic urethral meatus, hypoplastic foreskin, and penis curvature. Its pathogenic background is not clearly understood. Surgery options differ according to the type of hypospadia and according to the surgeon's experience. It is sometimes hard to deal with, especially in a perineal form, where genetic and hormonal studies are recommended. These interventions can lead to complications ranging from stenosis to fistula. Therefore, parents have to be informed of the benefits and risks of the surgical procedures. Epispadias is rare but more serious because of the increasing risk of urinary incontinence. Finally, abnormalities of the corpora cavernosa - often associated with hypospadias - can include penis curvature and micropenis, for which an endocrinological analysis is essential.
    No preview · Article · Oct 2012 · Archives de Pédiatrie
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    Full-text · Article · Apr 2011 · Ultrasound in Obstetrics and Gynecology
  • T. Hor · M. Chabaud · G. Audry

    No preview · Article · Jun 2010 · Archives de Pédiatrie