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Papers by Christophe Berney
Background: The impact of SARS-COV-2 virus (COVID-19) has been well documented in international s... more Background: The impact of SARS-COV-2 virus (COVID-19) has been well documented in international settings with a reduction in overall emergency presentations both influenced by social distancing and lockdowns. This study focuses on several common acute general surgical pathologies exploring differences in presentations and clinical outcomes for appendicitis, cholecystitis, and incarcerated hernias during the first wave. Methods: A retrospective review of medical records of all patients was analysed in two groups: the non-COVID-19 group (combined 2017–2019) and the COVID-19 group (2020). Results: There were 3,316 acute emergency surgical presentations with an 8.2% decrease in total presentations in 2020. There were 477 appendicectomies, 224 cholecystectomies, and 121 repair of incarcerated hernias. All general surgical procedures demonstrated significant differences between non-COVID and COVID cohorts, including length of stay (LoS) (2.7 vs 2.1, p = 0.009) and onset of symptoms (1.6 v...
BMC Surgery
Background Laparoscopic large hiatal hernia (LHH) repair remains a challenge despite three decade... more Background Laparoscopic large hiatal hernia (LHH) repair remains a challenge despite three decades of ongoing attempts at improving surgical outcome. Its rarity and complexity, coupled with suboptimal initial approach that is usually best suited for small symptomatic herniae have contributed to unacceptable higher failure rates. Results We have therefore undertaken a systematic appraisal of LHH with a view to clear out our misunderstandings of this entity and to address dogmatic practices that may have contributed to poor outcomes. Conclusions First, we propose strict criteria to define nomenclature in LHH and discuss ways of subcategorising them. Next, we discuss preoperative workup strategies, paying particular attention to any relevant often atypical symptoms, indications for surgery, timing of surgery, role of surgery in the elderly and emphasizing the key role of a preoperative CT imaging in evaluating the mediastinum. Some key dissection methods are then discussed with respect...
Cureus, 2021
Lipomas of the cord are common and generally associated with an indirect hernia sac, but not alwa... more Lipomas of the cord are common and generally associated with an indirect hernia sac, but not always, as the lipoma may be the only pathology identified during groin exploration. Missed lipoma of the spermatic cord is unfortunately not infrequent and may lead to persistence of post-operative groin pain, with confirmation of unresected cord lipoma on postoperative ultrasound, often necessitating reoperation. We present an interesting case of a 40-years-old male with symptomatic re-recurrent left inguinal hernia following previous open and subsequent endoscopic totally extraperitoneal (TEP) mesh repair. At laparoscopy, the previously inserted extraperitoneal mesh seemed well integrated with no evidence of recurrent hernia sac. Further transabdominal preperitoneal (TAPP) approach identified a moderate-size cord lipoma that had been missed twice before. His postoperative recovery was uneventful, and his previous symptoms completely subsided. This is of significant value as lipomas of the...
World Journal of Surgery, 1998
International Journal of Cancer, 2000
Genomic alterations at the long arm of chromosome 17, and in particular at the nm23 locus, are st... more Genomic alterations at the long arm of chromosome 17, and in particular at the nm23 locus, are still controversial in colorectal cancer (CRC). Our aim was to investigate the possible relationship of loss of heterozygosity (LOH) and microsatellite instability (MI), at 4 microsatellite loci spanning the 17q21-23 region, to the risk of liver metastasis and nm23 protein expression. Genomic DNA extracted from 58 primary and 54 liver secondary formalin-fixed and paraffin-embedded CRCs was obtained from 82 patients. A fluorescent PCR coupled with an automated DNA sequencer was applied. Increasing fraction of loci showing LOH was positively associated with risk of liver metastases (logrank test for trend, p = 0.005); this remained independent after adjusting to T-stage (Cox regression, p = 0.022), N-stage (p = 0.007), or Dukes' stage (p = 0.012). Conversely, increasing frequency of MI was associated with a reduced risk of liver metastases in Dukes' B tumours (logrank test for trend, p = 0.032). When comparing 30 primary and matched liver secondary lesions, we found concordant genomic alteration in 72% (NME1) to 43% (D17S579). Finally, we observed a trend in association between the proportion of loci with LOH and nm23 positivity (chi2 test for trend, p = 0.024). Our findings suggest that genomic alterations in the 17q21-23 region may affect prognosis of CRC as well as regulation of the nm23 protein expression via an unknown underlying mechanism.
International Journal of Cancer, 2000
ANZ Journal of Surgery, 2011
Gastroenterology Research and Practice, 2014
Medical Journal of Australia, Sep 1, 2008
“Your New National Health Service begins on 5th July ... It will provide you with all medical, de... more “Your New National Health Service begins on 5th July ... It will provide you with all medical, dental, and nursing care. Everyone — rich or poor, man, woman or child — can use it or any part of it. There are no charges, except for a few special items. There are no insurance qualifications. But it is not a “charity”. You are all paying for it, mainly as taxpayers, and it will relieve your money worries in time of illness.”*
British Journal of Surgery, 2021
Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numb... more Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst ...
International Journal of Surgery Research & Practice
Cureus, 2021
Vesicocutaneous fistulas (VCF) are abnormal tracts formed between the bladder and the cutaneous s... more Vesicocutaneous fistulas (VCF) are abnormal tracts formed between the bladder and the cutaneous surfaces of the body. Although rare, it has been reported following radiotherapy to the pelvic region, surgery and trauma. We present a case of a 70-year-old male who underwent neoadjuvant chemoradiotherapy for the treatment of rectal cancer metastatic to the perineum prior to definitive abdominoperineal resection (APR). Six months later, he developed urinary retention secondary to bladder obstructive outlet disease. This was managed with urinary catheterisation and a month later with transurethral resection of the prostate (TURP). At outpatient follow-up, he complained of urinary leakage in the perineal region approximately 10 months post-chemoradiotherapy. He underwent a computer tomography (CT) cystogram which confirmed the findings of a VCF extending to his perineum scar. He was managed conservatively with successful outcomes using a multidisciplinary team approach. This is the first ...
Oncology Research Featuring Preclinical and Clinical Cancer Therapeutics, Feb 1, 1998
We undertook a study to analyze the expression of urokinase-type plasminogen activator (u-PA) pro... more We undertook a study to analyze the expression of urokinase-type plasminogen activator (u-PA) protein in colorectal cancer (CRC) and to compare it with c-erbB-2 (HER2/neu) and nm23 protein expression. Paraffin-embedded specimens from 58 patients with CRC were retrospectively collected. Immunohistochemical staining of u-PA, c-erbB-2, and nm23 was quantitatively evaluated using a color video image analysis (color VIA) technique. No correlation was found between u-PA expression and tumor stage, age, sex, or tumor site. Although there was no evidence from our data that the level of u-PA in the primary tumors could predict risk of liver metastasis or survival duration, CRC showing overexpression of u-PA (above 85 pixels) had a worse prognosis (P = 0.013). There were significant positive correlations among all three u-PA, c-erbB-2, and nm23 proteins (u-PA vs. c-erbB-2, P = 0.003; u-PA vs. nm23, P < 0.001; c-erbB-2 vs. nm23, P = 0.001), suggesting that, in vivo, all proteins interact or are similarly regulated.
Background: The impact of SARS-COV-2 virus (COVID-19) has been well documented in international s... more Background: The impact of SARS-COV-2 virus (COVID-19) has been well documented in international settings with a reduction in overall emergency presentations both influenced by social distancing and lockdowns. This study focuses on several common acute general surgical pathologies exploring differences in presentations and clinical outcomes for appendicitis, cholecystitis, and incarcerated hernias during the first wave. Methods: A retrospective review of medical records of all patients was analysed in two groups: the non-COVID-19 group (combined 2017–2019) and the COVID-19 group (2020). Results: There were 3,316 acute emergency surgical presentations with an 8.2% decrease in total presentations in 2020. There were 477 appendicectomies, 224 cholecystectomies, and 121 repair of incarcerated hernias. All general surgical procedures demonstrated significant differences between non-COVID and COVID cohorts, including length of stay (LoS) (2.7 vs 2.1, p = 0.009) and onset of symptoms (1.6 v...
BMC Surgery
Background Laparoscopic large hiatal hernia (LHH) repair remains a challenge despite three decade... more Background Laparoscopic large hiatal hernia (LHH) repair remains a challenge despite three decades of ongoing attempts at improving surgical outcome. Its rarity and complexity, coupled with suboptimal initial approach that is usually best suited for small symptomatic herniae have contributed to unacceptable higher failure rates. Results We have therefore undertaken a systematic appraisal of LHH with a view to clear out our misunderstandings of this entity and to address dogmatic practices that may have contributed to poor outcomes. Conclusions First, we propose strict criteria to define nomenclature in LHH and discuss ways of subcategorising them. Next, we discuss preoperative workup strategies, paying particular attention to any relevant often atypical symptoms, indications for surgery, timing of surgery, role of surgery in the elderly and emphasizing the key role of a preoperative CT imaging in evaluating the mediastinum. Some key dissection methods are then discussed with respect...
Cureus, 2021
Lipomas of the cord are common and generally associated with an indirect hernia sac, but not alwa... more Lipomas of the cord are common and generally associated with an indirect hernia sac, but not always, as the lipoma may be the only pathology identified during groin exploration. Missed lipoma of the spermatic cord is unfortunately not infrequent and may lead to persistence of post-operative groin pain, with confirmation of unresected cord lipoma on postoperative ultrasound, often necessitating reoperation. We present an interesting case of a 40-years-old male with symptomatic re-recurrent left inguinal hernia following previous open and subsequent endoscopic totally extraperitoneal (TEP) mesh repair. At laparoscopy, the previously inserted extraperitoneal mesh seemed well integrated with no evidence of recurrent hernia sac. Further transabdominal preperitoneal (TAPP) approach identified a moderate-size cord lipoma that had been missed twice before. His postoperative recovery was uneventful, and his previous symptoms completely subsided. This is of significant value as lipomas of the...
World Journal of Surgery, 1998
International Journal of Cancer, 2000
Genomic alterations at the long arm of chromosome 17, and in particular at the nm23 locus, are st... more Genomic alterations at the long arm of chromosome 17, and in particular at the nm23 locus, are still controversial in colorectal cancer (CRC). Our aim was to investigate the possible relationship of loss of heterozygosity (LOH) and microsatellite instability (MI), at 4 microsatellite loci spanning the 17q21-23 region, to the risk of liver metastasis and nm23 protein expression. Genomic DNA extracted from 58 primary and 54 liver secondary formalin-fixed and paraffin-embedded CRCs was obtained from 82 patients. A fluorescent PCR coupled with an automated DNA sequencer was applied. Increasing fraction of loci showing LOH was positively associated with risk of liver metastases (logrank test for trend, p = 0.005); this remained independent after adjusting to T-stage (Cox regression, p = 0.022), N-stage (p = 0.007), or Dukes' stage (p = 0.012). Conversely, increasing frequency of MI was associated with a reduced risk of liver metastases in Dukes' B tumours (logrank test for trend, p = 0.032). When comparing 30 primary and matched liver secondary lesions, we found concordant genomic alteration in 72% (NME1) to 43% (D17S579). Finally, we observed a trend in association between the proportion of loci with LOH and nm23 positivity (chi2 test for trend, p = 0.024). Our findings suggest that genomic alterations in the 17q21-23 region may affect prognosis of CRC as well as regulation of the nm23 protein expression via an unknown underlying mechanism.
International Journal of Cancer, 2000
ANZ Journal of Surgery, 2011
Gastroenterology Research and Practice, 2014
Medical Journal of Australia, Sep 1, 2008
“Your New National Health Service begins on 5th July ... It will provide you with all medical, de... more “Your New National Health Service begins on 5th July ... It will provide you with all medical, dental, and nursing care. Everyone — rich or poor, man, woman or child — can use it or any part of it. There are no charges, except for a few special items. There are no insurance qualifications. But it is not a “charity”. You are all paying for it, mainly as taxpayers, and it will relieve your money worries in time of illness.”*
British Journal of Surgery, 2021
Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numb... more Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst ...
International Journal of Surgery Research & Practice
Cureus, 2021
Vesicocutaneous fistulas (VCF) are abnormal tracts formed between the bladder and the cutaneous s... more Vesicocutaneous fistulas (VCF) are abnormal tracts formed between the bladder and the cutaneous surfaces of the body. Although rare, it has been reported following radiotherapy to the pelvic region, surgery and trauma. We present a case of a 70-year-old male who underwent neoadjuvant chemoradiotherapy for the treatment of rectal cancer metastatic to the perineum prior to definitive abdominoperineal resection (APR). Six months later, he developed urinary retention secondary to bladder obstructive outlet disease. This was managed with urinary catheterisation and a month later with transurethral resection of the prostate (TURP). At outpatient follow-up, he complained of urinary leakage in the perineal region approximately 10 months post-chemoradiotherapy. He underwent a computer tomography (CT) cystogram which confirmed the findings of a VCF extending to his perineum scar. He was managed conservatively with successful outcomes using a multidisciplinary team approach. This is the first ...
Oncology Research Featuring Preclinical and Clinical Cancer Therapeutics, Feb 1, 1998
We undertook a study to analyze the expression of urokinase-type plasminogen activator (u-PA) pro... more We undertook a study to analyze the expression of urokinase-type plasminogen activator (u-PA) protein in colorectal cancer (CRC) and to compare it with c-erbB-2 (HER2/neu) and nm23 protein expression. Paraffin-embedded specimens from 58 patients with CRC were retrospectively collected. Immunohistochemical staining of u-PA, c-erbB-2, and nm23 was quantitatively evaluated using a color video image analysis (color VIA) technique. No correlation was found between u-PA expression and tumor stage, age, sex, or tumor site. Although there was no evidence from our data that the level of u-PA in the primary tumors could predict risk of liver metastasis or survival duration, CRC showing overexpression of u-PA (above 85 pixels) had a worse prognosis (P = 0.013). There were significant positive correlations among all three u-PA, c-erbB-2, and nm23 proteins (u-PA vs. c-erbB-2, P = 0.003; u-PA vs. nm23, P < 0.001; c-erbB-2 vs. nm23, P = 0.001), suggesting that, in vivo, all proteins interact or are similarly regulated.