Robotic-Assisted Laparoscopic Extended Pelvic Lymph Node Dissection for Prostate Cancer : Surgical Technique and Experience with the First 99 Cases. Commentaries
Identifieur interne : 001260 ( Main/Exploration ); précédent : 001259; suivant : 001261Robotic-Assisted Laparoscopic Extended Pelvic Lymph Node Dissection for Prostate Cancer : Surgical Technique and Experience with the First 99 Cases. Commentaries
Auteurs : Antje Feicke [Suisse] ; Martin Baumgartner [Suisse] ; Scherwin Talimi [Suisse] ; Daniel Max Schmid [Suisse] ; Hans-Helge Seifert [Suisse] ; Michael Müntener [Suisse] ; Markus Fatzer [Suisse] ; Tullio Sulser [Suisse] ; Rdto T. Strebel [Suisse] ; Alexandre Mottrie [Belgique] ; Karim Touijer [États-Unis]Source :
- European urology [ 0302-2838 ] ; 2009.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Robotique, Télémédecine, Chirurgie.
English descriptors
- KwdEn :
Abstract
Background: To date, there is still a paucity of data in the literature on robotic-assisted laparoscopic extended pelvic lymph node dissection (RALEPLND) in patients with prostate cancer. Objective: To assess the technical feasibility of RALEPLND and to present our surgical technique. Design, setting, and participants: From April 2006 to March 2008, we performed RALEPLND in 99 patients prior to robotic-assisted laparoscopic radical prostatectomy. Indications for RALEPLND were a prostate-specific antigen (PSA) >10 ng/ml or a preoperative Gleason score >7. The data were evaluated retrospectively. Surgical procedure: The transperitoneal approach was used in all cases. In order to gain optimal access to the common iliac bifurcation, the five trocars were placed in a more cephalad position than in patients undergoing radical prostatectomy without RALEPLND. After identification of important landmarks, the lymphatics covering the external iliac vein, the obturator lymphatic packet, and the lymphatics overlying the internal iliac artery were removed on both sides. Measurements: The total lymph node yield, the frequency of lymph node metastases, and the complication rate. Results and limitations: The median patient age was 64 yr (range: 45-78). The median preoperative PSA level was 7.7 ng/ml (range: 1.5-84.6). The median number of lymph nodes harvested was 19 (range: 8-53). In 16 patients (16%), we found lymph node metastasis. Complications occurred in seven patients (7%). Conclusions: RALEPLND is feasible, and its lymph node yield is well in the range of open series. The robotic-assisted laparoscopic approach in itself does not seem to limit a surgeon's ability to perform a complete extended pelvic lymph node dissection.
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Robotic-Assisted Laparoscopic Extended Pelvic Lymph Node Dissection for Prostate Cancer : Surgical Technique and Experience with the First 99 Cases. Commentaries</title><author><name sortKey="Feicke, Antje" sort="Feicke, Antje" uniqKey="Feicke A" first="Antje" last="Feicke">Antje Feicke</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Urology, University Hospital Zürich, University of Zürich</s1><s2>Zürich</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Baumgartner, Martin" sort="Baumgartner, Martin" uniqKey="Baumgartner M" first="Martin" last="Baumgartner">Martin Baumgartner</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Urology, University Hospital Zürich, University of Zürich</s1><s2>Zürich</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 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Schmid</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Urology, University Hospital Zürich, University of Zürich</s1><s2>Zürich</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Seifert, Hans Helge" sort="Seifert, Hans Helge" uniqKey="Seifert H" first="Hans-Helge" last="Seifert">Hans-Helge Seifert</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Urology, University Hospital Zürich, University of Zürich</s1><s2>Zürich</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Muntener, Michael" sort="Muntener, Michael" uniqKey="Muntener M" first="Michael" last="Müntener">Michael Müntener</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Urology, University Hospital Zürich, University of Zürich</s1><s2>Zürich</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Fatzer, Markus" sort="Fatzer, Markus" uniqKey="Fatzer M" first="Markus" last="Fatzer">Markus Fatzer</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Urology, University Hospital Zürich, University of Zürich</s1><s2>Zürich</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Sulser, Tullio" sort="Sulser, Tullio" uniqKey="Sulser T" first="Tullio" last="Sulser">Tullio Sulser</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Urology, University Hospital Zürich, University of Zürich</s1><s2>Zürich</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Strebel, Rdto T" sort="Strebel, Rdto T" uniqKey="Strebel R" first="Rdto T." last="Strebel">Rdto T. Strebel</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Urology, University Hospital Zürich, University of Zürich</s1><s2>Zürich</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Mottrie, Alexandre" sort="Mottrie, Alexandre" uniqKey="Mottrie A" first="Alexandre" last="Mottrie">Alexandre Mottrie</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>O.L.V. Clinic</s1><s2>Aalst</s2><s3>BEL</s3><sZ>10 aut.</sZ></inist:fA14><country>Belgique</country><wicri:noRegion>O.L.V. Clinic</wicri:noRegion></affiliation></author><author><name sortKey="Touijer, Karim" sort="Touijer, Karim" uniqKey="Touijer K" first="Karim" last="Touijer">Karim Touijer</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Department of Surgery, Urology Service, Memorial Sioan-Kettering Cancer Center</s1><s2>New York</s2><s3>USA</s3><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">09-0161374</idno><date when="2009">2009</date><idno type="stanalyst">PASCAL 09-0161374 INIST</idno><idno type="RBID">Pascal:09-0161374</idno><idno type="wicri:Area/PascalFrancis/Corpus">000064</idno><idno type="wicri:Area/PascalFrancis/Curation">000082</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000048</idno><idno type="wicri:doubleKey">0302-2838:2009:Feicke A:robotic:assisted:laparoscopic</idno><idno type="wicri:Area/Main/Merge">001262</idno><idno type="wicri:Area/Main/Curation">001260</idno><idno type="wicri:Area/Main/Exploration">001260</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Robotic-Assisted Laparoscopic Extended Pelvic Lymph Node Dissection for Prostate Cancer : Surgical Technique and Experience with the First 99 Cases. Commentaries</title><author><name sortKey="Feicke, Antje" sort="Feicke, Antje" uniqKey="Feicke A" first="Antje" last="Feicke">Antje Feicke</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Urology, University Hospital Zürich, University of Zürich</s1><s2>Zürich</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Baumgartner, Martin" sort="Baumgartner, Martin" uniqKey="Baumgartner M" first="Martin" last="Baumgartner">Martin Baumgartner</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Urology, University Hospital Zürich, University of Zürich</s1><s2>Zürich</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Talimi, Scherwin" sort="Talimi, Scherwin" uniqKey="Talimi S" first="Scherwin" last="Talimi">Scherwin Talimi</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Urology, University Hospital Zürich, University of Zürich</s1><s2>Zürich</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Schmid, Daniel Max" sort="Schmid, Daniel Max" uniqKey="Schmid D" first="Daniel Max" last="Schmid">Daniel Max Schmid</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Urology, University Hospital Zürich, University of Zürich</s1><s2>Zürich</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Seifert, Hans Helge" sort="Seifert, Hans Helge" uniqKey="Seifert H" first="Hans-Helge" last="Seifert">Hans-Helge Seifert</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Urology, University Hospital Zürich, University of Zürich</s1><s2>Zürich</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Muntener, Michael" sort="Muntener, Michael" uniqKey="Muntener M" first="Michael" last="Müntener">Michael Müntener</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Urology, University Hospital Zürich, University of Zürich</s1><s2>Zürich</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Fatzer, Markus" sort="Fatzer, Markus" uniqKey="Fatzer M" first="Markus" last="Fatzer">Markus Fatzer</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Urology, University Hospital Zürich, University of Zürich</s1><s2>Zürich</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Sulser, Tullio" sort="Sulser, Tullio" uniqKey="Sulser T" first="Tullio" last="Sulser">Tullio Sulser</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Urology, University Hospital Zürich, University of Zürich</s1><s2>Zürich</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Strebel, Rdto T" sort="Strebel, Rdto T" uniqKey="Strebel R" first="Rdto T." last="Strebel">Rdto T. Strebel</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Urology, University Hospital Zürich, University of Zürich</s1><s2>Zürich</s2><s3>CHE</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Suisse</country><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName></affiliation></author><author><name sortKey="Mottrie, Alexandre" sort="Mottrie, Alexandre" uniqKey="Mottrie A" first="Alexandre" last="Mottrie">Alexandre Mottrie</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>O.L.V. Clinic</s1><s2>Aalst</s2><s3>BEL</s3><sZ>10 aut.</sZ></inist:fA14><country>Belgique</country><wicri:noRegion>O.L.V. Clinic</wicri:noRegion></affiliation></author><author><name sortKey="Touijer, Karim" sort="Touijer, Karim" uniqKey="Touijer K" first="Karim" last="Touijer">Karim Touijer</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Department of Surgery, Urology Service, Memorial Sioan-Kettering Cancer Center</s1><s2>New York</s2><s3>USA</s3><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author></analytic><series><title level="j" type="main">European urology</title><title level="j" type="abbreviated">Eur. urol.</title><idno type="ISSN">0302-2838</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">European urology</title><title level="j" type="abbreviated">Eur. urol.</title><idno type="ISSN">0302-2838</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Complication</term><term>Endoscopy</term><term>Excision</term><term>Laparoscopy</term><term>Lymph node</term><term>Lymphadenectomy</term><term>Methodology</term><term>Nephrology</term><term>Pelvic ganglion</term><term>Procedure</term><term>Prostate cancer</term><term>Prostate tumor</term><term>Robotics</term><term>Surgery</term><term>Technique</term><term>Telemedicine</term><term>Treatment</term><term>Urology</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Cancer de la prostate</term><term>Robotique</term><term>Télémédecine</term><term>Tumeur de la prostate</term><term>Laparoscopie</term><term>Ganglion pelvien</term><term>Lymphadénectomie</term><term>Chirurgie</term><term>Technique</term><term>Complication</term><term>Endoscopie</term><term>Ganglion lymphatique</term><term>Excision</term><term>Méthodologie</term><term>Procédure</term><term>Néphrologie</term><term>Urologie</term><term>Traitement</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Robotique</term><term>Télémédecine</term><term>Chirurgie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: To date, there is still a paucity of data in the literature on robotic-assisted laparoscopic extended pelvic lymph node dissection (RALEPLND) in patients with prostate cancer. Objective: To assess the technical feasibility of RALEPLND and to present our surgical technique. Design, setting, and participants: From April 2006 to March 2008, we performed RALEPLND in 99 patients prior to robotic-assisted laparoscopic radical prostatectomy. Indications for RALEPLND were a prostate-specific antigen (PSA) >10 ng/ml or a preoperative Gleason score >7. The data were evaluated retrospectively. Surgical procedure: The transperitoneal approach was used in all cases. In order to gain optimal access to the common iliac bifurcation, the five trocars were placed in a more cephalad position than in patients undergoing radical prostatectomy without RALEPLND. After identification of important landmarks, the lymphatics covering the external iliac vein, the obturator lymphatic packet, and the lymphatics overlying the internal iliac artery were removed on both sides. Measurements: The total lymph node yield, the frequency of lymph node metastases, and the complication rate. Results and limitations: The median patient age was 64 yr (range: 45-78). The median preoperative PSA level was 7.7 ng/ml (range: 1.5-84.6). The median number of lymph nodes harvested was 19 (range: 8-53). In 16 patients (16%), we found lymph node metastasis. Complications occurred in seven patients (7%). Conclusions: RALEPLND is feasible, and its lymph node yield is well in the range of open series. The robotic-assisted laparoscopic approach in itself does not seem to limit a surgeon's ability to perform a complete extended pelvic lymph node dissection.</div></front></TEI><affiliations><list><country><li>Belgique</li><li>Suisse</li><li>États-Unis</li></country><region><li>Canton de Zurich</li><li>État de New York</li></region><settlement><li>Zurich</li></settlement></list><tree><country name="Suisse"><region name="Canton de Zurich"><name sortKey="Feicke, Antje" sort="Feicke, Antje" uniqKey="Feicke A" first="Antje" last="Feicke">Antje Feicke</name></region><name sortKey="Baumgartner, Martin" sort="Baumgartner, Martin" uniqKey="Baumgartner M" first="Martin" last="Baumgartner">Martin Baumgartner</name><name sortKey="Fatzer, Markus" sort="Fatzer, Markus" uniqKey="Fatzer M" first="Markus" last="Fatzer">Markus Fatzer</name><name sortKey="Muntener, Michael" sort="Muntener, Michael" uniqKey="Muntener M" first="Michael" last="Müntener">Michael Müntener</name><name sortKey="Schmid, Daniel Max" sort="Schmid, Daniel Max" uniqKey="Schmid D" first="Daniel Max" last="Schmid">Daniel Max Schmid</name><name sortKey="Seifert, Hans Helge" sort="Seifert, Hans Helge" uniqKey="Seifert H" first="Hans-Helge" last="Seifert">Hans-Helge Seifert</name><name sortKey="Strebel, Rdto T" sort="Strebel, Rdto T" uniqKey="Strebel R" first="Rdto T." last="Strebel">Rdto T. Strebel</name><name sortKey="Sulser, Tullio" sort="Sulser, Tullio" uniqKey="Sulser T" first="Tullio" last="Sulser">Tullio Sulser</name><name sortKey="Talimi, Scherwin" sort="Talimi, Scherwin" uniqKey="Talimi S" first="Scherwin" last="Talimi">Scherwin Talimi</name></country><country name="Belgique"><noRegion><name sortKey="Mottrie, Alexandre" sort="Mottrie, Alexandre" uniqKey="Mottrie A" first="Alexandre" last="Mottrie">Alexandre Mottrie</name></noRegion></country><country name="États-Unis"><region name="État de New York"><name sortKey="Touijer, Karim" sort="Touijer, Karim" uniqKey="Touijer K" first="Karim" last="Touijer">Karim Touijer</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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