A 74-year-old former surgeon was given a maximum 20-year prison sentence Wednesday by a French court for the rape and sexual assault of hundreds of patients, mostly children, over more than two decades.

Joël Le Scouarnec was sentenced after admitting molesting nearly 300 victims in one of the country’s largest-ever child sex abuse cases, which has raised questions about how he was able to abuse so many, for so long.

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