Low-Dose Radiation Yields Lower Rates of Pathologic Response in Esophageal Cancer Patients.

Background: Although neoadjuvant chemoradiation (nCRT) followed by surgery is standard treatment for locally advanced esophageal or gastroesophageal junction (E/GEJ) cancer, the optimal radiation dose is still under debate.

Objective: The aim of this study was to assess the impact of different preoperative radiation doses (41.4 Gy, 45 Gy or 50.

Functional, biological, and radiological evaluation of the pancreaticojejunal anastomosis 1 year after pancreatoduodenectomy: a prospective study.

Purpose: This prospective study aimed to analyze the functional, biological, and radiological aspects of the pancreatic anastomosis 1 year after pancreatoduodenectomy (PD).

Methods: From 2016 to 2019, patients with PD indication were screened. Questionnaires about pancreas insufficiency, fecal elastase tests, and magnetic resonance imaging (MRI) were performed before and 1 year after PD.

Impact of positive microscopic resection margins (R1) after gastrectomy in diffuse-type gastric cancer.

Introduction: Diffuse-type gastric cancer (DTGC) is associated with poor outcome. Surgical resection margin status (R) is an important prognostic factor, but its exact impact on DTGC patients remains unknown. The aim of this study was to assess the prognostic value of microscopically positive margins (R1) after gastrectomy on survival and tumour recurrence in DTGC patients.

Drain Versus No Drain in Open Mesh Repair for Incisional Hernia, Results of a Prospective Randomized Controlled Trial.

Background: Open mesh repair of incisional hernia is associated with different local complications, particularly bleeding and seroma formation. Traditionally, drains have been placed perioperatively to prevent these complications, despite the lack of scientific evidence or expert consensus. We formulated the hypothesis that the absence of drainage would reduce number of patients presenting collections or complications.

Recurrent complex incisional hernia repair by enhanced-view totally extraperitoneal (eTEP) technique.

Objective: Treatment of large recurrent abdominal wall hernias remains a surgical challenge. The enhanced-view totally extraperitoneal (eTEP) approach is an emerging technique used to treat hernias with minimally invasive procedure. This article illustrates a step-by-step eTEP approach, used in a complex recurrent hernia repair.

Cost-Benefit Analysis of an Enhanced Recovery Program for Gastrectomy A Retrospective Controlled Analysis.

Background: Enhanced recovery programs (ERP) demonstrated decreased postoperative complication rate and reduced length of stay (LOS). Recently, data on the financial impact revealed cost reduction for colorectal, liver and pancreatic surgery. The present study aimed to assess the cost-effectiveness of ERP in gastric surgery.

Early postoperative decrease of albumin is an independent predictor of major complications after oncological esophagectomy: A multicenter study.

Background And Objectives: Serum albumin perioperative decrease (∆Alb) may reflect the magnitude of the physiological stress induced by surgery. Studies highlighted its value to predict adverse postoperative outcomes, but data in esophageal surgery are scant. This study aimed to investigate the role of ∆Alb to predict major complications after esophagectomy for cancer.

Prognostic value of positive histological margins in patients with pancreatic head ductal adenocarcinoma and lymph node involvement: an international multicentric study.

Background: Resection margin status and lymph node (LN) involvement are known prognostic factors for patients who undergo pancreatoduodenectomy for pancreatic ductal adenocarcinoma (PDAC). This study aimed to compare overall survival (OS) and disease-free survival (DFS) by resection margin status in patients with PDAC and LN involvement.

Methods: A retrospective international multicentric study was performed including four Western centers.

Roux-en-Y Gastric Bypass with Manual Intracorporeal Anastomoses in 3D Laparoscopy: Operative Technique.

Bariatric surgery is the only treatment for severe obesity recognized as truly effective, and Roux-en-Y gastric bypass is one of the most frequent procedures. The aim of this study is to present a 3D laparoscopic bypass technique with intracorporal anastomosis, performed completely by hand. After positioning the patient and creating the 20 mL gastric pouch, the gastrojejunal anastomosis is performed with two continuous sutures of resorbable V-Lock 3.

Gastroesophageal Reflux Disease Following Roux-en-Y Gastric Bypass.

Gastroesophageal reflux disease (GERD) is one of the most important obesity-related comorbidity, with prevalence >50% in obese population. Roux-en-Y gastric bypass (RYGB) is considered the gold standard for metabolic surgery in obese patients with GERD, but in a subgroup of patients this pathological GERD may be not really controlled after this technique. Aims of this article are to discuss surgical and endoscopic options to manage refractory GERD after RYGB.

Reflux Disease and Adenocarcinoma of the Esophagus and Cardia: Global Management and Surgical Treatment.

Adenocarcinoma of the esophagus and cardia is a rare cancer, associated with chronic reflux disease. Its associated mortality is still very high, reflecting both aggressive biology and lack of adequate treatments. The aim of this article was to describe up to date management of these complex tumors.

Long-Term Weight Loss, Metabolic Outcomes, and Quality of Life at 10 Years After Roux-en-Y Gastric Bypass Are Independent of Patients' Age at Baseline.

Background: Conflicting data have been published for bariatric surgery in older patients, with no long-term large-scale studies available. Our aim was to provide long-term (> 10 years) results on weight loss, metabolic outcomes, and quality of life in a large homogenous series of Roux-en-Y gastric bypass (RYGB) patients, according to age at baseline.

Patients And Methods: All consecutive patients who underwent primary RYGB between 1999 and 2007, and therefore eligible for 10-year follow-up, were retrospectively analyzed.

F- FDG PET/CT-derived parameters predict clinical stage and prognosis of esophageal cancer.

Background: Although F- FDG PET/CT is validated in baseline workup of esophageal cancer to detect distant metastases, it remains underused in assessing local staging and biology of the primary tumor. This study aimed to evaluate the association between F- FDG PET/CT-derived parameters of esophageal cancer, and its clinico-pathological features and prognosis.

Methods: All patients (n = 86) with esophageal adenocarcinoma or squamous cell cancer operated between 2005 and 2014 were analyzed.

Assessment of Avoidable Readmissions in a Visceral Surgery Department with an Algorithm: Methodology, Analysis and Measures for Improvement.

Background: Standardized quality indicators assessing avoidable readmission become increasingly important in health care. They can identify improvements area and contribute to enhance the care delivered. However, the way of using them in practice was rarely described.

[Can surgery treat type 2 diabetes ? Yes, according to international companies].

Type 2 diabetes (DM2) and obesity are chronic diseases that often coexist with considerable morbidity and mortality. Approximately 85 % of all DM2 patients have a body mass index (BMI) ranking them as overweight (BMI 25‑29,9 kg/m) or obese (BMI > 30 kg/m). Metabolic surgery is the only treatment for diabetes that results in long-term remission in 23 to 60 % of patients in the office depending on the preoperative duration of diabetes and the severity of the disease.

[Surgery of abdominal wall hernias in 2018 : an update of current practices].

Abdominal wall hernias remain common problem that affect a large proportion of the population from various ages. The management as well as the referral to surgeons can be oriented with guidelines. One of the aims of this article is identification of emergencies compared to eligible cases allowing watchful waiting strategy in the setting of the three most common abdominal wall hernias.

Accuracy of preoperative staging for a priori resectable esophageal cancer.

This study assessed the accuracy of preoperative staging in patients undergoing oncological esophagectomy for adenocarcinoma and squamous cell carcinoma. All patients undergoing surgery for resectable esophageal cancer in a university hospital from 2005 to 2016 were identified from our institutional database. Patients with neoadjuvant treatment were excluded to avoid bias from down-staging effects.

Locoregional Tumor Extension and Preoperative Smoking are Significant Risk Factors for Early Recurrence After Esophagectomy for Cancer.

Background: Tumor recurrence during the first year after oncological esophagectomy has been reported in up to 17-66% of patients. However, little is known as to the risk factors potentially associated with this adverse outcome. The aim of this retrospective observational study was to identify clinically relevant parameters associated with early recurrence.

Roux-en-Y Gastric Bypass: Ten-year Results in a Cohort of 658 Patients.

Objective: The aim of this paper is to report, with a high follow-up rate, 10-year results in a large cohort of patients after Roux-en-Y gastric bypass (RYGBP) done essentially by laparoscopy.

Background: RYGBP has been performed for 50 years, including 20 years by laparoscopy, yet very few long-term results have been reported, mostly after open surgery.

Methods: Prospective bariatric database established since the introduction of bariatric surgery.

Laparoscopic Roux-En-Y Gastric Bypass Improves Lipid Profile and Decreases Cardiovascular Risk: a 5-Year Longitudinal Cohort Study of 1048 Patients.

Background: Dyslipidemia is a known risk factor for cardiovascular (CV) events. The aim of the study was to assess lipid profiles and their impact on CV risk changes in a large patient cohort 5 years after Roux-en-Y gastric bypass (RYGB).

Methods: All patients who underwent primary RYGB for severe obesity in our two hospitals between January 1999 and December 2009 were included.

[Novelties in surgery in 2016].

The year 2016 allowed further implementation of previous years innovations with the PIPAC treatment for peritoneal carcinomatosis, the development of new surgical technologies and procedures and challenging general principles in general and digestive surgery, including cholecystectomy and appendectomy. Prevention, improved general and perioperative care (ERAS program) become an integral part of our standard surgical activity.

[Hiatal hernia : current diagnostic and therapeutic management].

Hiatal hernia is a frequent pathology. Two types have been described : sliding hernia and paraesophageal hernia (PEH). The first one is the most frequent and is associated with reflux disease.