Publications by authors named "Baste J"
Lung cancer remains the leading cause of cancer-related deaths worldwide. The introduction of targeted treatments and immunotherapy in lung cancer has transformed patient care by offering "precision medicine" focused on the characteristics of the disease. The same concept has emerged in lung cancer surgery.
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- A multicenter study investigated the frequency of Patient Safety Incidents (PSI) during lung surgeries in France and their effects on postoperative outcomes within 90 days.
- Out of 1919 surgeries screened, 953 were included, revealing a 32% PSI incidence, which was mostly attributed to human factors, organizational issues, and technology problems.
- The severity of PSI significantly increased the risk of complications, readmission, and mortality at 90 days, highlighting the importance of addressing human factors in surgical settings.
Background: Chronic giant diaphragmatic hernia is a severe disease with challenging diagnosis and treatment. Given the risk of loss of domain, the use of botulinum toxin A is an option but has been minimally studied in diaphragmatic hernia surgery.
Case Report: We present a case of a giant diaphragmatic hernia in a 66-years-old patient who showed a 12-year history of progressive chronic respiratory insufficiency.
Article Synopsis
- The study aimed to evaluate safety and survival outcomes of lobectomy, segmentectomy, and wedge resection for early-stage lung cancer using data from the French EPITHOR registry between 2016 and 2022.
- A total of 19,452 patients were analyzed, finding that lobectomy was the most common procedure (72.2%), and while short-term 90-day mortality rates were similar across the three methods, significant differences emerged in 5-year overall survival.
- The results indicated that wedge resection was linked to worse long-term survival compared to lobectomy, suggesting that all types of sublobar resections may not provide equal effectiveness in treating lung cancer.
Robotic-assisted thoracic surgery training in France: a nation-wide survey from young surgeons.
Interdiscip Cardiovasc Thorac Surg
July 2024
Article Synopsis
- A study was conducted to assess the training of thoracic surgeons-in-training in robotic-assisted thoracic surgery (RATS) across France, gathering responses from 101 participants.
- Over half of the trainees had access to robotic systems, with a significant number considering robotic training essential, though only a small percentage had performed a complete procedure independently.
- The findings suggest that training opportunities vary by institution, with higher exposure and performance among fellows at high-volume centers, highlighting the need for increased access and simulation training to improve skills in RATS.
Article Synopsis
- - The study aimed to investigate whether the preoperative Leicester Cough Questionnaire (LCQ) can predict postoperative complications after major lung surgery for non-small cell lung cancer (NSCLC).
- - Conducted at Rouen University Hospital, the retrospective cohort study included 71 patients, finding that 27.1% experienced significant postoperative complications, but the LCQ's predictive value was marginal (ROC curve area of 0.60).
- - The researchers concluded that the LCQ was not a reliable predictor of complications, citing the need for larger studies to confirm findings due to insufficient statistical precision.
Objectives: To assess the current practice of pulmonary metastasectomy at 15 European Centres. Short- and long-term outcomes were analysed.
Methods: Retrospective analysis on patients ≥18 years who underwent curative-intent pulmonary metastasectomy (January 2010 to December 2018).
Article Synopsis
- - Robotic-assisted thoracic surgery (RATS) is gaining popularity among surgeons in Europe, but access and training vary significantly; 22% of surveyed centers had no robots, while 31% had limited access, highlighting disparities in availability.
- - A survey of 174 thoracic surgeons indicated that most centers primarily use video-assisted thoracic surgery (VATS) over RATS, with many respondents believing VATS training aids robotic preparation; however, over half reported that robotic surgery training isn't part of their curriculum.
- - Despite variations in approach, many surgeons (71%) agree future thoracic surgeons should be skilled in both VATS and RATS, noting that RATS may offer advantages like improved lymph node harvesting, although
Despite robot-assisted surgery (RAS) becoming increasingly common, little is known about the impact of the underlying work organization on the stress levels of members of the operating room (OR) team. To this end, assessing whether RAS may impact work-related stress, identifying associated stress factors and surveying relevant measurement methods seems critical. Using three databases (Scopus, Medline, Google Scholar), a systematic review was conducted leading to the analysis of 20 articles.
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- Non-small cell lung cancer (NSCLC) often leads to compromised lung function, and this study focuses on the effects of surgical methods, specifically minimally invasive surgery (MIS), on 90-day post-operative mortality in high-risk patients.
- The research analyzed data from over 46,000 patients, identifying high-risk individuals with poor lung function, and found a significantly higher mortality rate in this group compared to low-risk patients.
- Results indicated that high-risk patients undergoing MIS had lower mortality rates than those undergoing traditional open surgery, even matching the mortality rates of low-risk patients.
Lynch syndrome is the most common autosomal dominant inherited cancer predisposing syndrome, due to mutations in DNA mismatch repair genes. The key feature of cancers in Lynch syndrome is microsatellite instability and a high risk of developing mainly colorectal and uterine cancers. However, cancers with microsatellite instability outside this spectrum, for example, lung cancer, are extremely rare.
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- The Lungsco01 study is the first to evaluate the effectiveness and economic impact of video-thoracoscopy compared to open thoracotomy for treating non-small cell lung cancer in France, involving 259 patients from 10 medical centers over a four-year period.
- Results indicated that the average costs for open thoracotomy were lower than for video-thoracoscopy at both 30 days and 3 months post-surgery, with video-thoracoscopy showing a higher incremental cost-utility ratio per additional quality-adjusted life-year (QALY) gained.
- The analysis revealed a 64% probability that video-thoracoscopy was cost-effective at the 30-day mark
Article Synopsis
- * Immune checkpoint inhibitors and targeted therapies have transformed treatment for NSCLC, offering better outcomes than traditional chemotherapy, although issues with acquired resistance remain.
- * Thoracic surgery has improved through minimally invasive techniques and precision surgery, emphasizing comprehensive patient care from pre-operative support through post-treatment follow-up and potential salvage surgery options.
Objective: The aim of this study was to determine if robotic-assisted lobectomy (RPL-4) is cost-effective and offers improved patient-reported health utility for patients with early-stage non-small cell lung cancer when compared with video-assisted thoracic surgery lobectomy (VATS-lobectomy).
Background: Barriers against the adoption of RPL-4 in publicly funded health care include the paucity of high-quality prospective trials and the perceived high cost of robotic surgery.
Methods: Patients were enrolled in a blinded, multicentered, randomized controlled trial in Canada, the United States, and France, and were randomized 1:1 to either RPL-4 or VATS-lobectomy.
Article Synopsis
- This study compared postoperative outcomes for lung cancer surgeries performed via open thoracotomy (OT), video-assisted (VATS), and robotic-assisted (RA) methods, using a large patient dataset from 2010 to 2020.
- VATS showed lower in-hospital mortality and major complications compared to OT, while both VATS and RA reduced occurrences of pneumonia and atelectasis compared to OT.
- Overall, both VATS and RA led to shorter hospital stays and improved outcomes compared to OT, with VATS showing the best results in reducing mortality.
Upstaged from cT1a-c to pT2a lung cancer, related to visceral pleural invasion patients, after segmentectomy: is it an indication to complete resection to lobectomy?
Interdiscip Cardiovasc Thorac Surg
October 2023
Objectives: Segmentectomy may be indicated for T1a-cN0 non-small-cell lung cancer. However, several patients are upstaged pT2a at final pathological examination due to visceral pleural invasion (VPI). As resection is usually not completed to lobectomy, this may raise issue of potential worse prognosis.
View Article and Find Full Text PDFIntroduction: The prevention of respiratory complications is a major issue after thoracic surgery for lung cancer, and requires adequate post-operative pain management. The erector spinae plane block (ESPB) may decrease post-operative pain. The objective of this study was to evaluate the impact of ESPB on pain after video or robot-assisted thoracic surgery (VATS or RATS).
View Article and Find Full Text PDFObjectives: Adequate pain management after thoracoscopic surgery is a major issue in the prevention of respiratory complications. The combination of the paravertebral block (PVB) with the serratus anterior plane block (SAPB) may decrease postoperative pain. The objective of this study was to evaluate the impact of the combination of PVB and SAPB on the consumption of morphine and pain after video- or robot-assisted thoracic surgery.
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- Patients with chronic respiratory diseases show increased respiratory muscle activity, and this study explored the relationship between respiratory muscle metabolism and lung function impairment in lung cancer surgery patients using F-FDG-PET/CT scans.
- The study included 156 patients, revealing that certain respiratory muscles exhibited hypermetabolism, which correlated with impaired lung function and overall survival outcomes.
- The results suggest that assessing respiratory muscle activity using F-FDG-PET/CT could provide important prognostic information for patients undergoing lung cancer surgery.
Background: Oxygen uptake (V̇O2) and heart rate (HR) kinetics during a constant work-rate test (CWRT) are used to evaluate the response to exercise in healthy subjects as well as subjects with various pathologies.
Objectives: This study aimed to explore the feasibility of these measures and their responsiveness to a prehabilitation program in patients with non-small cell lung cancer (NSCLC).
Method: This study is preregistered (NCT04041297) ancillary analysis of a subgroup of individuals with NSCLC included in the Preo-Dens study (NCT03936764).