Publications by authors named "Bruno Heyd"
Background: The use of multiagent FOLFIRINOX chemotherapy for pancreatic adenocarcinoma in a neoadjuvant setting has been associated with an increased rate of complete pathological response (CPR) after surgery. This study investigated the long-term outcomes of patients with CPR in a multicenter setting to identify prognostic factors for overall survival (OS) and recurrence-free survival (RFS).
Methods: This retrospective cohort study examined biopsy-proven pancreatic adenocarcinomas with CPR after neoadjuvant chemotherapy or chemoradiotherapy and surgery, between January 2006 and December 2023 across 22 French and 2 Belgian centers.
Background: Despite the increasing efficacy of chemotherapy, permanently unresectable colorectal liver metastases are associated with poor long-term survival. We aimed to assess whether liver transplantation plus chemotherapy could improve overall survival.
Methods: TransMet was a multicentre, open-label, prospective, randomised controlled trial done in 20 tertiary centres in Europe.
Introduction: After total thyroidectomy (TT), postoperative hypoparathyroidism (PH) is the most frequent complication. Yet, management strategies for PH remain disputed. The aim of this study was to evaluate outcomes of a reactive supplementation in case of symptomatic PH.
View Article and Find Full Text PDFBackground: The planification of radiation therapy (RT) for pancreatic cancer (PC) requires a dosimetric computed tomography (CT) scan to define the gross tumor volume (GTV). The main objective of this study was to compare the inter-observer variability in RT planning between the arterial and the venous phases following intravenous contrast.
Methods: PANCRINJ was a prospective monocentric study that included twenty patients with non-metastatic PC.
Background: Appropriate risk stratification for the difficulty of liver transplantation (LT) is essential to guide the selection and acceptance of grafts and avoid morbidity and mortality.
Methods: Based on 987 LTs collected from 5 centers, perioperative outcomes were analyzed across the 3 difficulty levels. Each LT was retrospectively scored from 0 to 10.
Background: Despite the increasing efficacy of chemotherapy (C), the 5-year survival rate for patients with unresectable colorectal liver metastases (CLM) remains around 10%. Liver transplantation (LT) might offer a curative approach for patients with liver-only disease, yet its superior efficacy compared to C alone remains to be demonstrated.
Methods: The TransMet randomised multicentre clinical trial (NCT02597348) compares the curative potential of C followed by LT versus C alone in patients with unresectable CLM despite stable or responding disease on C.
Article Synopsis
- The study focuses on clinically relevant post-pancreatectomy hemorrhage (CR-PPH) specifically after distal pancreatectomy (DP), as most existing data is based on pancreatoduodenectomy.
- A total of 1188 patients were analyzed, revealing that 5.5% developed CR-PPH, which led to higher mortality, morbidity, and hospital stays compared to patients without CR-PPH.
- Multivariable analysis indicated that longer surgery times and pre-existing postoperative pancreatic fistula (POPF) were significant risk factors for developing CR-PPH.
Background: Anastomotic leakage presentation after Ivor Lewis esophagectomy may vary on imaging. Such variations may influence anastomotic leakage management and outcomes.
Methods: All consecutive patients who underwent Ivor Lewis esophagectomy for cancer between 2012 and 2019 in 2 referral centers were included.
CD226 has been reported to participate in the rescue of CD8 T cell dysfunction. In this study, we aimed to assess the prognostic value of CD226 in tumor-infiltrating lymphocytes (TILs) derived from colorectal cancer (CRC) liver metastases treated with chemotherapy and radical surgery. TILs from 43 metastases were isolated and analyzed ex vivo using flow cytometry.
View Article and Find Full Text PDFBackground: In the current setting of organ shortage, brain-dead liver donors with recent liver trauma (RLT) represent a potential pool of donors. Yet, data on feasibility and safety of liver transplantation (LT) using grafts with RLT are lacking.
Methods: All liver grafts from brain-dead donors with RLT proposed for LT between 2010 and 2018 were identified from the nationwide CRISTAL registry of the Biomedicine Agency.
Acute fulminant hepatitis related to the use of dasatinib: First case report.
Clin Res Hepatol Gastroenterol
October 2022
Objectives: The purpose of this study was to identify the preoperative CT features that are associated with inadvertent enterotomy (IE) during adhesive small bowel obstruction (ASBO) surgery.
Methods: From January 2015 to December 2019, all patients with ASBO who underwent an abdominal CT were reviewed. Abdominal CT were retrospectively reviewed by two radiologists with a consensus read in case of disagreement.
Article Synopsis
- Anastomotic biliary stricture (ABS) is the most common issue after liver transplants, with 27.1% of patients in this study developing it after an average of 142 days post-surgery.
- Key risk factors for ABS include donor BMI, cytomegalovirus (CMV) infections, and the presence of anastomotic biliary fistulas, though technical difficulty during anastomosis did not significantly affect ABS risk.
- Treatment primarily involved endoscopic procedures, with no need for repeat liver transplants, and ABS occurrence did not affect overall patient or graft survival rates.
Article Synopsis
- Delayed return of gastrointestinal function (DGIF) occurred in 19.9% of 206 patients after hepatectomy, often leading to serious complications like aspiration pneumonia and extended hospital stays.
- Four key independent risk factors for DGIF were identified: patient age, need for vascular reconstruction, volatile anesthetic use, and epidural analgesia.
- A simple risk score was developed using these factors to help stratify patients into low, intermediate, and high-risk groups for DGIF, highlighting the importance of risk assessment in improving postoperative outcomes.
Article Synopsis
- Tissue-resident memory T (TRM) cells act as immune guardians in tissues, playing a crucial role in fighting solid tumors and improving cancer treatment outcomes.
- Recent research shows that these T cells are vital for effective cancer surveillance and are associated with positive responses to immunotherapy in patients.
- The review discusses the latest insights into the characteristics and regulation of T cells, particularly in gastrointestinal cancers, and emphasizes their potential in clinical applications.
Background: The prognosis of critical ill patients with non-occlusive mesenteric ischemia (NOMI) is poor and not fully understood. We aimed to determine preoperative factors associated with 28-day mortality in NOMI.
Methods: Variables associated with 28-day mortality were entered into a multivariate cox regression model and were used to compute a NOMI mortality score.
Confirmed diagnosis of alveolar echinococcosis (AE) is based on pathological criteria and molecular evidence. This parasite-borne disease, caused by the cestode Echinococcus multilocularis, sparingly involves humans as a dead-end host. In humans, the parasite mainly colonizes the liver but can colonize any organ and cause atypical forms, often difficult to characterize clinically.
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- The study aimed to assess the safety of performing an anastomosis after rectal cancer surgery in patients who had previously been treated for prostate cancer.
- Researchers compared outcomes between patients who had restorative surgery (RS+ group) and those who had a permanent stoma (RS- group) over a period from 2008 to 2018.
- Findings showed that restorative surgery is safe for these patients, with no significant increase in complications, and using delayed coloanal anastomosis could be a beneficial option.
Article Synopsis
- - Ovarian cancer is highly lethal, but combining cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (IPC), along with intraperitoneal epinephrine, may improve patient survival rates.
- - A study analyzed 124 patients with advanced serous epithelial ovarian cancer, revealing a median overall survival of 60.8 months and median disease-free survival of 21.2 months, with certain factors affecting these outcomes.
- - The treatment resulted in a manageable complication rate, with 27.42% experiencing significant surgical issues, but low rates of renal toxicity and mortality, suggesting the approach is both effective and relatively safe.
Background: The ABO blood group system may influence tumorigenesis, but its prognostic value in liver transplantation (LT) for hepatocellular carcinoma (HCC) has never been assessed.
Methods: All consecutive patients who underwent LT for HCC between 2013 and 2017 at 9 centers were analyzed. Predictors of tumor recurrence were identified using multivariable analysis, while comparison between group A and non-A recipients was performed after propensity score matching.
Background: Major bile duct injuries (BDI) following cholecystectomy require complex reconstructive surgery. The aim was to collect the liver transplantations (LT) performed in France for major BDI following cholecystectomy, to analyze the risk factors and to report the results.
Methods: National multicenter observational retrospective study.
Introduction: To identify factors associated with irreversible transmural necrosis (ITN) among critically ill patients experiencing nonocclusive mesenteric ischemia (NOMI) and to compare the predictive value regarding ITN risk stratification with that of the previously described Clichy score.
Methods: All consecutive patients admitted to the intensive care unit between 2009 and 2019 who underwent exploratory laparotomy for NOMI and who had an available contrast-enhanced computed tomography with at least 1 portal venous phase were evaluated for inclusion. Clinical, laboratory, and radiological variables were collected.
Article Synopsis
- Surgical resection and chemotherapy are the main treatments for localized pancreatic ductal adenocarcinoma (LPDAC), but most patients experience recurrence, highlighting the need for improved preoperative therapy assessments.
- A study at Besancon University Hospital analyzed factors from 146 LPDAC patients to predict relapse-free survival (RFS), focusing on immunological and nutritional elements.
- It found that preoperative lymphopenia (low lymphocyte count) and sarcopenia (low muscle mass) significantly impact RFS, allowing for the classification of patients into three risk groups with varied survival outcomes.
Background: Postoperative acute pancreatitis (POAP) emerges as a distinct pancreas-specific complication increasing both the risk and the burden of POPF after pancreatoduodenectomy. Among various risk factors, pancreas stump (PS) hypoperfusion might play a role in POAP occurrence but has never been investigated. The current study aimed at evaluating the feasibility of intraoperative fluorescence angiography (IOFA) of the PS using ICG and its association with POAP.
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