Publications by authors named "Facy O"
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.
Article Synopsis
- - The study aims to assess how effective drain fluid lipase is in predicting postoperative pancreatic fistula, a serious complication after pancreatic surgery, and determines the most suitable day for measuring this biomarker.
- - Conducted across seven hospitals, the LIPAse DRAIN study analyzed drain fluid from 625 patients over six days, finding that drain fluid lipase is a reliable indicator on days 3 and 4, with significant statistical values suggesting its diagnostic utility.
- - Results showed that on postoperative day 3, a specific threshold of lipase levels could reasonably identify patients at risk for developing a pancreatic fistula, recommending routine measurement of this biomarker by day 3 post-surgery.
Study Objective: To evaluate the feasibility and benefit of a diagnostic and therapeutic algorithm for management of patients presenting with a high C-reactive protein (CRP) level after colorectal surgery.
Patients And Methods: Prospective study including patients with CRP>125mg/L at the 4th postoperative day following elective colorectal surgery. The protocol involved CT-scan of which the results were to orient subsequent management: antibiotics, radiological drainage, endoscopy or surgical redo.
Article Synopsis
- Minimally invasive surgery (MIS) for left pancreatic resections has been increasingly utilized, but its advantages over traditional open surgery for distal pancreatectomy in treating pancreatic neuroendocrine tumors are still debated.
- A retrospective study involving 274 patients across 21 French centers analyzed short and long-term outcomes of MIS versus open surgery, focusing on factors like tumor size and patient characteristics.
- Results showed that MIS reduced major complications and delayed gastric emptying while maintaining comparable survival rates, suggesting it is a safe option for patients with resectable left pancreatic neuroendocrine tumors.
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.
Introduction: Due to longer life expectancy, an increasing number of older people are at risk of developing cancer. Surgical resection of a non-metastatic and resectable digestive tumor remains the main therapeutic weapon. The objective of our study is to assess the possibility of curative oncological surgery in patients over 80years of age, to study its impact in terms of morbidity and mortality, and to look for risk factors for the occurrence of complications.
View Article and Find Full Text PDFArticle Synopsis
- - This study analyzed data from over 39,000 patients who had liver surgery between 2011 and 2019 to assess how the number of surgeries performed at a hospital affects patient outcomes.
- - It found that hospitals performing more than 25 liver resections annually had lower in-hospital mortality rates and better management of specific complications, despite experiencing more overall complications.
- - The research concluded that higher surgical volumes contribute to improved patient rescue rates after complications, while liver transplantation activity did not influence these outcomes.
Transthoracic subtotal esophagectomy with two-field lymph node (mediastinal and abdominal) and monobloc posterior mediastinectomy is called Ivor Lewis esophagectomy. This intervention requires an abdominal and thoracic time that is carried out here entirely by robotic way. It is performed a reconstruction by gastroplasty with a manual esophago-gastric anastomosis also by robotic way.
View Article and Find Full Text PDFAim: Anastomotic leak results in increased morbidity and affects functional and oncological outcomes after colectomy. Measurement of C-reactive protein (CRP) allows early detection of anastomotic leaks. The aim of this study was to evaluate the benefit to the patient of earlier diagnosis and management of anastomotic leaks, namely avoiding takedown of the anastomosis.
View Article and Find Full Text PDFBackground: Computed tomography (CT) scan with rectal contrast enema (RCE-CT) could increase the detection rate of anastomotic leaks (AL) in the early postoperative period following colorectal surgery, compared to CT scan without RCE. The aim of this study was to assess the benefit of RCE-CT for the early diagnosis of AL following colorectal surgery.
Methods: Patients who had a RCE-CT for suspected AL in the early postoperative period following colorectal surgery with anastomosis between January 2012 and July 2019 at the Dijon University Hospital were retrospectively included.
Purpose: Fast-track protocols are increasingly used after digestive surgery. After esophagectomy, the gravity and the fear of anastomotic leak may be an obstacle to generalization of such protocols. C-reactive protein (CRP) might be a reliable tool to identify patients at low risk of anastomotic leak after esophagectomy, so that they can be safely included in a fast-track program.
View Article and Find Full Text PDFObjective: Defining robust and standardized outcome references for distal pancreatectomy (DP) by using Benchmark analysis.
Background: Outcomes after DP are recorded in medium or small-sized studies without standardized analysis. Therefore, the best results remain uncertain.
Background: Our objective was to describe real-world patterns of care and outcomes in pancreatic cancer. Methods: 912 patients diagnosed with pancreatic cancer from 2014 to 2017 were registered by the population-based cancer registry of Burgundy (France). Progression-free and net survival were estimated.
View Article and Find Full Text PDFMany studies identified colonoscopy quality indicators in order to improve performance and safety. We conducted a colonoscopy improvement study. Our study was designed according to a Plan-Do-Study-Act cycle: first recording of our quality indicators and identification of shortcomings, second identification of improvement targets and implementation of new procedures, third second recording of quality indicators, fourth validation of procedures and identification of new goals.
View Article and Find Full Text PDFSurgical treatment of digestive cancer in a well-defined elderly population.
Clin Res Hepatol Gastroenterol
March 2022
Introduction: Digestive cancer is of concern because of its frequency and severity with an increasing older median age of onset. The purpose of this study was to describe in a well-defined population presenting with non-metastatic digestive cancer the frequency of surgical resection and outcomes according to age.
Patients And Methods: We analyzed 7760 patients with a non-metastatic digestive cancer, recorded in the Burgundy population-based digestive cancer registry between 2009 and 2017.
Background: The optimal surgical procedure for duodenal gastrointestinal stromal tumors (D-GISTs) remains poorly defined. Pancreaticoduodenectomy (PD) allows for a wide resection but is associated with a high morbidity rate.
Objectives: The aim of this study was to compare the short- and long-term outcomes of PD versus limited resection (LR) for D-GISTs and to evaluate the role of tumor enucleation (EN).
Article Synopsis
- The study aimed to identify hospitals in France with unusual mortality rates for major pancreatectomies by analyzing 30-day mortality data from 2009 to 2018.
- They extracted data from a national database, using observed-to-expected mortality rates to assess hospital quality.
- Results indicated a slight improvement in hospital quality over the years, but emphasized a critical need for better organization of care for pancreatic surgery in France.
Aim: To assess postoperative complications and control of hormone secretions following pancreatoduodenectomy (PD) performed on multiple endocrine neoplasia type 1 (MEN1) patients with duodenopancreatic neuroendocrine tumors (DP-NETs).
Background: The use of PD to treat MEN1 remains controversial, and evaluating the right place of PD in MEN1 disease makes sense.
Methods: Thirty-one MEN1 patients from the Groupe d'étude des Tumeurs Endocrines MEN1 cohort who underwent PD for DP-NETs between 1971 and 2013 were included.
Background: FTR appears as a major cause of postoperative mortality (POM). Hospital volume has an impact on FTR in pancreatic surgery but no study has investigated this relationship more specifically in DP.
Methods: We analysed patients with DP between 2009 and 2018 through a nationwide database.
Article Synopsis
- The study reviews the use of liquid ethylene vinyl alcohol (EVOH) copolymer for preoperative portal vein embolization (PVE) in patients with liver cancer, focusing on its effectiveness in enhancing future liver remnant (FLR) size before surgery.
- Twenty-six patients underwent PVE, achieving a 100% success rate in targeting the intended portal veins and resulting in a significant increase in FLR volume (52.9% increase on average) within 3-6 weeks post-procedure.
- The procedure demonstrated good safety, with minor complications in four patients, and a high subsequent liver resection rate of 84.5%, indicating EVOH's feasibility and effectiveness for FLR
Background: The addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to cytoreductive surgery has been associated with encouraging survival results in some patients with colorectal peritoneal metastases who were eligible for complete macroscopic resection. We aimed to assess the specific benefit of adding HIPEC to cytoreductive surgery compared with receiving cytoreductive surgery alone.
Methods: We did a randomised, open-label, phase 3 trial at 17 cancer centres in France.