Enhanced recovery after surgery program in Gynaecologic Oncological surgery in a minimally invasive techniques expert center.

Background: Enhanced Recovery After Surgery Programs (ERP) includes multimodal approaches of perioperative patient's clinical pathways designed to achieve early recovery after surgery and a decreased length of hospital stay (LOS).

Methods: This observational study evaluated the implementation of ERP in gynaecologic oncological surgery in a minimally invasive techniques (MIT) expert center with more than 85% of procedures done with MIT. We compared a prospective cohort of 100 patients involved in ERP between December 2015 and June 2016 to a 100 patients control group, without ERP, previously managed in the same center between April 2015 and November 2015.

Postoperative sepsis in cancer patients undergoing major elective digestive surgery is associated with increased long-term mortality.

Background: Major postoperative events (acute respiratory failure, sepsis, and surgical complications) are frequent early after elective gastroesophageal and pancreatic surgery. It is unclear whether these complications impact equally on long-term outcome.

Methods: Prospective observational study including the patients admitted to the surgical intensive care unit between January 2009 and October 2011 after elective gastroesophageal and pancreatic surgery.

Allogeneic hematopoietic stem cell transplantation after reduced intensity conditioning regimen: Outcomes of patients admitted to intensive care unit.

Purpose: The prognosis of allogeneic hematopoietic stem cell transplantation (HSCT) patients admitted to the intensive care unit (ICU) is still poor. Overall, when these patients receive reduced intensity conditioning (RIC) regimens, the survival is better. To date, no study has specifically evaluated the outcome of RIC allogeneic HSCT admitted to the ICU.

[Febrile neutropenia in onco-hematology patients hospitalized in Intensive Care Unit].

Febrile neutropenia in cancer patients is associated with a high mortality. Patients are frequently admitted to Intensive Care Unit (ICU) for severe sepsis or septic shock. Empirical antibiotic treatment, including monotherapy β-lactam covering Pseudomonas aeruginosa, must be prompt.

De-escalation of antimicrobial treatment in neutropenic patients with severe sepsis: results from an observational study.

Background: In severe sepsis, guidelines recommend de-escalating the empirical antimicrobial treatment as soon as the microbiological results are available. We aimed to determine the rate of de-escalation of the empirical antimicrobial treatment in neutropenic patients with severe sepsis. The characteristics of antimicrobial treatment associated with de-escalation and its impact on short- and long-term survival were also determined.

Initial experience with hyperthermic intraperitoneal chemotherapy.

Background: Until 2004, we treated peritoneal carcinomatosis with cytoreductive surgery accompanied by perioperative systemic chemotherapy. From October 2004, we decided to initiate a hyperthermic intraperitoneal chemotherapy (HIPEC) program for this condition.

Objective: To determine the effect of HIPEC on postoperative outcomes at a single institution performing a high volume of cancer operations.

Should the portal vein be routinely resected during pancreaticoduodenectomy for adenocarcinoma?

Introduction: In pancreatic adenocarcinoma (PA), a margin negative resection (R0) is critical for long-term survival.

Background: Although pancreaticoduodenectomy (PD) with en-bloc portal vein/superior mesenteric vein (PV/SMV) resection is used in patients with venous involvement by tumor, its utility in patients with no venous involvement is unknown. This study examines survival in patients with no venous involvement who had PD with PV/SMV resection.

Prognosis of acute respiratory distress syndrome in neutropenic cancer patients.

To date, no study has been specifically designed to identify determinants of death in neutropenic cancer patients presenting with acute respiratory distress syndrome (ARDS). The aim of this study was to identify early predictive factors of 28-day mortality in these patients. Factors associated with 28-day mortality during intensive care unit (ICU) stay were also described.

Barriers to staff adoption of a surgical safety checklist.

Objective: Implementation of a surgical checklist depends on many organisational factors and on socio-cultural patterns. The objective of this study was to identify barriers to effective implementation of a surgical checklist and to develop a best use strategy.

Setting: 18 cancer centres in France.

Monocyte deactivation in neutropenic acute respiratory distress syndrome patients treated with granulocyte colony-stimulating factor.

Introduction: In severely neutropenic septic acute respiratory distress syndrome (ARDS) patients, macrophages and monocytes are the last potentially remaining innate immune cells. We have previously shown, however, a deactivation of the alveolar macrophage in neutropenic septic ARDS patients. In the present study, we tried to characterize in vitro monocyte baseline cytokine production and responsiveness to lipopolysaccharide exposure.

N-terminal pro-brain natriuretic peptide as an early prognostic factor in cancer patients developing septic shock.

Introduction: The overall prognosis of critically ill patients with cancer has improved during the past decade. The aim of this study was to identify early prognostic factors of intensive care unit (ICU) mortality in patients with cancer.

Methods: We designed a prospective, consecutive, observational study over a one-year period.

Short-term outcome after laparoscopic or open restorative mesorectal excision for rectal cancer: a comparative cohort study.

Purpose: The laparoscopic approach to rectal cancer is still a controversial procedure. A comparative cohort study was conducted to assess short-term results of laparoscopic restorative mesorectal excision.

Methods: From January 1998 to December 2000, laparotomy was performed on all primary rectal cancer undergoing radical excision.

Perineal small bowel fistula after pelvic exenteration for cancer: technical guidelines for perineal fistula.

Background: To determine guidelines for the management of perineal small bowel fistula (PSF) after total or posterior pelvic exenteration.

Methods: During 15 years, 315 curative pelvic exenterations were performed. PSF occurred in 15 patients (3.

Neuromuscular blocking agents decrease inflammatory response in patients presenting with acute respiratory distress syndrome.

Objective: To evaluate the effects of neuromuscular blocking agents (NMBAs) on pulmonary and systemic inflammation in patients with acute respiratory distress syndrome ventilated with a lung-protective strategy.

Design: Multiple-center, prospective, controlled, and randomized trial.

Setting: One medical and two medical-surgical intensive care units.

Development and validation of a perioperative satisfaction questionnaire.

Background: Satisfaction is considered a valuable measure of outcome of healthcare processes. Only a few anesthesia-related validated questionnaires are reported. Because their scope is restricted to specific clinical contexts, their use remains limited.

Hemorrhage after duodenopancreatectomy: impact of neoadjuvant radiochemotherapy and experience with sentinel bleeding.

Postoperative hemorrhage (PH) after duodenopancreatectomy (DP) is frequently lethal. The aim of this study was to delineate guidelines of management. Between August 1994 and July 2003, 172 patients underwent DP for cancer.

Deactivation of alveolar macrophages in septic neutropenic ARDS.

Study Objectives: Neutrophils often have been involved in the pathophysiology of ARDS. However, authentic ARDS has been described in patients with severe neutropenia, suggesting the presence of other potential mechanisms that are responsible of this syndrome. Alveolar macrophages (AMs) could be involved in the development of ARDS, and so we decided to study AM activation in neutropenic patients.