Publications by authors named "Lefevre J"

Background: The efficacy of the laparoscopic approach for total gastrectomy(TG) in Western countries remains under discussion. Recently, Textbook Outcome(TO) has gained recognition as a comprehensive measure of care quality in upper gastrointestinal surgery. Although predictive factors for TO after TG are well-documented, the influence of the surgical approach requires further analysis.

View Article and Find Full Text PDF

Background And Aims: Postoperative recurrence requiring medical treatment intensification or redo-surgery is common after ileocolic resection (ICR) for Crohn's disease (CD). This study aimed to identify a subgroup of CD patients for whom ICR could achieve durable remission.

Methods: This retrospective follow-up study analyzed 592 CD patients who underwent ICR (2013-2015) in a nationwide prospective cohort.

View Article and Find Full Text PDF

While apoptosis dismantles the cell to enforce immunological silence, pyroptotic cell death provokes inflammation. Little is known of the structural architecture of cells undergoing pyroptosis, and whether pyroptotic corpses are immunogenic. Here we report that inflammasomes trigger the Gasdermin-D- and calcium-dependent eruption of filopodia from the plasma membrane minutes before pyroptotic cell rupture, to crown the resultant corpse with filopodia.

View Article and Find Full Text PDF

Background: The potential oncological benefit of extending the waiting period between neoadjuvant radiochemotherapy and surgical resection for rectal cancer is debated.

Objective: To evaluate the impact of prolonging this waiting period on the 5-year oncological prognosis and 2-year functional result of locally advanced rectal adenocarcinoma.

Design: Phase III, multicenter, randomized, open-label, parallel-group, controlled trial.

View Article and Find Full Text PDF

Aim: Diverting ileostomy (DS) after restorative proctocolectomy (RPC) can be omitted in selected patients. Its omission could improve functional outcomes and quality of life (QoL), as has been demonstrated in patients after proctectomy. The aim of this study was to report the impact of diverting ileostomy on functional outcomes and QoL after ileal pouch-anal anastomosis (IPAA).

View Article and Find Full Text PDF

The use of graph centrality measures applied to biological networks, such as protein interaction networks, underpins much research into identifying key players within biological processes. This approach however is restricted to dyadic interactions and it is well-known that in many instances interactions are polyadic. In this study we illustrate the merit of using hypergraph centrality applied to a hypernetwork as an alternative.

View Article and Find Full Text PDF

Background: Early complicated Crohn's disease (CD) may require ileal resection as first-line treatment.

Aim: To evaluate the long-term outcomes of patients who underwent early ileal resection.

Methods: We conducted a retrospective study in two inflammatory bowel diseases (IBD) referral centres, including patients with ileocaecal resection and segmental ileal resection within 5 years of CD diagnosis.

View Article and Find Full Text PDF

Objective: To report the 90-day mortality benefit associated with the implementation of the new regulatory reform on oncological surgical digestive authorizations.

Summary Background Data: New thresholds in digestive cancer surgery were applied in 2023, accrediting centers for major interventions. No evidence has been provided to support their justification.

View Article and Find Full Text PDF

Background: Neoadjuvant immunotherapy emerges as a promising strategy for patients with localized colon cancer (CC) harboring microsatellite instability/mismatch repair deficiency (MSI/dMMR). The aim of this study is to evaluate the concordance between clinical cTN stage assessed by preoperative computed tomography (CT) scan and pTN stage of MSI/dMMR CC.

Patients And Methods: Consecutive patients diagnosed for localized MSI/dMMR CC and treated with upfront surgery between 2013 and 2022 in two French centers were eligible.

View Article and Find Full Text PDF
Article Synopsis
  • Microsatellite instability (MSI), often linked to mismatch repair deficiency in colorectal cancer (CRC), leads to numerous noncoding DNA mutations, particularly affecting RNA splicing sites.
  • This research shows that these noncoding mutations happen early in tumor development, even before the cancer cells become mutated in their coding regions, and are associated with altered splicing patterns in mRNA.
  • The altered RNA splicing impacts cellular differentiation and promotes the initiation of MSI CRC, indicating that these noncoding changes are significant for cancer progression before traditional coding mutations occur.
View Article and Find Full Text PDF

In this article, I describe my academic journey as a Canadian researcher in the field of mathematical cognition. The article is a version of the talk I gave when I was presented with the Donald O. Hebb Award from the Canadian Society for Brain, Behaviour and Cognitive Science in July 2023 at the University of Guelph.

View Article and Find Full Text PDF

This study explores the conversion coefficients from air kerma to operational quantities for radiation protection, using x-ray spectrometry for the narrow-beam qualities below 300 keV as defined by ISO 4037-1. By employing custom spectral correction algorithms combined with modern cadmium telluride (CdTe) semiconductor detectors, we effectively corrected spectral distortions caused by detection processes, ensuring more reliable measurements. These measurements are crucial for meeting radiation protection standards.

View Article and Find Full Text PDF

Background: Esophageal cancer posed significant global health challenges, particularly due to poor survival rates, especially in advanced stages. Primary endoscopic resection had emerged as an alternative treatment for early esophageal cancer, aiming to preserve organ function and reduce surgical morbidity.

Methods: This retrospective multicenter cohort study included 334 patients with early esophageal cancer (T1a-b, N0) from 30 French-speaking European centers between 2000 and 2010.

View Article and Find Full Text PDF

Background: Bladder drainage is systematically used in rectal cancer surgery; however, the optimal type of drainage, transurethral catheterization (TUC) or suprapubic catheterization (SPC), is still controversial. The aim was to compare the rates of urinary tract infection on the fourth postoperative day (POD4) between TUC and SPC, after rectal cancer surgery regardless of the day of removal of the urinary drain.

Methods: This randomized clinical trial in 19 expert colorectal surgery centers in France and Belgium was performed between October 2016 and October 2019 and included 240 men (with normal or subnormal voiding function) undergoing mesorectal excision with low anastomosis for rectal cancer.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to analyze the rates of definitive stoma and the incidence of follow-up reconstructive surgeries in patients who underwent subtotal colectomy (STC) for inflammatory bowel disease (IBD).
  • Conducted as a national retrospective study in France from 2013 to 2021, it included 1,860 patients, with the majority suffering from ulcerative colitis, and assessed the relationship between definitive stoma and various risk factors.
  • Results showed that 33% of patients had a definitive stoma, with significant risk factors being older age, Crohn's disease, surgical complications, a situation involving laparotomy, and treatment at low-volume hospitals.
View Article and Find Full Text PDF

Aim: Although proximal faecal diversion is standard of care to protect patients with high-risk colorectal anastomoses against septic complications of anastomotic leakage, it is associated with significant morbidity. The Colovac device (CD) is an intraluminal bypass device intended to avoid stoma creation in patients undergoing low anterior resection. A preliminary study (SAFE-1) completed in three European centres demonstrated 100% protection of colorectal anastomoses in 15 patients, as evidenced by the absence of faeces below the CD.

View Article and Find Full Text PDF

Background: Abdominoperineal resection (APR) leads to a substantial loss of tissue and a high rate of complications. The Taylor flap is a musculocutaneous flap used in reconstruction after APR.

Objectives: We aimed to analyze the short and long-term morbidity of reconstruction with a Taylor flap (oblique rectus abdominis flap) after APR and to identify the risk factors for postoperative complications.

View Article and Find Full Text PDF

Background: Although numerous treatments exist for the management of rectovaginal fistula, none has demonstrated its superiority. The role of diverting stoma remains controversial. A few series include Martius flap in the armamentarium.

View Article and Find Full Text PDF

Background: Although several prognostic factors in GIST have been well studied such as tumour size, mitotic rate, or localization, the influence of microscopic margins or R1 resection remains controversial. The aim of this study was to evaluate the influence of R1 resection on the prognosis of GIST in a large multicentre retrospective series of patients.

Methods: From 2001 to 2013, 1413 patients who underwent surgery for any site of GIST were identified from 61 European centers.

View Article and Find Full Text PDF

A major advance has been made in the management of rectal cancer, with the emergence in 2021 of total neoadjuvant treatment. The main publications from the RAPIDO and PRODIGE-23 trials reported a significant improvement in progression-free survival and the pathological complete response rate. The aim of this review is to synthesize recent data on neoadjuvant treatment of rectal cancer, to explain the long-term results of the RAPIDO and PRODIGE-23 trials, and to put them into perspective, considering current advances in de-escalation strategies.

View Article and Find Full Text PDF

Background: The aim of our study was to evaluate the external validity of the MIRO randomized controlled trial findings in a similar nationwide setting "real life" population, especially the benefit of a hybrid approach in esophageal resection for pulmonary complication. The external validity of randomized controlled trial findings to the general population with the same condition remains problematic because of the inherent selection bias and rigid inclusion criteria.

Methods: This study was a cohort study from a National Health Database (Programme de Medicalisation des Systemes d'Informations) between 2010 and 2022.

View Article and Find Full Text PDF

Aim: Digestive stoma are frequently performed. The last French guidelines have been published twenty years ago. Our aim was to update French clinical practice guidelines for the perioperative management of digestive stoma and stoma-related complications.

View Article and Find Full Text PDF

Introduction: Contradictions remain on the impact of interhospital competition on the quality of care, mainly the mortality. The aim of the study is to evaluate the impact of interhospital competition on postoperative mortality after surgery for colorectal cancer in France.

Methods: We conducted a retrospective cross-sectional study from 2015 to 2019.

View Article and Find Full Text PDF

Background: Postoperative complications occur in up to 43% of patients after surgery, resulting in increased morbidity and economic burden. Prehabilitation has the potential to increase patients' preoperative health status and thereby improve postoperative outcomes. However, reported results of prehabilitation are contradictory.

View Article and Find Full Text PDF