Publications by authors named "Ortega-Deballon P"

Objectives: To assess the diagnostic accuracy, in a validation cohort, of a score based on three CT items, which has shown good performance for predicting ischaemia complicating acute adhesive small-bowel obstruction (SBO).

Methods: This retrospective single-centre study of diagnostic accuracy included consecutive patients admitted for acute adhesive SBO in 2015-2022, who were treated conservatively or underwent surgery within 24 h after CT. The gold standard for ischaemia was an intraoperative diagnosis for operated patients, while the absence of ischaemia was confirmed either by its absence during surgery or by clinical follow-up in patients who did not undergo surgery.

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  • * A literature review of 16 studies found that while abdominal binders (AB) did not reduce hernia rates or complications, they helped decrease postoperative pain for 48-72 hours.
  • * Despite their safety, the evidence does not support routine use of AB after surgery, indicating a need for more research on their benefits and costs.
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Background: Postoperative rectovaginal fistula leads to a loss of patients' quality of life and presents significant challenges to the surgeon. The literature focusing specifically on postoperative rectovaginal fistulas is limited. The objective of the present study is to identify factors that can enhance the success of the management of this postoperative rectovaginal fistula.

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  • - 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.
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Introduction: Parastomal hernias are a challenging complication of digestive ostomies. Ileal-conduit parastomal hernias after cystectomy have specific aspects. The aim of this study was to describe the incidence and natural history of ileal-conduit parastomal hernias in order to guide their management, as well as to identify risk factors to prevent them.

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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.

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Introduction: Nutritional intake and dysregulation of fatty acid metabolism play a role in the progression of various tumors, but the consumption of fatty acids is difficult to assess accurately with dietary questionnaires. Biomarkers can objectively assess intake, storage and bioavailability.

Objective: We studied the association between the polyunsaturated fatty acid (PUFA) composition of abdominal subcutaneous adipose tissue (good indicator of dietary intake over 2-3 years) and all-cause mortality.

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Background: In the decision to perform elective surgery, it is of great interest to have data about the outcomes of surgery to individualize patients who could safely undergo sigmoid resection. The aim of this study was to provide information on the outcomes of elective sigmoid resection for sigmoid diverticular disease (SDD) at a national level.

Methods: All consecutive patients who had elective surgery for SDD (2010-2021) were included in this retrospective, multicenter, cohort study.

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  • - The study examines the risk of bowel obstruction after incisional hernia repair (IHR) using intraperitoneal mesh (IPOM), which is the current standard treatment that can enhance quality of life but poses some risks.
  • - Researchers compared a group of 815 patients who underwent laparoscopic IHR with IPOM to a control group of 1630 patients with similar surgical histories without IHR, tracking bowel obstruction incidents over five years.
  • - Findings indicate that the IPOM group had a significantly higher rate of bowel obstruction (7.36%) compared to the control group (4.42%), suggesting that laparoscopic IPOM increases the risk of bowel obstruction post-surgery.
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  • Acute appendicitis is a common emergency surgery, and this study examines its potential link to an increased risk of developing colorectal cancer afterwards in France.
  • Researchers analyzed data from nearly 230,349 patients with acute appendicitis between 2010 and 2015 and compared them to a control group of 460,698 patients with trauma to ensure accuracy.
  • The findings revealed that patients treated for appendicitis had a significantly higher risk of being diagnosed with colon cancer, particularly in the first year post-appendicitis, with a notable increase in risk for those under 40 and for right-sided colon cancer.
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Objective: The aim of this study was to compare the likelihood of bowel obstruction according to the placement of the mesh (either intraperitoneal or extraperitoneal) in ventral hernia repairs.

Materials And Methods: Patients were divided into two groups, an intraperitoneal (IP) group (mesh placed by laparoscopy or with an open approach) and an extraperitoneal (EP) group, all operated on in the Digestive Surgery Department at the Dijon University Hospital. The primary outcome was the occurrence of an episode of bowel obstruction requiring hospitalization and confirmed by abdominal CT scan.

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Purpose: Incisional hernias are common after laparotomies. The aims of this study were to assess the rate of incisional hernia repair after abdominal surgery, recurrence rate, hospital costs, and risk factors, in France.

Methods: This national, retrospective, longitudinal, observational study was based on the exhaustive hospital discharge database (PMSI).

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  • - 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.
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Aim: 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.

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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.

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Background: Standard synthetic and biologic meshes, often used in hernia repair, have commonly been used and each have their strengths but associated drawbacks. Long-term biosynthetic absorbable (LTBA) mesh has been developed to combine the strengths of synthetic and biologic meshes without the associated weaknesses. As a newer type of mesh, the supporting evidence base is still growing, and their optimum use has yet to be defined.

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Introduction: Incisional hernia (IH) is the most frequent mid-term and long-term complication after midline laparotomy. The current standard treatment includes repair using a mesh. In a contaminated field, the use of a non-absorbable mesh increases the risk of surgical site infection and the costs.

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Background: The modulation of perioperative inflammation seems crucial to improve postoperative morbidity and cancer-related outcomes in patients undergoing oncological surgery. Data from the literature suggest that perioperative corticosteroids decrease inflammatory markers and might be associated with fewer complications in esophageal, liver, pancreatic and colorectal surgery. Their benefit on cancer-related outcomes has not been assessed.

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  • The study focuses on the management of ano-rectovaginal fistulas (ARVF) resulting from obstetrical anal sphincter injury (OASIS), aiming to identify factors influencing surgical success.
  • A total of 60 patients were reviewed, revealing a 91.7% overall success rate in managing ARVF, though only 37.2% of specific surgical procedures were successful.
  • The research indicates that while a diverting stoma isn't necessary for improved outcomes, the Martius flap and Musset procedures yield better results than the less invasive endorectal advancement flap (ERAF) in cases involving sphincter injuries.
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Purpose: To analyze the incisional hernia recurrence rate at a long-term follow-up using a biosynthetic long-term absorbable mesh in patients with a higher risk of surgical infection in a contaminated surgical field.

Methods: This was a retrospective multicentric study. All patients undergoing incisional hernia repair between 2016 and 2018 at 6 participating university centers were included.

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Strong evidence suggests that differences in the molecular composition of lipids in exosomes depend on the cell type and has an influence on cancer initiation and progression. Here, we analyzed by liquid chromatography-mass spectrometry (LC-MS) the lipidomic signature of exosomes derived from the human cell lines normal colon mucosa (NCM460D), and colorectal cancer (CRC) nonmetastatic (HCT116) and metastatic (SW620), and exosomes isolated from the plasma of nonmetastatic and metastatic CRC patients and healthy donors. Analysis of this exhaustive lipid study highlighted changes in some molecular species that were found in the cell lines and confirmed in the patients.

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Purpose: Abdominal wall injuries (AWI) is a clinical and radiological diagnosis of fasciomuscular and at times cutaneous defects after abdominal trauma. Their severity encompasses a spectrum of parietal defects, with the most severe being a burst abdomen with eviscerated organs. With the wide use of CT scans in trauma settings, their incidence is being more recognized.

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