Impact of neoadjuvant chemoradiotherapy on postoperative outcomes after esophageal cancer resection: results of a European multicenter study.

Objectives: To assess the impact of neoadjuvant chemoradiotherapy (NCRT) on anastomotic leakage (AL) and other postoperative outcomes after esophageal cancer (EC) resection.

Background: Conflicting data have emerged from randomized studies regarding the impact of NCRT on AL.

Methods: Among 2944 consecutive patients operated on for EC between 2000 and 2010 in 30 European centers, patients treated by NCRT after surgery (n=593) were compared with those treated by primary surgery (n=1487).

Open versus laparoscopically-assisted oesophagectomy for cancer: a multicentre randomised controlled phase III trial - the MIRO trial.

Background: Open transthoracic oesophagectomy is the standard treatment for infracarinal resectable oesophageal carcinomas, although it is associated with high mortality and morbidity rates of 2 to 10% and 30 to 50%, respectively, for both the abdominal and thoracic approaches. The worldwide popularity of laparoscopic techniques is based on promising results, including lower postoperative morbidity rates, which are related to the reduced postoperative trauma. We hypothesise that the laparoscopic abdominal approach (laparoscopic gastric mobilisation) in oesophageal cancer surgery will decrease the major postoperative complication rate due to the reduced surgical trauma.

[Surgery after chemotherapy: gastric cancer].

Perioperative chemotherapy for gastric cancer is validated by two phase III studies. The impact of the preoperative neoadjuvant sequence is probably major in the benefit of this treatment. This chemotherapy increases the R0 resection without increasing either morbidity or mortality.

Conservative vs restrictive individualized goal-directed fluid replacement strategy in major abdominal surgery: A prospective randomized trial.

Objectives: To compare the influence of 2 volumes of fluid, integrated with goal-directed fluid therapy, on hypovolemia (a key trigger of tissue hypoperfusion) and central venous oxygen saturation (Scvo₂) and to assess their relationships with postoperative morbidity.

Design, Setting, And Patients: A prospective, randomized trial of 70 consecutive patients undergoing major abdominal surgery.

Interventions: Patients were randomly assigned to 6 mL/kg/h of crystalloid (a restrictive fluid strategy) or 12 mL/kg/h of crystalloid (a more conservative fluid strategy).

Massive hepatic necrosis with gastric, splenic, and pancreatic infarctions after ethanol ablation for hepatocellular carcinoma.

Hepatic necrosis after ethanol ablation for hepatocellular carcinoma (HCC), although rare, is well known and described, particularly in patients with chronic liver disease. The present report describes a rare case of massive hepatic necrosis with partial gastric, splenic, and pancreatic infarctions after local treatment of liver HCC with ethanol ablation and discusses the reasons for this complication. With the increasing use of percutaneous techniques to treat liver tumors, it is imperative for the interventional radiologist to be aware of the potential vascular complications of these techniques.

Peng's binding pancreaticojejunostomy after pancreaticoduodenectomy: a French prospective study.

Background: Pancreatic fistula (PF) is the single most important complication after pancreaticoduodenectomy. Recently, a 0% rate of PF was reported using a binding pancreaticojejunostomy with intussusception of the pancreatic stump. The aim of this study was to assess the safety of this new binding pancreaticojejunostomy in condition most susceptible to PF, i.