Publications by authors named "Scatton O"
Article Synopsis
- The study investigated the link between portal hypertension (PHT) complications and the use of non-selective beta blockers (NSBBs) in patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE).
- Of the 109 patients analyzed, 32% either did not receive NSBBs despite needing them, increasing the risk of complications like ascites and hepatic encephalopathy, especially in those with esophageal varices (EV).
- The findings highlight that inadequate NSBB treatment significantly correlates with higher rates of PHT-related complications and hindered access to further HCC treatments, suggesting a need for better screening and prophylactic measures in patients undergoing TACE.
Background: Despite the increasing efficacy of chemotherapy, permanently unresectable colorectal liver metastases are associated with poor long-term survival. We aimed to assess whether liver transplantation plus chemotherapy could improve overall survival.
Methods: TransMet was a multicentre, open-label, prospective, randomised controlled trial done in 20 tertiary centres in Europe.
Article Synopsis
- A study was conducted to compare robotic minor liver resections (RMLR) with laparoscopic minor liver resections (LMLR) in patients undergoing surgery on the anterolateral liver segments.
- The analysis included over 10,000 patients and employed propensity score matching to balance the groups for accuracy in comparisons.
- Results indicated RMLR had benefits like less blood loss, lower major morbidity, and shorter hospital stays than LMLR, although the difference in 30-day readmission rates suggested RMLR may have some drawbacks.
Background: Laparoscopic liver resection (LLR) has been associated with improved patient recovery as well as reduced postoperative adhesions compared to open LR (OLR) and could therefore facilitate redo liver surgery. LLR prior to liver transplantation (LT) is increasingly performed, LT being saved for HCC recurrence. LT is still performed by open surgery due to vascular reconstructions and underlying liver chronic disease.
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- The study aimed to create global benchmark outcome indicators for laparoscopic right posterior sectionectomies (L-RPS/H67) to improve surgical standards.
- It analyzed data from 854 patients across 57 centers globally, establishing key performance benchmarks for low-risk cases based on specific outcome indicators.
- The findings set standard benchmarks for metrics like operation time and complication rates, serving as a reference for surgical auditing and improvement.
Article Synopsis
- The study aimed to establish a common language regarding extreme liver surgery to facilitate better comparison of surgical outcomes across different centers.
- A Delphi methodology was used, gathering opinions from 38 expert surgeons, who largely agreed on key definitions related to total vascular occlusion and surgical approaches, achieving consensus on various topics.
- Ultimately, 75% agreed on a definition for extreme liver surgery, highlighting the importance of a unified approach in managing patients with complex liver diseases.
Objective: To analyse outcomes after adult right ex-situ split graft liver transplantations (RSLT) and compare with available outcome benchmarks from whole liver transplantation (WLT).
Summary Background Data: Ex-situ SLT may be a valuable strategy to tackle the increasing graft shortage. Recently established outcome benchmarks in WLT offer a novel reference to perform a comprehensive analysis of results after ex-situ RSLT.
Article Synopsis
- The study investigates the risk factors and outcomes related to open conversion during minimally invasive liver resections (MILR), especially in minor hepatectomies, highlighting its association with inferior results.
- Analysis was conducted on data from over 10,500 patients who underwent laparoscopic or robotic liver resections from 2004 to 2020, identifying key independent predictors for open conversion.
- Results show that patients who required open conversion experienced longer recovery times, increased blood loss, higher complications, and elevated 90-day mortality rates compared to those who had successful minimally invasive surgeries.
Background: Appropriate risk stratification for the difficulty of liver transplantation (LT) is essential to guide the selection and acceptance of grafts and avoid morbidity and mortality.
Methods: Based on 987 LTs collected from 5 centers, perioperative outcomes were analyzed across the 3 difficulty levels. Each LT was retrospectively scored from 0 to 10.
Background: Despite the increasing efficacy of chemotherapy (C), the 5-year survival rate for patients with unresectable colorectal liver metastases (CLM) remains around 10%. Liver transplantation (LT) might offer a curative approach for patients with liver-only disease, yet its superior efficacy compared to C alone remains to be demonstrated.
Methods: The TransMet randomised multicentre clinical trial (NCT02597348) compares the curative potential of C followed by LT versus C alone in patients with unresectable CLM despite stable or responding disease on C.
Article Synopsis
- Minimally invasive liver surgery has become more common over the last 30 years, especially for treating colorectal liver metastases, but the effects of neoadjuvant chemotherapy on surgical outcomes are not well understood.
- A study analyzed a large database of nearly 5,000 patients who underwent minimally invasive liver surgeries to compare outcomes between those who received neoadjuvant chemotherapy and those who did not.
- The results showed that neoadjuvant chemotherapy did not significantly affect the short-term surgical outcomes in patients undergoing these liver procedures.
Context: Clinical adoption of ex situ liver perfusion is growing. While hypothermic perfusion protects against ischemia-reperfusion injury in marginal grafts, normothermic perfusion enables organ viability assessment and therefore selection of borderline grafts. The combination of hypothermic and normothermic perfusion, known as "cold-to-warm," may be the optimal sequence for organ preservation, but is difficult to achieve with most commercial perfusion systems.
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- Optimal management of colorectal liver metastasis (CRLM) involves chemotherapy and surgical resection, with the tumor regression grade (TRG) score helping assess chemotherapy response.
- In a study of 327 patients, 41% showed a good response to treatment (TRG 1-2-3), while 36.7% had a poor response (TRG 4-5) and 22.3% had heterogeneous responses.
- The good response group had significantly better overall survival compared to the heterogeneous and poor response groups, indicating a need for tailored treatment approaches based on TRG scores.
Background Both Liver Imaging Reporting and Data System (LI-RADS) and histopathologic features provide prognostic information in patients with hepatocellular carcinoma (HCC), but whether LI-RADS is independently associated with survival is uncertain. Purpose To assess the association of LI-RADS categories and features with survival outcomes in patients with solitary resected HCC. Materials and Methods This retrospective study included patients with solitary resected HCC from three institutions examined with preoperative contrast-enhanced CT and/or MRI between January 2008 and December 2019.
View Article and Find Full Text PDFBackground: There are no data to evaluate the difference in populations and impact of centers with liver transplant programs in performing laparoscopic liver resection (LLR).
Methods: This was a multicenter study including patients undergoing LLR for benign and malignant tumors at 27 French centers from 1996 to 2018. The main outcomes were postoperative severe morbidity and mortality.
Article Synopsis
- Primary liver cancer can originate from two cell types, leading to different types of tumors: hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICCA), with combined tumors (cHCC-CCA) displaying mixed characteristics.
- Researchers utilized deep learning to categorize tumors in a study involving 405 cHCC-CCA patients, successfully distinguishing between HCC and ICCA types.
- This deep learning method showed potential for enhancing treatment strategies and improving patient outcomes for those with complex liver cancers.
Background: Postoperative pulmonary complications after major abdominal surgery are frequent and carry high morbidity and mortality. Early identification of patients at risk of pulmonary complications by lung ultrasound may allow the implementation of preemptive strategies. The authors hypothesized that lung ultrasound score would be associated with pulmonary postoperative complications.
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- The study investigates how portal hypertension (PHT) affects the development of ascites and the effectiveness of radiotherapy in cirrhotic patients with hepatocellular carcinoma (HCC).
- A total of 60 cirrhotic patients who received radiotherapy for HCC from 2012 to 2022 were analyzed, revealing that a high PHT score significantly correlates with an increased likelihood of developing ascites.
- The findings suggest that patients with a PHT score of 5 or higher should be monitored closely during treatment, as ascites can hinder further HCC management options.
Article Synopsis
- This study assessed how liver cirrhosis (LC) influences the challenges of minimally invasive liver resection (MILR), specifically for minor surgeries involving primary liver tumors in anterolateral segments.
- Conducted from 2004 to 2021 across 60 centers, the research involved 3,675 patients, with varying degrees of cirrhosis classified as Child A and Child B.
- Results indicated that patients with Child A cirrhosis faced higher risks of complications, such as increased blood loss and rates of open conversion, while those with Child B cirrhosis had longer hospital stays and more significant morbidity; overall, the severity of LC complicates the surgical process, highlighting the need for better difficulty
Article Synopsis
- Combined hepatocholangiocarcinoma is a rare and aggressive type of cancer combining features of both hepatocellular carcinoma and intrahepatic cholangiocarcinoma, leading to a poor prognosis.
- A multicenter international study analyzed the surgery outcomes for patients with combined hepatocholangiocarcinoma and compared them with those having either hepatocellular carcinoma or intrahepatic cholangiocarcinoma from 2000 to 2021.
- The results showed significant differences in overall survival rates at 1, 3, and 5 years among the groups, with combined hepatocholangiocarcinoma having the lowest survival rates, while disease-free survival rates were similar across groups, suggesting that combined hepatochol
Article Synopsis
- Minimally invasive liver resections (MILR) can reduce blood loss and recovery time compared to traditional methods, but the impact of cirrhosis on these procedures is not fully understood.
- A study reviewed data from 2534 patients who underwent minimally invasive major liver surgeries worldwide, focusing on outcomes related to different levels of cirrhosis.
- Results showed that advanced cirrhosis leads to higher blood transfusion rates, more postoperative complications, and longer hospital stays, suggesting that cirrhosis severity should be considered in future assessments of surgical difficulty in MILR.*
Article Synopsis
- - Legionnaires' disease (LD) is a serious infection particularly affecting solid organ transplant recipients, though details about its impact on this group have not been well documented.
- - A 10-year study in France identified 101 patients with LD among transplant recipients, finding that severe cases were linked to factors like negative urinary antigen tests and respiratory symptoms.
- - Key imaging results showed significant lung involvement, and the study reported a 30-day mortality rate of 8% and a 12-month mortality rate of 20% among these patients.
Background: Rescue liver transplantation (LT) is the only life-saving option for posthepatectomy liver failure (PHLF) whenever it is deemed as irreversible and likely to be fatal. The goals were to perform a qualitative systematic review of rescue LT for PHLF and a survey among various international LT experts.
Methods: A literature search was performed from 2000 to 2022 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Population, Intervention, Comparison, Outcome framework, and to this, the authors' experience was added.
Article Synopsis
- The study investigates how cirrhosis and portal hypertension (PHT) affect the complexity and outcomes of minimally invasive liver surgery in specific liver segments.
- It examines a large patient group, revealing that those with cirrhosis experienced more complications and required more blood transfusions during surgery.
- The findings suggest that the presence of cirrhosis and PHT should be considered when evaluating the difficulties and risks associated with minimally invasive liver resections.