Publications by authors named "Trousse D"
Objectives: To evaluate the impact of a quality improvement initiative on intraoperative lymph node (LN) dissection adequacy.
Methods: A single-centre cohort of 781 naïve patients who underwent resection of non-small cell lung cancer with pathological LN involvement and survived beyond 90 days was reviewed. LN dissection metrics were compared before and after the implementation of a quality improvement initiative.
Article Synopsis
- A multicenter study investigated the frequency of Patient Safety Incidents (PSI) during lung surgeries in France and their effects on postoperative outcomes within 90 days.
- Out of 1919 surgeries screened, 953 were included, revealing a 32% PSI incidence, which was mostly attributed to human factors, organizational issues, and technology problems.
- The severity of PSI significantly increased the risk of complications, readmission, and mortality at 90 days, highlighting the importance of addressing human factors in surgical settings.
Article Synopsis
- In minimally invasive thoracic surgery, paravertebral block (PVB) is a common technique for postoperative pain relief but relies heavily on the surgeon's skill and available resources, prompting a search for better methods when pain control fails.
- The study aimed to compare the effectiveness of PVB performed by surgeons during video-assisted thoracoscopic surgery (PVB-VATS) against the traditional PVB technique done by anesthesiologists (PVB-US) to see if they produce similar pain management outcomes.
- Conducted as a randomized clinical trial with 196 patients, the primary focus was on the differences in opioid consumption post-surgery, along with secondary measures such as pain scores
Is the Epithor conversion score reliable in robotic-assisted surgery anatomical lung resection?
Eur J Cardiothorac Surg
September 2023
Objectives: Despite an improvement in surgical abilities, the need for an intraoperative switch from a minimally invasive procedure towards an open surgery (conversion) still remains. To anticipate this risk, the Epithor conversion score (ECS) has been described for video-assisted thoracoscopic surgery (VATS). Our objective was to determine if this score, developed for VATS, is applicable in robotic-assisted thoracoscopic surgery (RATS).
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- This study compared postoperative outcomes for lung cancer surgeries performed via open thoracotomy (OT), video-assisted (VATS), and robotic-assisted (RA) methods, using a large patient dataset from 2010 to 2020.
- VATS showed lower in-hospital mortality and major complications compared to OT, while both VATS and RA reduced occurrences of pneumonia and atelectasis compared to OT.
- Overall, both VATS and RA led to shorter hospital stays and improved outcomes compared to OT, with VATS showing the best results in reducing mortality.
Article Synopsis
- The study aimed to analyze the epidemiology of patients who had lung surgery for suspected localized primary lung cancers without prior tissue confirmation between 2010 and 2020.
- Out of 1,392 patients, 15.3% were diagnosed with benign conditions, and 2.1% underwent unnecessary large resections that didn't benefit their treatment.
- Factors linked to malignancy included older age, smoking history, cardiovascular disease, previous cancer history, and clinical N involvement, highlighting the differences in preoperative profiles between benign and malignant cases.
Predictors of Postoperative Urinary Retention Following Pulmonary Resection.
Semin Thorac Cardiovasc Surg
March 2022
Article Synopsis
- The study aimed to identify predictors of postoperative urinary retention (POUR) in patients who underwent pulmonary resection between 2004 and 2020, using a retrospective analysis of medical charts.
- A total of 6004 patients were reviewed, with POUR occurring in 301 cases (5%), and factors such as male gender, age, benign prostatic hyperplasia, and COPD identified as significant predictors, while video-assisted surgery showed a protective effect.
- The research suggests that further prospective studies are needed to explore the potential benefits of using α-blockers perioperatively to prevent POUR.
Article Synopsis
- The study examined the surgery benefits versus risks for octogenarians with early-stage non-small cell lung cancer (NSCLC) from 2005-2020, focusing on patient selection and outcomes.
- Out of 100 patients, major complications occurred in 15, leading to 7 deaths, while factors like co-existing health issues significantly influenced recovery and survival rates.
- Key findings included improved overall survival rates due to a specialized geriatric assessment pathway and the advantages of minimally invasive surgical techniques, suggesting effective treatment parallels with younger patients.
Article Synopsis
- The study examined the outcomes of 31 patients with small-cell lung cancer (SCLC) who underwent surgery with the intention to cure between 2005 and 2018.
- A majority of the patients had unknown or misleading preoperative diagnoses, and lung resections predominantly involved lobectomies, with a high rate of successful tumor removal (R0 resection) achieved in 90.3% of cases.
- Despite challenges in diagnosis and treatment adherence, about one-third of patients experienced long-term disease-free survival, indicating potential benefits of surgical intervention even in advanced cases.
Article Synopsis
- Health care-associated infections (HAIs) after lung cancer surgery can lead to serious complications and increased hospital costs, prompting this study to assess the effectiveness of screening for Staphylococcus aureus nasal carriers before surgery.
- A retrospective study compared two patient groups: a control group without screening and an experimental group that underwent nasal screening and decolonization treatment; outcomes measured included rates of postoperative HAIs and mechanical ventilation needs.
- Results showed that the experimental group had significantly fewer HAIs (8.3% vs. 17.6%) and reduced mechanical ventilation requirements (3.7% vs. 11.1%), suggesting that preoperative screening could improve postoperative outcomes for lung cancer surgery patients.
Article Synopsis
- Robotic assistance in early-stage non-small cell lung cancer surgery was compared to video-assisted surgery in terms of postoperative morphine consumption and patient health metrics.
- The study involved 194 patients, with findings showing that those who underwent robotic surgery consumed more morphine (33 mg) compared to the video-assisted group (23 mg), indicating a statistically significant difference.
- Additionally, robotic surgery was linked to worse haemodynamic and respiratory function than video surgery, raising concerns about its impact on patient recovery.
Article Synopsis
- The paper reviews the surgical techniques involved in lung transplantation, including anesthesiological preparation, lung graft explantation, implantation, and donor lung preparation.
- It addresses the significant improvements in surgical and anesthetic practices since the first successful lung transplants in the 1980s.
- The article will also highlight common surgical complications post-transplant and discuss their management, with visual aids like photos and videos to enhance understanding.
Article Synopsis
- - The study aimed to determine if using chlorhexidine gluconate (CHG) for oropharyngeal and nasopharyngeal decontamination could reduce respiratory complications following lung cancer surgery, similar to its effects observed in cardiac surgeries.
- - In a trial with 474 lung cancer patients, 450 were analyzed after some withdrew consent, showing no significant difference in the need for postoperative mechanical ventilation or respiratory infections between those treated with CHG and those with a placebo.
- - Although the CHG group had fewer cases of certain infections, like bacteremia and surgical-site infection, the trial found no substantial differences in overall health outcomes or hospital stays between the groups after surgery.
Article Synopsis
- A study aimed to evaluate a fast method for determining if lung tissue is cancerous or not using a device called the Microflex LTTM MALDI-TOF analyzer.
- The method involved preparing fresh samples quickly and analyzing them, which resulted in a high accuracy rate (92.1% sensitivity and 97.1% specificity) for distinguishing between cancerous and non-cancerous tissues.
- The findings suggest that this rapid analysis technique could be beneficial for real-time evaluations in surgery, especially for cases with uncertain preoperative diagnoses, and should be considered alongside traditional frozen-biopsy methods.
Article Synopsis
- This study investigates the use of an embedded device that measures endogenous fluorescence to differentiate between malignant lung lesions and healthy lung tissue in patients suspected of having non-small cell lung cancer (NSCLC).
- The study involved 96 patients and found that the fluorescence intensity was significantly higher in NSCLC lesions compared to surrounding healthy tissue and non-tumoral lesions.
- The findings suggest that the embedded device could help improve diagnostic accuracy for lung cancer, as it identified specific fluorescence characteristics (like photobleaching) that were more pronounced in malignant lesions.
Article Synopsis
- The study aims to identify a specific biomarker, N-terminal pro-peptide type III procollagen (NT-PCP-III), that can help detect patients with fibroproliferation after Acute Respiratory Distress Syndrome (ARDS) who may benefit from corticosteroid treatments.
- Researchers included patients with moderate to severe non-resolving ARDS and measured NT-PCP-III levels during lung biopsies, determining a threshold of 9 µg/L for effective diagnosis of fibroproliferation.
- Results showed that patients with NT-PCP-III levels above this threshold had a significantly higher mortality rate, indicating that measuring this biomarker can help identify candidates for potential therapies.
High-emergency waiting list for lung transplantation: early results of a nation-based study.
Eur J Cardiothorac Surg
September 2014
Article Synopsis
- The French organ transplantation authorities established the 'high-emergency waiting list' (HEWL) in 2007 to address the high mortality rate among patients on the regular waiting list for lung transplantation (LTx).
- A study analyzing data from 101 HEWL patients showed that 95 received transplants, with a median wait time of 4 days, while 6 patients died before receiving LTx; the patients commonly suffered from conditions like cystic fibrosis and pulmonary fibrosis.
- Despite the HEWL improving access to LTx for patients in respiratory distress, it also resulted in a higher risk of post-transplant mortality, with survival rates at one and three years being 67.5% and 59%, respectively.
Intravascular large B-cell lymphoma (IVLBCL) remains a diagnostic challenge, because of non-specific findings on clinical, laboratory, and imaging studies. We present a case in which 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography was particularly useful to suspect the diagnosis, to detect unexpected locations, to guide contributive biopsy, and to assess the response to treatment. In case of initial negative results, FDG-PET should be repeated in the course of clinical evolution.
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- The study evaluates the impact of lymph node (LN) involvement type—intracapsular (ICLNI) vs. extracapsular (ECLNI)—on disease-free survival (DFS) in patients with oesophageal cancer, highlighting that the AJCC's new classification might overlook the significance of ECLNI.
- In a review of 416 patients who had surgery, researchers found that those with ECLNI had poorer median DFS compared to those with ICLNI, suggesting that ECLNI significantly worsens survival outcomes.
- The findings indicate that ECLNI should be considered in the TNM staging system for oesophageal cancer due to its strong correlation with negative survival outcomes, emphasizing the need for updated classification criteria.
Aim: The standard treatment of locally-advanced esophageal adenocarcinoma consists of neoadjuvant radiochemotherapy followed by surgical resection. Very little data are available concerning the feasibility of this strategy in patients older than 70 years of age.
Patients And Methods: Between 1996 and 2008, 118 patients underwent transthoracic esophagectomy with lymphadenectomy for adenocarcinoma of the esophagus and gastric cardia (Siewert I and II).
Article Synopsis
- The study investigates the impact of postoperative complications, specifically respiratory failures, on disease-free survival (DFS) after oesophagectomy for cancer, highlighting their prevalence and seriousness.
- Among the 341 patients analyzed, respiratory complications were seen in 31%, and despite this, DFS rates did not significantly differ between patients with no complications and those with varying grades of complications.
- Logistic regression identified that factors such as c-N stage and lymph node involvement were more influential on DFS than the occurrence of respiratory complications or their severity.
Non-tumoral vascular disorders of the lung are multiple, even if cases diagnosed in the adulthood are rare. They include congenital or acquired conditions, which related symptoms, if present, are non specific. This explains why their diagnosis is challenging and usually delayed.
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