Publications by authors named "Xb D'Journo"

Objectives: While minimally invasive surgery (MIS) is the preferred approach in patients with early-stage lung cancer, intraoperative adverse events (IOAE) may still occur. The objective of this study was to assess the impact of a dedicated preoperative planning program on adverse event occurrence.

Methods: A single-centre cross-sectional comparative study was conducted, including all patients with proven/suspected lung cancer undergoing curative MIS, prior (September 2021-October 2022) and after (November 2022-January 2024) the implementation of a preoperative planning program.

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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.

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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.
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Context: Gastric and oesophageal cancers are common. They are also expected to increase in incidence in the next few years and are characterized by poor prognosis. Surprisingly, whereas the incidence of severe anxiety and depression is high in patients with gastric and oesophageal cancers, the influence of symptoms of depression and anxiety on postoperative complications has barely been explored.

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Background: Radiotherapy combined with fluorouracil (5FU) and cisplatin for locally advanced esophageal cancer is associated with a 20-25% pathologic complete response (pCR) rate. Cetuximab increases the efficacy of radiotherapy in patients with head and neck carcinomas. The aim of this phase I/II trial was to determine the optimal doses and the pCR rate with chemoradiotherapy (C-RT) plus cetuximab.

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Objective: To evaluate prognostic differences between minimally invasive esophagectomy (MIE) and open esophagectomy (OE) in patients with surgery after a prolonged interval (>12 wk) following chemoradiotherapy (CRT).

Background: Previously, we established that a prolonged interval after CRT before esophagectomy was associated with poorer long-term survival.

Methods: This was an international multicenter cohort study involving 17 tertiary centers, including patients who received CRT followed by surgery between 2010 and 2020.

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Background: Esophagectomy is associated with significant mortality. A better understanding of the causes leading to death may help to reduce mortality. A root cause analysis of mortality after esophagectomy was performed.

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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
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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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Objective: To determine the impact of delayed surgical intervention following chemoradiotherapy (CRT) on survival from esophageal cancer.

Background: CRT is a core component of multimodality treatment for locally advanced esophageal cancer. The timing of surgery following CRT may influence the probability of performing an oncological resection and the associated operative morbidity.

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Article Synopsis
  • A study evaluated the 1-year mortality risk for patients undergoing lung transplants, focusing on different stages of the transplant process from registration to post-operation.
  • The research analyzed a total of 478 patients from 2014 to 2019 across three French academic centers, using logistic regression models to assign mortality risk into low, intermediate, and high categories.
  • Results showed that risk prediction models significantly aid in identifying high-risk patients, potentially improving outcomes by allowing caregivers to intervene based on individual risk levels.
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Purpose: While perioperative chemotherapy provides a survival benefit over surgery alone in gastric and gastroesophageal junction (G/GEJ) adenocarcinomas, the results need to be improved. This study aimed to evaluate the efficacy and safety of perioperative cetuximab combined with 5-fluorouracil and cisplatin.

Patients And Methods: Patients received six cycles of cetuximab, cisplatin, and simplified LV5FU2 before and after surgery.

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Objectives: Our goal was to evaluate the association between the distance of the tumour to the visceral pleura and the rate of local recurrence in patients surgically treated for stage pI lung cancer.

Methods: We conducted a single-centre retrospective review of 578 consecutive patients with clinical stage IA lung cancer who underwent a lobectomy or segmentectomy from January 2010 to December 2019. We excluded 107 patients with positive margins, previous lung cancer, neoadjuvant treatment and pathological stage II or higher status or for whom preoperative computed tomography (CT) scans were not available at the time of the study.

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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.
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Uncontrolled inflammation of the airways in chronic obstructive lung diseases leads to exacerbation, accelerated lung dysfunction and respiratory insufficiency. Among these diseases, asthma affects 358 million people worldwide. Human bronchial epithelium cells (HBEC) express both anti-inflammatory and activating molecules, and their deregulated expression contribute to immune cell recruitment and activation, especially platelets (PLT) particularly involved in lung tissue inflammation in asthma context.

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Background: There is currently a lack of evidence-based guidelines regarding surveillance for recurrence after esophageal and gastric (OG) cancer surgical resection, and which symptoms should prompt endoscopic or radiological investigations for recurrence. The aim of this study was to develop a core symptom set using a modified Delphi consensus process that should guide clinicians to carry out investigations to look for suspected recurrent OG cancer in previously asymptomatic patients.

Methods: A web-based survey of 42 questions was sent to surgeons performing OG cancer resections at high volume centers.

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Background: The purpose of this randomized controlled trial was to determine if enhanced recovery after surgery (ERAS) would improve outcomes for three-stage minimally invasive esophagectomy (MIE).

Methods: Patients with esophageal cancer undergoing MIE between March 2016 and August 2018 were consecutively enrolled, and were randomly divided into 2 groups: ERAS+group that received a guideline-based ERAS protocol, and ERAS- group that received standard care. The primary endpoint was morbidity after MIE.

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Background: Physiotherapy is a major cornerstone of enhanced rehabilitation after surgery (ERAS) and reduces the development of atelectasis after thoracic surgery. By initiating physiotherapy in the post-anaesthesia care unit (PACU), the aim was to evaluate whether the ultra-early initiation of rehabilitation (in the first hour following tracheal extubation) would improve the outcomes of patients undergoing elective thoracic surgery.

Methods: A case-control study with a before-and-after design was conducted.

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Objectives: The reporting of patient safety incidents (PSIs) occurring in minimally invasive thoracic surgery (MITS) is crucial. However, previous reports focused mainly on catastrophic events whereas minor events are often underreported.

Methods: All voluntary reports of MITS-related PSIs were retrospectively extracted from the French REX database for 'in-depth analysis'.

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Objectives: This study reports the results of an international expert consensus process evaluating the assessment of intraoperative air leaks (IAL) and treatment of postoperative prolonged air leaks (PAL) utilizing a Delphi process, with the aim of helping standardization and improving practice.

Methods: A panel of 45 questions was developed and submitted to an international working group of experts in minimally invasive lung cancer surgery. Modified Delphi methodology was used to review responses, including 3 rounds of voting.

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Background: The aim of this study was to assess the impact of baseline health related quality of life (HRQOL) on the occurrence of postoperative complications and death in patients with resectable esophageal cancer.

Methods: Existing data from a prospective, multicenter, open label, randomized, controlled phase III trial comparing hybrid versus open esophagectomy in patients with resectable esophageal cancer from 2009 to 2012 in France were used. A Cox regression model was used to assess the prognostic value of the baseline HRQOL score on the occurrence of major complications (MC), and major pulmonary complications (MPC) at 30 days post-surgery, as well as on 1-year postoperative overall survival (OS).

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Background: Few studies have exclusively investigated the value of pathological complete response (pCR), in esophageal squamous cell carcinoma (ESCC) patients, although it is a clinically significant parameter to evaluate the impact of neoadjuvant chemoradiotherapy (nCRT) on treatment outcome after surgery. The aim of our study was to explore the relationship between pCR after nCRT and survival among patients with local ESCC.

Methods: All patients receiving nCRT followed by surgery in NEOCRTEC5010-trial (NCT01216527) were included.

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Importance: Ninety-day mortality rates after esophagectomy are an indicator of the quality of surgical oncologic management. Accurate risk prediction based on large data sets may aid patients and surgeons in making informed decisions.

Objective: To develop and validate a risk prediction model of death within 90 days after esophagectomy for cancer using the International Esodata Study Group (IESG) database, the largest existing prospective, multicenter cohort reporting standardized postoperative outcomes.

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