49 results match your criteria: "Jean Mermoz Private Hospital[Affiliation]"

Background: This article summarizes the French intergroup guidelines regarding rectal adenocarcinoma (RA) management published in September 2023, available on the French Society of Gastroenterology website.

Methods: This work was supervised by French medical and surgical societies involved in RA management. Recommendations were rated from A to C according to the literature until September 2023.

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Diagnostic work-up of bile duct strictures: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.

Endoscopy

December 2024

Hepatogastroenterology Unit, 2nd Department of Internal Medicine, Propaedeutic, Medical School, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece.

1: ESGE recommends the combination of endoscopic ultrasound-guided tissue acquisition (EUS-TA) and endoscopic retrograde cholangiopancreatography (ERCP)-based tissue acquisition as the preferred diagnostic approach for tissue acquisition in patients with jaundice and distal extrahepatic biliary stricture in the absence of a pancreatic mass. 2: ESGE suggests that brushing cytology should be completed along with fluoroscopy-guided biopsies, wherever technically feasible, in patients with perihilar biliary strictures. 3: ESGE suggests EUS-TA for perihilar strictures when ERCP-based modalities yield insufficient results, provided that curative resection is not feasible and/or when cross-sectional imaging has shown accessible extraluminal disease.

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Clinico-biological factors predicting the benefit of the LV5FU2 maintenance strategy as a first-line therapy in patients with metastatic pancreatic cancer.

Oncologist

September 2024

Department of Gastroenterology, University Hospital Pontchaillou, Rennes 1 University, INSERM U1242 "Chemistry Oncogenesis Stress Signalling," Rennes, France.

Article Synopsis
  • The study investigates predictive markers for the benefits of LV5FU2 maintenance therapy after first-line FOLFIRINOX treatment in patients with metastatic pancreatic cancer.
  • It compares two patient groups from the PRODIGE-35 trial: one receiving 12 cycles of FOLFIRINOX, and another receiving 8 cycles followed by LV5FU2 maintenance.
  • Results indicate that certain factors, like age and metastatic sites, affect patient outcomes, suggesting that LV5FU2 maintenance is generally beneficial except for some specific cases.
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Trans people have diverse life experiences which may include gender-affirming care (GAC). GAC positively impacts the quality of life of trans adults. However, they are often met with barriers to care and are particularly vulnerable within the healthcare system.

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A scapular statistical shape model can reliably predict premorbid glenoid morphology in conditions of severe glenoid bone loss.

J Shoulder Elbow Surg

November 2024

Roth | McFarlane Hand and Upper Limb Centre, St Joseph's Health Care, London, Canada; Department of Surgery, Western University, London, Canada. Electronic address:

Background: Knowledge of premorbid glenoid parameters at the time of shoulder arthroplasty, such as inclination, version, joint line position, height, and width, can assist with implant selection, implant positioning, metal augment sizing, and/or bone graft dimensions. The objective of this study was to validate a scapular statistical shape model (SSM) in predicting patient-specific glenoid morphology in scapulae with clinically relevant glenoid erosion patterns.

Methods: Computed tomography scans of 30 healthy scapulae were obtained and used as the control group.

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Atezolizumab plus modified docetaxel, cisplatin, and fluorouracil as first-line treatment for advanced anal cancer (SCARCE C17-02 PRODIGE 60): a randomised, non-comparative, phase 2 study.

Lancet Oncol

April 2024

Clinical Investigation Centre 1431, University Hospital of Besançon, Besançon, France; Department of Oncology, University Hospital of Besançon, Besançon, France; National Institute of Health and Medical Research (INSERM), Unit 1098, University of Bourgogne Franche-Comté, Besançon, France; Oncology Multidisciplinary Group (GERCOR), Paris, France; Fédération Francophone de Cancérologie Digestive, Paris, France.

Article Synopsis
  • The study investigates the combination of the modified docetaxel, cisplatin, and fluorouracil (mDCF) regimen with atezolizumab as a first-line treatment for advanced squamous cell carcinoma of the anus, building on mDCF’s established efficacy.
  • Conducted across 21 centers in France, the phase 2 study randomly assigned participants to receive either the combination therapy or mDCF alone, focusing on 12-month progression-free survival as the primary endpoint.
  • With 97 participants enrolled, the study found a median follow-up of 26.5 months, providing valuable insights into the potential benefits of combining immunotherapy with standard chemotherapy.
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Background: The etiology of humeral posterior subluxation remains unknown, and it has been hypothesized that horizontal muscle imbalance could cause this condition. The objective of this study was to compare the ratio of anterior-to-posterior rotator cuff and deltoid muscle volume as a function of humeral subluxation and glenoid morphology when analyzed as a continuous variable in arthritic shoulders.

Methods: In total, 333 computed tomography scans of shoulders (273 arthritic shoulders and 60 healthy controls) were included in this study and were segmented automatically.

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Article Synopsis
  • The study aimed to investigate the potential link between muscle imbalances and humeral posterior subluxation in arthritic shoulders by comparing the volumes of rotator cuff muscles and deltoids in patients with different glenoid types.
  • A total of 333 CT scans were analyzed to measure muscle volume ratios, but no significant differences or correlations were found between muscle ratios and glenoid morphology/humeral subluxation in the arthritic shoulder group.
  • However, a notable finding was that the AP ratio for type A glenoids was higher compared to type B and C glenoids, highlighting some moderate correlations between these muscle ratios and glenoid positioning across both health statuses.
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Article Synopsis
  • The European Society of Gastrointestinal Endoscopy (ESGE) emphasizes the need for structured training in diagnostic endoscopic ultrasound (EUS), presenting a formal framework to develop and maintain necessary skills.
  • Key prerequisites for trainees include competence in upper gastrointestinal endoscopy and exposure to diagnostic EUS training environments with high procedure volumes and expertise.
  • Trainees must follow a structured syllabus and complete at least 250 supervised EUS procedures across various categories to demonstrate competence before practicing independently.
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What distinguishes endoscopic submucosal dissection (ESD) from endoscopic mucosal resection is the need for three foot pedals to activate the electrosurgical unit, flushing and knife injection. The lack of connection between the various pedals of different shapes and brands leads to numerous pedals displacements and potential mistakes. The aim of this study was to evaluate an Innovative PEdal FIXator (IPEFIX) to reduce pedal mistakes during ESD.

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Despite the increasing rate of detection of incidental pancreatic cystic lesions (PCLs), current standard-of-care methods for their diagnosis and risk stratification remain inadequate. Intraductal papillary mucinous neoplasms (IPMNs) are the most prevalent PCLs. The existing modalities, including endoscopic ultrasound and cyst fluid analysis, only achieve accuracy rates of 65-75% in identifying carcinoma or high-grade dysplasia in IPMNs.

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Impact of surgery after endoscopically resected high-risk T1 colorectal cancer: results of an emulated target trial.

Gastrointest Endosc

March 2024

Department of Gastroenterology, Digestive Oncology and Endoscopy, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Paris Cité University, Paris, France.

Article Synopsis
  • The study aimed to compare long-term outcomes for patients with high-risk T1 colorectal cancer who underwent endoscopic resection, assessing the effectiveness of additional surgery versus surveillance alone.
  • Data was collected from patients treated at 14 centers between 2012 and 2019, with the primary outcome focusing on cancer recurrence or death within 48 months.
  • Results showed no significant difference in the rates of death or cancer recurrence between the two groups, suggesting that additional surgery may not provide benefits for these patients.
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Article Synopsis
  • The study examines the impact of surgically addressing non-R0 resections of rectal neuroendocrine tumors (r-NETs) to prevent disease recurrence.
  • It involved a retrospective analysis of 100 patients who underwent endoscopic procedures to remove tumor scars after initial unsuccessful resections.
  • The findings indicate that using advanced endoscopic techniques achieved near 100% complete resection (R0) of scars, revealing that residual r-NET was present in 43% of cases.
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Objective: Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) has been constantly increasing, particularly in the treatment of pancreatic neuroendocrine neoplasms (pNENs). While emerging data in this field are accumulating, we aimed to assess the pooled efficacy and safety of EUS-RFA for pNENs.

Methods: The PubMed/Medline, Embase, and Cochrane Library databases search was conducted to identify studies reporting EUS-RFA of pNENs with outcomes of interest (efficacy and safety).

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Introduction: This document is a summary of the French intergroup guidelines regarding the management of esophageal cancer (EC) published in July 2022, available on the website of the French Society of Gastroenterology (SNFGE) (www.tncd.org).

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Revision rotator cuff repair: can a Sugaya III tendon considered to be healed or not.

J Shoulder Elbow Surg

February 2024

Orthopedic Department, CHU Toulouse - Hopital Purpan, Toulouse, France.

Background: Sugaya et al described a classification system to assess postoperative rotator cuff tendon healing. Although Sugaya I and II tendons can be considered as healed and Sugaya type IV and V can be considered as retorn, the exact status of Sugaya III tendons remains unclear. The objective of this study was to evaluate the impact of Sugaya III tendons on postoperative functional scores in a population of patients undergoing revision rotator cuff repair.

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Hypothesis: Rotator cuff repair remains associated with high retear rates, which range from 13% to 79%. The objective of this study was to evaluate the long-term clinical and structural results after revision rotator cuff repair at a minimum 10-year follow-up.

Methods: We retrospectively studied the records of all patients who underwent revision rotator cuff repair in 3 different institutions between July 2001 and December 2007 with a minimum 10-year follow-up.

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Article Synopsis
  • The FACET study is a clinical trial aimed at assessing an electronic device suite's effectiveness in detecting hand-foot skin reactions in patients with metastatic colorectal cancer who are on regorafenib treatment.
  • The study involves 38 patients across six centers in France, monitored over two treatment cycles (about 56 days) with tools like connected insoles and a mobile app to gather patient feedback and educational resources.
  • The trial seeks to enhance the usability of the device suite before a larger study and also discusses potential challenges in using digital tools in everyday medical practice.
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Article Synopsis
  • - The study investigated the safety and effectiveness of endoscopic resection for early esophageal tumors in patients with liver cirrhosis or portal hypertension, given their shared risk factors like alcohol use and obesity.
  • - It analyzed data from 112 patients who underwent this procedure between 2005 and 2021, finding that a majority had liver cirrhosis, and various methods were employed to reduce bleeding risks during the surgery.
  • - Results showed high rates of complete and curative resection but also identified some adverse events, such as delayed bleeding and infections; the findings suggest that expert centers should perform these procedures following established guidelines to ensure patient safety and treatment effectiveness.
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BACKGROUND : The diagnosis of cholangiocarcinoma in patients with a biliary stricture without mass syndrome can be obtained by biliary brushing with a sensitivity of ~50 %. We performed a multicenter randomized crossover trial comparing the aggressive Infinity brush with the standard RX Cytology Brush. The aims were to compare sensitivity for cholangiocarcinoma diagnosis and cellularity obtained.

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Background: In case of high risk of lymph node invasion after endoscopic resection (ER) of superficial esophageal squamous cell carcinoma (SCC), adjuvant chemoradiotherapy (CRT) can be an alternative to surgery. We assessed long-term clinical outcomes of adjuvant therapy by CRT after non-curative ER for superficial SCC.

Methods: We performed a retrospective multicenter study.

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Mechanisms of esophageal stricture after extensive endoscopic resection: a transcriptomic analysis.

Endosc Int Open

February 2023

Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique - Hôpitaux de Paris, France.

Article Synopsis
  • Esophageal stricture is a common complication following endoscopic resection for early esophageal cancers, with current prevention methods being largely ineffective and causing significant side effects.
  • Researchers conducted a study to analyze transcript changes in patients at risk for strictures, focusing on the differences between those who developed strictures and those who did not by examining biopsies taken at specific intervals.
  • The study found that on Day 14, there was increased activity of the interleukin-1 group and decreased activity of interferon-gamma and NUPR1 in patients with strictures, suggesting that targeting IL-1 or supplementing INFγ may offer new prevention strategies for this condition.
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Background And Objectives: The background of this study was to evaluate the outcomes of perihilar cholangiocarcinoma (pCCA) patients treated with EUS-guided hepaticogastrostomy (EUS-HGS).

Methods: All patients with pCCA who underwent EUS-HGS from 2010 to 2020 were analyzed. The primary outcome was clinical success; the secondary outcomes were technical success, adverse events (AEs), stent patency, and oncological outcomes.

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Background: Short-stem implants in shoulder arthroplasty were recently developed and reported clinical outcomes are good. However, radiological analysis often reveals humeral stem misalignment in the frontal plane, along with high filling ratios that can lead to proximal bone remodeling under stress shielding. The aim of this cadaveric study was to test whether using compactors for standard-length (> 100 mm) stems to implant short (< 100 mm) stems reduces the risk of stem misalignment without compromising in terms of a higher filling ratio.

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