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Biological mesh reconstruction of the pelvic floor following abdominoperineal excision for cancer:A review

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World Journal of Clinical Oncology 2017年第3期8卷 249-254页

作者： Boris Schiltz Nicolas Christian Buchs Marta Penna Cosimo Riccardo Scarpa Emilie Liot Philippe Morel Frederic Ris Division of Visceral Surgery Department of SurgeryUniversity Hospitals of Geneva Department of Colorectal Surgery Churchill HospitalOxford University Hospitals

Extralevator abdominoperineal excision and pelvic exenteration are mutilating operations that leave wide perineal wounds.Such large wounds are prone to infection and perineal herniation,and their closure is a major concern to most surgeons.Different approaches to the perineal repair exist,varying from primary or mesh closure to myocutaneous flaps.Each technique has its own associated advantages and potential complications and the ideal approach is still debated.In the present study,we reviewed the current literature and our own local data regarding the use of biological mesh for perineal wound closure.Current evidence suggests that the use of biological mesh carries an acceptable risk of wound complications compared to primary closure and is similar to flap reconstruction.In addition,the rate of perineal hernia is lower in early follow-up,while long-term hernia occurrence appears to be similar between the different techniques.Finally,it is an easy and quick reconstruction method.Although more expensive than primary closure,the cost associated with the use of a biological mesh is at least equal,if not less,than flap reconstruction.

关键词： Biological mesh Rectal cancer Pelvic exenteration Abdominoperineal resection Primary perineal wound closure Perineal wound infection Perineal hernia

Cell-free DNA liquid biopsy for early detection of gastrointestinal cancers:A systematic review

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World Journal of Gastrointestinal Oncology 2021年第11期13卷 1799-1812页

作者： Isabelle Uhe Monika Elisabeth Hagen Frederic Ris Jeremy Meyer Christian Toso Jonathan Douissard Abdominal Surgery Division Geneva University HospitalsGeneva 1211Switzerland

BACKGROUND Gastrointestinal tumors are among the most common cancer types,and early detection is paramount to improve their management.Cell-free DNA(cfDNA)liquid biopsy raises significant hopes for non-invasive early detection.AIM To describe current applications of this technology for gastrointestinal cancer detection and screening.METHODS A systematic review of the literature was performed across the PubMed database.Articles reporting the use of cfDNA liquid biopsy in the screening or diagnosis of gastrointestinal cancers were included in the analysis.RESULTS A total of 263 articles were screened for eligibility,of which 13 articles were included.Studies investigated colorectal cancer(5 studies),pancreatic cancer(2 studies),hepatocellular carcinoma(3 studies),and multi-cancer detection(3 studies),including gastric,oesophageal,or bile duct cancer,representing a total of 4824 patients.Test sensitivities ranged from 71% to 100%,and specificities ranged from 67.4% to 100%.Pre-cancerous lesions detection was less performant with a sensitivity of 16.9% and a 100% specificity in one study.Another study using a large biobank demonstrated a 94.9% sensitivity in detecting cancer up to 4 years before clinical symptoms,with a 61% accuracy in tissue-of-origin identification.CONCLUSION cfDNA liquid biopsy seems capable of detecting gastrointestinal cancers at an early stage of development in a non-invasive and repeatable manner and screening simultaneously for multiple cancer types in a single blood sample.Further trials in clinically relevant settings are required to determine the exact place of this technology in gastrointestinal cancer screening and diagnosis strategies.

关键词： Cell-free DNA Tumor DNA Liquid biopsy Next-generation sequencing Cancer genomics Pancreatic cancer Colorectal cancer Hepatocellular carcinoma Multicancer detection Cancer screening Public health Precision oncology

Role of near-infrared fluorescence in colorectal surgery

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World Journal of Gastroenterology 2021年第31期27卷 5189-5200页

作者： Elodie Zocola Jeremy Meyer Niki Christou Emilie Liot Christian Toso Nicolas Christian Buchs Frederic Ris Medical School University of GenevaGenève 1205Switzerland Division of Digestive Surgery University Hospitals of GenevaGenève 1205Switzerland Service de Chirurgie Digestive Endocrinienne et GénéraleCHU de LimogesLimoges Cedex 87025France

Near-infrared fluorescence(NIRF)is a technique of augmented reality that,when applied in the operating theatre,allows the colorectal surgeon to visualize and assess bowel vascularization,to identify lymph nodes draini... 详细信息

关键词： Fluorescence Enhanced reality Anastomotic leak Ureter Anastomosis

Natural history of uncomplicated sigmoid diverticulitis

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World Journal of Gastrointestinal Surgery 2015年第11期7卷 313-318页

作者： Nicolas C Buchs Neil J Mortensen Frederic Ris Philippe Morel Pascal Gervaz Department of Colorectal Surgery Oxford University Hospitals Division of Visceral and Transplantation Surgery Department of Surgery Faculty of Medicine University Hospitals of Geneva

While diverticular disease is extremely common, the natural history(NH) of its most frequent presentation(i.e., sigmoid diverticulitis) is poorly investigated. Relevant information is mostly restricted to populationbased or retrospective studies. This comprehensive review aimed to evaluate the NH of simple sigmoid diverticulitis. While there is a clear lack of uniformity in terminology, which results in difficulties interpreting and comparing findings between studies, this review demonstrates the benign nature of simple sigmoid diverticulitis. The overall recurrence rate is relatively low, ranging from 13% to 47%, depending on the definition used by the authors. Among different risk factors for recurrence, patients with C-reactive protein > 240 mg/L are three times more likely to recur. Other risk factors include: Young age, a history of several episodes of acute diverticulitis, medical vs surgical management, male patients, radiological signs of complicated first episode, higher comorbidity index, family history of diverticulitis, and length of involved colon > 5 cm. The risk of developing a complicated second episode(and its corollary to require an emergency operation) is less than 2%-5%. In fact, the old rationale for elective surgery as a preventive treatment, based mainly on concerns that recurrence would result in a progressively increased risk of sepsis or the need for a colostomy, is not upheld by the current evidence.

关键词： Diverticulitis Colon Cohort Recurrence Natural his