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Introduction: Low‐pressure pneumoperitoneum (LLP) in laparoscopy colorectal surgery (CS) has resulted in reduced hospital stay and lower analgesic consumption. Microsurgery (MS) in CS is a technique that has a significant impact with respect to postoperative pain. The combination of MS plus LLP, known as low‐impact laparoscopy (LIL), has never been applied in CS. Therefore, this trial will assess the efficacy of LLP plus MS versus LLP alone in terms of decreasing postoperative pain 24 h after surgery, without taking opioids. Method: PAROS II will be a prospective, multicentre, outcome assessor‐blinded, randomised controlled phase III clinical trial that compares LLP plus MS versus LLP alone in patients undergoing laparoscopic surgery for colonic or upper rectal cancer or benign pathology. The primary outcome will be the number of patients with postoperative pain 24 h after the surgery, as defined by a visual analogue scale rating ≤3 and without taking opioids. Overall, PAROS II aims to recruit 148 patients for 50% of patients to reach the primary outcome in the LLP plus MS arm, with 80% power and an 5% alpha risk. Conclusion: The PAROS II trial will be the first phase III trial to investigate the impact of LIL, including LLP plus MS, in laparoscopic CS. The results may improve the postoperative recovery experience and decrease opioid consumption after laparoscopic CS. [ABSTRACT FROM AUTHOR]

Background: Hepaticojejunostomy (HJ) is the gold standard procedure for repairing major bile duct injury (BDI). Dilation status of the BD before repair has not been assessed as a risk factor for anastomotic stricture. Method: This retrospective single-centre study was performed on a population of 87 patients with BDI repaired by HJ between 2007 and 2021. Dilation status was assessed preoperatively, and dilation was defined as the presence of visible peripheral intrahepatic BDs with remaining BD diameter > 8 mm. The short- and long-term outcomes of HJ were assessed according to preoperative dilation status. Results: Before final repair, the BDs were dilated (dBD) in 56.3% of patients and not dilated (ND) in 43.7%. Patients with ND at the time of repair had more severe BDI injury than those with dBD (94.7% vs. 77.6%, p = 0.026). The rate of preoperative cholangitis was lower in patients with ND than in those with dBD (10.5% vs. 44.9%, p = 0.001). The rate of short-term morbidity after HJ was 33.3% (ND vs. dBD: 38.8% vs. 26.3%, p = 0.32). Long-term anastomotic stricture rate was 5.7% with a mean follow-up period of 61.3 months. There were no differences in long-term biliary complications according to dilation status (ND vs. dBD: 12.2% vs. 10.5%, p = 1). Conclusion: Dilation status of the BD before HJ for BDI seemed to have no impact on short- or long-term outcomes. Both surgical and radiological external biliary drainages after BDI appear to be acceptable options to reduce cholangitis before repair without increasing risk for long-term anastomotic stricture. [ABSTRACT FROM AUTHOR]

High-risk pancreatic anastomosis can lead to a high mortality rate after PD due to the development of postoperative pancreatic fistula (POPF). Performing a wirsungostomy by externalizing the pancreatic duct is a poorly known alternative to anastomosis which could reduce the risk of POPF and the associated severe morbidity We retrospectively evaluated patients who underwent primary wirsungostomy with PD from January 2007 to December 2021 in our tertiary referral center. Rates of morbidity and mortality with long-term pancreatic functions were studied. Sixty patients were included. The median Updated Alternative Fistula Risk Score (ua-FRS) was 52%, with 95% patients in the high-risk ua-FRS category and 88.3% patients with stage D risk of developing POPF according to the classification of the ISGPS. The mortality rate was 3.3%, and overall 90-day postoperative morbidity was 63.7% with 50% of patients developing major complications. Mean follow-up was 29.8 months. Twelve patients (20%) became diabetic and 35 patients (58.3%) had preserved pancreatic endocrine function Preemptive wirsungostomy with PD could be an appropriate procedure for patients with high-risk pancreatic anastomosis. The high associated morbidity could be compromised by the low mortality and preservation of endocrine function compared to total pancreatectomy or severe POPF. [ABSTRACT FROM AUTHOR]

Introduction: Protective diverting ileostomy is commonly performed in rectal surgery to avoid septic complications of low colorectal anastomosis. Ileostomy closure usually occurs three months after the surgery and can be realized in two ways: hand sewn or stapled. Existing randomized studies comparing the two techniques showed no difference in terms of complications. Methods: Our study describes the standard technique of ileostomy reversal as done in Bordeaux University Hospital in 10 steps individually illustrated and with an explicative video. We also collected data concerning the 50 last patients who underwent an ileostomy reversal in our center from June 2021 to June 2022. Results: Mean duration of the ileostomy closure was 46.8 minutes, and the mean total hospital stay was 4.66 days. Five of 50 (10%) patients had a post-operative bowel obstruction, 2/50 (4%) patients had a post-operative bleeding, 1/50 (2%) patient had a wound infection, and there was no anastomotic leakage observed. Conclusion: Stapled side-to-side anastomosis is a rapid, simple, and reproducible technique for ileostomy reversal. There are no more complications compared to hand-sewn anastomosis. It engenders an additional cost compensated by the gain in operating time which altogether saves money. [ABSTRACT FROM AUTHOR]

Background: Hepaticojejunostomy (HJ) is the gold standard procedure for the reconstruction of the bile duct in many benign and malignant situations. One of the major situation is the bile duct injury (BDI) after cholecystectomy, either for early or late repair. This procedure presents some specificities associated to a debated management of BDI. Purpose: This article provides a state-of-the-art of the hepaticojejunostomy procedure focusing on bile duct injury including its indications and outcomes Conclusion: Performed at the right moment and respecting the technical rules, HJ provides a restoration of the biliary patency in the long term of 80 to 90%. It is the main surgical technique to repair BDI. Complications and failure of this procedure can be difficult to manage. That is why the primary repair requires an appropriate multidisciplinary approach associated with an expert high quality surgical technique. [ABSTRACT FROM AUTHOR]

Sacrificing a replaced right hepatic artery (rRHA) from the superior mesenteric artery is occasionally necessary to obtain an R0 resection after pancreaticoduodenectomy (PD) for pancreatic adenocarcinoma (PA). Preoperative embolization (PEA) of the rRHA has been proposed to avoid the onset of postoperative biliary and ischemic liver complications. Eighteen patients with cephalic PA with an rRHA underwent PEA of the rRHA from 2013 to 2019. The monitoring after embolization and PD was systematic and included a clinical-biological evaluation and a computed tomography scan. This study aimed to determine the feasibility of PEA of the rRHA, postoperative morbidity at 90 days, and quality of oncologic resection after PD. Feasibility of PEA was 100% without complications. A PD was performed in 16/18 patients. Mortality was 2/16 with one death after septic shock with hepatic ischemia without an arterial obstruction. Overall morbidity was 44% including one hepatic abscess after hepatic ischemia (6%). Two resections were R1 (<1 mm) in contact with the origin of the rRHA (2/4 R1). PEA of the rRHA before PD was safe and reproducible. PEA of the rRHA followed by en bloc PD resection seems to limit the risk of bilio-hepatic ischemia and could facilitate oncologic resection. [Display omitted] [ABSTRACT FROM AUTHOR]

The Pringle maneuver during laparoscopic liver resection appears crucial and can be performed in two different ways, i.e., intracorporeally or extracorporeally. In previous reports, the intracorporeal Pringle maneuver was performed using materials and techniques that made it difficult and reduced its efficiency. Here, we present our experience with the intracorporeal Pringle maneuver using a urinary catheter with a video demonstration. Using an intracorporeal technique with a urinary catheter is quicker than other intracorporeal technique and requires less material. Comparing to extracorporeal technique, there is no supplemental port with less risk of gas leak. Intracorporeal Pringle maneuver using a urinary catheter is easy, reproducible, and safe and thus remains a good alternative to the classic technique. [ABSTRACT FROM AUTHOR]

Background: Despite the minimally invasive approach and early rehabilitation, abdominal-perineal resection (APR) remains a procedure with high morbidity, notably due to postoperative trapped bowel ileus and perineal healing complications. Several surgical techniques have been described for filling the pelvic void to prevent abscess formation and ileus by trapped bowel loop. Objective: The aim of our study was to compare the post APR complications for cancer of two of these techniques, omentoplasty and cecal mobilization, in a single-center study from an expert colorectal surgery center. Patients: From 2012 to 2022, 84 patients were included, including 58 (69%) with omentoplasty and 26 (31%) with cecal mobilization. They all underwent APR at Bordeaux University Hospital Center. Settings: A propensity score was used to avoid confounding factors as far as possible. Patient and procedure characteristics were initially comparable. Results: The 30-day complication rate was significantly higher in the cecal mobilization group (53.8% vs. 5.2% p < 0.01), as was the rate of pelvic abscess (34.6% vs. 0% p < 0.001). Conclusion: These findings suggest that, when feasible, omentoplasty should be considered the preferred method for pelvic reconstruction following APR. [ABSTRACT FROM AUTHOR]

Sol-gel based layers doped with Rhodamine B phosphors (RB) were directly microstructured to produce sub-lambda 2D gratings, using nanoimprint lithography. Such an approach enables the simplification of technological processes, since no further etching process is required, which reduces considerably the number of technological steps and thus production costs. Surface microstructuring improved fluorophore emission in the visible range. Demonstrations were performed experimentally and samples were characterized using angle-resolved fluorescence. The emissions measured on microstructured luminescent coatings were 3–4 times higher, depending on the angle of observation, than those recorded on flat surfaces. This technological approach is very promising for the next generation of low-cost, high-performance anti-counterfeiting marking processes and for the traceability of objects based on unique optical effects. [Display omitted] • Variations in photoluminescence quantum yields as a function of excitation wavelength and RB concentrations were studied • The nanoimprint lithography technique was used to produce a 2D grating on a luminescent (TEOS/MTEOS)/RB base sol-gel coating. • Surface microstructuring improved fluorophore emission in the visible range. • Angle-resolved photoluminescence was investigated on the luminescent films with and without grating. [ABSTRACT FROM AUTHOR]

Abstract: Controlling supramolecular growth at solid surfaces is of great importance to expand the scope of supramolecular materials. A dendritic benzene‐1,3,5‐tricarboxamide peptide conjugate is described in which assembly can be triggered by a pH jump. Stopped‐flow kinetics and mathematical modeling provide a quantitative understanding of the nucleation, elongation, and fragmentation behavior in solution. To assemble the molecule at a solid–liquid interface, we use proton diffusion from the bulk. The latter needs to be slower than the lag phase of nucleation to progressively grow a hydrogel outwards from the surface. Our method of surface‐assisted self‐assembly is generally applicable to other gelators, and can be used to create structured supramolecular materials. [ABSTRACT FROM AUTHOR]

Abstract: Controlling supramolecular growth at solid surfaces is of great importance to expand the scope of supramolecular materials. A dendritic benzene‐1,3,5‐tricarboxamide peptide conjugate is described in which assembly can be triggered by a pH jump. Stopped‐flow kinetics and mathematical modeling provide a quantitative understanding of the nucleation, elongation, and fragmentation behavior in solution. To assemble the molecule at a solid–liquid interface, we use proton diffusion from the bulk. The latter needs to be slower than the lag phase of nucleation to progressively grow a hydrogel outwards from the surface. Our method of surface‐assisted self‐assembly is generally applicable to other gelators, and can be used to create structured supramolecular materials. [ABSTRACT FROM AUTHOR]

Summary: Recognition of the psychic injury potentially inferred by a traumatic event''s reality led to cares reproduction for the persons concerned by the event (victims, families, rescuers). These early psychological care are conceived for potentially traumatic events, meaning sudden, violent, unpredictable events leading to life threatening experiences. Being confronted to death''s reality leads to the annihilation of the usual defence mechanisms and to an incapacity to be able to elaborate what is being experienced. Confrontation with the trauma can have multiple and unpredictable consequences. Premature psychic cares for the persons implied are therefore implemented, as are somatic cares. If these processes allow coverages (care) adapted to the clinical demonstrations (appearances) of the psychic injured (wounded) persons, they can lead (drive) to multiple drift of which their use for not traumatic facts. The current situation is paradoxical: on one side there is a bigger recognition of the reality of the psychic wounds and the potential consequences caused by a traumatic event and of other, this systematic consideration leads to a collective identical demand of the traumatic fact transforming it into a political stake. The social and political recognition of the psychic traumatism is parallel to its instrumentalisation and exploitation. That leads inevitably to maintaining the subjects involved in a state of dependence, vulnerability and psychic incompetence, that of the victim. Support for children and adolescents faced a traumatic event requires thinking devices adapted to the traumatic temporality, namely in immediate, then the event remotely. In such circumstances, it is common that is decided the establishment of a group of children or adolescents that are always conceived the expected objectives and framework for such interventions. Our experience with children and adolescents exposed to major traumatic events, allows us to consider the group as a space of mental restoration, but under certain conditions. We will remember in the first part of the dimension of psychological space of the groups, in a second time the relevance of the traumatic context groupal work but also its limits. Finally we will propose, from a clinical example, a framework for this type of support adapted to the circumstances. Our references are these of René Kaës, for which, each group is, an era of “psychic work” between three spaces of psychic reality. Which brings us to consider the group as the post-traumatic psychic creativity, it is the spontaneous investment in children and in particular among adolescents, group, as soon as a traumatic event comes change their lives. It is also our experience with children and teenagers for which the Group was a real “potential era” where the restauration of their psychic abilities was made possible by labour psychic groupal. Beyond these findings, it is not encouraging at all costs to the systematic group supported following a traumatic event. Each situation remains singular and committed individual, groupal, institutional, specific stories. We know as “injunction” to the Group and group by untrained professionals animation effects and this situation make worst the disorders for children and adolescents. It is therefore necessary to propose a framework for intervention in this context, so that these supported could value the group and make a space of psychic care. [Copyright &y& Elsevier]

This article discusses a case study of a 20-year-old woman who experienced a recto-neovaginal fistula after undergoing gender-affirming surgery using the penile inversion technique. The initial treatment involved conservative management with a left colostomy and a transanal approach to perform an advancement rectal flap. However, when the fistula persisted, a robotic sigmoid colon vaginoplasty was performed. The postoperative recovery was successful, and the patient was discharged after six days. The article provides a video vignette showcasing the step-by-step surgical management using the robotic approach. The authors declare no conflicts of interest, and no new data were created or analyzed in this study. [Extracted from the article]

Purpose: A transjugular intrahepatic portosystemic shunt (TIPS) before the liver transplantation (LT) has been considered a contraindication in cases of hepatocellular carcinoma (HCC) because of the risk of tumour growth. We aimed to assess the impact of TIPS on incidental HCC and oncological outcomes in transplanted patients with pre-existing HCC. Methods: All consecutive transplanted patients for cirrhosis who had a previous TIPS with or without HCC were included. Between 2007 and 2014, 1912 patients were transplanted. We included 122 (6.3%) patients having TIPS before LT. A 1:3 matched cohort of 366 patients (18.9%) having LT without previous TIPS was selected using a propensity score. Incidental HCC rate and risk factor of HCC recurrence were evaluated using multivariate analysis with a competing risk model. Results: Before LT, in the TIPS group, 27 (22.1%) had an HCC vs. 81 (22.1%) in the control group (p = 1). The incidental HCC rate was similar: 10.5% (10/95) in the TIPS group vs. 6.3% (18/285) in the control group (p = 0.17). Recurrence occurred in 1/27 (3.7%) patient in the TIPS group and in 7/81 (8.6%) patients in the control group, without significant difference (p = 0.51). After multivariate regression, patient’s gender (p < 0.01) was significantly associated with HCC recurrence while a tumour within Milan criteria (p = 0.01, sHR: 0.17 [0.04; 0.7]) and an incidental HCC (p<0.01) were found to be protector factors against HCC recurrence. Conclusion: TIPS did not worsen the prognosis of transplanted patients for HCC. TIPS should no longer be contraindicated for oncological reasons in patients with HCC waiting for an LT. [ABSTRACT FROM AUTHOR]

Objective:Children with bronchopulmonary dysplasia (BPD) often suffer from growth failure because of disturbances in energy balance with an increase of resting energy expenditure (REE). Evaluation of REE is a useful tool for nutritional management. Indirect calorimetry is an elective method for measuring REE, but it is time consuming and requires rigorous procedure. The objective of this study was to test accuracy of prediction equation to evaluate REE in BPD children.Patients and methods:Fifty-two children aged 4–10 years with BPD (30 boys and 22 girls) and 30 healthy lean children (20 boys and 10 girls) were enrolled. In this study, indirect calorimetry was compared to four prediction equations (Schoffield-W, Schoffield-HW, Harris–Benedict and Food and Agriculture Organization equation) using Bland–Altman pair wise comparison.Results:The Harris–Benedict equation was the best equation to predict REE in children with BPD, and Schoffield-W was the best in healthy children. For the children with chronic lung disease of prematurity the Harris–Benedict equation showed the lowest mean predicted REE−REE measured by indirect calorimetry difference (difference=15 kcal/day; limits of agreement −266 and 236 kcal/day; 95% confidence interval for the bias −207 to 177 kcal/day), and graphically, the best agreement. For the group of healthy children, it was the Schofield-W equation (−2.9 kcal/day; limits of agreement −275 and 269 kcal/day; 95% confidence interval for the bias −171 to 165 kcal/day), and graphically, the best agreement.Conclusion:Differences in prediction equation are minimal compared to calorimetry. Prediction equation could be useful in the management of children with BPD.European Journal of Clinical Nutrition (2006) 60, 1323–1329. doi:10.1038/sj.ejcn.1602463; published online 28 June 2006 [ABSTRACT FROM AUTHOR]

Background: Detection of children's psychological difficulties in crises and low resource settings is challenged by the lack of a validated, rapid and simple tool. We present the results of two confirmatory validations of the Psychological Screening for Young Children aged 3 to 6 years (PSYCa 3-6) scale. Methods: We performed cross-cultural validations, assessing the performance of the scale in different contexts. These were conducted in Mathare, Nairobi, Kenya and Buenaventura, Colombia between December 2009 and February 2012. External validity was assessed comparing the PSYCa 3-6 against a clinical interview and the Clinical Global Impression Severity scale (CGI). Results: A total of 160 mothers or caregivers of children 3 to 6 years old in Mathare and 148 in Buenaventura were included in the study. Both demonstrated good concurrent validity (Buenaventura ρ=0.49, p<0.0001; Mathare ρ=0.41, p<0.0001). Inter-rater reliability was found to be acceptable in Buenaventura (intraclass correlation [ICC]=0.69 [0.4-0.84]) and high in Mathare (0.87 [0.75-0.94]). Conclusions: As shown by its validation in diverse contexts, use in other populations may help improve the delivery of mental health care to children in crises and low-resource settings. Additional research on the design and delivery of intervention models for crises remains essential. [ABSTRACT FROM AUTHOR]