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Article ; Online: Spleen-preserving pancreatectomy with removal of splenic vessels: impact on splenic parenchyma ?

Lete, Coralie / Brichard, Martin / Rosa, Maria Luisa / Salavracos, Mike / Hubert, Catherine / Navez, Benoit / Closset, Jean / Pezzullo, Martina / Navez, Julie

BMC surgery

2023 Volume 23, Issue 1, Page(s) 245

Abstract: Background: While outcomes after spleen-preserving distal pancreatectomy (SP-DP) have been widely reported, impacts on splenic parenchyma have not been well studied. This study aimed to compare postoperative outcomes, particularly spleen-related ... ...

Abstract	Background: While outcomes after spleen-preserving distal pancreatectomy (SP-DP) have been widely reported, impacts on splenic parenchyma have not been well studied. This study aimed to compare postoperative outcomes, particularly spleen-related outcomes, by assessing splenic imaging after SP-DP with or without splenic vessels removal. Methods: Data for all patients who underwent SP-DP with splenic vessels removal (Warshaw technique, WDP) or preservation (Kimura technique, KDP) between 2010 and 2022 in two tertiary centres were retrospectively analysed. Splenic ischemia and volume at early/late imaging and postoperative outcomes were reviewed. Results: Eighty-seven patients were included, 51 in the WDP and 36 in the KDP groups. Median Charlson's Comorbidity Index was significantly higher in the WDP group compared with the KDP group. Postoperative morbidity was similar between groups. There was more splenic ischemia at early imaging in the WDP group compared to the KDP group (55% vs. 14%, p = 0.018), especially severe ischemia (23% vs. 0%). Partial splenic atrophy was observed in 29% and 0% in the WDP and KDP groups, respectively (p = 0.002); no complete splenic atrophy was observed. Platelet levels at POD 1, 2 and 6 were significantly higher in the WDP group compared to KDP group. At univariate analysis, age, Charlson Comorbidity Index, platelet levels at POD 6, and early splenic infarction were prognostic factors for development of splenic atrophy. No episodes of overwhelming post-splenectomy infection or secondary splenectomy were recorded after a median follow-up of 9 and 11 months in the WDP and KDP groups, respectively. Conclusions: Splenic ischemia appeared in one-half of patients undergoing SP-DP with splenic vessels removal at early imaging, and partial splenic atrophy in almost 30% at late imaging, without clinical impact or complete splenic atrophy. Age, Charlson Comorbidity Index, platelet levels at POD 6, and early splenic infarction could help to predict the occurrence of splenic atrophy.
MeSH term(s)	Humans ; Splenic Infarction ; Pancreatectomy ; Retrospective Studies ; Splenic Diseases ; Atrophy
Language	English
Publishing date	2023-08-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2050442-1
ISSN	1471-2482 ; 1471-2482
ISSN (online)	1471-2482
ISSN	1471-2482
DOI	10.1186/s12893-023-02133-0
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Article ; Online: Distalization of Standard Roux-en-Y Gastric Bypass: Indications, Technique, and Long-Term Results.

Ngomba Muakana, Judith A / Thissen, Jean-Paul / Loumaye, Audrey / Thoma, Maximilien / Deswysen, Yannick / Navez, Benoit

Obesity surgery

2023 Volume 33, Issue 5, Page(s) 1373–1381

Abstract: ... is a challenge for bariatric surgeons. Failure to achieve a body mass index (BMI) <35 kg/m: Methods ... loss (EWL) >50% or BMI <35 kg/m: Results: The mean BMI values before and after DRYGB were 43.7 kg/m ...

Abstract	Introduction: Weight loss failure or weight regain after primary Roux-en-Y gastric bypass (RYGB) is a challenge for bariatric surgeons. Failure to achieve a body mass index (BMI) <35 kg/m Methods: Retrospective data were reviewed for 22 patients who had undergone RYGB and failed to achieve an excess weight loss (EWL) >50% or BMI <35 kg/m Results: The mean BMI values before and after DRYGB were 43.7 kg/m Conclusion: The DRYGB procedure results in substantial and sustained long-term weight loss. Due to the risk of malnutrition, patients must be strictly followed for life after the procedure.
MeSH term(s)	Humans ; Gastric Bypass/methods ; Obesity, Morbid/surgery ; Retrospective Studies ; Reoperation/methods ; Weight Loss ; Body Mass Index ; Laparoscopy/methods
Language	English
Publishing date	2023-03-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-023-06524-3
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Article ; Online: Circadian clock dysfunction in human omental fat links obesity to metabolic inflammation.

Maury, Eleonore / Navez, Benoit / Brichard, Sonia M

Nature communications

2021 Volume 12, Issue 1, Page(s) 2388

Abstract: To unravel the pathogenesis of obesity and its complications, we investigate the interplay between circadian clocks and NF-κB pathway in human adipose tissue. The circadian clock function is impaired in omental fat from obese patients. ChIP-seq analyses ... ...

Abstract	To unravel the pathogenesis of obesity and its complications, we investigate the interplay between circadian clocks and NF-κB pathway in human adipose tissue. The circadian clock function is impaired in omental fat from obese patients. ChIP-seq analyses reveal that the core clock activator, BMAL1 binds to several thousand target genes. NF-κB competes with BMAL1 for transcriptional control of some targets and overall, BMAL1 chromatin binding occurs in close proximity to NF-κB consensus motifs. Obesity relocalizes BMAL1 occupancy genome-wide in human omental fat, thereby altering the transcription of numerous target genes involved in metabolic inflammation and adipose tissue remodeling. Eventually, clock dysfunction appears at early stages of obesity in mice and is corrected, together with impaired metabolism, by NF-κB inhibition. Collectively, our results reveal a relationship between NF-κB and the molecular clock in adipose tissue, which may contribute to obesity-related complications.
MeSH term(s)	ARNTL Transcription Factors/metabolism ; Adipocytes/immunology ; Adipocytes/metabolism ; Adiponectin/genetics ; Adult ; Animals ; Biopsy ; Case-Control Studies ; Cells, Cultured ; Chromatin Immunoprecipitation Sequencing ; Circadian Clocks/genetics ; Circadian Clocks/immunology ; Diet, High-Fat/adverse effects ; Disease Models, Animal ; Female ; Gene Expression Regulation ; Humans ; Inflammation/immunology ; Inflammation/pathology ; Intra-Abdominal Fat/immunology ; Intra-Abdominal Fat/pathology ; Male ; Mesenchymal Stem Cells ; Mice, Transgenic ; Middle Aged ; NF-kappa B/metabolism ; Obesity/complications ; Obesity/immunology ; Obesity/metabolism ; Obesity/pathology ; Omentum/immunology ; Omentum/pathology ; Period Circadian Proteins/genetics ; Primary Cell Culture ; Transcription, Genetic
Chemical Substances	ARNTL Transcription Factors ; BMAL1 protein, human ; Adiponectin ; Adipoq protein, mouse ; NF-kappa B ; Per2 protein, mouse ; Period Circadian Proteins
Language	English
Publishing date	2021-04-22
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2553671-0
ISSN	2041-1723 ; 2041-1723
ISSN (online)	2041-1723
ISSN	2041-1723
DOI	10.1038/s41467-021-22571-9
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Article ; Online: A Retrospective Comparative Study of Primary Versus Revisional Roux-en-Y Gastric Bypass: Long-Term Results.

Dardamanis, Dimitrios / Navez, Julie / Coubeau, Laurent / Navez, Benoit

Obesity surgery

2018 Volume 28, Issue 8, Page(s) 2457–2464

Abstract: ... BMI (kg/m: Conclusions: Revisional and primary gastric bypass have no statistical differences ...

Abstract	Aims: To compare the perioperative parameters and excess weight loss between patients operated by laporoscopic Roux-en-Y gastric bypass (LRYGB), as a primary operation or a revisional, for insufficient weight loss after vertical banded gastroplasty (VBG) or adjustable gastric banding (AGB). Methods: A retrospective analysis of all patients who underwent a LRYGB was performed for the period 2004-2011. Demographics, preoperative body mass index (BMI), co-morbidities, operation time, conversion rate, perioperative complications, hospitalization period, and % of excess BMI loss (%EBMIL) were investigated and compared between groups. Results: Three hundred forty-two laparoscopic gastric bypass operations were performed, 245 were primary, and 97 revisional. Median follow-up was 30 months (range 0-108 months). Mean BMI (kg/m Conclusions: Revisional and primary gastric bypass have no statistical differences in terms of morbidity. The % of excess BMI loss is lower after revisional gastric bypass during the first 2 years of follow-up. The trend of weight loss or weight regain was similar in both groups.
MeSH term(s)	Adult ; Bariatric Surgery ; Body Mass Index ; Comorbidity ; Female ; Gastric Bypass/methods ; Gastroplasty/methods ; Hospitalization ; Humans ; Laparoscopy/methods ; Laparotomy ; Male ; Middle Aged ; Obesity, Morbid/surgery ; Operative Time ; Reoperation/methods ; Retrospective Studies ; Weight Loss
Language	English
Publishing date	2018-03-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-018-3186-z
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Article ; Online: Tumoral acidosis promotes adipose tissue depletion by fostering adipocyte lipolysis.

Lefevre, Camille / Thibaut, Morgane M / Loumaye, Audrey / Thissen, Jean-Paul / Neyrinck, Audrey M / Navez, Benoit / Delzenne, Nathalie M / Feron, Olivier / Bindels, Laure B

Molecular metabolism

2024 Volume 83, Page(s) 101930

Abstract: Objective: Tumour progression drives profound alterations in host metabolism, such as adipose tissue depletion, an early event of cancer cachexia. As fatty acid consumption by cancer cells increases upon acidosis of the tumour microenvironment, we ... ...

Abstract	Objective: Tumour progression drives profound alterations in host metabolism, such as adipose tissue depletion, an early event of cancer cachexia. As fatty acid consumption by cancer cells increases upon acidosis of the tumour microenvironment, we reasoned that fatty acids derived from distant adipose lipolysis may sustain tumour fatty acid craving, leading to the adipose tissue loss observed in cancer cachexia. Methods: To evaluate the pro-lipolytic capacities of acid-exposed cancer cells, primary mouse adipocytes from subcutaneous and visceral adipose tissue were exposed to pH-matched conditioned medium from human and murine acid-exposed cancer cells (pH 6.5), compared to naive cancer cells (pH 7.4). To further address the role of tumoral acidosis on adipose tissue loss, a pH-low insertion peptide was injected into tumour-bearing mice, and tumoral acidosis was neutralised with a sodium bicarbonate buffer. Prolipolytic mediators were identified by transcriptomic approaches and validated on murine and human adipocytes. Results: Here, we reveal that acid-exposed cancer cells promote lipolysis from subcutaneous and visceral adipocytes and that dampening acidosis in vivo inhibits adipose tissue depletion. We further found a set of well-known prolipolytic factors enhanced upon acidosis adaptation and unravelled a role for β-glucuronidase (GUSB) as a promising new actor in adipocyte lipolysis. Conclusions: Tumoral acidosis promotes the mobilization of fatty acids derived from adipocytes via the release of soluble factors by cancer cells. Our work paves the way for therapeutic approaches aimed at tackling cachexia by targeting the tumour acidic compartment.
MeSH term(s)	Lipolysis ; Animals ; Mice ; Acidosis/metabolism ; Adipocytes/metabolism ; Humans ; Adipose Tissue/metabolism ; Cachexia/metabolism ; Male ; Tumor Microenvironment ; Cell Line, Tumor ; Mice, Inbred C57BL ; Fatty Acids/metabolism ; Neoplasms/metabolism ; Neoplasms/pathology ; Female ; Glucuronidase/metabolism ; Hydrogen-Ion Concentration
Chemical Substances	Fatty Acids ; Glucuronidase (EC 3.2.1.31)
Language	English
Publishing date	2024-04-01
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2708735-9
ISSN	2212-8778 ; 2212-8778
ISSN (online)	2212-8778
ISSN	2212-8778
DOI	10.1016/j.molmet.2024.101930
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Article ; Online: Opioid-free versus opioid-based anesthesia in pancreatic surgery.

Hublet, Stéphane / Galland, Marianne / Navez, Julie / Loi, Patrizia / Closset, Jean / Forget, Patrice / Lafère, Pierre

BMC anesthesiology

2022 Volume 22, Issue 1, Page(s) 9

Abstract: Background: Opioid-free anesthesia (OFA) is associated with significantly reduced cumulative postoperative morphine consumption in comparison with opioid-based anesthesia (OBA). Whether OFA is feasible and may improve outcomes in pancreatic surgery ... ...

Abstract	Background: Opioid-free anesthesia (OFA) is associated with significantly reduced cumulative postoperative morphine consumption in comparison with opioid-based anesthesia (OBA). Whether OFA is feasible and may improve outcomes in pancreatic surgery remains unclear. Methods: Perioperative data from 77 consecutive patients who underwent pancreatic resection were included and retrospectively reviewed. Patients received either an OBA with intraoperative remifentanil (n = 42) or an OFA (n = 35). OFA included a combination of continuous infusions of dexmedetomidine, lidocaine, and esketamine. In OBA, patients also received a single bolus of intrathecal morphine. All patients received intraoperative propofol, sevoflurane, dexamethasone, diclofenac, neuromuscular blockade. Postoperative pain management was achieved by continuous wound infiltration and patient-controlled morphine. The primary outcome was postoperative pain (Numerical Rating Scale, NRS). Opioid consumption within 48 h after extubation, length of stay, adverse events within 90 days, and 30-day mortality were included as secondary outcomes. Episodes of bradycardia and hypotension requiring rescue medication were considered as safety outcomes. Results: Compared to OBA, NRS (3 [2-4] vs 0 [0-2], P < 0.001) and opioid consumption (36 [24-52] vs 10 [2-24], P = 0.005) were both less in the OFA group. Length of stay was shorter by 4 days with OFA (14 [7-46] vs 10 [6-16], P < 0.001). OFA (P = 0.03), with postoperative pancreatic fistula (P = 0.0002) and delayed gastric emptying (P < 0.0001) were identified as only independent factors for length of stay. The comprehensive complication index (CCI) was the lowest with OFA (24.9 ± 25.5 vs 14.1 ± 23.4, P = 0.03). There were no differences in demographics, operative time, blood loss, bradycardia, vasopressors administration or time to extubation among groups. Conclusions: In this series, OFA during pancreatic resection is feasible and independently associated with a better outcome, in particular pain outcomes. The lower rate of postoperative complications may justify future randomized trials to test the hypothesis that OFA may improve outcomes and shorten length of stay.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Analgesics, Opioid/administration & dosage ; Anesthesia/methods ; Anesthetics, Local/administration & dosage ; Animals ; Anti-Inflammatory Agents/administration & dosage ; Dexamethasone ; Female ; Humans ; Ketamine ; Lidocaine ; Male ; Middle Aged ; Morphine ; Pain, Postoperative/drug therapy ; Pancreas/surgery ; Remifentanil ; Retrospective Studies
Chemical Substances	Analgesics, Opioid ; Anesthetics, Local ; Anti-Inflammatory Agents ; Esketamine (50LFG02TXD) ; Ketamine (690G0D6V8H) ; Morphine (76I7G6D29C) ; Dexamethasone (7S5I7G3JQL) ; Lidocaine (98PI200987) ; Remifentanil (P10582JYYK)
Language	English
Publishing date	2022-01-04
Publishing country	England
Document type	Comparative Study ; Journal Article
ZDB-ID	2091252-3
ISSN	1471-2253 ; 1471-2253
ISSN (online)	1471-2253
ISSN	1471-2253
DOI	10.1186/s12871-021-01551-y
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Article ; Online: Correction to: Opioid-free versus opioid-based anesthesia in pancreatic surgery.

Hublet, Stéphane / Galland, Marianne / Navez, Julie / Loi, Patrizia / Closset, Jean / Forget, Patrice / Lafère, Pierre

BMC anesthesiology

2022 Volume 22, Issue 1, Page(s) 33

Language	English
Publishing date	2022-01-22
Publishing country	England
Document type	Published Erratum
ZDB-ID	2091252-3
ISSN	1471-2253 ; 1471-2253
ISSN (online)	1471-2253
ISSN	1471-2253
DOI	10.1186/s12871-022-01572-1
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Article ; Online: Circadian clock dysfunction in human omental fat links obesity to metabolic inflammation

Eleonore Maury / Benoit Navez / Sonia M. Brichard

Nature Communications, Vol 12, Iss 1, Pp 1-

2021 Volume 17

Abstract: Whether chronic inflammation contributes to metabolic disease through the dysregulation of circadian systems remains incompletely understood in humans. Here the authors show that circadian clock function is perturbed in adipose tissue from individuals ... ...

Abstract	Whether chronic inflammation contributes to metabolic disease through the dysregulation of circadian systems remains incompletely understood in humans. Here the authors show that circadian clock function is perturbed in adipose tissue from individuals with obesity, and that inhibition of NFkB improves clock function.
Keywords	Science ; Q
Language	English
Publishing date	2021-04-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
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Article ; Online: Long-Term Outcomes 10 Years after Laparoscopic Sleeve Gastrectomy: a Single Center Retrospective Analysis.

Vital, Roxane / Navez, Julie / Gunes, Seda / Tonneau, Camille / Mehdi, Abdelilah / Moussaoui, Imad El / Closset, Jean

Obesity surgery

2023 Volume 33, Issue 8, Page(s) 2356–2360

Abstract: ... with a median preoperative body mass index of 42.0 ± 6.5 kg/m: Conclusion: Ten years after LSG, the rate ...

Abstract	Introduction: Laparoscopic sleeve gastrectomy (LSG) is the most frequently performed bariatric procedure in the world. The aim of the study was to evaluate outcomes after 10 years. Methods: Patients who underwent LSG between 2005 and 2010 in a single center were retrospectively assessed, focusing mainly on the percentage of excess weight loss (%EWL) after 10 years. Inadequate weight loss was defined as a %EWL < 50% or the need to perform a revisional bariatric surgery. Results: Overall, 149 patients underwent LSG, with a median preoperative body mass index of 42.0 ± 6.5 kg/m Conclusion: Ten years after LSG, the rate of inadequate weight loss was high, reaching 80% of patients. Thirty percent of patients required a revisional bariatric procedure. New studies must try to identify patients who are good candidates for LSG and strategies to improve long-term outcomes.
MeSH term(s)	Humans ; Obesity, Morbid/surgery ; Retrospective Studies ; Laparoscopy/methods ; Gastrectomy/methods ; Weight Loss ; Body Mass Index ; Treatment Outcome
Language	English
Publishing date	2023-06-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-023-06709-w
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Article: Solitary prostate cancer liver metastasis: an exceptional indication for liver resection.

Tilmans, Gilles / Navez, Julie / Komuta, Mina / Saussez, Thibaud / Lerut, Jan

Acta chirurgica Belgica

2020 Volume 121, Issue 6, Page(s) 427–431

Abstract: Introduction: Prostatic cancer metastases (PCM) are usually systemic. Isolated PCM liver metastases (PCLM) are very rare. The treatment of PCM consists of hormono- and chemotherapy eventually combined with stereotactic radiation.: Patient and ... ...

Abstract	Introduction: Prostatic cancer metastases (PCM) are usually systemic. Isolated PCM liver metastases (PCLM) are very rare. The treatment of PCM consists of hormono- and chemotherapy eventually combined with stereotactic radiation. Patient and discussion: A case of a 67-year old man presenting with a solitary, metachronous PCLM undergoing a left extended hepatectomy due to resistance to hormono- and chemotherapy is reported. He died of recurrent systemic disease 31 months later. Conclusions: The very rare indication and possible role of liver resection in the treatment of PCLM is discussed.
MeSH term(s)	Aged ; Hepatectomy ; Humans ; Liver Neoplasms/surgery ; Male ; Neoplasms, Second Primary/surgery ; Prostatic Neoplasms/surgery
Language	English
Publishing date	2020-02-11
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	210274-2
ISSN	0001-5458
ISSN	0001-5458
DOI	10.1080/00015458.2020.1722929
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