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International audience; Background: The French Society of Surgery has endorsed a cohort aiming to prospectively assess the frequency of recurrence after incisional hernia repair and to identify the risk factors.Methods: Consecutive patients undergoing incisional hernia repair in the participating centers were included in the prospective French Society of Surgery cohort over a 6-month period. Patients were followed up with a computed tomography scan at 1 y and a clinical assessment by the surgeon at 2 years.Results: A total of 1,075 patients undergoing incisional hernia repair were included in 61 participating centers. The median follow-up was 24.0 months (interquartile range: 14.0-25.3). The follow-up rates were 83.0% and 68.5% at 1 and 2 years, respectively. The recurrence rates were 18.1% at 1 year and 27.7% at 2 years. Recurrence risk factors at 2 years were a history of hernia (odds ratio = 1.57, 95% confidence interval = 1.05-2.35, P = .028), a lateral hernia (odds ratio = 1.84, 95% confidence interval = 1.19-2.86, P = .007), a concomitant digestive operation (odds ratio = 1.97, 95% confidence interval = 1.20-3.22, P = .007), and the occurrence of early surgical site complications (odds ratio = 1,90, 95% confidence interval = 1.06-3.38, P = .030). The use of surgical mesh was strongly associated with a lower risk of recurrence at 2 years (P < .001).Conclusion: After incisional hernia repair, the 2-year recurrence rate is as high as 27.7%. History of hernia, lateral hernia, concomitant digestive operation, the onset of surgical site complications, and the absence of mesh are strong risk factors for recurrence.

Although laparoscopic adjustable gastric banding (LAGB) is a popular metabolic/bariatric procedure, few prospective studies have assessed its outcomes. This study aimed to prospectively assess LAGB safety and effectiveness outcomes using the MIDBAND™ (MID, Dardilly, France).Between May 2005 and September 2006, 262 morbidly obese patients underwent primary gastric banding with pars flaccida technique in 13 French medical centers. Excess weight loss and change in body mass index (BMI, kilogram per square meter), percentage of patients with comorbidities, and obesity-related complications were recorded. Patients were followed at 6-month intervals for 3 years. A multivariable individual growth model was used to analyze weight change over time and determine potential predictors of weight loss.The majority of patients were female (n = 233, 89%), with mean age of 36.4 ± 9.7 years. At 3 years, LAGB with MIDBAND resulted in significant decrease in mean BMI from 41.8 ± 4.2 to 30.7 ± 5.8 (p 0.0001). Median excess weight loss and excess BMI loss were 61% and 68%, respectively. The prevalence of obesity-related comorbidities had significantly decreased from 71% to 15% (p 0.0001). Complications were observed in 26 patients (10%); device-related complications occurred in 20 patients (8.2%), requiring band removal in 8 (3.3%), and port revision in 8 (3.3%). Individual growth analysis identified significant predictors of weight loss including the number of follow-up visits.Prospective outcomes demonstrate the safety and efficacy of gastric banding over time using the MIDBAND. Individual growth modeling demonstrated that postoperative weight loss is strongly related to the frequency and consistency of follow-up visits.

Intratumor ethanol injection was studied in the treatment of small hepatocellular carcinoma (HCC). One of the major drawbacks of this technique remains the lack of objective information about its efficiency and the practical conditions of injection. To ensure accurate evaluation of alcoholization, we developed a model based on the tumor obtained after subcutaneous injection of human hepatoma cell lines into nude mice. Each of three cell lines (Hep G2, Hep 3B, PLC/PRF/5) was tested on 24 mice. A total of 0.1 ml of a solution containing 5 × 106 cells was injected under the abdominal skin of a male nude mouse weighing 30 g. The Hep G2 cell line appeared to be the most suitable for the model. It enabled us to obtain tumors of 20 mm in diameter within a mean delay (m ± SD) of 45 ± 16 days (range: 29-60) with only a 25% failure rate. No visceral spreading of the carcinoma was noticed and the tumors obtained, similar to human HCC, were convenient to be measured, monitored, and treated by alcoholization. To validate this model for alcoholization, 38 tumors ranging in diameter from 10 to 20 mm were treated using either a unique centretumoral injection (n = 27) or five cross-shaped injections (n = 11). Intratumor absolute ethanol injection resulted in tumoral necrosis which was easily quantified as a percentage of the tumor volume, using a semiquantitative method. It is concluded that the Hep G2 cell line transplanted in nude mice resulted in a relevant model to assess tumoral destruction by alcoholization.