Bertrand Trilling

• Medical Doctor at Centre Hospitalier Universitaire de Grenoble

Context Patients undergoing bowel resection with anastomosis experience postoperative impaired gastrointestinal motility, sometimes leading to symptoms such as nausea, vomiting, bloating, delayed passage of flatus and stools, and inability to tolerate solid food. We determined the times for recovery of gastrointestinal motility (in minutes) followi...

In Surgical Data Science (SDS), there is an increasing demand for large, realistic annotated datasets to facilitate the development of machine learning techniques. However, in laparoscopic surgery, most publicly available datasets focus on low-granularity procedural annotations (such as phases or steps) and image segmentation of instruments or spec...

Laparoscopic ventral mesh rectopexy (LVR) has gained increasing acceptance for the treatment of patients with a full-thickness rectal prolapse (RP), but literature on follow-up of at least 10 years is scarce. We studied recurrence rate, long-term functional results and quality of life in patients who had LVR for RP more than 12 years ago. The study...

The enhanced recovery after surgery (ERAS) protocol has been introduced over the past three decades for patients undergoing colorectal surgery. However, the effect of this program on long-term survival is poorly studied. We evaluated the effect of ERAS on 5-year overall survival (OS) and recurrence-free survival (RFS) after colorectal cancer surger...

Acute right colic diverticulitis (ARD) is less frequent in Western countries than acute sigmoid diverticulitis (ASD). We aimed to compare the management of ARD and ASD operated on in emergency. All consecutive patients who had emergency surgery for ASD and ARD (2010–2021) were included in a retrospective, multicenter, cohort study. Patients were id...

Background Postoperative rectovaginal fistula leads to a loss of patients’ quality of life and presents significant challenges to the surgeon. The literature focusing specifically on postoperative rectovaginal fistulas is limited. The objective of the present study is to identify factors that can enhance the success of the management of this postop...

Aim The rate of surgical recurrence following ileorectal anastomosis (IRA) in patients with Crohn's disease (CD) remains poorly understood. Most studies were conducted before the advent of biologics. Our aim was to assess the fate of IRA in patients with CD during the biologics era and identify risk factors for endoscopic, clinical, and surgical re...

Background Laparoscopic ventral mesh rectopexy (LVR) has gained increasing acceptance for the treatment of patients with a full-thickness rectal prolapse (RP), but the literature on follow-up of at least ten years is scarce. We studied recurrence rate, long-term functional results, and quality of life in patients who had LVR for RP more than twelve...

Objectives To evaluate the relationship between socioeconomic deprivation and postoperative outcomes in patients who underwent colonic resection for sigmoid diverticulitis (SD). Background The potential impact of socioeconomic inequalities on the management of SD has been scarcely studied in the literature. Considering other gastrointestinal patho...

Bladder drainage is systematically used in rectal cancer surgery; however, the optimal type of drainage, transurethral catheterization (TUC) or suprapubic catheterization (SPC), is still controversial. The aim was to compare the rates of urinary tract infection on the fourth postoperative day (POD4) between TUC and SPC, after rectal cancer surgery...

There is scarce literature on the effect of mechanical abdominal massage on the duration of ileus after colectomy, particularly in the era of enhanced recovery after surgery (ERAS). The aim of this study was to determine whether abdominal massage after colorectal surgery with anastomosis and no stoma helps toward a faster return of intestinal trans...

In the decision to perform elective surgery, it is of great interest to have data about the outcomes of surgery to individualize patients who could safely undergo sigmoid resection. The aim of this study was to provide information on the outcomes of elective sigmoid resection for sigmoid diverticular disease (SDD) at a national level. All consecuti...

To analyze the surgical management of sigmoid diverticular disease (SDD) before, during, and after the first containment rules (CR) for the first wave of COVID-19. From the French Surgical Association multicenter series, this study included all patients operated on between January 2018 and September 2021. Three groups were compared: A (before CR pe...

Purpose Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new surgical technique, developed for the treatment of peritoneal carcinomatosis (PC). In this retrospective observational study we assessed the impact of body mass index (BMI) on postoperative pain and opioid consumption. Methods We analyzed pain scores after 100 PIPAC procedur...

Aim: The long-term urological sequelae after iatrogenic ureteral injury (IUI) during colorectal surgery are not clearly known. The aims of this work were to report the incidence of IUI and to analyse the long-term consequences of urological late complications and their impact on oncological results of IUI occurring during colorectal surgery throug...

BACKGROUND Intraperitoneal aerosol spray chemotherapy (PIPAC) is a new surgical technique, developed for the treatment of peritoneal carcinomatosis (PC). In this retrospective observational study we assessed the impact of body mass index (BMI) on postoperative pain and opioid consumption. METHODS We analysed pain scores after 100 PIPAC procedures w...

BACKGROUND Intraperitoneal aerosol spray chemotherapy (PIPAC) is a new surgical technique, developed for the treatment of peritoneal carcinomatosis (PC). In this retrospective observational study we assessed the impact of body mass index (BMI) on postoperative pain and opioid consumption. METHODS We analysed pain scores after 100 PIPAC procedures w...

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is a treatment option for peritoneal metastases (PM) but is associated with significant postoperative morbidity. The aim of this study was to determine the prognostic value of computed tomographic (CT)-measured sarcopenia on postoperative outcomes and survival in patie...

BackgroundA recent meta-analysis showed that obesity increased the conversion rate and postoperative morbidity of rectal cancer surgery, but did not influence pathological results. However, this meta-analysis included patients with cancer of the upper rectum and had many biases. The aim of the present retrospective study was to investigate the impa...

Introduction As life expectancy is currently growing, more elderly and fragile patients need colorectal resection for cancer. We sought to assess the link between enhanced rehabilitation after surgery (ERAS), risk factors and overall survival at 3 years, in patients aged 65 and over. Methods Between 2005 and 2017, all patients undergoing colorecta...

Background: A successful innovative medical device is not only technically challenging to develop but must also be readily usable to be integrated into health care professionals' daily practice. Through a user-centered design (UCD) approach, usability can be improved. However, this type of approach is not widely implemented from the early stages o...

Purpose Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new surgical technique, for the treatment of initially unresectable peritoneal metastasis (PM). Our objective was to assess postoperative pain and morbidity. Methods Between July 2016 and September 2020, data from 100 consecutive PIPAC procedures with oxaliplatin (PIPAC Ox) or d...

Background Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new surgical technique for the treatment of initially unresectable peritoneal carcinomatosis (PC). Our objective was to assess its oncological outcomes. Methods Between July 2016 and September 2020, data from 100 PIPAC procedures with oxaliplatin or doxorubicin-cisplatin in 4...

Purpose Several recent studies have shown that the enhanced recovery after surgery (ERAS) protocol reduces morbidity and mortality and shortens the length of stay compared to conventional recovery strategy (pre-ERAS). The aim of this study was to evaluate the effect of the implementation of this protocol on 3-year overall survival and postoperative...

Management of malignant left-sided colonic obstruction remains challenging and requires a stoma in 40–65% of patients. In those with obstructive splenic flexure colon cancer (OSFCC), a debate still exists regarding the most appropriate surgery. The aim of this muticenter study was to report and compare the different surgical procedures in OSFCC pat...

Riassunto Al giorno d’oggi, la malattia di Hirschsprung è scoperta eccezionalmente in età adulta, di fronte a una stipsi ostinata che risale sempre alla prima infanzia. L’intervento è raccomandato per proteggere il paziente da gravi complicanze digestive. La preparazione in questa patologia deve essere drastica, per permettere di trattare la zona d...

Resumen En la actualidad, la enfermedad de Hirschsprung se descubre excepcionalmente en la edad adulta, ante un estreñimiento persistente que se remonta siempre a la primera infancia. Se recomienda la intervención para evitar al paciente las complicaciones digestivas graves. La preparación debe ser draconiana en esta enfermedad, para poder tratar l...

Background Management of rectovaginal fistula (RVF) in Crohn’s disease (CD) is challenging. Available studies are heterogeneous and retrospective, with short-term follow-up. The aim of this study was to assess the overall long-term medico-surgical treatment results in women with RVF due to CD.MethodsA retrospective study was conducted on consecutiv...

Objective: To report the largest multicentric experience on surgical management of retrorectal tumors (RRT). Summary background data: Literature data on RRT is limited. There is no consensus concerning the best surgical approach for the management of RRT. Methods: Patients operated for RRT in 18 academic French centers were retrospectively inc...

BACKGROUND A successful innovative medical device is not only technically challenging to develop, but must also be readily usable for it to be integrated into healthcare professionals’ practice. Usability is studied and enhanced via a user-centred approach, the advantages of which have been demonstrated. However, this type of approach is not widely...

Background For many abdominal surgical interventions, laparotomy has gradually been replaced by laparoscopy, with numerous benefits for the patient in terms of post-operative recovery. However, during laparoscopy, the endoscope only provides a single viewpoint to the surgeon, leaving numerous blind spots and opening the way to peri-operative advers...

Background The place of surgery and interventional radiology in the management of delayed (> 24 h) hemorrhage (DHR) complicating supramesocolic surgery is still to define. The aim of the study was to evaluate outcomes of DHR using a combined multimodal strategy.Methods Between 2005 and 2019, 57 patients (median age 64 years) experienced 86 DHR epis...

Introduction : Literature on rectal anastomosis and diverting ileostomy in patients treated with hyperthermic intraperitoneal chemotherapy (HIPEC) is limited. This study assesses the safety of rectal anastomoses during cytoreductive surgery (CRS) and HIPEC, with and without fecal diversion, and its morbidity when performed. Methods: From January 20...

Background Complete cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is the only curative treatment for pseudomyxoma peritonei (PMP) arising from the appendix. High peritoneal carcinomatosis index (PCI) is associated with an increased risk of surgical complications. The objective of this study was to prese...

Introduction Literature on rectal anastomosis and diverting ileostomy in patients treated with hyperthermic intraperitoneal chemotherapy (HIPEC) is limited. This study assesses the safety of rectal anastomoses during cytoreductive surgery (CRS) and HIPEC, with and without fecal diversion, and its morbidity when performed. Materials and methods Fro...

Background The absence of visibility of the entire surgical scene in laparoscopic surgery can lead to unforeseen intraoperative complications. An Enhanced Laparoscopy Vision System (ELViS) was developed to eliminate the blind spots of the traditional endoscope by providing a broad view of the surgical scene from a distance, thanks to two additional...

Background Complete cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is the only curative treatment for pseudomyxoma peritonei (PMP) arising from the appendix. High peritoneal carcinomatosis index (PCI) is associated with an increased risk of surgical complications. The objective of this study was to prese...

Internal biliary stenting during biliary reconstruction in liver transplantation decrease anastomotic biliary complications. Implantation of a resorbable internal biliary stent (RIBS) is interesting since it would avoid an ablation gesture. The objective of present work was to evaluate adequacy of selected PLA-b-PEG-b-PLA copolymers for RIBS aimed...

Objectif Rapporter l’expérience française de la prise en charge chirurgicale des tumeurs rétro-rectales (TRR). Méthodes Tous les patients opérés d’une TRR dans 17 centres français étaient rétrospectivement inclus (2000–2019). Les voies d’abord (antérieure, postérieure et combinée) étaient comparées. Résultats Deux cent trente-six patients (184 fe...

Introduction La prise en charge optimale des hémorragies tardives (HMT) après chirurgie sus-mésocolique (> 3 jours) n’est pas définie. Méthodes Entre 2005–2019, 56 patients (44 hommes, âge moyen 62 ans) ont présenté une HMT après transplantation hépatique (n = 24) et résection pancréatique (n = 32). Un scanner (TDM) en urgence suivi d’un traitemen...

Background Bladder invasion by colon cancer is rare; however, its management is still controversial. Our objective was to report outcomes and identify risk factors for local recurrence in colon cancer with clinically suspected bladder invasion. Methods We conducted a retrospective study in 23 centers in France. All patients who underwent colon sur...

Objective To assess the efficacy and safety of sacral nerve modulation (SNM) in patients with faecal incontinence (FI) after pelvic radiotherapy in comparison with results of SNM for FI related to other conditions. Methods Prospectively collected data from patients who underwent SNM therapy between January 2010 and December 2015 at 7 tertiary colo...

Background: GRECCAR 2 was the first multicentre, randomised trial to compare local excision with total mesorectal excision in downstaged low rectal cancer. Encouraging oncological results were noted at 3 years' follow-up but needed to be corroborated with longer follow-up. In this study, we aimed to report the 5-year oncological outcomes, includin...

The implantation of an internal biliary stent (IBS) during liver transplantation has recently been shown to reduce biliary complications. To avoid a potentially morbid ablation procedure, we developed a resorbable and radiopaque internal biliary stent (RIBS). We studied the mechanical and radiological properties of RIBS upon in vivo implantation in...

Background To date, there has been no consensus concerning the vascular approach during sigmoid colectomy for diverticular disease. The aim of this study was to determine the functional impact of elective laparoscopic sigmoidectomy performed with high ligation of the inferior mesenteric artery for diverticulitis in consecutive male patients. Metho...

Background There is ongoing debate regarding surgical treatment of splenic flexure cancer. The main points of controversy include the appropriate extent of colon resection, either to the right or to the left, and the appropriate extent of lymph-node dissection. The aim of this study was to review our experience in laparoscopic treatment of splenic...

Purpose There is limited literature regarding the feasibility and safety of laparoscopic procedures in patients having mechanical circulatory support, especially colonic resections. Methods The aim of this study is to present the case of a laparoscopic colectomy for cancer undergone in a 69-year-old patient having a HeartWare II at our institution...

Background: Some authors, either with anatomical studies or Doppler laser flowmetric investigations have shown the blood flow to the posterior midline of the anus to be potentially deficient. This relative local ischaemia might explain pathogenesis of anal fissure, which is often located posteriorly. The aim of this study was to record the exact p...

Biliary diseases are the third most common cause of surgical digestive disease. There is a close relationship between the mechanical performance of the bile duct and its physiological function. Data of biomechanical properties of human main bile duct are scarce in literature. Furthermore, mechanical properties of soft tissues are affected by these...

Background Peritoneal carcinomatosis (PC) from colorectal cancer is associated with poor prognosis. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has improved survival for patients with colorectal peritoneal carcinomatosis. However, standardization of HIPEC protocols, including which chemotherapeutic ag...

Introduction L’influence du jour opératoire a été décrit comme une tendance à l’augmentation de la mortalité chez les patients opérés le vendredi. Le but de cette étude était d’analyser l’influence du jour opératoire en chirurgie colorectale pour cancer. Méthode Nous avons conduit une étude rétrospective monocentrique d’une cohorte de 414 patients...

Background There is no demonstrated benefit of high-tie versus low-tie vascular transections in low rectal cancer surgery. The aim of this study was to compare the effects of high tie and low tie of the inferior mesenteric artery on colonic length. Methods This study was conducted in a surgical anatomy research laboratory. Anatomical dissections w...

Background The over-the-scope clip proctology system is rather new and information regarding its use for the closure of anorectal fistulas is scarce. No study has been designed to focus exclusively on its application in the treatment of rectovaginal fistulas. The aim of the study was to evaluate the feasibility, safety, and effectiveness of the cli...

Background: Surgical treatment for low rectal cancer septic complications often requires an ileostomy for fecal diversion. Delayed coloanal anastomosis (CAA) has been performed for several years to reduce septic complications and to avoid ileostomy. The aim of this study was to report the technical, functional and oncological results of delayed CA...

Aim: To report the results of surgery for obstructive right colon cancer (ORCC) and to identify risk factors associated with worse outcomes that may help surgeons to choose the best surgical option. Methods: This is a retrospective national cohort study, including all patients operated on for ORCC from 2000 to 2015. Those treated with colonic stent...

La malattia di Crohn è spesso complicata da una lesione anorettale, perineale e, a volte, vaginale, la cui incidenza è variamente apprezzata in letteratura. La sua presenza costituisce sempre una complicanza grave, perché l’impatto sulla qualità della vita è importante. Accanto alle lesioni infiammatorie diffuse e alle lesioni primarie, come ulcera...

La enfermedad de Crohn se complica frecuentemente con lesiones anorrectales, perineales y a veces vaginales, cuya incidencia varía en la literatura. En todos los casos, constituyen una complicación grave, ya que tienen una repercusión importante sobre la calidad de vida. Además de las lesiones inflamatorias difusas y de las lesiones primarias como...

PurposeFew studies compare management and outcomes of obstructive colonic cancer, depending on the tumor site. We aim to evaluate the differences in patient characteristics, tumor characteristics, and outcomes of emergency surgery for obstructive right-sided versus left-sided colonic cancers. Methods Between 2000 and 2009, 71 consecutive patients h...

Objective of the study: Ventral rectopexy can be performed robotically with only limited trauma for the patient, making its performance in an ambulatory setting potentially interesting. The aim of this study is to report our preliminary experience with ambulatory robotic ventral rectopexy in consecutive patients. Patients and methods: Ten consec...

Background: Colorectal cancers represent a heterogenous group of tumours. While left segmental colectomy is an accepted and oncologically safe practice for left-sided colonic cancer (CC), some authors suggest that limited segmental resection of right-sided cancer should be debated in order to preserve length of the resected colon. To our knowledge...