Infrared thermography for assessing skin temperature differences between Partial Body Cryotherapy and Whole Body Cryotherapy devices at −140 °C

International audienceBecause of the scarcity of the literature on the comparative efficiency of Partial Body Cryotherapy versus Whole Body Cryotherapy, it appears that the decision to switch from the former to the latter is purely arbitrary and does not actually meet any scientifically established criterion. The motivation of this study is to draw up an objective observation of the differences between Partial Body Cryotherapy and Whole Body Cryotherapy treatments, based on the analysis of skin temperature distribution. Ten healthy subjects who engage in regular physical activity participated in the study (50% female; means ± S.D.: age 45.8 ± 5.5 years, height 168.7 ± 9,3 cm, weight 75.3 ± 13.1 kg, body fat percentage 19.3 ± 9,8). Sessions took place in a cryosauna and a cryochamber at identical temperature (−140 °C), duration of cryostimulation (3 min) and nature of the refrigerant used (liquid nitrogen vapor). It is shown that the skin temperature difference between Partial Body Cryotherapy and Whole Body Cryotherapy varies according to the vertical location of the body regions, increasingly from 15% on the lower areas of the body (no significant difference in skin temperature for legs P = .171) up to 53% for the upper areas (significant difference P < 0.001 for chest). These observations show the caution with which these two cryotherapy systems must be considered. The knowledge of the differences in cutaneous thermal response between these two systems should guide sports coaches and physicians in prescribing differentiated treatment protocols in order to achieve comparable skin temperature effects and consequently to efficiently cool tissues in the same way

Endoscopic full-thickness resection (eFTR) of colorectal lesions: results from the Dutch colorectal eFTR registry

Background Endoscopic full-thickness resection (eFTR) is a minimally invasive resection technique that allows definite diagnosis and treatment for complex colorectal lesions <= 30mm unsuitable for conventional endoscopic resection. This study reports clinical outcomes from the Dutch colorectal eFTR registry.Methods Consecutive patients undergoing eFTR in 20 hospitals were prospectively included. The primary outcome was technical success, defined as macroscopic complete en bloc resection. Secondary outcomes were: clinical success, defined as tumor-free resection margins (R0 resection); full-thickness resection rate; and adverse events.Results Between July 2015 and October 2018, 367 procedures were included. Indications were difficult polyps (non-lifting sign and/or difficult location; n = 133), primary resection of suspected T1 colorectal cancer (CRC; n = 71), reresection after incomplete resection of T1 CRC (n = 150), and subepithelial tumors (n = 13). Technical success was achieved in 308 procedures (83.9%). In 21 procedures (5.7 %), eFTR was not performed because the lesion could not be reached or retracted into the cap. In the remaining 346 procedures, R0 resection was achieved in 285 (82.4%) and full-thickness resection in 288 (83.2%). The median diameter of resected specimens was 23mm. Overall adverse event rate was 9.3% (n = 34/367): 10 patients (2.7 %) required emergency surgery for five delayed and two immediate perforations and three cases of appendicitis.Conclusion eFTR is an effective and relatively safe en bloc resection technique for complex colorectal lesions with the potential to avoid surgery. Further studies assessing the role of eFTR in early CRC treatment with long-term outcomes are needed.Cellular mechanisms in basic and clinical gastroenterology and hepatolog

Endoscopic full-thickness resection of T1 colorectal cancers: a retrospective analysis from a multicenter Dutch eFTR registry

Background Complete endoscopic resection and accurate histological evaluation for T1 colorectal cancer (CRC) are critical in determining subsequent treatment. Endoscopic full-thickness resection (eFTR) is a new treatment option for T1 CRC Methods Consecutive eFTR procedures for T1 CRC, prospectively recorded in our national registry between November 2015 and April 2020, were retrospectively analyzed. Primary outcomes were technical success and R0 resection. Secondary outcomes were histological risk assessment, curative resection, adverse events, and short-term outcomes. Results We included 330 procedures: 132 primary resections and 198 secondary scar resections after incomplete T1 CRC resection. Overall technical success, R0 resection, and curative resection rates were 87.0 % (95 % confidence interval [CI] 82.7 %-90.3 %), 85.6 % (95 %CI 81.2 %-89.2 %), and 60.3 % (95 %CI 54.7 %-65.7 %). Curative resection rate was 23.7 % (95 %CI 15.9 %-33.6 %) for primary resection of T1 CRC and 60.8 % (95 %CI 50.4 %-70.4 %) after excluding deep submucosal invasion as a risk factor. Risk stratification was possible in 99.3 %. The severe adverse event rate was 2.2 %. Additional oncological surgery was performed in 49/320 (15.3 %), with residual cancer in 11/49 (22.4 %). Endoscopic follow-up was available in 200/242 (82.6 %), with a median of 4 months and residual cancer in 1 (0.5 %) following an incomplete resection. Conclusions eFTR is relatively safe and effective for resection of small T1 CRC, both as primary and secondary treatment. eFTR can expand endoscopic treatment options for T1 CRC and could help to reduce surgical overtreatment. Future studies should focus on long-term outcomes