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Dr. Raphael Vuille-dit-Bille
Department of Pediatric Surgery, University Children’s Hospital of Basel, 4056 Basel, Switzerland

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0 Pediatric Surgery
0 intestinal absorption
0 Metaanalyses
0 Short gut syndrome
0 Minimal-invasive surgery

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Review
Published: 15 August 2021 in Nutrients
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L-Citrulline is a non-essential but still important amino acid that is released from enterocytes. Because plasma levels are reduced in case of impaired intestinal function, it has become a biomarker to monitor intestinal integrity. Moreover, oxidative stress induces protein citrullination, and antibodies against anti-citrullinated proteins are useful to monitor rheumatoid diseases. Citrullinated histones, however, may even predict a worse outcome in cancer patients. Supplementation of citrulline is better tolerated compared to arginine and might be useful to slightly improve muscle strength or protein balance. The following article shall provide an overview of L-citrulline properties and functions, as well as the current evidence for its use as a biomarker or as a therapeutic supplement.

ACS Style

Stefano Maric; Tanja Restin; Julian Louis Muff; Simone Mafalda Camargo; Laura Chiara Guglielmetti; Stefan Gerhard Holland-Cunz; Pascal Crenn; Raphael Nicolas Vuille-Dit-Bille. Citrulline, Biomarker of Enterocyte Functional Mass and Dietary Supplement. Metabolism, Transport, and Current Evidence for Clinical Use. Nutrients 2021, 13, 2794 .

AMA Style

Stefano Maric, Tanja Restin, Julian Louis Muff, Simone Mafalda Camargo, Laura Chiara Guglielmetti, Stefan Gerhard Holland-Cunz, Pascal Crenn, Raphael Nicolas Vuille-Dit-Bille. Citrulline, Biomarker of Enterocyte Functional Mass and Dietary Supplement. Metabolism, Transport, and Current Evidence for Clinical Use. Nutrients. 2021; 13 (8):2794.

Chicago/Turabian Style

Stefano Maric; Tanja Restin; Julian Louis Muff; Simone Mafalda Camargo; Laura Chiara Guglielmetti; Stefan Gerhard Holland-Cunz; Pascal Crenn; Raphael Nicolas Vuille-Dit-Bille. 2021. "Citrulline, Biomarker of Enterocyte Functional Mass and Dietary Supplement. Metabolism, Transport, and Current Evidence for Clinical Use." Nutrients 13, no. 8: 2794.

Original article
Published: 16 July 2021 in Pediatric Surgery International
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Purpose It is unknown if failed preoperative vacuum bell (VB) treatment in patients undergoing minimally invasive repair of pectus excavatum (MIRPE), delays repair and/or affects postoperative outcomes. Methods A retrospective data analysis including all consecutive patients treated at one single institution undergoing MIRPE was performed between 2000 and 2016. Patients were stratified into preoperative VB therapy versus no previous VB therapy. Results In total, 127 patients were included. Twenty-seven (21.3%) patients had preoperative VB treatment for 17 months (median, IQR 8–34). All 27 patients stopped VB treatment due to the lack of treatment effect. Eight (47.1%) of 17 assessed VB patients showed signs of skin irritation or hematoma. VB treatment had no effect on length of hospital stay (p = 0.385), postoperative complications (p = 1.0), bar dislocations (p = 1.0), and duration of bar treatment (p = 0.174). Time spent in intensive care unit was shorter in patients with VB therapy (p = 0.007). Long-term perception of treatment including rating of primary operation (p = 0.113), pain during primary operation (p = 0.838), own perspective of look of chest (p = 0.545), satisfaction with the procedure (p = 0.409), and intention of doing surgery again (p = 1.0) were not different between groups. Conclusions Failed preoperative VB therapy had no or minimal effect on short-term outcomes and long-term perceptions following MIRPE.

ACS Style

J. L. Muff; L. C. Guglielmetti; S. J. Gros; L. Buchmüller; G. Frongia; S. G. Holland-Cunz; T. de Trey; Raphael N. Vuille-Dit-Bille. Failed preoperative vacuum bell therapy does not affect outcomes following minimally invasive repair of pectus excavatum. Pediatric Surgery International 2021, 1 -7.

AMA Style

J. L. Muff, L. C. Guglielmetti, S. J. Gros, L. Buchmüller, G. Frongia, S. G. Holland-Cunz, T. de Trey, Raphael N. Vuille-Dit-Bille. Failed preoperative vacuum bell therapy does not affect outcomes following minimally invasive repair of pectus excavatum. Pediatric Surgery International. 2021; ():1-7.

Chicago/Turabian Style

J. L. Muff; L. C. Guglielmetti; S. J. Gros; L. Buchmüller; G. Frongia; S. G. Holland-Cunz; T. de Trey; Raphael N. Vuille-Dit-Bille. 2021. "Failed preoperative vacuum bell therapy does not affect outcomes following minimally invasive repair of pectus excavatum." Pediatric Surgery International , no. : 1-7.

Article
Published: 09 March 2021 in Cochrane Database of Systematic Reviews
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Background Infantile hypertrophic pyloric stenosis (IHPS) is a disorder of young children (aged one year or less) and can be treated by laparoscopic (LP) or open (OP) longitudinal myotomy of the pylorus. Since the first description in 1990, LP is being performed more often worldwide. Objectives To compare the efficacy and safety of open versus laparoscopic pyloromyotomy for IHPS. Search methods We conducted a literature search on 04 February 2021 to identify all randomised controlled trials (RCTs), without any language restrictions. We searched the following electronic databases: MEDLINE (1990 to February 2021), Embase (1990 to February 2021), and the Cochrane Central Register of Controlled Trials (CENTRAL). We also searched the Internet using the Google Search engine (www.google.com) and Google Scholar (scholar.google.com) to identify grey literature not indexed in databases. Selection criteria We included RCTs and quasi‐randomised trials comparing LP with OP for hypertrophic pyloric stenosis. Data collection and analysis Two review authors independently screened references and extracted data from trial reports. Where outcomes or study details were not reported, we requested missing data from the corresponding authors of the primary RCTs. We used a random‐effects model to calculate risk ratios (RRs) for binary outcomes, and mean differences (MDs) for continuous outcomes. Two review authors independently assessed risks of bias. We used GRADE to assess the certainty of the evidence for all outcomes. Main results The electronic database search resulted in a total of 434 records. After de‐duplication, we screened 410 independent publications, and ultimately included seven RCTs (reported in 8 reports) in quantitative analysis. The seven included RCTs enrolled 720 participants (357 with open pyloromyotomy and 363 with laparoscopic pyloromyotomy). One study was a multi‐country trial, three were carried out in the USA, and one study each was carried out in France, Japan, and Bangladesh. The evidence suggests that LP may result in a small increase in mucosal perforation compared with OP (RR 1.60, 95% CI 0.49 to 5.26; 7 studies, 720 participants; low‐certainty evidence). LP may result in up to 5 extra instances of mucosal perforation per 1,000 participants; however, the confidence interval ranges from 4 fewer to 44 more per 1,000 participants. Four RCTs with 502 participants reported on incomplete pyloromyotomy. They indicate that LP may increase the risk of incomplete pyloromyotomy compared with OP, but the confidence interval crosses the line of no effect (RR 7.37, 95% CI 0.92 to 59.11; 4 studies, 502 participants; low‐certainty evidence). In the LP groups, 6 cases of incomplete pyloromyotomy were reported in 247 participants while no cases of incomplete pyloromyotomy were reported in the OP groups (from 255 participants). All included studies (720 participants) reported on postoperative wound infections or abscess formations. The evidence is very uncertain about the effect of LP on postoperative wound infection or abscess formation compared with OP (RR 0.59, 95% CI 0.24 to 1.45; 7 studies, 720 participants; very low‐certainty evidence). The evidence is also very uncertain about the effect of LP on postoperative incisional hernia compared with OP (RR 1.01, 95% CI 0.11 to 9.53; 4 studies, 382 participants; very low‐certainty evidence). Length of hospital stay was assessed by five RCTs, including 562 participants. The evidence is very uncertain about the effect of LP compared to OP (mean difference −3.01 hours, 95% CI −8.39 to 2.37 hours; very low‐certainty evidence). Time to full feeds was assessed by six studies, including 622 participants. The evidence is very uncertain about the effect of LP on time to full feeds compared with OP (mean difference −5.86 hours, 95% CI −15.95 to 4.24 hours; very low‐certainty evidence). The evidence is also very uncertain about the effect of LP on operating time compared with OP (mean difference 0.53 minutes, 95% CI −3.53 to 4.59 minutes; 6 studies, 622 participants; very low‐certainty evidence). Authors' conclusions Laparoscopic pyloromyotomy may result in a small increase in mucosal perforation when compared with open pyloromyotomy for IHPS. There may be an increased risk of incomplete pyloromyotomy following LP compared with OP, but the effect estimate is imprecise and includes the possibility of no difference. We do not know about the effect of LP compared with OP on the need for re‐operation, postoperative wound infections or abscess formation, postoperative haematoma or seroma formation, incisional hernia occurrence, length of postoperative stay, time to full feeds, or operating time because the certainty of the evidence was very low for these outcomes. We downgraded the certainty of the evidence for most outcomes due to limitations in the study design (most outcomes were susceptible to detection bias) and imprecision. There is limited evidence available comparing LP with OP for IHPS. The included studies did not provide sufficient information to determine the effect of training, experience, or surgeon preferences on the outcomes assessed.

ACS Style

Ralph F Staerkle; Fabian Lunger; Lukas Fink; Tom Sasse; Martin Lacher; Erik von Elm; Ahmed I Marwan; Stefan Holland-Cunz; Raphael Nicolas Vuille-Dit-Bille. Open versus laparoscopic pyloromyotomy for pyloric stenosis. Cochrane Database of Systematic Reviews 2021, 2021, CD012827 .

AMA Style

Ralph F Staerkle, Fabian Lunger, Lukas Fink, Tom Sasse, Martin Lacher, Erik von Elm, Ahmed I Marwan, Stefan Holland-Cunz, Raphael Nicolas Vuille-Dit-Bille. Open versus laparoscopic pyloromyotomy for pyloric stenosis. Cochrane Database of Systematic Reviews. 2021; 2021 (3):CD012827.

Chicago/Turabian Style

Ralph F Staerkle; Fabian Lunger; Lukas Fink; Tom Sasse; Martin Lacher; Erik von Elm; Ahmed I Marwan; Stefan Holland-Cunz; Raphael Nicolas Vuille-Dit-Bille. 2021. "Open versus laparoscopic pyloromyotomy for pyloric stenosis." Cochrane Database of Systematic Reviews 2021, no. 3: CD012827.

Journal article
Published: 26 January 2021
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The use of electronic media in informed consent giving has become increasingly important in recent years. Due to the easy access to information via electronical media, patients are primed in a heterogeneous manner concerning expectations and wishes regarding surgical interventions. Inherent to its nature elective interventions are critically questioned as there is time for information gathering and reflection. In this study, we set out to investigate the effect of an educational video as a supporting element in the process of informed consent giving for one the most frequently performed interventions in general surgery, namely inguinal hernia repair. In a multicentre setup, eligible patients for primary inguinal hernia repair will be randomly assigned to one of three groups. All three groups will have a preoperative informed consent discussion with a physician in which they will eventually sign the informed consent sheet if participation is desired. Eventually, all three groups will get an online link. For two groups, the link will lead to a video with audiovisual information (an inguinal hernia video for the intervention group and a mock video for the control group). The intervention video provides basic principles of endoscopic extraperitoneal hernia repair. The second video is similar in length and design and displays general aspects of day surgery in the two study centres. All the three study groups will be provided with a copy of the informed consent form as it is standard by now. The third group's link will lead to the digital version of the informed consent brochure. Primary outcomes will consist of (1) score in a multiple choice test assessing gain of knowledge regarding hernia repair, (2) difference in the State-Trait Anxiety Inventory and (3) patient satisfaction questionnaire Individual Clinician Feedback (ICF, Picker Institute, Germany) as assessed 1-2 days after the first consultation. The study design guarantees double blinding, there will be no unblinding at any point. All patients will receive the same, quality and number of medical consultations as well as in the same surgical treatment. (Minor differences in the total extraperitoneal technique of the surgical treatment due to anatomical or pathophysiological differences are independent of the group allocation). Except for the additional videos, there will be no difference in in the information provided and the treatment prior, during or after the hernia repair. We plan to publish the study in a peer-reviewed journal. The proposed research project has been reviewed by the Cantonal Ethics Committee (BASEC-No 2020-01548). In accordance with national legal regulations in Switzerland stated by the Human Research Act, the proposed project was declared exempt from approval requirement. NCT04494087; Pre-results.

ACS Style

Fabian Lunger; Florian Frank; Georgios Peros; Alexander Lunger; Raphael Vuille-Dit-Bille; Laura Guglielmetti; Stefan Breitenstein; Felix Grieder; Jan Ehlers; Christian Gingert. Potential benefit in information providing and influence on patient anxiety and satisfaction by means of preoperative explanatory videos in total extraperitoneal inguinal hernioplasty: study protocol of a multicentre, double-blinded, randomised parallel-group controlled trial. 2021, 11, e043702 .

AMA Style

Fabian Lunger, Florian Frank, Georgios Peros, Alexander Lunger, Raphael Vuille-Dit-Bille, Laura Guglielmetti, Stefan Breitenstein, Felix Grieder, Jan Ehlers, Christian Gingert. Potential benefit in information providing and influence on patient anxiety and satisfaction by means of preoperative explanatory videos in total extraperitoneal inguinal hernioplasty: study protocol of a multicentre, double-blinded, randomised parallel-group controlled trial. . 2021; 11 (1):e043702.

Chicago/Turabian Style

Fabian Lunger; Florian Frank; Georgios Peros; Alexander Lunger; Raphael Vuille-Dit-Bille; Laura Guglielmetti; Stefan Breitenstein; Felix Grieder; Jan Ehlers; Christian Gingert. 2021. "Potential benefit in information providing and influence on patient anxiety and satisfaction by means of preoperative explanatory videos in total extraperitoneal inguinal hernioplasty: study protocol of a multicentre, double-blinded, randomised parallel-group controlled trial." 11, no. 1: e043702.

Publisher correction
Published: 11 December 2020 in European Surgery
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A Correction to this paper has been published: 10.1007/s10353-020-00656-x

ACS Style

Kim Tai Vuong; Laura C. Guglielmetti; Thomas G. Albert; Waldemar Brillat Arce; Ralph F. Staerkle; Raphael N. Vuille-Dit-Bille. Correction to: Outpatient before inpatient—the good, the bad and the ugly. European Surgery 2020, 53, 40 -40.

AMA Style

Kim Tai Vuong, Laura C. Guglielmetti, Thomas G. Albert, Waldemar Brillat Arce, Ralph F. Staerkle, Raphael N. Vuille-Dit-Bille. Correction to: Outpatient before inpatient—the good, the bad and the ugly. European Surgery. 2020; 53 (1):40-40.

Chicago/Turabian Style

Kim Tai Vuong; Laura C. Guglielmetti; Thomas G. Albert; Waldemar Brillat Arce; Ralph F. Staerkle; Raphael N. Vuille-Dit-Bille. 2020. "Correction to: Outpatient before inpatient—the good, the bad and the ugly." European Surgery 53, no. 1: 40-40.

Observational study
Published: 04 December 2020 in Medicine
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Over one-third of infants with congenital diaphragmatic hernia (CDH) eventually require a Nissen fundoplication (NF). We examined pre- and intraoperative predictors for need of a NF in children undergoing CDH repair to elucidate, which patients will need a later NF.

ACS Style

Laura C. Guglielmetti; Arturo E. Estrada; Ryan Phillips; Ralph F. Staerkle; Jason Gien; John P. Kinsella; Kenneth W. Liechty; Ahmed I. Marwan; Raphael N. Vuille-Dit-Bille. Congenital diaphragmatic hernias. Medicine 2020, 99, e23383 .

AMA Style

Laura C. Guglielmetti, Arturo E. Estrada, Ryan Phillips, Ralph F. Staerkle, Jason Gien, John P. Kinsella, Kenneth W. Liechty, Ahmed I. Marwan, Raphael N. Vuille-Dit-Bille. Congenital diaphragmatic hernias. Medicine. 2020; 99 (49):e23383.

Chicago/Turabian Style

Laura C. Guglielmetti; Arturo E. Estrada; Ryan Phillips; Ralph F. Staerkle; Jason Gien; John P. Kinsella; Kenneth W. Liechty; Ahmed I. Marwan; Raphael N. Vuille-Dit-Bille. 2020. "Congenital diaphragmatic hernias." Medicine 99, no. 49: e23383.

Article
Published: 02 December 2020 in Cochrane Database of Systematic Reviews
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This protocol for a Cochrane Review has been withdrawn by Cochrane colorectal group.

ACS Style

Corina Giovanoli; Ralph F Staerkle; Svenja Leu; Lukas Fink; Christopher Soll; Stefan Gaukel; Raphael Nicolas Vuille-Dit-Bille. Neostigmine for the treatment of acute colonic pseudo-obstruction. Cochrane Database of Systematic Reviews 2020, 1 .

AMA Style

Corina Giovanoli, Ralph F Staerkle, Svenja Leu, Lukas Fink, Christopher Soll, Stefan Gaukel, Raphael Nicolas Vuille-Dit-Bille. Neostigmine for the treatment of acute colonic pseudo-obstruction. Cochrane Database of Systematic Reviews. 2020; (12):1.

Chicago/Turabian Style

Corina Giovanoli; Ralph F Staerkle; Svenja Leu; Lukas Fink; Christopher Soll; Stefan Gaukel; Raphael Nicolas Vuille-Dit-Bille. 2020. "Neostigmine for the treatment of acute colonic pseudo-obstruction." Cochrane Database of Systematic Reviews , no. 12: 1.

Pediatric urology
Published: 13 November 2020 in Urology
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Objective To describe five cases with complete urinary bladder duplication, their associated conditions, and their respective treatment. Urinary bladder duplication is an extremely rare congenital anomaly of the urinary system. So far about 70 cases have been published in the English literature, most of them as case reports and a few case series. Methods and Results All consecutive patients with bladder duplication treated at our institution between 2000 and 2015 were included. Patient records were retrospectively analyzed, and five patients with urinary bladder duplication were identified (see Summary Figure). Two patients were male. All duplications were recognized by health care providers. In one case recognition was prenatal (MRI in utero at 22 weeks of gestation), the latest recognition was at 12 months of age. A voiding cystourethrography was performed in four patients to confirm the diagnosis. In four patients the bladder duplication could be classified according to Abrahamson with three complete reduplications and one complete sagittal septum. All patients suffered from associated congenital diseases, but only one patient had urinary tract infections. Surgical treatment was only performed in one patient. Median follow-up was 34 months. Discussion Urinary bladder duplications reflect extremely seldom disorders that are almost always associated with other congenital anomalies. Treatment depends on patients' symptoms and associated conditions and hence needs to be individualized to each patient.

ACS Style

Mellissa Delcont; Laura Chiara Guglielmetti; Nripesh Rajbhandari; Jonathan Walker; Duncan Wilcox; Raphael N Vuille-Dit-Bille. Bladder Duplication - A Case Series. Urology 2020, 149, 199 -205.

AMA Style

Mellissa Delcont, Laura Chiara Guglielmetti, Nripesh Rajbhandari, Jonathan Walker, Duncan Wilcox, Raphael N Vuille-Dit-Bille. Bladder Duplication - A Case Series. Urology. 2020; 149 ():199-205.

Chicago/Turabian Style

Mellissa Delcont; Laura Chiara Guglielmetti; Nripesh Rajbhandari; Jonathan Walker; Duncan Wilcox; Raphael N Vuille-Dit-Bille. 2020. "Bladder Duplication - A Case Series." Urology 149, no. : 199-205.

Review article
Published: 03 November 2020 in Clinical Science
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ACE2 is a type I membrane protein with extracellular carboxypeptidase activity displaying a broad tissue distribution with highest expression levels at the brush border membrane (BBM) of small intestine enterocytes and a lower expression in stomach and colon. In small intestinal mucosa, ACE2 mRNA expression appears to increase with age and to display higher levels in patients taking ACE-inhibitors (ACE-I). There, ACE2 protein heterodimerizes with the neutral amino acid transporter Broad neutral Amino acid Transporter 1 (B0AT1) (SLC6A19) or the imino acid transporter Sodium-dependent Imino Transporter 1 (SIT1) (SLC6A20), associations that are required for the surface expression of these transport proteins. These heterodimers can form quaternary structures able to function as binding sites for SARS-CoV-2 spike glycoproteins. The heterodimerization of the carboxypeptidase ACE2 with B0AT1 is suggested to favor the direct supply of substrate amino acids to the transporter, but whether this association impacts the ability of ACE2 to mediate viral infection is not known. B0AT1 mutations cause Hartnup disorder, a condition characterized by neutral aminoaciduria and, in some cases, pellagra-like symptoms, such as photosensitive rash, diarrhea, and cerebellar ataxia. Correspondingly, the lack of ACE2 and the concurrent absence of B0AT1 expression in small intestine causes a decrease in l-tryptophan absorption, niacin deficiency, decreased intestinal antimicrobial peptide production, and increased susceptibility to inflammatory bowel disease (IBD) in mice. Thus, the abundant expression of ACE2 in small intestine and its association with amino acid transporters appears to play a crucial role for the digestion of peptides and the absorption of amino acids and, thereby, for the maintenance of structural and functional gut integrity.

ACS Style

Simone M.R. Camargo; Raphael N. Vuille-Dit-Bille; Chantal F. Meier; François Verrey. ACE2 and gut amino acid transport. Clinical Science 2020, 134, 2823 -2833.

AMA Style

Simone M.R. Camargo, Raphael N. Vuille-Dit-Bille, Chantal F. Meier, François Verrey. ACE2 and gut amino acid transport. Clinical Science. 2020; 134 (21):2823-2833.

Chicago/Turabian Style

Simone M.R. Camargo; Raphael N. Vuille-Dit-Bille; Chantal F. Meier; François Verrey. 2020. "ACE2 and gut amino acid transport." Clinical Science 134, no. 21: 2823-2833.

Original article
Published: 20 October 2020 in European Surgery
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Summary Background In January 2019 the Swiss Federal Department of Home Affairs defined a group of six selected surgical interventions to be performed on an outpatient basis. The aim of this paper is to assess surgeons’ opinions on patient safety, costs and treatment based on this new regulation. Methods An online survey was sent electronically to all 942 members of the Swiss Society of Surgery between August and October 2019. Results About half of the participants think the new regulation could harm patients (52%) and will lead to lower patient satisfaction (49%). Whereas half of the participants expect a reduction in health care costs (52%), most expect surgeons to earn less due to the new regulation (82%). About three quarters (73%) of the participants expect the new regulation to negatively affect surgical resident education. More than half (62%) of the participants assume that diagnoses allowing reimbursement for inpatient treatment (such as, e.g., bilateral instead of unilateral inguinal hernia) could be made more generously. Accordingly, 70% assume that the new regulation may result in not necessarily indispensable or possibly unnecessarily extended interventions (such as, e.g., bilateral inguinal hernia repair). Furthermore, most (86%) participants fear that the new regulation could possibly lead to hospitals/surgeons rejecting patients. Conclusion Whereas about half of the participants expect a reduction in health care costs, about two thirds fear that more generous diagnoses and not necessarily indispensable or possibly unnecessarily extended interventions could be performed due to the new regulation demanding outpatient care for said surgical interventions.

ACS Style

Kim Tai Vuong; Laura C. Guglielmetti; Thomas G. Albert; Waldemar Brillat Arce; Ralph F. Staerkle; Raphael N. Vuille-Dit-Bille. Outpatient before inpatient—the good, the bad and the ugly. European Surgery 2020, 53, 11 -15.

AMA Style

Kim Tai Vuong, Laura C. Guglielmetti, Thomas G. Albert, Waldemar Brillat Arce, Ralph F. Staerkle, Raphael N. Vuille-Dit-Bille. Outpatient before inpatient—the good, the bad and the ugly. European Surgery. 2020; 53 (1):11-15.

Chicago/Turabian Style

Kim Tai Vuong; Laura C. Guglielmetti; Thomas G. Albert; Waldemar Brillat Arce; Ralph F. Staerkle; Raphael N. Vuille-Dit-Bille. 2020. "Outpatient before inpatient—the good, the bad and the ugly." European Surgery 53, no. 1: 11-15.

Journal article
Published: 09 October 2020 in Clinical Nutrition
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Summary Background & aims Plasma citrulline, a non-protein amino acid, is a biochemical marker of small intestine enterocyte mass in humans. Indeed, citrulline is highly correlated with residual bowel length in patients with short bowel syndrome. It is known to be synthesised in epithelial cells of the small intestine from other amino acids (precursors). Citrulline is then released into systemic circulation and interconverted into arginine in kidneys. If plasma citrulline concentration depends on abundance of intestinal amino acid transporters is not known. The aim of the present study was to explore whether plasma citrulline concentration correlates with the expression of intestinal amino acid transporters. Furthermore, we assessed if arginine in urine correlates with plasma citrulline. Methods Duodenal samples, blood plasma and urine were collected from 43 subjects undergoing routine gastroduodenoscopy. mRNA expression of seven basolateral membrane amino acid transporters/transporter subunits were assessed by real-time PCR. Plasma and urine amino acid concentrations of citrulline, its precursors and other amino acids were analysed using High Performance Liquid Chromatography measurements. Amino acid transporter mRNA expression was correlated with blood plasma and urine levels of citrulline and its precursors using Spearman's rank correlation. Likewise, urine arginine was correlated with plasma citrulline. Results Plasma citrulline correlated with the mRNA expression of basolateral amino acid transporter LAT4 (Spearman's r = 0.467, p = 0.028) in small intestine. None of the other basolateral membrane transporters/transporter subunits assessed correlated with plasma citrulline. Plasma citrulline correlated with urinary arginine, (Spearman's r = 0.419, p = 0.017), but not with urinary citrulline or other proteinogenic amino acids in the urine. Conclusions In this study, we showed for the first time that small intestinal basolateral LAT4 expression correlates with plasma citrulline concentration. This finding indicates that LAT4 has an important function in mediating citrulline efflux from enterocytes. Furthermore, urine arginine correlated with plasma citrulline, indicating arginine in the urine as possible additional marker for small intestine enterocyte mass. Finally, basolateral LAT4 expression along the human small intestine was shown for the first time.

ACS Style

Stefano Maric; Pascal Flüchter; Laura Chiara Guglielmetti; Ralph Fabian Staerkle; Tom Sasse; Tanja Restin; Christoph Schneider; Stefan Gerhard Holland-Cunz; Pascal Crenn; Raphael Nicolas Vuille-Dit-Bille. Plasma citrulline correlates with basolateral amino acid transporter LAT4 expression in human small intestine. Clinical Nutrition 2020, 40, 2244 -2251.

AMA Style

Stefano Maric, Pascal Flüchter, Laura Chiara Guglielmetti, Ralph Fabian Staerkle, Tom Sasse, Tanja Restin, Christoph Schneider, Stefan Gerhard Holland-Cunz, Pascal Crenn, Raphael Nicolas Vuille-Dit-Bille. Plasma citrulline correlates with basolateral amino acid transporter LAT4 expression in human small intestine. Clinical Nutrition. 2020; 40 (4):2244-2251.

Chicago/Turabian Style

Stefano Maric; Pascal Flüchter; Laura Chiara Guglielmetti; Ralph Fabian Staerkle; Tom Sasse; Tanja Restin; Christoph Schneider; Stefan Gerhard Holland-Cunz; Pascal Crenn; Raphael Nicolas Vuille-Dit-Bille. 2020. "Plasma citrulline correlates with basolateral amino acid transporter LAT4 expression in human small intestine." Clinical Nutrition 40, no. 4: 2244-2251.

Meta analysis
Published: 31 July 2020 in Medicine
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Background: It is still not clear if the contralateral side should be explored in children with unilateral inguinal hernias. The primary aim of the present study was to assess the incidence of metachronous contralateral inguinal hernias (MCIHs) in the pediatric population. The second aim was to assess factors associated with increased risk of MCIH development. Methods: Prospective studies including patients from 0-19 years undergoing unilateral inguinal hernia repair without surgical exploration of the contralateral side between 1947 and April 2020 with a minimal follow-up of one year were searched. Searches included EMBASE, MEDLINE, and the Cochrane Central Register of Controlled Trials. Results: Seven studies involving 1774 children (1452 boys (82%) and 322 girls (18%) were identified. Overall the incidence of MCIH was 6%. Incidence of MCIH development was significantly higher in children with initial left-sided (9%) versus right-sided (3%) hernia (OR 2.55 with 95% CI from 1.56 to 4.17; P = 0.0002), in female (8%) versus male (4%) children (OR 1.74 with 95% CI from 1.01 to 3.01; P = 0.0469) and in patients with open (14%) versus closed (3%) contralateral processus vaginalis (CPV) (OR 4.17 with 95% CI from 1.25 to 13.9; P = 0.0202). There was no significant difference in MCIH development depending on follow-up duration (follow-up of ≤2 years (i.e. 1–2 years): calculated MCIH incidence 5% (95% CI from 0.00 to 0.11%; 3 studies; 569 patients), follow-up of ≥3 years (i.e. 3–4 years): 6% (95% CI from 0.03 to 0.09; 3 studies, 983 patients)) or patients’ age (MCIH incidence in children <1 year: 6.9%; older children: 4.5%; OR 1.87 with 95% CI from 0.97 to 3.62; P = 0.0618). Conclusions: Overall incidence of MCIH development is 6%. Initial left-sided hernia, female gender and open CPV are risk factors for MCIH development.

ACS Style

Ralph F. Staerkle; Laura C. Guglielmetti; Isabella N. Bielicki; Stefan Gaukel; Giovanni Frongia; Sarah Hilton; Lukas Fink; Raphael N. Vuille-Dit-Bille. Is it worth to explore the contralateral side in unilateral childhood inguinal hernia? Medicine 2020, 99, e21501 .

AMA Style

Ralph F. Staerkle, Laura C. Guglielmetti, Isabella N. Bielicki, Stefan Gaukel, Giovanni Frongia, Sarah Hilton, Lukas Fink, Raphael N. Vuille-Dit-Bille. Is it worth to explore the contralateral side in unilateral childhood inguinal hernia? Medicine. 2020; 99 (31):e21501.

Chicago/Turabian Style

Ralph F. Staerkle; Laura C. Guglielmetti; Isabella N. Bielicki; Stefan Gaukel; Giovanni Frongia; Sarah Hilton; Lukas Fink; Raphael N. Vuille-Dit-Bille. 2020. "Is it worth to explore the contralateral side in unilateral childhood inguinal hernia?" Medicine 99, no. 31: e21501.

Journal article
Published: 09 July 2020 in Medicina
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Background and objective: No current nationwide consensus exists on pilonidal disease (PD) treatment in Switzerland and Austria. The objective of this study was to assess and compare the spectrum of PD treatment strategies in Switzerland and Austria. Materials and Methods: A survey including 196 certified institutions (Switzerland, N = 99 and Austria, N = 97) was performed. Treatment strategies for both chronic and acute pilonidal disease were investigated, as well as evolution of treatment over the last 20 years. Results: In total, 92 of 196 (47%) hospitals participated in the survey. Recurrence rate (20%) was similar between the two countries. In acute pilonidal disease, a two-stage approach with incision and drainage as the first step was preferred over a one-stage procedure in both countries. In Austria, all patients with chronic pilonidal disease were treated as inpatients, whereas 28% of patients in Switzerland were treated on an outpatient basis (p = 0.0019). Median length of hospital stay was double in Austria (four days) compared to Switzerland (two days; p < 0.001). Primary resection and off-midline closure (p = 0.017) and the use of tissue flaps (p = 0.023) were performed more commonly in Austria than in Switzerland. Minimally invasive techniques were performed more often in Switzerland than in Austria (52% vs. 4%, p < 0.001). Overall, wide excision with secondary wound healing or midline closures declined over the last 20 years. Conclusion: Treatment strategies for chronic PD differ between Austria and Switzerland with more and longer inpatient care in Austria, increasingly minimally invasive approaches in Switzerland, and outdated procedures still being performed in both countries. Overall, heterogeneity of practice dominates in both countries.

ACS Style

Tenzin Lamdark; Raphael Vuille-Dit-Bille; Isabella Bielicki; Laura Guglielmetti; Rashikh Choudhury; Nora Peters; Dietrich Doll; Markus Luedi; Michel Adamina. Treatment Strategies for Pilonidal Sinus Disease in Switzerland and Austria. Medicina 2020, 56, 341 .

AMA Style

Tenzin Lamdark, Raphael Vuille-Dit-Bille, Isabella Bielicki, Laura Guglielmetti, Rashikh Choudhury, Nora Peters, Dietrich Doll, Markus Luedi, Michel Adamina. Treatment Strategies for Pilonidal Sinus Disease in Switzerland and Austria. Medicina. 2020; 56 (7):341.

Chicago/Turabian Style

Tenzin Lamdark; Raphael Vuille-Dit-Bille; Isabella Bielicki; Laura Guglielmetti; Rashikh Choudhury; Nora Peters; Dietrich Doll; Markus Luedi; Michel Adamina. 2020. "Treatment Strategies for Pilonidal Sinus Disease in Switzerland and Austria." Medicina 56, no. 7: 341.

Short communication
Published: 05 July 2020 in Amino Acids
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Gastrointestinal symptoms are common in COVID-19 patients, especially in younger patients. Our hypothesis was that intestinal SARS-CoV-2 receptor ACE2 expression depends on patients’ age. We examined duodenal biopsies from 43 healthy human adults. ACE2 gene expression was directly correlated with age (Spearman’s r = 0.317, p = 0.039). With each year, duodenal ACE2 expression increased by 0.083 RU. The higher intestinal ACE2 mRNA expression in older patients may impact on their susceptibility to develop intestinal symptoms.

ACS Style

Raphael N. Vuille-Dit-Bille; Kenneth W. Liechty; François Verrey; Laura C. Guglielmetti. SARS-CoV-2 receptor ACE2 gene expression in small intestine correlates with age. Amino Acids 2020, 52, 1063 -1065.

AMA Style

Raphael N. Vuille-Dit-Bille, Kenneth W. Liechty, François Verrey, Laura C. Guglielmetti. SARS-CoV-2 receptor ACE2 gene expression in small intestine correlates with age. Amino Acids. 2020; 52 (6-7):1063-1065.

Chicago/Turabian Style

Raphael N. Vuille-Dit-Bille; Kenneth W. Liechty; François Verrey; Laura C. Guglielmetti. 2020. "SARS-CoV-2 receptor ACE2 gene expression in small intestine correlates with age." Amino Acids 52, no. 6-7: 1063-1065.

Journal article
Published: 01 June 2020 in Journal of Pediatric Urology
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Urethral duplications are rare congenital anomalies of the urinary tract. Because of their rare occurrence, evidence about epidemiology, diagnosis and treatment is limited. The aim of this study was to describe the characteristics, presentation, and treatment of a single large cohort of patients. The authors describe a cohort of 19 consecutive patients with urethral duplications treated at a single referral institution over a 15-year period. Type of duplication, comorbidities, diagnosis, and treatments are described. 68% of the patients were male, and the age at diagnosis ranged from 0 days to 120 months. The most common type of urethral duplication in this cohort of patients was IIA-2 according to Effmann (26%). Diagnosis was made by healthcare providers in 90% and by the children's mothers in 10% of the patients. Furthermore, 10% of patients presented with urinary tract infections. Only 26% of the patients did not have associated diseases or disorders. Fifteen (79%) patients were treated surgically, with a mean number of 2 (standard deviation 1.6) surgeries per patient. Surgeries were performed ranging between 2 days and 10 years of age. The authors report one of the largest cohorts of patients with urethral duplication. There was a male preponderance, urinary tract infections were rare, and most patients had associated disorders, which is in line with previous reports. In this cohort, most duplications were discovered by healthcare providers, and a small number of patients did not undergo surgical treatment. The broad spectrum of duplications could be confirmed with type IIA-2 being the most common type. The mean number of two procedures per patient was low compared with previous reports.

ACS Style

Laura Chiara Guglielmetti; Mellissa Delcont; Jonathan Walker; Duncan Wilcox; Raphael N. Vuille-Dit-Bille. Urethral duplication—Epidemiology, diagnosis, and treatment in a case series of 19 patients. Journal of Pediatric Urology 2020, 16, 385.e1 -385.e9.

AMA Style

Laura Chiara Guglielmetti, Mellissa Delcont, Jonathan Walker, Duncan Wilcox, Raphael N. Vuille-Dit-Bille. Urethral duplication—Epidemiology, diagnosis, and treatment in a case series of 19 patients. Journal of Pediatric Urology. 2020; 16 (3):385.e1-385.e9.

Chicago/Turabian Style

Laura Chiara Guglielmetti; Mellissa Delcont; Jonathan Walker; Duncan Wilcox; Raphael N. Vuille-Dit-Bille. 2020. "Urethral duplication—Epidemiology, diagnosis, and treatment in a case series of 19 patients." Journal of Pediatric Urology 16, no. 3: 385.e1-385.e9.

Journal article
Published: 26 May 2020 in Minerva Chirurgica
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Raphael N Vuille-Dit-Bille; Ralph F Staerkle; Sarkis C Derderian; Lindel C Dewberry; Stefan Breitenstein; Christopher Soll. Appendiceal stump closure in children using polymeric clips is a reliable alternative to endoloops. Minerva Chirurgica 2020, 1 .

AMA Style

Raphael N Vuille-Dit-Bille, Ralph F Staerkle, Sarkis C Derderian, Lindel C Dewberry, Stefan Breitenstein, Christopher Soll. Appendiceal stump closure in children using polymeric clips is a reliable alternative to endoloops. Minerva Chirurgica. 2020; ():1.

Chicago/Turabian Style

Raphael N Vuille-Dit-Bille; Ralph F Staerkle; Sarkis C Derderian; Lindel C Dewberry; Stefan Breitenstein; Christopher Soll. 2020. "Appendiceal stump closure in children using polymeric clips is a reliable alternative to endoloops." Minerva Chirurgica , no. : 1.

Preprint content
Published: 21 May 2020
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SARS-CoV-2 binds via its spikes to its receptor angiotensin-converting enzyme 2 (ACE2). ACE2 is also expressed in small intestinal enterocytes, making the intestine a possible entry site. We examined duodenal biopsies from 43 healthy human adults. ACE2 gene expression was directly correlated with age (Spearman’s r= 0.317, p=0.039. With each year duodenal ACE2 expression increased by 0.083 RU. The higher intestinal ACE2 mRNA expression in older patients might make them more susceptible to oral SARS-CoV-2 infection.

ACS Style

Raphael N. Vuille-Dit-Bille; Kenneth Liechty; François Verrey; Laura C. Guglielmetti. SARS-CoV-2 Receptor ACE2 Gene Expression in Small Intestine correlates with Age. 2020, 1 .

AMA Style

Raphael N. Vuille-Dit-Bille, Kenneth Liechty, François Verrey, Laura C. Guglielmetti. SARS-CoV-2 Receptor ACE2 Gene Expression in Small Intestine correlates with Age. . 2020; ():1.

Chicago/Turabian Style

Raphael N. Vuille-Dit-Bille; Kenneth Liechty; François Verrey; Laura C. Guglielmetti. 2020. "SARS-CoV-2 Receptor ACE2 Gene Expression in Small Intestine correlates with Age." , no. : 1.

Editorial
Published: 30 March 2020 in Journal of International Medical Research
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Raphael N. Vuille-Dit-Bille. Special issue on surgical innovation: new surgical devices, techniques, and progress in surgical training. Journal of International Medical Research 2020, 48, 1 .

AMA Style

Raphael N. Vuille-Dit-Bille. Special issue on surgical innovation: new surgical devices, techniques, and progress in surgical training. Journal of International Medical Research. 2020; 48 (3):1.

Chicago/Turabian Style

Raphael N. Vuille-Dit-Bille. 2020. "Special issue on surgical innovation: new surgical devices, techniques, and progress in surgical training." Journal of International Medical Research 48, no. 3: 1.

Review
Published: 03 January 2020 in Gastroenterology Research and Practice
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Anastomotic leakage reflects a major problem in visceral surgery, leading to increased morbidity, mortality, and costs. This review is aimed at evaluating and summarizing risk factors for colorectal anastomotic leakage. A generalized discussion first introduces risk factors beginning with nonalterable factors. Focus is then brought to alterable impact factors on colorectal anastomoses, utilizing Cochrane systematic reviews assessed via systemic literature search of the Cochrane Central Register of Controlled Trials and Medline until May 2019. Seventeen meta-anaylses covering 20 factors were identified. Thereof, 7 factors were preoperative, 10 intraoperative, and 3 postoperative. Three factors significantly reduced the incidence of anastomotic leaks: high (versus low) surgeon’s operative volume (RR=0.68), stapled (versus handsewn) ileocolic anastomosis (RR=0.41), and a diverting ostomy in anterior resection for rectal carcinoma (RR=0.32). Discussion of all alterable factors is made in the setting of the pre-, intra-, and postoperative influencers, with the only significant preoperative risk modifier being a high colorectal volume surgeon and the only significant intraoperative factors being utilizing staples in ileocolic anastomoses and a diverting ostomy in rectal anastomoses. There were no measured postoperative alterable factors affecting anastomotic integrity.

ACS Style

Bradley Wallace; Fabia Schuepbach; Stefan Gaukel; Ahmed I. Marwan; Ralph F. Staerkle; Raphael N. Vuille-Dit-Bille. Evidence according to Cochrane Systematic Reviews on Alterable Risk Factors for Anastomotic Leakage in Colorectal Surgery. Gastroenterology Research and Practice 2020, 2020, 1 -15.

AMA Style

Bradley Wallace, Fabia Schuepbach, Stefan Gaukel, Ahmed I. Marwan, Ralph F. Staerkle, Raphael N. Vuille-Dit-Bille. Evidence according to Cochrane Systematic Reviews on Alterable Risk Factors for Anastomotic Leakage in Colorectal Surgery. Gastroenterology Research and Practice. 2020; 2020 ():1-15.

Chicago/Turabian Style

Bradley Wallace; Fabia Schuepbach; Stefan Gaukel; Ahmed I. Marwan; Ralph F. Staerkle; Raphael N. Vuille-Dit-Bille. 2020. "Evidence according to Cochrane Systematic Reviews on Alterable Risk Factors for Anastomotic Leakage in Colorectal Surgery." Gastroenterology Research and Practice 2020, no. : 1-15.

Article
Published: 01 November 2019 in Journal of Pediatric Gastroenterology & Nutrition
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In newborn rodents, intestinal maturation involves delayed fructose transporter GLUT5 expression until weaning. In jejunoileal atresia (JIA), distal intestinal segments lack exposure to amniotic fluid containing carbohydrates. We assessed in human newborns the impact of intestinal maturation and obstruction on mucosal monosaccharide transporter expression. Samples were obtained from 10 newborns operated for small intestinal atresia and from 17 adults undergoing gastroduodenoscopy and/or ileocolonoscopy. mRNA expression of the transporters SGLT1, GLUT1, GLUT2, GLUT5, and GLUT7 was measured in neonate samples proximal and distal of the atresia as well as in adult duodenum, ileum, and colon. Protein expression and localization was assessed using immunofluorescence. Although mRNA expression of monosaccharide transporters did not significantly differ between newborn and adult samples, luminal fructose transporter GLUT5 protein was absent in 0–4 days old neonates, but expressed in adults. The mRNA expression of the five tested monosaccharide transporters was unchanged distal from the JIA relative to proximal. Similarly, luminal sodium-dependent glucose transporter SGLT1 and basolateral GLUT2 were expressed proximal and distal to JIA as visualized by immunofluorescence staining. With the exception of glucose transporter GLUT1 that showed highest expression levels in colon, all investigated hexose transporters showed strongest expression in duodenum, lower levels in ileum and lowest in colon. Human newborns lack small intestinal fructose transporter GLUT5 protein expression and small intestinal atresia does not affect the expression of hexose transporters.

ACS Style

Chantal Florence Meier; Simone Mafalda Rodrigues Camargo; Schirin Hunziker; Svenja Leu; Stefan Gerhard Holland-Cunz; Francois Verrey; Raphael Vuille-Dit-Bille. Mucosal Monosaccharide Transporter Expression in Newborns With Jejunoileal Atresia and Along the Adult Intestine. Journal of Pediatric Gastroenterology & Nutrition 2019, 69, 611 -618.

AMA Style

Chantal Florence Meier, Simone Mafalda Rodrigues Camargo, Schirin Hunziker, Svenja Leu, Stefan Gerhard Holland-Cunz, Francois Verrey, Raphael Vuille-Dit-Bille. Mucosal Monosaccharide Transporter Expression in Newborns With Jejunoileal Atresia and Along the Adult Intestine. Journal of Pediatric Gastroenterology & Nutrition. 2019; 69 (5):611-618.

Chicago/Turabian Style

Chantal Florence Meier; Simone Mafalda Rodrigues Camargo; Schirin Hunziker; Svenja Leu; Stefan Gerhard Holland-Cunz; Francois Verrey; Raphael Vuille-Dit-Bille. 2019. "Mucosal Monosaccharide Transporter Expression in Newborns With Jejunoileal Atresia and Along the Adult Intestine." Journal of Pediatric Gastroenterology & Nutrition 69, no. 5: 611-618.