Level I and II centers frequently operate at over 80% bed occupancy, especially in the South and West, where nearly 80% exceeded this for 75 weeks or more. Under simulated scenarios, a patient influx of 1500–2000 daily leads to a deficit of over 20,000 beds within 45 days. Surgeons must consider these limits when planning […]
Category: General Surgery
Salvage Treatment After Incomplete Rectal NET Resection Shows Promise
Salvage treatment may be warranted after incomplete resection of rectal neuroendocrine tumors due to significant residual disease concerns. Incomplete resection rates: 73.1% for cold snare polypectomy; 29.8% for conventional EMR; 14.7% for endoscopic submucosal dissection. Residual tumor rate with salvage treatment is 25% (CI: 12%–40%). Individualized clinical decisions are crucial given the uncertainty in recurrence […]
Trends in IVC Reconstruction Show High Patency and Survival
IVC reconstruction during oncologic resections is safe, with robust mid-term outcomes. 80 patients treated; 94%+ primary patency at 2 years. 30-day survival rate was 96.3%, with 2- and 3-year survival at 76.8%. Most thrombosis occurrences tied to tumor recurrence or technical issues. Consider this technique in high-volume centers for complex oncologic cases. Journal Article by […]
Liver-First Approach Improves Outcomes in Colorectal Cancer
A liver-first surgical approach in stage IV colorectal cancer with isolated liver metastases leads to better survival and fewer complications. Liver resection before colon/rectal resection increased from 5.37% in 2010 to 15.43% in 2020. Patients receiving the liver-first approach had a lower 90-day mortality (1.11% vs 4.47%) and fewer 30-day readmissions (3.69% vs 5.81%). Select […]
More Female Residents Could Mean More Female Applicants in Surgery
Increasing female representation in surgery can enhance mentorship and attract more women to the field. Higher percentages of female residents correlate with more female applicants (r = 0.943, p < 0.0001). The strongest correlation was seen in urology (r = 1.0, p < 0.0001), followed by general surgery (r = 0.944, p = 0.016). Prioritizing […]
Transanal Surgery Offers R0 Resection for Rectal GISTs
Transanal endoscopic microsurgery (TEM) provides promising outcomes for rectal gastrointestinal stromal tumors (GISTs) while preserving function. High rates of R0 resection were achieved in 13 patients with rectal GIST, underscoring the technique’s efficacy. Tumor size should not automatically disqualify candidates for en-bloc excision with negative margins. Neoadjuvant imatinib may help select borderline cases, but more […]
Preoperative fitness impacts esophagectomy outcomes
Prehabilitation focusing on nutrition and fitness can significantly influence postoperative recovery in esophageal cancer patients. Higher preoperative BMI linked to more overall complications (p = .029). Better exercise capacity and muscle function correlated with fewer pulmonary complications (p < .045) and improved functional capacity (p < .032). Addressing fatigue preoperatively is crucial, as it relates […]
Hepatic Artery Infusion Pump Shows Promise in Colorectal Liver Metastases
A small fraction of unresectable colorectal liver metastasis patients qualify for liver transplant, but HAIP chemotherapy can improve outcomes. Only 4.8% of patients in the study were liver transplant-eligible. After HAIP, the median overall survival was 61 months, with a 5-year survival rate of 53%. This suggests that HAIP may aid in patient selection for […]
EUS-Guided Biopsy for Pancreatic Cysts: Key Outcomes and Risks
EUS-guided through-the-needle biopsy (EUS-TTNB) offers valuable diagnostic insights for pancreatic cysts but carries significant risks that surgeons must navigate. Diagnostic adequacy is high at 80.3%, with changes in management seen in 16.3% of cases. Adverse events (AEs) occurred in 20.9% of procedures, predominantly acute pancreatitis (15%). Intraductal papillary mucinous neoplasm (IPMN) significantly raises AE risk […]
Smaller Staplers Safe in Esophagojejunostomy Outcomes
Using smaller circular staplers in esophagojejunostomy does not harm patients’ quality of life post-surgery. No differences were found in quality-of-life scores between patients using small vs. large staplers. Anastomotic lumen diameter had no impact on quality-of-life outcomes. Surgeons can confidently select smaller staplers when anatomical constraints arise without compromising patient recovery. Findings challenge the notion […]