EUS-guided radiofrequency ablation is a safe alternative for patients with branch-duct IPMNs showing worrisome features who cannot undergo surgery. Technical success was 100% in 62 procedures, with 98% achieving local control. Adverse events occurred in 27%, primarily mild abdominal pain; no deaths reported. This procedure effectively prevents cancer progression in patients unsuitable for traditional surgery. […]
Category: General Surgery
Navigating Role Ambiguity in Surgical Education
In surgery, unclear team roles amid rising demands can lead to poor learning, burnout, and patient safety risks. Role ambiguity during high case volumes disrupts teamwork and learning, impacting both residents and advanced practice providers. Increased cognitive load and diminished educational opportunities are evident when residents face unclear responsibilities. Addressing these systemic issues can enhance […]
Laparoscopic Approach to Complex Liver Resection for Cholangiocarcinoma
Laparoscopic hemi-hepatectomy with portal vein resection offers effective options for patients with perihilar cholangiocarcinoma and portal vein involvement. Successfully completed in 450 minutes with minimal blood loss (200 ml). Achieved negative resection margins for a patient with Bismuth-Corlette type IV cholangiocarcinoma. Consider this approach for select patients to improve surgical outcomes while maintaining safety. Journal […]
Laparoscopic Sectionectomy: Safe, Low-Cost Technique In Action
A new laparoscopic posterior sectionectomy approach demonstrates effective liver resection while minimizing costs and resource use. Success with a single-energy device led to an R0 resection in a patient with a liver lesion. Operative time was 220 minutes with an estimated blood loss of only 60 ml. The patient was discharged on postoperative day 5, […]
Adjuvant Radiotherapy Boosts Survival in Node-Positive PDAC
Adjuvant radiotherapy improves survival for patients with margin-negative, node-positive pancreatic ductal adenocarcinoma after surgery. Median overall survival (OS) for adjuvant radiotherapy patients was 26.0 months versus 24.1 months for those without it (p < 0.001). Stage IIb patients benefited most, showing a notable OS improvement; no difference was seen in Stage III patients. Consider adjuvant […]
Delayed surgery worsens outcomes in adhesive small bowel obstruction.
Early mortality rises with surgical delay: 3.6% (0-1 days) to 7.1% (≥9 days). Bowel resection rates increase from 18.0% to 24.5% as delays lengthen. Timely surgical intervention is critical to improve patient survival and reduce long-term recurrence rates. Non-operative treatment leads to recurrence in 23.5% vs. 8.8% for surgical patients; laparoscopic surgery further lowers recurrence […]
Burnout Interventions for Surgeons: Insights from a Review
Surgeons face significant burnout, and this review evaluates intervention effectiveness to combat it. 44 studies examined various strategies, including organizational changes and individual support methods like mentorship and mindfulness. Improvements in burnout scores were noted; however, many lacked statistical significance, raising concerns about their reliability. Ongoing research is crucial to develop effective solutions in a […]
Elevated FIT Test: IBD Risk Higher Than CRC for Young Patients
Surgeons should note that inflammatory bowel disease (IBD) is frequently diagnosed following a positive faecal immunochemical test (FIT), particularly in patients under 50. 2.3% of patients with FIT ≥10 µg Hb/g were diagnosed with IBD; this drops to 0.1% with lower levels. Among patients under 50 with elevated FIT and faecal calprotectin (FCP), the IBD […]
Socioeconomic Disadvantage Cuts Survival in Pancreatic Cancer
Living in socioeconomically disadvantaged areas significantly reduces survival in patients with nonmetastatic pancreatic cancer, even with guideline-concordant treatment. Patients in high deprivation areas had a 1.9 times higher risk of decreased survival compared to those in lower deprivation areas. Not receiving guideline-concordant treatment increased the risk of poor outcomes by 1.7 times. Surgeons should consider […]
Noninvasive Liver Tests Identify Surgical Risks in CRLM Patients
Noninvasive tests for liver fibrosis can predict complications in colorectal liver metastases surgery. High fib-4 index or SAFE score correlates with greater postoperative complication rates. Analysis involved 107 patients, with findings validated in a separate cohort of 277. Preoperative fibrosis assessment should be standard to optimize surgical outcomes. Journal Article by Tuffs C, Marg O […]