Identifying molecular biomarkers could enhance patient selection for salvage surgery in locally recurrent rectal cancer, impacting surgical strategies and patient outcomes. Locoregional recurrence rates after surgery ranged from 15% to 52% over 3-5 years. Five-year overall survival rates varied from 22% to 53%. Surgeons should consider serum biomarkers like CEA and CA19-9, linked to poor […]
Category: General Surgery
Rethinking Surgical Oncology Fellowship Training
Surgical oncology fellowships need to evolve to meet the actual career paths of graduates. Current selection favors research, but most trainees intend to focus on clinical practice. Only a small percentage of fellows achieve long-term research productivity despite extensive dedicated research time. Adapting fellowships to include clinically intensive tracks could better prepare surgeons for today’s […]
Redo Hepatic Vein Reconstruction Effective for Liver Metastases
Late-onset venous stenosis after hepatic vein reconstruction may signal tumor recurrence, impacting how you monitor and treat patients. In a study of 72 reconstructed veins, 19 developed stenosis: 14 due to technical issues, and 5 linked to tumor recurrence. Technical stenoses occurred within 6 months, whereas late stenoses were associated with tumor recurrence detected years […]
New technique safely guides liver surgery in rare anatomy
Surgeons can effectively navigate complex liver anatomy using the Arantius-first approach, particularly with right-sided ligamentum teres (RSLT). RSLT occurs in about 0.43% of patients, complicating conventional techniques. The Arantius-first approach enhances visibility and control, reducing the risk of injuries during laparoscopic left hemi-hepatectomy. Effective application of this method can improve surgical outcomes in patients with […]
Training Gaps in Robotic Surgery Across Specialties
Robotic training varies significantly among general surgery, gynecology, and urology residents, affecting their confidence and preparedness. Current general surgery residents report 89.5% satisfaction and 27.8% confidence in training, compared to 37.5% satisfaction and 75% confidence in gynecology. Urology residents have 76.7 bedside cases and 195.4 console cases per resident, vastly outpacing general surgery (2.2 bedside, […]
New Staging System Cuts Risks in Perihilar Cholangiocarcinoma
This study introduces the ABC scoring system for preoperative staging in perihilar cholangiocarcinoma, aiming to improve patient selection for curative surgery. Patients with a score of 3 had a 21% 90-day mortality rate versus 6% for score 0. Six-month recurrence rates were 18% for score 3 compared to 5% for score 0. Median overall survival […]
Rural Surgical Access at Risk as Workforce Declines
Osteopathic surgeons are critical for rural access but their numbers are dwindling. 18.3% of DO surgeons vs. 9.7% of MD surgeons practice in rural areas. DO surgeons have twice the odds of working in rural communities compared to their MD counterparts (OR 2.05). The trend shows worrying declines in rural practice among newer surgeons, with […]
Log Odds of Lymph Nodes Enhance Risk Prediction Post-Esophagectomy
Researchers found that the log odds of positive lymph nodes significantly improve risk stratification for early recurrence after radical esophagectomy in cT3 esophageal squamous cell carcinoma. Higher log odds predict early recurrence; significant cut-off at -2.69. Patients with log odds > -2.69 have a 30% 5-year survival rate versus 66% for those ≤ -2.69 (p […]
Surgery for Gastroesophageal Junction Cancers May Be Omitted
New data raises the question of whether surgery can be skipped for certain gastric and gastroesophageal junction cancers with high pathologic complete response rates. Patients with mismatch-repair deficient tumors have a 60% pathologic complete response to neoadjuvant immunotherapy. Those with mismatch repair intact tumors show about 20% pathologic complete response with chemo-immunotherapy. Surgeons should consider […]
Long-term Outcomes of Pancreaticojejunostomy Techniques
A study comparing invagination versus duct-to-mucosa pancreaticojejunostomy shows similar long-term anastomotic patency and pancreatic function. Remnant pancreatic duct dilatation occurred in 18.6% of invagination and 9.8% of duct-to-mucosa patients, with no significant clinical impact. Cumulative incidences of benign stricture at 3 and 5 years were 9.3% and 19.9% for invagination, compared to 9.5% and 13.4% […]