Histotripsy, a novel noninvasive ultrasound technique, demonstrated effective tumor control in liver cancer treatments. 70% of patients treated with curative intent achieved nonviable tumors at 30 and 90 days. Complications were rare, with only 1% classified as significant. Targeting accuracy remains critical; improvements are expected as surgeons gain experience. 75% of treatments aimed for complete […]
Category: General Surgery
Robotic Crush and Clip Technique Reduces Complications in Pancreatectomy
The crush and clip technique for pancreatic transection in robotic distal pancreatectomy shows promise for reducing complications. Postoperative pancreatic fistula rates were 13% for crush and clip vs. 26% for stapler (p=0.280). Significant advantage in thick pancreas cases: 6% vs. 47% for crush and clip vs. stapler (p=0.013). This technique eliminates major complications, with none […]
Improved Prognosis for Locally Advanced Rectal Cancer Patients
A new prognostic model combines tumor regression grading and yptnm staging to better predict outcomes in locally advanced rectal cancer after neoadjuvant therapy. The novel trg-yptnm model outperformed the traditional yptnm system in both training (1,046 patients) and validation (354 patients) cohorts. Trg and yptnm are independent prognostic factors, enhancing risk stratification for surgical candidates. […]
Preoperative CRP Levels Predict Difficult Laparoscopic Appendectomy
Elevated preoperative C-reactive protein levels can predict the complexity of laparoscopic appendectomy, aiding in better patient selection. A CRP cut-off of 220 mg/l indicates an 87% sensitivity and 90% specificity for predicting conversion to open surgery. The area under the ROC curve is 0.941, demonstrating strong diagnostic accuracy. This information can guide surgeons in deciding […]
Addressing Ageism in Surgery for Better Outcomes
Surgeons must confront ageism, which can delay vital procedures and worsen outcomes for older adults. Cognitive biases were highlighted in studies involving over 149,000 participants, revealing how they influence surgical decisions. Systemic inequities, such as transplant referral disparities, were noted across studies with over 24,000 participants, affecting resource allocation. Taking action against age-based discrimination can […]
Laparoscopic Pancreatoduodenectomy Shortens Stay in African Hospital
Hospital stay: 8.1 days (LPD) vs 10.6 days (open), p=0.049. Lower intraoperative blood loss and transfusion rates in the LPD group. These findings affirm LPD as a feasible option in resource-limited settings, enhancing patient recovery without compromising oncological safety. Comparable oncologic outcomes, including margin status and lymph node yield, suggest LPD’s effectiveness in cancer surgery. […]
Advancing Endoscopic Resection for Colorectal Lesions
A new saline-immersion technique shows promise for complex colorectal resections. 181 lesions treated with an en bloc approach achieved an R0 resection rate of 92.3%. Overall, 4.4% of patients experienced adverse events, with only four needing further intervention. This technique enhances the safety profile of endoscopic procedures, supporting wider use in Western surgical practice. 93.4% […]
Endoscopic Resection Worse for Poorly Differentiated Gastric Cancer
Surgical resection offers better survival outcomes for poorly differentiated early gastric cancer. Surgical resection linked to better cancer-specific survival (CSS) and overall survival (OS) with hazard ratios of 0.61 and 0.56, respectively. Statistically significant differences in CSS and OS observed after propensity score matching (p-values 0.034 and 0.033). Surgeons should favor surgical resection to align […]
Surgery First Improves Outcomes in Primary Intestinal Lymphoma
Surgery first significantly enhances survival and safety in primary intestinal lymphoma compared to chemotherapy first. 3-year and 5-year overall survival rates were higher in the surgery first group (p < 0.05). Patients under 60, with stage I-II disease and low international prognostic index (IPI) scores, saw even greater survival benefits (p < 0.05). You should […]
New Insights on Fluid Management in Acute Pancreatitis
Dynamic fluid therapy strategies in acute pancreatitis can significantly impact patient mortality. Identified five dynamic fluid therapy trajectories within the first 72 hours: low stable (7.3%), low-moderate sustained (10.8%), moderate stable (66.0%), moderate-high fluctuating (7.4%), and high sustained (8.6%). Hazard ratios reveal increased in-hospital mortality: moderate-high fluctuating group (2.08) and high sustained group (2.91) compared […]