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Best Papers in General Surgery
The five that matter, every day.
A multicenter study has established that a high C-reactive protein-to-albumin ratio (≥0.234) correlates with increased risk of three-year disease progression and decreased five-year survival in patients undergoing neoadjuvant chemotherapy for colorectal liver metastases. The developed clinical prediction model, incorporating the ratio, clinical risk score, and…
A user-friendly prediction tool, combining multimodal features, achieved significant advancements in preoperative T-staging accuracy for gallbladder cancer (GBC). In a multicenter study analyzing 189 patients, the weighted GBC T-staging (wgbct) model outperformed existing methods with an AUC of 0.910 and demonstrated perfect sensitivity (1.0) in…
Analysis of 1,074 studies involving 130,599 patients revealed that higher annual surgical volumes significantly decrease recurrence rates for pilonidal sinus disease. Specifically, patients treated in centers performing 30 or more surgeries annually showed improved outcomes, with 5-year recurrence rates dropping to 12.5%. However, midline closure…
A multicentre randomized controlled trial involving 52 patients revealed that chewing gum can significantly shorten postoperative ileus following laparotomy for gastroduodenal perforations. The median duration of ileus was reduced by 21.5 hours in patients who chewed gum compared to those who did not (28.5 hours…
Researchers outline essential techniques for robotic pancreaticoduodenectomy, emphasizing vascular protection and drainage positioning. Key strategies include utilizing 4/0 PDS stitches to control bleeding, avoiding energy during pancreas dissection to prevent ischemia, and implementing a modified Blumgart anastomosis to reduce fistula formation. These practical tips aim…
A review highlights that sentinel lymph node mapping significantly enhances metastasis detection in esophageal cancer. This technique targets lymph nodes likely to harbor metastases using various tracers, aiding surgical lymphadenectomy, increasing accuracy, and personalizing treatment. While the need for larger studies and long-term data remains,…
A critical study found that pre-treatment fibrinogen levels below 1.3 g/l indicate poor prognosis in patients with major bleeding. Among 7,063 patients analyzed, those with fibrinogen above this threshold experienced a significant survival benefit after 28 days. Furthermore, a post-treatment fibrinogen target of 2.0-2.5 g/l…
A study involving 194 patients with borderline resectable pancreatic cancer revealed significant early recurrence rates, with 69% of patients experiencing recurrence, primarily within six months post-surgery. Researchers developed a preoperative scoring system using CA19-9 and CA125 levels, achieving an AUC of 0.700, alongside a postoperative…
An international study involving 3,676 gallbladder cancer patients identified critical risk factors for node involvement. Tumor stage, lymphovascular, and perineural infiltration were significant predictors, forming the omega node positivity prediction score (omega-nopps) with robust c-statistics of 0.81 and 0.79. This score highlights that incidental gallbladder…
The incidence of positive circumferential resection margin (CRM) after robot-assisted total mesorectal excision (R-TME) was found to be 6.0% in a study of 1,390 patients. Significant predictors include CT4 tumors, involvement of the mesorectal fascia on MRI, and non-sphincter-saving surgeries. A predictive model demonstrated over…
