Emergency colorectal surgeries performed by specialized colorectal surgeons lead to significantly lower 30-day and in-hospital mortality rates (30-day mortality odds ratio 0.64; p < 0.0001). These specialists also demonstrate higher rates of primary anastomosis (odds ratio 2.95; p < 0.0001) and laparoscopic procedures (odds ratio 2.38; p = 0.001), paired with a reduced likelihood of […]
Category: General Surgery
Machine Learning Model Accurately Predicts Early Recurrence in PCCA Patients
A multicenter study developed a machine learning model to predict early recurrence in patients with perihilar cholangiocarcinoma (PCCA) after curative surgery. The model, leveraging five key factors, including carbohydrate antigen 19-9 and tumor size, achieved superior predictive performance, particularly with the random forest algorithm (AUC: 0.983) compared to others. High-risk patients showed significantly different recurrence-free […]
Pathological response correlates with improved survival in UHCC patients
In a study of 76 patients with unresectable hepatocellular carcinoma (UHCC) undergoing conversion surgery after triple therapy, major pathological response (MPR) and pathological complete response (PCR) were observed in 69.7% and 32.9% of cases, respectively. Those achieving MPR had significantly higher overall survival rates at one and two years compared to non-MPR patients (100.0% and […]
Per-Oral Endoscopic Myotomy (POEM) Offers Critical Guidelines
A clinical practice update presented vital guidance on per-oral endoscopic myotomy (POEM), emphasizing that extensive diagnostic evaluations are essential before treatment. It highlights POEM as the preferred option for type III achalasia, while also supporting laparoscopic Heller myotomy and pneumatic dilation for other types. Antibiotic prophylaxis, post-procedure monitoring for gastroesophageal reflux disease, and individualized discharge […]
Improved methods reveal high liver margin cancer rates in surgery
A multicenter study on perihilar cholangiocarcinoma revealed a significant discrepancy in liver margin (lm) resection rates. The discovery cohort showed a lm R1 resection rate of 38.6%, compared to 5.6% in the control cohort, indicating that whole-mount digital large sections (WDLS) identify more R1 cases. Additionally, carcinoma was predominantly within 20 mm of the proximal […]
Postoperative complications significantly reduce survival in gastric cancer patients
Postoperative complications notably impact overall survival rates in gastric cancer patients. Among a cohort of 236 individuals, those experiencing complications showed a stark decrease in survival—58.1% at three years compared to 82.3% without complications. Delirium was the most common complication observed. Furthermore, non-cancer-related deaths, primarily from pneumonia, were substantially higher in patients with complications. Factors […]
Multidisciplinary protocol effectively reduces surgical readmissions
A multidisciplinary protocol implemented in a tertiary hospital significantly reduced the unplanned surgical readmission rate from 7.9% to 5.6%, reflecting a 30% decrease. The study included 874 patients, revealing that the strategy, which featured a dedicated nurse liaison and post-discharge follow-up, enhanced patient care and hospital efficiency. Continued monitoring and audits will be necessary to […]
Perioperative chemotherapy significantly improves survival in esophageal cancer patients
A retrospective analysis of over 57,000 patients with stage II to III esophageal cancer revealed that both perioperative chemotherapy and trimodality therapy significantly enhance overall survival compared to definitive chemoradiation therapy (DCRT). Perioperative chemotherapy showed a median overall survival of 66.2 months, while trimodality therapy had a median of 43.9 months. In contrast, patients receiving […]
Robotic gastrectomy outperforms laparoscopic for gastric cancer
A comprehensive analysis of 68,755 patients indicates that robotic gastrectomy (rg) offers superior outcomes compared to laparoscopic gastrectomy (lg) in gastric cancer treatment. Key benefits of rg include increased lymph node retrieval, reduced intraoperative blood loss, shorter hospital stays, and faster recovery metrics, such as time to first flatus and oral intake. Although rg is […]
Laparoscopic central hepatectomy shows promise for liver tumors
Laparoscopic central hepatectomy (CH) demonstrates comparable perioperative outcomes to hemihepatectomy (HH) for patients with centrally located hepatocellular carcinoma (HCC). A review of 70 CH cases revealed shorter postoperative hospital stays (median 6 days vs. 9 days) and fewer ICU transfers (19% vs. 44%) compared to HH. Additionally, the 90-day mortality rate was notably lower in […]