A systematic review and meta-analysis involving 9,352 patients reveals that endoscopic submucosal dissection (ESD) outperforms endoscopic mucosal resection (EMR) in effectively treating early Barrett’s neoplasia. ESD achieved significantly higher en-bloc resection rates (odds ratio 25.96) but was associated with greater incidence of adverse events. The findings highlight the need for careful consideration of the balance […]
Category: General Surgery
Early esophago-gastric adenocarcinoma linked to high lymph node metastasis risk
A multicenter study involving 1,601 patients revealed a 13.5% incidence of lymph node metastasis (lnm) in early esophago-gastric adenocarcinoma. Factors such as tumor depth and lymphovascular invasion showed initial associations with lnm but lacked significance in multivariable analyses. Notably, surgery following endoscopic resection significantly improved survival rates, highlighting the potential need for reevaluation of predictive […]
Postoperative insulin resistance worsens recovery after gastrectomy.
A cohort study involving 60 gastric cancer patients revealed that postoperative insulin resistance significantly worsens short-term recovery after radical gastrectomy. Key findings indicated increased insulin resistance and inflammation, along with decreased nutritional markers. The gut microbiome showed notable changes, including reduced bifidobacterium and butyrate levels. Negative correlations were found between insulin resistance and beneficial gut […]
Gender gap persists in surgical specialties with low female representation
A comprehensive analysis of over 1.1 million physicians reveals only 16.7% of surgeons are female, highlighting significant ongoing gender disparities in surgery. While there is a gradual increase in female representation, specialty-specific trends show that women are less likely to enter cardiac surgery compared to colorectal surgery. Variations related to practice setting and graduation year […]
GAME-SCORE predicts chemotherapy response in colorectal liver metastases
GAME-SCORE demonstrates predictive value for pathological and radiological responses to neoadjuvant chemotherapy in colorectal liver metastases. High-risk GAME-SCORE patients exhibited significantly lower pathological response rates (82.6%) and increased radiological progression (10%) compared to low (3.8%) and moderate (3.5%) risk groups. Furthermore, multivariable analysis identified high-risk GAME-SCORE as an independent predictor of pathological response, alongside factors […]
Positive circumferential resection margin linked to recurrence in rectal cancer
A study analyzed 682 patients with locally advanced rectal cancer, revealing that 6.9% experienced local recurrence post-neoadjuvant chemoradiotherapy and total mesorectal excision. Key risk factors identified included positive circumferential resection margin, venous invasion, and perineural invasion. Among those with recurrence, 53.2% were resectable, and 65.2% of those who underwent curative resection achieved R0 status. Superior […]
Independent risk factors identified for postoperative pain management
In a study of 2,180 patients who underwent major hepatobiliary and pancreatic surgery, 8.4% experienced moderate-to-severe pain within 24 hours post-operation. Key independent risk factors identified include younger age, lower body mass index, open surgical procedures, and the use of sufentanil for analgesia. Additionally, inadequate postoperative pain management correlated with prolonged hospital stays, highlighting the […]
Tumor burden score predicts prognosis better than liver cancer stages.
In a study involving 192 patients with combined hepatocellular-cholangiocarcinoma, tumor burden score (TBS) outperformed standard primary liver cancer staging in predicting post-surgical prognosis. Stratified into low, medium, and high TBS, patient outcomes declined as TBS increased. TBS proved to be an independent prognostic factor across various analyses and demonstrated optimal discrimination and consistency in predictions. […]
New roadmap aids in identifying futile resuscitation in trauma patients
A systematic review highlights the urgent need for reliable parameters that indicate futile resuscitation among severely bleeding trauma patients. By examining existing literature, researchers propose a clear roadmap to guide clinicians in recognizing when massive transfusions may be ineffective. This approach aims to enhance blood product stewardship amid ongoing challenges in maintaining blood supply, ensuring […]
CALLY index predicts surgical complications in obstructive colorectal cancer
The C-reactive protein-albumin-lymphocyte (CALLY) index effectively predicts postoperative complications for patients with obstructive colorectal cancer undergoing colonic stenting. In a study of 263 patients, those with a low CALLY index experienced significantly higher blood loss, poorer performance status, and increased complications compared to those with a high index. Multivariate analysis revealed prolonged operative time, greater […]