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Best Papers in General Surgery
The five that matter, every day.
Assessment of tertiary lymphoid structures (TLSs) through a digital gene panel proved highly accurate in predicting TLS status and demonstrated associations with survival and response to anti-cancer therapies in gastric cancer patients. Patients with high TLS gene signature exhibited significant benefits from adjuvant chemotherapy and…
Researchers analyzed 623 esophageal squamous cell carcinoma (ESCC) patients post-neoadjuvant therapy, finding lymph node metastases in 34% of cases. Metastases were most frequent along the right recurrent nerve (10.1%), paracardial station (11.4%), and left gastric artery (10.9%). The data, differentiated by tumor location and pretreatment…
Osteosarcopenia, identified in 16.5% of patients, significantly increased the risk of postoperative complications after curative surgery for colorectal cancer. Patients with osteosarcopenia had lower 5-year overall survival and recurrence-free survival rates compared to those without osteosarcopenia. Multivariate analysis confirmed osteosarcopenia as an independent prognostic factor…
Providers in veterans affairs hospitals utilize elements of shared decision-making when caring for critically ill surgical patients in the ICU. Through qualitative interviews, key components of shared decision-making were identified, along with barriers and facilitators to its implementation. These findings offer valuable insights for interventions…
Perioperative data collection is crucial for enhancing surgical safety, yet low- and middle-income countries face significant challenges in this regard. A survey of 229 stakeholders across 36 LMICs revealed common barriers and facilitators to collecting surgical outcome data. Institutions with experience in data collection reported…
Artificial intelligence (AI) using ChatGPT 4 shows promising proficiency in grading postoperative complications according to the Clavien-Dindo Classification. ChatGPT 4 precisely mirrors the classification system, surpassing previous versions and achieving high accuracy in generating clinical examples and grading complications from real and fictional scenarios. AI…
Endoscopic submucosal dissection (ESD) yields superior en bloc resection, higher R0 resection, and curative resection rates compared to endoscopic mucosal resection (EMR) for Barrett's neoplasia and esophageal adenocarcinoma. ESD also shows lower local recurrence rates. Adverse events between the two techniques were similar. These findings…
Triple-row staple technology may reduce the risk of anastomotic leak in left-sided colorectal anastomoses. After reviewing 340 relevant citations, 6 retrospective cohort studies met inclusion. Overall, 19,372 patients had anastomoses with double-row staple technology, and 2,298 patients with triple-row staple technology. Most operations were anterior…
Proximal gastrectomy with double-tract reconstruction leads to lower glucose variability postoperatively compared to total gastrectomy. Patients who underwent the procedure exhibited smaller fluctuations in glucose levels and experienced fewer dumping symptoms. Food flow into the remnant stomach was crucial for maintaining better glycemic control and…
Non-compliance with NCCN guidelines for colon cancer treatment affects one in four patients. Factors such as older age, female sex, black race, and tumor characteristics decrease the likelihood of guideline compliance. Conversely, higher hospital volume, specific surgical approaches, and insurance status increase compliance rates. Patient…
