Lymph node metastasis (LNM) in nonfunctional pancreatic neuroendocrine tumors (NF-PNET) has a negative impact on disease-free survival (DFS) and overall survival (OS). In a systematic review of 52 studies involving 24,608 PNET cases, reported LNM rates for NF-PNET ranged from 7% to 64%, with higher rates in tumors >2 cm. Additionally, 66% of the studies […]
Category: General Surgery
CA19-9 and DUPAN-2 Combination Identifies Early-Stage Pancreatic Adenocarcinoma
Patients with pancreatic ductal adenocarcinoma (PDAC) and normal levels of CA19-9 and DUPAN-2 are more likely to have resectable and early-stage cancer. In a study of 521 patients, those with normal CA19-9 and DUPAN-2 had a significantly higher proportion of resectable PDAC (71.5%) and a 5-year survival rate of 66.0%, much better than other groups […]
Minimally Invasive Surgery Conversion Provides Survival Benefit in Colon Cancer
Conversion from minimally invasive surgery to open surgery in colon cancer patients resulted in higher overall survival compared to upfront laparotomy. This survival advantage was particularly notable in patients over 65 years old, those with significant comorbidities, and individuals with left-sided tumors. Minimally invasive surgery should be favored in the absence of contraindications for patients […]
Primary Anastomosis with Diverting Loop Ileostomy in Acute Complicated Diverticulitis
A study of 16,921 cases of nonelective sigmoidectomy for acute complicated diverticulitis revealed a rising trend in the use of primary anastomosis with diverting loop ileostomy, from 5.3% in 2012 to 8.4% in 2020. Compared to Hartmann’s procedure, primary anastomosis with diverting loop ileostomy was associated with lower rates of major adverse events (24.6% vs […]
Significant Variability in Managing Malignant Gastric Outlet Obstruction in Pancreatic Cancer, with Rising Use of EUS-Gastrojejunostomy
Survey of 290 pancreatologists revealed significant differences in managing malignant gastric outlet obstruction (MGOO) due to pancreatic cancer. Endoscopic stenting (ES) was most common, but EUS-Gastrojejunostomy (EUS-GJ) adoption is increasing. Decision drivers include life expectancy and patient frailty, with lack of standardized algorithms. Availability of EUS-GJ remains suboptimal, attributed to the steep learning curve. Journal […]
Nonoperative Management of Uncomplicated Appendicitis in Adults Linked to Longer Hospital Stays and Higher Costs
Researchers examined 167,125 patients with uncomplicated appendicitis, finding that 82.4% underwent surgical management, while 17.6% underwent nonoperative management (NOM). The NOM group had older patients (53 vs. 43 years), more Medicare recipients (33.6% vs. 16.1%), and higher rates of comorbidities like diabetes (7.8% vs. 5.5%). NOM was associated with longer hospital stays (5.4 vs. 2.3 […]
Nomogram Predicts Survival in Lymph Node-Negative Hepatocellular Carcinoma
Clinicians developed a nomogram to predict cancer-specific survival (CSS) in hepatocellular carcinoma (HCC) patients without lymph node metastasis (LNM), achieving high accuracy in both internal and external validation. Analysis of 6,840 HCC patients revealed age, gender, bone metastasis, lung metastasis, AFP, T stage, surgery, and chemotherapy as significant prognostic factors. The nomogram’s concordance index (C-index) […]
Straight Stomach Reconstruction Reduces Delayed Gastric Emptying After Pancreaticoduodenectomy
Clinicians found that anchored straight stomach reconstruction (SSR) significantly reduces the incidence of delayed gastric emptying (DGE) after pancreaticoduodenectomy (PD), also leading to improved postoperative nutritional recovery. A case series analysis of 125 PD patients showed that those in the SSR group had a DGE rate of 13%, compared to 33% in the non-SSR group. […]
Accuracy of Conflicts in Interest Reporting in General Surgery Journals
Study finds high inaccuracy (31%) in self-reported conflicts of interest (COIs) in prominent general surgical journals. Authors from the US had the lowest accuracy rate at 69%, compared to the UK (93%) and Australia (96%). Most inaccuracies were observed in corresponding/senior authors (39%), highlighting the need for journals to verify COIs for more accurate reporting. […]
Post-Discharge Mental Healthcare Reduces Readmissions in Emergency General Surgery Patients with Serious Mental Illness
A study of 88,092 Medicare patients over 65 with serious mental illness (SMI) found that a post-discharge mental health visit (MHV) within 30 days after emergency general surgery (EGS) hospitalization was associated with significantly lower odds of acute care readmission in both operative (odds ratio 0.60) and non-operative (odds ratio 0.67) groups. There was no […]