In a meta-analysis of 11 randomized controlled trials involving 3,185 rectal cancer patients, researchers compared total neoadjuvant therapy (TNT) to standard long course chemoradiotherapy (LCRT). TNT did not significantly differ in mortality or major complications but increased the risk of breached total mesorectal excision (TME). However, TNT showed a lower risk of disease progression during […]
Category: General Surgery
Perioperative Chemotherapy Improves Overall Survival in Synchronous Colorectal Liver Metastases
Analyzing 72,376 patients with colorectal liver metastases (CRLM) from the National Cancer Database, researchers found that liver-only CRLM patients undergoing perioperative chemotherapy had a superior median overall survival (OS) of 44.7 months. Resection of both primary and metastatic sites also correlated with better OS (38.9 months) compared to metastatic site alone (30.2 months) or primary […]
Predictive Scoring Model Identifies Risks for Unplanned ICU Readmission in Surgical Patients
Analyzing 1,112 surgical ICU patients, researchers identified congestive heart failure, high SOFA-hepatic score, carbapenem use, and pre-discharge factors (inadequate glycemic control, positive fluid balance, low PaO2/FiO2 ratio, and total parenteral nutrition) as predictors for unplanned ICU readmission. The developed scoring model showed good discrimination, with an AUC of 0.74. Patients with scores ≥4 points had […]
Laparoscopy Safely Manages Anterior Abdominal Stab Wounds
In a retrospective study spanning 25 years, researchers evaluated laparoscopic surgery’s role in diagnosing and treating anterior abdominal stab wounds (AASWs). Among 142 surgical patients, laparoscopy (62.7%) proved safe, with only 2 cases of overlooked injuries. For stable patients without significant injuries, laparoscopy demonstrated advantages, including reduced blood loss and shorter hospital stays compared to […]
Predicting Portal Vein System Thrombosis: A Nomogram Using Preoperative Portal Vein Velocity after Splenectomy with Esophagogastric Devascularization
In cirrhotic patients with portal hypertension undergoing splenectomy with esophagogastric devascularization (SED), portal vein system thrombosis (PVST) is a serious concern. This study involving 562 patients revealed that low preoperative portal vein velocity (PVV) was the strongest independent risk factor for PVST. Patients with PVV ≤ 16.5 cm/s had a significantly higher incidence of PVST. […]
Validating Basic Robotic Surgical Skills: A Proficiency Test for the Versius Surgical Robot Using a Virtual Reality Simulator
In assessing competency for the Versius surgical robot, researchers developed a virtual reality simulator-based test. Participants, categorized by experience, underwent exercises on the Versius trainer. Discriminatory analysis revealed parameters distinguishing novices and experienced surgeons but not intermediates. Test-retest reliability analysis showed moderate reliability for selected parameters. Non-compensatory pass/fail levels were defined, indicating novices’ failure and […]
Deep Neuromuscular Blockade Mitigates Working Space Issues in Low-Pressure Pneumoperitoneum during Laparoscopic Cholecystectomy
In a non-inferiority RCT comparing low-pressure pneumoperitoneum (LPP) with deep neuromuscular blockade (NMB) to standard pressure pneumoperitoneum (SPP) with moderate NMB for laparoscopic cholecystectomy, researchers found similar surgeon satisfaction scores between groups. This suggests that LPP with deep NMB is not inferior to SPP with moderate NMB, indicating a potential approach to address working space […]
International Consensus Guides Obesity Management: IFSO Delphi Study
In a Delphi survey involving 43 global obesity experts, unanimous consensus (≥70% agreement) was achieved on 15 essential definitions and reporting standards in metabolic bariatric surgery (MBS). Notable agreement (95/121 statements) covered preferred surgical procedures like Roux-en-Y gastric bypass and sleeve gastrectomy. Moderate consensus existed for specific procedures, but none for intra-gastric balloons. Agreement extended […]
Combined Hepatic Resection and Ablation Ensure Safety and Long-Term Survival in Extensive Colorectal Liver Metastases
Examining 161 patients with colorectal liver metastases (CRLM), researchers investigated the safety and efficacy of simultaneous hepatic resection (HR) and ablation. With 77.6% having bilobar disease and 57.1% having ≥5 tumors, the combined procedure demonstrated acceptable safety and durable long-term survival (median 38.2 months, 5-year OS 33.2%). Simultaneous colon resection increased complications. Importantly, patients with […]
Pelvic Exenterations and Cytoreductions Safely Combined for T4 Rectal Cancers with Peritoneal Metastasis
Investigating the combination of pelvic exenterations and cytoreductions in T4 rectal cancers with peritoneal metastasis, a study on 39 patients (median age 35) revealed safety in terms of morbidity (18% major complications). Although achieving CC-0 in 97.4%, hyperthermic intraperitoneal chemotherapy was administered to 15 patients. Despite safety, overall and recurrence-free survival remained modest at 17 […]