In a Danish cohort study emulating a randomized controlled trial, researchers assessed adjuvant chemotherapy’s impact on node-negative (PN0) and node-positive (PN+) pancreatic cancer survival after surgery. Among PN0 patients, adjuvant therapy showed no significant 2-year survival difference (-2.2%). For PN+ individuals, a 9.9% improvement in 2-year survival was noted. Median overall survival was 24.9 months […]
Category: General Surgery
AI Text-to-Image Generators Reinforce Bias: Underrepresentation of Diversity in Surgeon Depictions
Examining three popular AI text-to-image generators, the study assessed the demographic accuracy of surgeon representations. It found these models overwhelmingly portrayed surgeons as white and male, reinforcing societal biases. Trainees, especially non-white and female, were underrepresented. While one model reflected attending surgeons accurately, all underestimated trainee diversity. The study emphasizes the need for safeguards and […]
Optimal Surgical Approach for Small Bowel Neuroendocrine Tumors
In addressing the surge in small bowel neuroendocrine tumors (SB-NETs), this study underscores surgery’s pivotal role. Emphasizing multifocal assessment and mesenteric-sparing strategies, it delineates eight systematic steps for surgical planning. While stressing the necessity of achieving oncological control, some controversies persist, notably regarding resection in the presence of liver metastasis. The study encourages SB-NET resection […]
Outcomes of Esophagectomy in Elderly Patients with Esophageal Cancer
Analyzing 120 elderly esophageal cancer patients (Stage I-IV), the study revealed a 5-year overall survival rate of 45.2%. Lower body mass index, reduced pre-albumin levels, advanced tumor stage, postoperative pulmonary issues, and specific treatments significantly influenced outcomes. Despite a median 31-month follow-up, esophagectomy proved safe and feasible for elderly patients, emphasizing the importance of preventing […]
Optimal Timing for Gastric Cancer Surgery: Impact on Lymph Node Upstaging and Survival
Analyzing clinically node-negative gastric cancer patients, the study investigated the influence of time from diagnosis to surgery. Among 1824 patients, those with a longer interval (≥ 8 weeks) experienced less lymph node upstaging. Although overall survival differences appeared in Kaplan-Meier curves, multivariable analysis didn’t associate timing with survival. The findings suggest extended intervals don’t predict […]
Optimizing Surgical Approach in Synchronous Colorectal Liver Metastases
Analyzing data from 976 patients with synchronous colorectal liver metastases, researchers compared simultaneous and staged resections. Simultaneous resection, beneficial for low to moderate tumor burden and node-negative right-sided primary tumors, showed increased complications in high tumor burden cases. Staged resection demonstrated better outcomes for patients with node-positive left-sided primaries and higher tumor burden scores. Tailoring […]
Innovative Imaging for Anastomotic Site Assessment in Esophagectomy
In a prospective study on esophageal cancer patients undergoing thoracic esophagectomy, researchers compared tissue oxygen saturation and indocyanine green measurements. Tissue oxygen saturation imaging proved valuable in identifying the anastomotic site, overcoming limitations of indocyanine green. In 57 patients, decreased tissue oxygen saturation at the conduit tip correlated with congestion and an increased risk of […]
Surgery in Acute Lower Gastrointestinal Bleeding
In a cohort study of 10,342 acute lower gastrointestinal bleeding (ALGIB) cases, surgery was performed in 1.3%. Colonoscopy (87.7%) and endoscopic hemostasis (26.7%) were common. Surgery indications included diverticular bleeding (24%) and colorectal cancer (22%). Sixty-four percent were for severe refractory bleeding. Postoperative rebleeding rates were 22% (presumptive/obscure source) and 12% (definitive identification). Thirty-day mortality […]
Postoperative Atrial Fibrillation and Warfarin: Impact on Mortality
In the Regroup trial focusing on coronary artery bypass grafting (CABG), 28.6% developed postoperative atrial fibrillation (POAF). Among 269 POAF patients, 85 received oral anticoagulation (OAC) with warfarin, and 184 did not. During active follow-up, stroke rates were similar (3.5% OAC vs. 5.4% no-OAC), but major adverse cardiac events were higher with OAC (20% vs. […]
Margin Clearance and Survival in Ampullary Adenocarcinoma After Pancreaticoduodenectomy
Examining 128 patients undergoing pancreaticoduodenectomy for ampullary adenocarcinoma, Danish researchers found that a margin clearance of ≥1 mm was independently associated with significantly improved survival compared to