A European multicenter study comparing total (TG) and subtotal gastrectomy (SG) for antropyloric poorly cohesive carcinoma found no significant difference in 5-year overall survival (TG: 53.8%, SG: 53.0%) or disease-free survival (TG: 46.0%, SG: 45.3%). Despite similar baseline characteristics, TG showed higher postoperative complications. This study supports subtotal gastrectomy as a viable option, offering comparable […]
Category: General Surgery
Comparative Analysis of Robotic Posterior Retroperitoneal and Lateral Transperitoneal Adrenalectomy
Robotic posterior retroperitoneal adrenalectomy and lateral transperitoneal adrenalectomy were compared using a 1:1 matched propensity analysis. In 154 matched cases, no significant differences were found in operative time, conversion to open surgery, postoperative pain, morphine use, length of stay, or 90-day complications. While posterior retroperitoneal adrenalectomy had lower estimated blood loss, it was not considered […]
Normocalcemic hyperparathyroidism presents a diagnostic challenge
A study introduced a preoperative calcium challenge for patients with elevated parathyroid hormone and normal calcium levels. Of 29 patients, 55% normalized parathyroid hormone with persistent normocalcemia, confirming secondary hyperparathyroidism. In 19%, classic primary hyperparathyroidism was diagnosed. Short-interval calcium supplementation revealed ∼50% resolved secondary hyperparathyroidism due to low calcium intake, avoiding unnecessary surgery. This approach, […]
Complex Bariatric Surgery Sequencing: Double Conversions from Adjustable Gastric Band to Sleeve Gastrectomy and Then to Roux-en-Y Gastric Bypass
Examining 276 cases, researchers found that patients undergoing double conversions from adjustable gastric band (AGB) to sleeve gastrectomy (SG) and then to Roux-en-Y gastric bypass (RYGB) primarily did so due to gastroesophageal reflux disease (GERD) or inadequate weight loss/weight regain. Those converted for weight issues had higher baseline body mass index and sleep apnea prevalence, […]
Surgical Management of Esophageal Cancer in Patients with Right Aortic Arch or Double Aortic Arch: A Case Series
Analyzing 34 cases with right aortic arch (RAA) or double aortic arch (DAA) and esophageal cancer, the study found that esophagectomy, whether via thoracotomy or thoracoscopic surgery, can be safely performed for both conditions. Patients, predominantly Japanese males with squamous cell carcinoma, commonly underwent left thoracotomy for RAA and showed similar left and right approaches […]
Video-Based Coaching in Surgery: Practical Implementation and Risk Mitigation
Video-based surgical coaching, recognized as a valuable tool for continuous professional growth, is explored further in this second part of the series. Researchers focus on its practical applications for team-based quality improvement, particularly in trauma bay settings. The paper delves into the associated risks, addressing legal and ethical concerns in video recording, storage, and distribution. […]
Disparities and Challenges in Surgical Cancer Care at Safety-Net Hospitals
Analyzing 37 studies covering January 2000 to October 2021, researchers explored surgical cancer care in US safety-net hospitals (SNHs). Breast cancer (43%), colorectal (30%), and hepatopancreatobiliary (16%) cases were most represented. Barriers like financial constraints, cultural/language issues, and insurance limitations were common, contributing to advanced disease presentation (24-61% of patients). Limited data on cancer survival […]
Patient and Case Disparities in Resident-Performed Surgeries at Teaching Hospitals
Analyzing over 600,000 cases at Veterans Affairs teaching hospitals, this study delves into resident operative autonomy, revealing distinct patient and case differences. In cases where residents operate independently, patients were younger, had lower comorbidities, and underwent less complex procedures. Notably, core general surgery cases dominated, indicating attending judgment in allowing autonomy. However, despite some patients […]
Laparoscopic vs. Open Pancreatoduodenectomy in Long-Term OS Battle
In the clash of surgical titans for pancreatic or periampullary tumors, laparoscopic and open approaches square off. The 3-year showdown reveals no knockout punches. Among the contenders, laparoscopic pancreaticoduodenectomy (LPD) doesn’t outshine open PD in the ring of overall survival (OS). Both LPD and open PD go the distance with a similar 3-year OS, showcasing […]
Thyroid Carcinoma: Unraveling the Biomarker Enigma in High-Stakes Diagnosis
In the thyroid cancer arena, the study unveils the tricky identity crisis of anaplastic thyroid carcinoma (ATC). Often emerging from differentiated thyroid carcinoma (DTC), ATC’s rebel nature complicates diagnosis. Researchers scoured 36 cases, discovering ATC’s deceptive biomarker profile. While TTF1 stays mum, PAX8 and divergent markers like GATA3 and SATB2 stage a confusing spectacle. These […]