In a paradigm-shifting viewpoint, academic surgery is urged to move beyond the traditional ‘triple threat’ model of clinical care, research, and teaching. The study advocates for a more sustainable and individualized approach, recognizing that the evolving healthcare landscape and external pressures make the current model less tenable. Surgeons are encouraged to define success based on […]
Category: General Surgery
Optimizing Pancreatic Body Cancer Surgery: Distal Pancreatectomy with Portal Resection
For pancreatic body cancers, researchers compared distal pancreatectomy with portal vein resection (DP-PVR) to the more common pancreaticoduodenectomy with PVR. Despite DP-PVR having higher occlusion and complication rates, both approaches showed similar survival outcomes. Meticulous surgical techniques, including various reconstruction methods for DP-PVR, were crucial. The study emphasizes a surgical algorithm based on arterial and […]
Gastric Cancer: Prognostic Impact of Categorized Tumor Deposits
In a gastric cancer retrospective study, researchers classified tumor deposits into distinct types. Of 868 patients, 11.1% had tumor deposits, revealing poorer survival (3-year overall survival: 53.2%) compared to those without (87.0%). Irregular nodule and the tumor deposits complex showed the worst prognosis (3-year overall survival: 41.9%), while smooth nodule displayed a better outcome (3-year […]
Robotic Triumph: US Study Reveals Advantages in Gastric Cancer Surgery
In the quest for optimal gastric cancer surgery, a study of 11,173 patients in the US compared robotic and laparoscopic gastrectomy. The analysis revealed that robotic gastrectomy (RG) outshone laparoscopic gastrectomy (LG) in terms of adequate lymphadenectomy, negative margins, shorter hospital stay, lower mortality, and superior 5-year overall survival. Propensity score matching affirmed RG’s superiority […]
Robotic Surgery Revolution: 3D Drawing Annotations Enhance Telementoring
In a groundbreaking study, researchers explored the effectiveness of telementoring in robotic surgery with 3D drawing annotations. Conducted 140 km apart, the study used the Saroa™ surgical robot, evaluating 20 medical students. The 3D annotation group demonstrated potential for shorter working time, fewer retries, and needle drops compared to the control. Notably, they outperformed in […]
Rare Hemorrhage After Distal Pancreatectomy
In the post-distal pancreatectomy (DP) landscape, researchers explored the rare territory of clinically relevant post-pancreatectomy hemorrhage (CR-PPH). Among 1,188 patients, 5.5% encountered CR-PPH, marked by increased 90-day mortality and morbidity. Prolonged operative time and co-existing postoperative pancreatic fistula independently heightened CR-PPH risk. Strikingly, the failure-to-rescue rate was significantly higher in CR-PPH cases, emphasizing the gravity […]
Pancreatic Cancer Diagnosis: FDG-PET/CT Ratio Signals Malignancy in Branch-Duct IPMNs
In the realm of pancreatic branch-duct intraductal papillary mucinous neoplasms (bd-IPMNs), spotting malignancy is tricky. However, researchers delving into 58 cases discovered a game-changer. The standardized uptake value (SUV) from FDG-PET/CT, specifically the tumor-to-blood pool ratio (TBR), emerged as a potent indicator of malignancy. Correlating significantly with histopathology, TBR proved independently significant in scenarios defining […]
Preventing Obstruction: Identifying Risk Criteria for Colon Cancer Patients Undergoing Neoadjuvant Chemotherapy
In the FOxTROT trial, analyzing high-risk colon cancer patients undergoing neoadjuvant chemotherapy (NAC), researchers identified pre-treatment risk criteria to stratify obstruction risk. Among 699 patients, 4.3% developed obstruction. Two independent criteria, obstructing disease on endoscopy or inability to pass through the tumor, and stricturing disease on radiology or endoscopy, were associated with higher risk. This […]
Enhancing Training for Surgical Oncology Excellence
Complex General Surgical Oncology (CGSO) fellowship graduates, while generally feeling prepared for practice, expressed concerns about research and specific clinical areas like thoracic, hyperthermic intraperitoneal chemotherapy (HIPEC), and hepato-pancreato-biliary surgery. The study reveals potential gaps between trainee expectations and surgical oncology practice realities, suggesting opportunities to refine the training model. Improvements, such as increased autonomy, […]
Navigating Neoadjuvant Uncertainty: Ampullary and Duodenal Adenocarcinoma Management
The study delves into the uncertain territory of neoadjuvant therapy (NAT) for ampullary (AA) and duodenal adenocarcinoma (DA). Analyzing 15 retrospective studies, no clear survival differences were found between NAT and upfront surgery. While some studies hinted at benefits like increased pathologic response, overall evidence supporting NAT for AA and DA is weak. The research […]