In colorectal liver metastases (CRLM), the review investigates the association between KRAS status, histopathological growth patterns (HGPs), and their impact on resection margins around major vasculature and bile ducts. The study emphasizes the importance of balancing negative margins and preserving vascular and biliary structures during surgery. While parenchymal sparing is crucial, the review explores how […]
Category: General Surgery
Identifying Low Phospholipid Associated Cholelithiasis as an Under-Recognized Cause of Post-Cholecystectomy Pain
Among patients under 40 undergoing cholecystectomy, 1.9% exhibited symptoms suggestive of low phospholipid associated cholelithiasis (lpac). Family and obstetric history may aid in its diagnosis, as none of the lpac cases were initially recognized by clinicians. This study highlights the importance of considering lpac in cases of post-cholecystectomy pain, as timely treatment can prevent long-term […]
Endoscopic gallbladder stenting reduces recurrent cholecystitis in deferred cholecystectomy patients
Endoscopic gallbladder stenting (ETGS) significantly reduces recurrent cholecystitis in patients with deferred cholecystectomy, demonstrating 0% recurrence at 3 months compared to 18.3% in the non-ETGS group. Although not statistically significant, ETGS also shows a trend towards lower recurrence (0% vs. 10%) at 3-6 months. Technical and clinical success rates for ETGS are 90% and 100%, […]
Declining Opioid Prescriptions, Yet Disparities Persist
Surgeons in the US decreased opioid prescriptions post-surgery from 2013 to 2017, with 81.6% of counties showing a decreasing trend. Factors such as lower median population age, higher education levels, insufficient sleep rates, healthcare costs, fewer mental health providers, and uninsured adults were linked to higher opioid prescription rates. Suboptimal access to healthcare, particularly mental […]
Mood and Sleep Improvement Post-Parathyroidectomy for Primary Hyperparathyroidism
Patients with primary hyperparathyroidism experience significant improvements in mood and sleep quality after parathyroidectomy. Depression scores significantly decreased at 3 and 12 months post-surgery compared to preoperative levels. Sleep quality showed improvement at 12 months, particularly in daytime dysfunction. These findings highlight the importance of considering mood and sleep disturbances in preoperative assessments for patients […]
Biologic Therapies Effective in Chronic Antibiotic Refractory Pouchitis
Studies on chronic antibiotic refractory pouchitis highlight limited evidence for non-pharmacologic therapies while demonstrating efficacy of biologic therapies such as mesalamine, budesonide, anti-tumor necrosis factor alpha therapies, ustekinumab, and vedolizumab in managing the condition. Biologic therapies offer a steroid-sparing option, with vedolizumab showing favorable results in randomized controlled trials. Non-medication therapies like hyperbaric oxygen and […]
Low Risk of Health Hazards from Surgical Smoke Generated by Electrocautery
Exposure to surgical smoke from electrocautery in operating rooms poses minimal health risks to personnel, with low levels of pollutants and particulate matter. Virus transmission through electrocautery remains uncertain. Current mandates for smoke evacuators are deemed unnecessary based on the limited health hazards associated with surgical smoke exposure. Review by Hurst RD and Stewart CL […]
Variable Complication Reporting in Canadian Trauma Registries
In a comparison of nine trauma registries in Canada, researchers found significant variability in the abstraction and definitions of complications reported. Of the 53 identified complications, 40% were recorded by only one registry, and 56% of those collected by more than one registry had different definitions. This diversity in reporting complicates reliable benchmarking, emphasizing the […]
Key findings from documentation of trauma-informed care for young assault trauma patients
Results from a retrospective chart review show that 96% of pediatric assault trauma patients had at least one trauma-informed element documented, compared to 82.5% of adult patients. Social workers were the most likely to document trauma-informed elements, with pain assessment and social support being the most frequently documented. However, safety assessments for suicidal ideation, retaliatory […]
Adjuvant Chemotherapy Improves 5-Year Survival in Near-Pathological Complete Response Patients with Locally Advanced Rectal Cancer
Patients achieving near-pathological complete response in locally advanced rectal cancer benefited from adjuvant chemotherapy, particularly those with ypt1-t2 stage tumors and positive lymph nodes. Act was associated with improved 5-year disease-free survival rates in downstage patients, emphasizing its significance in post-surgery outcomes. Additionally, serum carcinoembryonic antigen levels before treatment and ypT stage were identified as […]