Surgeon-led geriatric service and good quality surgery are key in achieving good outcomes in older colorectal cancer surgery patients. A 10-year review of 233 patients aged ≥75 years or frail showed low 30-day mortality (1.7%) and complications (12.0%), with a median length of stay of 7.0 days. Cumulative sum analysis demonstrated sustained improvement in outcomes, […]
Category: General Surgery
Belonging in Surgery: Validated Instrument and Pilot Study
Researchers developed and validated an instrument to measure belonging in surgery among residents. The final instrument with 11 items showed a high internal consistency (Cronbach’s alpha = 0.90). Belonging in surgery was associated with race, graduating with one’s original intern cohort, and inversely correlated with resident stress levels. This validated instrument can be used to […]
Elevated Postoperative AST/ALT Predicts Morbidity in Hepatocellular Carcinoma Resection
Elevated postoperative serum AST and ALT levels, measured as changes from preoperative values, were associated with increased postoperative morbidity in hepatocellular carcinoma patients undergoing curative resection. The optimal cutoff value for postoperative complications was identified as AST/ALT change ≥5. Routine use of AST and ALT can effectively predict the risk of complications after surgery for […]
Validating Japanese Criteria for Locally Resected Pt1 Colorectal Carcinoma: Long-term Outcomes
Researchers validated Japanese criteria for locally resected pt1 colorectal carcinoma (CRC), assessing long-term outcomes in 4719 patients. Patients without risk factors had a low lymph node metastasis (LNM) incidence (1.8%), contrasting with risk-positive cases in Group B/C (10.3%). Group A, with risk factors, showed higher recurrence (3.4%) than those without (0.1%). Disease-free survival in risk-negative […]
Early-Onset Intrahepatic Cholangiocarcinoma: Poorer Survival and Altered Genomic Features
Patients with early-onset intrahepatic cholangiocarcinoma (ICC) had worse 5-year recurrence-free and disease-specific survival compared to patients with typical-onset ICC. Genomic analysis revealed distinct upregulated and downregulated genes in early-onset ICC. Morphologic and clinicopathologic characteristics could not fully explain the outcome differences between the two groups, highlighting the need for further research into early-onset ICC’s molecular […]
European Hospital Staff Well-being and Patient Safety: Critical Concerns and Intervention Priorities
Prevalent issues among European hospital physicians and nurses include burnout, job dissatisfaction, and concerns about patient safety. Better work environments and staffing correlate with lower rates of adverse health indicators and improved quality of care. Interventions prioritized by clinicians for well-being include improving nurse staffing levels and reducing bureaucracy, while individual mental health interventions are […]
Significant Survival Benefit of Multimodality Treatment in Gallbladder Neuroendocrine Neoplasms
Gallbladder neuroendocrine neoplasms (GB NENs) are predominantly represented by neuroendocrine carcinomas. Outcomes analysis of 147 patients revealed a median overall survival (OS) of 6.14 months, with significant improvement to 20.20 months for those who received multimodality treatment versus 4.00 months for those who did not. These findings highlight the efficacy of multimodality approaches in improving […]
Impact of Rapid Onsite Evaluation on Adequacy of Thyroid Nodule Fine-Needle Aspiration
Utilizing rapid onsite evaluation (ROSE) during first-time fine-needle aspiration (FNA) of thyroid nodules significantly increased diagnostic adequacy from 76% to 92%. ROSE implementation raised the odds of adequate FNA by 22%, with a 28% increase seen in institutions with lower baseline diagnostic rates. Conversely, institutions with higher baseline rates saw a 5% increase. Overall, ROSE […]
Broader Surgical Indications in Primary Hyperparathyroidism: Lower Biochemical Severity and Excellent Cure Rates
Modern trends in primary hyperparathyroidism reveal patients presenting with lower parathyroid hormone and calcium levels. Parathyroidectomy, now more common for borderline cases with osteopenia and modest calciuria, yields a 93.7% cure rate, regardless of guideline concordance. This suggests a role for broader surgical indications, given excellent cure rates and rare postoperative hypocalcemia. Journal Article by […]
Key Findings on Hemodynamic Instability Prediction in Pheochromocytoma Resection
Robot-assisted retroperitoneal pheochromocytoma resection was associated with lower perioperative hemodynamic instability compared to laparoscopic surgery. A nomogram predicting instability risk was developed, including tumor size, abnormal blood glucose, preoperative systolic blood pressure, robot-assisted surgery, and catecholamines as significant factors. The nomogram had an area under the curve of 0.816, providing clinicians with a tool to […]