Achieving textbook outcomes (TO) and textbook oncological outcomes (TOO) is linked to significantly better overall survival and disease-free survival after gastric and esophageal cancer surgeries. For gastrectomy, patients who achieved TO/TOO had a 40% reduction in overall survival risk (HR 0.60) and a 46% reduction in disease-free survival risk (HR 0.54). For esophagectomy, the overall […]
Category: General Surgery
Complete Resection of Hepatic and Pulmonary Metastases Boosts Survival
Complete resection of simultaneous hepatic and pulmonary metastases from metastatic colorectal cancer shows significant survival benefits and should be a key treatment goal for selected patients. The 5-year overall survival rate post-metastasectomy is 53.6%, with a 3-year rate of 70.9%. Patients undergoing complete metastasectomy had a hazard ratio of 0.30 for overall survival compared to […]
Understanding Spiritual Distress Can Influence Surgical Outcomes
Patients facing elective surgery often experience significant spiritual distress, impacting their preoperative mindset and potentially their recovery. In a study of 29 surgical patients, 23 reported spiritual distress, expressing greater anxiety and fear regarding their impending surgery. Conversely, those with higher spiritual well-being approached surgery as a restorative experience, demonstrating resilience. Assessing spiritual well-being may […]
Robotic vs. Open Hepatectomy: Comparable Outcomes, Different Metrics
Robotic hepatectomy in IWATE expert-level liver resections results in less blood loss and a shorter hospital stay compared to open surgery, without increasing major complications or mortality. In a matched cohort of 68 patients, robotic surgery had a median operative time of 240 minutes versus 206 minutes for open surgery (p = 0.002), lower estimated […]
Liver Resection Improves Outcomes in Advanced Hepatocellular Carcinoma
In patients with advanced hepatocellular carcinoma who responded to systemic therapy, surgical resection significantly prolongs time to treatment failure compared to maintenance therapy. Median time to treatment failure was 20.4 months with surgery versus 11.8 months with maintenance therapy (hazard ratio 0.60; p=0.015). Adverse events were higher in the surgery group (39%) versus maintenance (21%), […]
New Classification System for Surgical Site Outcomes
A new classification system called DISH (Dehiscence, Infection, Seroma, Haematoma) standardizes the reporting of surgical site outcomes, enhancing clinical management and research. DISH categorizes outcomes by five grades of intervention (0-4) and four grades of presentation (a-d), providing a detailed snapshot of surgical site status. This system exhibited high reliability, with inter-rater agreement at 0.93 […]
Pancreaticobiliary Maljunction Linked to Recurrence in Gallbladder Cancer
Patients with pancreaticobiliary maljunction (PBM) have significantly worse recurrence-free survival following surgical resection for gallbladder carcinoma without hepaticojejunostomy. PBM is associated with a 2.10-fold increased risk of recurrence (95% CI 1.13-3.89, p=0.019) compared to non-PBM patients in the study population. Overall survival in palliative settings is also adversely impacted, with a hazard ratio of 3.10 […]
Streamlined Robotic Pancreatoduodenectomy Technique Improves Workflow
A counterclockwise, step-by-step approach for robotic pancreatoduodenectomy enhances surgical workflow and appears to reduce operative complications. Mean console time was 279 minutes across 150 procedures, with no conversions to open surgery. Major complications occurred in 13.3% of patients, with a postoperative pancreatic fistula rate of 6.7% and delayed gastric emptying in 23.3%. The 30- and […]
Biological Mesh for Pelvic Reconstruction Not Cost-Effective
Using biological mesh for pelvic floor reconstruction after extralevator abdominoperineal resection in low rectal cancer patients does not provide a cost-effective solution despite slightly reducing perineal complications. Pelvic reconstruction with biological mesh increased costs (€57,991) versus primary closure (€56,232) without significant improvement in long-term patient outcomes or quality of life. The study’s conclusions suggest routine […]
Endoscopic Therapy for Cystic Duct Remnant Stones Shows High Success
ERCP is a highly effective and safe option for managing symptomatic cystic duct remnant stones in post-cholecystectomy patients, reducing the need for surgical excision. Technical success was achieved in 95% of cases (20/21), with clinical success at 91% (19/21). Balloon sweep alone cleared stones in 43% of patients, with cholangioscopy and electrohydraulic lithotripsy frequently required […]