Identifying immune signatures could refine patient selection and surgical outcomes for those with MEN1-related neuroendocrine tumors. Analyzed 42 MEN1 patients with duodenopancreatic neuroendocrine tumors (DPNETs); 14 had liver metastasis. Identified 1,117 immunoglobulin-bound proteins; 435 antigens enriched in DPNET patients, with 130 higher in those with liver metastasis. Surgeons may consider these findings for better risk […]
Category: General Surgery
Navigating Hepatectomy: New Standards for Liver Remnant Volume
A study identifies critical thresholds for future liver remnant volume (FLRV) to reduce post-hepatectomy liver failure in cancer patients. FLRV of ≥30% in normal livers and ≥50% in impaired livers reduces the risk of severe morbidity. For every 10% increase in FLRV, the odds of severe liver failure-related complications decrease by nearly 40%. Focus on […]
Multimodal Prehabilitation Reduces Complications in Frail Elderly with Gastric Cancer
A multimodal prehabilitation program improves outcomes for older patients with frailty undergoing radical gastrectomy. Complications dropped significantly in the prehabilitation group (17.2% vs 28.7%; p=0.01). Minor complications were halved (10.7% vs 20.2%; p=0.01), and medical complications also decreased (8.3% vs 16.9%; p=0.02). Patients in the prehabilitation group improved their functional capacity before surgery with an […]
Wearable Acupoint Stimulation Beats Metoclopramide for PONV
A novel wearable device significantly outperforms metoclopramide in managing moderate to severe postoperative nausea and vomiting (PONV). The TEAS group achieved a 2-hour remission rate of 77.6% vs. 55.2% for controls (p < 0.001). 24-hour relapse rates were 12.2% for TEAS compared to 56.3% for metoclopramide (p < 0.001). This suggests wearable TEAS could enhance […]
Liver Fibrosis Increases Recurrence Risk in Colorectal Metastases
Background liver fibrosis intensifies the risk of intrahepatic recurrence after surgery for colorectal liver metastases, impacting surgical decision-making. Intrahepatic recurrence occurred in 36.3% of patients post-surgery, with 58.3% in the fibrosis group vs. 29.5% in the non-fibrosis group (p = 0.019). Each 1% increase in fibrotic area raised recurrence risk by 45% (hazard ratio 1.45; […]
Identifying Risks After Pancreatoduodenectomy
In-hospital mortality after pancreatoduodenectomy reveals critical timing for interventions impacting patient outcomes. 3.5% of patients (156 of 4474) died in the hospital, primarily from three complication clusters: postpancreatectomy-specific (51.9%), vascular (25.6%), and cardiopulmonary (17.9%). Complications emerge at different postoperative intervals: median 9 days for postpancreatectomy, 4.5 days for vascular, and 3 days for cardiopulmonary issues. […]
Reducing Water Waste at OR Scrub Sinks
Surgeons are wasting an estimated 337,596 liters of water annually during surgical scrubs, representing 34.2% of total usage. The median water wasted per wet scrub at timer-controlled sinks is 10 liters. Wet scrubs are performed in 25.9% of cases by attending surgeons and OR staff. Optimizing scrub practices could lead to significant water conservation without […]
CA 19-9 Testing Improves Survival in Resected Ampullary Cancer
Routine CA 19-9 surveillance detects recurrences early and enhances survival in resected ampullary cancer patients. Five-year overall survival stands at 56.4% in 572 patients, with 43.88% experiencing recurrences, predominantly distant. A serial rise in CA 19-9 is a strong predictor for recurrence, showing 71.05% sensitivity and 91.67% specificity. Detecting recurrences early through CA 19-9 testing […]
Active Surveillance Offers Quality of Life Benefits in Oesophageal Cancer
Active surveillance after neoadjuvant chemoradiotherapy provides similar survival to surgery while significantly enhancing quality of life for patients with locally advanced oesophageal cancer. Active surveillance patients reported significantly better scores for dysphagia, dyspnoea, fatigue, and physical functioning at 6 months (Cohen’s d of -1.09, -0.63, -0.70, and 0.77, all p ≤ 0.001). Dysphagia improvements were […]
Intrathoracic Side-Overlap Anastomosis Reduces Pain and Reflux
Intrathoracic side-overlap esophagogastrostomy (SOE) shows promise as a viable alternative to circular stapled (CSE) technique in esophagectomy for Siewert type I/II adenocarcinoma. SOE leads to significantly lower postoperative pain scores: 3.49 vs. 4.04 on day one (p=0.002). Severe gastroesophageal reflux is lower with SOE (14.5%) compared to CSE (34.0%) (p=0.019). Dysphagia symptoms are reduced with […]