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Machine learning predicts duodenal stump leakage risk in gastric cancer

A new predictive model utilizing machine learning has shown promise in forecasting duodenal stump leakage after laparoscopic gastrectomy for gastric cancer. Analyzing data from 4,070 patients, the support vector machine emerged as the most effective algorithm, achieving high sensitivity, accuracy, and specificity. Key factors influencing leakage risk include tumor location, tumor stage, operation time, preoperative pyloric obstruction, and patient age. This model not only aids in risk assessment but also supports preventive strategies in surgical care.

Journal Article by Li Y, Su Y (…) Qin J et 3 al. in BMC Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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Intracorporeal ileocolic anastomosis shows comparable outcomes to extracorporeal technique

A multicenter randomized trial assessed intracorporeal versus extracorporeal ileocolic anastomosis in laparoscopic right hemicolectomy for right-sided colon cancer. Results indicated that both methods exhibited similar anastomotic leakage rates within 30 days post-surgery and comparable 3-year disease-free survival rates. Intracorporeal anastomosis also demonstrated advantages in terms of faster postoperative recovery, suggesting it as a viable alternative to the traditional extracorporeal method. This study potentially reshapes surgical approaches in managing right-sided colon cancer.

Journal Article by Wu S, Wei P (…) Zhang Z et 6 al. in Surg Endosc

© 2024. The Author(s).

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New guidelines recommend optimal surgical management for diverticulitis

Evidence-informed guidelines indicate that patients with complicated diverticulitis without sepsis should prefer primary resection and anastomosis (pra) over Hartmann’s resection (hr) or laparoscopic lavage (lpl), contingent on surgical expertise. Conversely, hr is advised for septic or frail patients. Key outcomes highlighted a greater probability of avoiding stoma formation at one year with pra. The guidelines emphasize shared decision-making and conditional recommendations to enhance surgical management across Europe.

Journal Article by Antoniou SA, Huo B (…) Bonjer HJ et 24 al. in Surg Endosc

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Sleeve gastrectomy reduces all-cause mortality compared to RYGB.

In adults with morbid obesity, sleeve gastrectomy (SG) significantly lowers all-cause mortality risks during follow-up compared to Roux-en-Y gastric bypass (RYGB). A systematic review and meta-analysis of 22 studies involving 333,713 patients revealed that SG is linked to reduced reoperation, reintervention, and hospitalization rates, although it has a higher revision rate. These findings underscore the potential survival benefits of SG in bariatric surgery, prompting the need for further large-scale trials for validation.

Journal Article by Sakurai Y, Balakrishnan P (…) Munie S et 7 al. in Surg Obes Relat Dis

Copyright © 2024 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

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Fatigue and Alopecia Are Key Challenges in Esophageal Cancer Treatment

In a study of 75 esophageal squamous cell carcinoma patients undergoing neoadjuvant immunochemotherapy, treatment-related adverse events (TRAEs) were better characterized over time using latent-class mixed-modeling. Most TRAEs, including pruritus, nausea, vomiting, and pain, improved, while fatigue and alopecia worsened. Patients with severe gastrointestinal TRAE trajectories had significantly poorer overall survival compared to those with mild trajectories, indicating a need for closer monitoring of these adverse effects throughout treatment.

Journal Article by Li Z, Huang S (…) Qiao G et 6 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Novel surgical technique shows promise for pancreatic cancer

Laparoscopic radical antegrade modular pancreatosplenectomy, when combined with portal vein reconstruction and celiac axis resection, demonstrated safety and efficacy for treating pancreatic neck-body cancer. A 74-year-old patient underwent the procedure following neoadjuvant chemotherapy, resulting in significant tumor size reduction. The surgery lasted 300 minutes with manageable blood loss, and the patient experienced no recurrence or metastasis during 15 months of follow-up. This approach offers a crucial option for patients with complex vascular involvement.

Journal Article by Wang X, Yang Y, Li J and Sun P in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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New approach enhances laparoscopic hemihepatectomy outcomes

A dorsal approach to the middle hepatic vein from the hilar plate in laparoscopic hemihepatectomy has shown promising results. In a study involving 28 patients, the average surgery duration was 260 minutes, with median blood loss at 80 ml. Postoperative major complications occurred in only 3.6% of cases. This technique promotes better visualization and surgical precision, which are essential for reducing complications and improving overall outcomes in hemihepatectomy procedures.

Journal Article by Kim JH in World J Surg

© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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High energy intake in postoperative nutrition mitigates complications.

Supplementary parenteral nutrition (h-spn) with higher energy intake decreased postoperative hospital stays and infectious complications among gastric cancer patients. In a study of 128 patients, the h-spn group had an average stay of 8.11 days compared to 10.38 days for the l-spn group and significantly fewer infections, particularly pulmonary. Furthermore, there were no added costs or complications associated with h-spn, indicating it as an effective nutritional support strategy after surgery.

Journal Article by Sun S, Sun W (…) Zhou H et 5 al. in BMC Surg

© 2024. The Author(s).

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Robotic surgery research has significantly increased over the last decade.

Recent analysis highlights a consistent rise in robotic surgery publications from 2014 to 2023, with the United States leading in both quantity and citations. The Journal of Robotic Surgery tops the publication list, while the University of Washington presents the highest average citation rate. Key research areas include techniques, complications, and applications across various medical fields. Notably, artificial intelligence has emerged as a significant keyword, signaling a key trend for future advancements in robotic surgery.

Review by Song M, Liu Q (…) Zhang H et 2 al. in J Robot Surg

© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.

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Serious illness exacerbates post-surgical pain and caregiving needs.

The analysis of 1,896 older adults who underwent major elective surgeries revealed that 60% had serious illness. Notably, those with serious illness experienced greater baseline levels of pain (43% vs. 38%), depression (22% vs. 13%), and required assistance with activities of daily living (ADLs) compared to their healthier counterparts. Post-surgery, serious illness was significantly associated with increased pain, depression, and a doubling of informal caregiving needs, highlighting a critical area for palliative care intervention.

Journal Article by Min JWS, Wang Y (…) Cooper Z et 9 al. in Ann Surg

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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