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Deep-learning model surpasses traditional methods in predicting HCC recurrence

A novel deep-learning model, Recurr-Net, showed superior accuracy in predicting hepatocellular carcinoma (HCC) recurrence post-surgery compared to histological microvascular invasion (MVI) and conventional clinical prediction scores. In a study of 1,231 patients, Recurr-Net achieved AUROC scores between 0.770 and 0.857 for internal validation, significantly better than MVI and various clinical risk scores. The model effectively stratified recurrence risks at two and five years, demonstrating its potential for improved preoperative prognostication in HCC cases.

Journal Article by Hui RW, Chiu KW (…) Seto WK et 17 al. in Hepatology

Copyright © 2024 American Association for the Study of Liver Diseases.

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Delayed gastrointestinal recovery affects 16% of hepatectomy patients

The study found that 16% of patients experienced delayed return of gastrointestinal function (DRGF) after partial hepatectomy, which was notably linked to major surgery, longer operation times, and postoperative complications like biliary leaks. Among the 82 affected patients, some required a second nasogastric tube placement, and they also experienced increased risks of pneumonia and lengthened hospital stays. The implementation of enhanced recovery protocols did not significantly change DRGF rates, remaining consistent pre- and post-adoption.

Journal Article by Piazza G, Labgaa I (…) Joliat GR et 3 al. in Dig Surg

© 2024 The Author(s). Published by S. Karger AG, Basel.

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Forceps Grasp Counts Correlate with Surgical Proficiency

The analysis of 741 surgical procedures revealed that forceps grasp counts correlated strongly with procedure time in single-incision laparoscopic surgeries. Statistically significant differences were noted, with longer times and higher grasp counts for male patients compared to female patients. As surgeons gained experience, both grasp counts and procedure times decreased, although novice surgeons took longer to enhance forceps manipulation skills. These findings underscore efficient forceps manipulation as a critical measure of surgical competency.

Journal Article by Sanmoto Y, Kawami A (…) Masumoto K et 3 al. in Asian J Endosc Surg

© 2024 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.

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Subcomplete sealing technique minimizes recurrent laryngeal nerve palsy

The subcomplete sealing technique significantly mitigated the risk of recurrent laryngeal nerve (RLN) palsy during esophagectomy. Among 76 patients undergoing the procedure, only 3.95% experienced grade IIa RLN palsy, with no cases of more severe injuries. This approach utilizes advanced bipolar energy devices to achieve vessel sealing while preventing thermal injury to nearby nerves, thereby promoting safer lymph node dissection around the RLNs and reducing bleeding risks associated with traditional methods.

Journal Article by Hayashi M, Fujita T and Matsushita H in Asian J Endosc Surg

© 2024 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.

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Hybrid Robotic Surgery Enhances Distal Gastrectomy Efficiency

A novel hybrid robotic surgery, integrating minimally invasive laparoscopic techniques with the da Vinci single-port system, demonstrates promise in distal gastrectomy for gastric cancer. This approach allows for a more spacious environment for surgical teams, enhancing their efficiency. The setup permits dual operability—robotic and laparoscopic—facilitating effective nodal dissection with improved surgical quality and reduced operative time. Findings suggest that MILAR surgery could revolutionize traditional methods, offering significant advantages in complex procedures.

Journal Article by Yoshikawa T, Hayashi T (…) Seto Y et 6 al. in Asian J Endosc Surg

© 2024 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.

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Adjuvant therapy benefits vary by cancer type in esophageal cancer

A large-scale observational study identified that adjuvant therapy after esophagectomy is beneficial primarily for patients with node-positive squamous cell carcinoma and specific advanced adenocarcinoma stages. Patients with adenocarcinoma experienced survival benefits mainly in cases with PT4 or PTanyN3M0 cancers, while a decrement was noted in less severe cases. For squamous cell carcinoma, survival improvements ranged from 4 to 21 months, highlighting the need for tailored treatment guidelines based on cancer type and stage.

Journal Article by Raja S, Rice TW (…) Ishwaran H et 7 al. in Ann Surg Open

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

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New guidelines reduce opioid consumption after surgical procedures

An analysis of the Michigan Surgical Quality Collaborative registry reveals that patient-reported opioid consumption decreased from 2018 to 2021 following updated prescribing guidelines. Out of 39,493 opioid-naive patients, the guidelines did not change for seven procedures but were lowered for nine, predominantly by five pills. New upper limits of 10 pills or fewer were established for all procedures, demonstrating a successful effort to balance adequate pain management and minimizing excessive opioid prescriptions.

Journal Article by Kulkarni AJ, Gunaseelan V (…) Bicket MC et 3 al. in Ann Surg Open

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

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360-degree feedback tool enhances intraoperative performance evaluation.

An automated 360-degree feedback tool, known as the ‘intraoperative 360′ (i360), proved effective in assessing surgeons’ technical, nontechnical, and teaching skills. Feedback gathered from 960 surveys highlighted strong performance in technical (4.87/5) and nontechnical skills (4.65/5), while teaching skills rated lower (2.92/3). Semi-structured interviews revealed the tool’s perceived value and identified themes such as utility and logistical challenges. This initiative offers actionable insights for improving efficiency, teamwork, and patient safety in surgical settings.

Journal Article by Soelling SJ, Sinyard RD (…) Smink DS et 7 al. in Ann Surg Open

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

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Splenectomy linked to shorter survival in pancreatic cancer patients

A nationwide analysis of pancreatic cancer patients reveals that those who underwent total pancreatectomy with a spleen-preserving approach exhibited significantly prolonged survival (17.3 months) compared to those who had splenectomy (9.6 months). The study highlighted splenectomy as an independent risk factor for shorter overall survival, corroborated by a meta-analysis linking the procedure to decreased longevity in patients undergoing various pancreatic surgeries. These findings urge surgeons to reconsider splenectomy’s role in treatment plans.

Multicenter Study by Kießler M, Jäger C (…) Oldhafer KJ et 14 al. in Langenbecks Arch Surg

© 2024. The Author(s).

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Augmented Reality and Fluorescence Imaging Enhance Hepatectomy Outcomes

A study examined laparoscopic parenchyma-sparing hepatectomy for colorectal liver metastases, comparing procedures using augmented reality navigation and fluorescence imaging (ARN-FI) versus traditional methods. Findings indicated that the ARN-FI group experienced shorter transection times, reduced postoperative stays, and wider margins, although recurrence-free survival rates did not differ significantly. Notably, for deep-seated tumors, the ARN-FI approach resulted in less blood loss and higher R0 resection rates, highlighting its potential benefits in surgical efficiency and accuracy.

Journal Article by Zeng X, Li X (…) Yang J et 5 al. in Int J Surg

Copyright © 2024. Published by Wolters Kluwer Health, Inc.

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