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Liver venous deprivation is safe and promotes liver growth.

A multicentric study demonstrated the safety and efficacy of liver venous deprivation (LVD) in enhancing future liver remnant (FLR) volume prior to major hepatectomy. Out of 192 patients, LVD achieved a 100% technical success rate, with only a 2.6% rate of severe complications. FLR volume increased by an average of 61.7% within 27 days. Although major hepatectomy was completed in 83.8% of cases, 16.2% were unable to proceed due to cancer progression.

Journal Article by Boubaddi M, Marichez A (…) Laurent C et 8 al. in Hepatobiliary Surg Nutr

2024 AME Publishing Company. All rights reserved.

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New colorectal anastomotic devices show lower leak rates

A recent systematic review and meta-analysis examined alternative colorectal anastomotic devices, finding a pooled complication rate of 9.7% in human studies. Notably, the leak rate for compression anastomoses was only 3.3%, demonstrating no variation among studies. This review included 18 studies with a total of 955 anastomoses and highlighted significant advancements in new technologies, particularly a novel device with transanal catheters that allowed for intraoperative assessment.

Review by Shakir T, Pampiglione T (…) Wexner S et 5 al. in Am J Surg

Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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Mesh Bridging Improves Outcomes in Burst Abdomen Repairs

Findings indicate that using mesh bridging for temporary closure of burst abdomen significantly reduces hospital stays and severe complications compared to negative pressure wound therapy (NPWT). Among 119 patients studied, those receiving mesh bridging had a remarkable average stay of 29 days, opposed to 93 days with NPWT. Furthermore, mesh bridging led to fewer severe complications (46% vs. 100%) and reduced reoperation rates (20% vs. 100%), with no notable difference in mortality across groups.

Journal Article by van Grinsven V, Bessems SAM (…) Aarts F et 3 al. in Surg Technol Int

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Evidence-based perioperative safety recommendations are inconsistent.

A systematic review of 267 clinical practice guidelines revealed significant variability in perioperative patient safety recommendations. Among 4,666 recommendations identified, 44.9% were strongly endorsed; however, only 18 guidelines excelled in methodological quality. A notable gap was found in recommendations related to pre-admission and post-discharge care. These findings underscore the inconsistency between the strength of recommendations and their supporting evidence, highlighting the need for improved standards to enhance surgical safety and inform policy decisions.

Systematic Review by Martinez-Nicolas I, Arnal-Velasco D (…) Soria-Aledo V et 14 al. in BJS Open

© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.

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Surgical resection improves survival for gastric cancer liver metastases

A population-based analysis of 3,694 gastric cancer patients with liver metastases revealed that those undergoing cancer-directed surgery experienced significantly longer median overall survival, 12 months versus 6 months for non-resection patients. After adjusting for selection bias, Cox regression indicated a substantial survival benefit, with a hazard ratio of 0.562. These findings highlight the importance of surgical resection in this challenging condition, although identifying optimal candidates for surgery remains a critical area for further research.

Journal Article by Sun W and Li X in Health Sci Rep

© 2024 The Authors. Health Science Reports published by Wiley Periodicals LLC.

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Early recurrence in IPMN-derived pancreatic cancer is predictable.

In an international multicenter study, early recurrence in resected intraductal papillary mucinous neoplasm (IPMN)-derived pancreatic cancer was identified at 10.5 months. Among 381 patients, 42% experienced recurrence, with 38% classified as early recurrences. Key predictors included CA19-9 levels and N2 disease staging. The study stratified patients into low, intermediate, and high-risk groups, revealing that adjuvant chemotherapy improved overall survival solely for high-risk patients, underscoring the need for targeted treatment strategies.

Journal Article by Habib JR, Javed AA (…) Daamen LA et 14 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Preoperative TACE enhances survival in intermediate-stage liver cancer

In patients with intermediate-stage hepatocellular carcinoma (HKLC stage IIB), preoperative transarterial chemoembolization (TACE) significantly improves survival outcomes compared to upfront surgery alone. A study involving 154 matched patients found that the median overall survival for the TACE group undergoing surgical resection was 90.97 months, versus 30.68 months for the surgery-only group. Additionally, disease-free survival was also enhanced in those receiving TACE, indicating its potential as an effective neoadjuvant strategy.

Journal Article by Nandy K, Varty GP (…) Goel M et 6 al. in World J Surg

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

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Decision tree algorithm enhances treatment choices for acute cholecystitis

An innovative decision tree algorithm was developed to classify patients with acute cholecystitis based solely on laboratory parameters. Analyzing 1,352 cases, the algorithm showed an impressive 82.17% accuracy in predicting the need for surgery and 73.86% accuracy for identifying gangrenous cholecystitis. Key parameters included the platelet-to-lymphocyte ratio, C-reactive protein levels, and patient age, enabling efficient distinction between uncomplicated and complicated cases, and facilitating timely treatment to enhance patient outcomes and reduce healthcare costs.

Journal Article by Sezikli İ, Tutan MB (…) Topcu R et 2 al. in Ulus Travma Acil Cerrahi Derg

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Sacral neuromodulation emerges as the gold standard for fecal incontinence.

Fecal incontinence, a common yet often overlooked condition, can be managed surgically when conservative treatments fail. This review highlights that sacral neuromodulation (SNM) has established itself as the first-line treatment option due to its high success rates and minimal invasiveness. In contrast, sphincteroplasty is only advisable for specific patients with anal sphincter lesions and shows moderate long-term success. The evolving treatment landscape underscores the limitations in surgical options available for fecal incontinence management.

Review by Bittorf B and Matzel KE in Visc Med

© 2024 S. Karger AG, Basel.

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AI Model Achieves High Accuracy in Panendoscopic Lesion Detection

An AI model was developed for the automatic detection of pleomorphic lesions during capsule endoscopy, achieving notable results across various gastrointestinal sites. The binary esophagus CNN attained 83.6% accuracy, while the gastric CNN reached 96.6%. The small bowel CNN excelled with 97.6% accuracy in identifying lesions with different hemorrhagic potentials. Additionally, the colonic CNN demonstrated a 94.9% overall accuracy. This advancement addresses critical interoperability challenges in minimally invasive endoscopic diagnostics.

Journal Article by Mascarenhas M, Mendes F (…) Macedo G et 8 al. in GE Port J Gastroenterol

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

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