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Radical resection with autotransplantation improves survival in pancreatic cancer

A study involving 208 locally advanced pancreatic cancer (LAPC) patients found that those undergoing radical resection combined with intestinal autotransplantation (RRCIA) after systemic treatment significantly improved overall survival (OS) and progression-free survival (PFS). Specifically, the RRCIA group showed a median OS of 25.8 months compared to 14.2 months for those without surgery. Additionally, successful outcomes were linked to a minimum of 8 cycles of systemic treatment and normalization of CA19-9 levels.

Journal Article by Qiao G, Bai X (…) Liang T et 10 al. in Ann Surg

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

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Completion transanal total mesorectal excision is oncologically safe.

A study analyzed the oncological safety and technical feasibility of completion transanal total mesorectal excision (TaTME) following local excision in 189 rectal cancer patients. Results showed a low complication rate, with only 7% experiencing anastomotic leakage. The two-year local recurrence rate was 5%, while disease-free and overall survival rates were 85% and 95%, respectively. These findings suggest that TaTME is a safe and effective option after local excision, supporting its use in rectal cancer management.

Journal Article by Dingemans SA, Kreisel SI (…) Brown CJ et 3 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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Nomogram predicts delayed bleeding risk after colorectal ESD

A nomogram has been developed to predict delayed bleeding risks following endoscopic submucosal dissection (ESD) for colorectal tumors. Analysis of 587 patients revealed an 8.98% incidence of delayed bleeding, influenced by lesion location in the rectum, size, and surgical duration. The model’s c-index was 0.89, indicating strong predictive accuracy. Implementing this nomogram can enhance surgical decision-making, conserve medical resources, and elevate patient satisfaction by potentially minimizing postoperative complications.

Journal Article by Bian F, Li K, Bian G and Li X in Int J Colorectal Dis

© 2024. The Author(s).

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Postoperative renal insufficiency affects 6.58% of colectomy patients.

A study of 7,477 patients undergoing colectomy for diverticulitis revealed a 6.58% incidence of postoperative renal insufficiency. Key comorbidities associated with increased kidney injury risk included diabetes, congestive heart failure, hypertension, and chronic obstructive pulmonary disease. Multivariate regression analysis identified that postoperative renal insufficiency is independently linked to a 3.8-fold increase in mortality risk. These findings underscore the importance of assessing renal function and managing comorbidities for patients undergoing this common surgical procedure.

Journal Article by Elsawwah JK, Flanagan JS (…) Nemeth ZH et 2 al. in Tech Coloproctol

© 2024. Springer Nature Switzerland AG.

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Surgical options enhance treatment for achalasia patients

A review of recent literature highlights effective surgical interventions for achalasia, including laparoscopic/robotic heller myotomy (LHM/RHM) and fundoplication methods. Both approaches exhibit low morbidity and mortality rates, with RHM offering advantages like improved procedural visibility and reduced risk of mucosal laceration. The findings suggest surgery is particularly beneficial for patients under 40 or those with persistent complications from endoscopic treatments. Additionally, esophagectomy is recommended for select end-stage cases to enhance quality of life.

Review by Plum PS, Niebisch S and Gockel I in Visc Med

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

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Visual Endoscopic Therapy Reduces Appendicitis Recurrence Risks

In a study comparing visual endoscopic retrograde appendicitis therapy (v-erat) with antibiotic therapy for uncomplicated appendicitis, no significant difference was found in treatment success rates (93.6% vs 90.5%). However, v-erat notably lowered appendicitis recurrence risk and appendectomy rates during initial hospitalization (4.3% vs 9.5%). Additionally, patients undergoing v-erat experienced a shorter hospital stay (3 days vs 4 days) and longer time to recurrence (269 days vs 70 days). Adverse event rates were similar.

Journal Article by Zhan K, Bai Y (…) Liu W et 9 al. in Am J Gastroenterol

Copyright © 2024 by The American College of Gastroenterology.

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Expert Consensus Established on Postoperative Symptoms After Oesophago-gastric Cancer Surgery

A multidisciplinary expert panel achieved consensus on 26 postoperative symptoms and management of 10 related conditions following oesophago-gastric cancer surgery. Defined diagnostic criteria and first-line treatments were agreed upon to improve patient care and quality of life. Notably, 85.7% of symptoms were identified as potential indicators of cancer recurrence. However, agreement on further treatment levels for certain conditions was not reached. This framework aims to reduce care variability and enhance symptom management in affected patients.

Journal Article by Byrne BE, Siaw-Acheampong K (…) Davies AR et 16 al. in Br J Surg

© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.
© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

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Bile acid levels predict anastomotic leakage and safe discharge

Bile acid levels in drainage fluid demonstrate high negative predictive value for early identification of anastomotic leakage post minimally invasive rectal cancer resection. In a study with 419 patients, those with leakage had significantly elevated bile acid levels compared to non-leakage cases on postoperative days 3 and 5. Furthermore, of the 384 who met discharge criteria, 99% were safely discharged, with anastomotic leakage rates of only 0.5% and readmission rates at 0.3%.

Journal Article by Gao L, Zhang T (…) Tang B et 4 al. in BMC Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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NIRAF imaging significantly enhances parathyroid gland identification

Near-infrared autofluorescence (NIRAF) imaging significantly improves the ability of surgical trainees to recognize parathyroid glands during thyroidectomy and parathyroidectomy. Detection rates soared for junior trainees from 46.5% to 94.8% and for senior trainees from 68% to 97%. Additionally, NIRAF identified 48.3% more glands for juniors, 29% for seniors, and increased confidence in recognizing known glands for 51.7% of juniors, 71% of seniors, ultimately enhancing overall detection rates across all levels (p < 0.0001).

Journal Article by Akgun E, Ibrahimli A (…) Berber E et 3 al. in J Surg Oncol

© 2024 Wiley Periodicals LLC.

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Endoscopic repair dominates groin hernia surgeries in Japan.

In 2022, Japan reported 118,365 groin hernia repairs, with endoscopic repair being the preferred method for 53.3% of patients. Among registered institutions, 81.6% of bilateral hernias were treated endoscopically. However, day surgery rates remained low at just 5.1%. The study highlights the need for improved data collection and greater participation in the National Clinical Database to meet international standards. The TAPP method was the most utilized, being employed in 48.8% of cases.

Journal Article by Poudel S, Yamamoto H (…) Hachisuka T et 8 al. in Surg Today

© 2024. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.

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