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New treatment guidelines enhance management of esophageal and gastric cancer.

Comprehensive updates on the treatment of esophageal and gastric cancer emphasize the crucial role of perioperative systemic therapy. Neoadjuvant chemoradiotherapy followed by postoperative immunotherapy is standard for locally advanced squamous cell carcinoma, while perioperative FLOT chemotherapy shows superior outcomes for adenocarcinoma. Promising results are also noted for MSI-high tumor patients receiving neoadjuvant immunotherapy. The focus on prehabilitation and specialized care aims to lower the high cancer-specific mortality rates, which currently reach 70%.

Review by Lordick Obermannová R, Jedlička V (…) Kiss I et 6 al. in Rozhl Chir

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Minimally invasive approach linked to higher complications in pancreatic surgery

A cohort analysis of 1,130 patients with postoperative pancreatic fistulas (popf) found that those undergoing minimally invasive pancreatoduodenectomy (mipd) faced a significantly higher risk of additional complications compared to traditional open procedures (opd). Notably, 55% of mipd-popf patients encountered a secondary complication, including a higher occurrence of postpancreatic hemorrhage (21% vs 8%). Mipd also resulted in extended hospital stays and a greater need for reoperations, despite comparable mortality rates.

Journal Article by Bruna CL, Emmen AMLH (…) Abu Hilal M et 20 al. in JAMA Surg

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Telementoring enhances surgical skills in rural hospitals

A surgical telementoring system significantly improved surgical skills and job interest among medical students in rural Japan. Surgeons reported enhanced mental performance and reduced frustration when using the telementoring system. Furthermore, a substantial increase in interest for rural hospital work was noted among medical students after the experience, with more expressing a desire to pursue surgery. These findings indicate that telementoring could effectively address surgeon shortages in remote areas.

Journal Article by Tokunaga T, Yoshikawa M and Shimada M in World J Surg

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

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XR technologies enhance surgical training effectiveness and acceptance

An umbrella review of 44 studies highlights the significant potential of extended reality (XR) technologies in surgical training, particularly for orthopedics, neurology, and laparoscopy. Findings revealed that XR improves surgical skills and procedural accuracy while reducing risks and operating room time. User-friendly systems increased accessibility for trainees across skill levels, and positive reinforcement from experienced surgeons enhanced learning experiences. However, financial and resource limitations must be addressed for successful adoption and integration into existing curricula.

Review by Toni E, Toni E, Fereidooni M and Ayatollahi H in Syst Rev

© 2024. The Author(s).

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Oral antibiotics may replace surgery for uncomplicated appendicitis.

A clinical trial is set to evaluate the efficacy of oral moxifloxacin versus placebo in treating uncomplicated acute appendicitis without hospitalization. Targeting adults aged 18-60, the APPAC IV trial will assess treatment success 30 days post-discharge, aiming to determine if antibiotics and inpatient care can be safely eliminated. This noninferiority trial, conducted across nine Finnish hospitals, seeks to address a significant gap in managing appendicitis with antibiotic therapy alone.

Journal Article by Lund H, Haijanen J (…) Salminen P et 10 al. in Scand J Surg

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Primary anastomosis shows better outcomes in sigmoid volvulus surgery

In a comprehensive analysis of 1,083 sigmoid volvulus cases treated over 58 years, primary anastomosis emerged as the superior technique compared to stoma creation following urgent sigmoidectomy. Key findings include significantly lower complication rates, shorter hospitalization durations, and reduced costs associated with primary anastomosis. Notably, patients undergoing primary anastomosis experienced fewer incidents of shock, bowel gangrene, and perforation. However, stoma remains preferable for older patients or those in poorer health.

Journal Article by Agirman E, Disci E, Peksoz R and Atamanalp SS in Pak J Med Sci

Copyright: © Pakistan Journal of Medical Sciences.

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Consensus Established on Neoadjuvant Therapy for Pancreatic Cancer

Expert consensus has identified 82 best practices for delivering neoadjuvant therapy (NT) in localized pancreatic ductal adenocarcinoma (PDAC). Key areas include pre-NT evaluations, effective initiation and management during NT, and post-NT surgical and follow-up strategies. With 47 North American specialists involved, the findings aim to standardize care delivery, reduce variation, and potentially improve patient outcomes. Future research will be essential to implement these guidelines within clinical settings.

Journal Article by Cloyd JM, Sarna A (…) Snyder RA et 42 al. in JAMA Surg

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Need for Standardized Robotic Training Curriculum Identified

A survey involving 1,045 gastrointestinal surgery professionals across 38 European countries revealed a significant knowledge gap regarding dedicated robotic training programs. Notably, 68% of experts and trainees were unaware of such curricula, and 48% of trainees with robotic access had not performed any robotic surgeries. Participants emphasized the necessity for early engagement in bedside assisting and console operations, and highlighted a lack of assessment tools. These findings underscore the need for a comprehensive robotic training consensus.

Journal Article by Fadel MG, Walshaw J (…) Francis NK et 13 al. in Surg Endosc

© 2024. The Author(s).

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Area Deprivation Index affects follow-up rates in pancreas cancer patients

A study analyzing 1,001 pancreas ductal adenocarcinoma patients found that those from less marginalized backgrounds, indicated by the Area Deprivation Index (ADI), were 1.57 times more likely to attend follow-up appointments post-surgery compared to marginalized individuals. The study highlights significant disparities in patient follow-up rates, suggesting social determinants of health significantly influence care outcomes. This underscores the need for systemic changes to improve accessibility for marginalized populations affected by pancreas cancer.

Journal Article by Muaddi H, Glasgow A (…) Thiels CA et 7 al. in J Surg Oncol

© 2024 Wiley Periodicals LLC.

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Immature granulocyte percentage effectively predicts complicated appendicitis.

A study revealed that the immature granulocyte percentage serves as a reliable biomarker for distinguishing complicated from uncomplicated acute appendicitis. With a specificity of 92% at a cut-off value of 0.6, this biomarker outperformed other indicators, such as the immature granulocyte count and procalcitonin levels. Data collection involved patients diagnosed with appendicitis over a year, highlighting the significant differences in blood work between the two groups, emphasizing the biomarker’s predictive efficacy.

Journal Article by Yazla M, Kadıoğlu B (…) Katipoğlu B et 3 al. in Rev Assoc Med Bras (1992)

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