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Early oral feeding reduces complications after colorectal surgery

A systematic review of 13 studies involving 1,556 patients revealed that early oral feeding (EOF) significantly reduces total complications after elective colorectal surgery, with an odds ratio of 0.50. Specifically, EOF decreased anastomotic leakage rates (odds ratio 0.40) and shortened hospital stays. However, an increased incidence of vomiting (odds ratio 1.58) was noted, alongside a trend toward higher nasogastric tube reinsertion rates. Overall, EOF is deemed a safe and effective postoperative practice.

Systematic Review by Lee SY and Han EC in Dig Surg

S. Karger AG, Basel.

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Neoadjuvant therapy shows high efficacy in advanced gastric cancer

Neoadjuvant chemotherapy combining a PD-1 inhibitor, apatinib, S-1, and oxaliplatin demonstrates significant efficacy for locally advanced gastric cancer (LAGC). In a study involving 130 patients, clinical complete response was achieved in 4.6%, with a total response rate of 71.5%. Notably, 96.1% underwent R0 resection, while 21.6% attained pathological complete response. The treatment was deemed safe, with no severe adverse events reported, underscoring the potential of this approach in improving surgical outcomes.

Journal Article by Tang Y, Dai L (…) Wang Q et 13 al. in Medicine (Baltimore)

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

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Levothyroxine treatment reduces goiter recurrence after thyroid surgery

A 20-year follow-up of patients who underwent unilateral thyroid lobectomy revealed that those receiving postoperative levothyroxine treatment experienced a significantly lower recurrence of nodular goiter compared to those who did not, with rates of 3.3% versus 30.0%, respectively. Additionally, 4.9% of the levothyroxine group required further surgery, contrasting with 30.0% in the untreated group. Notably, levothyroxine was particularly effective among iodine-deficient patients, markedly reducing their recurrence rates.

Journal Article by Barczyński M, Gołkowski F, Hubalewska-Dydejczyk A and Konturek A in World J Surg

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

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Diverting ileostomy effectively addresses ileoanal pouch dysfunction.

Diverting ileostomy provides symptom relief and reduces the need for complex surgeries in patients with dysfunctional ileoanal pouches. This technical approach includes preoperative planning by a multidisciplinary team and meticulous surgical technique using laparoscopic methods to minimize complications. Postoperative care emphasizes stoma management and symptom management, ensuring patients experience improvements in their quality of life. Indications for this procedure encompass serious complications such as pelvic sepsis and pouchitis, reflecting its necessity in clinical practice.

Journal Article by Weng S, Mangana O, Calabrese P and Celentano V in Int J Colorectal Dis

© 2024. The Author(s).

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Minimally invasive surgery reduces costs and missed workdays

A study examining minimally invasive surgery (MIS) for hepatic and pancreatic procedures found significant benefits compared to open surgery. Among 8,705 patients, MIS was associated with a mean decrease in 1-year post-discharge healthcare costs of $9,739 and fewer missed workdays. After adjusting for factors such as demographics and comorbidities, the results highlighted that MIS not only offers lower financial burden but also enhances recovery efficiency, making it a preferable option for patients.

Journal Article by Khan MMM, Woldesenbet S (…) Pawlik TM et 7 al. in HPB (Oxford)

Copyright © 2024 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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ERAS protocol significantly improves recovery for laparoscopic bile duct procedures

A study evaluating the Enhanced Recovery After Surgery (ERAS) protocol for laparoscopic common bile duct exploration (LCBDE) found marked improvements in patient outcomes. The ERAS group experienced significantly lower anxiety levels and complication rates (p < 0.05). Additionally, they reported reduced postoperative pain scores, achieving a satisfaction rating of 90% and a recovery time of just five days. Long-term, the average time to return to work was 25 days, indicating enhanced recovery and satisfaction.

Randomized Controlled Trial by He L, Chen Z, Wang Z and Pan Y in BMC Surg

© 2024. The Author(s).

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Endoscopic submucosal dissection improves recovery in early gastric cancer patients

Endoscopic submucosal dissection (ESD) was found to enhance postoperative gastrointestinal function and nutritional status in patients with early gastric cancer (EGC). A study involving eighty patients demonstrated higher resection rates with ESD compared to endoscopic mucosal resection (EMR). Though the ESD group experienced increased operative bleeding and longer surgery times, they enjoyed quicker gastrointestinal recovery. These findings suggest that ESD could play a vital role in improving patient outcomes after EGC surgeries.

Journal Article by Xu QD, Liu H (…) Wu ZY et 3 al. in World J Gastrointest Oncol

©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.

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Elevated Lactate Levels Predict Anastomotic Leakage Risk

Elevated postoperative lactate levels significantly predict anastomotic leakage (AL) following minimally invasive esophagectomy, with an occurrence rate of 8.9% among evaluated patients. Analysis revealed that lactate measured on postoperative day 2 serves as a strong independent predictor of AL, showcasing an odds ratio of 11.9. Patients with higher lactate not only experienced severe AL more frequently, but also had an earlier onset and longer treatment duration, highlighting the clinical importance of monitoring lactate levels post-surgery.

Journal Article by Takahashi N, Okamura A (…) Watanabe M et 5 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Stair climbing test predicts postoperative outcomes better than gait speed.

In a study involving 548 gastric cancer patients undergoing radical gastrectomy, stair climbing test (SCT) proved to be a superior predictor of postoperative complications and survival outcomes compared to gait speed test (GST). Low SCT performance correlated significantly with increased complications and longer recovery times, while GST did not show similar predictive validity. Combining SCT results with sarcopenia assessments enhanced accuracy in forecasting complications and mortality, highlighting SCT’s critical role in perioperative evaluations.

Journal Article by He CH, Li ZZ (…) Huang DD et 7 al. in Eur J Surg Oncol

Copyright © 2024 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

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New AI model enhances detection of colorectal liver metastases

An innovative AI-based recognition model for detecting colorectal liver metastases during contrast-enhanced intraoperative ultrasonography was developed. By integrating the basic recognition model and a subtraction model, a combination model demonstrated superior accuracy, reaching 96.5%. Overall, the combination model achieved an exceptional area under the curve (AUC) of 0.99, significantly surpassing individual models, which achieved 89.4% and 86.6% accuracy. This advancement could streamline tumor detection, improving surgical outcomes.

Journal Article by Takayama M, Ito K (…) Hasegawa K et 7 al. in J Hepatobiliary Pancreat Sci

© 2024 The Author(s). Journal of Hepato‐Biliary‐Pancreatic Sciences published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society of Hepato‐Biliary‐Pancreatic Surgery.

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