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Ultrasonic devices enhance hepatectomy outcomes compared to clamp-crushing.

A systematic review evaluated 1,417 patients undergoing liver resections with either ultrasonic devices or clamp-crushing techniques. While the clamp-crush method yielded shorter operation times, the ultrasonic group demonstrated significantly less blood loss and lower transfusion rates. Both groups had comparable mortality and postoperative bleeding rates; however, the ultrasonic devices were linked to a notably lower overall complication rate, particularly in terms of bile leakage. These devices thus show promise for improving perioperative outcomes.

Review by Yu ZN, Xu LL (…) Zhang M et 5 al. in World J Surg Oncol

© 2024. The Author(s).

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Innovative parenchyma-sparing surgery successfully treats liver metastases

A complex parenchyma-sparing hepatectomy was successfully performed on a 61-year-old woman with multiple bilobar colorectal liver metastases after she showed a partial response to second-line chemotherapy. Utilizing advanced three-dimensional reconstruction and intraoperative ultrasound for guidance, clinicians executed a unique transection of several liver segments, significantly preserving healthy tissue while addressing extensive disease. This innovative approach highlights the potential for less invasive surgeries in advanced hepatobiliary cancer cases typically requiring major resections.

Journal Article by Costa G, Torzilli G, Laurenti V and Procopio F in Updates Surg

© 2024. Italian Society of Surgery (SIC).

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PRRT enhances survival in patients after GEP-NET progression

Peptide receptor radionuclide therapy (PRRT) significantly improves progression-free survival (PFS) and overall survival (OS) in patients with advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs) who progress after surgical resection. Among 237 analyzed patients, those receiving PRRT experienced a median PFS of 32.4 months compared to 11.0 months for those who did not (p < 0.001). Median OS was also longer at 49.8 months versus 38.4 months (p = 0.009), supporting PRRT as a beneficial treatment approach.

Journal Article by Borbon LC, Sherman SK (…) Howe JR et 9 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Laparoscopic fundoplication enhances esophageal motility in GERD patients

Laparoscopic fundoplication significantly improves esophageal motility in patients with gastroesophageal reflux disease (GERD), irrespective of their initial motility status. A study involving 124 patients found that successful fundoplication was associated with normalization of motility, with 103 achieving good outcomes. All procedures were performed laparoscopically without postoperative mortality in the first 90 days. These findings suggest that laparoscopic fundoplication effectively addresses motility issues in GERD patients.

Journal Article by Vittori A, Capovilla G (…) Valmasoni M et 9 al. in J Gastrointest Surg

Copyright © 2024 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights reserved.

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Successful implementation of anal cancer screening program in Brazil

A screening program for high-grade anal dysplasia has been successfully implemented at a Brazilian cancer center. Over 324 exams were conducted between March 2022 and June 2024, revealing anal high-grade squamous intraepithelial lesions (AHSIL) in 38.2% of high-risk patients. Specifically, AHSIL was detected in 34.9% of men who have sex with men, 31.6% of transgender women, and 45.8% of women living with HIV. The program emphasizes ongoing treatment and follow-up for patients.

Journal Article by Araujo ROC, Valadão M (…) Leal FE et 7 al. in J Surg Oncol

© 2024 Wiley Periodicals LLC.

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Modified surgical technique significantly lowers anastomotic leakage rates

A new surgical technique for subtotal esophagectomy effectively reduced anastomotic leakage (AL) rates. Researchers compared outcomes between a conventional group and a modified procedure group. AL decreased from 16.9% to 2.8% (p=0.002), with further analysis showing 14% in the conventional group versus 0% in the test group (p=0.006). Key factors contributing to AL included the type of anastomotic procedure and body mass index. The modified approach is a promising enhancement in surgical practice.

Journal Article by Okumura T, Miwa T (…) Fujii T et 7 al. in Dis Esophagus

© The Author(s) 2024. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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New consensus outlines resectability criteria for advanced HCC

An expert panel from the Japan Liver Cancer Association and Japanese Society of Hepato-Biliary-Pancreatic Surgery has established clear criteria for assessing the oncological resectability of hepatocellular carcinoma (HCC). Three classifications were introduced—resectable, borderline resectable 1, and borderline resectable 2—distinguishing treatment strategies and anticipated survival outcomes. This consensus aims to facilitate discussions on “conversion therapy” and enhance management approaches for patients with advanced HCC as systemic therapies evolve.

Journal Article by Akahoshi K, Shindoh J (…) Kokudo N et 15 al. in Liver Cancer

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

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Stool-based strategies significantly reduce colonoscopies post-polypectomy.

Stool-based surveillance for individuals with post-polypectomy indications has been shown to safely decrease the need for colonoscopies by 15% to 41%. A study of 3,453 participants found that multitarget stool DNA tests were most effective (AUC 0.72), but also more costly than colonoscopy. In contrast, fecal immunochemical tests were cost-saving. Overall, these strategies could revolutionize colorectal cancer surveillance, significantly reducing patient burden while maintaining effectiveness.

Journal Article by Carvalho B, de Klaver W (…) Meijer GA et 34 al. in Gastroenterology

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

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Normal ca19-9 levels correlate with improved survival in pancreatic cancer

In a study involving 1,558 pancreatic cancer patients, 13.9% exhibited normal carbohydrate antigen 19-9 (ca19-9) levels, linked to significantly longer median survival rates (18.1 vs. 9.7 months). Those with stage IV ca19-9-normal cancer had a 5-year survival chance of 22.4%, compared to 6.8% in the ca19-9-high group. Findings suggest that glucose control, influenced by insulin levels, may provide a new therapeutic avenue in improving overall survival among this indolent subgroup.

Journal Article by Zhu X, Xiao Z (…) Yu X et 8 al. in Ann Surg

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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Whole blood resuscitation reduces trauma mortality rates significantly.

Whole blood (wb) resuscitation shows significant benefits in trauma patients, leading to lower odds of mortality at 4-hour, 24-hour, and 30-day intervals compared to component-only transfusions. Data from 12,275 patients indicate that higher wb to total transfusion volume (wb:ttv) ratios further decrease mortality, with each 10% increase correlating to a 13% reduction in 4-hour mortality odds. Balanced blood component transfusions alongside wb also notably enhance survival rates.

Multicenter Study by Dorken-Gallastegi A, Spinella PC (…) Brown JB et 4 al. in Ann Surg

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

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