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Deep learning accurately classifies colorectal liver metastasis growth patterns

A new deep learning algorithm successfully distinguishes between desmoplastic and non-desmoplastic histopathological growth patterns in colorectal liver metastases, achieving high discriminatory power with area under the curve values of 0.93 and 0.95 during development and external validation, respectively. This automated classification parallels manual scoring regarding overall survival outcomes, ensuring its potential utility in routine histopathological assessments. The method leverages extensive digitalized imaging from a large patient cohort to enhance predictive accuracy for patient prognosis.

Journal Article by Höppener DJ, Aswolinskiy W (…) Verhoef C et 11 al. in BJS Open

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

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Eosinophil counts are causally linked to pancreatic cancer.

A comprehensive study using MR-PheWAS and mendelian randomization demonstrated a causal association between pancreatic cancer and eosinophil counts, highlighting a notable correlation. Among 776 phenotypes analyzed, 41 showed significance, with specially validated results indicating that genetically predicted pancreatic cancer was linked to elevated eosinophils. This suggests a self-reinforcing relationship between the two. The findings call for further investigations into these associations, giving insights into pancreatic cancer’s potential predictors and underlying mechanisms.

Systematic Review by Guan A, Li Z and Guo X in Medicine (Baltimore)

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

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Endoscopic submucosal dissection is pivotal for early gastric cancer treatment

Endoscopic submucosal dissection (ESD) is crucial for early gastric cancer (EGC) management, often necessitating additional gastrectomy in cases deemed non-curative. Analysis of 134 patients revealed key factors such as deep submucosal invasion and positive margins that led to further surgical intervention. Notably, independent risk factors for lymph node metastasis included positive vertical margin and lymphatic invasion, indicating ESD’s significant role in both diagnosis and therapy for optimal EGC treatment.

Journal Article by Im DW, Chung JH (…) Lee SH et 4 al. in Medicine (Baltimore)

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

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Standardized Trocar Technique Improves Outcomes in Robotic Surgery

Implementation of a standardized trocar placement method using a 5-cm umbilicus incision combined with two robotic ports resulted in successful outcomes for robotic liver resection (RLR) and robotic pancreaticoduodenectomy (RPD) across a cohort of 60 patients. The approach achieved 82.8% uptake for RLR and 100% for RPD, with no serious postoperative complications, including hepatic insufficiency or pancreatic fistulas. The median hospital stays were 5 and 8 days, respectively, reflecting effective patient recovery.

Journal Article by Kawaguchi Y, Ito K (…) Hasegawa K et 5 al. in J Am Coll Surg

Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Anterior quadratus lumborum block reduces post-operative pain effectively

A meta-analysis of 89 articles assessed the effectiveness of the anterior quadratus lumborum (AQL) block in abdominal surgeries. Results revealed that patients receiving the AQL block experienced significantly lower post-operative pain scores and reduced opioid consumption at 12 and 24 hours compared to controls. Furthermore, the AQL block demonstrated non-inferiority to the transversus abdominis plane (TAP) block, with some evidence suggesting its superiority in managing pain post-surgery. Limitations include study design variability.

Review by Evans BGA, Ihnat JMH (…) Ayyala HS et 7 al. in Am J Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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Liver resection improves survival in colorectal metastases with extrahepatic disease

A population-based analysis of 170,978 patients revealed that liver resection significantly enhances overall survival for those with colorectal liver metastases and concurrent extrahepatic disease. Among 62,003 patients with this dual condition, only 6% underwent liver resection, yet they experienced markedly better median overall survival (52 months) compared to those without resection (27 months). Factors influencing selection included younger age, fewer comorbidities, and the presence of single-site extrahepatic disease.

Journal Article by Mahuron KM, Hernandez MC (…) Melstrom LG et 6 al. in J Surg Oncol

Journal of Surgical Oncology© 2024 The Author(s). Journal of Surgical Oncology published by Wiley Periodicals LLC.

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Bolus exposure predicts postoperative symptom resolution better.

In a retrospective study involving 72 patients, bolus exposure emerged as a superior predictor for postoperative symptom resolution in gastroesophageal reflux disease (GERD) after laparoscopic Nissen fundoplication. It outperformed traditional parameters like acid exposure time and DeMeester score for predicting symptom relief, notably for epigastric pain and regurgitation. Notably, in patients without pathological reflux, bolus exposure retained significant diagnostic accuracy across various symptoms, suggesting its potential role in identifying candidates for antireflux surgery.

Journal Article by Jung SW, Lee I (…) Park S et 10 al. in Int J Surg

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

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Colonoscopy significantly reduces colorectal cancer incidence

In a retrospective analysis of colorectal cancer (CRC) patients, researchers found a strong link between colonoscopy screenings and reduced CRC incidence. Despite the increase of early-onset CRC among individuals under 50, no correlation was observed between familial cancer history and CRC incidence. Alarmingly, delays of up to six years were noted between initial symptoms and treatment commencement, severely affecting prognosis. The study underscores the importance of timely screenings and awareness to enhance diagnosis and outcomes in this demographic.

Journal Article by Laska E and Richter P in Pol Przegl Chir

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Surgical quality improvement projects show room for better planning

The evaluation of 242 surgical quality improvement projects revealed an average pre-conduct score of 52%, highlighting suboptimal planning across the board. Projects excelled in goal specification (65%) but struggled with strategic planning (44%) and problem detailing (52%). Notably, few projects addressed possible limitations (5%) or contextual issues (12%). These findings underscore the need for enhanced preparation in surgical quality initiatives, suggesting the American College of Surgeons quality framework as a potential guide for improvement.

Journal Article by Shah TA, Peters XD (…) Ko CY et 5 al. in J Am Coll Surg

Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Adjuvant chemotherapy improves survival in select gastric cancer patients

Findings reveal that adjuvant chemotherapy significantly enhances overall survival in patients with locally advanced gastric cancer post-neoadjuvant chemotherapy. Specifically, those receiving adjuvant therapy showed a 2-year overall survival rate of 86.2% compared to 64.1% for those who did not (p = 0.002). Critical factors influencing adjuvant treatment inclusion included patient age and ASA grade, while the downstaging effect of neoadjuvant chemotherapy proved more impactful than completing full treatment cycles.

Journal Article by Li Z, Sun C (…) Du C et 4 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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