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Machine learning predicts early recurrence after liver surgery.

A new machine learning model successfully predicted early extrahepatic recurrence (EEHR) following curative resection of colorectal liver metastases (CRLM). Among 1,410 patients, 131 (9.3%) experienced EEHR, with median overall survival significantly lower for affected patients (35.4 months) versus those without (120.5 months, p < 0.001). The model achieved a c-index of 0.77, highlighting primary tumor categories and tumor burden as key predictors. An online risk calculator is now available to assist clinicians.

Journal Article by Kawashima J, Endo Y (…) Pawlik TM et 18 al. in World J Surg

© 2024 The Author(s). World Journal of Surgery published by John Wiley & Sons Ltd on behalf of International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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Decreased HVPG Post-Surgery Linked to Improved Outcomes

Laparoscopic splenectomy plus esophagogastric devascularization significantly reduced hepatic venous pressure gradient (HVPG) in patients with portal hypertension, with 66% showing a decrease. Notably, those exhibiting a postoperative HVPG reduction greater than 20% demonstrated improved recurrent hemorrhage-free survival rates compared to others. Baseline HVPG and preoperative Child-Turcotte-Pugh class B were found to correlate with decreased HVPG response. These findings underscore the potential of HVPG as a prognostic tool in surgical management of portal hypertension.

Journal Article by Zhang M, Wang D (…) Yin J et 6 al. in BMC Gastroenterol

© 2024. The Author(s).

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Combined radiomics and body analysis enhance predictive accuracy for pancreatic surgery complications

A new model integrating radiomics, pancreatic duct diameter, and body composition analysis effectively predicts clinically relevant postoperative pancreatic fistula in patients undergoing pancreaticoduodenectomy. This combined approach achieved an area under the ROC curve of 0.839, outperforming existing models. Internal validation through 1,000 bootstrap resamples demonstrated the model’s reliability, culminating in the development of a web-based calculator for clinical use. Future work will focus on expanding sample sizes to further validate this promising predictive tool.

Journal Article by Wu H, Yu D (…) Ding X et 4 al. in Gland Surg

2024 AME Publishing Company. All rights reserved.

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New tool effectively identifies non-technical errors in surgery

A novel tool, SICNESS, has been developed to identify and categorize non-technical errors linked to surgical mortality. Validated through a two-pilot approach using 844 mortality cases from Australia and New Zealand, the tool demonstrated high inter-rater reliability, particularly in leadership and decision-making aspects. Its systematic application can help to retrospectively pinpoint these errors, enhancing surgical practices and potentially preventing future adverse events associated with poor non-technical skills.

Validation Study by Ey JD, Kollias V (…) Maddern GJ et 4 al. in Br J Surg

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

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Intraoperative administration of indocyanine green enhances visualization

The study compared intraoperative (IS) and preoperative (PS) indocyanine green administration for near-infrared cholangiography during laparoscopic cholecystectomy. While both methods yielded similar signal-to-background ratios, IS significantly lowered liver fluorescence intensity and achieved higher visualization scores for common hepatic ducts. Furthermore, IS facilitated a quicker critical view of safety, taking an average of 9.4 minutes versus 11.0 minutes for PS. This highlights IS’s convenience and effectiveness in enhancing surgical outcomes.

Journal Article by Lin W, Tao H (…) Yang J et 7 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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Predictive model for pathologic complete response in esophageal cancer

A new predictive model, combining small ribonucleic acids (srnas) and clinical factors, shows promise in forecasting pathologic complete response (pcr) in esophageal squamous cell carcinoma post-neoadjuvant chemoradiotherapy. Among 99 patients, significant predictors included isomirs of let-7b and mir-93, plus specific clinical indicators. The model achieved an area under the curve of 0.84, suggesting its potential utility in enhancing treatment decision-making for patients undergoing surgery after chemoradiation.

Journal Article by Hirohata R, Yamamoto Y (…) Tahara H et 5 al. in Ann Surg Oncol

© 2024. The Author(s).

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Laparoscopic cholecystectomy is optimal for pregnant patients with gallbladder disease

In a systematic review of 63,523 pregnant women, laparoscopic cholecystectomy (LC) emerged as the most favorable treatment for gallbladder disease. It significantly reduced risks of preterm delivery (RR: 0.23), fetal complications (RR: 0.42), and maternal complications (RR: 0.44) compared to open cholecystectomy. While cholecystectomy is safe in any trimester, the third trimester poses heightened maternal risk, necessitating cautious evaluation before proceeding. These findings highlight the importance of treatment timing in managing gallbladder issues during pregnancy.

Review by Koh YX, Zhao Y (…) Goh BKP et 7 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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A nomogram predicts postoperative biliary fistula after pancreaticoduodenectomy.

A novel nomogram has been developed to predict postoperative biliary fistula (PBF) risk after pancreaticoduodenectomy. Analyzing data from 196 patients, researchers identified diabetes, low albumin, postoperative gastroparesis, abdominal bleeding, abdominal infection, and pancreatic fistula as independent risk factors. The model demonstrated good discriminative ability with an AUC of 0.807 in the training set and 0.782 in the validation set, indicating its clinical application value for identifying high-risk patients.

Journal Article by Ou Z, Yan A and Zhu W in Gland Surg

2024 AME Publishing Company. All rights reserved.

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Telemedicine is favored by older cancer patients for consultations

A significant majority (77%) of older cancer patients opted for telemedicine consultations over in-person visits at the Cancer and Aging Interdisciplinary Team clinic. Factors influencing in-person visit choices included older age, lower educational status, living in New York City, cognitive impairments, performance measure challenges, and social support issues. The findings highlight the potential of telemedicine to effectively engage older adults in their cancer care, suggesting a need for enhanced remote healthcare infrastructure.

Journal Article by Alexander K, Tin AL (…) Korc Grodzicki B et 4 al. in Front Med (Lausanne)

Copyright © 2024 Alexander, Tin, McMillan, Amirnia, Yulico, Sun and Korc Grodzicki.

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Nomogram effectively predicts severe complications post-surgery after COVID-19

A novel nomogram crafted to forecast severe postoperative complications in elective hepato-pancreato-biliary surgery following COVID-19 breakthrough infections demonstrated high accuracy. The model utilized data from 2,636 patients and identified significant predictors, including timing of surgery relative to the infection and vaccination status. With an area under the curve (AUC) ranging from 0.841 to 0.919 across cohorts, this tool can assist clinicians in better risk stratification and decision-making for vulnerable surgical patients.

Journal Article by Yang Y, Dang Z (…) Zhou WP et 6 al. in Hepatobiliary Pancreat Dis Int

Copyright © 2024 First Affiliated Hospital, Zhejiang University School of Medicine in China. Published by Elsevier B.V. All rights reserved.

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