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Minimally invasive liver resection options show safety for colorectal cancer patients

A systematic review and network meta-analysis involving 13 studies and 6,582 patients examined the effectiveness of open, laparoscopic, and robotic liver resections for colorectal liver metastases. Findings indicated no significant differences in R0 resection rates, disease-free survival, or overall survival among the methods. However, laparoscopic and robotic techniques displayed reduced postoperative complications, with robotic procedures linked to fewer blood transfusions. Laparoscopic approaches resulted in shorter hospital stays but had a higher conversion rate to open surgery.

Review by Mkabaah LB, Davey MG (…) Donlon NE et 7 al. in J Surg Oncol

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

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Neoadjuvant therapies are increasingly used for gastric adenocarcinoma.

A significant increase in the utilization of neoadjuvant therapies, particularly neoadjuvant chemotherapy (NAC) and neoadjuvant chemoradiotherapy (NCRT), was observed from 2012 to 2017 among gastric adenocarcinoma patients. The analysis included 25,073 patients, revealing median overall survival rates of 51.0 months for those receiving neoadjuvant therapy versus 42.4 months for adjuvant therapy and 38.0 months for surgery only. Disparities in treatment access were noted among Black patients and those from lower-income backgrounds.

Journal Article by Vitello DJ, Zaza NN (…) Bentrem DJ et 3 al. in J Surg Oncol

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

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Nomogram predicts gangrenous or perforated appendicitis effectively

A newly developed nomogram model demonstrates effective identification of gangrenous or perforated appendicitis in adults, crucial for timely intervention. Analyzing 796 appendectomy patients, researchers identified seven independent predictors. The model exhibited robust discrimination and calibration: an AUC of 0.806 in the training set and 0.799 in the testing set, alongside varying sensitivity and specificity rates. Validation confirmed its utility, suggesting improved outcomes and informed surgical decisions for at-risk patients.

Multicenter Study by Liang Y, Sailai M (…) Su Y et 11 al. in BMC Gastroenterol

© 2024. The Author(s).

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Intracorporeal anastomosis offers benefits over extracorporeal method

A systematic review of seven randomized controlled trials involving 720 patients indicates that intracorporeal anastomosis in laparoscopic right hemicolectomy does not significantly increase the risk of anastomotic leakage compared to the extracorporeal technique. However, it is associated with lower rates of postoperative ileus and surgical site infections, along with quicker recovery of bowel function and shorter hospital stays, suggesting it is a safe and effective option for this procedure.

Systematic Review by Wei P, Li Y (…) Zhang Z et 4 al. in Dig Surg

© 2024 S. Karger AG, Basel.

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Major morbidity and mortality linked to complications post-surgery

Among 2,186 patients undergoing major liver resection for perihilar cholangiocarcinoma, a failure to rescue (FTR) rate of 24% was identified in those with severe complications. Key factors associated with FTR included age, higher ASA classification, jaundice at presentation, right-sided resections, and low annual hospital surgical volume. Notably, liver failure significantly increased the odds of FTR by nearly nine times. The study highlights considerable variability in complication rates across medical centers.

Journal Article by Olthof PB, Bouwense SAW (…) Groot Koerkamp B et 26 al. in Ann Surg Oncol

© 2024. The Author(s).

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Effective resuscitation strategies improve outcomes for trauma patients

Timely and balanced resuscitation strategies are crucial for optimizing outcomes in unstable injured surgical patients. A review of 55 studies highlights the significance of controlled fluid and blood product administration, permissive hypotension during hemorrhagic shock, and damage control surgery. By emphasizing evidence-based practices and educational frameworks, this study enhances the understanding of trauma resuscitation among surgical trainees. The review promotes interdisciplinary teamwork and personalized approaches, aiming to improve both theoretical knowledge and practical skills.

Journal Article by Abdulkhaleq Mamalchi S, Matar M and Bass GA in Postgrad Med J

© The Author(s) 2024. Published by Oxford University Press on behalf of Fellowship of Postgraduate Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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Liraglutide effectively addresses weight regain post-bariatric surgery

A randomized, placebo-controlled trial demonstrated that liraglutide 3.0 mg significantly combats weight regain after Roux-en-Y gastric bypass, with 76% of subjects achieving at least a 5% total body weight loss compared to 17% in the placebo group. Notably, 21% of liraglutide recipients exceeded their postoperative nadir weight. Throughout the study, nonserious adverse events were reported in 41.6% of liraglutide users, while serious adverse events occurred less frequently, highlighting its safety profile in this context.

Journal Article by Lofton HF, Maranga G (…) Fielding C et 5 al. in Surg Obes Relat Dis

Copyright © 2024 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

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Tumor-stroma percentage predicts survival in gastric cancer patients

A predictive model utilizing tumor-stroma percentage (tsp) in gastric cancer (gc) demonstrated its significance as an adverse prognostic factor for overall survival (OS). Among 872 gc patients, tsp-visual showed a hazard ratio of 2.042, indicating a correlation with advanced pathological staging. The developed nomogram effectively identified patients at risk for poor prognosis, while a novel computer-aided detection system (tsp-cad) is expected to improve tsp evaluation, enhancing prognostic assessments for gc patients.

Journal Article by Xu Y, Yang Y (…) Huang C et 6 al. in Gastroenterol Rep (Oxf)

© The Author(s) 2024. Published by Oxford University Press and Sixth Affiliated Hospital of Sun Yat-sen University.

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Robotic surgery enhances early discharge and reduces complications.

In a study of 282,490 patients undergoing elective colectomy, robotic surgery emerged as the strongest predictor of early discharge (15.3%), surpassing both laparoscopic and open techniques. Patients discharged early exhibited significantly lower rates of 30-day readmissions (5.84% vs. 10.37%), bounceback readmissions (3.56% vs. 5.75%), and overall complications (5.65% vs. 18.63%). These findings underscore the advantages of robotic-assisted procedures in optimizing patient outcomes and recovery times post-surgery.

Journal Article by Hsu AT, Zion M (…) Wolf JH et 4 al. in J Robot Surg

© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.

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Cancer patients face higher mortality and complications from acute cholecystitis

Analysis of 8,673 patients revealed that those with active malignancies experienced significantly elevated 30-day mortality, with an odds ratio of 5.85. Furthermore, cancer patients had greater rates of infectious complications, including sepsis and pneumonia. The cancer cohort was also more likely to receive nonoperative management. These disparities in clinical outcomes and treatment processes underscore the need for tailored strategies in managing acute cholecystitis among cancer patients, particularly in relation to their ongoing cancer therapies.

Journal Article by Johnson PL, Williams JE (…) Hemmila MR et 7 al. in BMC Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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