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Most prescribed opioids for surgery are unused by patients

A significant portion of opioids prescribed post-elective colorectal surgery remains unused, with 63% of pills going unconsumed. In a study of 344 patients, the median prescribed amount was 13 pills, yet many reported using none. Factors like younger age, higher preoperative anxiety, and the number of pills prescribed correlated with increased consumption. These findings suggest the potential for reducing opioid dependency through alternative pain management strategies.

Journal Article by Olleik G, Lapointe-Gagner M (…) Fiore JF et 19 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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Short-Course TNT Outperforms Long-Course Treatment in Rectal Cancer

A multi-institutional review of 857 patients demonstrated that short-course total neoadjuvant therapy (sc TNT) significantly increases complete response (CR) rates in rectal cancer compared to long-course chemoradiation (lCRT). Specifically, CR rates were 34.1% for sc TNT versus 20.3% for lCRT. Notably, patients completing 5-6 months of consolidation chemotherapy had a CR rate of 42.9%. Despite this, three-year progression-free survival rates were analogous between the two treatments.

Journal Article by Bauer PS, Gamboa AC (…) Wise PE et 12 al. in J Surg Oncol

© 2024 Wiley Periodicals LLC.

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Consensus guidelines established for peri-operative care in obese patients

A modified Delphi process yielded 94 consensus statements on optimising peri-operative care for patients with obesity undergoing non-bariatric surgery. Key pre-operative strategies include access to prehabilitation and risk stratification tools, while intra-operative focus centres on the roles of anaesthetists and surgeons, minimally invasive techniques, and infection prevention. Post-operative care emphasises analgesia, nutritional support, and physiotherapy. This collaborative effort aims to standardise clinical practices and enhance quality of care in this vulnerable patient population.

Journal Article by Cullinane C, Edwards-Murphy A (…) Fleming C et 7 al. in Surgeon

Copyright © 2024 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

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Magnesium supplementation may help prevent acute pancreatitis.

A systematic review of twelve studies reveals magnesium deficiency in pancreatic acinar cells is often linked to reduced serum calcium, predisposing individuals to acute pancreatitis. The research indicates that magnesium acts as a natural calcium antagonist, mitigating intracellular calcium accumulation and premature enzyme activation. Supplementation shows promising benefits in preventing acute pancreatitis, particularly post-endoscopic retrograde cholangiopancreatography. However, the significant heterogeneity among studies poses challenges for definitive conclusions.

Journal Article by Pergolini I, Schorn S, Friess H and Demir IE in Visc Med

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

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Omitting Abdominal Drains Reduces Complications After Left Pancreatectomy

A systematic review and meta-analysis, including 15,817 patients, reveals that omitting abdominal drainage after left pancreatectomy significantly lowers major morbidity, postoperative pancreatic fistula rates, readmissions, and surgical site infections. The no-drain group demonstrated a relative risk of 0.77 for major complications and a striking 51% reduction in postoperative pancreatic fistula occurrence. Additionally, patients without drains experienced shorter hospital stays, underscoring the potential benefits of this surgical approach.

Journal Article by Ahmed A, Fatima M (…) Aziz H et 4 al. in Ann Surg

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

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Surgery improves outcomes in metastatic neuroendocrine tumors

Evidence suggests that surgical intervention, prior to peptide receptor radionuclide therapy, significantly enhances progression-free survival for patients with metastatic gastroenteropancreatic neuroendocrine tumors. In a study of 89 well-matched patients, those who underwent surgery had a median progression-free survival of 26.1 months, compared to 15.6 months in the no-surgery group (p = .04). Furthermore, liver debulking demonstrated the greatest impact, with patients achieving a median survival of 26.2 months.

Journal Article by Tobias J, Abou Azar S (…) Keutgen XM et 6 al. in BMC Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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Innovative use of euthanized animals reduces costs in surgical training

Maximizing tissue use from euthanized porcine models significantly lowers educational costs in surgical training. Harvesting tissues such as the abdominal wall and small intestine resulted in substantial cost reductions, with estimated expenses dropping from $847 to $109 per procurement. The process of timed tissue procurement not only provided similar quality material compared to commercial sources but also increased surgical exposure for trainees. This method aligns with the 3 Rs of animal research, promoting ethical practices in education.

Journal Article by Ladowski JM, Martinino A (…) Jackson KL et 9 al. in J Surg Res

Copyright © 2024 Elsevier Inc. All rights reserved.

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New machine learning model accurately predicts cancer treatment response

A novel machine learning model, utilizing systemic inflammation-nutritional index (SINI), successfully predicts pathological complete response (PCR) in patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiotherapy (NCRT). The model achieved a mean area under the curve (AUC) of 0.877 during training and demonstrated consistent performance in both internal (AUC 0.86) and external validation sets (AUC 0.83). Identified key predictors included SINI, clinical T-stage, and tumor size, supporting tailored treatment strategies.

Journal Article by Wang Y, Pan Z (…) Guan G et 6 al. in Eur J Surg Oncol

Copyright © 2024. Published by Elsevier Ltd.

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Mobile surgical units improve access to healthcare in remote Africa

Mobile surgical units (MSUs) effectively enhance surgical care access in underserved remote African communities, according to recent literature. Interventions involving minor and major surgeries, including obstetric procedures, have significantly improved patient outcomes. Despite challenges like financial constraints, the deployment of MSUs leads to reduced healthcare disparities and emergency surgical care accessibility. The narrative review emphasizes the necessity for increased funding and interdisciplinary collaboration to ensure the sustainability of these vital healthcare initiatives in such regions.

Review by Mugisha N, Uwishema O (…) Shariff S et 3 al. in BMC Surg

© 2024. The Author(s).

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Healthcare systems can significantly reduce their greenhouse gas emissions.

A systematic review analyzed 205 studies on healthcare’s environmental impact, revealing effective strategies to lower greenhouse gas (GHG) emissions. Key approaches included changing clinical practices, implementing governance policies, managing waste, and adjusting transportation methods. Over half of the studies focused on macro-level interventions, highlighting the importance of collective action. While numerous frameworks for measuring GHG emissions were presented, the lack of implementation and evaluation of sustainability initiatives was noted, underlining areas needing improvement for long-term decarbonization.

Journal Article by Braithwaite J, Smith CL (…) Zurynski Y et 16 al. in BMJ

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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