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Grip strength decreases risk of postoperative ileus in surgery

A study found that grip strength is a significant predictor of postoperative ileus (POI) in patients undergoing abdominal minimally invasive surgery. Among 393 patients analyzed, those with higher grip strength exhibited a reduced risk of developing POI. Specifically, each increase of 1 kg in grip strength correlated with decreased odds of POI. Males and older adults showed a notable relationship, emphasizing the potential for targeted preoperative assessments to mitigate POI risks.

Journal Article by Liang W, Liu Y (…) Zhou J et 3 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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High compliance with enhanced recovery programs improves liver surgery outcomes

A study involving 706 patients highlights the significant impact of high compliance with enhanced recovery programs (ERP) on achieving textbook outcomes after elective liver surgery. Of the patients, 30.7% attained these outcomes, with 24% from the high compliance group and only 6.6% from the low compliance group. High ERP compliance notably increased the odds of achieving these outcomes compared to lower compliance, despite factors like cholangiocarcinoma and intraoperative hypotension posing risks to success.

Journal Article by Gosse J, Mariani P (…) Brustia R et 14 al. in World J Surg

© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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Adjuvant chemotherapy improves outcomes in rectal cancer patients.

In patients with locally advanced rectal cancer, adjuvant chemotherapy significantly reduces the risk of mortality and locoregional recurrence after neoadjuvant treatment and proctectomy. Among 746 patients studied, those with a complete total mesorectal excision (TME) showed a 73% lower risk of mortality and an 88% reduction in locoregional recurrence when receiving adjuvant chemotherapy. Noncomplete TME patients displayed similar rates of chemotherapy receipt but lacked sufficient data for recurrence analysis, suggesting a potential gap in treatment strategies.

Journal Article by Althans AR, Holder-Murray J (…) Tessler RA et 7 al. in J Surg Res

Copyright © 2024 Elsevier Inc. All rights reserved.

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A predictive model for delayed gastric emptying after surgery

A new model for predicting delayed gastric emptying (DGE) in pancreatic ductal adenocarcinoma patients post-pancreatoduodenectomy has been developed and validated. Researchers identified four key predictors: days to pancreatic drain removal, pancreatic fistula presence, sepsis/septic shock, and reoperation. The model, described as a DGE risk stratification (DGERS) tool, showed strong calibration and performance during validation, with AUC values indicating effective risk stratification across different risk groups.

Journal Article by Gu Z, Du Y (…) Zhang J et 3 al. in United European Gastroenterol J

© 2024 The Author(s). United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.

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Risk-specific training enhances surgical complication prediction

Utilizing deep learning models on separately defined risk cohorts significantly improved predictive accuracy for postoperative complications. Training on high-risk patients yielded better area under the precision-recall curve for predicting in-hospital mortality, acute kidney injury, and prolonged ICU stays. This tailored approach notably enhanced F1 scores for various complications, suggesting that risk-specific training could address class imbalance issues in surgical risk prediction, thereby enabling better clinical decision-making in surgical settings.

Journal Article by Balch JA, Ruppert MM (…) Loftus TJ et 8 al. in JAMA Surg

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Lymph node ratio predicts survival in duodenal adenocarcinoma

The lymph node ratio (LNR) has been identified as a crucial prognostic factor in patients with postoperative duodenal adenocarcinoma. In a study involving 943 patients, those with an LNR of 0.12 or greater experienced poorer overall survival. A nomogram integrating key prognostic factors, including LNR and tumor size, provided effective risk stratification. High-risk patients benefited from adjuvant chemotherapy, while low-risk patients may avoid it, promoting personalized treatment strategies and reducing overtreatment risks.

Journal Article by Zhang D, Zheng Y (…) Lu J et 5 al. in BMC Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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Robotic-assisted hemi-hepatectomy shows improved outcomes compared to open surgery

A study analyzed 163 patients who underwent either robotic-assisted hemi-hepatectomy (rh) or open hemi-hepatectomy (oh). Robotic procedures demonstrated significantly less blood loss overall and achieved better postoperative outcomes, especially for left hemi-hepatectomy, which resulted in fewer complications and shorter hospital stays. In the case of right hemi-hepatectomy, rh had lower intraoperative blood transfusions but required more time to perform. Overall, robotic-assisted techniques proved to be safe and effective alternatives to traditional methods.

Journal Article by Wang XY, Huang XT (…) Yin XY et 4 al. in J Surg Res

Copyright © 2024 Elsevier Inc. All rights reserved.

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Laparoscopic techniques improve outcomes in ulcerative colitis surgery

A multicenter study with 379 ulcerative colitis patients reveals that laparoscopic colectomy and restorative procedures significantly enhance pouch function. Key findings indicate that mesocolic dissection and the transanal-transection single-stapling anastomosis are associated with reduced complications like pouchitis and cuffitis. Moreover, approaches such as mesentery lengthening increase failure risk while hand-sewn anastomoses correlate with stenosis. Findings advocate for adopting newer surgical methods to optimize postoperative outcomes.

Journal Article by Mineccia M, Ferrero A (…) Sampietro GM et 9 al. in Dig Liver Dis

Copyright © 2024. Published by Elsevier Ltd.

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Distinct imaging features differentiate complicated from uncomplicated appendicitis

A comprehensive analysis of imaging findings in 1,094 appendicitis patients identified critical differentiators. The study revealed that the diameter of the appendix, periappendiceal air, effusion, and intraluminal appendicolith were significantly greater in the perforated appendicitis group. Additionally, appendiceal wall thickness varied notably between the groups. These parameters are vital for accurate diagnosis and treatment decisions, enhancing clinical practice. The findings necessitate further studies to validate these imaging markers for improved appendicitis management.

Comparative Study by Şimşek O, Şirolu S (…) Tutar O et 4 al. in Ulus Travma Acil Cerrahi Derg

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Visual endoscopic retrograde appendicitis therapy reduces recurrence risk

Findings indicate that visual endoscopic retrograde appendicitis therapy (v-erat) and antibiotic therapy have similar treatment success rates for uncomplicated acute appendicitis (93.6% vs. 90.5%). However, v-erat significantly lowers the recurrence risk during follow-up and decreases the appendectomy rate (4.3% vs. 9.5%). Additionally, patients undergoing v-erat experience a shorter initial hospitalization (3 days vs. 4 days) and prolonged time to recurrence (269 days vs. 70 days), with overall adverse events being comparable.

Journal Article by Zhan K, Bai Y (…) Liu W et 9 al. in Am J Gastroenterol

Copyright © 2024 by The American College of Gastroenterology.

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