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Circulating biomarkers predict peritoneal metastasis in gastric cancer

A prospective clinical study evaluates the predictive effects of circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) in peritoneal lavage fluid for metachronous peritoneal metastasis (PM) in gastric cancer patients following radical resection. A total of 200 patients will be monitored over two years, with a primary focus on PM incidence one year post-surgery. The findings aim to enhance early diagnosis and improve survival rates in high-risk gastric cancer patients.

Clinical Trial Protocol by Bai L, Guan Y (…) Zhang Z et 8 al. in BMJ Open

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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Persistent acute kidney injury worsens outcomes in liver surgery

In a study involving 990 liver resection patients, persistent acute kidney injury (AKI) was linked to significantly worse postoperative outcomes, including increased morbidity, extended hospital stays, and higher 90-day mortality rates. Among 384 patients with hepatocellular carcinoma, persistent AKI correlated with poorer overall survival, identified as an independent poor prognostic factor. Key predictors of persistent AKI included chronic kidney disease, albumin-bilirubin grade ≥2, and anatomical resection, emphasizing the need for effective prevention strategies.

Journal Article by Doi S, Yasuda S (…) Sho M et 6 al. in Hepatol Res

© 2024 Japan Society of Hepatology.

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Robot-assisted hemihepatectomy shows improved outcomes over laparoscopic approach

In a comparative study involving 96 patients, robot-assisted hemihepatectomy (rob-hh) demonstrated significant advantages over laparoscopic hemihepatectomy (lap-hh) via dorsal approach. Rob-hh resulted in reduced estimated blood loss (median: 100 ml vs. 300 ml), lower blood transfusion rates (4.9% vs. 29.1%), and fewer postoperative complications (26.8% vs. 54.5%). The study confirms that the dorsal approach is both safe and effective for minimizing intraoperative risks in liver surgery.

Journal Article by Wang K, Xie DD (…) Yu DC et 4 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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Dexamethasone reduces postoperative pain and nausea in surgery.

Dexamethasone combined with bupivacaine significantly decreased postoperative pain and the incidence of nausea and vomiting in patients undergoing laparoscopic cholecystectomy. A randomized clinical trial involving 104 patients revealed a mean visual analog scale score of 3.5 in the dexamethasone group compared to 6.2 in the control group. These findings suggest that preperitoneal administration of local corticosteroids during laparoscopic surgeries could effectively manage pain and nausea, promoting better recovery outcomes for patients.

Journal Article by Eslamian M, Sheikhbahaei E (…) Talebzadeh H et 4 al. in Ann Med Surg (Lond)

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

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Nearly half of T2N0 gastric cancer patients experience upstaging

Among 4,076 patients with clinical T2N0 gastric adenocarcinoma undergoing upfront resection, 47.4% were pathologically upstaged. Factors increasing upstaging included tumor size over 3.0 cm and poor differentiation. In patients upstaged, adjuvant chemotherapy correlated with significantly improved survival, whereas it had no survival benefit in non-upstaged patients. These findings suggest that surgical intervention may be prioritized for select patients to potentially avoid unnecessary chemotherapy, highlighting the need for accurate clinical staging.

Journal Article by Baril JA, Ruedinger BM (…) Ellis RJ et 9 al. in BMC Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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Same-day discharge for anastomotic bariatric surgeries shows promising outcomes

A study involving 208 patients from a high-volume Canadian center assessed early outcomes of same-day discharge (SDD) following various anastomotic metabolic and bariatric surgeries. Results demonstrated low rates of unplanned overnight stays, readmissions, and reinterventions. With a mean patient age of 41.4 years and a preoperative BMI of 41.9 kg/m², these findings suggest that SDD after anastomotic surgeries can be safe and effective when conducted under strict patient selection and proper postoperative care.

Journal Article by Deffain A, Denis R (…) Studer AS et 6 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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Laparoscopic repair reduces mortality for peptic ulcer perforation

In a systematic review of nine randomized controlled trials involving 670 patients, laparoscopic repair for peptic ulcer perforation (PUP) demonstrated significantly lower mortality rates (risk ratio 0.37) and morbidity, alongside a reduced length of hospital stay compared to open surgery. The findings suggest that laparoscopic repair is preferable for PUP treatment, contingent upon available surgical expertise. Overall, this study advocates for a shift towards laparoscopic methods in managing PUP cases effectively.

Journal Article by Sokhal BS, Mohamedahmed A (…) Hajibandeh S et 5 al. in Ann R Coll Surg Engl

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Outpatient management is effective for acute uncomplicated diverticulitis

In a study involving 688 patients with acute uncomplicated diverticulitis, outpatient management proved to be effective, showing no significant differences in treatment failure, pain recurrence, or elective surgery needs compared to inpatient care. Inpatients had higher rates of severe symptoms such as elevated CRP levels and systemic inflammatory responses. Notably, previous episodes of diverticulitis significantly increased the likelihood of elective surgery and pain recurrence, suggesting that a conservative ambulatory approach is sufficient for most patients.

Comparative Study by Fonseca F, Moreira JM (…) Ourô S et 2 al. in Tech Coloproctol

© 2024. Springer Nature Switzerland AG.

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Laparoscopic Appendectomy Conversion Rates Continue to Decline

In a study of 3,411 laparoscopic appendectomies over nearly three decades, researchers identified a conversion rate of 0.96%, decreasing to around 0.4% after the initial learning curve. The primary causes of conversion included perforation, adhesions, and pneumoperitoneum intolerance. Notably, age over 65 and symptom duration exceeding 24 hours were statistically significant preoperative factors associated with conversion. Ultimately, the findings reinforce the safety of laparoscopic approaches in experienced centers, despite the necessity for conversion in specific cases.

Comparative Study by Aragone L, Arrechea R (…) Pirchi D et 2 al. in Eur Surg Res

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

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Re-examining the entire colon enhances polyp detection rates.

A randomized controlled trial involving 406 patients demonstrated that re-examination of the entire colon significantly improves the detection of concealed polyps and adenomas compared to standard colonoscopic methods. While polyp detection rates were generally similar between the study and control groups, the second withdrawal significantly increased the number of detected polyps and adenomas. These findings suggest that a comprehensive re-examination strategy can effectively mitigate the risk of interval cancers in patients.

Journal Article by Lee DS, Ji JS (…) Choi H et 2 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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