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Endoscopic sleeve gastroplasty shows comparable outcomes to surgery

A retrospective analysis of patients undergoing endoscopic sleeve gastroplasty (ESG) versus laparoscopic sleeve gastrectomy (LSG) revealed similar improvements in obesity-related comorbidities. While LSG resulted in greater percentage total body weight loss at 6 months, 1 year, and 2 years, ESG was associated with shorter hospital stays and fewer severe adverse events. Patients undergoing ESG were also older and less obese compared to those receiving LSG, indicating its viability as a less invasive weight loss option.

Journal Article by Joseph S, Vandruff VN (…) Ujiki MB et 8 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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Machine learning models outperform traditional risk scores in bariatric surgery

Advanced machine learning techniques, particularly random forest, demonstrated superior performance in predicting 30-day complications in metabolic bariatric surgery compared to the established MBSAQIP risk score. The random forest model achieved an area under the receiver operating characteristic curve (AUROC) of 0.94 in training and 0.88 in validation. Key predictive features included serum alkaline phosphatase, platelet count, triglycerides, glycated hemoglobin, and albumin, highlighting potential for improved patient risk assessment.

Journal Article by Zucchini N, Capozzella E (…) Palmisano S et 5 al. in Obes Surg

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Enhanced recovery protocols significantly reduce delayed recovery rates

Identifying key factors impacting recovery, clinicians analyzed data from 1,535 patients undergoing elective colorectal surgery across 22 hospitals. Despite a median adherence to protocols at 75%, 31.7% experienced delayed recovery. The study highlighted six critical protocol items, including pre-admission counseling and early removal of the nasogastric tube, which independently improved recovery outcomes. Notably, adherence to all six items reduced the delayed recovery rate to 13%, emphasizing the importance of specific practices in enhancing postoperative recovery.

Multicenter Study by Ceresoli M, Ripamonti L (…) Braga M et 4 al. in Tech Coloproctol

© 2024. Springer Nature Switzerland AG.

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EUS-guided biopsy yields valuable mutation data in pancreatic cancer

A study evaluated the feasibility of EUS-guided fine-needle biopsy (EUS-FNB) for next-generation sequencing (NGS) in unresectable pancreatic ductal adenocarcinoma (PDAC). The technical yield of EUS-FNB met criteria in 48% of cases, while the molecular yield was remarkably high at 98%. This means that nearly all qualifying biopsies provided sufficient DNA for mutation detection. Most frequently mutated genes were identified, contributing important insights for targeted treatment possibilities in this lethal cancer.

Journal Article by Buchberg J, de Stricker K (…) Detlefsen S et 2 al. in Endosc Ultrasound

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc on behalf of Scholar Media Publishing.

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Racial Disparities Impact Surgical Outcomes in Diverse Patient Populations

A comprehensive analysis of over 7.5 million surgical patients reveals significant racial disparities in postoperative outcomes. White, Asian, and Native Hawaiian patients exhibited better outcomes compared to Black and American Indian patients, who faced higher rates of complications. Additionally, socio-economic factors such as wealth, healthcare access, and food security influence discharge destinations and recovery. The findings highlight the urgent need for targeted investigations to address these disparities and improve surgical care for all racial and ethnic groups.

Journal Article by Matar DY, Knoedler S (…) Panayi AC et 10 al. in Ann Surg Open

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

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EUS-BD offers reduced pancreatitis risk compared to ERCP

A systematic review and meta-analysis revealed that endoscopic ultrasound-guided biliary drainage (EUS-BD) is a safe alternative to ERCP transpapillary drainage (ERCP-TPD) for primary biliary drainage in patients with distal malignant biliary obstruction (DMBO). Among 815 patients analyzed, clinical and technical success rates were similar for both techniques. However, EUS-BD showed a significant reduction in post-procedure pancreatitis risk, with a lower occurrence of adverse events compared to ERCP-TPD, along with shorter procedural times.

Journal Article by Nabi Z, Samanta J (…) Reddy DN et 8 al. in J Clin Gastroenterol

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

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Biological agents significantly reduce surgery rates in Crohn’s disease

In the era of biological agents, Crohn’s disease patients show varying surgery rates based on Montreal classifications. Notably, type B3 patients have the highest likelihood of requiring surgery, while type A1 patients tend to undergo surgery earlier than A2 and A3. The use of biological agents within one month of diagnosis significantly decreases the chances of surgical intervention, as does receiving treatment within 19 months of symptoms onset. Behavior changes during the disease course indicate poorer surgical outcomes.

Journal Article by Yang L, Yao B (…) Yuan L et 5 al. in Int J Colorectal Dis

© 2024. The Author(s).

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Radiation-emitting stents improve survival in cholangiocarcinoma patients

In a multicenter trial, the use of radiation-emitting metallic stents (REMS) combined with hepatic arterial infusion chemotherapy (HAIC) significantly enhanced overall survival (10.2 months vs. 6.7 months) and time to symptomatic progression (8.6 months vs. 5.4 months) compared to self-expandable metallic stents (SEMS) with HAIC in patients with unresectable Bismuth type III or IV perihilar cholangiocarcinoma. Both groups had similar jaundice relief rates and adverse event occurrences.

Journal Article by Chen Q, Ge NJ (…) Lu J et 19 al. in Int J Surg

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

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Liver immune status index enhances prognostic accuracy in HCC

The liver immune status index (LISI) demonstrated strong predictive capabilities for postoperative outcomes in hepatocellular carcinoma (HCC) patients, particularly with vascular invasion. In a study of 1,337 hepatectomies, LISI effectively stratified patients into distinct risk groups, correlating significantly with established prognostic markers. Notably, LISI provided superior predictive performance for two-year overall survival and recurrence rates. The HISCO-HCC score, which integrates LISI, tumor burden score, and alpha-fetoprotein, further augments prognostic precision, aiding personalized patient care.

Journal Article by Imaoka Y, Ohira M (…) Ohdan H et 10 al. in J Hepatobiliary Pancreat Sci

© 2024 The Author(s). Journal of Hepato‐Biliary‐Pancreatic Sciences published by John Wiley & Sons Australia, Ltd on behalf of Japanese Society of Hepato‐Biliary‐Pancreatic Surgery.

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Intraoperative factors improve prediction of hospital stay length

A new model predicting length of stay (LOS) after colorectal surgery demonstrates enhanced accuracy by including intraoperative risk factors. The intraoperative prediction model (IP model) achieved an area under the curve (AUC) of 0.84, outperforming the preoperative model (PP model) with an AUC of 0.75. This significant improvement, validated across 2,140 patients, supports better patient care and resource management within healthcare systems. Incorporating intraoperative data crucially aids in anticipating patient outcomes.

Journal Article by Huisman DE, Ingwersen EW (…) Daams F et 3 al. in Ann Surg Open

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

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