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Robotic approach yields better early outcomes for large hernia repairs

A multicenter analysis of over 5,500 patients showed that robotic-assisted ventral hernia repairs (VHR) lead to improved outcomes within 30 days compared to traditional open techniques. While both methods were analyzed, robotic surgery resulted in no significant difference in serious surgical outcomes (SSO) at the 30-day mark. Notably, the robotic group had a higher median BMI, suggesting that these patients may present more complex cases.

Journal Article by Lima DL, Nogueira R (…) Sreeramoju P et 4 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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Virtual collaboration enables safe robotic pancreatoduodenectomy program

A structured robotic pancreatoduodenectomy (rpd) program was successfully initiated with virtual expert collaboration, demonstrating excellent perioperative outcomes. Over 68 patients underwent the procedure from August 2020 to December 2023, achieving a median operative time of 407 minutes, an estimated blood loss of 150 ml, and 90% negative margins. Notably, the operative time significantly decreased in later cases (380 min vs. 441 min, p < 0.01) and conversion rates dropped from 21% to 6%.

Journal Article by Blair AB, Soares KC (…) Wei AC et 4 al. in HPB (Oxford)

Copyright © 2024. Published by Elsevier Ltd.

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Stereotactic body radiation therapy shows promise for hepatocellular carcinoma

Stereotactic body radiation therapy (SBRT) has emerged as a viable treatment for hepatocellular carcinoma (HCC), particularly for patients with advanced stages. Recognized in clinical guidelines as effective against alternatives like radiofrequency ablation, SBRT demonstrates local control rates of 80-90%. Its role in downstaging unresectable tumors or as a bridge to transplant is gaining traction, with promising results reported when combined with immunotherapy, indicating a need for further randomized studies to solidify SBRT’s positioning in HCC management.

Review by Sharma D, Khosla D (…) Kapoor R et 2 al. in J Clin Exp Hepatol

© 2024 Indian National Association for Study of the Liver. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

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Robotic colectomy leads to better short-term oncologic outcomes.

Analysis of over 44,000 minimally invasive colectomy cases indicates that robotic techniques significantly enhance short-term oncologic results for colon cancer patients. Robotic colectomy correlated with nearly double the likelihood of chemotherapy initiation within 90 days (RR 1.98), more lymph nodes harvested, a 36% reduction in blood transfusion rates (RR 0.64), and a 74% decrease in ostomy formation necessity (RR 0.26), compared to laparoscopic colectomy, suggesting marked advantages for robotic procedures.

Comparative Study by de Almeida Leite RM, Araujo SEA (…) Ricciardi R et 2 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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A machine learning tool predicts musculoskeletal injury risk in surgeons

A study highlighted alarming findings regarding musculoskeletal strain among surgeons, with 90.6% reporting related pain. Key risk factors include long surgical interventions without breaks, obesity, and improper laparoscopic screen positioning. A novel online calculator was developed to predict musculoskeletal injury risk based on these factors, aiming to facilitate personalized prevention strategies. Enhanced ergonomics training was deemed necessary by 89.6% of surgeons, revealing a critical gap in current training protocols and occupational health approaches.

Journal Article by Sánchez-Guillén L, Lozano-Quijada C (…) Arroyo A et 7 al. in Surg Endosc

© 2024. The Author(s).

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Robotic surgery shows clinical effectiveness in various procedures

A review of 165 systematic reviews revealed that robotic-assisted surgery offers mostly positive or neutral clinical outcomes compared to open and laparoscopic techniques, particularly excelling against open surgery. However, it is associated with longer operative times. Most reviews exhibited low quality due to bias in observational studies. The findings support expanding the use of robotic surgical approaches in common procedures while acknowledging the need for economic assessments to optimize their capacity due to high costs.

Systematic Review by Lai TJ, Roxburgh C, Boyd KA and Bouttell J 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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Higher positive lymph node ratio predicts worse survival in esophageal cancer

Findings indicate that the positive lymph node ratio (plnr) significantly predicts overall and disease-free survival in locally advanced esophageal squamous cell carcinoma (ESCC). Out of 439 patients, higher plnr was associated with poorer survival outcomes, with an optimal cutoff identified at 10%. Major prognostic factors include plnr and metastatic lymph nodes along the left gastric artery for overall survival, while plnr and total main bronchus lymph nodes were crucial for disease-free survival, highlighting significant survival disparities.

Journal Article by Xu H, Huang S (…) Wu H et 5 al. in J Gastrointest Oncol

2024 Journal of Gastrointestinal Oncology. All rights reserved.

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YAP-based nomogram enhances prognosis prediction in hepatocellular carcinoma

A novel nomogram incorporating YAP expression and clinical metrics has been developed to predict postoperative prognosis in hepatocellular carcinoma (HCC) patients. Researchers evaluated 262 patients post-partial hepatectomy and found that those with high YAP expression faced significantly poorer recurrence-free survival (RFS) and overall survival (OS) rates. The model, validated externally, integrates critical factors like hepatitis B markers and tumor characteristics, proving its predictive accuracy. Improved prognostic tools may enable better management of HCC patients post-surgery.

Journal Article by Zhou W, Ye F (…) Liu H et 4 al. in J Gastrointest Oncol

2024 Journal of Gastrointestinal Oncology. All rights reserved.

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Wide hot snare polypectomy outperforms other methods for small tumors

In a study assessing salvage treatments for rectal neuroendocrine tumors (RNETs) under 10 mm, wide hot snare polypectomy (WHSP) showed superior outcomes. Of 121 patients analyzed, WHSP achieved an impressive 72.7% R0 resection rate compared to other methods. With a focus on effectiveness and safety, WHSP emerged as a rapid and straightforward approach for these small tumors, especially in patients without additional risk factors, highlighting its potential as a preferred salvage technique.

Journal Article by Ju Y, Bong JW (…) Lee SI et 3 al. in Ann Surg Treat Res

Copyright © 2024, the Korean Surgical Society.

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PIPAC improves quality of life and survival in cancer treatment

The analysis demonstrated that patients receiving pressurized intraperitoneal aerosolized chemotherapy (PIPAC) experienced significantly more good days and reduced hospital stays compared to those treated with standard therapy (ST). Specifically, PIPAC patients had a median of 181 good days at six months versus 131 days for ST, and an overall survival median of 11.3 months compared to 5.1 months with ST. Importantly, PIPAC showed no negative impact on health-related quality of life despite its repeated administration.

Journal Article by Waheed MT, Ruel N (…) Raoof M et 8 al. in Ann Surg Oncol

© 2024. The Author(s).

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