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Higher lower esophageal sphincter pressure predicts better outcomes after POEM

In a study involving 237 patients undergoing per oral endoscopic myotomy (POEM), researchers found that while achalasia type was not predictive of the need for further interventions or symptom relief, a higher integrated relaxation pressure (IRP) on preoperative manometry was associated with greater postoperative symptom improvement, indicated by reduced Eckardt scores (p=0.03). This suggests that patients with elevated IRP may experience more significant relief compared to those with lower pressures.

Journal Article by Chatha HN, Lyons J (…) Marks JM et 7 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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Flexible endoscopic treatment for Zenker’s diverticulum proves effective

A multicenter study involving 327 patients demonstrated that flexible endoscopic treatment for Zenker’s diverticulum exhibits high success rates, achieving technical success of 99.2% and clinical success of 97.4%. While the rates of adverse events and re-admissions were reported at 11.2% and 16.7%, respectively, the mortality rate remained low at 0.3%. Importantly, the study found no significant differences in outcomes based on the various incision methods or additional prophylactic measures employed.

Journal Article by Steinbrück I, Rempel V (…) Allgaier HP 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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Outcomes for Colon Cancer Patients Vary by Facility Type

Surgical outcomes for colon cancer patients show significant variance based on facility type. Analysis of 125,935 patients revealed that those treated in academic/research programs (ARP) experienced the best median overall survival of 129 months, contrasting sharply with 103.7 months for community cancer programs (CCP). Additionally, ARP demonstrated lower readmission and mortality rates compared to other facility types. These findings highlight the importance of facility-specific factors on patient outcomes, guiding future resource allocations.

Journal Article by Shustak A, Horesh N (…) Wexner SD et 5 al. in Surg Endosc

© 2024. The Author(s).

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Peritoneum to portal vein distance predicts pancreatic fistula risk

A study investigating postoperative pancreatic fistula (POPF) risk factors in 210 distal pancreatectomy patients revealed that a peritoneum to portal vein distance (PPD) of 68 mm serves as a significant predictor for POPF, outperforming the visceral fat area (VFA). Among the identified risk factors, CRP levels and drain amylase on postoperative day three also emerged as independent predictors. Overall, the PPD distance is easily measurable and beneficial for clinical application in assessing POPF risk.

Journal Article by Uemura S, Ban D (…) Shimada K et 4 al. in World J Surg

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

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Concomitant hiatal hernia repair with TIF shows promise for GERD

A systematic review of seven observational studies involving 306 patients found that concomitant hiatal hernia repair with transoral incisionless fundoplication (CTIF) is a viable alternative for refractory gastroesophageal reflux disease (GERD). The study highlighted a median proton pump inhibitor discontinuation rate of 73.8% and notable improvements in validated GERD questionnaires. Complications were low, with a 4.4% incidence rate, suggesting CTIF offers comparable short-term efficacy and safety to conventional anti-reflux surgery.

Review by Jaber F, Ayyad M (…) Skef W et 4 al. in Surg Endosc

© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.

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Biosynthetic mesh significantly lowers hernia recurrence rates.

In a study involving 503 patients undergoing robotic hiatal and paraesophageal hernia repair, the use of biosynthetic mesh significantly reduced long-term anatomic hernia recurrence rates from 44.9% to 24.7% compared to suture-only repairs. Symptomatic recurrence also decreased from 42.2% to 17.2%. Despite comparable short-term outcomes, the findings advocate for biosynthetic mesh reinforcement in managing medium and large hernias, while emphasizing the need for further multicenter randomized studies for conclusive evidence.

Journal Article by Salehi N, Marshall T (…) Zarnegar R et 10 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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Robotic surgery outperforms laparoscopic technique for extended mesorectal excision

A comprehensive meta-analysis reveals that robotic-assisted extended mesorectal excision (r-etme) demonstrates lower recurrence rates and fewer hospital admission days compared to laparoscopic-assisted extended mesorectal excision (l-etme). Although operative times were longer for robotic surgery, urinary complications were also more significant in the laparoscopic group. Overall, the findings support the potential advantages of robotic techniques in managing lateral lymph node metastasis during surgical procedures, suggesting a need for more research in this area.

Journal Article by Abdelsamad A, Mohammed MK (…) Mohamed KA et 6 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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Alvimopan significantly reduces recovery time and hospital stays.

A systematic review of ten studies involving 18,822 abdominal surgery patients revealed that alvimopan enhances gastrointestinal recovery post-surgery. The 6 mg dosage expedited recovery by an average of 14 hours and shortened hospital stays by 5.2 hours compared to placebo. Furthermore, the 12 mg dosage decreased recovery time by 13.5 hours, with a 6.2-hour reduction in hospital duration. These findings affirm alvimopan’s benefits, particularly in laparoscopic surgeries, supporting its integration into patient care protocols.

Systematic Review by Kayyale AA, Ghani S and Olaniyan O in Langenbecks Arch Surg

© 2024. Crown.

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Totally mechanical Collard technique reduces anastomotic stricture rates

The totally mechanical Collard technique significantly lowers anastomotic stricture rates in cervical esophagogastric anastomosis compared to the triangular technique during minimally invasive esophagectomy. In a matched-cohort study of 117 patients, researchers found that the incidence of stricture was 2.5% in the Collard group versus 27.5% in the triangular group (p = 0.003). Other postoperative complications, such as pneumonia and nerve palsy, showed no significant differences between the techniques.

Journal Article by Goto H, Oshikiri T (…) Kakeji Y et 9 al. in Esophagus

© 2024. The Author(s) under exclusive licence to The Japan Esophageal Society.

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Minimally invasive surgery offers reliable outcomes for duodenal adenocarcinoma.

In a multicenter retrospective study involving 2,189 patients, researchers found that radical surgery significantly improved overall survival rates for duodenal adenocarcinoma, with 1-, 3-, and 5-year survival rates at 91.78%, 69.30%, and 55.86%, respectively. The median overall survival was 73 months. Notably, minimal differences in survival were observed between laparotomy and minimally invasive approaches, though the latter resulted in reduced blood loss, fewer transfusions, and shorter hospital stays.

Journal Article by Xiao Q, Wu X (…) Zhang J et 15 al. in BMC Surg

Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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