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Total Mesogastric Excision Shows Promising Short-Term Outcomes

A study examining total mesogastric excision (TME) for gastric cancer found that it results in significantly lower mean blood loss and a higher number of metastatic lymph nodes compared to standard D2 lymphadenectomy. With 37 patients involved, initial findings suggest TME offers advantages in peroperative and short-term outcomes, potentially improving disease-free survival. Conducted in Istanbul, this research contributes unique insights to the growing body of literature on surgical techniques for gastric cancer.

Journal Article by Duzkoylu Y, Ozdedeoglu M (…) Nayci AE et 3 al. in J Coll Physicians Surg Pak

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Neoadjuvant treatment improves survival in esophageal cancer patients

A retrospective analysis involving 645 patients with cT2 staged adenocarcinomas indicated that neoadjuvant treatment followed by surgery (nat/s) yields significantly better overall survival compared to primary surgery (ps). Median overall survival was 114.0 months for nat/s versus 51.0 months for ps in the cT2cnany cohort. Additionally, nat/s was associated with improved disease-free survival in cT2cn0 patients. Notably, 38.1% of cT2cnany and 34.2% of cT2cn0 patients were found to be understaged.

Journal Article by Wirsik NM, Kooij CD (…) Bruns CJ et 23 al. in Ann Surg

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

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Adrenalectomy shows promising survival rates for metastatic patients

A population-based analysis of 2,515 patients undergoing adrenalectomy for metastatic cancer revealed a one-year survival rate of 84.3%. Thirty-day mortality and morbidity rates were low at 1.3% and 29.9%, respectively. The study highlighted that prior radiotherapy correlated with increased complication rates. Laparoscopic procedures comprised 85.3%, maintaining resection completeness at 92.9%. Factors like extra-adrenal metastases and incomplete resection negatively impacted overall survival. These findings emphasize the rising importance of adrenalectomy for metastatic cases.

Journal Article by Rémond A, Marciniak C (…) Caiazzo R et 26 al. in Ann Surg

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

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High 30-Day Morbidity and Mortality Rates for PPU Surgery

In an international cohort study of 1,874 patients with perforated peptic ulcer (PPU), researchers found a 30-day morbidity rate of 48.5% and a mortality rate of 9.3%. Key factors affecting these rates included age over 50, female gender, shock on admission, and acute kidney injury, all significantly associated with increased morbidity and mortality. Delayed presentation correlated with higher morbidity but not mortality. The study highlights critical insights for improving surgical outcomes in PPU patients.

Journal Article by Abouelazayem M, Jain R (…) Mahawar K et 96 al. in Surg Endosc

© 2024. Crown.

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Anticoagulants significantly increase postoperative bleeding risks

An analysis of 37,973 patients undergoing ventral hernia repair revealed that while 11.5% were on antiplatelet therapy and 5.8% on anticoagulants, the latter category exhibited a considerably heightened risk for postoperative bleeding complications. Anticoagulant use was linked to a 2.4 times higher risk for transfusion, a 6.3 times greater likelihood of reoperation for bleeding, and a 4.9 times increased chance of readmission. Antiplatelet therapy showed no such associated risks.

Journal Article by Reed BL, Warren JA (…) Carbonell AM et 3 al. in Am J Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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Inadequate surgical treatment affects non-functioning pancreatic neuroendocrine tumours.

A retrospective study of 384 patients undergoing surgery for non-functioning pancreatic neuroendocrine tumours revealed that 40% received potentially inadequate treatment. Of these, 34% experienced potential overtreatment while 6% were potentially undertreated. Key predictors of overtreatment included smaller tumour sizes and earlier surgical intervention, while larger tumour diameter indicated potential undertreatment. Patients facing undertreatment exhibited significantly worse disease-free and overall survival. Radiological tumour size was crucial for determining surgical appropriateness.

Journal Article by Partelli S, Battistella A (…) Falconi M et 6 al. in BJS Open

© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.

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Small-bite fascial closure reduces hernia rates after surgery

A randomized clinical trial found that small-bite fascial closure significantly decreased the incidence of incisional hernia in open colorectal cancer surgery patients. At one year, hernia rates were 7% for the small-bite group versus 27% for the conventional group (p < 0.001). This disparity persisted into the second year (9% vs 31%, p < 0.001). Additionally, surgical-site infections were less common in the small-bite group (18% vs 31%, p = 0.03), highlighting its benefits.

Randomized Controlled Trial by Ozcan C, Colak T (…) Ertas E et 2 al. in Br J Surg

Published by Oxford University Press on behalf of BJS Foundation Ltd. 2024.

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Endoscopic sleeve gastroplasty shows cost-effectiveness for obesity treatment

Endoscopic sleeve gastroplasty (ESG) demonstrated cost-effectiveness compared to lifestyle modification in adults with class I/II obesity within a five-year horizon, achieving an incremental cost-effectiveness ratio of $23,432 per quality-adjusted life year (QALY). ESG remained cost-effective across sensitivity analyses and was dominant over longer timeframes. The findings suggest ESG as a viable treatment alternative for individuals with obesity, encouraging its consideration in commercial health plans for eligible patients.

Journal Article by Sharaiha RZ, Wilson EB (…) Dayyeh BKA et 2 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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Foley catheter balloon compression effectively controls hemorrhage in trauma.

A retrospective review of 18,303 trauma patients in Venezuela revealed that 45% of 1,757 patients with vascular injuries utilized Foley catheter balloon compression for hemorrhage control. The majority (75%) of catheter placements occurred in emergency departments, while 53.2% were employed in non-compressible anatomical junctions. This method proves effective across various trauma care settings, preserves collateral circulation, and requires minimal attention to maintain hemostasis, highlighting its potential as a vital technique for hemorrhage management.

 

Journal Article by Zinco A, Fields AC (…) Raykar N et 5 al. in Eur J Trauma Emerg Surg

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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A new technique may reduce bile duct injury during surgery

The shoeshine technique enhances safety in laparoscopic cholecystectomy by achieving atraumatic exposure of the hepatocystic area and improving visibility in Calot’s triangle. This method, utilized in over 2,000 cases by the authors, demonstrated effectiveness in reducing risks of bile duct injuries. By employing a blunt dissection tool along with gauze for traction, this approach facilitates hemostatic control and stability, particularly beneficial in inflamed conditions.

Journal Article by Ribeiro Junior MAF, Rizzi R (…) Mohseni S et 2 al. in Acta Cir Bras

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