Blog

Causal relationships exist between biliary disorders and GERD.

Significant causal effects of genetically predicted cholelithiasis, cholecystitis, and cholecystectomy on gastroesophageal reflux disease (GERD) were identified, with odds ratios of 1.04, 1.06, and 2.56, respectively. Additionally, the study confirmed a bidirectional relationship, where GERD also influences the likelihood of developing cholelithiasis and cholecystitis. Mediation analyses showed that both biliary disorders and GERD partially mediate the effect of body mass index (BMI) on each other, emphasizing the intertwined nature of these conditions.

Journal Article by Lin H, Lu R (…) Chen L et 4 al. in Int J Surg

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

read the whole article in Int J Surg

open it in PubMed

KRAS and RYR2 mutations significantly predict unresectable recurrence

The study identified several key prognostic factors impacting unresectable recurrence-free survival (urfs) in colorectal liver-only metastasis patients. Significant predictors included KRAS G12D mutation positivity (HR: 7.69), RYR2 mutation positivity (HR: 4.03), KRAS G12S mutation positivity (HR: 3.96), CA19-9 > 37 U/ml prior to hepatectomy (HR: 3.62), and primary tumor PN2 stage (HR: 3.22). These findings underscore the importance of specific mutations in shaping patient outcomes.

Journal Article by Chen K, Okamura Y (…) Yamaguchi K et 13 al. in Surg Today

© 2024. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.

read the whole article in Surg Today

open it in PubMed

Opioid prescription size and persistent use significantly decreased.

Among 989,354 opioid-naïve patients, initial opioid prescription size dropped from 282 mg to 164 mg morphine equivalents, and new persistent opioid use declined from 2.7% in 2013 to 1.1% in 2021. These changes suggest effective opioid stewardship practices. Increases in prescription size correlated with higher persistent use, with every 30 mg increase linked to a 3.1% rise in new persistent opioid use. Other significant predictors included preoperative non-opioid prescriptions and specific surgical procedures.

Journal Article by Luby AO, Alessio-Bilowus D (…) Bicket MC et 3 al. in Ann Surg

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

read the whole article in Ann Surg

open it in PubMed

Cap-assisted polidocanol foam sclerobanding outperforms ERBL

A study involving 195 patients revealed that cap-assisted endoscopic polidocanol foam sclerobanding (EFSB) significantly reduced hemorrhoid severity scores (HSS) compared to endoscopic rubber band ligation (ERBL) at eight weeks. While post-procedural pain was notably lower in the EFSB group, long-term satisfaction and effective relief from recurrence of prolapse and pain were also achieved 24 hours post-procedure. Thus, EFSB presents a promising alternative for managing symptomatic grade II-III internal hemorrhoids.

Randomized Controlled Trial by Qu CY, Zhang FY (…) Shen F et 10 al. in World J Gastroenterol

©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.

read the whole article in World J Gastroenterol

open it in PubMed

One-quarter of pancreaticoduodenectomies may be futile

A retrospective analysis of 66,326 patients revealed that 25.3% of pancreaticoduodenectomies (PD) for non-metastatic pancreatic ductal adenocarcinoma were futile, defined as death within 12 months. Factors increasing futility included macroscopically positive margins, poor tumor differentiation, and N2 nodal stage. Conversely, systemic therapy, radiation, and neoadjuvant therapy reduced the likelihood of futility. In the subgroup receiving neoadjuvant therapy, a longer diagnosis-to-surgery interval correlated with lower futility rates.

Journal Article by Marcinak CT, Ahmed KS (…) Zafar SN et 9 al. in J Surg Oncol

© 2024 Wiley Periodicals LLC.

read the whole article in J Surg Oncol

open it in PubMed

Higher surgical volume significantly reduces postoperative morbidity in Crohn’s surgery

Analysis of 4,205 patients revealed that postoperative morbidity (POM) following ileocolic resection (ICR) for Crohn’s disease is significantly lower in high-surgical-volume centers (6.2%) compared to low-surgical-volume centers (9.1%) with a p-value of 0.0004. Independent factors influencing major POM include surgical hospital volume, male sex, Elixhauser Comorbidity Index ≥ 1, and minor POM. Findings advocate for centralizing surgery for Crohn’s disease, particularly in patients with significant comorbidities.

Journal Article by Bitterlin T, Valibouze C (…) Zerbib P et 3 al. in J Crohns Colitis

© The Author(s) 2024. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

read the whole article in J Crohns Colitis

open it in PubMed

Investigational 4F-PCC Shows Noninferiority for VKA Reversal

Findings from this randomized clinical trial demonstrated that the investigational 4-factor prothrombin complex concentrate (4F-PCC) is statistically noninferior to the control 4F-PCC for rapid reversal of vitamin K antagonists (VKAs) in patients at substantial risk for bleeding during urgent surgeries. Effective hemostasis was achieved in 94.3% of patients receiving the investigational 4F-PCC compared to 94.2% with the control. Safety profiles were comparable, with no significant differences in thrombotic events or mortality rates.

Multicenter Study by Sarode R, Goldstein JN (…) Milling TJ et 4 al. in JAMA Netw Open

read the whole article in JAMA Netw Open

open it in PubMed

More PIPAC treatments correlate with improved patient survival

Conducting three or more pressurized intraperitoneal aerosol chemotherapy (PIPAC) procedures significantly enhances survival among patients with unresectable peritoneal surface malignancies. In a cohort of 346 patients undergoing 1200 treatments, approximately two-thirds completed at least three procedures. Disease progression was the primary reason for treatment cessation in over half of cases. The findings suggest that increasing the number of PIPAC treatments, particularly with systemic chemotherapy, correlates with better outcomes and warrants further prospective validation.

• Why it matters: Disease progression limits treatment options for advanced cancer patients.

Journal Article by Orgad R, Bakrin N (…) Kepenekian V et 5 al. in Ann Surg

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

read the whole article in Ann Surg

open it in PubMed

Social determinants significantly impact surgical outcomes in veterans

Findings indicate that older veterans living in deprived neighborhoods and identifying as black experience poorer surgical outcomes and higher care fragmentation. The study analyzed 93,644 veterans and identified that black veterans had worse outcomes (adjusted odds ratio, 1.06) and those with increased non-VA care days exhibited higher doors scores (adjusted odds ratio per 20%, 1.01). Notably, veterans in rural areas showed better outcomes than their urban counterparts, suggesting care improvements are necessary for specific demographics.

• Why it matters: Surgical outcomes are affected by social determinants in veterans.

Journal Article by Jacobs MA, Gao Y (…) Hall DE et 8 al. in JAMA Surg

read the whole article in JAMA Surg

open it in PubMed

Neoadjuvant chemotherapy significantly improves survival in gastric cancer.

Findings indicate that neoadjuvant chemotherapy (ctx) for resectable gastric cancer results in significantly longer overall survival (OS) compared to neoadjuvant chemoradiation (crtx). Analysis of 14,266 patients revealed a 20%-30% improvement in 5-year OS for the ctx group, despite a higher prevalence of complete pathological response in the crtx cohort. The study posits that current AJCC staging may overestimate survival for patients undergoing crtx and introduces a nomogram for enhanced OS prediction.

• Why it matters: Neoadjuvant treatments impact survival rates in gastric cancer patients.

Journal Article by Takahashi H, Nakauchi M, Hiotis S and Datta R in J Surg Oncol

© 2024 Wiley Periodicals LLC.

read the whole article in J Surg Oncol

open it in PubMed