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Nursing Care Interventions Reduce Pain and Anxiety in Ambulatory Surgery Patients

Nursing care interventions significantly reduce pain and anxiety in patients undergoing ambulatory surgery, according to a meta-analysis of nine studies. Pain reduction (SMD = -1.224) and anxiety reduction (SMD = -1.53) were substantial, though improvements in functional status were not significant. High heterogeneity was observed for both pain (I² = 98.2%) and anxiety (I² = 96.6%). These findings support the integration of nursing care into postoperative management for ambulatory surgeries, highlighting its effectiveness in alleviating pain and anxiety, with further research needed on functional recovery.

Review by Xu H and Shi Y in Pak J Med Sci

Copyright: © Pakistan Journal of Medical Sciences.

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Minimally Invasive Liver Surgery Outperforms Open Surgery in Surgical Outcomes

Minimally invasive liver resection (MILR) demonstrated superior outcomes compared to open surgery in a study of 260 patients. MILR, performed in 68% of cases, resulted in shorter operative times, less blood loss, lower rates of major complications and bile leaks, and reduced hospital stays. Despite a higher proportion of prior abdominal surgeries in the open surgery group, outcomes such as tumor size and liver pathology were comparable. The findings highlight the necessity of including laparoscopic or robotic surgery in the standard practice for liver resections to achieve optimal patient outcomes.

Journal Article by Yu YD, Halazun KJ, Chandwani R and Samstein B in J Minim Access Surg

Copyright © 2024 Copyright: © 2024 Journal of Minimal Access Surgery.

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Malnutrition and Nutritional Support After Gastrectomy in Gastric Cancer Patients

Malnutrition, common among gastric cancer patients, can be improved with nutritional support after gastrectomy. Total gastrectomy poses significant challenges, but function-preserving surgeries show promise. Effective nutritional screening and support enhance outcomes, including reduced complications and improved quality of life. Preoperative interventions vary in effectiveness, while postoperative support consistently benefits patients. Enteral nutrition is effective for gastric outlet obstruction, while oral nutrition supplements and parenteral nutrition help maintain weight and improve biomarkers. This review stresses the importance of nutritional support in improving outcomes for gastric cancer patients post-gastrectomy.

Review by Kang MK and Lee HJ in Ann Gastroenterol Surg

© 2024 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.

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Subgrading of G2 Pancreatic Neuroendocrine Tumors Reveals Behaviorally Distinct Subsets

Subgrading G2 pancreatic neuroendocrine tumors into 2A (Ki67 3% to < 10%) and 2B (10% to ≤ 20%) identifies distinct subsets with different metastasis rates and aggressiveness. G2B cases show significantly higher rates of liver/distant metastasis, lymph node metastasis, and histopathologic signs of aggressiveness compared to G2A. G2B tumors behave similarly to G3, suggesting they may require more aggressive treatment strategies. This subcategorization should be considered in diagnostic guidelines to tailor management protocols accordingly, potentially necessitating closer follow-up for the higher-risk G2B group.

Journal Article by Eren OC, Bagci P (…) Adsay NV et 18 al. in Ann Surg Oncol

© 2024. The Author(s).

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Circulating Exosomal MicroRNA Panel Predicts Peritoneal Metastasis in Advanced Gastric Cancer

A circulating exosomal microRNA panel, robustly predicting peritoneal metastasis in advanced gastric cancer patients, was developed and validated with remarkable accuracy. The risk-stratification model, combined with currently used tumor markers, significantly outperformed conventional clinical factors in predicting metastasis. This novel liquid biopsy assay shows potential for improved patient selection and management, offering clinical impact in guiding personalized treatment strategies.

Journal Article by Wada Y, Nishi M (…) Shimada M et 6 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Anatomical variations of the recurrent laryngeal nerve increase risk of vocal cord paralysis in thyroidectomy

Anatomical variations of the recurrent laryngeal nerve (RLN) during thyroidectomy, such as extralaryngeal branching and relation to the inferior thyroid artery (ITA), significantly increase the risk of vocal cord paralysis (VCP). This retrospective study on 1070 neck sides found that extralaryngeal branching nerves had higher VCP rates compared to nonbranching nerves. RLN crossing anteriorly or posteriorly to the ITA also elevated VCP risk. These findings highlight the impact of RLN anatomical variations on post-thyroidectomy complications, emphasizing the importance of intraoperative vigilance to prevent VCP.

Journal Article by Aygun N, Unlu MT (…) Uludag M et 3 al. in Langenbecks Arch Surg

© 2024. The Author(s).

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Robot-assisted Ventral Hernia Repair: Cost-effective with Shorter Stay and Lower Complications

Robot-assisted ventral hernia repair is associated with decreased length of stay and lower complication rates compared with open repair, resulting in a more cost-effective procedure. In a retrospective cohort study, patients undergoing robot-assisted repair had a significantly shorter mean stay of 0.3 days, lower readmission rate of 4%, and lower total procedure cost of 1,094 euros compared to open repair. The cost-effectiveness of robot-assisted repair was particularly evident in incisional hernia cases, showcasing the potential benefits of this approach in reducing healthcare costs and improving patient outcomes.

Journal Article by Henriksen NA, Marckmann M, Christoffersen MW and Jensen KK in Hernia

© 2024. The Author(s).

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Laparoscopic segmentectomy using ICG fluorescent navigation shows superior outcomes

Laparoscopic segmentectomy using ICG fluorescence navigation with the negative staining method showed superior outcomes compared to open segmentectomy. Patients who underwent laparoscopic surgery experienced shorter operative times, reduced blood loss, and shorter hospital stays. Additionally, they had significantly fewer grade II and grade III or higher postoperative complications. These findings highlight the precision and safety of laparoscopic segmentectomy, especially in the posterosuperior segment, demonstrating its potential for better short-term outcomes.

Journal Article by Araki K, Watanabe A (…) Shirabe K et 7 al. in Ann Gastroenterol Surg

© 2024 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery.

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Higher Lymph Node Yield Improves Survival in Pancreatic Cancer Patients

Increased lymph node yield (LNY) of 22 or more nodes is linked to better overall survival (OS) and longer time to recurrence (TTR) in node-negative pancreatic ductal adenocarcinoma (PDAC) patients receiving neoadjuvant therapy (NAT). This association was observed in two separate patient cohorts, highlighting the importance of LNY in predicting oncologic outcomes and suggesting potential for improved patient stratification and treatment planning.

Journal Article by Servin-Rojas M, Fong ZV (…) Qadan M et 7 al. in Ann Surg

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

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Robotic Pancreatoduodenectomy: Experience Matters

Robotic pancreatoduodenectomy showed decreased complications and increased efficiency with experience, as seen in 150 consecutive patients. Morbidity was lower, mortality rates were comparable, and operative times significantly reduced in the latter half of cases. Higher lymph node resection and more partial portal vein resections were observed in experienced cases. These results emphasize the safety and feasibility of robotic pancreatoduodenectomy in specialized centers with experienced surgeons, highlighting the importance of skill and practice in achieving optimal outcomes.

Journal Article by Machado MAC, Mattos BV, Lobo Filho MM and Makdissi F in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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