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Endoscopic Treatments for Gastroesophageal Reflux Disease: EBL and TIF Show Superior Efficacy

Endoscopic band ligation (EBL) and transoral incisionless fundoplication (TIF) show comparable efficacy in improving health-related quality of life in patients with GERD, outperforming other endoscopic interventions like Stretta, EFTP, and Endocinch. EBL and TIF also significantly decrease esophagitis incidence compared to PPIs. While TIF increases lower esophageal sphincter pressure, it is less effective than PPIs in reducing esophageal acid exposure. The study suggests that EBL and TIF may be superior treatments for GERD, providing valuable insights into the relative effects of different endoscopic therapies for this condition.

Journal Article by Yao L, Lin Y (…) Li D et 4 al. in J Gastrointest Surg

Copyright © 2024. Published by Elsevier Inc.

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ERAS Protocols Improve Outcomes and Cost-Efficiency in Minimally Invasive Liver Surgery

Enhanced Recovery after Surgery (ERAS) recommendations in minimal invasive liver surgery significantly reduce postoperative complications by 14% and prove cost-effective by offsetting the expenses associated with complications. Complications greater than Clavien-Dindo grade II incur the highest costs, reducing profit margins by a median of € 6,640. Embracing ERAS society recommendations in liver surgery leads to a notable reduction in complications, justifying the higher initial costs of implementing a well-structured ERAS protocol. This study highlights the benefits of perioperative multimodal concepts like ERAS in enhancing patient outcomes and cost-efficiency in minimal invasive liver surgery.

Journal Article by Moosburner S, Dahlke PM (…) Krenzien F et 11 al. in Langenbecks Arch Surg

© 2024. The Author(s).

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Early follow-up colonoscopy after colorectal cancer resection detects significant pathology

Follow-up colonoscopies post colorectal cancer resection found 2.7% cancer and 13.2% advanced adenomas in initial procedures. Timely surveillance detected 4.4% cancer progression. Older age, stage IV cancer, and synchronous cancers increased the odds of finding advanced neoplasia. Subsequent colonoscopies revealed 1.8% cancer and 11.4% advanced adenomas. Advanced adenomas during prior exams predicted advanced neoplasia in later screenings. Prolonged intervals between colonoscopies post-surgery should be avoided to catch advanced neoplasia early, highlighting the importance of timely surveillance after colorectal cancer resection.

Journal Article by Finlay BP, Symonds EL, Raman M and Hollington P in ANZ J Surg

© 2024 Royal Australasian College of Surgeons.

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Surgeon Workload’s Impact on Pregnancy Outcomes

Surgeons experiencing high workload during pregnancy have increased risks of major complications, preeclampsia/gestational hypertension, intra/post-partum complications, unplanned cesarean sections, and preterm deliveries. Most institutions lack policies for workload modification, leading to many surgeons not adjusting their workload. These findings highlight the importance of creating a supportive workplace culture and implementing formal policies to protect the health and well-being of pregnant surgeons.

Journal Article by Tatarian T, Anderson B (…) Altieri MS et 6 al. in Ann Surg

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

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Heparin reduces risk of posthepatectomy liver failure

Heparin was found to significantly reduce the risk of posthepatectomy liver failure in patients who underwent liver cancer hepatectomy. A study of 1388 patients showed that heparin administration was associated with a decreased occurrence of liver failure, indicating its potential as a preventive option. Statistical analysis demonstrated a significant association between heparin treatment and reduced risk of liver failure post-surgery, with an odds ratio of 0.518 and a 95% confidence interval of 0.295-0.910. These findings highlight the efficacy and safety of using heparin to prevent hepatic dysfunction after hepatectomy, offering a promising approach to mitigate this common complication.

Journal Article by Xu ZY, Peng M (…) Jiang D et 3 al. in World J Gastroenterol

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

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Robotic-assisted esophagectomy improves R0-resection in esophageal cancer patients

A single-center experience found that robotic-assisted minimally invasive esophagectomy with total mesoesophageal excision led to a significantly higher R0-resection rate compared to open transthoracic esophagectomy. This approach also reduced postoperative pneumonia rates, shortened ICU and hospital stays, with comparable mortality rates. The study suggests that combining robotic assistance with a structured dissection method may result in better short-term clinical and oncologic outcomes, potentially improving long-term survival and overall postoperative recovery in esophageal cancer patients.

Journal Article by Hoelzen JP, Fortmann L (…) Juratli MA et 9 al. in BMC Surg

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

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Robotic-assisted surgery shows better outcomes in rectal cancer resection

Patients with rectal cancer who underwent robotic-assisted surgery (RAS) had a higher likelihood of ileostomy formation but experienced fewer complications, less bleeding, and improved recovery compared to laparoscopic and open surgery. RAS patients had lower rates of ileus, anastomotic leak, and reoperation, as well as a higher rate of discharge to home. Results suggest that RAS offers clinical advantages over laparoscopic and open surgery in terms of postoperative outcomes and patient recovery after rectal cancer resection with stoma creation.

Journal Article by Goldstone RN, Francone T (…) Ricciardi R et 4 al. in Surg Endosc

© 2024. The Author(s).

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Colectomy Outcomes in the U.S. Improve Significantly from 2012 to 2020

Significant improvements in postoperative outcomes after colectomy in the United States were observed between 2012 and 2020. The adoption of quality improvement initiatives led to a decrease in postoperative length of stay, rates of surgical site infections, and pulmonary embolism. Notably, mortality rates remained unchanged. Specifically, undergoing a colectomy in 2020 compared to 2012 was associated with a 14% decrease in postoperative length of stay. These findings highlight the positive impact of national quality improvement initiatives on colorectal patient care.

Journal Article by Kane WJ, Kuron M (…) Hedrick TL et 5 al. in Am J Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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CA 19-9 Surveillance Enhances Survival in Resected Ampullary Cancers

CA 19-9 surveillance in resected ampullary cancers significantly improves survival rates by detecting recurrences early. Among 572 patients, a rise in CA 19-9 levels predicted recurrences accurately, with a serial increase proving to be a more reliable indicator. The optimal threshold for identifying a recurrence was established, leading to prompt detection and treatment. Patients with elevated CA 19-9 levels showed superior median survival compared to those with undetected recurrences. Overall, routine serum CA 19-9 testing during follow-up evaluations is crucial for early recurrence detection and improved outcomes in resected ampullary cancers.

Journal Article by Bhandare MS, Varty GP (…) Shrikhande SV et 9 al. in Ann Surg

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

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Age, BMI, and Surgery Duration Impact Microbial Composition of Surgical Infections

Age, BMI, and duration of surgery significantly influence the microbial composition of surgical-site infections, with older age, lower BMI, and longer surgical procedures associated with a shift from skin bacteria to intestinal pathogens like enterobacterales and enterococcus spp. These patient-dependent factors were identified as key predictors of microbial composition in surgical infections, regardless of the type of surgery. The findings highlight the importance of personalized treatment strategies in managing surgical-site infections and suggest potential implications for improving outcomes in patients undergoing surgical procedures.

Journal Article by Peisl S, Guillen-Ramirez H (…) Beldi G et 3 al. in Br J Surg

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

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