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Day-case robotic liver resection: safety and feasibility

Day-case robotic liver resection is safe and feasible, with 65% of patients discharged within 24 hours. No major complications or mortalities were reported in this case series, indicating the potential for a shorter hospital stay and improved recovery. Implementation of follow-up pathways is crucial for monitoring and timely intervention. This study showcases the safety and feasibility of robotic day-case liver resection, offering a promising alternative for patients with small liver lesions requiring surgery.

Journal Article by Yeung KTD, Vellaisamy R (…) Jiao LR et 7 al. in Surg Endosc

© 2024. Crown.

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Impact of Care Fragmentation and Social Determinants on Postoperative Mortality

Veterans receiving more non-Veterans Affairs care and residing in highly deprived areas have higher postoperative mortality rates. Conversely, black veterans and those in rural areas exhibit lower mortality rates. Integrating social determinants of health into models did not enhance predictive accuracy. Addressing care fragmentation and considering area deprivation in care pathways could reduce postoperative mortality and mitigate disparities in healthcare outcomes.

Journal Article by Duncan CA, Jacobs MA (…) Hall DE et 10 al. in J Surg Res

Published by Elsevier Inc.

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Cephalosporins Superior to Non-cephalosporins in Preventing SSIs in Colorectal Surgery

Meta-analysis of eight studies demonstrates that the incidence of surgical site infections (SSIs) was significantly lower in patients receiving cephalosporin antibiotics compared to non-cephalosporins after colorectal surgery (14.8% vs 25.1%). Cephalosporins may be more effective in the short term, but long-term efficacy is similar. Clinicians should consider antibiotic spectrum, pharmacokinetics, and bacterial resistance when selecting perioperative antibiotics.

Journal Article by Lin Z and Chen X in Am Surg

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Robotic Surgery Shows Superiority Over Laparoscopic Surgery in Gastric Cancer Treatment

Robotic gastrectomy (RG) demonstrated higher overall survival, lower postoperative complications, faster recovery, and other advantages compared to laparoscopic gastrectomy (LG) in gastric cancer patients. While mortality and disease-free survival were similar between the two techniques, RG offered better outcomes in specific scenarios like intracorporeal reconstruction and certain stages of cancer. These findings support the use of robotic surgery in clinical practice for treating gastric cancer.

Journal Article by Li Z, Zhou W (…) Hong L et 13 al. in Int J Surg

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

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Prognostic Value of Examined Lymph Node Count in CRC

Higher examined lymph node (ELN) counts (≥17) in stage III colorectal cancer (CRC) patients correlate with improved long-term survival outcomes. ELN count independently predicts overall survival, cancer-specific survival, and progression-free survival. Subgroup analysis highlights benefits in patients treated with adjuvant chemotherapy with medium to large ELN counts (≥12). Increased immune activation in the tumor microenvironment is observed in patients with higher ELN counts, emphasizing the dual prognostic and predictive value of ELNs in stage III CRC.

Journal Article by Wei R, Zheng Z (…) He W et 6 al. in World J Surg Oncol

© 2024. The Author(s).

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Effects of grit on medical students’ clerkship wellbeing

Medical students’ perseverance, a subconstruct of grit, was found to be associated with lower burnout and higher compassion satisfaction during clerkships in both surgical and non-surgical specialty units. Older students experienced less burnout, and male students reported higher compassion satisfaction compared to their female counterparts. Cultivating perseverance in medical education could positively impact students’ well-being, although additional factors contributing to burnout need further exploration.

Journal Article by Lin YK, Lin CD, Chen DY and Lin BY in Front Med (Lausanne)

Copyright © 2024 Lin, Lin, Chen and Lin.

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Endoscopic Resection Clinical Algorithm

Malignancies in the upper gastrointestinal tract can be effectively treated through endoscopic resection at an early stage. Key factors influencing successful resection include thorough pre-resection assessment, precise delineation of margins, and selection of appropriate resection techniques. This review outlines clinical algorithms for the endoscopic resection of esophageal squamous cell carcinoma, Barrett’s neoplasia, and gastric neoplasia, emphasizing the importance of post-resection risk assessment and tailored follow-up strategies based on histopathological findings.

Review by Denzer UW in Visc Med

© 2024 S. Karger AG, Basel.

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Management and Prevention of Postoperative Ileus

Preventive measures like coffee consumption, probiotics, and use of dikenchuto within enhanced recovery programs significantly reduce postoperative ileus frequency and duration. Minimally invasive surgical approaches show promise as additional preventive strategies. Treatment options like alvimopan, NSAIDs, and acupuncture are effective, but lidocaine use raises concerns. Ongoing exploration of novel therapeutic strategies such as targeting mast cells and vagal nerve stimulation holds promise for enhanced treatment of postoperative ileus.

Review by Iskander O in Medicine (Baltimore)

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

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Higher Adoption of Best Practices in Minimally Invasive Surgery with Surgical Intelligence

Surgical intelligence led to a significant increase in Critical View of Safety (CVS) adoption in laparoscopic cholecystectomy procedures, reaching 69.2% from 39.2% within six months. Visualization of the cystic duct and artery significantly improved adoption rates. Procedures with full CVS were shorter with fewer events, demonstrating improved efficiency. Surgical intelligence can uncover new insights, modify surgeon behavior, and support best practices to enhance surgical quality and efficiency.

Journal Article by Fried GM, Ortenzi M (…) Wolf T et 5 al. in Ann Surg

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

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Preoperative Biliary Stenting and Persistent Hyperbilirubinemia: Predicting Post-Hepatectomy Complications

Following preoperative biliary stenting, patients with persistent hyperbilirubinemia (>1.2 mg/dl) are at higher risk of serious complications post-anatomic hepatectomy. Persistent hyperbilirubinemia independently predicts increased rates of serious complications and mortality, highlighting its importance in preoperative risk assessment. Failed preoperative biliary drainage serves as a crucial predictive factor for adverse post-operative outcomes in patients undergoing hepatectomy.

Journal Article by Kirkland M, Verhoeff K (…) Dajani K et 5 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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