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Impact of Conversion Surgery on Patients Responding to Immunotherapy for Unresectable Biliary Tract Cancer

Conversion surgery significantly improves survival outcomes in patients with positive responses to PD-1/PD-L1 inhibitor-based combined therapy for unresectable biliary tract cancer. Median progression-free survival and overall survival were significantly longer with conversion surgery compared to continued systemic therapy alone. The estimated 3-year survival rates post-surgery are promising, highlighting the potential benefits of this intervention in this patient population.

Journal Article by Wang S, Wang Y (…) Zhao H et 12 al. in Int J Surg

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

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Utilizing Mediastinal Drains Alone After Esophageal Cancer Surgery

Utilizing mediastinal drains alone post-esophageal cancer surgery is safe and reduces postoperative pain. It can potentially replace closed thoracic drains, showing comparable results in terms of hyperthermia, leukocytes, drainage, hospitalization, and pulmonary complications. Early detection of abnormal drainage fluid is a significant benefit, with no increase in anastomotic leakage incidence or mortality rates.

Journal Article by Li Y, Zhang D and Zhao D in World J Surg Oncol

© 2024. The Author(s).

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Risk Factors Analysis for Motorcycle Crashes in Barcelona

Alcoholism, poor road conditions, and speeding contribute to severe injuries in motorcycle crashes in Barcelona. Elderly riders are less at risk, while those aged 25-40 face higher odds of injury. Both supervised and unsupervised techniques effectively identify these risk factors, emphasizing the need for enhanced road maintenance and speed enforcement to improve motorcyclists’ safety.

Journal Article by Aiash A and Robusté F in Eur J Trauma Emerg Surg

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

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Surgical and Anesthesiology Departments Adaptations During COVID-19 Pandemic

Surgical and anesthesiology departments in high-income countries adapted to COVID-19 through staffing changes and task-shifting. A scoping review of 108 articles revealed these common strategies, emphasizing that well-resourced surgical systems were more resilient during the pandemic. However, the absence of reports from low-income countries suggests a gap in understanding their responses. Strengthening surgical systems could enhance future disaster preparedness.

Review by Hey MT, Carroll M (…) Anderson GA et 13 al. in Am J Disaster Med

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Transversus Abdominis Plane Block vs. Wound Infiltration for Pain Control After Laparoscopic Cholecystectomy

Ultrasound-guided subcostal approach of transversus abdominis plane (STAP) blocks offers superior postoperative analgesia compared to wound infiltration (WI) in patients undergoing laparoscopic cholecystectomy (LC). A meta-analysis of 6 randomized controlled trials (RCTs) with 314 participants showed significantly lower 24-hour opioid consumption and reduced pain scores in the STAP group. The incidence of postoperative nausea and vomiting (PONV) did not differ significantly between the two groups. Further robust trials are needed to validate these findings.

Comparative Study by Park S, Park JH (…) Choi YS et 3 al. in Medicine (Baltimore)

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

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Impact of Hospital Volume and Risk-Standardized Mortality Rate on Complex Oncologic Surgery Outcomes

High-volume and high-performance centers had lower risk-standardized mortality rates for hepato-pancreatobiliary procedures. Redistributing patients based on risk-standardized mortality rate may save more lives compared to volume-based redistribution. These findings suggest that risk-standardized mortality rate may be a superior measure of hospital quality in complex oncologic surgery.

Journal Article by Julian WT, Elshami M (…) Ocuin LM et 2 al. in Ann Surg Oncol

© 2024. The Author(s).

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Endoscopic Resection for Intermediate- or High-Risk Gastric Gastrointestinal Stromal Tumors

Endoscopic resection is a safe and effective method for treating intermediate- or high-risk gastric small gastrointestinal stromal tumors, with a 5-year overall survival rate of 97.4%. Close follow-up is necessary for these patients, but there were no recurrences or metastases observed, even among those with R1 resections. This approach allows for a wait-and-see strategy before considering adjuvant therapy or surgery.

Journal Article by Xu E, Shi Q (…) Zhong Y et 13 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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Caffeine Consumption and Bowel Recovery After Colorectal Surgery

A meta-analysis of eight studies with 610 patients found that caffeine intake after colorectal surgery significantly reduces time to first bowel movement and time to first solid food intake. The data suggest that postoperative caffeine consumption can be a useful strategy to prevent postoperative ileus. However, time to first flatus, length of hospital stay, and postoperative morbidity did not significantly differ between caffeinated and non-caffeinated groups. Further large-scale randomized controlled trials are needed to determine optimal caffeine dosing and form.

Journal Article by Vaghiri S, Prassas D (…) Krieg A et 2 al. in Updates Surg

© 2024. The Author(s).

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Quality Assessment of Meta-Analyses on the WHO Surgical Safety Checklist

Meta-analyses show that the WHO Surgical Safety Checklist is associated with lower complication and mortality rates. However, the studies in these analyses were mostly observational, with potential biases, leading to critically low overall confidence in the results. Using the AMSTAR 2 assessment tool, the systematic review highlighted the limitations in statistical methods and publication bias. Continued evaluation of the WHO checklist is essential to ensure patient safety and the validity of these results.

Journal Article by González Mariño MA in Ann Med Surg (Lond)

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

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Prognostic Biomarkers in Locally Advanced Rectal Cancer Patients

This study of 245 patients with locally advanced rectal cancer (LARC) found that post-treatment blood markers, such as platelet-to-lymphocyte ratio (PLR), predicted pathological complete response. The neutrophil-to-lymphocyte ratio (NLR) at two treatment timepoints significantly predicted overall survival, while the platelet-neutrophil (PN) index was associated with disease-free survival. In patients with pathological stage II, the PN index identified those at higher risk for disease recurrence. These blood parameters could help stratify LARC patients for targeted therapeutic strategies beyond traditional tumor node metastasis (TNM) staging.

Journal Article by Morais M, Fonseca T (…) Carneiro S et 5 al. in Ann Med Surg (Lond)

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

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