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Interpretable machine learning-based clinical prediction model for predicting lymph node metastasis in patients with intrahepatic cholangiocarcinoma

Researchers developed and validated machine learning-based predictive models for lymph node metastasis (LNM) in intrahepatic cholangiocarcinoma (ICC) using clinicopathological data from 345 patients. The study used six machine learning algorithms, identifying the Extreme Gradient Boosting (XGB) model as the best, with an average area under the curve (AUC) of 0.908. Factors such as alcoholic liver disease, smoking, boundary, tumor diameter, and white blood cell count were identified as significant predictors. A web calculator based on the XGB model was created to help clinicians predict LNM and tailor treatment plans.

Journal Article by Xie H, Hong T (…) Lv X et 9 al. in BMC Gastroenterol

© 2024. The Author(s).

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Impact of Repeated EGD at Specialized Center on Surgical Strategy for Gastroesophageal Cancer

A multicenter retrospective study evaluated the benefits of repeating esophagogastroduodenoscopy (EGD) at specialized esophagogastric cancer (EGC) centers in Denmark before gastric and esophageal cancer surgery. Among 953 patients who underwent both initial EGD and EGD at referral to a specialized center, 644 cases (68%) lacked sufficient preoperative tumor information from the initial EGD, and 113 cases (12%) required significant changes in surgical strategy based on the specialized EGD findings. The results indicate that repeated EGD at a specialized center can improve surgical planning for gastroesophageal cancer.

Journal Article by Christensen AK, Egeland C (…) Achiam MP et 6 al. in Scand J Surg

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Enhancing Diagnosis of Acute Appendicitis: Combined Modified Alvarado Score and Ultrasound Study

A prospective study combines ultrasound with the Modified Alvarado Score (MAS) for acute appendicitis diagnosis. Among 55 patients undergoing appendectomy, the combined MAS demonstrated high sensitivity (98.18%) and accuracy (89.09%), outperforming MAS and ultrasound alone. This approach, requiring no additional financial burden, presents a promising alternative to CT/MRI imaging, especially in resource-limited settings, warranting further validation.

Journal Article by Sirpaili S, Rajthala L (…) Shrestha E et 4 al. in Ann Med Surg (Lond)

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

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Postoperative Mortality Among Patients in Ethiopia

A systematic review and meta-analysis examined postoperative mortality in Ethiopia, revealing a pooled mortality rate of 4.53% (95% CI: 3.70-5.37). Significant factors associated with increased mortality included an American Society of Anesthesiologists score of ≥III (AOR: 2.45, 95% CI: 2.02-2.96), age ≥65 years (AOR: 3.03, 95% CI: 2.78-3.31), and comorbidity (AOR: 3.28, 95% CI: 1.91-5.63). The findings suggest that the Ministry of Health and other relevant bodies should focus on quality improvement to reduce postoperative mortality.

Review by Tsehay YT, Bogale AD (…) Belayneh AG et 10 al. in Ann Med Surg (Lond)

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

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Artificial Intelligence for Predicting Lymph Node Metastases in Early-Stage Colorectal Cancer

Artificial intelligence models demonstrated high accuracy levels in predicting lymph node metastasis in early-stage colorectal cancers, outperforming traditional clinical guidelines. With models such as support vector machine and deep learning, there is potential for refining clinical decisions and improving outcomes in this critical area of cancer treatment.

Journal Article by Thompson N, Morley-Bunker A (…) Eglinton T et 2 al. in BJS Open

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

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Effectiveness of Micronized Purified Flavonoid Fraction in Posthemorrhoidectomy Period

In this open-label randomized trial, researchers assessed the efficacy of micronized purified flavonoid fraction in reducing posthemorrhoidectomy complications. Fifty patients who underwent hemorrhoidectomy were divided into two groups: a control group receiving standard care and a study group receiving standard care plus micronized purified flavonoid fraction. The study group experienced significantly lower rates of thrombosis and edema of mucocutaneous bridges and reported improved patient-assessed treatment effect. However, there was no significant difference in pain intensity between the groups.

Video-Audio Media by Medkova YS, Tulina I (…) Tsarkov P et 5 al. in Dis Colon Rectum

Copyright © The ASCRS 2024.

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Long-Term Survival Benefits of Surgery with HIPEC for Perforated Low-Grade Appendiceal Mucinous Neoplasms

Study demonstrates that combining surgery with HIPEC significantly improves 5- and 10-year overall survival rates and relapse-free survival of LAMN perforation patients without impacting short-term outcomes. Analysis of 91 patients revealed higher survival rates in the HIPEC group compared to non-HIPEC group, highlighting the potential impact of this combined approach on patient outcomes.

Research Support, Non-U.S. Gov’t by Han Z, Liu X (…) Zhou Y et 15 al. in World J Surg

© 2023 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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Association between Lymph Node Status on FDG-PET and Prognosis in Esophageal Cancer Patients

Fluorodeoxyglucose positron emission tomography (FDG-PET) effectively predicts lymph node status and prognosis in patients with esophageal squamous cell carcinoma (ESCC) undergoing esophagectomy after neoadjuvant chemotherapy (NCT). Researchers reviewed data from 124 ESCC patients and found that FDG-PET pre- and post-NCT correlated significantly with pathological lymph node metastasis, with post-NCT assessments serving as an independent predictor of both recurrence-free survival and overall survival. This indicates that FDG-PET can guide individualized treatment strategies in ESCC patients.

Journal Article by Ohsawa M, Hamai Y (…) Okada M et 6 al. in World J Surg

© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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Modified Mesohepatectomy for Congenital Biliary Dilatation

Modified mesohepatectomy offers a safe and beneficial alternative to trisectionectomy for treating bilobar congenital biliary dilatation. It results in higher residual liver volume, lower parenchyma resection rate, reduced complications, and optimal long-term outcomes, making it a valuable option for patients ineligible for major hepatectomy or transplantation.

Comparative Study by Jin S, Jiang N (…) Dong JH et 7 al. in World J Surg

© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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Optimizing Perioperative Management in Acute Biliary Disease

Standardizing process in acute biliary disease, researchers identified modifiable factors impacting patients’ time to theater, intraoperative time, and time to discharge. Implementing a perioperative management protocol based on imaging selection, operative grade identification, and drain placement could lead to significant cost savings and improved patient outcomes.

Journal Article by Tranter-Entwistle I, Eglinton T and Connor S in World J Surg

© 2023 The Authors. World Journal of Surgery published by John Wiley & Sons Ltd on behalf of International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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