Comparing outcomes in patients with exsanguinating injuries, a study found prioritizing circulation over intubation led to significantly lower 24-hour mortality (11.1% vs. 69.2%), reduced odds of mortality within 24h (91%), and at 30 days (89%), along with lower rates of renal failure and higher ARDS incidence. These results highlight the potential benefits of prioritizing circulation in managing such injuries.
© 2024. The Author(s).
Clinicians evaluated the safety and efficacy of combining a programmed cell death 1 (PD-1) inhibitor with oxaliplatin plus S-1 (SOX) for treating Borrmann large type III and IV gastric cancers. In this retrospective analysis involving 89 patients, those who received PD-1 combined with SOX (P-SOX) had a significantly higher pathological response rate (42.86% with tumor regression grade 0/1) compared to those who received only SOX. This suggests that a PD-1 inhibitor combined with SOX could improve tumor regression rates during neoadjuvant therapy for patients with advanced gastric cancers.
Clinical Trial by Bao ZH, Hu C (…) Cheng XD et 5 al. in World J Gastrointest Oncol
©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Clinicians developed a preoperative checklist to support clinical risk assessment and patient selection for patients with ulcerative colitis considering ileoanal pouch surgery (IPAA). The checklist includes risk factors such as gender, advanced age, obesity, comorbidities, sphincteric impairment, Crohn’s disease, and pelvic radiation therapy. It also incorporates crucial steps in the decision-making process, like pouch nurse counselling and discussing surgical alternatives. The final step is discussion at a dedicated pouch multidisciplinary team (MDT) meeting. This checklist aims to improve patient selection and inform MDT case discussions.
Journal Article by Alves Martins BA, Shamsiddinova A (…) Faiz O et 9 al. in Frontline Gastroenterol
© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.
Effective maintenance therapies for Crohn’s disease post-surgery include 5-aminosalicylic acid, adalimumab, and thiopurine analogues. Cochrane reviews show these agents have varying levels of efficacy in preventing recurrence after surgery, with 5-ASA being probably more effective than placebo and adalimumab showing promise in network meta-analysis. Clinicians should consider these findings when discussing treatment options with patients, although further research on other therapies is needed due to low certainty of evidence.
Review by Gordon M in Frontline Gastroenterol
© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.
Researchers used machine learning (ML) to quantify cumulative ileal injury on CT-enterography (CTE) scans for patients with ileal Crohn’s disease (CD) to predict future bowel surgery. Analysis of 229 CTE scans with 8,424 mini-segments revealed strong agreement between ML and radiologists in grading bowel injury (κ=0.80), similar to inter-radiologist agreement (κ=0.87). Cumulative injury scores were higher in CD biologic users who underwent future surgery. Models using cumulative spatial metrics (AUC=0.76) outperformed those with conventional bowel measures (AUC=0.62). This approach may improve outcome prediction and aid personalized bowel assessment in CD.
Journal Article by Stidham RW, Enchakalody B (…) Wasnik AP et 4 al. in Am J Gastroenterol
Copyright © 2024 by The American College of Gastroenterology.
This study explored how the COVID-19 pandemic affected medical student education in surgery clerkships. Most directors shifted to virtual platforms and then back to in-person learning. Student preparation and progression were impacted, but interest in surgical careers remained stable. Despite initial challenges, the pandemic led to positive changes in virtual patient encounters, didactics, and student performance, highlighting opportunities for future research.
Journal Article by Spanknebel K, Ellison EC (…) Sachdeva AK et 9 al. in J Am Coll Surg
Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.
Researchers examined the impact of metabolic bariatric surgery (MBS) on cardiovascular diseases (CVDs) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). An analysis of the National Inpatient Sample from 2016 to 2020 revealed that MBS was significantly associated with a lower risk of hospitalization for various CVDs, including coronary artery disease, acute myocardial infarction, percutaneous coronary intervention, and thrombolysis. MBS also reduced the risk of hemorrhagic stroke and heart failure, although it did not significantly affect ischemic stroke risk.
Journal Article by Esparham A, Shoar S (…) Modukuru VR et 2 al. in Obes Surg
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Mindfulness interventions show promise in reducing perioperative pain and opioid use, offering a non-pharmacological approach to improve outcomes following surgery. Evidence suggests that brief mindfulness sessions preoperatively can alleviate pain and anxiety, while more extensive interventions postoperatively may help patients with persistent pain or prolonged opioid use. Understanding the psychophysiological mechanisms behind mindfulness is essential for enhancing pain management strategies.
Journal Article by Roberts RL, Hanley AW and Garland EL in Am Surg
Virtual reality (VR) is more effective than standard iPad use in decreasing pain after surgery in pediatric patients. A randomized controlled study found that patients using VR experienced lower pain scores and decreased opioid consumption compared to those using iPads. Younger patients benefited more from VR intervention during the immediate postoperative period.
Journal Article by Specht BJ, Buse CR (…) Lupa MC et 8 al. in Am Surg
The study evaluated the effectiveness of endoscopic ultrasound (EUS) in predicting colorectal invasion in patients with pelvic masses. EUS showed high diagnostic accuracy with sensitivity of 83.3% and specificity of 97.8%. It is recommended for preoperative diagnosis by gynecologists to determine suitable surgical methods and avoid unexpected situations during surgery.
Journal Article by She Y, Sun S and Ge N in Int J Surg
Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.