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Surgeon-Patient Sex Discordance Hinders Optimal Outcomes in Complex Cancer Surgery

Analyzing 495,628 patients undergoing complex cancer surgery, researchers found that sex discordance between surgeons and patients (51.2%) was linked to a decreased likelihood of achieving optimal postoperative outcomes. Such discordance correlated with higher risks of complications and 90-day mortality. Intriguingly, male patients treated by female surgeons exhibited outcomes comparable to female patients treated by male surgeons, emphasizing the impact of sex concordance on postoperative courses in cancer surgery.

Journal Article by Khan MMM, Munir MM (…) Pawlik TM et 7 al. in J Surg Oncol

© 2023 The Authors. Journal of Surgical Oncology published by Wiley Periodicals LLC.

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Tailoring Prophylaxis in Crohn’s Disease Surgery: Real-world Insights into Risk Factors and Recurrence

Examining 1404 Crohn’s disease patients post-ileocecal resection, researchers identified high-risk factors for surgical recurrence (multiple surgeries, active smoking, penetrating or perianal disease). Biologic prophylaxis post-surgery lowered surgical recurrence in high-risk patients. Additionally, prophylaxis reduced endoscopic recurrence regardless of risk, suggesting its potential benefits across risk profiles. These findings emphasize the relevance of individualized prophylactic approaches in postoperative Crohn’s disease management.

Journal Article by Shah RS, Bachour S (…) Click BH et 15 al. in Clin Gastroenterol Hepatol

Published by Elsevier Inc.

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ECCO Workshop Yields Postoperative Management Algorithm for Crohn’s Disease Patients

The 8th ECCO scientific workshop addressed postoperative recurrence (POR) in Crohn’s disease after ileocolonic resection. Despite modern therapies, POR remains a challenge, impacting patients’ lives. The workshop extensively reviewed data on preventive and treatment strategies, including medications, endoscopic procedures, and surgery. Synthesizing available knowledge, the workshop produced a practical algorithm for managing POR in daily clinical practice, providing a valuable guide for clinicians navigating the complexities of postoperative Crohn’s disease care.

Journal Article by Ferrante M, Pouillon L (…) Domènech E et 11 al. in J Crohns Colitis

© The Author(s) 2023. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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Prophylactic Dexamethasone in Hepatectomy with 25-Min Intermittent Pringle’s Maneuver for Hepatocellular Carcinoma: A Randomized Trial

In hepatectomy for hepatocellular carcinoma (HCC) using a 25-minute Intermittent Pringle’s Maneuver (IPM), preoperative dexamethasone administration demonstrated benefits. The study included 270 patients, with the dexamethasone group exhibiting reduced hepatocellular injury, inflammatory response, and major complications, along with shorter hospital stays compared to the control group. Notably, subgroup analyses indicated milder hepatocellular injury for cirrhotic patients and reduced inflammatory response for non-cirrhotic patients. Preoperative dexamethasone administration proved effective in improving perioperative outcomes in HCC patients undergoing hepatectomy with a 25-minute IPM.

Journal Article by Huang Y, Xu L (…) Jiang L et 4 al. in Int J Surg

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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Mutation-Annotated Prognostic Score for Intrahepatic Cholangiocarcinoma: Development and Validation

Researchers developed a Mutation-Annotated Prognostic Score (MAPS) for intrahepatic cholangiocarcinoma (ICC) after resection, integrating TP53 and KRASG12 mutations with clinical parameters. The MAPS model, validated internally and externally, demonstrated superior predictive efficacy (c-indices 0.782 and 0.731, respectively) compared to existing models. It effectively identified ICC patients’ overall survival and showed promise in predicting benefits from upfront surgery and adjuvant therapy, providing a valuable tool for personalized prognostication and treatment decision-making.

Journal Article by Wang XY, Zhu WW (…) Qin LX et 14 al. in Int J Surg

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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Minimally Invasive Distal Pancreatectomy Outcomes for Left-Sided Tumors: Impact of Modified Frailty Index

Examining 2,212 patients undergoing minimally invasive distal pancreatectomy (MIDP) for left-sided tumors, this study categorized participants into frail and nonfrail groups using the modified frailty index (MFI). The frail group (n=79) exhibited significantly higher clinically relevant postoperative pancreatic fistula, overall complications, and 90-day mortality (1.3%). MFI ≥0.27, extended pancreatectomy, BMI ≥30 kg/m², male sex, and malignancy were identified as risk factors for severe postoperative complications. MFI emerges as a valuable preoperative predictor for adverse outcomes in MIDP.

Journal Article by Park Y, Hwang DW (…) Kim SC et 5 al. in Int J Surg

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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Short-Term Outcomes of Laparoscopic Anatomical Liver Resection of Segment 8 for Hepatocellular Carcinoma

Examining 122 patients across seven Chinese centers, researchers evaluated three laparoscopic approaches for anatomical liver resection of segment 8 (LALR-S8) in hepatocellular carcinoma. The laparoscopic ultrasonography-guided, hepatic vein-guided, and Glissonean approaches showed comparable short-term oncological outcomes. Complication rates were low (5.73%), with the hepatic vein-guided approach being the most utilized. The study affirms the safety and feasibility of LALR-S8, emphasizing standardized techniques and suitable surgical approaches for hepatocellular carcinoma treatment.

Journal Article by Wang X, Li J (…) Wang H et 12 al. in Int J Surg

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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Minimally Invasive Surgery vs. Laparotomy for Nonmetastatic pT4a Colorectal Cancer: Propensity Score Analysis

Analyzing 634 nonmetastatic pT4a colorectal cancer patients (2015–2021), researchers compared minimally invasive surgery (MIS) and laparotomy outcomes. MIS exhibited lower blood loss, quicker recovery parameters, and a 3.5% conversion rate. After 5 years, MIS showed comparable overall survival (72.7%) and disease-free survival (72.2%) to laparotomy. Multivariate analysis identified age, lymph node metastasis, and carcinoembryonic antigen levels as independent variables for overall survival, while lymph node metastasis and CA125 levels were relevant for disease-free survival. MIS proves safe, accelerates recovery, and doesn’t compromise oncological outcomes.

Journal Article by Guo HL, Chen JY (…) Wu WH et 5 al. in Int J Surg

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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Prognostic Significance of Circumferential Radial Margin in Esophageal Cancer Resection

Examining esophagectomy outcomes for pathologic T3 esophageal cancer (n=519, 2000–2019), researchers categorized patients based on circumferential radial margin (CRM) involvement. CRM+ (tumor at CRM) correlated with shorter disease-free survival (DFS) and overall survival (OS) compared to CRM-. CRM-close (tumor >0 to 1 mm from CRM) showed similar outcomes to CRM-. After adjustments, College of American Pathologists (CAP)+ was linked to poorer outcomes, while Royal College of Pathologists (RCP)+ was not. CRM status proves critical for prognosis, emphasizing its significance in esophageal cancer surgery.

Journal Article by Boerner T, Carr R (…) Molena D et 15 al. in Int J Surg

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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Process 2023 Guidelines: Enhancing Reporting Quality in Surgical Case Series

The Process 2023 Guidelines, aimed at improving reporting quality in surgical case series, underwent updates through collaboration and a Delphi consensus exercise. Involving a steering group and expert panel, the majority of proposed changes received consensus, leading to the presentation of updated guidelines. Notably, items 3c and 6a, lacking consensus, remain unchanged. With participation from 38 contributors, the Process 2023 Guidelines continue their mission to elevate the standards of case series reporting in surgery.

Journal Article by Mathew G, Sohrabi C (…) Agha R et 3 al. in Int J Surg

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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