Blog

Navigating Neoadjuvant Therapies for Esophageal Cancer

In the exploration of treatments for advanced esophageal squamous cell carcinoma (ESCC), researchers compared outcomes of neoadjuvant chemotherapy (NCT), neoadjuvant chemoradiotherapy (NCRT), and neoadjuvant immunochemotherapy (NICT). NCRT and NICT groups exhibited superior pathological responses, with higher pathologic complete response rates (29.9% and 23.6%, respectively) compared to NCT (8.1%). NCRT significantly reduced lymph node metastasis in specific stations, highlighting its efficacy in select cases. Tailoring neoadjuvant strategies based on tumor characteristics emerges as crucial for optimizing therapeutic responses in ESCC.

Journal Article by Tian Y, Shi Z (…) Chen Y et 7 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

read the whole article in Ann Surg Oncol

open it in PubMed

Intraperitoneal Paclitaxel Shows Promise: Effective and Tolerable Combo for Gastric Cancer with Peritoneal Metastasis

In a phase II study, researchers explored the efficacy of intraperitoneal paclitaxel combined with S-1 and cisplatin for gastric cancer with peritoneal metastasis. Among 53 patients, the treatment achieved a 73.6% 1-year overall survival rate, meeting the primary endpoint. The median survival time was 19.4 months, and the 1-year progression-free survival rate reached 49.6%. While well-tolerated, with manageable toxicities, the study highlights the potential of this combination therapy for patients facing gastric cancer with peritoneal metastasis.

Journal Article by Kobayashi D, Kodera Y (…) Kitayama J et 21 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

read the whole article in Ann Surg Oncol

open it in PubMed

Insights from Percutaneous Transesophageal Gastro-Tubing in Japan

In a comprehensive study of 3,684 patients undergoing percutaneous transesophageal gastro-tubing (PTEG) in Japan, researchers found a mere 1.3% complication rate. PTEG served diverse purposes, with 1,455 cases for decompression and 2,193 for feeding. Notably, complications led to minimal invasive treatments, predominantly red blood cell transfusions and tube replacements. This real-world analysis not only sheds light on the safety of PTEG but also provides valuable practical insights, emphasizing its viability as an alternative intervention.

Journal Article by Nakama R, Inoue N (…) Fushimi K et 3 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

read the whole article in BMC Surg

open it in PubMed

Impact and Strategies for Unplanned Conversions in Robotic Pancreaticoduodenectomy

In the robotic frontier of pancreaticoduodenectomy, a study of 400 patients revealed a 10.5% unplanned conversion rate. Men, especially, faced this detour, often due to vascular surprises or bleeding challenges. While conversions meant shorter surgeries, they spiked blood loss and complications, with higher mortality rates. Thankfully, conversion rates decreased over time, suggesting growing surgeon proficiency. The study recommends a stepwise approach for safer conversions, underscoring the need for strategic planning in this high-stakes robotic terrain.

Journal Article by Slavin M, Ross SB (…) Rosemurgy AS et 5 al. in Surg Endosc

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

read the whole article in Surg Endosc

open it in PubMed

Beyond CT Scans: Nomogram Outshines in Predicting Lymph Node Metastasis in Colorectal Cancer

In a game-changing move for superficial colorectal cancer, researchers crafted a user-friendly nomogram for personalized lymph node metastasis (LNM) prediction after endoscopic surgery. Analyzing 608 cases, the nomogram trumped traditional CT scans, showcasing superior predictive power, as validated by ROC, DCA, and clinical impact curves. By spotlighting age, tumor features, and lipid levels, this tool shines in risk stratification, offering a noninvasive edge over conventional imaging methods.

Journal Article by Tang CT, Li J (…) Zeng CY et 2 al. in Surg Endosc

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

read the whole article in Surg Endosc

open it in PubMed

Seeing Green: Assessing Indocyanine’s Impact in Surgery Through Meta-Review

Exploring the surge in indocyanine green’s (ICG) role in surgeries, this meta-review of 116 studies uncovered varying ICG applications, from bariatric to urologic procedures. Despite benefits in anastomotic leak prevention, especially in colorectal surgery, and limited advantages in sentinel node detection, the study cautions on methodological shortcomings. Most meta-analyses scored low quality per AMSTAR 2, urging surgeons to approach ICG findings cautiously. The call echoes for standardized protocols and enhanced research methodologies to unleash ICG’s full potential in surgery decision-making.

Review by Pantelis AG, Machairiotis N (…) Drakakis P et 2 al. in Surg Endosc

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

read the whole article in Surg Endosc

open it in PubMed

A Mental Fitness Pilot for Academic Surgeons

In a pioneering initiative, academic surgeons underwent a six-week Positive Intelligence (PQ) training program, aiming to uplift mental fitness and well-being. Results from 15 participants showed significant PQ score improvements (59 to 65), endorsing the program’s impact. High users reported ongoing benefits, fostering a supportive community. While sleep and well-being metrics didn’t significantly shift, the study outlines a promising path for structured mental fitness programs, emphasizing the need for broader evaluations and potential implications on patient outcomes.

Journal Article by Bhat SG, Nagaraj M (…) Levi B et 6 al. in J Surg Res

Published by Elsevier Inc.

read the whole article in J Surg Res

open it in PubMed

Breaking Tradition: Bowel Preparations Questioned in Colo-Rectal Surgeries

In a retrospective dive into 1237 elective colo-rectal surgeries spanning 2008 to 2021, researchers challenged the long-standing use of mechanical bowel preparations (MBPs). No significant differences emerged between patients with MBPs, oral antibiotics, or no preparation, calling into question the routine use of MBPs in these surgeries. This study urges a rethink of the standard-of-care status for MBPs, echoing a shift away from convention in elective colo-rectal procedures.

Journal Article by Leitz-Najarian G and Najarian M in Am Surg

read the whole article in Am Surg

open it in PubMed

Melding Ancient Wisdom with Modern Medicine: Navigating Uncertainty in Transplants

To advance solid organ transplantation, the integration of personalized medicine is paramount. Beyond enhanced risk assessment and diagnostics, there’s a pressing need for targeted therapies and predictive markers. The study advocates a paradigm shift, urging clinicians to embrace uncertainty and probabilistic reasoning. Crucially, effective communication about inherent uncertainties is vital for both healthcare professionals and patients. The study underscores the necessity for a global consensus, emphasizing the collaborative spirit needed to navigate uncertainties in the era of personalized medicine.

Journal Article by Naesens M in Transpl Int

Copyright © 2023 Naesens.

read the whole article in Transpl Int

open it in PubMed

High Stakes for Cirrhotic Patients: Risks Post Emergency Appendicectomy

In England, a cohort study on emergency appendicectomy reveals stark realities for cirrhotic patients. Among 40,353 cases, 75 had cirrhosis, facing a threefold increase in 90-day mortality compared to non-cirrhotic counterparts. Notably older with more comorbidities, cirrhotic patients had prolonged hospital stays (4 vs. 3 days) and higher readmission rates (20% vs. 11%). The 90-day case fatality rate was 6.67%, emphasizing the heightened odds of death, signaling critical implications for cirrhotic individuals undergoing emergency appendicectomy.

Journal Article by Adiamah A, Rashid A (…) Humes DJ et 4 al. in Langenbecks Arch Surg

© 2023. The Author(s).

read the whole article in Langenbecks Arch Surg

open it in PubMed