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Predicting Pancreatic Complications: Machine Learning Triumphs Over Traditional Models.

Researchers crafted an innovative machine learning (ML) model for forecasting clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy. The ML model consistently outshone the existing modified fistula risk score (MFRS) in both internal and external validations, proving its versatility and efficacy in enhancing CR-POPF prediction. This breakthrough offers a more accurate risk stratification tool, potentially guiding tailored treatment strategies for pancreaticoduodenectomy candidates.

Journal Article by Verma A, Balian J (…) Benharash P et 4 al. in Ann Surg

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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Surgery Volume Matters: Risks in Low-Volume Centers for Colorectal Cancer.

A national study analyzing 16,883 cases across 80 centers unveils crucial associations. Low-volume centers show a 50% higher risk of severe postoperative complications, with reduced lymph node removal compared to high-volume centers. In rectal cancer cases, low-volume centers exhibit a 43% lower rate of adequate lymph node removal. Optimal outcomes and comprehensive cancer care advocate for centralizing rectal cancer cases. The study signals a need for strategic centralization to enhance colorectal cancer surgery outcomes.”

Journal Article by Rottoli M, Spinelli A (…) Poggioli G et 5 al. in Br J Surg

© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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Innovative AI Support in Surgery for Laparoscopic Cholecystectomy: Early Clinical Trial Shows Promise.

Surgeons embrace real-time artificial intelligence (AI) assistance for laparoscopic cholecystectomy, overcoming technical and cultural hurdles. The study proves the feasibility of deploying multiple AI models concurrently in operating rooms, offering live assistance during procedures. The research delves into diverse clinical applications, involving a collaborative effort with key stakeholders across disciplines. This marks a significant stride in leveraging AI and surgical digital data to enhance and revolutionize surgical care.

Journal Article by Mascagni P, Alapatt D (…) Padoy N et 5 al. in Br J Surg

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Rethinking Success in Academic Surgery: A Modern Paradigm

In a paradigm-shifting viewpoint, academic surgery is urged to move beyond the traditional ‘triple threat’ model of clinical care, research, and teaching. The study advocates for a more sustainable and individualized approach, recognizing that the evolving healthcare landscape and external pressures make the current model less tenable. Surgeons are encouraged to define success based on personal passion, fostering a healthier and more motivated academic environment. The call is for a modernized paradigm that aligns with the changing dynamics of academic surgery.

Journal Article by Han JJ, Soegaard Ballester JM and Cochran AL in JAMA Surg

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Optimizing Pancreatic Body Cancer Surgery: Distal Pancreatectomy with Portal Resection

For pancreatic body cancers, researchers compared distal pancreatectomy with portal vein resection (DP-PVR) to the more common pancreaticoduodenectomy with PVR. Despite DP-PVR having higher occlusion and complication rates, both approaches showed similar survival outcomes. Meticulous surgical techniques, including various reconstruction methods for DP-PVR, were crucial. The study emphasizes a surgical algorithm based on arterial and portal vein anatomy, aiding in optimal procedure selection and highlighting the importance of careful surgical manipulation for successful outcomes in DP-PVR.

Journal Article by Maekawa A, Oba A (…) Takahashi Y et 11 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Gastric Cancer: Prognostic Impact of Categorized Tumor Deposits

In a gastric cancer retrospective study, researchers classified tumor deposits into distinct types. Of 868 patients, 11.1% had tumor deposits, revealing poorer survival (3-year overall survival: 53.2%) compared to those without (87.0%). Irregular nodule and the tumor deposits complex showed the worst prognosis (3-year overall survival: 41.9%), while smooth nodule displayed a better outcome (3-year overall survival: 80%). The study highlights the negative prognostic impact of tumor deposits in gastric cancer, emphasizing the significance of their categorization.

Journal Article by Hayashi M, Abe M, Fujita T and Matsushita H in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Robotic Triumph: US Study Reveals Advantages in Gastric Cancer Surgery

In the quest for optimal gastric cancer surgery, a study of 11,173 patients in the US compared robotic and laparoscopic gastrectomy. The analysis revealed that robotic gastrectomy (RG) outshone laparoscopic gastrectomy (LG) in terms of adequate lymphadenectomy, negative margins, shorter hospital stay, lower mortality, and superior 5-year overall survival. Propensity score matching affirmed RG’s superiority in lymphadenectomy. This suggests that RG not only matches but potentially surpasses LG, marking a significant stride in the landscape of minimally invasive gastric cancer surgery.

Journal Article by Maegawa FB, Patel AD (…) Lin E et 6 al. in Surg Endosc

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

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Robotic Surgery Revolution: 3D Drawing Annotations Enhance Telementoring

In a groundbreaking study, researchers explored the effectiveness of telementoring in robotic surgery with 3D drawing annotations. Conducted 140 km apart, the study used the Saroa™ surgical robot, evaluating 20 medical students. The 3D annotation group demonstrated potential for shorter working time, fewer retries, and needle drops compared to the control. Notably, they outperformed in the global assessment of robot skills. The study unveils 3D drawing annotations as a game-changer, ensuring better comprehension and smoother operations in telementoring for local surgeons.

Journal Article by Nakanoko T, Oki E (…) Mori M et 16 al. in Surg Endosc

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

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Rare Hemorrhage After Distal Pancreatectomy

In the post-distal pancreatectomy (DP) landscape, researchers explored the rare territory of clinically relevant post-pancreatectomy hemorrhage (CR-PPH). Among 1,188 patients, 5.5% encountered CR-PPH, marked by increased 90-day mortality and morbidity. Prolonged operative time and co-existing postoperative pancreatic fistula independently heightened CR-PPH risk. Strikingly, the failure-to-rescue rate was significantly higher in CR-PPH cases, emphasizing the gravity of managing this uncommon but impactful complication after DP.

Journal Article by Duclos C, Durin T (…) Doussot A et 21 al. in HPB (Oxford)

Copyright © 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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Pancreatic Cancer Diagnosis: FDG-PET/CT Ratio Signals Malignancy in Branch-Duct IPMNs

In the realm of pancreatic branch-duct intraductal papillary mucinous neoplasms (bd-IPMNs), spotting malignancy is tricky. However, researchers delving into 58 cases discovered a game-changer. The standardized uptake value (SUV) from FDG-PET/CT, specifically the tumor-to-blood pool ratio (TBR), emerged as a potent indicator of malignancy. Correlating significantly with histopathology, TBR proved independently significant in scenarios defining high-grade dysplasia and invasive carcinoma or just invasive carcinoma. TBR might be the compass clinicians need for navigating malignant transformations in bd-IPMNs.

Journal Article by Suto H, Ando Y (…) Okano K et 10 al. in HPB (Oxford)

Copyright © 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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