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Factors influencing one-year mortality in elderly patients undergoing surgery for clinical T4 and locally recurrent rectal cancer

Higher one-year mortality rates were observed in elderly patients undergoing surgery for clinical T4 and locally recurrent rectal cancer. Factors associated with increased mortality included preoperative anemia, total pelvic exenteration, pulmonary complications, and higher grade complications. The main causes of death were failure to recover and disease recurrence. Tailoring treatment for these patients should consider these risk factors to improve survival outcomes.

Journal Article by van Ham NCM, Glazemakers S (…) Bloemen JG et 7 al. in Eur J Surg Oncol

© 2024 Elsevier Ltd, BASO ∼ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

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Self-Expanding Metallic Stenting Emerges as Safe Alternative for Left-Sided Colonic Obstruction

Emergency colonic resection has long been the standard treatment for left-sided malignant colonic obstruction, but self-expanding metallic stenting and decompressing stomas are emerging as viable alternatives. A systematic review and network meta-analysis of randomized controlled trials and propensity score matching studies found that stenting and stomas both significantly reduced permanent stoma rates, with stenting also facilitating minimally invasive surgery and reducing overall morbidity. Stenting also showed lower 90-day mortality compared to resection, making it a safe and effective management strategy.

Journal Article by McHugh FT, Ryan ÉJ (…) Kavanagh DO et 8 al. in Dis Colon Rectum

Copyright © The ASCRS 2024.

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Middle Eastern Study Highlights Non-Operative Management of Epiploic Appendagitis

Epiploic appendagitis (EPA) is a rare, self-limiting acute abdominal disorder that is mostly treated non-operatively. A retrospective analysis of 156 cases in a Middle Eastern country showed that EPA primarily affects males with a mean age of 33 years. Computerized tomographic scans were the main diagnostic tool, with surgery required in only a few cases. Early ultrasound and CT scans are crucial for prompt diagnosis after a high index of suspicion.

Journal Article by El-Menyar A, Naqvi SGA (…) Al-Thani H et 9 al. in World J Surg

© 2024 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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Resection Improves Survival in Patients with Local Recurrence of Esophageal Cancer

Patients with local recurrence of esophageal cancer following Ivor-Lewis esophagectomy have a significantly decreased overall survival. A retrospective study at a high-volume center showed that patients who underwent resection had better survival outcomes compared to those who did not. Chemoradiotherapy also showed promise in selected cases. Best supportive care was associated with shorter survival. These findings highlight the need for personalized treatment strategies and the importance of further prospective studies to optimize patient selection.

Journal Article by Knipper K, Krey T (…) Schmidt T et 9 al. in World J Surg

© 2024 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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Salvage Surgery Vital for Primary Ileal Pouch Leaks

Primary ileal pouch leaks after IPAA procedures are infrequent but challenging complications. Despite attempts at nonoperative management, success rates are limited. Salvage surgery has a high pouch retention rate, emphasizing its importance in leak management. A retrospective study at Cleveland Clinic over 27 years found that patients diagnosed with leaks after IPAA procedures had an average age of 41 years and a majority were male, with a BMI of 24.4 kg/m.

Journal Article by Alipouriani A, Hull T (…) Steele SR et 5 al. in J Gastrointest Surg

Copyright © 2024 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights reserved.

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Significant Risk Factors for Nonalcoholic Fatty Liver Disease Post-Pancreatic Resection

After analyzing 26 studies with 4055 patients, the pooled incidence of nonalcoholic fatty liver disease after pancreatectomy was 29%. Female sex, pancreatic ductal adenocarcinoma, portal vein or superior mesenteric vein resection, dissection of nerve plexus around the superior mesenteric artery, and adjuvant chemotherapy were significantly associated with nonalcoholic fatty liver disease. Pancreatic enzyme replacement therapy was not linked to the condition, suggesting the need for further research on its role in preventing nonalcoholic fatty liver disease post-pancreatic resection.

Review by Sugumar K, Naik L (…) Winter JM et 4 al. in J Gastrointest Surg

Copyright © 2024 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights reserved.

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Disparities in Clinical Trial Enrollment among Patients with Gastrointestinal Cancer: Lower Rates among Minority-Serving Hospitals and Black Individuals

Among over 1 million patients with gastrointestinal cancer, only a small percentage were enrolled in clinical trials, with significantly lower enrollment rates among patients treated at minority-serving hospitals and black individuals. The odds of enrollment in a clinical trial were much lower for patients at minority-serving hospitals compared to non-minority-serving hospitals, and even after controlling for hospital type, black patients were less likely to be enrolled compared to white patients.

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

Copyright © 2024 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights reserved.

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Impact of Sarcopenia on Perioperative Outcomes and Survival After Esophagectomy for Cancer

Patients with preoperative sarcopenia, identified using skeletal muscle index, had higher rates of major complications, including cardiac arrhythmia and mortality. They also had significantly lower overall survival and disease-free survival compared to non-sarcopenic patients. Sarcopenia was found to be an independent risk factor for lower survival on multivariate analysis. Sarcopenia is associated with increased risks of major complications and poorer survival outcomes after esophagectomy for esophageal cancer.

Journal Article by Park JS, Colby M (…) Sandroussi C et 5 al. in J Gastrointest Surg

Crown Copyright © 2024. Published by Elsevier Inc. All rights reserved.

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Religion rarely addressed in preoperative stoma counseling

Healthcare providers at a high-volume academic institution lack training on addressing religious beliefs impacting patients undergoing stoma surgery, with only 35% reporting training on how stomas interact with faith practices. Religious services are rarely present during counseling sessions, and interviewees note difficulties in discussing religious beliefs during preoperative sessions. Lack of support and awareness about existing resources contribute to the overlooking of faith-based issues in perioperative care.

Journal Article by Gomez Zubieta DM, Mubarak E, Messner K and Kwakye G in J Surg Res

Copyright © 2024. Published by Elsevier Inc.

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Residency Program Factors Influence Surgery Board Exam Pass Rates

Program factors such as residency length, resident class size, number of total physician faculty, average hours of didactics per week, and the percentage of residents graduating from US MD programs are associated with improved American Board of Surgery examination pass rates. Older programs, as well as those located in the West and Midwest, tend to perform better on the qualifying exam compared to younger programs in the South and Northeast.

Journal Article by Ray Velez D in Am Surg

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