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Limited Prognostic Impact of Preoperative TACE in Large HCC

Neoadjuvant transarterial chemoembolization (TACE) in upfront resectable large hepatocellular carcinoma (HCC) did not significantly impact long-term outcomes overall, but showed improved overall survival in HCC ≥10 cm and a trend in single HCC and after portal vein embolization/ligation. TACE should not be routinely performed in all cases, but selected patients with specific characteristics such as large and single tumors or those requiring portal vein embolization could potentially benefit from this approach.

Journal Article by Giannone F, Felli E (…) Pessaux P et 12 al. in HPB (Oxford)

Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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Higher social vulnerability linked to reduced surgery access and increased mortality in localized colon cancer patients.

The study aimed to investigate the impact of social vulnerability on treatment and survival outcomes in localized colon cancer patients. They found that higher social vulnerability was associated with reduced odds of receiving surgery and increased mortality. Patients under the age of 65 were particularly sensitive to variations in social vulnerability. These results underscore the importance of addressing community-level vulnerability to improve access to surgical care and reduce mortality rates.

Journal Article by Meier J, Murimwa G (…) Polanco P et 5 al. in Ann Surg

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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ABO Blood Type Does Not Impact Coagulopathy or Mortality in Exsanguinating Trauma Patients

Despite previous reports linking blood group O to increased hemorrhage complications, this study found no significant differences in coagulopathy or mortality between ABO blood types in patients with exsanguinating trauma. After adjusting for confounding factors, type A patients were more likely to be hypocoagulable than type O patients, suggesting factors other than von Willebrand factor expression may play a role in trauma-induced coagulopathy.

Journal Article by Gwin JC, Rangnekar N (…) Howley IW et 5 al. in Am J Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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Does Initial Observation vs. Interventional Radiology Impact Management of High-Grade Liver Injuries with Extravasation?

Patients with high-grade liver injuries and contrast extravasation managed initially with observation versus interventional radiology were compared. While interventional radiology patients had a higher rate of operation, there were similar rates of liver-related complications and mortality between the two groups. The results suggest that initial observation may be a reasonable approach for appropriately selected patients with high-grade liver injuries and extravasation.

Journal Article by Aryan N, Grigorian A (…) Nahmias J et 46 al. in Am J Surg

Copyright © 2024. Published by Elsevier Inc.

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Decrease in Preoperative Testing Rates for Low-Risk Patients Post Guideline Implementation

After the American Society of Anesthesiologists recommended against routine preoperative laboratory testing for low-risk patients, there was a significant decrease in testing rates. In low-risk patients, the percentage of those receiving tests dropped by 6.9% post-guidelines implementation, while higher-risk patients saw only a 1.1% reduction. Lack of testing in low-risk patients did not result in worse outcomes, suggesting the need for continued efforts towards deimplementation of unnecessary tests.

Journal Article by Stuart CM, Bronsert MR (…) Henderson WG et 6 al. in World J Surg

© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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Young males with papillary thyroid cancer under 40 show increased nodal metastasis but similar recurrence rates

Young males under 40 with papillary thyroid cancer exhibit higher rates of nodal metastasis compared to older males and females. However, they experience similar recurrence rates at 1 year as their female and older counterparts. No significant differences were found in other outcomes such as 30-day outcomes, reoperation, mortality, nerve injury, or hypocalcemia, highlighting the predictive role of sex and age in advanced papillary thyroid carcinoma cases.

Journal Article by Hood C, Zmijewski PV (…) Gillis A et 6 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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Which Diagnostic Pathway is Most Effective in Suspected Acute Appendicitis?

Combining clinical score and ultrasound outperformed CT scan or upfront surgery in diagnosing acute appendicitis, especially in equivocal cases. The study included 3,123 patients, with the best balance of sensitivity and specificity seen in the clinical evaluation + score + ultrasound group. Ultrasound was significantly associated with an increased probability of correctly diagnosing appendicitis, particularly in cases where the clinical score was unclear. This approach could be particularly beneficial in low-resource settings worldwide.

Journal Article by Coccolini F, Martinez-Perez A (…) Chiarugi M et 7 al. in World J Surg

© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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Improving Surgery-Specific Goals of Care Discussions in the Preoperative Setting

During a pilot study, surgeons and advanced practice providers utilized a template for goals of care discussions in the preoperative setting for gynecologic surgical oncology patients. The template improved documentation of topics of discussion, patient values, and advance care planning. Despite positive perceptions, implementation barriers were identified, highlighting the need for iterative revisions to enhance workflow utility.

Journal Article by Letica-Kriegel AS, Rosen R (…) Nash GM et 14 al. in J Surg Oncol

© 2024 Wiley Periodicals LLC.

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Effective guidance for safe laparoscopic total gastrectomy in remnant gastric cancer using indocyanine green fluorescence imaging

Researchers successfully performed laparoscopic total gastrectomy in two cases of remnant gastric cancer using intraoperative indocyanine green fluorescence imaging. The technique allowed visualization of the liver and common bile duct, leading to safe dissection of severe adhesions between hepatobiliary organs and the remnant stomach. This novel approach resulted in successful surgeries without complications, demonstrating the potential utility of real-time indocyanine green fluorescence imaging in guiding laparoscopic procedures for remnant gastric cancer with severe adhesions.

Journal Article by Yamazaki K, Mochizuki K (…) Aoki T et 2 al. in Am Surg

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Key Factors Impacting Timely Receipt of Appropriate Surgery for Stage 3 Colon Cancer

Research found that patients who are non-Hispanic white, younger, have fewer comorbidities, lower household income, and receive surgery at a community cancer program within 50 miles of their primary residence are more likely to undergo timely surgery for stage 3 colon cancer. These factors play an important role in reducing the time to surgery and ensuring appropriate treatment in traditionally marginalized populations.

Journal Article by Tobin EC, Dobbs E, Deslich S and Richmond BK in Am Surg

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