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Screening Saves: Total Colonoscopy’s Crucial Role in Gastric Cancer Patients

In a study of 796 preoperative gastric cancer patients, 5.4% had synchronous colorectal cancer (SCRC). Endoscopic treatments were successful, and all SCRC patients underwent curative treatment, with no attributed deaths. Cumulative mortality rates showed 12.6% for gastric cancer-related deaths but none for SCRC. Screening total colonoscopy proved effective, suggesting its vital role. Cost-effectiveness analysis revealed a screening cost of 5.86 million yen to prevent one colorectal cancer death compared to non-screened patients.

Journal Article by Koseki Y, Hikage M (…) Bando E et 8 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Histopathologic Insights into Median Arcuate Ligament Syndrome

In a breakthrough study, researchers introduced the first histopathologic grading system for Median Arcuate Ligament Syndrome (MALS). Examining specimens from 36 patients who underwent robotic MALS surgery, the team identified unique nerve and lipogranuloma findings. Histopathologic abnormalities correlated with postoperative improvement, supporting nerve compression and inflammation as key contributors to MALS pain. The study advocates for celiac ganglia resection to alleviate symptoms and emphasizes ongoing histopathologic analysis for a deeper understanding of MALS.

Journal Article by DeCicco J, Raja F, Ganesan S and El-Hayek K in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Shifting Tides: Embracing Total Neoadjuvant Therapy for Advanced Rectal Cancer

Examining trends from 2012 to 2020, researchers unveil that over 50% of 51,407 patients with locally advanced rectal cancer received total neoadjuvant chemoradiation (TNT). Factors like age and comorbidities influenced TNT rates, with stage III patients more likely to undergo it. Notably, TNT usage increased by 38% post-guideline inclusion in 2018. This study not only captures evolving treatment patterns but also establishes a benchmark for future assessments, reflecting a substantial adoption of TNT in rectal cancer care.

Journal Article by Unuvar M, Blansfield J, Wang S and Hoffman RL in Am J Surg

Copyright © 2023. Published by Elsevier Inc.

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Anastomosis Matters: Kono-S Offers Edge in Reducing Recurrence in Crohn’s Disease

Delving into Crohn’s disease post-ileocolic resection, this meta-analysis (17 studies, 2087 patients) compares anastomotic techniques. Endoscopic postoperative recurrence (epor) risk at ≥6 months was 37.2%. Kono-S anastomosis (17.7% cases) outshone conventional methods (81% cases), showing a lower epor incidence (24.7% vs. 42.6%). Results suggest Kono-S reduces epor risk, emphasizing its potential for challenging cases. While promising, larger randomized trials are urged for confirmation, presenting a pivotal shift toward Kono-S for improved Crohn’s postoperative outcomes.

Journal Article by Nardone OM, Calabrese G (…) Iacucci M et 6 al. in Inflamm Bowel Dis

© The Author(s) 2023. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
© The Author(s) 2023. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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Cracking the Code: Gastrojejunal Anastomosis Holds Clues to Weight Regain in Gastric Bypass Graduates

Researchers delved into the post-gastric bypass world, unraveling the mystery of weight regain (WR). Examining 34 Roux-en-Y gastric bypass alumni, they discovered a correlation between the gastojejunal anastomosis (GJA) diameter and WR. However, excluding outliers with GJA over 30 mm nullified the link. The study highlights the potential of visual GJA estimation and emphasizes that more pliable GJAs (with higher distensibility index) in a subset of patients correlate with reduced WR rates, unlocking insights for clinical management pending larger confirmatory studies.

Journal Article by Razzak FA, Kerbage A (…) Dayyeh BA et 7 al. in Obes Surg

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

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Robotic Surgery Linked to Lower Postoperative Infections and Shorter Hospital Stays in Pancreatoduodenectomy

In a retrospective study spanning 2013 to 2022, researchers delved into healthcare-associated infections (HAIs) post-pancreatoduodenectomy (PD). Among 2632 patients, HAIs decreased over time, especially in open PD (OPD). Robotic PD (RPD) exhibited significantly fewer HAIs (5.8% vs. 9.6% in OPD). RPD correlated with reduced infections, shorter hospital stays, and higher costs. Notably, attention should be directed at curbing infections in OPD, while efforts to trim RPD expenses persist.

Journal Article by Yu ZH, Du MM (…) Yao HW et 7 al. in J Gastroenterol Hepatol

© 2023 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

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Gallbladder Polyps: Size Matters in Predicting Cancer Risk

In this cohort study on 438 patients with gallbladder polyps (GPs), the risk of gallbladder cancer was 0.7% for all polyps, escalating to 5.9% for those ≥10 mm. GP size emerged as the sole predictor of malignancy (p = 0.0001), with a 21 mm cutoff indicating cancer risk. Patient’s age, symptoms, number of polyps, and changes in size were not predictive. The mean polyp growth rate was 0.3 mm/year, and 16% disappeared, prompting protocol adjustments favoring reduced scans and early discharge.

Journal Article by Hajibandeh S, Ashar S (…) Kumar N et 2 al. in J Gastroenterol Hepatol

© 2023 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

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Big Data Shapes Future of Hepatopancreatobiliary Cancer Surgery

In the realm of surgical oncology, randomized controlled trials (RCTs) often face recruitment and standardization challenges. This study dives into hepatopancreatobiliary (HPB) cancer surgery, spotlighting the pivotal role of large databases. While RCTs provide crucial evidence, big data steps in where they fall short. Beyond justifying current practices, this research maps the future of HPB oncology, leveraging expansive datasets to unravel complexities, inform health policies, and address gaps inaccessible to traditional trials.

Review by Shrikhande SV, Kunte AR (…) Bhandare MS et 2 al. in J Surg Oncol

© 2023 Wiley Periodicals LLC.

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Survival in the Spotlight: 3-Year Encore for TPF Therapy in Esophageal Cancer

Researchers belted out a 3-year follow-up tune on the NEOCRTEC-1601 stage, where docetaxel, cisplatin, and fluorouracil (TPF) took the spotlight. For those with borderline-resectable esophageal squamous cell carcinoma (BR-ESCC), the act featured 54.4% survival rates at the 3-year mark. Surgery danced into the spotlight for 57.4% of patients, confirming TPF’s encore as a promising rhythm in the survival score for BR-ESCC.

Journal Article by Wu JD, Wang ZQ (…) Yang H et 7 al. in Ann Surg Oncol

© 2023. The Author(s).

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Omentectomy Dilemma: Radical Move or Not for Gastric Cancer?

Researchers staged a retrospective showdown between total omentectomy (TO) and partial omentectomy (PO) in the radical gastrectomy arena for advanced gastric cancer (AGC) with serosal invasion. The verdict? No VIP pass for TO in preventing peritoneal recurrence. PO stole the spotlight with comparable recurrence-free survival and a better 5-year overall survival. Turns out, for T4a gastric cancer, a little less radical might still be radical enough.

Journal Article by Jeong SA, Kim S (…) Kim BS et 2 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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