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Effective Treatment for Gastric Cancer with Peritoneal Metastasis

A study examined cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) using paclitaxel and cisplatin in 22 patients with gastric cancer and peritoneal metastasis. Results showed that this treatment was well-tolerated with favorable oncologic outcomes. Patients experienced high rates of complete cytoreduction and R0 resection, and the treatment led to promising survival rates. Major complications were limited, and no deaths occurred within 90 days of the procedure. This approach shows promise in improving the prognosis for gastric cancer patients with peritoneal metastasis.

Journal Article by Buckarma E, Thiels CA, Jin Z and Grotz TE in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Shifting Trends in End-of-Life Care: Where Colorectal Cancer Patients Die in the US

Researchers investigated the locations of death among colorectal cancer (CRC) patients in the United States, aiming to identify determinants and trends. From 2003 to 2019, they observed a shift from hospital and institutional settings toward home and hospice as preferred places for end-of-life care. However, disparities existed among racial and educational groups, with non-white and less-educated individuals less likely to die at home or in hospice. This highlights the need for equitable end-of-life care policies to address healthcare disparities in CRC patients.

Journal Article by Sonal S, Jain B (…) Berger DL et 11 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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New Surgical Guidelines for Paraesophageal Hernias Offer Key Recommendations

The European Association for Endoscopic Surgery conducted a comprehensive review to update guidelines for paraesophageal hernias. They gathered an interdisciplinary panel of experts, including surgeons, gastroenterologists, and patient advocates, and utilized the latest evidence and methodology. Their recommendations emphasize surgery for asymptomatic/minimally symptomatic cases but recommend conservative management for frail patients. They also provide guidance on hiatal closure methods and fundoplication in paraesophageal hernia repair. These updated guidelines aim to offer clarity and help healthcare professionals and patients make informed decisions.

Journal Article by Markar SR, Menon N (…) Antoniou SA et 18 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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Sequential Treatment Outperforms Open Abdomen Approach for Duodenal Leakage-Induced Intra-Abdominal Bleeding

A cohort study examined treatments for intra-abdominal bleeding caused by duodenal leakage. The two approaches were “Sequential Treatment” (ST), which combines arterial embolization and drainage, and “Open Abdomen” (OA), a simultaneous method. ST had a lower mortality rate (28.2% vs. 51.3%) and better initial hemostasis success (94.4% vs. 77.8%) compared to OA. After propensity score matching, ST remained superior, reducing mortality and rebleeding. The study suggests that ST, involving arterial embolization and subsequent drainage, may be more effective in lowering mortality in this context.

Journal Article by Yao Z, Zhao G (…) Chen K et 5 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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Intraoperative Pancreatoscopy Safe and Beneficial in Managing Pancreatic Neoplasms

A systematic scoping review explored the role of intraoperative pancreatoscopy (IOP) in the surgical management of intraductal papillary mucinous neoplasms (IPMN) in the pancreas. IOP allows for the visualization of the main pancreatic duct, aiding in surgical planning. The review of five studies revealed IOP to be safe, detecting additional lesions in 34% of cases and prompting changes in surgical plans. While promising, larger, multi-center prospective studies are needed to further define IOP’s role in IPMN surgical strategy.

Review by Ciprani D, Frampton A (…) Aroori S et 3 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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Impact of Smoking on Elective Hernia Repair Outcomes

The Cleveland Clinic evaluated the effect of active smoking on surgical outcomes for patients undergoing elective abdominal wall reconstruction. They found that while active smokers showed a slight increase in wound complications and higher pulmonary issues, these differences didn’t reach statistical significance. Importantly, there were no mesh infections in the smoking group during early follow-up. This data can guide shared decision-making for patients contemplating elective hernia repair while actively smoking. The study suggests that surgical delays for smokers may not be necessary.

Journal Article by Messer N, Melland MS (…) Rosen MJ et 8 al. in Am J Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Hernia Repair Techniques and Male Fertility: Lichtenstein vs. TAPP

A clinical trial compared Lichtenstein and laparoscopic transabdominal preperitoneal (TAPP) techniques for bilateral inguinal hernia repair’s impact on male fertility. The study, involving 37 adult patients, examined hormonal levels, testicular health, semen quality, sexual activity, and quality of life before and after surgery. Although patients experienced improved quality of life after surgery, neither technique had a long-term negative impact on male fertility. Sperm morphology was even better in the Lichtenstein group after 180 days. The findings offer reassurance to men undergoing these hernia repair procedures.

Journal Article by Damous SHB, Damous LL (…) Utiyama EM 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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Reducing Parathyroid Tissue Removal: Near-Infrared Autofluorescence in Thyroid Surgery

This study explored the impact of near-infrared autofluorescence imaging during thyroid surgery on the inadvertent removal of parathyroid tissue. Comparing patients who underwent total thyroidectomy with or without this imaging tool, the results showed a lower rate of accidental parathyroid tissue removal in the near-infrared autofluorescence group. The reduction was more significant when this technology was used for both identification and confirmation, particularly for early-career surgeons. This suggests that near-infrared autofluorescence can be valuable in decreasing the unintended removal of parathyroid tissue during thyroid surgery.

Journal Article by Romero-Velez G, Avci SN (…) Berber E et 9 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Thyroid Surgery After Radiofrequency Ablation: Safe and Effective

Researchers assessed the impact of radiofrequency ablation on subsequent thyroid surgery. They compared outcomes and complications between patients who had thyroidectomy after radiofrequency ablation and those without prior ablation. The study included 96 patients, with no significant differences in operative time or complications between the groups. Importantly, no permanent complications were reported. This study suggests that radiofrequency ablation is a safe treatment for thyroid nodules, potentially offering reassurance to both clinicians and patients considering this approach.

Journal Article by Hussein M, Toraih E (…) Kandil E et 10 al. in BMC Surg

Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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Radiofrequency Ablation May Benefit Younger Patients with Thyroid Microcarcinoma

Researchers examined the best approach for treating papillary thyroid microcarcinoma, offering choices like radiofrequency ablation, active surveillance, or surgery. Their mathematical model assessed the likelihood of cancer progression, the need for thyroid replacement therapy, and treatment complications. Radiofrequency ablation outperformed active surveillance in averting progression and the need for lifelong thyroid therapy. Yet, the cost per progression-avoided was quite high, making radiofrequency ablation more practical for younger patients, while cost issues may limit its routine use among those with thyroid microcarcinomas.

Journal Article by Carlisle KM, Brown JP (…) Hu Y et 5 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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