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Guidelines for Bowel Preparation in Minimally Invasive Colorectal Surgery

A collaborative project by EAES, SAGES, and ESCP developed clinical practice recommendations for bowel preparation before minimally invasive colorectal surgery. After conducting a systematic review and network meta-analysis, a panel of experts suggested different approaches for various procedures. They recommend mechanical bowel preparation (MBP) with oral antibiotics for certain cases and offer conditional recommendations for others. These guidelines provide standardized and evidence-informed practices for bowel preparation, improving patient care in minimally invasive colorectal surgery.

Journal Article by Antoniou SA, Huo B (…) Morales-Conde S et 17 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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Discovering Key Factors for Type 2 Diabetes Remission After Bariatric Surgery

In the quest to understand why some individuals achieve type 2 diabetes (T2D) remission after bariatric surgery while others don’t, a study identified crucial factors. Patients who experienced T2D remission had better β-cell function and higher levels of acyl ghrelin, a hormone. They also had lower visceral fat compared to subcutaneous fat. Additionally, branched-chain amino acids (BCAAs) and VLDL particle size were key metabolic differences. The study suggests that targeting visceral fat and optimizing BCAA metabolism might enhance long-term T2D remission rates post-surgery.

Journal Article by Chaiyasoot K, Sakai NS (…) Batterham RL et 9 al. in Obes Surg

© 2023. The Author(s).

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Identifying Prognostic Factors for High-Risk Stage II Colon Cancer

In this analysis of high-risk stage II colon cancer patients, significant prognostic factors for disease-free survival (DFS) and overall survival (OS) were determined. Gender, tumor invasion depth, extent of lymph node dissection, number of examined lymph nodes, and postoperative adjuvant chemotherapy (POAC) were found to be independent predictors of DFS. Similarly, age, gender, tumor invasion depth, perforation/penetration, extent of lymph node dissection, number of examined lymph nodes, and POAC were significant factors for OS. The study emphasizes the importance of these factors in stage II colon cancer prognosis and treatment decisions.

Journal Article by Sugimoto K, Sakamoto K (…) Sadahiro S et 6 al. in Int J Colorectal Dis

© 2023. The Author(s).

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Comparing Surgical Approaches for Incisional Hernia Repair After Pancreatic Surgery

After analyzing data from the Herniamed registry, which included patients who underwent incisional hernia repair following pancreatic surgery, researchers found that both open and minimally invasive techniques were effective and safe, with low recurrence rates. Of the patients with one-year follow-up, 95% had previously undergone open pancreatic surgeries. Notable differences included a higher rate of defect closure and drainage in open repairs, while minimally invasive procedures utilized larger meshes. This study provides valuable insights into choosing the right approach for incisional hernia repair after complex pancreatic surgery.

Journal Article by Krueger CM, Patrzyk M (…) Riediger H et 3 al. in Hernia

© 2023. The Author(s).

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Enhancing Outcomes in Esophagectomy Patients: A Multi-Pronged Approach

Esophagectomy, a complex cancer surgery, poses substantial risks of major complications and death. To optimize patient outcomes, modern strategies focus on preventing and treating specific complications, implementing enhanced recovery practices, conducting thorough clinical and physiological risk assessments, involving high-volume surgical teams, and providing multimodal support. These approaches aim to safeguard and restore nutritional status, muscle health, and overall well-being throughout the patient’s journey. This study highlights a comprehensive strategy to improve perioperative outcomes for esophageal cancer patients.

Journal Article by Elliott JA, Guinan E and Reynolds JV in Dis Esophagus

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

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Enhancing International Collaboration in Clinical Trials

To streamline global clinical trial operations, Clinical Trial Units (CTUs) within academic research institutions worldwide must harmonize services to meet international standards. A survey involving experienced CTU members aimed to identify the most crucial services for seamless clinical trial execution. The results revealed that services related to research project quality and coordination were of utmost importance. Emerging CTUs should focus on offering management and regulatory expertise, alongside education and training, to ensure compliance with Good Clinical Practice (GCP) and relevant legislation. This study guides CTUs in aligning their services with international clinical research standards.

Journal Article by Hoffmann JM, Blümle A (…) Bradbury C et 3 al. in Front Med (Lausanne)

Copyright © 2023 Hoffmann, Blümle, Grossmann, Yau, Lang and Bradbury.

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Revamping Hemorrhoidal Classification for Improved Care

Hemorrhoids, a common anal condition, present recurring challenges. Effective treatment relies on accurate classification, making cure rates higher and recurrence rates lower. This study reviews various classification methods for hemorrhoids, assessing their pros and cons, treatment relevance, practicality, and assessment value. It proposes strategies to address current assessment limitations, aiming to enhance the classification of hemorrhoids and improve clinical diagnosis and management. This research offers valuable insights into upgrading hemorrhoidal care.

Review by Wang L, Ni J (…) Fan W et 5 al. in Front Med (Lausanne)

Copyright © 2023 Wang, Ni, Hou, Wu, Sun, Jiang, Cai and Fan.

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Unsupervised Training Proves Effective for Esophago-Gastric Endoscopic Submucosal Dissection

Experienced endoscopists seeking competence in endoscopic submucosal dissection (ESD) faced a challenging learning curve. This study introduced an unsupervised training model. Endoscopists initially observed 30 ESD cases and performed 15 unsupervised ex-vivo ESDs. Afterward, they tackled five human distal gastric ESDs and 55 unselected esophago-gastric cases. Results were promising, with a 93.0% en-bloc resection rate, 80.7% R0 resection rate, and an average operative time of 14.0 minutes per centimeter. Unsupervised training appears to successfully guide experienced endoscopists toward ESD competence.

Journal Article by Hadjinicolaou AV, Pappas A (…) di Pietro M et 3 al. in Gastrointest Endosc

Copyright © 2023 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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Setting the Bar for Surgical Video Deidentification Standards

This article dives into the crucial realm of standards for deidentifying surgical videos. In the modern operating room, surgical videos offer a wealth of valuable data. They enable performance assessment and complication rate analysis, enhancing the future of surgical care. The integration of routine video capture and analysis presents exciting prospects for quality improvement, competency evaluation, and education, moving us closer to real-time decision support in surgery.

Journal Article by Tollefson MK and Ross CJ in JAMA Surg

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Redefining Surgery for Widespread Biliary Malignancy: A Survival Analysis

Researchers explored the impact of hepatopancreaticoduodenectomy (HPD), a radical surgery for biliary carcinoma, on survival in patients with widespread cancer. Of the 54 patients who underwent HPD, 89% achieved R0 resection, significantly improving survival with a median of 36.9 months. Pathological portal vein involvement was identified as an independent prognostic factor. Those with peripancreatic lymph node metastasis or portal vein invasion might reconsider HPD as their first choice. This study offers insights to redefine surgical indications for advanced biliary malignancy.

Journal Article by Yoshimi Y, Noji T (…) Hirano S et 11 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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