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Tailoring Treatment for Hepatic Adenoma: Subtypes and Molecular Factors

Researchers reviewed advances in diagnosis and management of hepatic adenomas (HA), classified into at least eight subtypes. MRI is the best imaging method for diagnosis and can differentiate among subtypes. HA larger than 5cm have higher risks of bleeding and malignancy and should be resected. A high risk of malignant transformation was found in β-catenin exon 3-mutated HA, suggesting it as a precancerous lesion. Individualized treatment based on molecular subtypes is recommended.

Review by Aziz H, Underwood PW (…) Pawlik TM et 3 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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Enhanced Overall Survival and Tumor Reduction in EUS-RFA for Unresectable Pancreatic Adenocarcinoma

Researchers assessed EUS-RFA in 26 patients with unresectable pancreatic ductal adenocarcinoma, showing technical success in all cases and no major adverse events. Six months post-EUS-RFA, 42.3% of patients had improved overall survival and significant performance status enhancement. Tumor reduction and post-treatment necrotic areas were observed, while metastatic disease negatively impacted survival. EUS-RFA proved safe and potentially beneficial in locally advanced and non-metastatic cases, suggesting its role as targeted therapy for unresectable pancreatic adenocarcinoma.

Journal Article by Robles-Medranda C, Del Valle R (…) Tabacelia D et 15 al. in Gastrointest Endosc

Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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Successful laparoscopic and robotic s7 segmentectomy using ICG-enhanced compression for hepatocellular carcinoma

ICG-enhanced compression anatomical segment 7 segmentectomy in laparoscopic and robotic approach was successfully performed in two cases of Child-Pugh class A hepatocellular carcinoma. The technique enabled identification and resection of posterosuperior lesions with minimal liver stiffness and no postoperative complications, achieving R0-resection margins and quick patient discharge, showcasing feasibility and reliability for future adoption.

Journal Article by Procopio F, Mauri G (…) Torzilli G et 5 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Development of a 10-Point Score to Predict Post-Recurrence Survival in Intrahepatic Cholangiocarcinoma

Researchers developed a 10-point score to predict post-recurrence survival (PRS) in patients with intrahepatic cholangiocarcinoma (iCC) following resection. This score successfully stratified patients based on their PRS likelihood, with lower scores associated with higher survival rates. The score included factors like tumor grade, resection margin, and specific tumor markers, providing valuable guidance for treatment decisions in patients with recurrent ICC.

Journal Article by Tsilimigras DI, Endo Y (…) Pawlik TM et 14 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Preoperative chemotherapy improves overall survival in liver-limited metastasis from gastric cancer

Preoperative chemotherapy significantly increased overall survival in patients with liver-limited metastasis from gastric cancer who underwent hepatectomy, compared to upfront surgery. Patients who exhibited a partial response to preoperative chemotherapy had better outcomes than those with stable or progressive disease. The preoperative chemotherapy group also had a higher chance of undergoing surgical resection for recurrent tumors. These results suggest that preoperative chemotherapy can be recommended for patients with liver-limited metastasis from gastric cancer.

Journal Article by Hirose Y, Aizawa M (…) Nakagawa S et 8 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Malnutrition and Decreased Phase Angle Predict Postoperative Complications in Oncologic Abdominal Surgery

Preoperative malnutrition and decreased phase angle (< -0.5) on postoperative day 1 were independent predictors of postoperative morbidity in patients undergoing major oncologic upper-GI surgery. Patients with malnutrition had a higher complication rate, and a decline in phase angle was associated with a 13% increase in complication risk. Further investigation is needed to determine if proactive interventions can prevent these negative outcomes.

Journal Article by Sandini M, Gianotti L (…) Caccialanza R et 17 al. in Ann Surg Oncol

© 2024. The Author(s).

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Comparison of Long-Term Outcomes between Spleen-Preserving Distal Pancreatectomy with Splenic Vessel Resection and Preservation

Long-term outcomes of spleen-preserving distal pancreatectomy with splenic vessel resection showed higher prevalence of perigastric varices and lower platelet count compared to preservation. However, other complications such as gastric submucosal varices, splenic infarction, gastrointestinal bleeding, and hematologic parameters were similar between the two groups 5 years post-surgery. Spleen preserving distal pancreatectomy with splenic vessel preservation had acceptable late clinical events despite partial or complete occlusion of splenic vessels.

Journal Article by Maehira H, Tani M (…) Yagi S et 6 al. in BMC Surg

Copyright © 2024. Published by Elsevier Inc.

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Pelvimetry Measurements Predict Total Mesorectal Excision Quality in Rectal Cancer Surgery

Pelvimetry measurements using CT scans can predict the quality of total mesorectal excision in rectal cancer surgery. Factors like a deeper sacral curve and greater transverse distance of pelvic outlet were associated with incomplete excision. An increased area of pelvic inlet was linked to a higher rate of complete excision. Visceral obesity did not impact the results. A predictive model based on these measurements could help guide treatment strategies and compare outcomes of different surgical techniques.

Journal Article by Bolshinsky V, Sweet D (…) Steele SR et 5 al. in Dis Colon Rectum

Copyright © The ASCRS 2024.

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Impact of Intensive Pre-Operative Information Course on Long-Term Weight Loss Post-Bariatric Surgery

Intense pre-operative information course (IPIC) and higher pre-operative weight loss significantly contribute to sustained weight loss post-bariatric surgery, with 80.5% achieving EWL ≥ 50% and 53.1% achieving EWL ≥ 70%. Those who underwent IPIC had increased likelihood of maintaining EWL ≥ 50% and ≥ 70% after a median of 6.5 years, suggesting that IPIC and pre-operative weight loss play a crucial role in long-term weight outcomes and reducing weight regain.

Journal Article by Lucocq J, Thakur V (…) Robertson AG et 11 al. in Surg Endosc

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Enhanced Surgical Journal Clubs Expand Accessibility and Active Learning

Researchers adapted a surgical journal club curriculum to an asynchronous, virtual format during the pandemic, allowing for expanded participation and active learning opportunities. The new format enabled visual abstract generation and audio-synopsis creation, supporting learners’ critical appraisal skills of surgical literature. Rural surgeons could now participate in the expanded community-based journal clubs, promoting inclusivity and accessibility post-pandemic.

Review by Brown TA, Alterio M (…) Kumar AS et 4 al. in Am J Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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