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Marking Small Liver Tumors Before Surgery: Will It Improve Resection?

To enhance the precision of small liver tumor removal, a phase II study in Japan will evaluate preoperative marking’s effectiveness. Patients with liver tumors ≤15 mm requiring hepatectomy will undergo microcoil placement near the tumor using either the percutaneous or transvascular approach. The study aims to determine the successful resection rate, with secondary endpoints including the outcomes of preoperative marking and hepatectomy. Results will inform whether preoperative markings benefit curative resection in these cases.

Journal Article by Fukuhara S, Kuroda S (…) Ohdan H et 14 al. in BMJ Open

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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Japanese Study Highlights Trends in Penetrating Injuries and Mortality

A 10-year retrospective study in Japan examined penetrating injuries, their characteristics, and long-term mortality trends among 313,643 patients. The findings showed that while in-hospital mortality rates decreased over the study period, the severity-adjusted mortality trend didn’t significantly improve. Stab wounds remained the primary cause of penetrating injuries. Notably, patients with active bleeding who underwent urgent transcatheter arterial embolization had significantly lower mortality risk. However, surgical procedures for haemostasis didn’t reduce mortality risk for patients with stab wounds and active bleeding. This study emphasizes the need for targeted trauma care strategies.

Journal Article by Nagao T, Toida C and Morimura N in BMJ Open

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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Which Blood Thinners Are Safer for Gastrointestinal Hemorrhage in Atrial Fibrillation?

A systematic review and meta-analysis of real-world studies examined the safety of direct oral anticoagulants (DOACs) in patients with non-valvular atrial fibrillation who experience gastrointestinal hemorrhage (GIH). Apixaban showed a lower risk of GIH compared to dabigatran, rivaroxaban, and vitamin K antagonists (VKA). Rivaroxaban was associated with an increased risk of GIH compared to dabigatran and VKA. Dabigatran had a similar GIH risk to VKA. These findings provide valuable insights for clinicians choosing the right anticoagulant for patients with atrial fibrillation at risk of GIH.

Journal Article by Archontakis Barakakis P, Kokkinidis DG (…) Ntaios G et 6 al. in J Clin Gastroenterol

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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Endoscopic Ultrasound-guided Nerve Block Shows Promise in Easing Pancreatic Cancer Pain

In a network meta-analysis of ten randomized controlled trials, researchers assessed the effectiveness of endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) in addition to medical management for abdominal pain in unresectable pancreatic cancer. Results favored EUS-CPN combined with medical management, showing significantly reduced pain intensity at 4 and 12 weeks compared to medical management alone or other techniques like percutaneous CPN. While promising, the study acknowledges the need for cautious interpretation due to potential bias in the analyzed trials.

Journal Article by Okita M, Otani K and Matsui S in J Clin Gastroenterol

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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Pancreatic Cancer on the Rise Globally: Factors and Future Projections

Researchers analyzed data from 2020 to 2040 to understand the trends in pancreatic cancer (PC) incidence and mortality worldwide. PC is linked to higher socioeconomic status, with Asia, especially China, bearing the greatest burden. Among age groups, those aged 65 and older are most affected, except in countries with medium and low human development indices where younger populations are at risk. In certain countries, females are more affected. Disturbingly, PC incidence and mortality are predicted to increase by over 60% by 2040, making it crucial to develop targeted strategies and public health policies.

Journal Article by Sharma P, Vuthaluru S, Chowdhury S and Are C in J Surg Oncol

© 2023 Wiley Periodicals LLC.

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Optimizing Lymph Node Surgery for Duodenal Cancer Improves Patient Outcomes

In patients with non-ampullary duodenal adenocarcinoma (NADAC), researchers studied the extent of regional lymphadenectomy based on tumor location and its effect on survival. They found that certain lymph nodes, such as those near the pancreas and superior mesenteric artery, were frequently affected by metastasis. Implementing number-based nodal classification, they identified key regional nodes, allowing for accurate staging and improved patient prognostic stratification. This research sheds light on the importance of tailored lymph node surgery in NADAC for better patient outcomes.

Journal Article by Abe S, Sakata J (…) Wakai T et 14 al. in Eur J Surg Oncol

© 2023 Published by Elsevier Ltd.

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Perioperative Immunonutrition Reduces Postoperative Complications in Neck Cancer Patients

This study delves into the impact of perioperative immunonutrition on patients with head and neck or gastrointestinal (GI) cancers. Researchers analyzed 48 randomized controlled trials involving 4,825 patients and found that immunonutrition significantly decreased both total postoperative complications and infectious complications compared to standard nutritional therapy. This suggests that immunonutrition can play a vital role in improving postoperative outcomes for patients undergoing elective surgery for these types of cancers.

Journal Article by Matsui R, Sagawa M (…) Kotani J et 17 al. in Ann Surg

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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Tumor Necrosis Independently Predicts Poor Survival in Gallbladder Carcinoma Patients

This study delved into the significance of tumor necrosis in gallbladder carcinoma patients who underwent curative-intent surgery. Researchers analyzed 213 patients and found that the presence of tumor necrosis was linked to more aggressive tumor characteristics, such as larger size, poor differentiation, vascular invasion, lymph node metastasis, and higher tumor status. Importantly, tumor necrosis emerged as an independent predictor of reduced overall and disease-free survival. This highlights its value as a prognostic factor in gallbladder carcinoma, offering insights for clinical management.

Journal Article by Yang SQ, Wang JK (…) Hu HJ et 6 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Preserving Bronchial Arteries Reduces Postoperative Pneumonia After Esophagectomy

This study explored the impact of preserving bronchial arteries during radical esophagectomy, a surgical procedure for esophageal cancer, on the incidence of postoperative pneumonia. Researchers analyzed 348 patients and found that preserving bronchial arteries was associated with a decreased risk of postoperative pneumonia. They also identified factors like smoking history and lung function as additional contributors to postoperative pneumonia. By preserving these arteries, clinicians can potentially enhance patient outcomes and reduce the occurrence of this serious complication.

Journal Article by Fujisawa K, Ohkura Y (…) Udagawa H et 4 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Fragility Index Reveals Limited Robustness in Diverticular Disease Trial Outcomes

Researchers reviewed randomized trials exploring interventions for diverticular disease patients. They assessed the trials’ robustness using the fragility index, which measures how many non-events must turn into events to raise a p-value above 0.05. Analyzing 15 studies, they found a concerning lack of robustness. Changing a single outcome event often rendered statistically significant findings non-significant, indicating fragility in the evidence supporting interventions for diverticular disease. These results highlight potential weaknesses in the existing trials and underscore the need for more robust research.

Journal Article by McKechnie T, Yang S (…) Eskicioglu C et 9 al. in Dis Colon Rectum

Copyright © The ASCRS 2023.

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