Robotic and laparoscopic approaches to minimally invasive pancreatoduodenectomy yield similar oncologic and surgical outcomes in pancreatic cancer patients, with a lower conversion rate to open surgery for the robotic cohort. The learning curve has a significant impact on outcomes, with higher-volume centers showing improved results, particularly in reducing 90-day mortality.
Journal Article by Wehrle CJ, Chang JH (…) Naffouje SA et 9 al. in Surg Endosc
© 2024. The Author(s).
Analysis of 817 patients after pancreaticoduodenectomy revealed that 19.5% developed postoperative pancreatic fistula (popf), with 45.9% being post-pancreatectomy acute pancreatitis (ppap)-associated popf. These patients had higher morbidity and distinct risk factors (blood loss, pancreatic texture) compared to non-ppap-associated popf. Non-ppap-associated popf was linked to age, gender, and pancreatic duct size. Regardless of risk scores, the incidence of popf remained around 50% in ppap patients. Understanding these risk factors could lead to preventative measures in the early postoperative period.
Journal Article by Chen H, Wang W (…) Shen B et 9 al. in Ann Surg
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Establishing a Center for Trauma Survivorship (CTS) is not cost prohibitive, but a revenue generator for institutions. A post-and pre-cohort study found that CTS patients had more follow-up visits and surgeries, resulting in a $7,752 increase in net revenue per patient. The creation of dedicated centers improves patient outcomes and institution’s financial health.
Journal Article by Gore A, Huck G (…) Livingston DH et 4 al. in Ann Surg
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Palliative surgery aims to alleviate symptoms in seriously ill patients. Although common in surgical oncology, the durability of symptom improvement and quality of life post-surgery lacks high-quality evidence. Outdated studies with inconsistent definitions hinder decision-making. However, with effective communication and patient selection, palliative surgery can provide relief and reduce healthcare burdens for certain seriously ill patients.
Journal Article by Lilley EJ, Farber ON and Cooper Z in Br J Surg
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Studies analyzed 625,316 surgical procedures and found that claims with modifier 22 had higher charges, payments, but were more likely to be denied. Overall mean payments varied, with some procedures showing higher payments with modifier 22. However, for most surgeries, little financial advantage was seen, suggesting surgeons have little incentive to use modifier 22 under the current system.
Journal Article by Childers CP, Manisundaram NV, Hu CY and Chang GJ in JAMA Surg
Metabolic bariatric surgery offers durable weight loss and medical improvement for obesity, contrary to misconceptions about obesity as a lack of willpower. Despite its effectiveness and safety, surgical treatment remains vastly underutilized due to societal stigma and patient misconceptions. Healthcare practitioners must combat these perceptions, advocating for surgery as a legitimate treatment for obesity alongside medical interventions. Addressing societal attitudes and providing comprehensive care are crucial for improving access to effective obesity treatments.
Journal Article by Schirmer B in JAMA Surg
Comparing robotic and laparoscopic approaches in hiatal hernia repair and Heller myotomy, robotic surgery showed non-significantly shorter hospital stays, fewer conversions to open, and lower morbidity rates for hhr, while hm had significantly fewer esophageal perforations, reinterventions, and a non-significantly shorter stay. Both robotic procedures had longer operative times. Safety profiles and perioperative outcomes were similar between robotic and laparoscopic repairs, highlighting the need for further randomized controlled trials.
Journal Article by Awshah S, Mhaskar R (…) DuCoin C et 6 al. in J Am Coll Surg
Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.
First-degree relatives of patients with early-onset colorectal cancer have low rates of colorectal cancer screening, with only 44% undergoing screening despite guidelines recommending screening starting at age 40 or 10 years before the age of their relative’s diagnosis. Factors such as race, stage of disease, insurance coverage, and location were associated with lower screening rates, indicating the need for targeted interventions to improve awareness and access to screening in this high-risk population.
Journal Article by Almanzar A, Dahmani SL (…) Lisle D et 4 al. in Dis Colon Rectum
Copyright © The ASCRS 2024.
Rectal cancer patients who achieved pathologic complete response after neoadjuvant therapy had improved survival compared to those with residual carcinoma in situ. Factors associated with decreased survival included older age, higher comorbidity score, and poorly differentiated tumors, while factors linked to improved survival were female gender, private insurance, and receiving both neoadjuvant and adjuvant chemotherapy. Clinical stage did not significantly impact survival in this cohort, warranting further prospective trials.
Journal Article by Kohrman NM, Wlodarczyk JR (…) Koller SE et 5 al. in Dis Colon Rectum
Copyright © The ASCRS 2024.
Despite recent evidence supporting conservative management, 63.4% of papillary thyroid microcarcinoma (PTMC) patients in the community underwent total thyroidectomy, leading to higher rates of recurrent laryngeal nerve injury and hypocalcemia compared to lobectomy. Non-endocrine surgeons also administered radioactive iodine more frequently. Subgroup analysis showed variations in total thyroidectomy rates based on tumor size and surgery period. Overall, the study highlights the need for increased awareness and adherence to best practice guidelines for PTMC treatment.
Journal Article by Abraham PJ, Wu C (…) Chen H et 6 al. in Am J Surg
Copyright © 2024 Elsevier Inc. All rights reserved.