French nationwide study evaluated 61,169 high-risk digestive cancer surgeries. Postoperative mortality rates varied across types, with liver and pancreas surgeries showing benefits from the new criteria. Higher volume thresholds could further decrease mortality risks. Centralization policies and improved clinical pathways may enhance patient access to complex care in France.
Journal Article by Thereaux J, Badic B (…) Metges JP et 5 al. in Ann Surg Oncol
© 2024. Society of Surgical Oncology.
Patients with preoperative opioid exposure experienced higher pain scores 30 days after surgery compared to opioid-naïve individuals. As opioid exposure increased, the probability of reporting moderate to severe pain also increased. Furthermore, clinical outcomes such as ED visits, readmissions, and reoperations within 30 days, as well as patient-reported outcomes like satisfaction, regret, and quality of life, were worse with higher preoperative opioid exposure. This study highlights the negative impact of preoperative opioid use on postoperative recovery.
Journal Article by Frangakis SG, Kavalakatt B (…) Bicket MC et 5 al. in Ann Surg
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Among Medicare fee-for-service beneficiaries hospitalized for gastrointestinal bleeding, larger hospital size, greater case volume, increased staffing levels, and availability of advanced capabilities were associated with lower 30-day mortality. Patients treated at hospitals with multiple advanced specialized capabilities had a 22% reduction in mortality risk, compared to those without these services, although length of stay increased with additional services.
Journal Article by Siddique SM, Hettinger G (…) Lewis JD et 3 al. in Am J Gastroenterol
Copyright © 2024 by The American College of Gastroenterology.
Entrustable Professional Activities (EPAs) in general surgery show moderate validity evidence and practical recommendations for implementation, providing a more accurate assessment of residents’ competence compared to other methods. Challenges include obtaining faculty and resident buy-in for microassessments and feedback. EPAs represent a significant shift in evaluating general surgery residents, aligning with Competency-Based Education (CBE) progression. Best practices from this review can help programs and individuals effectively implement EPAs despite remaining pragmatic challenges.
Journal Article by Montgomery KB, Mellinger JD and Lindeman B in JAMA Surg
Investigators analyzed data from 12,433 patients who underwent ambulatory cancer surgery and completed 110,936 surveys on symptom severity and interference. Pain severity was highest on postoperative days 1-3, but gradually improved, with moderate initial fatigue that rarely reached severe levels. Nausea was common, while vomiting and shortness of breath were less frequent. These findings provide valuable insight for enhancing patient education and improving clinical care based on patient-reported outcomes.
Journal Article by Cracchiolo JR, Tin AL (…) Laudone V et 6 al. in JAMA Surg
Anatomic liver resection prioritizing portal territory margins for hepatocellular carcinoma (HCC) treatment offers improved surgical efficacy over traditional approaches. MPT-AR maximizes oncological and rehabilitation benefits, overcoming limitations of traditional AR and local liver resection while avoiding postoperative complications like liver failure. This innovation addresses challenges posed by HCC’s portal vein spread and cirrhosis-related liver function impairment.
Journal Article by Wang X, Cao J and Li J in JAMA Surg
Injecting indocyanine green into the Glisson pedicle in a patient with intrahepatic cholangiocarcinoma allowed accurate tracing of hepatic lymphatic drainage area during laparoscopic surgery. The technique enabled identification and dissection of regional lymph nodes, providing a potential method for precise lymph node mapping in liver cancer surgery.
Journal Article by Wang X, Xie F (…) Li J et 2 al. in Ann Surg Oncol
© 2024. Society of Surgical Oncology.
Implementing mobile health in surgical practice can improve patient outcomes, satisfaction, and system performance by addressing issues of poor communication and care coordination. Experts developed an implementation guide using human-centered design techniques, focusing on identifying mobile health use in surgical practice, mapping the pathway to implementation, and measuring impact on patients and the surgical system. This guide provides valuable recommendations for integrating mobile health in perioperative care.
Journal Article by Sinyard RD and Cauley CE in BMC Surg
Copyright © 2024 Elsevier Inc. All rights reserved.
Neoadjuvant immunotherapy for non-metastatic, mismatch repair deficient colon cancer showed high rates of pathologic complete responses in locally advanced cases. Among 8 included studies, complete resections were achieved in 98-100% of cases, with 50-91% showing ypt0n0 pathology post-treatment. Safety profiles were generally favorable, with mostly immune-related grade 1-2 adverse events reported in 22.2-70% of patients. Postoperative complications were minimal, indicating promising outcomes for neoadjuvant immunotherapy in this patient population.
Journal Article by Loria A, Ammann AM (…) Justiniano CF et 2 al. in Dis Colon Rectum
Copyright © The ASCRS 2024.
Researchers validated a quantitative method for precise polyp size and location measurement in upper gastrointestinal endoscopy, critical for malignancy prediction and intervention planning. Using an electromagnetic tracking sensor, the method showed high accuracy in a simulated endoscopy setting, with an average polyp size of 12mm and reliable test-retest results. Comparisons with caliper measurements revealed non-significant differences, indicating the potential clinical utility of this method.
Journal Article by Safavian N, Toh SKC, Pani M and Lee R in Surg Endosc
© 2024. The Author(s).