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Enhanced Recovery Protocols Improve Short-Term Outcomes in Esophagectomy: Evidence from India

Esophageal cancer surgery carries significant risks, especially in low and middle-income countries. This study investigated the impact of enhanced recovery protocols (ERP) in patients undergoing esophagectomy in India. Despite ERP patients having a higher predicted risk of complications, they experienced significantly lower 30-day morbidity and shorter hospital stays compared to those receiving standard pre-protocol care. The ERP group had no 30-day deaths and fewer postoperative complications, particularly in terms of pulmonary issues and prolonged ventilation. These findings support the adoption of ERP in esophagectomy patients in India.

Journal Article by Ramakrishnan P, Saini S, Arora A and Khurana G in World J Surg

© 2023. The Author(s) under exclusive licence to Société Internationale de Chirurgie.

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Research Residents Improve Student Perceptions of Surgery Clerkship

The surgical clerkship is a pivotal part of medical education, influencing students’ views on surgery. A program at one institution enlisted research residents as junior clerkship coordinators and educators. Student feedback before and after implementing this program showed no change in overall course perception. However, students noted improved clarity in written clerkship materials and found the feedback more valuable. Qualitative analysis confirmed an overall positive shift in students’ perception of the clerkship, highlighting the benefits of this scholar program in enhancing certain aspects of the medical school clerkship experience.

Journal Article by Ladowski JM, Howell TC (…) Vatsaas CJ et 5 al. in J Surg Res

Copyright © 2023 Elsevier Inc. All rights reserved.

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Machine Learning Model Predicts Benign Anastomotic Strictures in Rectal Cancer Patients

Aiming to improve the prediction of benign anastomotic strictures (BAS) in patients who’ve undergone rectal cancer surgery, a study harnessed machine learning. Data from 1,973 patients were analyzed using multiple machine learning models, with the random forest (RF) model emerging as the best predictor of BAS. The RF model achieved an impressive area under the curve (AUC) of 0.888 and identified key factors influencing predictions. Researchers developed a user-friendly online tool that could revolutionize BAS prevention, enhancing disease management and precise medical interventions in clinical practice.

Journal Article by Su Y, Li Y (…) Liu L et 3 al. in Eur J Surg Oncol

© 2023 Published by Elsevier Ltd.

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Digestive Cancer Surgery Outcomes in Low-Mid Income Countries: A Close Look at Morbidity and Mortality

This study delves into the postoperative outcomes of digestive cancer surgeries with curative intent in a low-mid income country. Analyzing data from 76 patients, the study revealed that immediate preoperative morbidity was around 36.84%, with a mortality rate of 5.26%. At 90 days post-surgery, morbidity remained consistent, while mortality increased to 7.9%. The research identified several risk factors contributing to higher morbidity and mortality, including factors like gender, obesity, and surgical approaches. This study sheds light on the challenges and outcomes of digestive cancer surgery in low-mid income settings.

Journal Article by Sekkat H, Agouzoul H (…) Sabbah F et 9 al. in Langenbecks Arch Surg

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Comparing Laparoscopic and Trans-Anal TME for Rectal Cancer: Insights from RCT Meta-Analysis

In a meta-analysis of randomized controlled trials, researchers evaluated two surgical approaches for rectal cancer: laparoscopic total mesorectal excision (LaTME) and trans-anal TME (TaTME). Analyzing data from 1,691 patients across six trials, they found no significant differences in morbidity, mortality, conversion to open surgery, or anastomotic leakage between the two techniques. However, TaTME patients were more likely to achieve a complete TME and had shorter hospital stays. This study highlights the value of TaTME as an effective option for rectal cancer treatment.

Review by Farooqi M, Hussain A (…) Khan A et 7 al. in Langenbecks Arch Surg

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Antibiotics Prove Effective in Uncomplicated Diverticulitis: A Japanese Nationwide Study

Investigating the effectiveness of antibiotics in treating uncomplicated diverticulitis, this study analyzed data from 131,936 admissions. After propensity score matching, it found that initiating antibiotics within 2 days of admission significantly reduced the rates of intestinal resection and stoma creation when compared to non-antibiotic treatment. While the antibiotic approach resulted in slightly higher median costs, it showed promise in reducing the need for surgical interventions in patients with moderate to severe disease activity. Further research is recommended to explore these findings.

Journal Article by Moroi R, Tarasawa K (…) Masamune A et 9 al. in Digestion

© 2023 The Author(s). Published by S. Karger AG, Basel.

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Endoscopic Sleeve Gastroplasty Proves Effective for Overweight Patients in Halting Obesity Progression

Researchers conducted a multicenter international study on overweight patients, exploring the effectiveness and safety of Endoscopic Sleeve Gastroplasty (ESG) as an early intervention against obesity. The results, involving 189 patients, revealed that ESG is safe and effective in treating overweight individuals, with a significant rate of BMI normalization. ESG shows promise as a tool to prevent or delay the progression from overweight to obesity.

Journal Article by Brunaldi VO, Neto MG (…) Abu Dayyeh BK et 8 al. in Gastrointest Endosc

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

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Irreversible Electroporation for Pancreatic Cancer: A Safer Alternative

A multi-institutional analysis of patients with locally advanced pancreatic cancer revealed that irreversible electroporation (IRE), a novel treatment, resulted in a lower rate of adverse events (25%) compared to pancreatectomy (39%) for early-stage disease. IRE patients had a greater risk of severe complications when they received high-dose neoadjuvant radiation, had electrodes close to vital blood vessels, or had bile duct stents for over six months. While IRE presents challenges, understanding its unique adverse events is vital for the care of patients.

Journal Article by Stephens K, Philips PP (…) Martin RCG et 3 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Simulation in Residency Transition Programs Lacks Emphasis on Non-Clinical Skills

Transition to residency programs often incorporate simulation to enhance clinical skills but tend to overlook non-clinical skills. In a scoping review of 38 articles, researchers found that simulation activities, such as mock paging and procedural skills training, primarily focused on clinical aspects. The most common simulation tools were standardized patients. While communication skills, critical thinking, and teamwork were among the non-clinical attributes addressed, increasing the variety of simulation activities or tools did not lead to a broader coverage of non-clinical skills. The study underscores the need for more targeted simulations to effectively promote these essential non-clinical abilities.

Journal Article by Anand A, Jensen R and Korndorffer JR in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Balanced Blood Transfusions Improve Survival in Trauma Patients

A retrospective analysis of trauma patients receiving blood transfusions aimed to validate findings from a previous study on transfusion outcomes. Researchers analyzed 17,047 patients and found that mortality increased with each unit of packed red blood cells transfused, with a higher likelihood of death at 11 units. Notably, patients receiving balanced transfusions had better survival rates between 6 and 23 units of blood. Protective factors included male gender and blunt trauma. Balanced transfusions significantly improved the chances of survival, shedding light on the importance of maintaining balance in blood transfusion.

Journal Article by Loudon AM, Rushing AP, Badrinathan A and Moorman ML in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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