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Age Impacts Surgical Outcomes in Ventral Hernia Repair

Patients aged 75 and older have significantly higher rates of perioperative complications after elective ventral or incisional hernia repair compared to younger patients. A retrospective cohort study of 116,643 patients showed that older age was associated with increased risk of post-operative complications, readmissions, extended hospital stays, and reoperations.

Journal Article by Greenwood Francis AK, Merchant NN, Aguirre K and Andrade A in Am J Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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Perioperative FOLFIRINOX Outperforms Adjuvant Gemcitabine in Resectable Pancreatic Cancer

Patients with resectable pancreatic cancer were randomized to receive either adjuvant gemcitabine or perioperative FOLFIRINOX. Perioperative FOLFIRINOX led to almost doubled median progression-free survival compared to adjuvant gemcitabine in patients who underwent surgical resection. Despite premature trial termination due to poor accrual, perioperative FOLFIRINOX showed feasibility and potential effectiveness in selected patient cohorts. Safety issues were not observed in the FOLFIRINOX arm, suggesting it as a promising treatment option for resectable pancreatic cancer.

Journal Article by Goetze TO, Reichart A (…) Al-Batran SE et 17 al. in Ann Surg Oncol

© 2024. The Author(s).

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“Biological R2 Definition” Predicts Early Recurrence in Pancreatic Cancer

One in ten patients with pancreatic ductal adenocarcinoma experiences very early recurrence after surgery (classified as biological R2), necessitating routine imaging within 12 weeks. Body-tail site lesion was the only preoperative predictor, with higher pt, g3 differentiation, and high lymph node ratio as pathological predictors. Neoadjuvant patients had different predictors, emphasizing the need for tailored follow-up strategies based on these findings.

Journal Article by Belfiori G, Crippa S (…) Falconi M et 11 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Textbook Outcome in Pancreatoduodenectomy for Nonfunctioning Pancreatic Neuroendocrine Tumors

Textbook outcome (TO) was achieved in one-third of patients after pancreatoduodenectomy (PD) for nonfunctioning pancreatic neuroendocrine tumors (NF-PANNETs). Tumor size, minimally invasive approach, and surgical volume were predictors of TO. TO was not associated with improved long-term survival, with similar rates seen in patients with and without TO. The TO rate was higher in patients with NF-PANNETs >2 cm compared to those ≤2 cm. Overall, achieving TO did not confer a survival benefit.

Journal Article by Partelli S, Fermi F (…) Falconi M et 24 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Selective Imaging Approach Reduces Costs and Radiation Exposure in Parathyroidectomy

Preoperative imaging based on the probability of having adenomas can significantly reduce unnecessary bilateral neck explorations in patients undergoing parathyroidectomy. Adenomas were associated with higher calcium and parathyroid hormone levels compared to hyperplasia. The likelihood that imaging helped with operative planning increased with the predicted probability of adenoma. A selective imaging approach considering preoperative probability could save patients millions of dollars and prevent excess radiation exposure.

Journal Article by Lunardi N, Jacob A (…) Balentine CJ et 7 al. in BMC Surg

Published by Elsevier Inc.

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GPT-4 Demonstrates Superior Readability in Bariatric Surgery Patient Education

Large language models (LLMs) like GPT-4 significantly improve the readability of bariatric surgery patient education materials (PEMs), with responses ranging from 6th to 9th grade reading levels. While GPT-3.5 and GPT-4 showed similar accuracy and comprehensiveness in simplifying responses, Bard’s responses were less comprehensive when simplified. This study emphasizes the potential of LLMs in enhancing the accessibility of PEMs for patients with varying literacy levels, advocating for further research in personalized PEM delivery.

Journal Article by Srinivasan N, Samaan JS (…) Samakar K et 3 al. in Surg Endosc

© 2024. The Author(s).

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High Mortality Rates in Hypotensive Combat Casualties Requiring Emergent Laparotomy

Combat casualties requiring emergent laparotomy have a mortality rate of 29.5%, compared to 6.5% in normotensive patients. Despite implementing damage control principles, mortality rates remained high in hypotensive patients. The study analyzed 1051 patients, showing no improvement in hypotensive casualty mortality rates after the implementation of clinical practice guidelines.

Journal Article by Pumiglia L, Williams JM (…) Schreiber M et 7 al. in Am J Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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Global Discrepancies in Metabolic and Bariatric Surgery Guidelines and Coverage

Analysis of worldwide IFSO survey on metabolic and bariatric surgery (MBS) indicates that 74.6% of national societies have MBS guidelines, with 34% adopting the latest ASMBS/IFSO 2022 guidelines. However, 22% still follow outdated NIH 1991 recommendations. Financial coverage for MBS is present in 65% of countries, highlighting the need for standardization of indications and increased coverage globally.

Journal Article by Pujol-Rafols J, Carmona-Maurici J (…) Balibrea JM et 10 al. in Obes Surg

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

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Identification of Difficulty Scores for Robotic Hepatectomy Using Tampa Difficulty Score System

Researchers developed and validated a novel Difficulty Score System for robotic hepatectomy based on 274 patients. Factors such as neoadjuvant chemotherapy, tumor characteristics, extent of resection, and additional procedures were associated with operative time and blood loss, resulting in difficulty scores ranging from 1 to 49. The patients were grouped into different levels of difficulty, showing significant differences in outcomes. This new system includes unique factors specific to robotic hepatectomy, highlighting its importance for preoperative planning and patient stratification.

Journal Article by Sucandy I, Dugan MM (…) Rosemurgy A et 4 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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Successful Surgical Management of Sigmoid Gallstone Ileus Resulting in Patient Discharge

Researchers report a successful case of a 90-year-old woman with a 6 cm gallstone causing sigmoid colon obstruction. Despite deferring colonoscopy due to gallstone size, urgent laparotomy for gallstone removal resulted in uneventful post-operative recovery and discharge on the 6th day. The study highlights the importance of multidisciplinary discussions between endoscopists and surgeons for optimal treatment decisions, especially in high-risk patients.

Journal Article by Pesce A, Lauro A (…) Feo CV et 4 al. in Dig Dis Sci

© 2024. The Author(s).

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