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Preoperative Weight Loss Program in Hepatocellular Carcinoma Patients with High BMI

Researchers investigated the impact of a weight-loss program (WLP) on patients with a high body mass index (BMI) before undergoing liver resection for hepatocellular carcinoma (HCC). In a study of 19 patients with a BMI of 25.0 or higher, WLP successfully led to weight loss without affecting short- or long-term surgical outcomes. The program improved liver function and immune-nutrition status while preserving skeletal muscle mass, offering a promising strategy for optimizing HCC patient health before surgery.

Journal Article by Saito Y, Morine Y (…) Shimada M et 8 al. in World J Surg

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

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Malnutrition Linked to Colorectal Cancer Outcomes

Researchers delved into the relationship between malnutrition, assessed by the Geriatric Nutritional Risk Index (GNRI), and the outcomes of patients who had undergone curative surgery for colorectal cancer (CRC). Those with lower GNRI scores had reduced overall survival and higher risk of recurrence, particularly within the first three years post-surgery. Importantly, this malnutrition also predicted a higher likelihood of non-CRC-related deaths over a five-year period. The findings underscore the importance of addressing preoperative nutritional status alongside cancer staging in CRC patient care.

Journal Article by Nakamura Y, Kawase M (…) Kuroda N et 5 al. in J Surg Oncol

© 2023 Wiley Periodicals LLC.

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Factors Linked to Reduced Surgical Training Experience for General Surgery Residents

A study involving 20 institutions and over 1,300 general surgery residents found that those with the lowest logged case volume were more likely to be female, identify as underrepresented in medicine, and pursue fellowships. Additionally, they were more likely to have graduated from low-volume programs and institutions with lower National Institutes of Health funding. Understanding these disparities is essential for promoting equity in surgical education, potentially improving the operative experience for residents in the bottom quartile of case volume.

Journal Article by Price AD, Foote DC (…) Cortez AR et 9 al. in J Surg Res

Copyright © 2023 Elsevier Inc. All rights reserved.

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Embolization Reduces Failure of Nonoperative Management in Blunt Splenic Trauma

Researchers compared outcomes in patients with splenic pseudoaneurysms (PSAs) following blunt trauma, some treated with splenic artery embolization (Embo) and others without (No-Embo). Patients who underwent embolization had a significantly lower rate of failure of nonoperative management (FNOM) compared to the No-Embo group (3.1% vs. 13.3%). The study suggests that embolization may play a crucial role in improving outcomes for patients with splenic PSAs after blunt trauma, though the exact mechanism behind this effect remains unclear.

Journal Article by Dhillon NK, Harfouche MN (…) Scalea TM et 3 al. in J Surg Res

Copyright © 2023 Elsevier Inc. All rights reserved.

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3D Reconstructions Improve Understanding of Hepato-Biliary Surgical Anatomy

A multicentric survey involving 11 patients with liver tumors and 23 experienced surgeons demonstrated that 3D reconstructions significantly enhance the comprehension of complex liver anatomy and the relationship between tumors and adjacent vascular structures. Compared to standard 2D CT scans, the 3D models provided superior accuracy in identifying vascular structures related to tumors. This advancement in surgical visualization has the potential to influence the selection and extent of liver resection, with substantial benefits for complex hepato-biliary surgeries.

Journal Article by Cotsoglou C, Granieri S (…) Pugliese G et 31 al. in HPB (Oxford)

Copyright © 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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Mixed Results for Adjuvant Therapy in Duodenal and Ampullary Carcinomas

Researchers investigated whether adjuvant therapy benefits patients with duodenal adenocarcinoma (DAC) and intestinal subtype ampullary carcinoma (IAC) after surgery. The study found that while DAC patients with perineural invasion and IAC patients with specific risk factors (lymph node involvement, advanced tumor stage, perineural invasion) benefited from adjuvant therapy, overall survival wasn’t improved in all cases. DAC and IAC shared some similarities, yet their responses to adjuvant treatment differed, highlighting the need for personalized approaches in managing these distinct cancers.

Journal Article by Finton S, Bolm L (…) Ferrone CR et 15 al. in Ann Surg

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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Early Career Surgeons Face Higher Mortality and Complication Rates

A comprehensive study involving over a million operations performed by 14,399 surgeons reveals a concerning trend: early career surgeons, especially those in their first year of practice, have higher mortality and severe complication rates compared to their peers in their 15th year of practice. This research underscores the need for additional support and training for newly graduated surgeons to ensure the best patient outcomes. The results indicated significantly increased risks for both mortality and complications across 26 core surgical procedures.

Journal Article by Howard RA, Thelen AE (…) George BC et 12 al. in Ann Surg

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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Polygenic Risk Score Enhances Diverticulitis Prediction

In the quest to predict diverticular disease’s course, researchers harnessed genetic insights. They developed a polygenic risk score based on prior genome-wide studies and tested it on nearly 61,000 patients. This score effectively stratified individuals by their risk of diverticulosis and diverticulitis, with significant differences between high and low-risk groups. It also improved recurrent diverticulitis risk prediction compared to clinical factors alone. These findings suggest that alongside other factors, a polygenic risk score could guide discussions, potentially impacting surgical decisions for high-risk patients.

Journal Article by Schaeffer HD, Smelser DT (…) Hoffman RL et 5 al. in Dis Colon Rectum

Copyright © The ASCRS 2023.

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Enhancing Robotic Bariatric Surgery Training with Targeted Educational Resources

Surgical residents tackling robotic bariatric procedures got a boost from specialized educational resources. A study analyzing trainee performance metrics found that after distributing instructive case guides and narrated operative videos, residents spent more time actively operating the da Vinci surgical system. This increase was consistent across different levels of trainees. The study highlights the value of tailored educational tools in improving resident participation in robotic bariatric surgeries, setting the stage for further exploration of the impact on patient outcomes.

Journal Article by Clanahan JM, Awad MM and Dimou FM in Surg Endosc

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Stomach Partitioning Gastrojejunostomy Improves Outcomes for Gastric Outlet Obstruction in Unresectable Gastric Cancer

When faced with unresectable gastric cancer causing gastric outlet obstruction (GOO), the choice between stomach partitioning gastrojejunostomy (SPGJ) and conventional gastrojejunostomy (CGJ) matters. In a study involving 108 patients, SPGJ significantly reduced delayed gastric emptying, vomiting, and the need for prokinetics, enhancing patient recovery. Patients undergoing SPGJ resumed a solid diet faster and had shorter hospital stays. Importantly, there were no major differences in recurrence or survival. This research highlights the benefits of SPGJ for managing GOO in unresectable gastric cancer.

Journal Article by Hai NV, Thong DQ (…) Long VD et 8 al. in Am J Surg

Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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