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Heterogeneity of Postoperative Delirium: Preoperative Screening Inadequate for Hallucinatory Risk

This exploratory study on postoperative delirium in elective cancer surgery found that preoperative cognitive screening tools like the Mini-Cog and Geriatric-8 (G8) scores cannot detect hallucinatory delirium risk. Among patients who developed delirium, those with hallucinations had higher cognitive function and less frailty, indicating a subgroup not identified by conventional screening.

Journal Article by Yajima S, Nakanishi Y (…) Masuda H et 5 al. in Eur J Surg Oncol

© 2024 Elsevier Ltd, BASO ∼ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

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Flagship Hospitals Show Lower Mortality Rates Than Affiliate Hospitals

Patients undergoing inpatient general surgery at flagship system hospitals and flagship hospitals had lower 30-day mortality rates compared to control patients, while patients at flagship hospital affiliates had similar mortality rates to controls. Flagship hospitals also had lower mortality rates than affiliate hospitals, suggesting that flagship system affiliation alone does not guarantee better surgical outcomes.

Journal Article by Ramadan OI, Rosenbaum PR (…) Silber JH et 6 al. in Ann Surg

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

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Which Biomaterial Offers the Lowest Recurrence Rate in Congenital Diaphragmatic Hernia Repair?

Researchers reviewed 63 papers on 4598 CDH patients to evaluate patch repair outcomes. They found that goretex/marlex had the lowest recurrence rate at 3.6%. Recurrence rates were also low for teflon (4.2%) and dacron (5.6%), with goretex being the most popular patch material. Synthetic non-resorbable materials had the lowest recurrence rate (14.0%), while combined natural and synthetic resorbable materials had a 100% recurrence rate. Over one-third of CDH cases were closed with patches, using 19 different types.

Journal Article by Saxena AK and Hayward RK in Ann Surg

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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Core data set and definition for empty pelvis syndrome after pelvic exenteration

Empty pelvis syndrome (EPS) following pelvic exenteration is poorly defined, leading to inconsistent reporting. This study established a core outcome set and descriptor set for EPS through a consensus process involving healthcare professionals and patients. The study identified seven core outcomes (e.g., bowel obstruction, chronic perineal sinus) and four core descriptors (e.g., magnitude of surgery, radiotherapy-induced damage). An agreed written definition for EPS was also established, providing a framework for future research into preventing and managing this syndrome.

Journal Article by None None in Br J Surg

© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.

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Establishment of Patient-Derived Organoids from Pancreatic Cancer Biopsies for Personalized Medicine

A patient-derived organoid platform was successfully established from endoscopic ultrasound-guided fine needle biopsies of pancreatic ductal adenocarcinoma, with a high success rate and fast turnaround time. The organoids showed high concordance with the original tumor tissues, revealed more genetic alterations, and accurately predicted drug sensitivity in clinical correlation. This approach enables timely personalized medicine by allowing rapid testing of therapeutic drugs on patient-specific organoids.

Journal Article by Kim H, Jang J (…) Park JK et 16 al. in Gastrointest Endosc

Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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Improved Odds of Cytoreductive Surgery with HIPEC and Survival for Colorectal Peritoneal Metastases

Findings from a nationwide population-based study revealed that patients diagnosed in hipec centers had better odds of undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) and improved survival rates before 2016. However, after national efforts to increase awareness and improve referral networks, these differences were no longer present between patients diagnosed in hipec and referring centers from 2016 to 2021, indicating equal access to care and similar chances of survival at a national level.

Journal Article by van der Ven RGFM, van den Heuvel TBM (…) de Hingh IHJT et 10 al. in Ann Surg Oncol

© 2024. The Author(s).

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Preoperative Chemoradiotherapy Reduces Pancreatic Fistula Risk

Preoperative chemoradiotherapy, but not chemotherapy, was found to be associated with a reduced risk of postoperative pancreatic fistula in patients undergoing pancreatoduodenectomy for pancreatic ductal adenocarcinoma. Out of the 2,019 patients included in the study, postoperative pancreatic fistula occurred in 8.3% after immediate surgery, 4.2% after preoperative chemotherapy, and 2.0% after preoperative chemoradiotherapy. These findings highlight the importance of considering preoperative chemoradiotherapy for reducing complications in pancreatic cancer surgery.

Journal Article by Wismans LV, Suurmeijer JA (…) van Eijck CHJ et 21 al. in BMC Surg

Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

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Placement of Gastrostomy Tubes at the Time of Pancreaticoduodenectomy: No Impact on Delayed Gastric Emptying

The study investigated the utility of gastrostomy tube placement during pancreaticoduodenectomy in reducing delayed gastric emptying. Results showed no difference in delayed gastric emptying incidence between patients with or without a gastrostomy tube. However, patients with a tube experienced higher postoperative complications, including postoperative ileus and atrial fibrillation. Overall, placement of gastrostomy tubes during pancreaticoduodenectomy did not offer clinical benefits in terms of reducing delayed gastric emptying.

Journal Article by Pather K, Mobley EM and Awad ZT in Surg Endosc

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

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Endoscopic Vacuum Therapy Shortens Treatment Duration for Esophageal Perforations

Patients with traumatic esophageal perforations treated with endoscopic vacuum therapy (evt) had significantly shorter treatment duration than those treated with endoscopic self-expandable metal stent (e-sems). However, e-sems led to a shorter time of hospitalization and lower costs. Both methods had similar clinical outcomes, with high discharge rates.

Journal Article by de Oliveira AT, Barreira MA (…) de Vasconcelos PRC et 4 al. in Surg Endosc

© 2024. The Author(s).

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Robotic Surgery Shows Promise for Gallbladder Cancer Treatment

Robotic-assisted surgery for gallbladder cancer is found to be as effective as traditional methods in terms of oncological outcomes, with potential benefits in precision and perioperative recovery. A systematic review comparing robotic, open, and laparoscopic techniques highlights the feasibility and safety of robotic surgery, suggesting it as a viable alternative for treatment. Further research is needed to confirm the advantages of robotic surgery and establish comprehensive surgical guidelines.

Review by Mellado S, Chirban AM (…) Vega EA et 6 al. in Am J Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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