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Factors Affecting 1-Year Mortality in Elderly Cancer Patients After Major Abdominal Surgery

In a study involving 378 elderly cancer patients aged 80 or older who underwent major abdominal surgery, researchers found that 24.3% of them died within a year. Various factors were linked to this one-year mortality, including preoperative performance status, significant weight loss, the use of vasopressors during surgery, and postoperative blood transfusions. Encouragingly, adherence to enhanced recovery after surgery (ERAS) protocols and specific surgical approaches were associated with improved survival. These findings emphasize the importance of optimizing pre-, intra-, and postoperative care for this vulnerable population.

Journal Article by Canac J, Faucher M (…) Mokart D et 15 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Poor Mental Health Access Linked to Worse Outcomes in Gastrointestinal Cancer Patients

Mental health significantly impacts cancer care. Researchers analyzed Medicare data on patients with gastrointestinal cancer and mental illness from 2004 to 2016. They found that those with limited access to psychiatric services faced higher risks of postoperative complications, extended hospital stays, 90-day readmissions, and poorer overall outcomes. Patients with mental illness and restricted access to mental health services encountered worse postoperative results. This highlights the need for policymakers and healthcare providers to prioritize mental health support to bridge disparities among gastrointestinal cancer patients.

Journal Article by Katayama ES, Woldesenbet S (…) Pawlik TM et 5 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Clinical Calculator Accurately Predicts Freedom from Colon Cancer Recurrence

In a study validating the Memorial Sloan Kettering clinical calculator for predicting freedom from colon cancer recurrence, results demonstrated its accuracy. The calculator, based on clinical and molecular variables, was originally developed with selective microsatellite instability testing. However, when tested with data from patients thoroughly examined for instability, it remained reliable. The concordance index was 0.748, signifying good discrimination and calibration, and even in a secondary analysis considering tumor deposits, it maintained a high concordance index of 0.755. This confirms the calculator’s precision in predicting colon cancer recurrence.

Journal Article by Khan A, Thompson H (…) Weiser MR et 10 al. in Dis Colon Rectum

Copyright © The ASCRS 2023.

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Low-Dose Haloperidol Effectively Reduces Postoperative Nausea/Vomiting in Bariatric Surgery

In the pursuit of countering postoperative nausea and vomiting (PONV) among bariatric surgery patients, researchers integrated low-dose haloperidol into enhanced recovery protocols. Analyzing data from 475 patients, they found that those who received haloperidol had lower rates of PONV, required fewer additional antiemetics, and experienced significantly shorter hospital stays. This innovative approach not only eases patient discomfort but also enhances recovery, promoting safe discharge within 24 hours of bariatric surgery.

Journal Article by Lam P, Druar N (…) Shetty S et 2 al. in Surg Endosc

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

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Precise Tension Analysis Guides Hernia Repair Technique

In hernia repairs, the posterior components separation (PCS) technique plays a key role, but its precise impact on the abdominal wall remains unclear. Researchers at the Cleveland Clinic investigated this. They discovered that retrorectus dissection significantly reduced tension on the anterior fascia, ideal for cases requiring anterior fascial advancement. Meanwhile, incision of the posterior lamella of the internal oblique and transversus abdominis muscle release (TAR) lowered tension on the posterior fascia, making them beneficial for posterior fascial advancement. This quantitative insight aids surgeons in making informed intraoperative decisions during PCS.

Journal Article by Miller BT, Ellis RC (…) Rosen MJ et 6 al. in JAMA Surg

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Improved Survival in Esophageal Cancer: Key Role of Upper Mediastinal Lymphadenectomy in Minimally Invasive Surgery

Minimally invasive esophagectomy, when combined with upper mediastinal lymphadenectomy, has shown enhanced prognosis for esophageal squamous cell carcinoma. This study analyzed 339 patients and revealed higher efficacy indices around recurrent laryngeal nerves. Patients who underwent this procedure experienced significantly improved survival rates, highlighting the importance of upper mediastinal lymphadenectomy during minimally invasive esophagectomy, particularly in upper and middle-third tumors.

Journal Article by Oshikiri T, Goto H (…) Kakeji Y et 7 al. in J Am Coll Surg

Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Geographic Disparities in Esophageal Cancer Treatment in Michigan

This study delves into the uneven landscape of esophageal cancer treatment in Michigan. Analyzing data from over 8,600 patients, the researchers found that a mere 27.4% received esophageal surgery. Men, white individuals, the insured, and those in rural areas were more likely to get this surgery. Alarmingly, significant variations in care were discovered between urban and rural regions, with rural areas showing less access to surgery. This research underscores the need to address healthcare disparities in esophageal cancer treatment.

Journal Article by Lee JH, Arora A (…) Reddy RM et 3 al. in J Am Coll Surg

Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Early Cholecystectomy Benefits Frail Geriatric Patients with Acute Biliary Pancreatitis

When it comes to frail geriatric patients with acute biliary pancreatitis (ABP), opting for early cholecystectomy (CCY) during the index admission is a wise choice. A study comparing these patients to those managed nonoperatively (NOM) through endoscopic procedures found that CCY led to significantly lower 6-month rates of complications, readmissions, mortality, and fewer days spent in the hospital. NOM was less successful, with 1 in 7 patients experiencing failure within 6 months, leading to unplanned CCY and associated complications. Early CCY is recommended for these patients when feasible.

Journal Article by Nelson AC, Bhogadi SK (…) Joseph B et 6 al. in J Am Coll Surg

Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Preoperative Chemo Ups Survival in Nonmetastatic T4b Colon Cancer

A game-changer for colon cancer treatment! This study analyzed the impact of preoperative chemotherapy on nonmetastatic T4b colon cancer. Results showed that neoadjuvant chemotherapy significantly increased survival rates. Over the years, its use grew from 4% to 16%. Factors like younger age, male gender, recent diagnosis, academic centers, node-positive disease, and sigmoid colon tumors predicted higher neoadjuvant chemotherapy use. Patients who received it had better resection rates and overall survival, especially those with node-positive disease. Tailoring treatment decisions could save lives.

Journal Article by Kamel MK, Shchatsko A (…) Marar O et 6 al. in Dis Colon Rectum

Copyright © The ASCRS 2023.

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CT Scans Predict Feasibility of Intestinal Surgery in IBD Patients

Researchers at Cedars-Sinai have developed a groundbreaking technique using preoperative CT scans to predict whether a patient with inflammatory bowel disease (IBD) will be a suitable candidate for ileal pouch-anal anastomosis (IPAA). By measuring critical lengths related to the small bowel’s mesentery, they identified that patients with a mesenteric length of less than 14.6 cm or a mobilization length greater than 17 cm were at higher risk for nonreach, a condition where IPAA might not be feasible. This non-invasive, readily available method could significantly aid surgical planning and patient counseling.

Journal Article by Adams ED, Lansky CA (…) Fleshner PR et 2 al. in Dis Colon Rectum

Copyright © The ASCRS 2023.

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