Blog

Opportunities for Improving Care in Managing Acute Colonic Pseudo-Obstruction

Researchers examined outcomes of patients with acute colonic pseudo-obstruction (ACPO) and adherence to treatment guidelines. A total of 45 patients were identified, with 13 admitted under general surgery. Despite all patients receiving admission bloods, ACPO management, often overseen by general surgeons, may impact conservative treatment quality and intervention timeliness. Further optimization is necessary to improve patient care in managing ACPO.

Journal Article by Khan Z, Challand CP and Lee MJ in Ann R Coll Surg Engl

read the whole article in Ann R Coll Surg Engl

open it in PubMed

En-bloc resection of well-differentiated nonampullary duodenal neuroendocrine tumors is safe and effective

Endoscopic resection of well-differentiated nonampullary duodenal neuroendocrine tumors was safe and effective, with a high rate of en-bloc and R0 resections. Tumors located in the second part of the duodenum, ≥10mm in size, and with muscularis propria invasion were risk factors for non-curative resection. Adverse events were rare and successfully managed. Long-term outcomes showed low rates of recurrence and metastasis, making this treatment favorable for patients without regional lymph node or distant metastasis.

Journal Article by Wang Y, Ren Z (…) Lin SL et 7 al. in Gastrointest Endosc

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

read the whole article in Gastrointest Endosc

open it in PubMed

Higher postoperative complications and healthcare expenditures in dementia patients undergoing major surgery

Authors found that patients with Alzheimer’s disease and related dementias had lower rates of achieving textbook outcomes and home discharge after major surgery, along with higher healthcare expenditures. They also had increased odds of postoperative complications, extended length-of-stay, readmissions, and mortality. These findings highlight the importance of considering cognitive deficits in decision-making regarding surgical procedures for elderly patients.

Journal Article by Khalil M, Woldesenbet S (…) Pawlik TM et 8 al. in World J Surg

© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

read the whole article in World J Surg

open it in PubMed

Impact of Multibipolar Radiofrequency Ablation on Intrahepatic Cholangiocarcinoma Recurrence

Multibipolar radiofrequency ablation (RFA) resulted in lower local recurrence rates in patients with intrahepatic cholangiocarcinoma (ICCA) compared to monopolar RFA. Treatment-naive patients had a median overall survival of 26 months and tumor size and Child-Pugh B score were associated with higher mortality. Distant recurrence rates were lower for small ICCA tumors. Cirrhotic ICCA patients had shorter overall survival and higher local recurrences than hepatocellular carcinoma (HCC) patients. Multibipolar RFA may be beneficial for treating small ICCA tumors, and adjuvant chemotherapy should be considered due to high rates of extrahepatic metastasis at recurrence.

Journal Article by Alitti C, Rode A (…) Nault JC et 13 al. in Liver Int

© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

read the whole article in Liver Int

open it in PubMed

Immunosuppressive Induction Agents in Liver Transplantation: No Impact on Incisional Hernia Development

Despite the technical complexity of liver transplantation and the high incidence of incisional hernias, a retrospective cohort study found that the specific immunosuppressive induction agent administered during surgery did not affect the development of hernias. However, obesity and postoperative seroma of the abdominal wall were identified as potential risk factors. The overall incisional hernia rate at 5 years post-transplantation was 28.5%, highlighting the need for further research to validate these findings across different settings.

Journal Article by Kim YJ, Wlodarczyk J (…) Zielsdorf S et 3 al. in J Surg Res

Copyright © 2024 Elsevier Inc. All rights reserved.

read the whole article in J Surg Res

open it in PubMed

Long-Term Survival Unaffected by Complication Severity After Esophagectomy for Cancer

Survival following esophagectomy for esophageal cancer remains stable regardless of post-operative complication severity. A study of 721 patients showed no significant difference in long-term survival rates between those with no complications, minor, or major complications, with overall survival rates staying equivalent at 1, 3, and 5 years. Factors independently associated with survival were gender, comorbidity index, and disease stage. This suggests complications do not impact long-term survival post-esophagectomy.

Journal Article by Nevins EJ, Chmelo J (…) Phillips AW et 2 al. in Eur J Surg Oncol

© 2024 Published by Elsevier Ltd.

read the whole article in Eur J Surg Oncol

open it in PubMed

Hand-sewn ileal pouch-anal anastomosis improves survival in familial adenomatous polyposis patients

Comparison between stapled and hand-sewn ileal pouch-anal anastomosis in familial adenomatous polyposis patients showed that hand-sewn anastomosis was associated with better overall survival. The stapled group had higher rates of adenoma in the remnant rectum or anal transitional zone, metachronous rectal cancer, and mortality. Cox regression analysis confirmed the negative impact of stapled anastomosis on overall survival. Hand-sewn ileal pouch-anal anastomosis is recommended for improved prognosis in familial adenomatous polyposis patients.

Journal Article by Tatsuta K, Sakata M (…) Takeuchi H et 8 al. in Int J Colorectal Dis

© 2024. The Author(s).

read the whole article in Int J Colorectal Dis

open it in PubMed

Surgeons Exhibit Varied Views on PDAC Resectability, Regardless of Classification System

Surgeons’ classification of pancreatic ductal adenocarcinoma (PDAC) resectability varies significantly, regardless of the adopted classification system, according to a survey distributed to international HPB surgeons. The study found notable discordance among surgeons in determining resectability, with a median concordance rate of 62.5% with their chosen classification system. Overall, the findings highlight the need for standardized criteria in assessing PDAC resectability.

Journal Article by Irfan A, Feng W (…) Rose JB et 2 al. in HPB (Oxford)

Copyright © 2024 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

read the whole article in HPB (Oxford)

open it in PubMed

Development of a Preoperative Risk Score for Recurrence in Non-Cirrhotic Hepatocellular Carcinoma Patients

Researchers developed a preoperative risk score based on early recurrence to estimate outcomes after liver resection in non-cirrhotic hepatocellular carcinoma patients. By analyzing data from 263 patients, they identified macroscopic vascular invasion, multifocal tumor, and spontaneous tumor rupture as predictors of early recurrence. This score allows for stratification of patients based on recurrence risk assessment, aiding in better treatment planning.

Journal Article by Ruiz E, Honles J (…) Bertani S et 8 al. in HPB (Oxford)

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

read the whole article in HPB (Oxford)

open it in PubMed

Gastric Volumetry’s Key Role in Weight Loss and Fatty Liver Improvement

Researchers conducted a study on 63 morbidly obese patients undergoing laparoscopic sleeve gastrectomy to determine the optimal percentage of excised stomach for significant weight loss and improvement in fatty liver. They found that a %rgv value of >75.3% led to more significant weight loss, while a %rgv value of >56.4% resulted in improved fatty liver disease. Gastric volumetry is crucial in achieving successful outcomes in laparoscopic sleeve gastrectomy.

Journal Article by Chen HY, Yang PJ (…) Wu CH et 4 al. in J Formos Med Assoc

Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

read the whole article in J Formos Med Assoc

open it in PubMed