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Diagnostic Laparoscopy with Peritoneal Lavage in Gastric Adenocarcinoma: High Diagnostic Yield and Impact on Management

Diagnostic laparoscopy with peritoneal lavage in gastric adenocarcinoma has a high diagnostic yield, with 24.5% of patients having positive findings leading to exclusion from neoadjuvant treatment or surgical resection. Peritoneal metastases were identified in 10.3% of patients, with 12.5% having positive peritoneal cytology without macroscopic disease. Diffuse type carcinoma had the highest risk of peritoneal dissemination. Staging laparoscopy changes management in approximately one quarter of patients, highlighting its importance in guiding treatment decisions.

Journal Article by van Hootegem SJM, Chmelo J (…) Wijnhoven BPL et 3 al. in Eur J Surg Oncol

© 2024 Published by Elsevier Ltd.

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Virtual Informed Consent and the Importance of Trust-Building

Virtual formats for informed consent in surgery may hinder trust-building, as they rely on an information-transfer model rather than a trust-building one. This study suggests that a trust-building model is essential for a fuller understanding of the consent process, highlighting potential shortcomings of virtual formats on interpersonal and systemic levels. The ethical framework proposed can help physicians navigate this novel virtual space more effectively.

Journal Article by Lee JH, Neff KE and Vercler CJ in Ann Surg

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

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Development and Validation of a Privacy-proof Surgical Anonymization Algorithm for Live Streaming

Researchers developed and validated a pioneer surgical anonymization algorithm, named Robotic Anonymization Network (ROBAN), for real-time removal of out-of-body images during live surgery streaming. The algorithm achieved a high ROC AUC score of 99.89% after post-processing, outperforming previous state-of-the-art methods and offering reliable, accurate, and safe anonymization across different robotic platforms and procedural types.

Journal Article by De Backer P, Simoens J (…) Mottrie A et 12 al. in Ann Surg

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

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What is the main reason for re-establishing care in bariatric patients after metabolic/bariatric surgery?

Patients after metabolic/bariatric surgery who sought to re-establish care mostly presented due to recurrent weight gain. Sleeve gastrectomy patients had a higher rate of revision surgery, while Roux-en-Y gastric bypass patients underwent more endoscopic interventions. Additionally, response to anti-obesity medications, particularly GLP-1 drugs, was more effective in Roux-en-Y gastric bypass patients compared to sleeve gastrectomy patients.

Journal Article by Medhati P, Saleh OS (…) Tavakkoli A et 5 al. in J Am Coll Surg

Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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High waist circumference positively affects clinical outcomes in esophageal cancer patients receiving immune checkpoint inhibitors.

In patients with unresectable or recurrent esophageal cancer receiving immune checkpoint inhibitors, high waist circumference was associated with favorable progression-free survival and disease control rates. This suggests that body composition, specifically waist circumference, may influence clinical outcomes in esophageal cancer patients undergoing ICI treatment.

Journal Article by Kosumi K, Baba Y (…) Baba H et 13 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Association of Race/Ethnicity with Invasive Intraductal Papillary Mucinous Neoplasms

Patients of race/ethnicity other than white had significantly higher rates of invasive intraductal papillary mucinous neoplasms during surgical resection, with 20.5% of cases demonstrating invasion. Despite being younger and healthier, non-white patients had higher odds of invasive neoplasms, independent of clinicodemographic variables. Postoperative morbidity did not differ among racial/ethnic groups. This national cohort study highlights racial disparities in the invasiveness of resected intraductal papillary mucinous neoplasms in the US.

Journal Article by Allen WE, Greendyk JD (…) Ecker BL et 12 al. in BMC Surg

Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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Histopathological Evaluation of Pouch Neoplasia Reveals the Importance of Annual Surveillance for High-Risk Patients

Neoplasia in the ileal pouch of patients with inflammatory bowel diseases or familial adenomatous polyposis is rare but poses a significant risk. Annual endoscopic surveillance is crucial for detecting dysplasia in high-risk patients. While dysplastic polyps in familial adenomatous polyposis are easily identifiable and removable, glandular dysplasia in ulcerative colitis may be challenging to detect. Adequate tissue sampling and expert histological analysis are recommended to accurately diagnose and manage neoplasia in the pouch and rectal cuff.

Journal Article by Ko HM in Dis Colon Rectum

Copyright © The ASCRS 2024.

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Which Bariatric Procedure Shows Superior Long-Term Results: LSG or OAGB?

After a 7-year follow-up, OAGB demonstrated significantly higher %EWL and %TWL compared to LSG. Quality of life scores improved in both groups, with more OAGB patients reaching very good or excellent outcomes on the BAROS score. Both procedures led to significant drops in total body weight and BMI, with most patients experiencing remission or improvement in comorbidities. OAGB outperformed LSG as a successful bariatric procedure over the long term.

Journal Article by Jain M, Tantia O (…) Gupta S et 4 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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Development of Prediction Models for Mortality Risk After Colorectal Cancer Surgery

Researchers developed prediction models using preoperative data to assess short-term mortality risk following colorectal cancer surgery. The models showed good discrimination and calibration, with an area under the receiver operating characteristic curve of 0.88, 0.878, and 0.861 for 30-day, 90-day, and 1-year mortality, respectively. Subgroup analysis did not improve discrimination or calibration. Combining all operated patients resulted in better performing models than separate subgroups, with an overall mortality incidence of 4.48%, 6.64%, and 12.8% for 30-day, 90-day, and 1-year mortality, respectively.

Journal Article by Bräuner KB, Tsouchnika A (…) Gögenur I et 7 al. in Int J Colorectal Dis

© 2024. The Author(s).

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Machine learning does not outperform expert-informed predictions for outcome after major liver surgery

Expert-informed prediction models and machine learning models both showed similar performance in predicting postoperative overall morbidity in liver surgery patients, with high variability and over/underprediction. There was no improvement in performance for major liver surgery patients, indicating that machine learning may not have clinical relevance for predicting postoperative outcomes at this stage.

Journal Article by Staiger RD, Mehra T (…) Clavien PA et 7 al. in HPB (Oxford)

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

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