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Procalcitonin and CRP Predictors of Postoperative Complications in Elderly Patients

Plasma concentrations of procalcitonin and C reactive protein within 24 hours of surgery, along with their perioperative changes, were valuable predictors of major complications in elderly patients after non-cardiac surgery. Procalcitonin at 24 hours, C reactive protein at 24 hours, and their changes were particularly effective in predicting major complications, with good discriminatory ability.

Journal Article by Chen Y, Zhao Y (…) Hao X et 3 al. in BMJ Open

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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Advancements in Chronic Pancreatitis Management

Chronic pancreatitis is a result of repeated pancreatic inflammation leading to loss of function, causing symptoms such as abdominal pain and diabetes. The review highlights the latest research on diagnostic methods and treatment options, including genetic factors and surgical interventions for patients not responsive to medications. Promising clinical trials are ongoing to develop new medical therapies for this debilitating condition.

Review by Hines OJ and Pandol SJ in BMJ

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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International Guidelines and Registry for Surgical Patients with Borderline-resectable and Locally Advanced Pancreatic Cancer

International experts in pancreatic surgery and cancer management developed and validated guidelines for the perioperative care of patients with borderline resectable (BR) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC). The guidelines include 34 recommendations covering patient selection, timing of surgery, vascular reconstruction, lymphadenectomy, and more. Despite a low level of evidence for most clinical questions, experts agreed on the need for an international registry to advance understanding in this field.

Journal Article by Boggi U, Kauffmann E (…) Asbun HJ et 128 al. in Ann Surg

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

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Near-Infrared Fluorescence Imaging + Indocyanine Green Reduces Hypoparathyroidism Rates in Thyroid Cancer Patients

The study evaluated the impact of near-infrared fluorescence imaging plus indocyanine green fluorescence on postoperative hypoparathyroidism rates after total thyroidectomy and central neck lymph node dissection. The near-infrared fluorescence imaging + indocyanine green group showed significantly lower rates of both transient and permanent hypoparathyroidism compared to the control group and the near-infrared fluorescence imaging alone group. This imaging approach also improved the identification of parathyroid glands and reduced inadvertent resections, contributing to better surgical outcomes.

Journal Article by Di Lorenzo S, Carrillo Lizarazo JL (…) Donatini G et 2 al. in Br J Surg

© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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Identification of a Pathomics Signature for Chemotherapy Benefits in Stage III Colon Cancer

Researchers developed and validated a pathomics signature based on 4 features to estimate prognosis and chemotherapy benefits in stage III colon cancer. The signature was found to be significantly associated with disease-free survival (DFS) and overall survival (OS) in training and validation cohorts. Patients with a low pathomics signature were more likely to benefit from chemotherapy, highlighting the potential of this signature in identifying patients who may benefit from treatment.

Journal Article by Jiang W, Wang H (…) Yan J et 8 al. in JAMA Surg

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Specimen Extraction Site Affects Postoperative Incisional Hernia Risk After Minimally Invasive Right Colectomy

Minimally invasive right colectomy patients with midline specimen extraction have a higher risk of developing postoperative incisional hernia (ih) compared to those with pfannenstiel extraction. The study of 341 patients found that midline extraction was associated with a 25% ih rate, while pfannenstiel extraction had a 0% rate. Midline extraction was also linked to longer hospital stays and increased likelihood of ih development.

Journal Article by Johnson JA, Mesiti A (…) Jafari MD et 6 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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C-Reactive Protein Predicts Liver-Specific Infections After Resection

Researchers found that postoperative day 3 and day 5 C-reactive protein levels have high predictive value for detecting liver resection-surgical site infections, with optimal cut-off values identified. This information can assist in ruling out infections and making decisions regarding hospital discharge in patients undergoing liver resection.

Journal Article by Pattou M, Fuks D (…) Tzedakis S et 9 al. in BMC Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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Age and Grade III hemorrhoids are associated with a higher likelihood of choosing hemorrhoidectomy as the initial treatment

Patients with grade III hemorrhoids were more likely to choose hemorrhoidectomy as the initial treatment compared to grade II. Additionally, younger patients (18-30 and 31-50 age groups) were more likely to opt for hemorrhoidectomy as the initial treatment compared to older patients. However, there were no significant differences in the time to hemorrhoidectomy based on age or hemorrhoid grade for patients who initially underwent medical or office-based procedures.

Journal Article by Capece SJ, Browning CJ (…) Sangster W et 3 al. in Dis Colon Rectum

Copyright © The ASCRS 2024.

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Impact of Emergency Surgery on Patient Reported Outcomes

Patients undergoing emergency general surgery felt they had no choice and were often excluded from decision-making. Females reported this more commonly. Patients with minor complications expressed less trust and communication issues, while those with major complications showed more confidence in their team. Patients not admitted to the ICU highlighted good communication. The severity of complications impacted patient-reported outcomes, suggesting the need for tailored measures that consider patient reflections and feelings of exclusion.

Journal Article by Mathew PJ, Ali YM (…) Schuster KM et 3 al. in Am J Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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Impact of ICU Admission on Physical and Mental Health Outcomes in Trauma Survivors

Physical impairment and mental health symptoms are prevalent in trauma survivors who spent significant time in the ICU. ICU patients had higher rates of new ADL limitations, worse SF-12 mental and physical scores, with factors like age, gender, race, education level, polytrauma, ventilator use, psychiatric illnesses, and delirium during ICU stay contributing to poor outcomes. Early liberation from ventilator support and delirium prevention could be key intervention targets.

Journal Article by Herrera-Escobar JP, Lamarre T (…) Anderson GA et 13 al. in Am J Surg

Published by Elsevier Inc.

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