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Octreotide does not improve outcomes in adult patients with post-esophagectomy chylothorax

Octreotide’s efficacy in managing intrathoracic chyle leak post-esophagectomy in adults was investigated in a cohort study. Among 74 patients, 27 received octreotide, but there was no significant difference in chest tube duration, hospital length of stay, or overall survival compared to non-octreotide group. Multivariable analysis confirmed that octreotide did not affect clinical outcomes. The study concludes that octreotide lacks evidence for improving outcomes in adult patients with chyle leak post-esophagectomy, highlighting the need for further research.

Journal Article by Deboever N, Feldman H (…) Hofstetter WL et 10 al. in Dis Esophagus

© The Author(s) 2024. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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Effect of Perioperative Dexamethasone on Postoperative Complications after Pancreaticoduodenectomy

Perioperative dexamethasone did not significantly reduce postoperative complications within 30 days after pancreaticoduodenectomy, as evidenced by similar comprehensive complication index scores, major complications, and pancreatic fistula rates between the dexamethasone and placebo groups. However, in patients with a main pancreatic duct ≤3 mm, the dexamethasone group showed a significantly lower complication index score.

Journal Article by Chen H, Wang Y (…) Shen B et 20 al. in Ann Surg

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

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Improving End-of-Life Care for Veterans Undergoing Surgery

Researchers examined trends in end-of-life care services and satisfaction among veterans undergoing surgery. Over the study period, palliative care consultation and hospice use rates more than doubled, while satisfaction scores increased. Hospital location and accreditation were associated with the most significant changes. Improvements in satisfaction with end-of-life care corresponded with increased service usage, suggesting the need for targeted interventions to reduce hospital heterogeneity and enhance end-of-life care for veterans.

Journal Article by Dualeh SHA, Anderson MS (…) Suwanabol PA et 3 al. in Ann Surg

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

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Privacy-Proof Live Surgery Streaming: Development of a Reliable Robotic Anonymization Algorithm

Researchers developed a pioneer surgical anonymization algorithm, validated across various robotic platforms, to remove out-of-body images in real-time. The algorithm successfully achieved a framewise anonymization roc auc-score of 99.46% on unseen procedures, increasing to 99.89% after post-processing. The deep learning model, ROBAN, offers safe real-time anonymization during complex surgical procedures on different robotic platforms, outperforming previous state-of-the-art algorithms even on unseen 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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Prognostic value of tumour response and nodal status in oesophageal adenocarcinoma

Researchers found that higher Mandard score and residual nodal disease were associated with increased recurrence rates and worse overall survival in patients with oesophageal adenocarcinoma. Patients with better tumour response (trg1) had lower recurrence rates and longer overall survival compared to those with poorer response (trg>1). Residual nodal disease had a more negative impact on prognosis than residual disease at the primary tumour site.

Journal Article by Henckens SPG, Liu D (…) van Berge Henegouwen MI et 29 al. in Br J Surg

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

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Prognostic Significance of CA19-9 in Resectable Pancreatic Cancer

In a nationwide study on resectable pancreatic ductal adenocarcinoma (PDAC), researchers found that elevated preoperative CA19-9 levels (≥500 U/ml) significantly reduced overall survival after upfront resection, unlike Eastern Cooperative Oncology Group performance status. This highlights the prognostic value of incorporating CA19-9 into the preoperative staging of anatomically resectable PDAC, emphasizing the importance of considering both biological and conditional factors in evaluating resectability.

Journal Article by Schouten TJ, van Goor IWJM (…) Daamen LA et 26 al. in Ann Surg Oncol

© 2024. The Author(s).

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Identification of Promising Prediction Models for Morbidity and Mortality After Esophagectomy

A systematic review identified 33 prediction models for morbidity and mortality after esophagectomy, with 18 newly developed. Prognostic accuracy ranged from 0.51 to 0.85, with some models showing promise for further development. Performance status emerged as a potential modifiable risk factor, but none of the models are ready for clinical implementation. Two models for mortality and one for pulmonary complications have potential for future refinement. Availability of rigorous prediction models remains limited, with many studies showing a high risk of bias.

Review by van Nieuw Amerongen MP, de Grooth HJ (…) Tuinman PR et 3 al. in Ann Surg Oncol

© 2024. The Author(s).

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Task-Specific Metrics for Laparoscopic Fundoplication in Hiatal Hernia Repair

Researchers successfully developed and validated task-specific metrics (TSM) for laparoscopic Nissen fundoplication, a critical phase in laparoscopic hiatal hernia repair (LHHR). Utilizing structured interviews with expert foregut surgeons and a simulation involving participants with varying surgical expertise, the study demonstrated high interrater reliability and significant validity evidence for both global and TSM assessments. These LHHR-specific metrics are poised to enhance training through a planned virtual reality simulator.

Journal Article by Desir A, Marques C (…) Sankaranarayanan G et 4 al. in Surg Endosc

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

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Bariatric Surgery-Related Small Bowel Obstruction: Impact of Age, Gender, and Procedure Type

Patients who developed small bowel obstruction (SBO) after bariatric surgery were older, with lower BMI, and more likely female. Serious complications at 30 days post-operation were increased in SBO patients, with Roux-en-Y gastric bypass being the largest independent predictor of SBO development. COPD, prior DVT, lower BMI, and female sex were also predictive factors. SBO occurred in 0.3% of cases and was associated with serious outcomes, especially in female patients with lower BMI and those undergoing RBYG.

Journal Article by McLean C, Mocanu V (…) Switzer NJ et 2 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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Impact of Bariatric Surgery on Cognitive Performance and Metabolites

After bariatric surgery, attention capacity and executive function improved, while immediate memory worsened. Serine, glutamic acid, and glycolic acid were identified as potential metabolites linked to cognitive performance alterations. Cluster analysis revealed two subgroups, with cluster 2 showing improved attention and executive function but reduced immediate memory. These findings suggest that bariatric surgery affects cognitive function and circulating metabolites, providing potential biomarkers and therapeutic targets for preventing obesity-related cognitive decline.

Journal Article by Pino JMV, Silva VF (…) Lee KS et 8 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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