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Short-Term Expectant Management of Small Bile Duct Stones in Cholecystectomy

In cholecystectomy patients with small common bile duct stones (≤5 mm) identified by intraoperative ultrasound, a short-term expectant management approach, avoiding immediate duct clearance, proved safe. Among 51 patients, 46 underwent expectant management, with 89.1% not requiring postoperative interventions. Over 3 years, none presented with residual stones, and hospital length of stay was significantly reduced. This suggests potential benefits of a conservative approach, challenging the current guidelines advocating routine duct clearance for identified stones.

Journal Article by Bunting D, Adesuyi A (…) Sanders D et 2 al. in Langenbecks Arch Surg

© 2024. The Author(s).

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Ki-67 Proliferation Index as a Potential Surrogate for Tumor Grade in Pleural Epithelioid Mesotheliomas

Ki-67 proliferation index was found to be associated with tumor grade in pleural epithelioid mesotheliomas, showing comparable predictability for overall survival to mitotic score. High Ki-67 index and mitoses were significantly linked to poor overall survival, suggesting that Ki-67 index by digital image analysis could serve as a reliable surrogate for tumor grade in assessing prognosis for patients with pem.

Journal Article by Galeano B, Smith CJ (…) Aubry MC et 6 al. in Am J Surg Pathol

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

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Neoadjuvant chemotherapy improves survival in locally advanced colon cancer

Compared to upfront surgery, neoadjuvant chemotherapy for locally advanced colon cancer is associated with lower recurrence and mortality hazards, higher 5-year survival rates, and increased disease-free survival rates. Additionally, it reduces the risk of incomplete resection without significantly impacting perioperative complications or mortality. These findings emphasize the benefits of neoadjuvant chemotherapy as a treatment strategy for patients with locally advanced colon cancer.

Journal Article by Aliseda D, Arredondo J (…) Pastor C et 6 al. in Br J Surg

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

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Antegrade stenting followed by EUS-guided hepaticogastrostomy extends time to recurrent biliary obstruction in patients with unresectable malignant distal biliary obstruction.

Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is associated with higher rates of adverse events and recurrent biliary obstruction compared to antegrade stenting followed by EUS-HGS (EUS-HGAS) in patients with malignant distal biliary obstruction. However, EUS-HGAS significantly extends the time to recurrent biliary obstruction, potentially benefiting patients with longer life expectancy.

Journal Article by Ishiwatari H, Ogura T (…) Notsu A et 11 al. in Gastrointest Endosc

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

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Recurrence-Free Survival Strongly Correlates with Overall Survival in Neoadjuvant-Treated Oesophageal Squamous Cell Carcinoma

Recurrence-free survival is a valid surrogate endpoint for overall survival in surgically resectable advanced oesophageal squamous cell carcinoma (oscc) patients receiving neoadjuvant chemotherapy. A strong correlation (kendall’s τ 0.797) was found between the two endpoints, particularly in patients with a more favorable response to neoadjuvant treatment. This suggests that recurrence-free survival can be used as a reliable predictor of overall survival outcomes in oscc patients.

Journal Article by Okui J, Nagashima K (…) Kitagawa Y et 17 al. in Br J Surg

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

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Wound Irrigation in Laparotomy: No Significant Reduction in Surgical Site Infections

Wound irrigation with polyhexanide solution did not significantly decrease the incidence of surgical site infections compared to saline or no irrigation after laparotomies. The study, involving 689 patients, found an overall infection rate of 11.8%, with no statistically significant difference between the groups. Further research is needed to assess the potential benefits in contaminated and septic procedures, including emergency cases.

Journal Article by Mueller TC, Kehl V (…) Reim D et 29 al. in JAMA Surg

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Immunotherapy in High-Risk Rectal Cancer: Promising Results with Total Neoadjuvant Therapy

Researchers evaluated total neoadjuvant therapy with immunotherapy for high-risk rectal cancer with proficient mismatch repair status. The study showed a pathologic complete response rate of 33.3%, with 48% achieving clinical complete response. R0 resection was achieved in all patients. Adverse effects were manageable, with nausea being the most common. Patients with tumor shrinkage or clinical complete response had higher percentages of LRP1B mutation, associated with high tumor mutation burden and tumor neoantigen burden, which benefited from therapy.

Journal Article by Li Y, Pan C (…) Wu A et 16 al. in JAMA Surg

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Abdominal Wall Tension Does Not Impact Early Postoperative Outcomes in Posterior Component Separation with Transversus Abdominis Release

After analyzing 200 measurements from 100 patients undergoing posterior component separation with transversus abdominis release, researchers found that baseline and residual abdominal wall tensions did not affect early postoperative complications such as surgical site infection, readmission, ileus, and bleeding. Further investigation is required to determine if abdominal wall tension influences long-term outcomes like hernia recurrence.

Journal Article by Miller BT, Ellis R (…) Rosen MJ 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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Electric Bicycle Injuries on the Rise in the US from 2017 to 2022

Surge in Electric Bicycle Injuries: US Cases Soar 30-Fold from 2017 to 2022, with Head Trauma Incidence Surging 49 Times. Hospitalizations reach 5462, a 43-fold increase, with injuries in children rising to 13%. Head injuries rise sharply, while helmet use declines by 5.6% annually, worn by only 44% of injured e-bicyclists. Odds of head injury for non-helmeted e-bicyclists are 1.9 times higher

Journal Article by Fernandez AM, Li KD (…) Breyer BN et 4 al. in JAMA Surg

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Enhanced Recovery in Rectal Cancer Surgery Does Not Improve Long-Term Survival

Implementing enhanced recovery pathways in rectal cancer surgery decreased short-term morbidity and length of hospital stay. However, adherence to these protocols did not show an improvement in long-term overall survival, cancer-specific survival, or disease-free survival compared to non-enhanced care. Therefore, while enhanced recovery pathways reduce short-term complications, they do not affect long-term oncological outcomes in rectal cancer patients undergoing minimally invasive surgery.

Journal Article by Gomaa I, Aboelmaaty S (…) Larson DW et 7 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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