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Increased Risk of Postoperative Bleeding in Adrenalectomy for Secondary Adrenal Malignancy

Adrenalectomy for secondary adrenal malignancy (SM) poses an elevated risk of postoperative bleeding compared to benign nonfunctional (BNF) adrenal neoplasms. Among 3496 patients, those with SM were older and had higher rates of comorbidities. Laparoscopic adrenalectomy was common for both groups, with comparable mortality and morbidity rates. However, SM patients exhibited significantly higher postoperative bleeding rates (6.3% vs. 2.6%). Multivariable analysis confirmed this association, emphasizing the importance of counseling for patients meeting criteria for adrenal metastasectomy.

Journal Article by Green RL, Gao TP and Kuo LE in J Surg Res

Copyright © 2024 Elsevier Inc. All rights reserved.

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Implementation of Best Practices in Pancreatic Cancer Care: Limited Impact on Survival and Quality of Life

In a randomized trial involving 5,887 pancreatic cancer patients, implementing best practices, including optimal chemotherapy and supportive care, showed no improvement in one-year survival or quality of life. Notably, a substantial number of patients did not receive tumor-directed treatment, emphasizing the necessity for more personalized therapeutic approaches in pancreatic cancer care.

Journal Article by Mackay TM, Latenstein AEJ (…) Besselink MG et 37 al. in JAMA Surg

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How to Safely Manage the Spiegel/IVC Interface during Laparoscopic Caudate Resection: A Focus on Bleeding Prevention

Minimally invasive caudate lobectomy can lead to significant bleeding due to its proximity to the IVC, portal pedicle, and hepatic veins. Preoperative modeling and careful dissection techniques can help in safely managing the Spiegel/IVC interface during laparoscopic caudate resection, reducing the risk of thermal injury and ensuring successful outcomes.

Journal Article by Salirrosas O, Harandi H (…) Conrad C et 2 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Does palliative surgery improve outcomes in locally advanced pancreatic cancer?

Patients with locally advanced pancreatic cancer undergoing palliative surgery experienced slightly longer survival than those undergoing medical palliation, with hospital stays and readmission rates being significantly higher for the surgical group. Despite the marginal survival benefit, palliative surgery presents challenges in terms of hospitalization and risk of readmission.

Journal Article by Kramer SP, Tonelli C (…) Baker MS et 4 al. in Am J Surg

Copyright © 2024. Published by Elsevier Inc.

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Development and Validation of a New Tool for Assessing Minimally Invasive Inguinal Hernia Repair Procedural Safety

Researchers developed and tested an 8-item procedure-specific assessment tool for minimally invasive inguinal hernia repair, showing good to excellent inter-rater reliability. Robotic procedures had higher reliability, and easier cases had higher agreement levels. The tool was designed and evaluated with expert input and real-world operative videos, with promising results for safety assessments in surgical training programs.

Journal Article by Nikolian VC, Camacho D (…) Stulberg J 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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Improving emotional support and clarity in surgical trainee remediation

Trainees perceived remediation as harrowing and isolating, with long-lasting emotional effects. They reported a lack of clarity on underperformance and subjective goals, and viewed remediation as a superficial ‘performance’ exercise. The study highlights the need for better emotional support and improved remediation plans to address deficits, with a focus on enhancing trainee/supervisor dynamics for improved patient care outcomes.

Journal Article by McLeod K, Woodward-Kron R (…) Nestel D et 2 al. in Am J Surg

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

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Incidence and Patterns of Hollow Viscus Perforation in Blunt Abdominal Trauma

Isolated hollow viscus (HV) perforations in blunt abdominal trauma (BAT) are rare but increasing in incidence. A retrospective study at a trauma center found that 6.04% of BAT patients undergoing emergency surgery had HV perforations, mostly involving grade II-III jejunum and grade I transverse colon. Despite a trend towards delayed diagnosis, a systematic approach based on trauma mechanisms and patient status is crucial for early recognition and treatment of these injuries.

Journal Article by Rodriguez VI, Perez B (…) Teran A et 2 al. in World J Surg

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

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Immediate Postoperative Mobilization Does Not Increase Overall Physical Activity After Colorectal Surgery

Immediate mobilization in the post-anesthesia care unit did not increase overall postoperative physical activity after elective colorectal surgery, as indicated by no significant differences in steps taken between the intervention group and standard care group during hospital stay. Other outcomes, including complications and compliance with ERAS protocol, were also similar between groups.

Journal Article by Wilnerzon Thörn RM, Forsberg A (…) Ljungqvist O et 4 al. in World J Surg

© 2024 The Authors. World Journal of Surgery published by John Wiley & Sons Ltd on behalf of International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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Does Fundoplication at the Time of Paraesophageal Hernia Repair Reduce Postoperative Reflux?

Patients who underwent paraesophageal hernia repair without fundoplication did not report different rates of postoperative symptoms compared to those who did. The study found that fundoplication at the time of hernia repair may not reduce postoperative reflux, despite being a standard practice for sliding-type hiatal hernias. This suggests that the additional procedure may not be necessary for patients with paraesophageal hernias.

Journal Article by Logarajah S, Karumuri J (…) Jeyarajah DR et 2 al. in J Gastrointest Surg

Copyright © 2023. Published by Elsevier Inc.

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Tumor deposits negatively impact prognosis in colorectal cancers, new staging system proposed

Tumor deposits are a strong indicator of poor outcome in stage III colorectal cancers. A new staging system, considering tumor deposits, showed higher predictive values and better patient stratification for oncologic outcome compared to the current system. Tumor deposits were correlated with adverse prognostic indicators, confirming their negative impact on survival regardless of count. Revision of the staging system could optimize treatments, with the proposed new classification being easy to implement and more accurate.

Journal Article by Lieto E, Auricchio A (…) Cardella F et 6 al. in J Gastrointest Surg

Copyright © 2023 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights reserved.

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