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Distal Fistula Risk Score: Preoperative Tool for Predicting Pancreatic Fistula in Distal Pancreatectomy

Researchers conducted a nationwide retrospective Dutch cohort study to validate the preoperative and intraoperative Distal Fistula Risk Score (D-FRS) for postoperative pancreatic fistula (POPF) prediction in distal pancreatectomy (DP) patients. The study included 896 patients, of which 152 (17%) developed POPF. The preoperative D-FRS, based on pancreatic neck thickness and pancreatic duct diameter, had an acceptable predictive capacity (AUROC 0.73). The intraoperative D-FRS, including additional variables, showed slightly lower predictive capacity (AUROC 0.69). The findings suggest that the preoperative D-FRS could aid in improving preventative strategies, such as drain management.

Journal Article by van Bodegraven EA, den Haring FET (…) Besselink MG et 20 al. in Langenbecks Arch Surg

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Feasibility and Safety of Early Home Transfer for Surgical Patients

A cohort study evaluated the effectiveness and safety of a hospital at home (HAH) program for surgical patients. The study included 325 patients who underwent various surgeries and were transferred to the HAH unit. Results showed that overall escalation of care during HAH occurred in 7.3% of patients, with a 7% 30-day readmission rate. Most adverse events were managed at home, and there were no deaths. Patients with HAH were discharged three days earlier than the usual pathway, saving a total of 1,551 bed-days.

Journal Article by Ugarte A, Bachero I (…) Nicolás D et 17 al. in Ann Surg

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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Normalization Overestimates Tumor Budding Counts in Colorectal Carcinoma Assessment

Validation of the international tumor budding consensus conference (itbcc) method for assessing tumor budding in colorectal cancer (CRC) revealed that normalization overcorrects tumor budding counts, resulting in the downgrading of many borderline cases. Despite this, tumor budding counts in a 0.95 mm2 field remained clinically predictive. These findings highlight the implications of normalization for risk stratification and adjuvant treatment decisions, suggesting the need to re-evaluate its role in tumor budding assessment.

Journal Article by Cyr DP, Pun C (…) Conner JR et 11 al. in Am J Surg Pathol

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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Low Utilization of Surgical Resection for Locally Advanced Pancreatic Cancer

Despite the positive outcomes reported by high-volume international centers, a multicenter retrospective study in the Netherlands found that surgical resection for locally advanced pancreatic cancer (LAPC) following induction chemotherapy is infrequently performed. Out of 142 patients who underwent resection, only 34.5% met the national comprehensive cancer network criteria. The most commonly used chemotherapy was FOLFIRINOX, and venous and arterial resections were performed in a minority of patients. The study also revealed acceptable morbidity and mortality rates, with a median overall survival of 26 months and a 5-year survival rate of 18%.

Journal Article by Stoop TF, Seelen LWF (…) Besselink MG et 22 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Radical resection provides improved OS for patients with high-risk histology in T2N0M0 rectal adenocarcinoma

Local excision may be a reasonable approach for patients with low-risk histopathology and clinical stage T2N0M0 rectal adenocarcinoma, as it showed similar overall survival rates compared to radical resection. However, radical resection provided a significant survival advantage for patients with high-risk histology.

Journal Article by Kramer SP, Swanson J (…) Baker MS et 6 al. in BMC Surg

Copyright © 2023. Published by Elsevier Inc.

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Reducing Postoperative Labs in Colorectal Surgery has No Impact on Stay or Readmissions

A quality improvement study investigated the impact of reducing postoperative laboratory testing after colorectal surgery. The intervention group showed a 33% reduction in labs per hospital stay, 26% reduction in labs per day, and a 49% increase in lab-free days. There were no differences in length of stay or readmissions between the intervention and non-intervention groups. The findings prompted the implementation of lab work reduction approaches and a change in the laboratory order set. These efforts contribute to the prioritization of high-value surgical care.

Journal Article by Dave YA, Temple L (…) Cannon LM et 4 al. in Dis Colon Rectum

Copyright © The ASCRS 2023.

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Robotic Ramps Safely Improves Short-Term Outcomes for Pancreatic Cancer Patients

A retrospective cohort study compared robotic and open radical antegrade modular pancreatosplenectomy (ramps) for pancreatic ductal adenocarcinoma (PDAC) and found that robotic ramps had advantages in operative time, estimated blood loss, delayed gastric emptying, and postoperative hospital stay. The rate of severe postoperative complications was similar between the groups. Both robotic and open ramps had comparable oncological outcomes and long-term survival rates. Robotic ramps expanded the indications for minimally invasive surgeries for PDAC, providing a safe alternative to open procedures.

Journal Article by Song Y, Zou W (…) Liu R et 5 al. in Surg Endosc

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Higher Weight Loss and Postprandial Regurgitation in Banded Sleeve Gastrectomy

Five-year results from a three-year randomized controlled trial comparing banded and non-banded sleeve gastrectomy (SG) showed that banded sleeve gastrectomy (BSG) resulted in significantly higher excess weight loss (9%) and total weight loss (4.2%) compared to non-banded SG. Most patients experienced remission of type 2 diabetes, with no significant difference between the two groups. However, BSG had a higher incidence of postprandial regurgitation, which was the main added morbidity in these patients.

Journal Article by Fink JM, Reutebuch M (…) Fink M et 4 al. in Obes Surg

© 2023. The Author(s).

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EUS-Fiducial Markers Improve Pancreas Surgery Guidance

Researchers conducted a preliminary controlled trial to evaluate the feasibility of using endoscopic ultrasound-guided fiducial markers (EUS-FMP) to guide pancreas surgery. The study enrolled 20 patients with resectable pancreas masses and found that EUS-FMP was successful and technically straightforward before planned surgery. Intraoperative detection of the markers was feasible and improved compared to lesions without a marker. The mean tumor size detected by EUS was 1.7 cm. The study suggests that EUS-FMP can be a useful tool for guiding pancreatic resection.

Journal Article by Chang PW, Sadik J (…) Buxbaum JL et 9 al. in J Clin Gastroenterol

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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Pragmatic Sleep Protocol Yields No Increase in Postoperative Sleep Time in Surgical Oncology Patients

Researchers conducted a randomized controlled trial to evaluate the effects of a sleep protocol on postoperative sleep time in surgical oncology patients. The study included 101 patients undergoing major oncologic surgery, with half receiving the sleep protocol and half receiving standard care. Results showed no significant difference in postoperative sleep time between the two groups. Major complication rates were also similar. The study suggests that implementing a more humane sleep protocol for postoperative inpatients should be considered.

Journal Article by Kelly K, Kolbeinsson H (…) Chung M et 5 al. in J Surg Oncol

© 2023 Wiley Periodicals LLC.

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