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Comparing Simple and Radical Cholecystectomy in T1B Gallbladder Cancer: Similar Survival Outcomes

Among 950 patients with pathologic T1B gallbladder cancer, receiving either simple or radical cholecystectomy, there was no significant difference in median overall survival between the two groups. This suggests that highly selected patients may not benefit from extended resection, highlighting comparable outcomes with simple cholecystectomy in this population.

Journal Article by Rhodin KE, Goins S (…) Lidsky ME et 8 al. in HPB (Oxford)

Copyright © 2024 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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The Equipoise Ruler: Study Reveals Surgeons’ Varied Judgment on the Value of Surgery

Professional judgment about the value of surgery varies among US surgeons, according to a national survey. Researchers found that for 19 out of 30 exemplar cases, there was consensus on the value of surgery, with a range of 63% to 99% agreement. Exposure to peer responses increased the number of cases with consensus. Women were more likely to endorse non-operative approaches when treatment had high mortality, while specialists were less likely to opt for salvage procedures. Surgeons often let patients decide despite their own assessment.

Journal Article by Zychowski KL, Stalter LN (…) Schwarze ML et 8 al. in Ann Surg

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

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Low-risk pedunculated polyps do not increase colorectal cancer risk compared to fit+/colonoscopy negative group

Colorectal cancer (CRC) risk after resection of low- and high-risk adenomas was investigated in a fit-based CRC screening program. The study included 87,248 post-fit+ colonoscopies and found that patients with low-risk adenomas did not have an increased CRC incidence compared to the fit+/colonoscopy negative group. However, patients with high-risk adenomas had a significantly higher CRC incidence, particularly those with risk factors such as proximal location, non-pedunculated morphology, and high-grade dysplasia. Patients with distal pedunculated polyps without high-grade dysplasia did not have an increased risk. This finding suggests a potential reduction in surveillance burden in fit programs.

Journal Article by Zorzi M, Battagello J (…) Hassan C et 24 al. in Clin Gastroenterol Hepatol

Copyright © 2024. Published by Elsevier Inc.

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Short-term Safety of Magnetic Sphincter Augmentation vs Minimally Invasive Fundoplication

This study compared the outcomes of patients undergoing magnetic sphincter augmentation (MSA) or fundoplication for anti-reflux surgery using the ACS-NSQIP registry. A total of 7,882 patients were included, with MSA patients being younger and more often male. Compared to fundoplication, MSA was associated with reduced postoperative complications, fewer readmissions, shorter hospital stays, and shorter operative times. The study supports the use of MSA as a safe alternative for anti-reflux surgery, although further randomized trials are needed.

Journal Article by Wisniowski P, Putnam LR (…) Lipham JC et 3 al. in Surg Endosc

© 2024. The Author(s).

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Robotic Surgery Reduces the Incidence and Severity of Low Anterior Resection Syndrome in Patients with Lower Rectal Cancer

Robotic surgery has been shown to significantly reduce the occurrence and severity of low anterior resection syndrome (LARS) in patients with lower rectal cancer. In a study involving 342 patients, the incidence of major LARS was significantly lower in the robotic surgery group compared to the laparoscopic surgery group at 6, 12, and 18 months postoperatively. The study also identified various independent risk factors for major LARS and developed a reliable prediction model, which can aid surgeons in individualized treatment planning for low rectal cancer patients.

Journal Article by Zhang L, Hu C (…) Shi F et 6 al. in Surg Endosc

© 2024. The Author(s).

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Simulation in African Surgical Education: A Critical Need for Training in Low-Middle-Income Countries

Researchers conducted a needs assessment in African surgical education, revealing a critical need for comprehensive surgical training in low-middle-income countries (LMICs). The survey of program directors identified high priority skills such as intracorporeal suturing, laparoscopic camera driving, and medial visceral rotation. Interviews highlighted a desire for laparoscopic surgery and a need for a simulation curriculum to familiarize staff and trainees with laparoscopic techniques. Faculty and surgical trainees in LMICs expressed interest in learning advanced surgical techniques, particularly laparoscopy, indicating the potential for a tailored simulation curriculum to bridge this educational gap.

Journal Article by Obayemi JE, Donkersloot J (…) Kim GJ et 3 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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Comparative Outcomes and Prognostic Factors in Adrenalectomy for Adrenal Metastasis

Adrenalectomy for adrenal metastasis remains controversial, and the feasibility of laparoscopic adrenalectomy (LA) is under debate. A retrospective review of 141 patients undergoing adrenalectomy compared open adrenalectomy (OA) to LA. For tumors less than 8 cm without adjacent organ resection, LA had shorter operation time, less blood loss, and shorter hospital stay. Positive pathological margin, disease activity at the primary site, other metastases, and larger tumor size were associated with poor locoregional recurrence-free survival. Metachronous metastasis was linked to longer overall survival, while positive pathological margin, metastases to other organs, and larger tumor size were associated with shorter overall survival.

Journal Article by Kwak J, Bae HL (…) Lee KE et 5 al. in Surg Endosc

© 2024. The Author(s).

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Liver Resection Outperforms Ablation in Multifocal Hepatocellular Carcinoma

Examining T2 multifocal hepatocellular carcinoma (MHCC), researchers compared liver resection (LR) and tumor ablation (TA) in a cohort of 1225 patients. Despite higher 30-day mortality with LR, 10-year overall survival favored LR over TA (27.5% vs. 14.7%). Stratified analysis revealed significant benefits in patients with negative resection margins, no lymphovascular invasion, and a Charlson-Deyo score ≤1. Multivariable analysis confirmed LR’s independent association with improved long-term survival. These findings suggest that LR provides superior outcomes, particularly when transplantation is not an option.

Journal Article by Kakish H, Suraju MO (…) Aziz H et 3 al. in J Surg Oncol

© 2024 The Authors. Journal of Surgical Oncology published by Wiley Periodicals LLC.

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Gender Disparities in Family Planning and Career Advancement in General Surgery

The study reveals notable gender disparities in family planning, parental leave, and career advancement among general surgeons. Of the respondents, 26% had utilized fertility services, while 36.4% of men and 100% of women took parental leave during training. A higher percentage of women agreed that their training influenced their decision on having and timing children. Additionally, women expressed more concerns about future family planning, fertility, parental leave, and perceived parental leave to have an impact on career advancement. The findings underscore the need for further research and support to address gender inequalities in general surgery.

Journal Article by Patel A, Wilson CA (…) Seemann NM et 3 al. in J Surg Res

Copyright © 2024 Elsevier Inc. All rights reserved.

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Preoperative Sarcopenia Predicts Poor Prognosis in Gastric Cancer

Preoperative sarcopenia is significantly associated with lower overall survival (OS) and relapse-free survival (RFS) in patients with gastric cancer. A retrospective study of 781 gastric cancer patients who underwent radical gastrectomy revealed that preoperative sarcopenia is an independent risk factor for 10-year OS and RFS. Patients with sarcopenia had a higher risk of death and recurrence within the first postoperative year. However, postoperative adjuvant chemotherapy significantly improved the long-term outcomes of stage II-III patients with sarcopenia.

Journal Article by Zheng HL, Wei LH (…) Li P et 8 al. in Eur J Surg Oncol

© 2024 Elsevier Ltd, BASO ∼ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

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