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Intestinal Autotransplantation Results in Prolonged Survival for Locally Advanced or Recurrent Colon Cancer Involving SMA

Intestinal autotransplantation (iatx) combined with extended resections of multiple organs, including the superior mesenteric artery (SMA), was performed on 10 patients with locally advanced or recurrent colon cancer invading the SMA. The study found that iatx, either alone or in combination with pancreaticoduodenectomy, is a safe procedure and is associated with a 68% recurrence-free survival and 80% overall survival rate at 3 years after surgery. The patients experienced postoperative complications, but 80% of them were alive without evidence of disease during the follow-up period of 23.9 months.

Journal Article by Wu G, Zhao L (…) Liang T et 5 al. in Ann Surg

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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The Impact of Fatigue on Surgical Performance

Researchers conducted a systematic review to evaluate the effect of fatigue on surgical outcomes. Out of 7,251 studies, 134 were included in the analysis, comprising over 1.6 million surgeries. Simulator studies showed that fatigue led to a deterioration in surgical outcomes in 46% of cases, while real-life studies reported a deterioration in 35.5% of cases. The difference may be attributed to increased motivation and effort by surgeons during real surgeries. Current fatigue and outcome measures are inadequate to fully define the impact of fatigue on surgical outcomes.

Journal Article by Reijmerink IM, van der Laan MJ (…) Cnossen F et 2 al. in Br J Surg

© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.
© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.

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Percutaneous Creation of Gastrointestinal Anastomosis via Lumen-Apposing Metallic Stents for Gallbladder Drainage

Researchers discuss the emerging frontier of percutaneous cholecysto-enteric anastomoses for internal drainage of the gallbladder, focusing on the percutaneous delivery and deployment of lumen-apposing metallic stents. The study highlights the efficacy and safety of using these stents for creating gastrointestinal anastomosis, providing a less invasive option for gallbladder drainage compared to traditional surgical procedures.

Journal Article by Klein E, Barragan C and Shlomovitz E in JAMA Surg

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Medical Students’ Perceptions on Family Planning Influence Specialty Choice

Medical students in a qualitative study revealed four main perceptions that impact their choice of medical specialty: (1) there is no ideal time for family building within a medical career, (2) family planning is a taboo topic, (3) surgical specialties provide less support for family building, and (4) residents with children are seen as a burden to their colleagues. These perceptions influence specialty selection and highlight the need for integrating family planning discussions and support into medical curricula to improve team dynamics and workload during parental leave.

Journal Article by Dason ES, Maxim M (…) Simpson AN et 5 al. in JAMA Surg

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Enhancing R0 Resection in Anorectal Cancers: A Posterior-First, 2-Stage Approach

Using a posterior-first, 2-stage approach, researchers achieved consistent R0 resection of locally advanced primary and recurrent anorectal cancers involving the deep pelvic sidewall. All 10 patients in the study achieved R0 resection, although nine experienced complications, including gluteal wound issues. Four patients developed metastatic disease during follow-up, highlighting the importance of close monitoring. Overall, the new approach shows promise for improving R0 resection rates, but careful management of wound healing is crucial.

Journal Article by Sakata S, Karim SM (…) Dozois EJ et 5 al. in Dis Colon Rectum

Copyright © The ASCRS 2023.

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Enhanced Recovery Programs and Colorectal Surgery Outcomes: reduces Racial Disparities in Complications, but not in Length of Stay

The study aimed to determine the impact of enhanced recovery programs on social vulnerability and race-related disparities in colorectal surgery outcomes. The researchers found no significant association between social vulnerability and length of stay, complications, or readmissions in either the enhanced recovery or non-enhanced recovery groups. Black race was associated with increased length of stay in both groups. Enhanced recovery program adherence reduced racial disparities in complications, but disparities in length of stay persisted. Further research is needed to understand the underlying mechanisms behind these disparities.

Journal Article by Smith BP, Katta M (…) Chu DI et 5 al. in Dis Colon Rectum

Copyright © The ASCRS 2023.

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Conversion Risks in Laparoscopic Resection for Intrahepatic Cholangiocarcinoma: Vessel Proximity and Prior Surgery

Patients with intrahepatic cholangiocarcinoma (ICC) who required conversion from laparoscopic to open surgery were studied to determine the risk factors and outcomes associated with this conversion. Tumor proximity to major vessels and previous upper abdominal surgery were identified as independent predictors of unplanned conversions. Surgical conversions resulted in longer operative times, increased blood loss, higher transfusion rates, longer hospital stays, and higher rates of major morbidity compared to successful laparoscopic liver resections. However, there was no significant difference in mortality between the two groups.

Journal Article by Sheng Y, Zheng J (…) Liang X et 2 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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Force Feedback Function in Surgical Robot Improves Suturing Procedure

Adding a force feedback function to robotic surgical systems significantly reduced the maximal force applied to the robotic forceps while maintaining the quality of suturing. The force feedback function did not affect the objectively assessed suturing score but slightly shortened the task accomplishment time in younger surgeons. This suggests that robots with force feedback can facilitate the educational process for novice surgeons, enhancing surgical outcomes.

Journal Article by Yamasaki Y, Tokunaga M (…) Kinugasa Y et 6 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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Implementation of ERAS Protocols in Colorectal Surgery Yields Positive Outcomes

Despite advancements in surgical and anesthetic care, the implementation of Enhanced Recovery After Surgery (ERAS) protocols in colorectal surgery still provides benefits. This single-center study compared patients undergoing elective colorectal surgery under an ERAS program to those receiving standard care and found that ERAS led to a reduction in non-surgical complications, shorter length of stay, and lower costs. These findings highlight the continued importance of implementing ERAS protocols in specialized colorectal centers.

Journal Article by Süsstrunk J, Mijnssen R (…) Steinemann DC et 3 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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Metachronous Para-aortic Lymphadenectomy in Colorectal Cancer: Surgical Management Improves Survival

The systematic review focused on the outcomes of metachronous para-aortic lymphadenectomy in colorectal cancer treatment. Surgical resection of metachronous para-aortic lymph node metastasis (m-palnm) was found to be the preferred management strategy in 64% of patients. Patients who underwent surgical management experienced longer disease-free survival and overall survival rates. However, the evidence available is limited, and further randomized trials are necessary to provide more definitive evidence on the management of m-palnm and its impact on survival.

Review by Onafowokan OO, Redfern J (…) Baltatzis M et 2 al. in Langenbecks Arch Surg

© 2023. Crown.

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