Blog

Failed nonoperative management of appendicitis in older adults increases morbidity, length of stay, and costs

The study analyzed the risks and consequences of failed nonoperative management of appendicitis in older adults. Using data from the 2004-2017 national inpatient sample, the researchers found that nonoperative failure in patients under 65 was associated with increased morbidity, length of stay, costs, and discharges to skilled facilities. Similar outcomes were observed in patients aged 65 and above. Therefore, the nonoperative management of appendicitis should be approached cautiously in older adults.

Journal Article by Lunardi N, Marten E (…) Balentine CJ et 3 al. in Am J Surg

Published by Elsevier Inc.

read the whole article in Am J Surg

open it in PubMed

Study Finds Adverse Events Associated with Single Operator Cholangioscopy System

Analysis of the MAUDE database reveals that the single operator cholangioscopy (SOC) system, specifically the SpyGlass DS and DS II devices, carries additional risks compared to standard endoscopic retrograde cholangiopancreatography. The study identifies 2,331 device problems reported between January 2016 and August 2023, with optical issues being the most prevalent. Patient-related events were found in 3.5% of reports, including bleeding, perforation, infection, fever, or sepsis, and pancreatitis. These findings offer important insights into the potential problems associated with SpyGlass SOC.

Journal Article by Chandan S, Ramai D (…) Kochhar GS et 3 al. in Gastrointest Endosc

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

read the whole article in Gastrointest Endosc

open it in PubMed

Preoperative CA 19-9 predicts disease progression in colorectal peritoneal metastases treated with CRS/HIPEC

Elevated levels of CA 19-9, a tumor marker, were found to be associated with decreased progression-free survival (PFS) in patients with colorectal peritoneal metastases (CRPM) treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). The study, which included 279 patients, showed that patients with elevated CA 19-9 had a much worse PFS rate compared to those with normal levels. CA 19-9 was independently predictive of worse PFS in patients who underwent upfront CRS/HIPEC. However, further prospective studies are needed to confirm this association.

Journal Article by Fackche NT, Schmocker RK (…) Greer JB et 18 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

read the whole article in Ann Surg Oncol

open it in PubMed

Robotic Surgery Improves Oncologic Outcomes in Rectal Cancer Patients with Unfavorable Characteristics After Neoadjuvant Chemoradiotherapy

The study compared long-term oncologic outcomes of robotic and laparoscopic surgeries in rectal cancer patients who underwent neoadjuvant chemoradiotherapy (NCRT) followed by radical resection. After propensity score matching, the robotic group demonstrated higher 5-year disease-free survival and local recurrence-free survival rates compared to the laparoscopic group. The advantage of the robotic approach was particularly evident in patients with unfavorable factors and stage III disease after NCRT. These findings highlight the potential benefits of robotic surgery for improving oncologic outcomes in this patient population.

Journal Article by Shin JK, Kim HC (…) Park YA et 4 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

read the whole article in Ann Surg Oncol

open it in PubMed

Salvage Surgery Improves Overall Survival Rates in Unresectable Hepatocellular Carcinoma Patients

Among patients with initially unresectable hepatocellular carcinoma (uhcc), combination therapy with transcatheter arterial chemoembolization, lenvatinib, and anti-PD-1 antibodies achieved high tumor response rates and converted some cases to resectable disease. A retrospective study compared outcomes in uhcc patients who underwent salvage surgery (sr group) versus those who did not (non-sr group). The sr group demonstrated significantly better overall survival rates, with 1- and 2-year rates of 92.0% and 79.9% compared to 85.5% and 39.6% in the non-sr group, respectively. Salvage surgery is recommended for unresectable uhcc patients who achieve partial response after conversion therapy.

Journal Article by Wu JY, Wu JY (…) Yan ML et 8 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

read the whole article in Ann Surg Oncol

open it in PubMed

CA19-9 Gene Test Enhances Prognostic Assessment in Postoperative Pancreatic Cancer

A study investigated the use of a fut variant-based CA19-9 tumor marker gene test to assess the outcome of pancreatic cancer surgery. The test showed that higher preoperative CA19-9 levels were associated with recurrence and mortality in patients with higher fut groups, but not in lower fut groups. CA19-9 levels after neoadjuvant therapy and normalization based on fut group were found to be predictors of response to therapy and early recurrence. The gene test modestly improved the prognostic performance of CA19-9.

Journal Article by Ando Y, Dbouk M (…) Goggins M et 9 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

read the whole article in Ann Surg Oncol

open it in PubMed

Myosteatosis and Low CCR Predict Poor Survival in Post-surgery Pancreatic Cancer Patients

Myosteatosis and creatinine-to-cystatin C ratio (CCR) were evaluated as prognostic biomarkers in patients with pancreatic cancer (PC) who underwent radical surgery. The study included 215 patients, and the results showed that myosteatosis and CCR ≤ 1.09 were independent risk factors associated with poor overall survival (OS) and disease-free survival (DFS). Furthermore, patients with the combination of myosteatosis and CCR ≤ 1.09 had the worst OS. These findings highlight the importance of considering myosteatosis and CCR as predictive factors for survival in PC patients post-surgery.

Journal Article by Bi S, Jiang Y (…) Jing X et 4 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

read the whole article in Ann Surg Oncol

open it in PubMed

Improved Survival with Neoadjuvant Chemotherapy in i-IPMN vs. PDAC

The study compared the response to neoadjuvant chemotherapy and overall survival in patients with invasive intraductal papillary mucinous neoplasm (i-ipmn) and de novo pancreatic ductal adenocarcinoma (pdac). The results showed that i-ipmn histology was independently associated with a lower risk of recurrence and death. Pathological, radiological, and positron emission tomography responses to neoadjuvant therapy were comparable between i-ipmn and pdac. Furthermore, i-ipmn patients had a significantly higher overall survival and disease-free survival compared to pdac patients. Neoadjuvant chemotherapy can be considered as a treatment option for selected i-ipmn patients.

Journal Article by Fogliati A, Zironda A (…) Truty MJ et 10 al. in Ann Surg Oncol

© 2024. The Author(s).

read the whole article in Ann Surg Oncol

open it in PubMed

Validated Clinical Score Predicts Gastroesophageal Reflux in Patients with Chronic Laryngeal Symptoms

A validated clinical score, the COuGH RefluX, has been developed to predict the likelihood of gastroesophageal reflux disease (GERD) in patients with chronic laryngeal symptoms. The score, based on cough, overweight/obesity, globus, hiatal hernia, regurgitation, and male sex, accurately stratifies patients as low or high likelihood of GERD. With a sensitivity of 79% and specificity of 81%, the score can guide diagnostic strategies and reduce unnecessary treatment for patients with chronic laryngeal symptoms.

Journal Article by Krause AJ, Kaizer AM (…) Yadlapati R et 9 al. in Clin Gastroenterol Hepatol

Copyright © 2024. Published by Elsevier Inc.

read the whole article in Clin Gastroenterol Hepatol

open it in PubMed

Chronic Lymphocytic Thyroiditis Linked to Reduced Central Lymph Node Metastasis in Papillary Thyroid Carcinoma

In the study evaluating the impact of chronic lymphocytic thyroiditis on papillary thyroid carcinoma patients, researchers found that patients with chronic lymphocytic thyroiditis exhibited different clinical features compared to those without. The presence of chronic lymphocytic thyroiditis was associated with a lower risk of central lymph node metastasis. Notably, angiolymphatic invasion was identified as the sole independent risk factor for central lymph node metastasis in patients with papillary thyroid carcinoma and chronic lymphocytic thyroiditis. These findings suggest a potential protective role of chronic lymphocytic thyroiditis against metastasis.

Journal Article by Heo DB, Won HR (…) Koo BS et 11 al. in BMC Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

read the whole article in BMC Surg

open it in PubMed