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Aqueous Povidone-Iodine Irrigation Does Not Reduce Surgical Site Infection Incidence Compared to Saline Irrigation

Researchers conducted a randomized controlled trial to compare the effectiveness of intraoperative wound irrigation with aqueous povidone-iodine (PVP-I) versus saline in reducing surgical site infections (SSI) in clean-contaminated wounds after gastroenterological surgery. The study included 941 patients and found that the incidence of incisional SSI was slightly higher in the group receiving PVP-I (7.6%) compared to the saline group (5.1%). These results suggest that the current recommendation for PVP-I irrigation should be reconsidered.

Journal Article by Maemoto R, Noda H (…) Rikiyama T et 23 al. in Ann Surg

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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Development of Multitask AI Model to Identify Surgical Skill Level from Open Surgical Videos

A study developed a multitask AI model capable of real-time understanding of surgical behaviors by analyzing a large collection of annotated open surgical videos. The model successfully identified kinematic descriptors of surgical skill related to the efficiency of hand motion. The compound skill feature derived from the model was found to be a significant discriminator between experienced surgeons and surgical trainees, with higher values indicating experienced surgeons. This AI-based analysis has the potential to optimize surgical skill acquisition and improve surgical care.

Journal Article by Goodman ED, Patel KK (…) Yeung-Levy S et 12 al. in JAMA Surg

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Understanding the Levels of Robotic Mesopancreas Dissection According to Malignancy and Vascular Anatomy

A recent study provides a comprehensive step-by-step overview of mesopancreas dissection during robotic pancreatoduodenectomy (PD) and its three levels based on tumor type. Surgeons interested in the robotic approach for PD should be familiar with these levels to ensure safe and successful dissections. The study aims to familiarize clinicians with tips and indications related to mesopancreas dissection according to tumor type and vascular anatomy, offering valuable insights for surgeons performing robotic pancreatoduodenectomy.

Journal Article by Ielpo B, d’Addetta MV (…) Burdio F et 6 al. in Ann Surg Oncol

© 2023. The Author(s).

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Association Between RAS/BRAF Mutations and Lower Complete Response Rates in Rectal Cancer Patients

The study aimed to assess the impact of RAS/BRAF mutations on complete response rates after total neoadjuvant therapy (TNT) in advanced rectal cancer patients. Findings revealed that patients with mutant RAS/BRAF had significantly lower rates of achieving clinical and overall complete response compared to those with wild-type RAS/BRAF. However, there was no significant difference in pathological complete response rates. These results suggest that RAS/BRAF mutations negatively affect primary tumor response to TNT, emphasizing the need for larger-scale studies to determine if mutation status can guide optimal oncologic therapy selection.

Journal Article by Bedrikovetski S, Traeger L (…) Sammour T et 4 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Financial toxicity risk among patients undergoing CRS-HIPEC: Study reveals one-third at risk

Researchers conducted a retrospective cohort study on 163 patients who underwent cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) between 2016 and 2022. They found that 31.9% of patients were at risk of financial toxicity, with higher out-of-pocket expenditures and lower income quartiles being significant risk factors. The median out-of-pocket expenditure for at-risk patients was $5000, compared to $3341 for those not at risk. These findings suggest the need for interventions and identification of patients who may benefit from financial support in CRS-HIPEC treatment.

Journal Article by Ciftci Y, Radomski SN, Johnston FM and Greer JB in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Splenic Vein Tumor Thrombosis is an Independent Prognostic Factor in Distal Pancreatic Adenocarcinoma

The study aimed to assess the prognostic relevance of splenic vessel involvement in distal pancreatic adenocarcinoma. The researchers identified 149 patients who underwent surgery, with 46.3% showing splenic vascular involvement. Among them, 14.8% had a pathologic tumor thrombosis of the splenic vein. The presence of splenic vein tumor thrombosis was associated with larger tumors, more invasion, and positive lymph nodes. The study found that splenic vein tumor thrombosis independently affected overall survival. Therefore, preoperative evaluation of splenic vessel involvement and thrombosis is necessary to define perioperative oncological strategies for resectable distal pancreatic adenocarcinoma.

Journal Article by Jeune F, Collard M (…) Gaujoux S et 12 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Gasless TOETVA and Open Surgery have Comparable Effects on Oral Function and Psychological Well-being in Papillary Thyroid Cancer Patients

The study analyzed 212 papillary thyroid cancer patients who underwent either gasless transoral endoscopic thyroidectomy vestibular approach (TOETVA) or open surgery. The gasless TOETVA group exhibited higher oral health impact profile-14 scores in the first year after surgery compared to the open surgery group, but the difference disappeared after one year. State anxiety scores did not differ between the groups, but the gasless TOETVA group had significantly lower trait anxiety scores throughout follow-up. Additionally, gasless TOETVA patients more than one year post-surgery showed increased trait anxiety scores.

Journal Article by Chen J, Fang J (…) Wang S et 3 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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Central Lymph Nodes in Frozen Sections Predict Extended Lymph Node Resection Need in Papillary Thyroid Carcinoma

Central lymph node metastasis (CLNM) in frozen sections accurately predicted neck lateral lymph node metastasis (NLLNM) in patients with papillary thyroid carcinoma (PTC). Furthermore, risk factors for NLLNM metastasis were identified, including maximum metastatic diameter, total number, and ratio of metastatic lymph nodes (LNs). Based on these findings, patients with PTC with >5 CLNMs, 2-5 CLNMs, and maximum metastatic diameter >2mm should be considered for extended lateral neck lymph node dissection, aiding in the selection of patients who can benefit from this procedure.

Journal Article by Peng L, Zheng X (…) Yu S et 3 al. in Ann Med

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High Rate of Misdiagnosis of Suspected Cancer Found in Pancreatoduodenectomy Patients Over Three Decades

Researchers investigated the misdiagnosis of suspected cancer among patients undergoing pancreatoduodenectomy (PD) over a 30-year period. They found that diagnostic errors resulted in PD being mistakenly performed for benign disease. Of the 1,812 patients who underwent PD for suspected malignancy, 97 (5.2%) were ultimately diagnosed with a benign condition. The study also highlighted the challenges in accurately diagnosing certain benign diseases that can mimic malignancy, such as autoimmune and chronic pancreatitis.

Journal Article by Halle-Smith JM, Bartlett D (…) Roberts KJ et 5 al. in HPB (Oxford)

Copyright © 2023. Published by Elsevier Ltd.

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Lymph Node Dissection on Intrahepatic Cholangiocarcinoma: Potential Benefit only for Clinically Node-Negative Patients

According to a systematic review and meta-analysis, researchers found that lymph node dissection (LND) did not significantly impact overall survival, disease-free survival, or risk of major complications in patients with intrahepatic cholangiocarcinoma (ICC). However, for clinically node-negative patients, LND was associated with improved overall survival and a trend towards improved disease-free survival compared to no LND. These findings suggest that LND may benefit a specific subgroup of ICC patients, but its overall impact on long-term survival and morbidity in ICC is still limited.

Review by Yeow M, Fong KY (…) Kabir T et 6 al. in HPB (Oxford)

Copyright © 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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