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Association of Preoperative Thyroid Hormone Replacement with Increased Morbidity and Length of Stay in Major Abdominal Surgery

Preoperative thyroid hormone replacement is significantly associated with higher morbidity and longer length of stay following major abdominal surgery. A retrospective study on 2700 patients found that those on thyroid replacement had a 1.5-fold increased risk of serious morbidity and a 1.7-fold greater risk for serious sepsis. They also had a longer length of stay compared to patients not on thyroid replacement. These findings imply that preoperative thyroid hormone replacement independently predicts operative morbidity and longer hospital stays.

Journal Article by Haring CT, Heft Neal ME (…) Spector ME et 3 al. in Am J Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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Bariatric surgery reduces longitudinal cancer risk, particularly for breast, ovarian, and endometrial cancers

The review highlights the strong association between bariatric surgery and decreased incidence of breast, ovarian, and endometrial cancers. However, there is heterogeneity in the findings regarding esophageal, gastric, liver, pancreas, colon, and rectal cancers. The study identifies epidemiologic shortcomings in cohort studies that potentially explain these discrepancies. The review offers a framework to identify subgroups of patients who may benefit most from bariatric surgery in terms of reducing cancer risk.

Journal Article by Lim PW, Stucky CH (…) Ven Fong Z et 4 al. in JAMA Surg

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Successful left hepatectomy with right hepatic artery resection and reconstruction for treating hilar cholangiocarcinoma

The study presents the successful use of left hepatectomy combined with right hepatic artery reconstruction for treating hilar cholangiocarcinoma. A 60-year-old male patient with obstructive jaundice underwent the procedure, which involved resection of the right hepatic artery invaded by tumors, lymphadenectomy, and hepaticojejunostomy. The operation was completed in 345 minutes with minimal bleeding, and the patient had a smooth recovery without complications. Pathology results showed negative margins and lymph nodes, and the patient remained disease-free after 12 months.

Journal Article by Zhang J, Xu B (…) Wen Z et 8 al. in Ann Surg Oncol

© 2024. The Author(s).

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Nomogram Enhances Prediction of Hepatic Lymph Node Metastases in Colorectal Liver Metastases Patients

Researchers conducted a retrospective study on colorectal liver metastases (CRLM) patients to compare different models of diffusion-weighted imaging (DWI) in predicting hepatic lymph node metastases (LNM). They found that a nomogram incorporating pre-treatment distributed diffusion coefficient (DDC) and the short axis of the largest lymph node after treatment had excellent performance in distinguishing between benign and malignant lymph nodes. The nomogram showed superior diagnostic performance compared to quantitative parameters derived from DWI, and could serve as a preoperative assessment tool for determining the status of hepatic lymph nodes in CRLM patients undergoing chemotherapy before surgery.

Journal Article by Zhu HB, Zhao B (…) Sun YS et 3 al. in World J Gastroenterol

©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.

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Pilot Study Identifies Top Priorities for Assessing Low Anterior Resection Syndrome

Researchers conducted a pilot study to assess the severity of Low Anterior Resection Syndrome (LARS) following intersphincteric resection for ultralow rectal cancer. They used an exploratory instrument based on the Delphi consensus, which identified eight symptoms and eight consequences as the highest priorities for defining LARS. The study found that “emptying difficulties” and “dissatisfaction with the bowels” were the most frequent symptoms and consequences, respectively. The severity of these priorities strongly correlated with condition-specific quality of life and improvements were observed in the summary score of fecal incontinence quality of life scale.

Journal Article by Zhang B, Zhuo GZ (…) Ding JH et 4 al. in Dis Colon Rectum

Copyright © The ASCRS 2024.

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Robot-assisted KangDuo surgical robot found comparable to da Vinci Xi system for colorectal cancer surgery

Results from a multicenter randomized controlled trial in China showed that the KangDuo surgical robot (KD-SR-01) is a viable option for colorectal cancer surgery. The study found that the short-term outcomes of surgery using the KD-SR-01 system were comparable to those achieved with the da Vinci Xi robotic system. No significant differences were observed in operation success rate, surgical and pathological outcomes, or postoperative complications between the two groups. Surgeons reported a high level of comfort with the KD-SR-01 system.

Journal Article by Sun Z, Ma T (…) Xiao Y et 7 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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Laparoscopy’s Underutilization in Abdominal Stab Wound Management

Despite conflicting guidelines, this study found that laparoscopy is infrequently used in stable patients with abdominal stab wounds. Among the included patients, only 7% received therapeutic laparoscopy and 8% underwent laparoscopy converted to open surgery. However, patients who underwent therapeutic laparoscopy had better outcomes, including shorter ICU and hospital stays and fewer infection complications. This suggests that laparoscopy could be a viable alternative to open surgery for select injuries, highlighting the need for increased utilization of this approach.

Journal Article by Campbell BR, Rooney AS (…) Krzyzaniak MJ et 8 al. in Am J Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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Home-based laparoscopic training program proves effective in improving surgical skills

A national home-based laparoscopic and core surgical skills course, Monash Online Surgical Training (MOST), was evaluated for its educational impact. The 6-week remote course, designed to address limitations to surgical education access during the COVID-19 pandemic, showed statistically significant improvement in all 11 learning-outcome domains, including core laparoscopic skills and instrument handling. Participants completed 3460 tasks, reflecting 158.2 hours of practice, and rated the course, live webinars, and instrument tracking software highly. Qualitative analysis revealed the benefits of a safe learning environment and self-paced, self-directed learning.

Journal Article by Leng S, Chaudhry N, Pacilli M and Nataraja RM in Surg Endosc

© 2024. The Author(s).

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The Effect of Staple Line Reinforcement on Short-term Outcomes of Laparoscopic Sleeve Gastrectomy

A comparative study analyzed data from patients undergoing laparoscopic sleeve gastrectomy (LSG) in Egypt over 11 years to evaluate the efficacy and safety of staple line reinforcement (SLR). The SLR group had longer surgery times but a lower rate of postoperative bleeding compared to the non-SLR group. All leakage cases occurred in the non-SLR group, and the two mortality cases also belonged to the non-SLR group. While SLR increased operation time, it significantly reduced the incidence of morbidity, particularly bleeding, and the need for reoperation.

Journal Article by El Masry MAMA and Attia MS in Surg Endosc

© 2023. The Author(s).

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Patterns of Trauma Deaths in Western Cape of South Africa

Death patterns and factors associated with trauma deaths in the Western Cape of South Africa were examined through a retrospective cross-sectional analysis. The study found that the majority of trauma deaths (94.0%) occurred on-scene, predominantly among young men. Firearms were the leading cause of injury (32.6%), followed by road traffic collisions (17.8%). On-scene deaths were significantly more likely to be caused by firearms compared to healthcare system deaths. Shortening delays to care within emergency centers could potentially improve mortality outcomes, particularly for deaths occurring within 4-24 hours.

Journal Article by Finn J, Dixon JM (…) Mould-Millman NK et 15 al. in World J Surg

© 2023 The Authors. World Journal of Surgery published by John Wiley & Sons Ltd on behalf of International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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