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Predictive Risk Score Identifies Recurrence of Acute Diverticulitis

Researchers conducted a prospective observational study to develop a predictive risk model for the recurrence of acute diverticulitis (AD) after the first episode. They analyzed data from 368 patients with AD who had a good response to treatment and found that colonic perforation in the antimesenteric location and a CRP level greater than 100 mg/dL were independent risk factors for recurrence. They developed a risk score using five variables, which successfully differentiated patients into intermediate and high-risk groups based on their likelihood of recurrence.

Journal Article by Pastor-Mora JC, Fortea-Sanchís C (…) Llueca A et 6 al. in World J Surg

© 2023 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

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ctDNA Assessment in Characterizing Recurrence Sites after Resection for Metastatic Colorectal Cancer

Among 31 patients who underwent optimal resection for metastatic colorectal cancer (mCRC), circulating tumor DNA (ctDNA) was detected in 83.4% of those who experienced postoperative recurrence, while remaining undetectable in those without recurrence. ctDNA was detected earlier than clinical diagnosis by a median of nine weeks, and its levels were significantly lower in peritoneal-only recurrence compared to distant recurrence. These findings suggest that ctDNA testing can effectively characterize recurrence sites after resection for mCRC, aiding in the development of targeted treatments specific to the involved sites.

Journal Article by Bansal VV, Belmont E (…) Shergill A et 7 al. in J Am Coll Surg

Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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The Feasibility and Promising Results of Conversion Surgery for Esophageal Cancer with Distant Metastasis

A multi-institutional retrospective study investigated the clinical impact of conversion surgery for esophageal cancer with synchronous distant metastasis after induction therapy. Out of the 66 enrolled patients, distant lymph node metastasis occurred in 77%, while distant organ metastasis occurred in 23%. The study found that conversion surgery after chemotherapy or chemoradiotherapy is feasible and may significantly improve long-term prognosis, particularly for patients with controlled nodal status. Pathologic nodal status was identified as an independent predictor of poor prognosis.

Journal Article by Sugimura K, Tanaka K (…) Doki Y et 13 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Robotic Surgery Breakthrough: Step-by-Step Technique for Treating Perihilar Cholangiocarcinoma IIIA

Researchers present the first-ever full robotic surgical step-by-step technique for treating perihilar cholangiocarcinoma, a challenging procedure. This innovative approach allows for better dissection and suture due to the flexible and accurate movements of the robotic instruments, overcoming the limitations of laparoscopic techniques. The study showcases the successful performance of an extended right hemihepatectomy for perihilar cholangiocarcinoma bismuth type IIIA, resulting in a radical resection, free margins, and node retrieval. The patient experienced minimal complications and was discharged without drainage after 21 days.

Journal Article by Ielpo B, Rosso E (…) Burdio F et 4 al. in Ann Surg Oncol

© 2024. The Author(s).

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Minimally Invasive Pancreaticoduodenectomy Benefits Frail Patients with Pancreatic Cancer

Frail patients with pancreatic cancer who underwent minimally invasive pancreaticoduodenectomy had improved postoperative outcomes compared to open surgery, according to a study. The analysis of pancreaticoduodenectomy cases for pancreatic ductal adenocarcinoma revealed lower rates of complications, major morbidity, and nonhome discharge for those who underwent minimally invasive procedures. Robotic surgery had even better outcomes than laparoscopy, with fewer complications and a lower mortality rate. The findings highlight the advantages of minimally invasive pancreaticoduodenectomy in improving postoperative outcomes for frail patients with pancreatic cancer.

Journal Article by Farah E, Al Abbas A (…) Polanco PM et 7 al. in BMC Surg

Crown Copyright © 2023. Published by Elsevier Inc. All rights reserved.

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The Value of a Laparoscopic Approach in Pancreaticoduodenectomy

A propensity score-matched analysis compared the outcomes of laparoscopic pancreaticoduodenectomy (LPD) and open pancreaticoduodenectomy (OPD). LPD showed longer operative times, reduced blood loss, higher rates of pancreatic fistula and delayed gastric emptying, while postpancreatectomy hemorrhage, major morbidity, mortality, hospital stay, and readmissions were not significantly different. LPD was associated with higher intensive care use and overall costs. The study suggests that OPD offers similar to improved outcomes over LPD and is a more cost-effective approach for patients undergoing pancreaticoduodenectomy.

Journal Article by Stauffer JA, Hyman D (…) Almerey T et 3 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Grade-C Postoperative Pancreatic Fistulas Are Associated with High Morbidity and Increased Risk in Patients with Diabetes Mellitus

Grade-C postoperative pancreatic fistulas (POPfs) following pancreaticoduodenectomy are serious complications associated with high morbidity and mortality rates. Researchers analyzed a national database of 26,552 patients who underwent this surgery and found that 1.2% of patients suffered from grade-C POPfs, while the rate of grade-B POPfs significantly increased over time. Grade-C POPfs were associated with several complications such as delayed gastric emptying, infections, respiratory issues, and renal complications. Diabetes mellitus was identified as a risk factor for developing grade-C POPfs. Further strategies are needed to improve outcomes and mitigate the risks associated with these complications.

Journal Article by Turner KM, Delman AM (…) Patel SH et 7 al. in J Surg Res

Copyright © 2024 Elsevier Inc. All rights reserved.

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Prevalence and clinical characteristics of annular pancreas

A meta-analysis examined the clinical features and prevalence of annular pancreas (AP), a rare gastrointestinal congenital malformation. Analysis of 12,729,118 patients found a pooled prevalence of AP at 0.0045%. The most common comorbidity in adults and children with AP was duodenal obstruction, with pooled prevalence rates of 24.04% and 52.58%, respectively. The predominant surgical procedure in adult AP patients was duodenojejunostomy, with a pooled prevalence of 3.62%. Accurate identification of AP relies on imaging studies due to its nonspecific clinical symptoms.

Review by Plutecki D, Ostrowski P (…) Koziej M 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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Comparative Study Reveals Differences in Intraductal Papillary Neoplasms of the Bile Ducts between Europe and Nagoya

This comparative study analyzed the tumor characteristics, management strategies, and outcomes of patients with intraductal papillary neoplasms of the bile ducts (IPNB) in Europe and Nagoya, Japan. The results showed that European patients had more multiple lesions, less invasive carcinoma, and more intrahepatic tumors compared to patients in Nagoya. European patients also had a lower rate of 90-day complications but a higher 90-day mortality rate. R0 resections and overall survival (excluding postoperative deaths) were similar in both regions.

Journal Article by Lluís N, Onoe S (…) Ramia JM et 38 al. in HPB (Oxford)

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

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Older age does not contraindicate esophagectomy for cancer, but mortality increases

Age should not be a contraindication to esophagectomy for cancer treatment, according to the results of an international multicenter retrospective analysis. The study included 575 patients who underwent esophagectomy between 2007 and 2016 and found that postoperative mortality increased with age, from 2% in younger patients to 4.8% in older patients. However, disease-free and disease-related survival rates were comparable among different age groups. The study suggests that esophagectomy can still be an option for selected elderly patients, especially when using minimally invasive techniques and enhanced recovery protocols.

Journal Article by Mengardo V, Weindelmayer J (…) Giacopuzzi S et 4 al. in Dis Esophagus

© The Author(s) 2023. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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