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Smoke Evacuators Effectively Reduce Volatile Organic Compounds and Particles in Surgical Smoke

A randomized controlled trial investigated the impact of smoke evacuators on reducing volatile organic compounds (VOCs) and particles in surgical smoke during laparotomy procedures. The study found that the use of smoke evacuators significantly decreased the levels of acetaldehyde and formaldehyde in surgical smoke compared to the control group. Additionally, the smoke evacuator group had significantly lower particle counts across various sizes. These findings highlight the effectiveness of dedicated smoke evacuators in reducing exposure to VOCs and particles in surgical smoke, thereby addressing occupational health concerns.

Journal Article by Kawaguchi Y, Yoshizaki Y (…) Hasegawa K et 10 al. in J Am Coll Surg

Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Positive relationship between hospital volume and surgical outcomes in liver resection

The systematic review and Bayesian network meta-analysis compared outcomes of high-volume, medium-volume, and low-volume hospitals performing liver resections. The analysis included 20 studies and 248,707 patients. The results indicated a significant association between hospital volume and postoperative mortality, favoring high-volume hospitals. Patients from high-volume hospitals generally experienced lower mortality rates and shorter lengths of stay compared to those in medium-volume and low-volume hospitals. No significant differences were observed in failure-to-rescue, morbidity, or hospital costs across the three groups.

Review by Koh YX, Zhao Y (…) Poh Goh BK et 7 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Low Rates of Proctectomy and Rectal Cancer in Familial Adenomatous Polyposis Patients Undergoing Total Abdominal Colectomy with Ileorectal Anastomosis

The study investigated the rate of proctectomy and rectal cancer among 197 familial adenomatous polyposis (FAP) patients selected for total abdominal colectomy with ileorectal anastomosis. The results showed that the incidence of proctectomy was 8%, with rectal cancer identified in 3% of cases. Patients with < 20 rectal polyps had a lower rate of proctectomy and rectal cancer compared to those with ≥ 20 polyps. The number of rectal polyps at the time of colectomy was associated with the likelihood of proctectomy but not incident rectal cancer. Total abdominal colectomy with ileorectal anastomosis remains a safe treatment option for FAP patients.

Journal Article by Banerjee S, Burke CA (…) Liska D et 6 al. in Dis Colon Rectum

Copyright © The ASCRS 2023.

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Early Mobilization in Pancreatic Surgery: Multifaceted Perspectives

The main result of this study is the identification of three main categories that influence the implementation of early mobilisation in pancreatic surgery: attitude towards early postoperative mobilisation, subjective norm, and perceived behavioural control. These factors, which include perceived advantages or disadvantages, impact from healthcare professionals, family members, and fellow patients, as well as knowledge, abilities, resources, and environment, highlight the diverse and multidimensional nature of early mobilisation. The successful implementation of early mobilisation requires the dedication of both patients and healthcare professionals.

Journal Article by Ni YX, Li Z, Zhou LL and Gong S in BMJ Open

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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Increasing diversity, specialization, and publication productivity among past presidents of major surgical organizations.

The study examined trends in the demographics, additional degrees pursued, and scientific publication characteristics of past presidents of three major surgery organizations. They found that the proportion of female presidents significantly increased from the 1990s to the 2010s, as did the percentage of non-white presidents and presidents with additional degrees. The most common area of expertise among presidents shifted from cardiothoracic surgery to surgical oncology. Additionally, there was an increase in the ratio of presidents’ post-induction to pre-induction publications and a change in research topics over time.

Journal Article by Ma AC, Hu J (…) Guo WA et 3 al. in J Surg Res

Copyright © 2023 Elsevier Inc. All rights reserved.

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Wire-guided localization improves outcomes in non-palpable recurrent thyroid carcinoma

Wire-guided localization (HWG) surgery for non-palpable recurrent thyroid carcinoma (TC) has been found to have improved outcomes compared to traditional procedures. A retrospective cohort study analyzed the results of HWG resection and found that it reduced surgical morbidity and improved re-recurrence-free survival (RRFS) and re-recurrent/progressive disease (RRD). The HWG cohort had a lower rate of complications (17.3%) compared to the control group (28%). These findings highlight the benefits of using wire-guided localization in the surgical resection of non-palpable recurrent thyroid carcinoma.

Journal Article by Carrillo JF, Carrillo LC (…) Oñate-Ocaña LF et 3 al. in Eur J Surg Oncol

© 2023 Published by Elsevier Ltd.

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Risk of Intraoperative Hemodynamic Instability in Adrenalectomy for Pheochromocytoma

Adrenalectomy for pheochromocytoma carries a risk of intraoperative hemodynamic instability (HDI). In this study, researchers retrospectively reviewed the charts of 205 patients who underwent adrenalectomy for pheochromocytoma. They found that HDI occurred in 75.6% of patients but was rarely associated with major cardiovascular events. Patients with intraoperative HDI had higher rates of postoperative complications. Overall, the study suggests that adrenalectomy for pheochromocytoma in multidisciplinary centers has low morbidity, and there may be a link between HDI and postoperative cardiovascular events.

Journal Article by Tariel F, Dourmap C (…) Peyronnet B et 9 al. in Am Surg

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Impact of COVID-19 on Surgical Resident Autonomy within VA Teaching Hospitals

During the COVID-19 pandemic, surgical trainees at VA teaching hospitals experienced a significant decrease in operative volume due to the suspension of elective cases nationwide. A retrospective analysis of surgical cases revealed that operative cases dropped by half during the peak of the pandemic and remained 20% below pre-pandemic levels the following year. Interestingly, there was an increase in resident autonomy as primary surgeons without attending scrubbed, especially during the peak of COVID-19. However, this trend has started to regress towards pre-pandemic levels and requires further attention.

Journal Article by Tsui GO, Kunac A (…) Anjaria DJ et 2 al. in Am Surg

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Survival Advantage of Multivisceral Resection in Locally Advanced Gastric Cancer

Patients with locally advanced gastric cancer often require multivisceral resection to achieve complete tumor removal. A systematic review of 30 studies including 3362 patients showed that R0 resection was achieved in 67.77% of cases, with the spleen, colon, and pancreas being the most frequently resected organs. The most common postoperative complications were pancreatic fistulae, intraabdominal abscesses, and anastomotic leaks. The estimated 1-year, 3-year, and 5-year survival rates for the entire cohort were 62.2%, 33.05%, and 30.21% respectively, with survival mainly influenced by lymphatic invasion, tumor size, and patient age. Multivisceral resection may offer a survival advantage when compared to other surgical treatments in a selected group of patients.

Review by Schizas D, Giannakodimos I (…) Alexandrou A et 6 al. in J Clin Med

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Surgical Margin Prediction by Surgeons in Colorectal Liver Metastases: Inaccuracy Revealed

Surgeons’ ability to accurately predict surgical margins following resection of colorectal liver metastases (CRLM) was evaluated in this study. The analysis included 190 preoperative and 190 postoperative assessments from 95 cases, comparing surgeon assessments to histopathologic assessment. Results showed that surgeons are inaccurate at predicting positive and close surgical margins, with low sensitivity and positive predictive values. Therefore, a predicted close margin should not necessarily deter surgeons from considering resection of CRLM.

Journal Article by McIntyre SM, Soares KC (…) D’Angelica MI et 10 al. in Ann Surg

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