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Flot chemotherapy regimen is the most appropriate treatment for elderly patients with resectable gastric cancer

Researchers conducted a retrospective study to compare the outcomes and safety of different chemotherapy regimens as perioperative treatment in elderly patients with resectable gastric cancer. They found that the Flot and DCF regimens were associated with longer overall survival compared to other regimens, with Flot showing the most significant improvement. Additionally, the DCF regimen had longer progression-free survival, but with a higher rate of adverse events. Based on these findings, the researchers propose that the Flot regimen is the most appropriate treatment option for elderly patients with resectable gastric cancer.

Journal Article by Forouhari A, Moghaddas A and Darakhshandeh A in J Res Med Sci

Copyright: © 2023 Journal of Research in Medical Sciences.

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Elevated Postoperative Risks in Gastrointestinal Surgery for Chronic KRT Patients

Patients on chronic kidney replacement therapy (KRT), particularly those on peritoneal dialysis, exhibit high rates of gastrointestinal surgery and increased morbidity. Peritoneal dialysis patients have the highest postoperative mortality risk, especially after emergency procedures. Infective complications surpass cardiac issues. Additionally, a U-shaped association between body mass index and mortality is observed.

Journal Article by Palamuthusingam D, Hawley CM (…) Fahim M et 6 al. in Ann Surg

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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Laparoscopic Gastrectomy Demonstrates Benefits in Reducing Complications

Researchers conducted a study to examine the influence of a randomized controlled trial (RCT) on the practice and outcomes of laparoscopic gastrectomy in the Netherlands. The RCT included 10 Dutch centers and compared laparoscopic to open gastrectomy. Data analysis showed that there was no significant effect on clinical outcomes within the RCT itself. However, nationally, there was a shift towards a beneficial effect of laparoscopic gastrectomy, with a significant reduction in overall, severe, and cardiac complications observed after the trial. The study also highlighted the safe dissemination of laparoscopic gastrectomy across the country following the trial.

Journal Article by Markar SR, Visser MR (…) van Hillegersberg R et 16 al. in Ann Surg

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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Timing of First Whole Blood Transfusion Associated with Improved Survival in Trauma Patients

Earlier timing of whole blood transfusion as an adjunct to a massive transfusion protocol (MTP) is associated with improved survival at 24 hours and 30 days for trauma patients with severe hemorrhage. A retrospective cohort study analyzed data from 1394 adult trauma patients and found that receiving whole blood transfusion earlier within the first 24 hours of emergency department arrival was associated with a significant survival benefit. This suggests that earlier administration of whole blood may offer a survival advantage for actively hemorrhaging patients requiring MTP.

Journal Article by Torres CM, Kenzik KM (…) Sakran JV et 5 al. in JAMA Surg

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Endoscopic ultrasound-guided gallbladder drainage is a safe and effective option for patients with unsuccessful biliary drainage

This narrative review highlights the use of endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) as a salvage approach for patients with unsuccessful conventional management. EUS-GBD is a minimally invasive technique with high technical and clinical success rates, low adverse event rates, and serves as a rescue option for patients who did not respond to other drainage methods. Proper patient selection and risk assessment are crucial for the safe and effective implementation of EUS-GBD.

Review by Fugazza A, Khalaf K (…) Repici A et 10 al. in World J Gastroenterol

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

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Reconstructing Both Hepatic Arteries in Right Lobe Grafts Is Safe in Living-Donor Liver Transplantation

Researchers conducted a single-center retrospective study on 1,601 living-donor liver transplant recipients to evaluate the risks of hepatic artery thrombosis (HAT) and the efficacy of reconstructing two hepatic arteries (HA) in right lobe grafts. They found that HAT occurred in 1.2% of patients, and risk factors included pretransplant hepatectomy, female donor, smaller graft-to-recipient weight ratio, and undergoing extraanatomical reconstruction. However, having two HA openings in right liver grafts was not a risk factor for HAT. The study suggests that reconstructing both HAs when possible is a safe approach.

Journal Article by Kim SM, Moon DB (…) Lee SG et 13 al. in Liver Transpl

Copyright © 2024 American Association for the Study of Liver Diseases.

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Novel Method of Calculating Drained Liver Volume for Improved Biliary Drainage in Unresectable Malignant Hilar Biliary Obstruction

A study investigated the use of a 3D volume analyzer to accurately calculate the drained liver volume (DLV) in patients with unresectable malignant hilar biliary obstruction (UMHBO). Out of 104 cases, 63% of patients underwent drainage of ≥50% liver volume, which resulted in a significantly higher clinical success rate compared to those with <50% DLV. Additionally, patients with ≥50% DLV had longer median times to recurrence of biliary obstruction and improved overall survival compared to those with <50% DLV.

Journal Article by Imagawa N, Fukasawa M (…) Enomoto N et 12 al. in Dig Dis Sci

© 2024. The Author(s).

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Surgical Resection and Radiofrequency Ablation Yield Comparable Efficacy in Elderly Patients with Hepatocellular Carcinoma

The study examined the efficacy of surgical resection (SR) and radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) in elderly patients aged 65 or older. After propensity score matching, there was no significant difference in mortality rates between the two groups. Liver-related mortality was also similar. However, the SR group had significantly longer recurrence-free survival compared to the RFA group. Therefore, RFA was found to have a therapeutic effect comparable to SR in elderly patients with resectable HCC.

Journal Article by Kim JI, Lee J (…) Yoo JJ et 3 al. in Dig Dis Sci

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Trajectories of Postoperative Depressive Symptoms in Older Surgical Patients

Older adults undergoing major surgery experience distinct trajectories of postoperative depressive symptoms, with three identified groups: sustained low, sustained moderate, and sustained high symptoms. The study, spanning 18 months, reveals that depressive symptoms remained stable for most patients, emphasizing the need for early intervention and screening to improve postoperative outcomes and health trajectories. Preoperative depression, functional dependence, and higher baseline depressive burden are associated with sustained postoperative depressive symptoms.

Journal Article by Cenzer I, Inouye SK (…) Tang VL et 3 al. in JAMA Netw Open

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Metabolic syndrome linked to increased risk of surgical complications

This study reviewed the evidence on the risks of surgical complications in patients with metabolic syndrome (mets) compared to those without mets. The meta-analysis included 63 studies with 1,919,347 patients with mets and 11,248,114 patients without mets. The results revealed that individuals with mets had a higher risk of mortality, surgical site infection, cardiovascular complications, increased hospital stay, and hospital readmission. Despite these risks, there is a lack of evidence on interventions to reduce surgical complications in patients with mets.

Journal Article by Norris P, Gow J (…) Ralph N et 3 al. in Int J Surg

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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