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Development and Validation of an Interpretable Model for Predicting Multiple Postoperative Complications

Researchers developed and validated a Markov-embedded multilabel model to predict the risks of various postoperative complications among surgical inpatients. The model outperformed other existing models, achieving the highest average area under the receiver operating characteristic curve (AUC) for eight outcomes, including cardiac complications, neurological complications, and mortality. The model identified important preoperative variables, but the interaction between complications was found to contribute more to the risk. The interpretability of the model provides valuable insights for clinical decision-making and the identification of high-risk patients.

Journal Article by Yu X, Zhang L (…) Jiang J et 9 al. in Int J Surg

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

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Racial Disparities in Surgical Treatment Offer for Neuroendocrine Neoplasms

The study investigated the factors associated with offering surgery for pancreatic and small bowel neuroendocrine neoplasms (pannen and sbnen). Analysis of the surveillance databases revealed that non-white race was associated with decreased odds of surgery offer for sbnen but not pannen. These findings highlight racial/ethnic disparities in the course of treatment, indicating that non-white patients are less likely to be offered surgery for sbnen, potentially due to differences in referral rates to academic centers for these malignancies.

Journal Article by Zarate Rodriguez JG, Raper L (…) Hammill CW et 2 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Hand-sewn Gastrojejunal Anastomosis Reduces Delayed Gastric Emptying after Pancreaticoduodenectomy

A retrospective clinical study on 1,077 patients undergoing pancreaticoduodenectomy compared hand-sewn anastomosis to stapled anastomosis in reducing delayed gastric emptying. After propensity score matching, the hand-sewn group demonstrated a significantly lower incidence of delayed gastric emptying and upper gastrointestinal tract bleeding. It also resulted in reduced length of stay and hospitalization expenses. Logistic regression analysis identified stapled anastomosis, intra-abdominal infection, and postoperative pancreatic fistula as independent prognostic factors for delayed gastric emptying. Surgeons should consider hand-sewn anastomosis to improve patient outcomes and minimize delayed gastric emptying.

Journal Article by Fu Z, Gao S (…) Jin G et 15 al. in BMC Surg

Copyright © 2023. Published by Elsevier Inc.

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Comparison of Endoscopic Submucosal Dissection and Laparoscopic and Endoscopic Cooperative Surgery for Duodenal Tumors

Endoscopic submucosal dissection (ESD) and laparoscopic and endoscopic cooperative surgery (LECS) were compared in patients with superficial non-ampullary duodenal epithelial tumors. The study found that both ESD and LECS achieved high rates of en bloc and curative resection, with no significant difference between the two techniques. ESD had shorter resection and suturing times. There were no significant differences in postoperative adverse events and 3-year overall survival rates were high in both groups. The study concluded that ESD and LECS are effective treatments for superficial duodenal tumors.

Journal Article by Seya M, Dohi O (…) Itoh Y et 19 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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Long-term functional disturbances observed in female patients after multivisceral resection for advanced rectal cancers

Female patients who underwent multivisceral resection for rectal cancer experienced long-term functional disturbances, particularly in urinary and sexual functions, according to a cross-sectional study. Out of the 198 patients who had the surgery, 69 were assessed for functional outcomes. The study found that the removal of the uterus and posterior vaginal wall were common procedures, with 30% of patients undergoing vaginal reconstructive surgery. The most reported issues included urinary frequency, hair loss, pain during intercourse, and bowel frequency. The study highlighted the physical and psychosocial changes associated with these surgeries.

Journal Article by Kazi M, Choubey K (…) Saklani A et 4 al. in J Surg Oncol

© 2024 Wiley Periodicals LLC.

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A Comparative Analysis of Surgical Techniques and Outcomes for Internal Hemipelvectomy

Implementing advancements in technology and surgical technique for internal hemipelvectomy procedures can significantly impact patient outcomes. A retrospective study conducted at a single institution examined the experiences of surgeons and the utilization of new techniques and technologies over a 26-year period. The study found that the use of three-dimensional (3D) computer navigation and customized 3D-printed cutting guides increased, while freehand resections decreased. Collaboration with general surgeons for pelvic dissection also became more common. These changes led to a decrease in massive blood loss and local recurrence rates. However, operative time, tumor-free survival, and overall patient survival were not significantly influenced by surgeon experience or technological advancements.

Journal Article by Vucicevic RS, Zavras AG (…) Colman MW et 6 al. in J Surg Oncol

© 2024 Wiley Periodicals LLC.

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Optimal Follow-up Methods and Intensity after Surgery for Colorectal Liver Metastases

Recurrence after surgery for colorectal liver metastases (CRLM) is common within two years, but there is no established guidance on follow-up methods and intensity. A systematic review of 25 articles involving 9,945 patients revealed wide variation in follow-up methods, with CT as the most common imaging modality and CEA as the most common blood test. Overall survival ranged from 39% to 78.1% among the studies. There is a lack of strong evidence to support intensive follow-up, and the benefits of long-term follow-up remain unclear. Future research should focus on high-quality prospective studies.

Review by Jones A, Findlay A (…) Pathak S et 4 al. in Eur J Surg Oncol

© 2023 Published by Elsevier Ltd.

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Long-Course Chemoradiotherapy Outperforms Short-Course Radiotherapy in Locally Advanced Rectal Cancer

The study compared the oncological outcomes of long-course chemoradiotherapy (LC-CRT) and short-course radiotherapy with delayed surgery (SCRT-delay) in locally advanced rectal cancer (LARC) patients. The results showed that LC-CRT had higher overall survival (OS) rates at 1, 3, and 5 years compared to SCRT-delay. Additionally, LC-CRT group had higher cancer-specific survival (CSS) rates at 1, 3, and 5 years. Unfavorable magnetic resonance imaging response indicated a poor prognosis in LARC. However, there were no significant differences in histological response rates or local recurrence rates between the treatment groups.

Journal Article by Marjasuo S, Koskenvuo L and Lepistö A in Int J Colorectal Dis

© 2024. The Author(s).

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Big Data Analysis Reveals Hiatus Hernia’s Link to Esophageal Disorders

Researchers conducted a comprehensive analysis using big data to investigate the frequency of hiatus hernia (hh) and its association with esophageal disorders. They reviewed endoscopic reports of over 75,000 patients and found that hh was present in 16.8% of cases, with the majority being small hhs. They also found that hh was significantly associated with erosive reflux esophagitis and Barrett’s esophagus. Large hhs were associated with higher rates of benign esophageal strictures, Mallory Weiss syndrome, and incidents of food impactions.

Journal Article by Baker FA, Savarino E (…) Mari A et 6 al. in Dysphagia

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

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Structured follow-up after resection for biliary tract cancer improves overall survival

A retrospective multicenter cohort study compared two follow-up strategies for patients after curative resection of biliary tract cancer. The study found that structured follow-up resulted in more patients receiving palliative therapy after recurrence compared to pragmatic follow-up. Additionally, the median overall survival was significantly lower in the pragmatic group. However, patients who actually received chemotherapy had similar overall survival irrespective of the follow-up strategy. This study suggests that structured follow-up improves overall survival in patients with biliary tract cancer.

Journal Article by Nooijen LE, van der Snee L (…) Erdmann J et 5 al. in HPB (Oxford)

Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

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