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Improved Prognosis for Pancreatic Metastases from Renal Cell Carcinoma

A study evaluated the surgical pathology and outcomes of pancreatic metastases from renal cell carcinoma (RCC). The retrospective review included 25 patients who underwent pancreatic surgery, with 24 cases intended for cure. Postoperative complications occurred in 36% of patients, and one patient died during hospitalization. Recurrence was observed in 60% of patients, with a five-year overall survival (OS) rate of 83.6% and disease-free survival (DFS) rate of 32.3%. The median OS after pancreatic resection was 134.8 months, suggesting a favorable prognosis and curative potential of this surgical approach for RCC metastases to the pancreas.

Journal Article by Riemenschneider KA, Farooqui W (…) Hansen CP et 2 al. in Scand J Gastroenterol

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Use of Inlay Bridge of Posterior Fascia Enhances Repair for Difficult Abdominal Wall Hernias

The study explored the use of an inlay mesh bridge as a supplementary technique to a modified Rives-Stoppa repair for challenging abdominal wall hernias. Nineteen patients with large postoperative ventral hernias were examined. Results showed that the inlay mesh bridge, combined with a sublay ultrapro mesh, effectively repaired abdominal wall defects when the posterior fascia could not be fully approximated without tension. Minor complications were observed immediately after the procedure, and there were two instances of recurrence during the follow-up period.

Journal Article by Goldstein AL, Nevo N (…) Karin E et 5 al. in Am Surg

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Ernest Amory Codman’s End Result System: A Century-Old Contribution to Surgical Quality

Ernest Amory Codman’s end result system, aimed at achieving “perfection” in surgery by analyzing and improving cases that fell short, was initially rejected by his colleagues. Codman’s revolutionary idea laid the foundation for the quality movement in healthcare, including patient safety and the value equation. Despite facing ostracization and financial difficulties, Codman’s contributions were later recognized as fundamental in medicine, highlighting the importance of his end result system in improving surgical outcomes.

Editorial by Nakayama DK in Am Surg

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The National Resident Matching Program: Increasing Congestion and the Need for Reform

A comprehensive study examined trends in the National Resident Matching Program (NRMP) from 2007-2008 to 2022-2023, focusing on competitive surgical specialties. The mean number of applicants to surgical specialties has increased by 47.99%, while the mean number of total ranked positions per applicant increased by 88.07%. The top 5 most competitive specialties experienced a 57.66% increase in applicants and an 83.33% increase in ranked positions per applicant. These findings highlight the growing congestion in the NRMP system and emphasize the urgent need for reform to address the burdens on applicants and residency programs.

Editorial by Nasef H, Awan MU (…) Elkbuli A et 3 al. in Am Surg

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Hidden Stitch Technique Prevents Complications in Laparoscopic Hernia Repair

Researchers introduced a novel hidden stitching technique for peritoneal closure in laparoscopic hernia repair to prevent complications associated with the use of barbed suture. The study retrospectively analyzed the data of patients undergoing laparoscopic transabdominal preperitoneal patch (TAPP) procedures. In the hidden stitch group, where the barbed suture was hidden on the dorsal side of the peritoneum, there were no postoperative complications. However, in the non-hidden stitch group, where the sutures were exposed in the peritoneal cavity, there were 8 cases of postoperative complications including bowel obstruction and seroma.

Journal Article by Wang L, Maejima T and Fukahori S in Am Surg

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Identification of Non-Medical Barriers Affecting Surgical Attrition in Pancreatic Cancer

Researchers evaluated factors contributing to surgical attrition in non-metastatic pancreatic cancer. Clinical trials showed 25-30% of patients did not undergo surgery, mainly due to disease progression. The overall surgical rate in the national cancer database was 49%, increasing to 67% in a cohort resembling clinical trial patients. Low-volume institutions and uninsured or Medicaid-insured patients were less likely to receive potentially curative surgery. A realistic target surgery rate of 70-75% in potentially-resectable pancreatic cancer was identified, highlighting the impact of non-medical barriers such as facility volume and insurance.

Journal Article by Kakish H, Zhao J (…) Hoehn RS et 6 al. in HPB (Oxford)

Copyright © 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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Positive family history increases the risk of developing inguinal hernia in both children and adults

The study conducted a systematic review with meta-analyses to assess the inheritance of groin hernias. It included 22 studies and found that a positive family history, particularly between mothers and daughters and between sisters, significantly increased the risk of inguinal hernia in children. In adults, patients with inguinal hernia had higher odds of having a positive family history compared to those without hernia. The study also revealed a higher risk of hernia repair when a sister had been repaired compared to a brother, as well as an increased risk of femoral hernia repair among siblings. Overall, the findings provide overwhelming evidence that a positive family history is a major risk factor for developing inguinal hernia in both children and adults.

Review by Öberg S, Sæter AH and Rosenberg J in Hernia

© 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.

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Optimal extent of lymphadenectomy in esophageal cancer surgery: Controversy and evidence

The current curative multimodal treatment of advanced esophageal cancers includes neoadjuvant or perioperative chemo(radio)therapy and radical surgical resection with a 2- or 3-field lymphadenectomy. Lymph node involvement is a significant predictor of long-term survival in esophageal cancer patients. The distribution pattern of lymph node metastases is unpredictable and depends on various factors. The extent of lymphadenectomy remains controversial, with some advocating for aggressive and extended dissection while others support a more restricted approach. This review provides an overview of the development and current evidence for lymphadenectomy in esophageal cancer treatment.

Journal Article by Schuring N, van Berge Henegouwen MI and Gisbertz SS in Dis Esophagus

© The Author(s) 2023. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus.

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Patients with Low Social Vulnerability More Likely to Receive Hernia Repair in Texas

The study aimed to assess the association between social vulnerability and the likelihood of receiving elective and emergency hernia repair in Texas. The results showed that patients with low social vulnerability were 36% more likely to receive surgery, while those with high social vulnerability were 14% less likely. This association remained significant after adjusting for various factors. The study suggests that the social vulnerability index can indicate social determinants of health barriers to hernia repair.

Journal Article by Collins RA, Abla H (…) Dissanaike S et 2 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Surgical repair of hernias in patients with ascites is a rare event with increased adverse outcomes

Researchers conducted a retrospective review of 176 patients with ascites undergoing ventral or inguinal hernia repair. The study found that surgical repair of hernias in patients with ascites is rare (1.4% in ventral hernia cohort, 0.2% in inguinal hernia cohort). The post-operative 30-day adverse clinical outcomes were significantly higher in both cohorts compared to patients without ascites. Readmission was the most common complication in both groups. There was variation in surgical approaches, suggesting a need for optimization in patient selection and timing of repair in this population.

Journal Article by Cassidy DE, Shao Z (…) Ehlers AP et 4 al. in Surg Endosc

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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