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Lack of Consensus on Quality-of-Life Assessments for Abdominal Wall Reconstruction

Surgeons employ a variety of quality-of-life instruments to track outcomes after abdominal wall reconstruction (AWR), but no universally agreed-upon tool exists. A scoping review identified six hernia-specific tools and six generic health tools used in AWR research. The most commonly used hernia-specific tools were the hernia-related quality-of-life survey and the Carolinas Comfort Scale, while the Short-Form 36 (SF-36) was the most widely utilized generic health tool. These instruments captured diverse patient outcomes ranging from abdominal wall functionality to mental health. The study suggests the need for a standardized assessment tool for AWR outcomes.

Review by LaGuardia JS, Milek D (…) Leckenby JI et 6 al. in J Surg Res

Copyright © 2023 Elsevier Inc. All rights reserved.

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New Guidelines Provide Comprehensive Non-Surgical Treatment Approach for Hepatocellular Carcinoma

Italian scientific societies have collaborated to develop updated multidisciplinary treatment guidelines for hepatocellular carcinoma (HCC). The second part of these guidelines focuses on the non-surgical treatment options and the role of multidisciplinary tumor boards. The document, produced using evidence-based grading methodology, addresses the increasing complexity of HCC management and aims to assist clinicians and researchers worldwide. The guidelines aim to improve patient outcomes and provide a comprehensive approach to managing the third leading cause of cancer-related death globally.

Practice Guideline by Cabibbo G, Daniele B (…) Alberto Iavarone M et 32 al. in Dig Liver Dis

Copyright © 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

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Neoadjuvant Radiation and Pulmonary Complications in Esophagectomy: Impact only in Pre-existing Pulmonary Disease

Patients undergoing esophagectomy for malignancy often experience post-operative pulmonary complications (POPC), and this study aimed to investigate if neoadjuvant radiation therapy contributes to their incidence. The analysis of database files revealed no consistent association between neoadjuvant radiation and POPC in all patients. However, in those with pre-existing pulmonary disease (PEPD), neoadjuvant chemoradiotherapy resulted in a higher incidence of POPC, particularly pneumonia. Clinicians should consider the risk of POPC when deciding on neoadjuvant treatment in esophageal cancer patients with PEPD.

Journal Article by Beier MA, Greenbaum AA, Kangas-Dick AW and August DA in Am Surg

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Robocalls Reduce No-Show Rates in Surgical Clinics

Automated reminder calls (robocalls) were introduced in surgical clinics to reduce appointment no-show rates. A study conducted in a safety-net hospital analyzed data from two surgical clinics before and after the implementation of robocalls. The results showed that robocalls significantly decreased the no-show rates, providing an effective tool for enhancing appointment attendance. Furthermore, the study found that new appointments were associated with higher no-show rates. Robocalls can also optimize staff allocation, enabling them to focus on more valuable tasks within the healthcare system.

Journal Article by Braschi C, Gutierrez G (…) Moazzez A et 4 al. in Am Surg

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Lidocaine Infusion Cuts Opioid Use in Laparoscopic Colectomy within ERAS

The study aimed to assess the impact of adding a lidocaine infusion for postoperative pain control in ERAS patients undergoing laparoscopic colectomy. The results of the retrospective review showed that patients who received the lidocaine infusion had a significant reduction in postoperative opioid use within the first 48 hours compared to those without it, with a 52% lower median morphine milligram equivalents (MME). This finding highlights the potential of lidocaine infusion as a means to decrease opioid consumption in ERAS patients undergoing laparoscopic colectomy.

Journal Article by Thomas GJ, Bauman JC (…) Ziegler MA et 2 al. in Am Surg

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Surgical Residents’ Poor Understanding of Operating Room Supply Costs and the Need for Education

Surgical residents have a poor understanding of the costs of common operating room supplies, and this does not improve with post-graduate training. A survey of 73 residents revealed that they accurately estimated costs for only 7 out of 21 items, with considerable error ranging from 26% to 5438%. They significantly underestimated the costs of the three highest-cost items. This study highlights the need for education to increase residents’ awareness of costs and ultimately reduce surgical healthcare expenses.

Journal Article by White EM, Hernandez A (…) Yoo PS et 3 al. in Am Surg

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Successful Fistula Closure Achieved through Surgical Management in Complex Duodenal Fistulas

This retrospective study analyzed the management options and outcomes of 50 adult patients with complex duodenal fistulas. Surgical closure combined with duodenal decompression yielded the highest success rate, with 76% of patients achieving fistula closure. In selected cases, nonoperative management was attempted, resulting in closure without surgery in 5 out of 6 patients. However, eventually failed nonoperative management led to a significant difference in fistula closure rates. The overall in-hospital mortality rate was 40%.

Research Support, Non-U.S. Gov’t by Leppäniemi A, Tolonen M and Mentula P in World J Emerg Surg

© 2023. The Author(s).

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A comparison of surgical sub-specialization in emergent colon cancer surgery reveals no significant difference in postoperative outcomes

Researchers conducted a retrospective population study to analyze the impact of surgical sub-specialization on short- and long-term outcomes in patients undergoing emergent surgery for colon cancer. The study included 656 patients divided into three groups based on specialization of the operating team. The results showed no significant differences in 5-year overall survival, 3-year recurrence-free survival, or postoperative complication rates between the groups. However, patients operated on by emergency surgical teams were more likely to have a permanent stoma after 3 years.

Research Support, Non-U.S. Gov’t by Arnarson Ö, Syk I and Butt ST in World J Emerg Surg

© 2023. The Author(s).

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Comparable disease progression for small pancreatic neuroendocrine tumors (≤2 cm) with or without surgery

Researchers compared the disease progression in patients with nonfunctional pancreatic neuroendocrine tumors (pnets) ≤2 cm who either underwent surgery or were observed. Out of the 52 patients, 75% had an operation while 25% were observed. Both groups had similar demographics and tumor characteristics. The observation group had a mean disease progression interval of 80.9 months, while the group that underwent surgery had a mean disease progression interval of 94.6 months. Overall, there was no significant difference in disease progression between the two groups.

Journal Article by Irfan A, Gleason F (…) Rose JB et 2 al. in Am Surg

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Higher Lymph Node Count Improves Survival in Stage III Gastric Cancer Patients After Surgery

Analysis of 2373 stage III gastric cancer patients who underwent curative gastrectomy revealed that a higher count of negative lymph nodes (NLN) (>14) significantly improved the 5-year overall survival rate compared to patients with a lower count (43.7% vs 23.1%). This study establishes NLN count as an independent prognostic factor for stage III gastric cancer patients and supports its inclusion in clinical practice for predicting patient outcomes.

Journal Article by Liu L, Ren J (…) Lei X et 4 al. in Am Surg

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