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Retroperitoneoscopic Adrenalectomy Offers Safe and Excellent Outcomes

Researchers conducted a study to evaluate the perioperative outcomes of retroperitoneoscopic adrenalectomy (RPA) before and after expert intensive trainings (EITs), and compared it to other laparoscopic adrenalectomy approaches. They found that RPA, in addition to offering direct surgical access, had shorter procedure duration, hospital stay, and fewer complications compared to transabdominal lateral adrenalectomy. The study suggests that with proper training, RPA can be a beneficial approach, motivating specialized endocrine surgery centers to include RPA training in their curriculum.

Journal Article by Lee SYH and Wong C in J Surg Res

Crown Copyright © 2024. Published by Elsevier Inc. All rights reserved.

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Progress and Challenges in Distinguishing Malignant from Benign Causes of Liver Hilum Obstruction

This study retrospectively analyzed consecutive patients who underwent surgery for hilar obstruction and aimed to determine factors distinguishing benign from malignant causes and long-term outcomes after resection. Among 182 patients, 14% had benign disease. Significant differences were found in ca19-9 levels and cross-sectional imaging features between malignant and benign strictures. Preoperative biopsy had moderate accuracy. Grade 3-4 complications occurred more frequently in patients with malignant strictures. Postoperative complications of chronic portal hypertension and recurrent cholangitis were observed in over 10% of patients, regardless of disease etiology.

Journal Article by Jain AJ, Lendoire M (…) Chun YS et 10 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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C-Reactive Protein/Albumin Ratio is an Independent Risk Factor for Recurrence and Survival in Older Patients with Colorectal Cancer

The study investigated prognostic factors in older patients (≥70 years) and younger patients (<70 years) with stage I-III colorectal cancer after curative resection. In older patients, preoperative low body mass index, high C-reactive protein/albumin ratio, and comorbidities were associated with poor prognosis, while tumor factors were associated with poor prognosis in younger patients. Importantly, the C-reactive protein/albumin ratio was independently associated with poor overall survival and recurrence-free survival in older patients. The ratio was a superior prognostic indicator compared to other inflammation-based indices in older patients throughout postoperative observation periods.

Journal Article by Bekki T, Shimomura M (…) Ohdan H et 10 al. in Ann Surg Oncol

© 2024. The Author(s).

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Optimal Time-to-Surgery Recommendations Based on Tumor Shrinkage for Resectable Esophageal Cancer

A retrospective study analyzed the outcomes of patients with resectable locally advanced esophageal squamous cell carcinoma (LA-ESCC) who underwent neoadjuvant chemoradiotherapy. Researchers found that tumor shrinkage rate is an independent prognostic factor for progression-free survival (PFS). For patients who responded to treatment, extending the time-to-surgery (TTS) improved overall survival (OS) and PFS. The optimal cutoff for tumor shrinkage was determined to be 45%. These findings suggest that delaying surgery can yield better outcomes for LA-ESCC patients who achieve significant tumor shrinkage.

Journal Article by Li J, Zhou X (…) Wang Q et 8 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Delayed Surgical Resection Reduces Complications and Ostomy Rate, but Increases Length of Stay and Costs in Geriatric Patients with Sigmoid Volvulus

Delaying sigmoid colectomy (>2 days) after decompression in geriatric patients with sigmoid volvulus is linked to reduced cardiac complications and a lower ostomy rate. However, it extends overall hospital length of stay and increases costs, showcasing the nuanced outcomes associated with the timing of surgical intervention.

Journal Article by Arnold SC, Rafaqat W (…) Hwabejire JO et 8 al. in Am J Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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Transumbilical stapling technique for OAGB has been successfully developed.

Researchers have developed a transumbilical stapling technique specifically tailored to the unique demands of one anastomosis gastric bypass (OAGB) procedures. The study builds upon previous work and addresses the challenge of creating a slender gastric tube spanning 25 cm for OAGB. The technique, called transumbilical stapling technique, has shown promising results and could effectively overcome the complexities associated with OAGB surgeries. Overall, this study demonstrates the successful development of a novel strategy to improve outcomes in OAGB procedures.

Journal Article by Qin X, Lee WJ (…) Zhu T et 3 al. in Obes Surg

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

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ERAS Protocols Reduce Adverse Surgical Outcomes in Bariatric Surgery

The systematic review and meta-analysis of randomized clinical trials on enhanced recovery after surgery (ERAS) protocols in bariatric surgery revealed that ERAS programs significantly reduce postoperative nausea and vomiting, intraoperative time, time to mobilization, intensive care unit stays, hospital stay, and readmission rates compared to standard care. These findings suggest that implementation of ERAS protocols should be considered for bariatric surgery patients, where possible.

Journal Article by Davey MG, Donlon NE (…) Conneely JB et 2 al. in Obes Surg

© 2024. The Author(s).

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Insulin-like growth factor 1 levels predict weight loss in women post laparoscopic sleeve gastrectomy

The study aimed to assess the association between insulin-like growth factor 1 (IGF-1) levels and weight loss in female patients post laparoscopic sleeve gastrectomy (SG). It included 100 patients who underwent clinical and laboratory investigations, with follow-up after one year. Results showed a significant reduction in body mass index, fasting HbA1c levels, and triglycerides, along with an increase in HDL and IGF-1 levels. Multiple regression analysis revealed that baseline IGF-1 levels were a crucial predictor of optimal initial clinical response. An IGF-1 cutoff value of ≤23 ng/ml detected suboptimal response with high accuracy.

Journal Article by Khattab MH, Said SM (…) Ghobashy AM et 3 al. in Obes Surg

© 2024. The Author(s).

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The Feasibility of Robotic Surgery for Locally Advanced or Recurrent Rectal Cancer

The systematic review aims to evaluate the safety and feasibility of robotic surgery for locally advanced and recurrent rectal cancer. Researchers will assess perioperative outcomes, oncological clearance rates, and survival and recurrence rates post-robotic beyond total mesorectal excision (TME) surgery. The review will include studies published until December 2023, with a thorough search of the Medline, Embase, and Scopus databases. The primary outcomes will focus on oncological clearance and survival rates, while secondary outcomes will include perioperative outcomes. No ethical approval is required, and the results will be disseminated through conference presentations and peer-reviewed publications.

Journal Article by Panagiotopoulou IG, Przedlacka A (…) Khan JS et 3 al. in BMJ Open

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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The Manual Layered Insertion Method Shows Promise in Reducing Anastomotic Leakage in Esophagectomy

A retrospective analysis evaluated the effectiveness of the manual layered insertion anastomosis technique in reducing anastomotic leakage post-esophagectomy. The study included 56 patients who underwent this technique, all receiving minimally invasive esophagectomy. With no reported anastomotic leakages, the technique showed potential in reducing complications such as anastomotic stenosis and gastric acid reflux. The method’s efficacy may improve postoperative results and patient quality of life, indicating its suitability for wider clinical application.

Journal Article by He X, Mao T (…) He W et 3 al. in J Surg Res

Copyright © 2023. Published by Elsevier Inc.

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