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Complication Rates Higher in Recurrent Rectal Cancer Patients Undergoing Sacral Resection during Total Pelvic Exenteration

This retrospective study investigated the surgical approach of total pelvic exenteration combined with sacral resection for rectal cancer and its impact on short-term outcomes. The association between the level of sacral resection and complications, specifically exhibiting a Clavien-Dindo grade III, was assessed. The results revealed a significantly higher complication rate for recurrent rectal cancer patients compared to primary cancer patients. In particular, “upper” sacral resection during total pelvic exenteration was found to be linked to a high complication rate in recurrent cases, emphasizing the importance of close monitoring.

Journal Article by Komori K, Tsukushi S (…) Shimizu Y et 21 al. in Am Surg

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Enhanced Recovery Protocol Benefits High-Risk Colon Cancer Surgery

The study analyzed the impact of an enhanced recovery protocol (ERP) on surgical outcomes in a high-risk population undergoing colon cancer surgery. Researchers retrospectively examined factors associated with postoperative complications (POC) and length of stay (LOS) in 408 elective colon cancer surgery patients. The results showed that ERP did not affect POC but was associated with a reduction in LOS. Additionally, obesity and medical comorbidities were linked to increased POC and LOS. The findings suggest that implementing ERP can optimize surgical outcomes in high-risk populations undergoing colon cancer surgery.

Journal Article by Wong DL, Holland A (…) Shibata D et 7 al. in Am Surg

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Early exposure to robotic surgery training enhances interest in surgical career and simulation skills

Early exposure of medical students to robotic surgery training positively influences their interest in a surgical career and improves their performance on simulation tasks. Seventy percent of students reported that the training had a positive impact on their decision to pursue a general surgery career. Furthermore, students felt more knowledgeable about robotics, comfortable operating robotically, and believed robotic surgery would play a significant role in the future of surgery.

Journal Article by Garcia-Chavez HJ, Scaria D, Read T and Iqbal A in Am Surg

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Residents with prior evaluations and feedback show improved performance and autonomy in common bile duct exploration

Surgical residents who receive prior evaluations and formative feedback for common bile duct exploration (CBDE) demonstrate better operative performance and greater autonomy compared to residents without prior evaluations. Cases with prior evaluations had a higher proportion of practice-ready or exceptional performance ratings according to both residents and attending surgeons. They also had a higher proportion of passive help or supervision only autonomy ratings. The study highlights the importance of feedback in helping residents achieve autonomous, practice-ready performance for rare surgical procedures like CBDE.

Research Support, Non-U.S. Gov’t by Nyren MQ, Filiberto AC (…) Loftus TJ et 10 al. in World J Emerg Surg

© 2023. The Author(s).

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Optimizing Mortality Reduction in Necrotizing Pancreatitis

Researchers conducted a systematic review and network meta-analysis to determine the optimal timing and intervention for reducing mortality in necrotizing pancreatitis. They analyzed 10 studies involving 570 patients and compared 8 treatment strategies. While no statistically significant differences were found in odds ratios, trends were confirmed by the surface under the cumulative ranking scores. The delayed surgical step-up approach (DSU) consistently performed the best in terms of reducing mortality and major complications. The study emphasizes avoiding drainage alone and postponing interventions for at least 4 weeks if possible.

Research Support, Non-U.S. Gov’t by Yang Y, Zhang Y, Wen S and Cui Y in World J Emerg Surg

© 2023. The Author(s).

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Long-Term Results of Conservative Management for Complicated Colonic Diverticulitis: Effective and Safe Option for Selected Patients

The study investigated the long-term outcomes of conservative management for complicated colonic diverticulitis. The results showed that non-operative treatment is effective and safe for selected patients, with recurrence rates of 38.1% and high severity recurrence rates of 11.1%. Lower CT stages and grade III diverticulitis were associated with higher recurrence rates. Chronic NSAID use was linked to a higher incidence of high severity recurrent episodes. No significant differences were found in recurrence rates between patients with or without home therapy.

Journal Article by Perrone G, Giuffrida M (…) Catena F et 5 al. in Eur J Trauma Emerg Surg

© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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Snapshot audit methodology provides insights into surgical care delivery and outcomes

Snapshot audit methodology, in the form of prospective observational cohort studies, offers a valuable alternative to retrospective administrative datasets and randomized control trials for exploring the effectiveness of surgical patient care. This study discusses the key features of implementing snapshot audits, including the importance of a diverse steering committee and the involvement of mentored trainees. The approach generates testable hypotheses, provides insights into care delivery and outcomes, and promotes guideline compliance. Current funding for such audits primarily comes from medical professional organizations.

Journal Article by Bass GA, Kaplan LJ (…) Mohseni S et 5 al. in Eur J Trauma Emerg Surg

© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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High incidence of bile duct injuries during laparoscopic cholecystectomies highlights need for improved techniques

The 11-year population-based study on bile duct injuries (BDIs) during laparoscopic cholecystectomies (LC) revealed an overall BDI incidence rate of 0.81%, with minor and major BDI rates of 0.68% and 0.13%, respectively. No significant decline in BDI incidence was observed over the study period, contradicting the hypothesis. Drainage and ERCP stent placement were the most commonly used methods for BDI management, though Roux-en-Y hepatojejunostomy was performed in severe cases. The study emphasized the high rate of long-term bile duct strictures and a mortality rate of 4.6% associated with BDI complications.

Journal Article by Reinsoo A, Kirsimägi Ü (…) Talving P et 3 al. in Eur J Trauma Emerg Surg

© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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Endoscopic Powered Resection Device Shows Safety and Effectiveness for Scarred Colorectal Lesions

The multicenter, prospective, international clinical study assessed the safety and effectiveness of an endoscopic powered resection (EPR) system for scarred adenomatous colorectal lesions. Among the 45 per-protocol patients with 48 lesions treated solely with the EPR device, technical success was achieved in 98% of patients. Adverse events were limited, including two delayed self-limited bleeds and one perforation, with no cases of colon stenosis. Completeness of resection and histopathological diagnosis were achieved in all patients. The study suggests EPR as a safe and effective alternative to surgery for persistent scarred colorectal adenomas.

Journal Article by Knabe M, Maselli R (…) Costamagna G et 14 al. in Gastrointest Endosc

Copyright © 2023 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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Effect of Hepatic Pedicle Clamping on Long-Term Survival following Hepatectomy for Hepatocellular Carcinoma

The study investigates the impact of hepatic pedicle clamping (HPC) on long-term survival in patients who underwent hepatectomy for hepatocellular carcinoma (HCC). The researchers analyzed data from a multicenter database and stratified patients based on whether they received intraoperative blood transfusion (IBT). While HPC did not significantly affect overall survival (OS) and recurrence-free survival (RFS) in the IBT cohort, it was associated with decreased OS and RFS in patients without IBT. The findings suggest that HPC adversely affects long-term survival in HCC patients who do not receive IBT during hepatectomy.

Journal Article by Tang SC, Xu JH (…) Yang T et 13 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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