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Functional Decline Common Among Critically Ill Surgical Patients

Approximately 36.5% of critically ill surgical patients experience functional decline after admission to the intensive care unit (ICU). The study, which analyzed data from over 52,000 surgical patients across 236 hospitals, revealed that patients undergoing pulmonary, musculoskeletal, neurological, gastrointestinal, and skin and soft tissue surgeries had increased odds of functional decline. Age, gender, comorbidities, and disease severity also influenced the likelihood of decline. These findings suggest the need for targeted resources in rehabilitating critically ill surgical patients, particularly those undergoing high-risk procedures.

Journal Article by An SJ, Smith C (…) Charles A et 3 al. in J Surg Res

Copyright © 2024 Elsevier Inc. All rights reserved.

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Laparoscopic Left Hepatectomy Achieves Comparable Results to Open Surgery for Intrahepatic Cholangiocarcinoma

A 66-year-old male with stage II intrahepatic cholangiocarcinoma underwent a 240-minute laparoscopic left hepatectomy using a no-touch en bloc technique and lymphadenectomy skeletonization. The patient was discharged after 6 days without complications and received postoperative gemcitabine and cisplatin treatment. After 14 months of follow-up, there was no recurrence. This study demonstrates that skilled surgeons can achieve outcomes similar to open surgery when utilizing laparoscopic techniques such as the no-touch en bloc technique and standardized lymphadenectomy.

Journal Article by Dai YS, Gao W (…) Li FY et 2 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Conversion of Failed J Pouch to Kock Pouch: Indications, Contraindications, and Outcomes

Conversion of the j pouch to a continent ileostomy is a significant surgical procedure aimed at creating a well-functioning reservoir with a high-quality valve mechanism while preserving as much small bowel as possible. This study provides an overview of the indications, contraindications, technical principles, and outcomes of such conversions. It concludes that the conversion of the j pouch to a continent ileostomy can be a successful option for patients experiencing j pouch failure, with proper expertise and careful consideration of exceptions.

Journal Article by Ahmed Ali U and Kiran RP in Dis Colon Rectum

Copyright © The ASCRS 2024.

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Lack of Representation and Reporting of Racial and Ethnic Minorities in US Colorectal Cancer Surgical Trials

A systematic review and regression analysis of 15 US-based colorectal cancer surgical trials found significant disparities in the representation and reporting of racially and ethnically diverse participants. Out of the included trials, 66.7% did not report race and 73.3% did not describe ethnicity adequately. The pooled proportion of white participants was 81.3%, while black, Asian, and Hispanic participants comprised only 6.2%, 3.6%, and 3.5% respectively. The study highlights the urgent need for improved reporting and inclusion of minority populations in surgical trials to ensure equitable outcomes.

Journal Article by Ore AS, Arean-Sanz R (…) Messaris E et 5 al. in Dis Colon Rectum

Copyright © The ASCRS 2024.

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Factors Associated with Performing Ileal Pouch-Anal Anastomosis After Total Colectomy for Ulcerative Colitis

Approximately 50.2% of patients who underwent total colectomy for ulcerative colitis in the United States received ileal pouch-anal anastomosis. Younger age, lower comorbidities, elective cases, and laparoscopic approach were associated with a higher likelihood of undergoing this procedure. Socioeconomic status did not influence the decision. These findings highlight the importance of providing restorative surgery as an option, particularly for patients undergoing urgent or emergent colectomies.

Journal Article by Chen KA, Pak J (…) Kapadia MR et 5 al. in Dis Colon Rectum

Copyright © The ASCRS 2024.

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Prognostic Significance of the Comprehensive Complication Index in Gastric Cardia Adenocarcinoma

The Comprehensive Complication Index (CCI) showed a stronger positive association than the Clavien-Dindo Classification (CDC) with short-term postoperative complications in patients with gastric cardia adenocarcinoma. The CCI demonstrated superior correlation strength for hospital length of stay, duration of ICU stay, time to return to normal activities, and total hospitalization cost. These findings suggest that the CCI has potential implications for improving postoperative patient management in gastric cardia adenocarcinoma.

Journal Article by Liu Y, Maitiyasen M (…) Yi J et 4 al. in J Surg Res

Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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Increased Overall Survival Associated with Achieving Modified Textbook Outcome in Surgery for Colorectal Liver Metastases

Findings from a nationwide analysis revealed that achieving a modified textbook outcome (MTO) after surgery for colorectal liver metastases (CRLM) was associated with better overall survival (OS). Out of 6,525 eligible patients, 81% achieved MTO. Between 2014 and 2018, patients achieving MTO had a 5-year OS of 46.7% compared to 33.7% in non-MTO patients. Not achieving MTO was linked to worse OS. The study emphasizes the importance of improving perioperative care and reducing postoperative complications in the surgical treatment of CRLM.

Journal Article by Voigt KR, de Graaff MR (…) Grünhagen DJ et 19 al. in Eur J Surg Oncol

© 2024 Published by Elsevier Ltd.

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Implications of precursor lesions and early cancerous changes in the gallbladder and bile ducts

The study explores terminology, classification, and significance of dysplasia and early carcinoma in the gallbladder and bile ducts. Most precursor lesions and early cancerous changes are clinically undetectable. Low-grade dysplasia is challenging to define and lacks clinical significance, but additional sampling is required to exclude significant lesions. High-grade dysplasia (carcinoma in situ) necessitates complete sampling to rule out invasion. Visible masses (intracholecystic and intraductal neoplasms) account for 5% to 10% of invasive cancers. Different subtypes of neoplasms exhibit varying clinical behavior, with some having a protracted clinical course and others leading to mortality.

Review by Adsay NV and Basturk O in Gastroenterol Clin North Am

Copyright © 2023 Elsevier Inc. All rights reserved.

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The 6:1 SL-WL Ratio: Laparotomy Closure Study in Elective and Emergency Surgeries

The researchers conducted a study on laparotomy closure quality and short term complications in elective and emergency surgeries. They analyzed the suture-to-wound length ratio (SL/WL) and surgical site occurrence (SSO) of midline and transverse incisions. The results showed no difference in short stitch quality between elective and emergency operations. The SL/WL ratio was higher in midline incisions compared to transverse incisions. The study also found that a short stitch 6:1 SL/WL ratio can only be achieved in 43% of cases. Transverse incisions should be closed in two layers to achieve a sufficient SL/WL ratio.

Journal Article by Golling M, Breul V, Zielska Z and Baumann P in Hernia

© 2024. The Author(s).

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Comparing Sutureless Techniques in Open Inguinal Hernia Repair

In open inguinal hernia repair, three sutureless techniques were compared: mesh fixation with glue, self-gripping mesh, and trabucco’s technique. Among 1034 patients, trabucco’s technique, utilizing standard/heavy mesh, significantly increased the odds of hematomas. The study assessed postoperative complications, acute/chronic pain, and discharge time, considering patient-related factors.

Journal Article by Baldini E, Lori E (…) Palumbo P et 21 al. in J Clin Med

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