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CA19-9 is a significant prognostic factor in stage III gastric cancer patients undergoing radical gastrectomy

The main result of this study is that preoperative and postoperative serum CA19-9 values are independent risk factors for predicting the prognosis in patients with stage III gastric cancer after curative gastrectomy. Patients with CA19-9 levels greater than 35 U/ml had significantly lower recurrence-free survival and overall survival rates compared to those with CA19-9 levels of 35 U/ml or lower. Lymph node metastases and postoperative adjuvant chemotherapy were also identified as independent factors influencing prognosis.

Journal Article by Ma X, Zhou X (…) Zhang P et 10 al. in BMC Surg

© 2024. The Author(s).

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Improved neoadjuvant and adjuvant therapy needed for biliary tract cancer

Neoadjuvant and adjuvant therapy for biliary tract cancer (BTC) have shown limited success in improving outcomes for patients. This review highlights that while a minority of BTC patients are eligible for curative surgery, their survival rates remain poor with high recurrence rates. The study evaluates current clinical trials and identifies challenges and limitations in their implementation. It calls for the development of more effective neoadjuvant and adjuvant treatment strategies, providing future directions to enhance the management of BTC.

Journal Article by Wilbur HC, Soares HP and Azad NS in Hepatology

Copyright © 2024 American Association for the Study of Liver Diseases.

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Low-volume Ambulatory Surgery Centers Linked to Higher Revisit Rates, especially for Multimorbid Patients

The study assessed the association between surgical volume and patient outcomes in ambulatory surgery centers (ASCs). It found that patients who had surgery at low-volume ASCs had a higher odds of revisiting within 7 days compared to those at higher-volume ASCs. This association was more pronounced among patients with multimorbidity, particularly those undergoing orthopedic procedures. The findings highlight the importance of surgical volume as an indicator of patient outcomes and suggest that older patients with multimorbidity should carefully consider the location of their care.

Journal Article by Jain S, Rosenbaum PR (…) Fleisher LA et 4 al. in JAMA Surg

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Selective Lateral Pelvic Lymph Node Dissection After Preoperative Chemoradiotherapy in Middle/Low Rectal Cancer

Selective lateral pelvic lymph node dissection after preoperative chemoradiotherapy has been found to decrease local recurrence in middle/low rectal cancer, providing survival benefits. The study investigated the safety, indications, and survival benefits of this procedure based on preoperative characteristics. Results showed that surgery times were significantly prolonged by preoperative chemoradiotherapy, and poor/mucinous/signet-ring adenocarcinoma and postchemoradiotherapy lateral pelvic lymph node short-axis diameter ≥7 mm were independent predictive factors for lateral pelvic lymph node metastasis. Additionally, swollen lateral pelvic lymph nodes beyond the obturator or internal iliac region, as well as involvement of multiple lateral pelvic lymph nodes, were identified as adverse prognostic factors.

Journal Article by Zhou S, Zhang H (…) Liu Q et 6 al. in Dis Colon Rectum

Copyright © The ASCRS 2023.

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Sodium thiosulfate effectively prevents cisplatin-induced nephrotoxicity in patients undergoing cytoreductive surgery with HIPEC

Sodium thiosulfate can effectively prevent cisplatin-induced nephrotoxicity in patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC), eliminating the need for preoperative intravenous hyperhydration. A retrospective analysis of 220 patients showed that the use of sodium thiosulfate significantly reduced serum creatinine levels and preserved glomerular filtration rate compared to hyperhydration alone or in combination with sodium thiosulfate. These findings have important implications for simplifying the management of patients with peritoneal metastases undergoing HIPEC with cisplatin.

Journal Article by Vachez E, Kefleyesus A (…) Glehen O et 6 al. in Eur J Surg Oncol

© 2024 Published by Elsevier Ltd.

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Non-Thermal Plasma accelerates wound healing in abdominal surgeries

Non-Thermal Plasma (NTP) therapy was evaluated as a method to speed up wound healing in patients who underwent laparoscopic and open abdominal surgeries. Researchers used a needle-type reactor with an irradiance of 0.5 w/cm² to apply NTP. The pilot study showed promising results, indicating that NTP therapy can be efficacious and safe in enhancing recovery after abdominal surgeries.

Journal Article by Rodríguez-Méndez BG, López-Callejas R (…) Jaramillo-Martínez C et 5 al. in J Clin Med

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Perioperative and long-term survival outcomes of pancreatectomy with arterial resection in pancreatic cancer

Despite the involvement of major arteries in pancreatic cancer, pancreatectomy with arterial resection (AR) following neoadjuvant therapy (NAT) can potentially enhance survival rates. A systematic review and meta-analysis of nine retrospective studies, with a total sample size of 215, showed that pancreatectomy with AR achieved an overall R0 resection rate of 79%. The median 1-, 2-, 3-, and 5-year survival rates were 92.3%, 64.8%, 51.6%, and 14%, respectively. However, prospective controlled studies are needed to validate these findings and address potential biases and limitations in current retrospective studies.

Journal Article by Xue K, Huang X (…) Tian B et 2 al. in Int J Surg

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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Shift from Laparoscopic to Robot-assisted Minimally Invasive Pancreatoduodenectomy in Europe

The first 3 years of the E-MIPS registry revealed acceptable morbidity and mortality rates after minimally invasive pancreatoduodenectomy (MIPD) in Europe. The study included 1,336 patients who underwent MIPD, with 835 robot-assisted and 501 laparoscopic procedures. The rate of centers performing laparoscopic MIPD decreased from 46.9% to 25%, while robot-assisted MIPD increased from 46.9% to 65.6%. Lower rates of major morbidity and postoperative complications were observed after laparoscopic MIPD. The impact of the shift from laparoscopic to robot-assisted MIPD and differences in outcomes between the two approaches should be further assessed.

Journal Article by Emmen AMLH, de Graaf N (…) Abu Hilal M et 28 al. in Int J Surg

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

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Improved Short-term Outcomes of Laparoscopic CRS-HIPEC compared to Open CRS-HIPEC in Peritoneal Metastasis

Laparoscopic cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is a safe and feasible procedure for selected patients with limited peritoneal disease. A retrospective analysis compared laparoscopic CRS-HIPEC to open CRS-HIPEC and found that laparoscopic procedures had lower estimated blood loss and overall morbidity rates. Grade III-IV complications, reintervention rates, and readmission rates were similar between the two groups. Additionally, patients treated with laparoscopic CRS-HIPEC had faster postoperative recovery and shorter hospital stays.

Journal Article by Bortoli N, Tonello M (…) Sommariva A et 3 al. in J Gastrointest Cancer

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

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Management Strategies for Refractory Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is a common condition with increasing prevalence worldwide and a high economic burden. Despite proton pump inhibitor (PPI) therapy, a significant number of patients remain symptomatic. This review highlights the importance of differentiating between unproven GERD and refractory GERD, and provides a comprehensive overview of the diagnostic workup and personalized management strategies for refractory GERD. Proper diagnosis and management of refractory GERD is crucial to prevent long-term complications such as strictures, Barrett’s esophagus, and esophageal adenocarcinoma.

Review by Davis TA and Gyawali CP in J Neurogastroenterol Motil

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