Researchers identified structural disorders in the ileal pouch-anal anastomosis, recognizing them as potential causes of chronic pelvic pouch complications following surgery. Understanding the critical pitfalls in pouch construction guides treatment decisions for patients exhibiting signs of pouch failure, helping address postoperative surgical complications and improve patient outcomes.
Journal Article by Schwartzberg DM, Kayal M and Barnes EL in Inflamm Bowel Dis
Approximately 4-9% of patients had a tumor-positive resection margin after neoadjuvant chemoradiotherapy (ncrt) and esophagectomy. Only a small proportion of patients received adjuvant therapy, despite the association of positive margins with decreased survival. However, a real-world study revealed that 61% of patients were treated with adjuvant immunotherapy (specifically nivolumab) in 2021-2022. Notably, patients who underwent radical esophagectomy had a median overall survival of 16.4 months, and long-term data will explore the potential benefits of nivolumab in improving outcomes.
Journal Article by van der Zijden CJ, van der Sluis PC (…) Lagarde SM et 6 al. in Ann Surg Oncol
© 2024. The Author(s).
Surgeons exhibit substantial variability in their skills, directly impacting patient outcomes. Despite limited efforts to enhance surgical skills, the potential lies in surgical coaching programs. This article discusses the promise of such programs, challenges faced in their development, and lessons learned from existing initiatives like the Wisconsin Surgical Coaching Program, SCOPE, MBSC, and ISQIC. While measured improvements in surgical outcomes remain elusive, these programs underscore the significant potential for enhancing surgical practice and patient care.
Journal Article by Stem JM and Greenberg CC in BMC Surg
Copyright © 2023 Elsevier Inc. All rights reserved.
The study analyzed 1892 cholecystectomies, including 147 bailout procedures. They found that difficult anatomy and dense adhesions were the main reasons for bailout. Out of the bailout procedures, 63.4% were converted to open surgery, with 66% resulting in complete cholecystectomy. The study revealed that subtotal cholecystectomy is a safe alternative to total cholecystectomy for challenging cases, reducing the risk of damaging surrounding structures. The choice between laparoscopic or open surgery should be based on the surgeon’s expertise.
Journal Article by Ledezma Dominguez J, Tariq N (…) Maqbool B et 3 al. in Am Surg
Patients with resectable biliary tract cancer (BTC) who had negative peritoneal washing cytology (PWC) exhibited longer recurrence-free survival and overall survival compared to those with positive PWC. Among the analyzed patients, ampullary carcinoma showed uniformly negative PWC. Serum carbohydrate antigen 19-9 level over 80 u/ml and multiple lymph node metastasis were independent factors associated with positive PWC. These findings suggest that negative PWC predicts better prognosis in BTC patients undergoing curative treatment.
Journal Article by Sumiyoshi T, Uemura K (…) Takahashi S et 9 al. in Langenbecks Arch Surg
© 2024. The Author(s).
Prophylactic mesh augmentation in emergency laparotomy closure was evaluated through a meta-analysis of randomized controlled trials. After reviewing 33 studies, four were included in the analysis, involving 464 patients. The results showed a significant decrease in incisional hernia incidence when mesh reinforcement was used (OR 0.18; 95% CI 0.07-0.44; p < 0.001). Despite the risk of seroma, prophylactic mesh augmentation was deemed safe and could be considered for emergency laparotomy closure. Further long-term studies are necessary to assess outcomes.
Review by Marcolin P, Mazzola Poli de Figueiredo S (…) Moffett JM et 4 al. in Hernia
© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
The study evaluated the safety and cost of outpatient laparoendoscopy for treating cholecystocholedocholithiasis. Data from patients treated between January 2015 and January 2019 were collected, and two groups were compared. The study found that outpatient treatment by laparoendoscopy was safe and viable for most cases, with lower costs. It also supports the reorientation of training and practice for hepatobiliary surgeons. The average age and physical status of patients in the outpatient group were better compared to the inpatient group.
Journal Article by Dos Santos JS, Kemp R (…) Lima LS et 7 al. in J Clin Med
Laparoscopic partial splenectomy in distal pancreatectomy may preserve splenic function and help retain immunocompetence, according to a study involving five patients. The procedure, which involves resection of the distal pancreas and the inferior portion of the spleen, was completed laparoscopically within four hours. All patients had a perfused splenic remnant on imaging and benign blood films post-surgery, suggesting retained splenic function. Preserving some spleen during distal pancreatectomy could provide long-term benefits for patients.
Journal Article by Bell-Allen N, McNamara A (…) O’Rourke N et 2 al. in ANZ J Surg
© 2024 Royal Australasian College of Surgeons.
The systematic review of 604 cases revealed that the accessory appendicular artery (AAA) is absent in most cases (83.6%). When present, it commonly originates from the posterior cecal artery (12.4%), followed by the descending branch of the ileocolic artery (2%), and the ileal branch of the ileocolic artery (0.7%). Instances of origin from the anterior cecal, common cecal, or the ileocolic trunk were even more infrequent. The study introduces a new simplified classification system and highlights the need for surgeons to consider the presence and origin of the AAA during appendectomy procedures.
Journal Article by Savvakis S, Karamitsou P (…) Poutoglidis A et 5 al. in ANZ J Surg
© 2024 Royal Australasian College of Surgeons.
The study analyzed the implications of the geometric location (fundal end vs cystic ductal end) of gallbladder cancer on postoperative outcomes. Researchers compared the oncologic outcomes of 575 patients with gallbladder cancer and found that patients with cancer located on the cystic ductal end had significantly lower rates of recurrence-free survival and overall survival compared to those with cancer located on the fundal end. Additionally, all recurrences in patients with stage 1 gallbladder cancer occurred in cases with cystic ductal end cancer with specific pathological characteristics.
Journal Article by Yoo D, Kim SR (…) Song KB et 7 al. in ANZ J Surg
© 2024 Royal Australasian College of Surgeons.