Blog

Predicting Portal Vein System Thrombosis: A Nomogram Using Preoperative Portal Vein Velocity after Splenectomy with Esophagogastric Devascularization

In cirrhotic patients with portal hypertension undergoing splenectomy with esophagogastric devascularization (SED), portal vein system thrombosis (PVST) is a serious concern. This study involving 562 patients revealed that low preoperative portal vein velocity (PVV) was the strongest independent risk factor for PVST. Patients with PVV ≤ 16.5 cm/s had a significantly higher incidence of PVST. A nomogram based on PVV demonstrated excellent predictive accuracy and could aid in preoperative assessment and risk stratification for PVST after SED.

Journal Article by Wang JL, Li J (…) Huang ZY et 6 al. in Surg Endosc

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

read the whole article in Surg Endosc

open it in PubMed

Validating Basic Robotic Surgical Skills: A Proficiency Test for the Versius Surgical Robot Using a Virtual Reality Simulator

In assessing competency for the Versius surgical robot, researchers developed a virtual reality simulator-based test. Participants, categorized by experience, underwent exercises on the Versius trainer. Discriminatory analysis revealed parameters distinguishing novices and experienced surgeons but not intermediates. Test-retest reliability analysis showed moderate reliability for selected parameters. Non-compensatory pass/fail levels were defined, indicating novices’ failure and most experienced surgeons’ success in the identified exercises. This marks a crucial step in establishing a proficiency-based training program for the Versius system.

Journal Article by Bjerrum F, Collins JW (…) Konge L et 2 al. in Surg Endosc

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

read the whole article in Surg Endosc

open it in PubMed

Deep Neuromuscular Blockade Mitigates Working Space Issues in Low-Pressure Pneumoperitoneum during Laparoscopic Cholecystectomy

In a non-inferiority RCT comparing low-pressure pneumoperitoneum (LPP) with deep neuromuscular blockade (NMB) to standard pressure pneumoperitoneum (SPP) with moderate NMB for laparoscopic cholecystectomy, researchers found similar surgeon satisfaction scores between groups. This suggests that LPP with deep NMB is not inferior to SPP with moderate NMB, indicating a potential approach to address working space challenges in laparoscopic surgery.

Journal Article by Arumugaswamy PR, Chumber S (…) Ranjan P et 8 al. in Surg Endosc

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

read the whole article in Surg Endosc

open it in PubMed

International Consensus Guides Obesity Management: IFSO Delphi Study

In a Delphi survey involving 43 global obesity experts, unanimous consensus (≥70% agreement) was achieved on 15 essential definitions and reporting standards in metabolic bariatric surgery (MBS). Notable agreement (95/121 statements) covered preferred surgical procedures like Roux-en-Y gastric bypass and sleeve gastrectomy. Moderate consensus existed for specific procedures, but none for intra-gastric balloons. Agreement extended to MBS in patients >65 and <18 years old with BMI >50 kg/m². This study establishes vital guidelines for obesity management endorsed by a multidisciplinary expert panel.

Journal Article by Salminen P, Kow L (…) Shikora S et 6 al. in Obes Surg

© 2023. The Author(s).

read the whole article in Obes Surg

open it in PubMed

Combined Hepatic Resection and Ablation Ensure Safety and Long-Term Survival in Extensive Colorectal Liver Metastases

Examining 161 patients with colorectal liver metastases (CRLM), researchers investigated the safety and efficacy of simultaneous hepatic resection (HR) and ablation. With 77.6% having bilobar disease and 57.1% having ≥5 tumors, the combined procedure demonstrated acceptable safety and durable long-term survival (median 38.2 months, 5-year OS 33.2%). Simultaneous colon resection increased complications. Importantly, patients with a high tumor burden (≥5 tumors) had comparable survival to those with fewer tumors. This study supports the viability of HR + ablation for managing extensive CRLM.

Journal Article by Wach MM, Washburn LA (…) Tohme S et 10 al. in HPB (Oxford)

Copyright © 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

read the whole article in HPB (Oxford)

open it in PubMed

Pelvic Exenterations and Cytoreductions Safely Combined for T4 Rectal Cancers with Peritoneal Metastasis

Investigating the combination of pelvic exenterations and cytoreductions in T4 rectal cancers with peritoneal metastasis, a study on 39 patients (median age 35) revealed safety in terms of morbidity (18% major complications). Although achieving CC-0 in 97.4%, hyperthermic intraperitoneal chemotherapy was administered to 15 patients. Despite safety, overall and recurrence-free survival remained modest at 17 and 9 months, respectively. This suggests the combined approach’s safety but underscores the ongoing challenges in improving survival outcomes for these patients.

Journal Article by Kazi M, Raghavan S, Desouza A and Saklani A in ANZ J Surg

© 2023 Royal Australasian College of Surgeons.

read the whole article in ANZ J Surg

open it in PubMed

Adjuvant Chemotherapy’s Limited Benefit in Node-Negative Pancreatic Cancer

In a Danish cohort study emulating a randomized controlled trial, researchers assessed adjuvant chemotherapy’s impact on node-negative (PN0) and node-positive (PN+) pancreatic cancer survival after surgery. Among PN0 patients, adjuvant therapy showed no significant 2-year survival difference (-2.2%). For PN+ individuals, a 9.9% improvement in 2-year survival was noted. Median overall survival was 24.9 months with adjuvant and 15.0 months without. The study suggests limited survival benefit from adjuvant chemotherapy in node-negative pancreatic cancer cases.

Journal Article by Kirkegård J, Ladekarl M, Johannsen IR and Mortensen F in Br J Surg

© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

read the whole article in Br J Surg

open it in PubMed

AI Text-to-Image Generators Reinforce Bias: Underrepresentation of Diversity in Surgeon Depictions

Examining three popular AI text-to-image generators, the study assessed the demographic accuracy of surgeon representations. It found these models overwhelmingly portrayed surgeons as white and male, reinforcing societal biases. Trainees, especially non-white and female, were underrepresented. While one model reflected attending surgeons accurately, all underestimated trainee diversity. The study emphasizes the need for safeguards and feedback mechanisms to prevent AI generators from perpetuating stereotypes, particularly in fields like surgery.

Journal Article by Ali R, Tang OY (…) Asaad WF et 13 al. in JAMA Surg

read the whole article in JAMA Surg

open it in PubMed

Optimal Surgical Approach for Small Bowel Neuroendocrine Tumors

In addressing the surge in small bowel neuroendocrine tumors (SB-NETs), this study underscores surgery’s pivotal role. Emphasizing multifocal assessment and mesenteric-sparing strategies, it delineates eight systematic steps for surgical planning. While stressing the necessity of achieving oncological control, some controversies persist, notably regarding resection in the presence of liver metastasis. The study encourages SB-NET resection for eligible patients, integrating evolving considerations, including minimally invasive surgery feasibility and tailored approaches based on individual patient factors.

Review by Søreide K, Stättner S and Hallet J in Ann Surg Oncol

© 2023. The Author(s).

read the whole article in Ann Surg Oncol

open it in PubMed

Outcomes of Esophagectomy in Elderly Patients with Esophageal Cancer

Analyzing 120 elderly esophageal cancer patients (Stage I-IV), the study revealed a 5-year overall survival rate of 45.2%. Lower body mass index, reduced pre-albumin levels, advanced tumor stage, postoperative pulmonary issues, and specific treatments significantly influenced outcomes. Despite a median 31-month follow-up, esophagectomy proved safe and feasible for elderly patients, emphasizing the importance of preventing postoperative pulmonary infections in enhancing overall survival.

Journal Article by Wang P, Lei M (…) Wang F et 11 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

read the whole article in Ann Surg Oncol

open it in PubMed