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Wittmann Patch-Assisted Closure for Open Abdomen: More Cost-Effective Than Ventral Hernia Repair

Wittmann Patch-Assisted Closure proves more clinically effective (19.43 QALYs) and cost-efficient ($7777 cost reduction) than planned ventral hernia repair. A decision tree analysis, rollback, and ICUR (-156,679.77) support Wittmann Patch’s cost-effectiveness, with a 96.8% confidence from Monte Carlo analysis. This study establishes Wittmann Patch-Assisted Closure as a superior and economically viable strategy for open abdomen management.

Journal Article by Abosena W, Tedesco A (…) Bloom JA et 6 al. in Am Surg

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Improved ypStage Grouping System for Esophageal Squamous Cell Carcinoma Patients

A revised ypStage grouping system was proposed for esophageal squamous cell carcinoma patients who underwent neoadjuvant chemoradiotherapy followed by surgery. The new system adequately addressed the limitations of the existing American Joint Committee on Cancer (AJCC) system, showing improved prognostic relevance and higher discrimination ability. The study cohort included 501 patients in the development cohort and 422 patients in the validation cohort. The new ypStage grouping system provides clearer stratification and better predicts survival outcomes for these patients.

Journal Article by Park SY, Park B (…) Kim HK et 9 al. in Ann Surg

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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Examining Surgical Team Member Adaptation to Uncertainty Using the Operating Room Black Box

Results from this observational study using the Operating Room Black Box demonstrated how surgical team members adapt their teamwork skills during instances of uncertainty, specifically when dealing with intraoperative adverse events (IAEs). Nurses exhibited increased backup behavior skills during IAEs, while surgeons and medical trainees expressed more psychological safety skills. However, all roles exhibited fewer situation assessment skills during IAEs. These findings highlight the unique contributions of each team member and emphasize the importance of tailored interventions to strengthen interprofessional teamwork in surgical settings.

Journal Article by Incze T, Pinkney SJ (…) Trbovich PL et 4 al. in Ann Surg

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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Impedance Planimetry Establishes New Diagnostic and Severity Values for Gastric Sleeve Stenosis

Impedance planimetry measurements provide objective assessments in diagnosing gastric sleeve stenosis (GSS), a common complication following sleeve gastrectomy. This retrospective analysis of 110 upper endoscopies identifies new benchmark values for the diagnosis and severity of GSS. Impedance planimetry measurements of diameter and distensibility index were significantly lower with increasing severity of GSS, regardless of balloon fill volumes. A diameter ≥20 mm and a distensibility index ≥15 mm2/mmHg indicate normal gastric sleeve anatomy. These findings establish objective criteria for diagnosing and grading GSS, aiding clinicians in evaluating and managing this adverse event.

Journal Article by Evans G, Yu JX (…) Schulman AR et 5 al. in Am J Gastroenterol

Copyright © 2024 by The American College of Gastroenterology.

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Higher Rate of Recurrence with Hybrid Resection for Laterally Spreading Lesions of the Papilla

Hybrid resection (HR) for laterally spreading lesions of the papilla, involving hot snare papillectomy and cold snare resection, was compared to conventional hot snare resection (CR) in a study. HR was associated with a significantly higher recurrence rate of recurrent or residual adenoma (RRAs) compared to CR. The odds of recurrence were 3.6 times higher with HR. HR also required a higher median number of procedures to treat RRAs. However, there was no difference between the two techniques in terms of bleeding risk. The study suggests that CR should remain the preferred management option for treating these lesions.

Journal Article by Gupta S, Craciun A (…) Bourke MJ et 9 al. in Gastrointest Endosc

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

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Book-Binding Technique (BBT) Shows Safe Intracorporeal Gastroduodenostomy in Totally Laparoscopic Distal Gastrectomy for Gastric Cancer

The book-binding technique (BBT) is a safe and feasible method for intracorporeal gastroduodenostomy in totally laparoscopic distal gastrectomy (TLDG) for patients with gastric malignancy. This retrospective study evaluated 188 patients who underwent TLDG with BBT reconstruction, showing low rates of anastomotic stenosis and leakage. The median time to the first diet was 3.1 days, and the median postoperative hospital stay was 11.9 days. BBT anastomoses were performed by multiple surgeons with decreasing completion times as proficiency increased. Postoperative endoscopic findings revealed some cases of reflux esophagitis, gastritis, residual food, and bile reflux.

Journal Article by Ota M, Oki E (…) Yoshizumi T et 6 al. in J Am Coll Surg

Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Indocyanine Green Fluorescence Navigation Enables Laparoscopic Anatomic Bi-segmentectomy

The study demonstrates that laparoscopic anatomic bi-segmentectomy using Takasaki’s approach and indocyanine green fluorescence navigation is technically feasible and safe, serving as a valuable alternative to formal right hepatectomy in select cases. The report describes a successful case of a 58-year-old male with hepatitis B virus-related hepatocellular carcinoma (HCC), where the laparoscopic procedure resulted in a negative surgical margin and a favorable postoperative course, leading to discharge on postoperative day 8. The study highlights the potential benefits of this approach in specific circumstances.

Journal Article by Yang W, Li B, Wei Y and Liu F in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Neoadjuvant Radiation Therapy Shows Marginal Impact on Outcomes of Mucinous Rectal Carcinoma

The impact of neoadjuvant radiation therapy on the outcomes of patients with stage II-III mucinous rectal carcinoma was assessed using data from the national cancer database. After propensity-score matching, it was found that patients who received neoadjuvant radiation therapy had marginal downstaging of the disease, fewer examined and positive lymph nodes, and similar overall survival compared to patients who did not undergo neoadjuvant radiation. However, there were no significant differences in short-term mortality, readmission, hospital stay, and positive surgical margins.

Journal Article by Emile SH, Horesh N (…) Wexner SD et 2 al. in Dis Colon Rectum

Copyright © The ASCRS 2024.

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International Consensus Achieved on Core Descriptor Sets for Rectal Prolapse Outcomes Research

Experts from around the world have achieved international consensus on core descriptor sets for rectal prolapse outcomes research. Through a three-round Delphi process, experts agreed on minimum descriptors to consider during clinical care, which were then grouped into core descriptor sets. Key findings included the correlation of age, body mass index, frailty, nutrition, and American Society of Anesthesiology score to physiologic status, inclusion of baseline bowel function in assessments, and willingness to complete a synoptic operative report. This marks an important step toward unifying language and data collection processes for rectal prolapse.

Journal Article by Gurland BH, Olson CH, McCarthy MS and Bordeianou LG in Dis Colon Rectum

Copyright © The ASCRS 2024.

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Emerging Trends and Collaborations in Research on Surgical Smoke

Knowledge mapping of surgical smoke from 2003 to 2022 was conducted through a bibliometric analysis. The study identified a growing interest in surgical smoke research, with a notable surge in publications in 2020. The journal Surgical Endoscopy and Other Interventional Techniques was the most active in this field. The USA, Italy, and China emerged as leading contributors, but wider and more intense international cooperation is needed. The top keywords and cluster trends revolved around laparoscopic surgery, the COVID-19 pandemic, and surgical smoke.

Journal Article by Li C, Geng M (…) Liu F et 4 al. in Surg Endosc

© 2024. The Author(s).

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