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Robotic Surgery Triumphs: Meta-Analysis on Hernia Repair

In a comprehensive review encompassing 64 studies, including 227,242 patients for inguinal hernia repair (IHR) and 158,384 for ventral hernia repair (VHR), robotic surgery exhibited superiority. Robotic IHR significantly lowered hernia recurrence risk (OR 0.54), demonstrating its safety and efficacy. The meta-analysis underscores that robotic surgery emerges as a commendable alternative, offering intraoperative and postoperative advantages compared to laparoscopy and open surgery in both IHR and VHR cases.

Review by de’Angelis N, Schena CA (…) Pessaux P et 13 al. in Surg Endosc

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

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Unveiling Survival Insights: Radiotherapy Redundant for Stage III Mucinous Rectal Cancer

Contrary to the conventional recommendation, researchers analyzed SEER data (2004-2015) for stage III rectal mucinous adenocarcinoma (RMC) patients. RMC, distinct in T and N stage at diagnosis, emerged as an independent poor prognostic factor for overall and cancer-specific survival. Notably, adjuvant radiotherapy failed to confer survival benefits, with no significant difference found between chemotherapy alone and chemotherapy plus radiotherapy groups. The study challenges the necessity of adjuvant radiotherapy for stage III RMC, emphasizing its limited efficacy in improving survival outcomes.

Journal Article by Liao H, Tang C (…) Lei X et 6 al. in J Gastrointest Surg

© 2023. The Society for Surgery of the Alimentary Tract.

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Decoding Aberrant Scarring: Unraveling Mechanisms and Implications

Skin wound healing often leads to abnormal scarring, such as keloids or hypertrophic scars, impacting millions globally. While the precise mechanisms remain elusive, evidence suggests ongoing inflammation in susceptible individuals perpetuates extracellular matrix changes, resulting in fibrotic lesions. Abnormal scarring, causing pain, functional impairment, and aesthetic concerns, lacks effective treatment. The study underscores the urgent need for standardized and innovative approaches to enhance outcomes in patients with pathological scarring.

Review by Jeschke MG, Wood FM (…) Gauglitz GG et 4 al. in Nat Rev Dis Primers

© 2023. Springer Nature Limited.

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Limited Exploration of Feasibility in Surgical Placebo Trials

Examining 131 randomized placebo-controlled surgical trials, a systematic review revealed a scarcity of published pilot or feasibility studies to inform the design and execution of these challenging trials. Only four studies, focused on orthopedic and oral/maxillofacial surgery, conducted true pilot work. With a dearth of reported feasibility efforts, the study underscores the necessity for more pilot studies to share crucial insights, aiding in the optimization of design for main randomized placebo-controlled surgical trials.

Journal Article by Cousins S, Gormley A (…) Blazeby JM et 4 al. in BMJ Open

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.

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Best Practices in Regression Analysis for Surgical Oncology Research: A Practical Guide

Analyzing tissue expander breast reconstruction cases (n=1986), researchers offered practical insights into regression modeling in surgical oncology. For breast-Q physical well-being, linear regression identified age, marital status, and dissection type as significant factors. Logistic regression for complications found BMI, age, bilateral reconstruction, and dissection type impactful. The study provides focused directives, urging researchers to judiciously select variables, confirm model fitting, and consider clinical plausibility for accurate interpretation in surgical oncology research.

Journal Article by Boe L, Vingan PS (…) Nelson JA et 5 al. in J Surg Oncol

© 2023 Wiley Periodicals LLC.

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Surgeon-Patient Sex Discordance Hinders Optimal Outcomes in Complex Cancer Surgery

Analyzing 495,628 patients undergoing complex cancer surgery, researchers found that sex discordance between surgeons and patients (51.2%) was linked to a decreased likelihood of achieving optimal postoperative outcomes. Such discordance correlated with higher risks of complications and 90-day mortality. Intriguingly, male patients treated by female surgeons exhibited outcomes comparable to female patients treated by male surgeons, emphasizing the impact of sex concordance on postoperative courses in cancer surgery.

Journal Article by Khan MMM, Munir MM (…) Pawlik TM et 7 al. in J Surg Oncol

© 2023 The Authors. Journal of Surgical Oncology published by Wiley Periodicals LLC.

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Tailoring Prophylaxis in Crohn’s Disease Surgery: Real-world Insights into Risk Factors and Recurrence

Examining 1404 Crohn’s disease patients post-ileocecal resection, researchers identified high-risk factors for surgical recurrence (multiple surgeries, active smoking, penetrating or perianal disease). Biologic prophylaxis post-surgery lowered surgical recurrence in high-risk patients. Additionally, prophylaxis reduced endoscopic recurrence regardless of risk, suggesting its potential benefits across risk profiles. These findings emphasize the relevance of individualized prophylactic approaches in postoperative Crohn’s disease management.

Journal Article by Shah RS, Bachour S (…) Click BH et 15 al. in Clin Gastroenterol Hepatol

Published by Elsevier Inc.

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ECCO Workshop Yields Postoperative Management Algorithm for Crohn’s Disease Patients

The 8th ECCO scientific workshop addressed postoperative recurrence (POR) in Crohn’s disease after ileocolonic resection. Despite modern therapies, POR remains a challenge, impacting patients’ lives. The workshop extensively reviewed data on preventive and treatment strategies, including medications, endoscopic procedures, and surgery. Synthesizing available knowledge, the workshop produced a practical algorithm for managing POR in daily clinical practice, providing a valuable guide for clinicians navigating the complexities of postoperative Crohn’s disease care.

Journal Article by Ferrante M, Pouillon L (…) Domènech E et 11 al. in J Crohns Colitis

© The Author(s) 2023. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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Prophylactic Dexamethasone in Hepatectomy with 25-Min Intermittent Pringle’s Maneuver for Hepatocellular Carcinoma: A Randomized Trial

In hepatectomy for hepatocellular carcinoma (HCC) using a 25-minute Intermittent Pringle’s Maneuver (IPM), preoperative dexamethasone administration demonstrated benefits. The study included 270 patients, with the dexamethasone group exhibiting reduced hepatocellular injury, inflammatory response, and major complications, along with shorter hospital stays compared to the control group. Notably, subgroup analyses indicated milder hepatocellular injury for cirrhotic patients and reduced inflammatory response for non-cirrhotic patients. Preoperative dexamethasone administration proved effective in improving perioperative outcomes in HCC patients undergoing hepatectomy with a 25-minute IPM.

Journal Article by Huang Y, Xu L (…) Jiang L et 4 al. in Int J Surg

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

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Mutation-Annotated Prognostic Score for Intrahepatic Cholangiocarcinoma: Development and Validation

Researchers developed a Mutation-Annotated Prognostic Score (MAPS) for intrahepatic cholangiocarcinoma (ICC) after resection, integrating TP53 and KRASG12 mutations with clinical parameters. The MAPS model, validated internally and externally, demonstrated superior predictive efficacy (c-indices 0.782 and 0.731, respectively) compared to existing models. It effectively identified ICC patients’ overall survival and showed promise in predicting benefits from upfront surgery and adjuvant therapy, providing a valuable tool for personalized prognostication and treatment decision-making.

Journal Article by Wang XY, Zhu WW (…) Qin LX et 14 al. in Int J Surg

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

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