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Minimally Invasive Distal Pancreatectomy Outcomes for Left-Sided Tumors: Impact of Modified Frailty Index

Examining 2,212 patients undergoing minimally invasive distal pancreatectomy (MIDP) for left-sided tumors, this study categorized participants into frail and nonfrail groups using the modified frailty index (MFI). The frail group (n=79) exhibited significantly higher clinically relevant postoperative pancreatic fistula, overall complications, and 90-day mortality (1.3%). MFI ≥0.27, extended pancreatectomy, BMI ≥30 kg/m², male sex, and malignancy were identified as risk factors for severe postoperative complications. MFI emerges as a valuable preoperative predictor for adverse outcomes in MIDP.

Journal Article by Park Y, Hwang DW (…) Kim SC et 5 al. in Int J Surg

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

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Short-Term Outcomes of Laparoscopic Anatomical Liver Resection of Segment 8 for Hepatocellular Carcinoma

Examining 122 patients across seven Chinese centers, researchers evaluated three laparoscopic approaches for anatomical liver resection of segment 8 (LALR-S8) in hepatocellular carcinoma. The laparoscopic ultrasonography-guided, hepatic vein-guided, and Glissonean approaches showed comparable short-term oncological outcomes. Complication rates were low (5.73%), with the hepatic vein-guided approach being the most utilized. The study affirms the safety and feasibility of LALR-S8, emphasizing standardized techniques and suitable surgical approaches for hepatocellular carcinoma treatment.

Journal Article by Wang X, Li J (…) Wang H et 12 al. in Int J Surg

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

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Minimally Invasive Surgery vs. Laparotomy for Nonmetastatic pT4a Colorectal Cancer: Propensity Score Analysis

Analyzing 634 nonmetastatic pT4a colorectal cancer patients (2015–2021), researchers compared minimally invasive surgery (MIS) and laparotomy outcomes. MIS exhibited lower blood loss, quicker recovery parameters, and a 3.5% conversion rate. After 5 years, MIS showed comparable overall survival (72.7%) and disease-free survival (72.2%) to laparotomy. Multivariate analysis identified age, lymph node metastasis, and carcinoembryonic antigen levels as independent variables for overall survival, while lymph node metastasis and CA125 levels were relevant for disease-free survival. MIS proves safe, accelerates recovery, and doesn’t compromise oncological outcomes.

Journal Article by Guo HL, Chen JY (…) Wu WH et 5 al. in Int J Surg

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

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Prognostic Significance of Circumferential Radial Margin in Esophageal Cancer Resection

Examining esophagectomy outcomes for pathologic T3 esophageal cancer (n=519, 2000–2019), researchers categorized patients based on circumferential radial margin (CRM) involvement. CRM+ (tumor at CRM) correlated with shorter disease-free survival (DFS) and overall survival (OS) compared to CRM-. CRM-close (tumor >0 to 1 mm from CRM) showed similar outcomes to CRM-. After adjustments, College of American Pathologists (CAP)+ was linked to poorer outcomes, while Royal College of Pathologists (RCP)+ was not. CRM status proves critical for prognosis, emphasizing its significance in esophageal cancer surgery.

Journal Article by Boerner T, Carr R (…) Molena D et 15 al. in Int J Surg

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

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Process 2023 Guidelines: Enhancing Reporting Quality in Surgical Case Series

The Process 2023 Guidelines, aimed at improving reporting quality in surgical case series, underwent updates through collaboration and a Delphi consensus exercise. Involving a steering group and expert panel, the majority of proposed changes received consensus, leading to the presentation of updated guidelines. Notably, items 3c and 6a, lacking consensus, remain unchanged. With participation from 38 contributors, the Process 2023 Guidelines continue their mission to elevate the standards of case series reporting in surgery.

Journal Article by Mathew G, Sohrabi C (…) Agha R et 3 al. in Int J Surg

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

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Feasibility and Safety of Single-Incision Robotic Assisted Colorectal Surgery

In a nonrandomized cohort pilot study, researchers explored the feasibility and safety of single-incision robotic-assisted surgery (SIRAS) using the Shurui Endoscopic Surgical Robotic System (SR-ENS-600). Seven patients underwent successful SIRAS for colorectal malignancy. The SR-ENS-600 platform exhibited preferable maneuverability/stability in confined fields. Although one case encountered intraoperative hemorrhage, overall outcomes were satisfactory, with no short-term complications or mortality. While affirming SIRAS feasibility, larger investigations are crucial for establishing safety and superiority in selected patients.

Journal Article by Guo Z, Shi Y (…) Zhao R et 8 al. in Int J Surg

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

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Storage Time of Transfused Red Blood Cells and Postoperative Infections in Clean-Contaminated Surgery

Investigating the impact of red blood cell storage time on postoperative infections in clean-contaminated surgery, a cohort study with 4,046 patients revealed no significant association between prolonged storage time and increased infection risk. Analyzing 11,604 transfusion episodes, even after adjusting for 17 confounders, no notable correlation was found in either episode-level or patient-level analysis. This suggests that, within the studied parameters, storage time of transfused red blood cells does not significantly contribute to higher infection risks post-surgery.

Journal Article by Xu X, Zhang Y (…) Huang Y et 3 al. in Ann Surg

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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Global Benchmarks for Robotic Bariatric Surgery

A comprehensive study across 17 centers on four continents, comparing robotic bariatric surgery with laparoscopic benchmarks, involved 9,097 patients. In expert centers, robotic Roux-en-Y gastric bypass demonstrated lower benchmark cut-offs for hospital stay, bleeding, and ulceration but had a longer operation duration. Robotic sleeve gastrectomy outperformed its laparoscopic counterpart in most outcomes. Overall, newly established benchmarks suggest enhanced safety in robotic bariatric surgery compared to laparoscopic, despite longer operation times for certain procedures.

Journal Article by Giudicelli G, Gero D (…) Jung MK et 38 al. in Br J Surg

© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.

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Combined Hepatocholangiocarcinoma: Worse Survival Than Hepatocellular Carcinoma, Similar to Intrahepatic Cholangiocarcinoma

In a retrospective study of 3,196 surgery-treated patients with combined hepatocholangiocarcinoma, hepatocellular carcinoma, and intrahepatic cholangiocarcinoma, survival outcomes were analyzed. Despite data limitations, overall survival for combined hepatocholangiocarcinoma was worse than hepatocellular carcinoma but similar to intrahepatic cholangiocarcinoma. Disease-free survival was comparable among the three groups. Predictors of mortality included the cancer subtype, metabolic syndrome, preoperative tumor markers, and satellite nodules, while recurrence was associated with satellite nodules rather than cancer subtype. The study suggests the need for future research on immunophenotypic profiling for better predictive capabilities.

Journal Article by Amory B, Goumard C (…) Brustia R et 31 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Appendectomy vs. Hemicolectomy for 1- to 2-cm Appendix Neuroendocrine Tumors: A Survival Analysis

Examining 3,189 patients with 1- to 2-cm neuroendocrine tumors of the appendix, researchers found that while the appendectomy rate increased over the years, it wasn’t linked to improved survival compared to right hemicolectomy. Grade 2 and 3 tumors were associated with a lower likelihood of appendectomy. Despite differences in tumor grades and patient travel distance, overall survival after appendectomy was similar to hemicolectomy. The study questions the routine use of hemicolectomy for these tumors, suggesting that it may not enhance treatment outcomes.

Journal Article by Ahmed FA, Wu VS (…) Hoehn RS et 5 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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