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Prophylactic Negative Pressure Wound Therapy in Emergency Laparotomy: No Significant Reduction in Surgical Site Infections

Examining 65,803 emergency laparotomy patients, researchers found no significant difference in surgical site infection (SSI) rates when comparing prophylactic negative pressure wound therapy (NPWT) to standard dressings. Propensity-matched cohorts with completely or partially closed incisions showed similar SSI rates (13.4% vs. 11.9% and 3.6% vs. 4.4%, respectively). Secondary outcomes, including postoperative complications and hospital length of stay, did not significantly differ between NPWT and standard dressing groups, suggesting no substantial benefit in reducing SSIs with prophylactic NPWT.

Journal Article by Rafaqat W, Proaño Zamudio JA (…) Hwabejire JO et 7 al. in Am J Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Objective Hiatal Hernia Sizing: Enhancing Precision in Surgical Decision-Making

Investigating hiatal hernia (HH) size reporting, researchers compared subjective estimates with objective axial length measurements in 93 patients. While endoscopic subjective size allocations correlated with intra-operative decisions, axial length measurements significantly correlated with manometry results. Only one barium swallow report included an objective HH size measurement. Integrating axial length measurements into endoscopy reports is crucial, enhancing outcome precision and informing clinical decisions, emphasizing the need to move beyond subjective terms in HH characterization.

Journal Article by Palenzuela DL, Gee D (…) Paranjape C et 3 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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Mitigating Laparoscopic Gas Leaks: A Clinical Trial with Optical Imaging and a Novel Vacuum-Ring Device

In a clinical trial, researchers utilized optical gas imaging to detect laparoscopic gas leaks during surgeries and tested a vacuum-ring device’s effectiveness in mitigating leaks. Among 1643 trocar instrumentations, leaks occurred in 62.6% of visualized instances. The intervention group, using the vacuum-ring device, showed a significant reduction in high-energy leaks (Class 3) compared to the control group. The study demonstrates that available technology, including optical imaging and the vacuum-ring device, can sensitively detect and effectively mitigate laparoscopic gas leaks.

Journal Article by Nolan K, Khan MF (…) Cahill RA et 6 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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Mentorship-Based Clerkship Boosts Student Confidence and Interest

A Mentorship-Based Surgery Clerkship (MBSC) significantly enhances medical students’ surgical experiences, confidence, and perceptions. In a nonrandomized trial with 84 participants, MBSC students reported increased confidence in surgical skills, positive perceptions of surgeons, and greater interest in pursuing surgery compared to the non-mentored group. The innovative program positively impacted students’ perceived meaningfulness, surgeon qualities, and career considerations, highlighting the effectiveness of mentorship in surgical education.

Journal Article by Joel M, Iosif L, Grenda T and Tholey R in J Surg Res

Published by Elsevier Inc.

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US Hepatopancreatobiliary Surgeon Supply Surpasses Demand

Examining 1998-2019 data, this study unveils a potential surplus in the supply of hepatopancreatobiliary (HPB) surgeons in the US. In 2019, 37,335 inpatient HPB procedures occurred, with an estimated 905-1191 practicing HPB surgeons. Factoring in centralization and volume-outcome benchmarks, the study projects a possible oversupply by 2030. Without adjustments, the data suggests a risk of insufficient case volume per HPB surgeon, challenging the maintenance of optimal volume-outcome standards in the near future.

Journal Article by Rengers T, Ubl D (…) Warner SG et 3 al. in HPB (Oxford)

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

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Advancing Rectal Cancer Care: Safe Implementation of a Stent-Assisted Ileal Bypass

In a study spanning January 2022 to January 2023, researchers explored the safety and viability of a pioneering stent-assisted ileal bypass for individuals undergoing sphincter-preserving surgery for rectal cancer. With 11 successful cases, the innovative approach, involving a biofragmentable ileal stent and diversion tube, proved safe and feasible. Results indicated potential benefits, including the avoidance of protective stomas and reduced need for secondary surgeries, offering a promising alternative for rectal cancer patients.

Journal Article by Wen ZL, Bai L and Zhou X in ANZ J Surg

© 2023 Royal Australasian College of Surgeons.

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Laparoscopic Liver Tunnel for Hepatocaval Confluence Tumors

Researchers present a groundbreaking laparoscopic liver tunnel technique for tumors at the hepatocaval confluence, expanding parenchyma-sparing surgery possibilities. A case study involving synchronous colorectal liver metastases demonstrates the feasibility of this approach, allowing resection of ill-located tumors with complex vascular relationships through minimally invasive means. The method significantly enhances the scope of liver surgery, particularly for challenging cases involving the hepatic confluence, showcasing its potential for improved patient outcomes.

Journal Article by Ferrero A, Lo Tesoriere R (…) Russolillo N et 3 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Pancreatic Adenocarcinoma: ASO Guidelines on Surgical and Multimodal Management

Addressing the aggressive nature of pancreatic adenocarcinoma, this study outlines ASO practice guidelines for surgical and multimodal management. Focusing on resectable, borderline resectable, and locally advanced cases, the guidelines aim to equip surgical oncologists with current recommendations. By delving into the supporting data, the study provides a comprehensive framework for effectively managing pancreatic adenocarcinoma, emphasizing the evolving paradigms that enhance survival in well-selected patients.

Review by Turner KM, Wilson GC, Patel SH and Ahmad SA in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Grant Rejection: Strategies for Success and Funding

In addressing the common challenge of rejected grants, researchers explore the crucial decision between revising and resubmitting. With only about 15% of initial submissions securing funding, the study emphasizes a success rate exceeding 30% with proper revision strategies. Recommendations include collaborative consultation, hypothesis modification, and crafting a concise introduction. The article guides investigators through post-rejection options, revealing that, with strategic adjustments and responsive revisions, obtaining funding for an original grant becomes more attainable than anticipated.

Journal Article by Hunter CJ, Leiva T and Dudeja V in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Neoadjuvant Therapy Impact on Pancreatic Cancer: Fibrotic Response Variation and Survival Associations

Examining pancreatic ductal adenocarcinoma (PDAC) cases (1991-2020) with neoadjuvant treatment (NAT), this study categorizes fibrotic responses and explores their links to different NAT strategies (chemotherapy, chemoradiation, or total neoadjuvant therapy, TNT). Major fibrosis, most prevalent in TNT cases, correlates with superior outcomes, including higher rates of downstaging, complete responses, favorable margins, and improved overall and disease-free survival. The study underscores the significance of fibrotic response assessment in understanding treatment efficacy and predicting PDAC patient outcomes.

Journal Article by Akumuo RC, Villano AM (…) Reddy SS et 3 al. in Am J Surg

Copyright © 2023. Published by Elsevier Inc.

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