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Body fat mass loss after radical resection for pancreatic ductal adenocarcinoma predicts poor prognosis

Body fat mass loss was analyzed in patients undergoing radical resection for pancreatic ductal adenocarcinoma (PDAC) using bioelectrical impedance analysis. The study found that a body fat mass loss of ≥14% one month after surgery was associated with a poor prognosis. Lymph node metastasis and non-adjuvant chemotherapy were also identified as independent poor prognostic factors. Preoperative body fat mass and albumin levels were found to be associated with the extent of postoperative body fat mass loss. These findings highlight the importance of monitoring body fat mass changes in PDAC patients after surgery.

Journal Article by Shibata Y, Sudo T (…) Takahashi S et 10 al. in BMC Surg

© 2024. The Author(s).

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Opoid-Free Analgesia Leads to Reduced Pain Severity and Risk of Side Effects After Surgery

Patients receiving opioid-free analgesia after surgery experience lower pain severity and decreased risk of side effects compared to those prescribed opioids, according to a multispecialty, prospective cohort study in 25 countries. The study involved 4273 patients from 144 centers, with 30.7% receiving opioid analgesia at discharge. The findings emphasize the need to routinely adopt opioid-free discharge analgesia to improve patient outcomes and reduce medication side effects.

Journal Article by None None in Br J Surg

© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.

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Frailty Score Correlates with Surgical Outcomes in Optimization Before Surgery

Researchers investigated the correlation between frailty score, pre-surgical optimization, and surgical outcomes in frail patients undergoing optimization before surgery. A retrospective study was conducted on patients referred to the surgical optimization clinic and assessed for frailty, and outcomes were evaluated based on whether they proceeded to surgery or had their surgery cancelled or delayed. The average frailty score was lower in patients who proceeded to surgery compared to those whose surgery was cancelled or not scheduled. Postoperative infection rates were low, but the 30-day readmission rate was high in frail patients cleared for surgery.

Journal Article by Hui LT, St Pierre D and Miller RS in J Am Coll Surg

Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Majority of Variation in Lymph Node Assessment for Colon Cancer Linked to Non-modifiable Tumor Factors

Researchers investigated the factors contributing to variation in lymph node assessment for colon cancer and found that non-modifiable tumor factors were responsible for the majority of variation. A dataset of over 280,000 patient records from 15,000 surgeons across 1,200 facilities was analyzed. The achievement of the 12 lymph node standard was high at 90.3%. Factors such as age, sex, primary tumor site, tumor grade, t stage, and comorbidities were significantly associated with meeting the standard. Modifiable factors accounted for 29% of the variation in lymph node assessment.

Journal Article by Egger ME, Feygin Y (…) Ellis CT et 6 al. in J Am Coll Surg

Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Higher 30-day surgical complications observed in Asian Americans after esophagectomy

Asian Americans face higher 30-day surgical complications following esophagectomy compared to Caucasians, according to a retrospective analysis of the ACS-NSQIP database. The study found that Asian Americans had a greater likelihood of pulmonary complications, particularly pneumonia, renal dysfunction, including progressive renal insufficiency, and bleeding events. They also had a longer length of stay. These findings highlight the need for further investigation into the underlying causes of these disparities and the development of strategies to mitigate them.

Journal Article by Li R, Luo Q and Gutierrez ID in Am J Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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Short-Term Metabolic Improvements Following Roux-en-Y Gastric Bypass

The study investigated the metabolic changes and physiological factors mediating the effects of Roux-en-Y gastric bypass (RYGB) surgery in obese patients. Results showed that insulin concentrations decreased significantly after the surgery, along with improvements in weight loss and insulin sensitivity. Additionally, triglycerides, remnant cholesterol, lactate, glycoprotein acetyls, and certain amino acids decreased post-surgery. The study highlighted that weight loss and improved insulin sensitivity were the key physiological outcomes mediating the short-term metabolic benefits of RYGB surgery.

Journal Article by Zhao S, Hörkkö S (…) Hukkanen J et 4 al. in Obes Surg

© 2024. The Author(s).

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The Obesity Epidemic: Misconceptions and Harmful Beliefs

The CDC’s recent statements on obesity causing metabolic syndrome and attributing it to individual behavior are contested. Bariatric surgery outcomes challenge the direct link between obesity and diabetes suggested by the CDC. The rise in diabetes rates from 2004 to 2012 contradicts behavior-based explanations. The study emphasizes the need for a nuanced understanding of obesity causes beyond personal responsibility, considering factors like pesticides and viruses.

Journal Article by Miller ZC, Kang BK (…) Pories WJ et 2 al. in Obes Surg

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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The Effect of Diet Composition on Post-operative Outcomes of Roux-en-Y Gastric Bypass in Mice: Key Findings

Regardless of diet, Roux-en-Y gastric bypass (RYGB) led to significant reductions in body weight, fat mass, and lean mass. RYGB and high-fat diet (HFD) independently affected bone mineral density and vitamin D levels. HFD after RYGB posed a significant health risk, impairing improvements to dyslipidemia, non-alcoholic fatty liver disease (NAFLD), and fibrosis. The study suggests that post-operative diet composition plays a crucial role in reversing obesity-induced metabolic abnormalities and offers potential targets for treating bone mineral density loss, vitamin D deficiency, and myeloid lineage commitment after RYGB.

Journal Article by Stevenson M, Srivastava A (…) Ragolia L et 12 al. in Obes Surg

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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High Likelihood of Recent Cholecystectomy in Elderly Patients Diagnosed with Pancreatic Adenocarcinoma

Elderly patients diagnosed with pancreatic adenocarcinoma are more likely to have had a recent cholecystectomy compared to those without. The rate of cholecystectomy in the year prior to cancer diagnosis was 1.9% for the cancer group, significantly higher than the 0.4% observed in the non-cancer group. Differences between the two groups included a higher age in the cancer cohort.

Journal Article by Fromer MW, Xu Q (…) Egger ME et 11 al. in Am Surg

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No Antibiotics Comparable to Antibiotics in Acute Diverticulitis: Level 1a Meta-Analysis

Researchers conducted a meta-analysis including 5 randomized controlled trials and 1934 patients to compare the use of antibiotics with no antibiotics in the management of acute uncomplicated diverticulitis (AUD). Their findings revealed that there is no significant difference in baseline characteristics, clinical presentation, and adverse health outcomes between AUD patients treated without antibiotics compared to with antibiotics. The rates of complicated diverticulitis were also comparable in both groups. These results support the recent guidelines recommending selective use of antibiotics in AUD patients.

Journal Article by Sokhal BS, Mostafa OES (…) Hajibandeh S et 4 al. in Am Surg

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