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Limited peritoneal disease progression in gastric cancer patients: No survival benefit with gastrectomy + cytoreductive surgery and HIPEC

Post author By STITCHES Newsletter
Post date 23/01/2024
Categories In Cytoreductive Surgery & Peritoneum, General Surgery, Upper Gastrointestinal Tract

The study aimed to evaluate the impact of gastrectomy with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) on the outcomes of gastric cancer (GC) patients with limited peritoneal disease progression following neoadjuvant chemotherapy (NAC). Results showed that there was no survival benefit among advanced GC patients with peritoneal metastasis (PM) who underwent gastrectomy with CRS+HIPEC compared to those who underwent gastrectomy with CRS alone.

Journal Article by Kobiałka S, Sędłak K (…) Rawicz-Pruszyński K et 7 al. in J Clin Med

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Preoperative QLB-LSAL decreases opioid usage and offers improved analgesia in laparoscopic colorectal surgery

Post author By STITCHES Newsletter
Post date 22/01/2024
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

A randomized controlled trial compared the effectiveness of anterior quadratus lumborum block at the lateral supra-arcuate ligament (QLB-LSAL) with lateral quadratus lumborum block (LQLB) for postoperative analgesia in laparoscopic colorectal surgery. The study found that QLB-LSAL reduced postoperative opioid usage, decreased morphine consumption at 24 hours postoperatively, and prolonged the time to the first patient-controlled analgesia request when compared to LQLB. These results suggest that preoperative bilateral ultrasound-guided QLB-LSAL can offer improved analgesia and decreased opioid usage in laparoscopic colorectal surgery.

Journal Article by Shi R, Shao P (…) Wang Y et 2 al. in J Am Coll Surg

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Early Discharge Reduces Postdischarge Complications in Minimally Invasive Colectomy

Post author By STITCHES Newsletter
Post date 22/01/2024
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

A retrospective cohort study analyzed the association between discharge timing and postdischarge complications in patients undergoing uncomplicated elective colectomy. After matching the early discharge group with the delayed discharge group, the study found that early discharge was associated with lower odds of postdischarge complications in laparoscopic and robotic approaches. However, there was no significant difference in open colectomy. The study suggests that surgical teams can safely select patients for early discharge after uncomplicated colectomy, particularly in minimally invasive approaches.

Journal Article by Balas M, Quereshy F, Bohnen J and Jung JJ in J Am Coll Surg

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Development of an MRI-Based Prediction Model for Anti-TNF Treatment Failure in Perianal Crohn’s Disease

Post author By STITCHES Newsletter
Post date 22/01/2024
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

A multicenter study developed a prediction model for anti-tumor necrosis factor (TNF) treatment failure in perianal Crohn’s disease. The model, based on clinical and radiologic parameters, accurately predicted the likelihood of treatment failure at 6 months. The model outperformed existing imaging-based perianal fistula activity indices and showed fair discriminatory capacity. Key predictors included age at diagnosis, time to initiate treatment, smoking, and various MRI characteristics. This study provides valuable insights for clinicians in identifying patients at risk of anti-TNF treatment failure in perianal Crohn’s disease.

Journal Article by McCurdy JD, Munir J (…) Macdonald B et 16 al. in Clin Gastroenterol Hepatol

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Comparable Outcomes of Gastric Bypass and Fundoplication for GERD in Patients with Obesity

Post author By STITCHES Newsletter
Post date 22/01/2024
Categories In General Surgery, Metabolic and Bariatric Surgery, Upper Gastrointestinal Tract

A retrospective study compared the outcomes of Roux-en-Y gastric bypass and fundoplication in patients with obesity and gastroesophageal reflux disease (GERD). Ninety-five patients with a BMI ≥35 underwent either procedure. Both groups saw an improvement in GERD symptoms and overall quality of life. There were no significant differences in postoperative reflux symptoms, dysphagia, or overall quality of life scores. However, patients who underwent fundoplication had better symptom control in the long term. Objective data showed no significant differences in postoperative pH testing, while weight loss was greater in the gastric bypass group.

Journal Article by Joseph S, Vandruff VN (…) Ujiki MB et 8 al. in BMC Surg

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The Impact of Prolonged Operative Time on Surgical Outcomes in Minimally Invasive Colorectal Surgery

Post author By STITCHES Newsletter
Post date 22/01/2024
Categories In General Surgery, Intestine and Lower Gastrointestinal Tract

Research conducted across multiple colorectal operations and surgical approaches found that prolonged operative time is associated with longer length of stay and increased complications. The study revealed that each additional hour above the median operative time is linked to a 1.08 relative risk of longer length of stay for open operations and a 1.07 relative risk for minimally invasive procedures. Despite longer operative times, laparoscopic and robotic approaches showed improved outcomes compared to open surgery.

Journal Article by Unruh KR, Bastawrous AL (…) Simianu VV et 5 al. in Dis Colon Rectum

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Development of a Predictive Tool for Hypocalcemia after Total Thyroidectomy

Post author By STITCHES Newsletter
Post date 22/01/2024
Categories In Endocrine Surgery, General Surgery

The study aimed to develop a tool to predict the probability of hypocalcemia after total thyroidectomy (TT) by evaluating the percentage decrease in serum parathyroid hormone (PTH) levels in the first 8 hours postoperatively. They prospectively evaluated 97 TT patients, determining the predictors of hypocalcemia requiring calcium supplementation. The results showed that the percentage decrease in PTH levels at 1 hour and 8 hours postoperatively, as well as postoperative magnesium (Mg2PO) levels, were isolated predictors of hypocalcemia. Two tools were developed to predict this complication, with one specifically predicting more severe hypocalcemia.

Journal Article by Soares CSP, Koga KH (…) da Silva Mazeto GMF et 5 al. in Langenbecks Arch Surg

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Frailty Index Successful in Predicting Morbidity in Elective Hernia Repair Patients

Researchers conducted a retrospective analysis using the Modified Frailty Index (MFI) to assess postoperative outcomes in elective hernia repair patients. The study included 14,125 robust patients and 1704 frail patients. Frail patients had higher in-hospital mortality, postoperative morbidity, longer hospital stays, higher healthcare costs, and were less likely to be discharged home. The findings suggest that the MFI may serve as a reliable predictor of postoperative morbidity and mortality, aiding in patient education and identification of high-risk individuals who could benefit from tailored prehabilitation.

Journal Article by Khamar J, McKechnie T (…) Hong D et 6 al. in Hernia

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Neoadjuvant GAS Treatment Shows High Efficacy in BRPC-A Pancreatic Cancer: Long-term Phase II Trial Results

Post author By STITCHES Newsletter
Post date 22/01/2024
Categories In General Surgery, HPB & Spleen

The long-term results of a phase II trial evaluating neoadjuvant gemcitabine, nab-paclitaxel, and S1 treatment in borderline resectable pancreatic cancer with arterial contact (BRPC-A) show promising outcomes. Of the 47 patients, 96% underwent pancreatectomy, and the updated median overall survival was 41.0 months with 2- and 5-year survival rates of 68.0% and 44.6%, respectively. Tumor diameter reduction and CA19-9 reduction after neoadjuvant chemotherapy, as well as no lymph node metastasis, no major surgical complications, and completion of adjuvant chemotherapy, were associated with improved survival.

Journal Article by Uemura K, Kondo N (…) Takahashi S et 7 al. in J Hepatobiliary Pancreat Sci

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Recurrence Risk in Ampullary Adenomas: FAP vs. Sporadic Cases After Endoscopic Papillectomy

Post author By STITCHES Newsletter
Post date 22/01/2024
Categories In General Surgery, HPB & Spleen, Surgical Endoscopy

Recurrence rates of ampullary adenomas (AA) after endoscopic papillectomy (EP) were compared between patients with familial adenomatous polyposis (FAP) and sporadic AA. The study included 257 patients from 10 tertiary hospitals. Recurrence occurred in 48% of patients with FAP and 36.9% of patients with sporadic AA. The risk of recurrence was higher in FAP patients after the first year of follow-up. Larger adenomas, biliary duct dilation, and periampullary extension increased the risk of recurrence, while en bloc resection decreased the risk. These factors should be considered in decision-making for EP patients.

Journal Article by Singh AD, Burke CA (…) Bhatt A et 22 al. in Dig Endosc

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