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Combined endoscopic approach for modified radical neck dissection in papillary thyroid carcinoma.

Researchers performed a combined endoscopic approach, using both the transoral and chest approaches, for modified radical neck dissection (MRND) in a patient with papillary thyroid carcinoma (PTC). The procedure included total thyroidectomy and bilateral central neck dissection via the transoral approach, and MRND for levels II, III, and IV via the combined approach. The surgery was successful, with no major complications, and the patient was satisfied with the cosmetic outcome. A total of 14 lymph nodes were harvested, including 2 metastatic nodes.

Journal Article by Ngo DQ, Le DT, Ngo QX and Van Le Q in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Higher recurrence rates for primary hyperparathyroidism found after less than subtotal parathyroidectomy in patients with multiple endocrine neoplasia type 1

Recurrence rates for primary hyperparathyroidism (PHPT) in patients with multiple endocrine neoplasia type 1 (MEN1) were assessed based on the type of surgery performed, and risk factors for recurrence were identified. The study found that recurrence was significantly higher after less than subtotal parathyroidectomy (LTSP) compared to subtotal parathyroidectomy (STP). The median time to recurrence was also shorter after LTSP. A mutation in exon 10 was identified as an independent risk factor for recurrence after STP.

Journal Article by Santucci N, Ksiazek E (…) Lifante JC et 16 al. in Ann Surg

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

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Intraoperative Autonomic Physiology in Surgeons: Real-time Cardiac Reactivity Study

Surgeons’ autonomic physiology, specifically their heart rate (interbeat intervals), varies intraoperatively. Attending surgeons exhibit higher heart rate reactivity during high-risk operations, while residents show lower reactivity during high-risk procedures relative to low-risk ones. Nurses respond similarly during both low-risk and high-risk operations; however, they are more reactive when the resident is operating. Attending surgeons’ physiological responses are well-calibrated to the demands of the operation, while residents and nurses’ responses are not as calibrated. These findings suggest that risk sensitivity is an adaptive response surgeons acquire.

Journal Article by Del Rosario K, West TV (…) Gogalniceanu P et 3 al. in Ann Surg

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

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Extended Postoperative Antibiotic Prophylaxis Does Not Reduce Surgical-Site Infections in Low- and Middle-Income Countries

Extended postoperative antibiotic prophylaxis does not lower surgical-site infection rates in low- and middle-income countries, according to a study of 8,714 patients across 19 hospitals in Ethiopia, Madagascar, India, and Bolivia. Prolonged use of antibiotics did, however, increase hospital stays by 1.4 days. The findings highlight the need for surgical initiatives to implement antimicrobial stewardship programs in resource-limited healthcare systems, as the pervasive use of antibiotics poses a growing threat of antimicrobial resistance.

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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Improved Short-term Outcomes Seen in Spleen-preserving Distal Pancreatectomy for IPMN

Researchers conducted an international multicenter cohort study to compare outcomes after distal pancreatectomy with or without splenectomy for intraductal papillary mucinous neoplasm (IPMN). They found that patients without preoperative suspicion of malignancy who underwent spleen-preserving distal pancreatectomy had improved short-term outcomes and no significant difference in overall survival compared to those who underwent distal pancreatectomy with splenectomy. The study also revealed a lymph node metastasis rate of 6.7% in patients undergoing distal pancreatectomy for IPMN.

Journal Article by Gorris M, van Bodegraven EA (…) Besselink MG et 24 al. in Br J Surg

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

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Prehospital “x-ABC” Resuscitation Reduces Mortality in Patients with Severe Hemorrhage

The introduction of a prehospital advanced resuscitative care (ARC) bundle, focusing on the “x-ABC” sequence prioritizing hemorrhage control, led to a reduction in in-hospital mortality. A total of 93 patients with severe hemorrhage were included in the analysis, with 62 in the x-ABC group and 31 in the ABC group. Compared to the ABC group, x-ABC patients showed significant improvements in vital signs upon admission to the emergency department. The overall mortality rate was significantly lower in the x-ABC group (13% vs. 47%). Prehospital circulation-first prioritization was independently associated with decreased mortality rates.

Journal Article by Ritondale J, Piehl M (…) Duchesne J et 13 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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Faculty Entrustment Associated with Resident Entrustability in Surgical Training Programs

In a cross-sectional study across 4 university-based surgical training programs, researchers used a validated tool to assess intraoperative faculty entrustment and resident entrustability behaviors. They found that faculty entrustment was positively associated with resident entrustability, and this association was consistent across the different surgical programs. The results suggest that developing faculty entrustment behaviors can enhance teaching and resident progression by promoting resident entrustability.

Journal Article by Millar JK, Matusko N (…) Sandhu G et 9 al. in JAMA Surg

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Etiologic and Physiologic Gender Differences in Fecal Incontinence

The study analyzed 200 men and 200 women with fecal incontinence to compare the causes and physiological characteristics. Both genders showed urge incontinence as the most common type. Men displayed higher prevalence of anal fistula, history of anal surgeries, rectal tumors, and pelvic radiotherapy as etiological factors, while pelvic surgeries were more common in women. Women also had higher instances of associated urinary incontinence and external anal sphincter defects. Men had lower incidence of decreased resting and squeeze pressures but higher rates of rectal hyposensitivity and anorectal dyssynergia compared to women.

Journal Article by Margalit-Yehuda R, Maradey-Romero C (…) Carter D et 2 al. in Am J Physiol Gastrointest Liver Physiol

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Effect of Mood Disorders on Weight Loss Outcomes in Bariatric Surgery Patients

The study aimed to assess the impact of mood disorders on weight loss outcomes in patients undergoing bariatric surgery. Data from 775 patients were analyzed, out of which 38.1% had pre-existing mood disorder diagnoses. Both groups experienced significant reductions in postoperative body mass index, with no significant difference between the mood disorder group and the control group. Additionally, there was no significant variation in mortality rates between the two groups. These findings suggest that mood disorders should not prevent individuals from undergoing weight loss surgery.

Journal Article by Mowoh DPM, Cole R (…) Khaitan L et 3 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Impact of Stoma App on Quality of Life in Stoma Patients

A randomized double-blind clinical trial investigated the effects of a mobile healthcare app, Stoma App, on the quality of life in stoma patients. The intervention group, using the full version of the app with personalized guidance and peer support, reported a significant 3.1-point improvement in stoma-related quality of life one month after surgery. However, no significant improvements were observed in secondary outcomes. The study highlights the importance of personalized guidance and peer support in enhancing self-efficacy and recommends the implementation of the app in standard stoma care pathways.

Journal Article by van der Storm SL, Consten ECJ (…) Schijven MP et 13 al. in Surg Endosc

© 2024. The Author(s).

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