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Extended pancreatic neck transection reduces postoperative pancreatic fistula in laparoscopic pancreaticoduodenectomy

Researchers conducted a multicentre randomised controlled trial to explore the impact of the level of pancreatic transection in laparoscopic pancreaticoduodenectomy. The trial compared extended pancreatic neck transection with conventional pancreatic neck transection. The results showed that extended pancreatic neck transection significantly reduced the incidence of clinically relevant pancreatic fistula. This finding suggests that extending the transection level may be a superior approach in preventing postoperative pancreatic fistula during laparoscopic pancreaticoduodenectomy.

Journal Article by You J, Zhang J (…) Cai Y et 8 al. in BMJ Open

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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Improved Survival and Acceptable Complication Rates with Bidirectional Intraoperative Chemotherapy for Peritoneal Sarcomatosis

A retrospective cohort study analyzed 29 patients with peritoneal sarcomatosis who underwent cytoreductive surgery (CRS) with bidirectional intraoperative chemotherapy (BDIC) using intravenous ifosfamide and hyperthermic intraperitoneal chemotherapy (HIPEC). The overall survival rates at 6, 12, 24, and 48 months after CRS/BDIC were 93.1%, 89.2%, 81.4%, and 73.3%, respectively. Disease recurrence rates were 15% at 6 months and 35% at 12, 24, and 48 months after CRS/BDIC. Complications were experienced by 31.0% of patients, but there were no deaths. BDIC shows potential as an effective treatment for peritoneal sarcomatosis.

Journal Article by Almasri MS, Hakeam HA (…) Amin TM et 3 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Size and grade predict lymph node metastasis in rectal neuroendocrine tumors

Rectal neuroendocrine tumors (NETs) sized 1-2 cm were analyzed to identify predictive factors for lymph node (LN) metastasis and recurrence. The study found that a higher rate of LN metastasis was observed in larger-sized tumors, advanced T stage, lymphovascular invasion, perineural invasion, and high tumor grade. Tumor size and grade were identified as significant risk factors for LN metastasis, with grade being the key factor for tumors sized 1-2 cm. Radical resection should be considered for NETs sized 2 cm in order to prevent LN metastasis.

Journal Article by Choi JS, Kim MJ (…) Ryoo SB et 5 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Patient Characteristics Have the Greatest Impact on Variations in Hospital Mortality After Complex Cancer Surgery

Researchers sought to identify the factors contributing to in-hospital mortality (IHM) after complex cancer surgery. They analyzed data from 52,838 patients across 294 hospitals and found that patient characteristics (PCS) had the largest influence on IHM, accounting for 32% of the variance. Case volume (CV) contributed 2.4%, hospital characteristics (HCS) contributed 1.3%, and social determinants of health (SDOH) contributed 1.2% to IHM variation. The study highlights the need to focus on optimizing patient factors to improve surgical care quality.

Journal Article by Munir MM, Woldesenbet S (…) Pawlik TM et 4 al. in Ann Surg Oncol

© 2024. The Author(s).

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Predictive Nomogram for Lymph Node Metastasis in Superficial Esophageal Squamous Cell Carcinoma

Researchers analyzed data from 474 patients with superficial esophageal squamous cell carcinoma (ESCC) to identify lymph node metastasis (LNM) risk factors. For intramucosal cancer, LNM prevalence was 3.29%, increasing to 26.40% for submucosal cancer. Tumor size, invasive depth, differentiation, growth pattern, budding, and lymphovascular invasion correlated significantly with LNM. A nomogram incorporating these factors demonstrated good predictive accuracy in both training (AUC = 0.789) and validation sets (AUC = 0.827). The nomogram aids in assessing LNM risk for better treatment decisions in superficial ESCC patients after endoscopic resection.

Journal Article by Wang J, Zhang X (…) Yang JL et 3 al. in World J Gastroenterol

©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.

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Bariatric Surgery in ESRD Patients on Dialysis: Safety and Outcomes in the Transplant Era

Patients with end-stage renal disease (ESRD) on dialysis who underwent bariatric surgery experienced longer operative times and increased postoperative complications compared to those without renal disease. The study, analyzing data from the 2015-2020 MBSAQIP database, found that laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) were safe procedures for ESRD patients seeking kidney transplantation, with low absolute complication rates. Despite the higher incidence of complications, these were not specific to bariatric surgery and should not be considered contraindications to the procedure.

Journal Article by Alothman S, Cornejo J (…) Sebastian R et 2 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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Comparison of Single-Port and Multiple-Port Sleeve Gastrectomy: Feasibility and Non-Inferiority

Researchers investigated the feasibility of single-port sleeve gastrectomy (SPSG) by introducing a routine gastric suspension technique. Analyzing 171 patients, they compared SPSG to multiple-port sleeve gastrectomy (MPSG) and found no significant differences in preoperative and perioperative parameters, complications, or total weight loss percentages. SPSG demonstrated feasibility and non-inferiority compared to MPSG, suggesting its potential as a viable laparoscopic technique for sleeve gastrectomy. Further studies are needed to assess the efficacy and safety of SPSG.

Journal Article by Yang J, Widjaja J (…) Gu Y et 5 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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Standardization and Trends in Lymphadenectomy During Laparoscopic Right Hemicolectomy in Italy

Italian researchers conducted a national study involving 788 patients from 76 highly specialized colorectal surgery wards to analyze the approach to lymphadenectomy during laparoscopic right hemicolectomy (RH). The study reveals that while laparoscopic RH is the preferred surgical technique, there is no standardized approach to lymphadenectomy. The analysis highlights the stable trend in surgical techniques and complications, but it also indicates a rise in the use of robotic approaches. The study underscores the need for further standardization in lymphadenectomy during RH procedures.

Journal Article by Anania G, Chiozza M (…) Guerrieri M et 8 al. in Surg Endosc

© 2024. The Author(s).

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Effect of Bariatric Surgery on NAFLD/NASH: Improvement in Short-Term and Long-Term Outcomes

The prevalence of non-alcoholic fatty liver disease (NAFLD) is high in patients with obesity scheduled for bariatric surgery. This single-centre observational prospective cohort study aims to evaluate the impact of bariatric surgery on NAFLD/NASH. Initial findings show that bariatric surgery significantly improves NAFLD/NASH in the short term. However, the extent of this improvement and long-term outcomes are still unknown. Extensive metabolic, cardiovascular, and microbiome analyses, as well as liver biopsies, will be conducted to assess liver fibrosis and steatosis changes after surgery. The study results will contribute to better understanding and management of NAFLD/NASH.

Journal Article by Theel WB, Boxma-de Klerk BM (…) Castro Cabezas M et 11 al. in BMJ Open

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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Economic burden of unmet surgical needs in Liberia

The economic burden associated with unmet surgical needs in Liberia was investigated through a nationwide enumeration of surgical procedures and providers. Researchers estimated that surgical activities prevented an economic loss ranging from $35 to $141 million in 2018, averting a total of 55,890 disability-adjusted life years (DALYs). Non-specialist physicians played a significant role in generating these economic benefits. Additionally, the unmet surgical need resulted in productivity losses between $388 million and $1.6 billion, equivalent to 11% and 46% of Liberia’s annual gross domestic product (GDP). Strengthening the surgical system and encouraging collaboration between specialists and non-specialists may be more economically effective than solely focusing on specialist training.

Journal Article by Adde HA, Oghogho MD (…) Bolkan HA et 4 al. in BMJ Open

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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