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Study Finds No Association Between Perioperative Hypothermia and Surgical Site Infections in Liver Resection Patients

Perioperative hypothermia is not significantly correlated with surgical site infections (SSI) in patients undergoing liver resection, according to a retrospective cohort study. Researchers analyzed data from 4,000 patients and found that among those with hypothermia, 6.8% developed SSI. However, after propensity score matching, there were no substantial differences in SSI rates between the hypothermia and normothermia groups. The study suggests that the implementation of perioperative temperature management, particularly active warming measures, may mitigate the impact of hypothermia on the occurrence of SSI in this patient population.

Journal Article by Zhou YD, Zhang WY (…) Fang XM et 5 al. in Hepatobiliary Pancreat Dis Int

Copyright © 2024 First Affiliated Hospital, Zhejiang University School of Medicine in China. Published by Elsevier B.V. All rights reserved.

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Successful Iterative Revisions of Clinical Pathways Led to 32% Decrease in Pancreatectomy Costs

Iterative revisions of risk-stratified pancreatectomy clinical pathways were associated with a 32% decrease in 90-day perioperative costs. The study included 814 patients with three iterations of the pathways, and each iteration showed a decrease in accordion grade 3+ complications and median hospital stays without an increase in readmissions. The greatest savings were seen in the reduction of index hospitalization costs, outpatient care costs, and component costs such as room/board and pharmacy costs.

Journal Article by Azimuddin A, Tzeng CD (…) Maxwell JE et 11 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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Impact of Tumor Subclassifications on Surgical Strategy for Intrahepatic Cholangiocarcinoma

This study compared the impact of subclassifying intrahepatic cholangiocarcinoma (ICC) into small and large duct types, on the selection of appropriate surgical strategies. By analyzing 118 patients who underwent liver resection, researchers found that patients with small duct-type ICC had better outcomes with hepatectomy alone, while those with large duct-type ICC benefited from advanced procedures like lymph node dissection and biliary reconstruction. The large duct-type group had higher incidences of lymph node metastasis/recurrence and pathological major vessel invasion, suggesting the need for more aggressive surgical approaches.

Journal Article by Kinoshita M, Sato Y (…) Kubo S et 11 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Significant Increase in Use of Acute Laparoscopic Surgery for General Surgical Conditions

Over a 10-year period, researchers assessed the utilization of acute laparoscopic surgery for common general surgical conditions in New Zealand. The study found that laparoscopic appendicectomy, cholecystectomy, adhesiolysis, and inguinal hernia repair significantly increased, with the highest rise observed in appendicectomy and adhesiolysis. Laparoscopic surgery cohorts had shorter hospital stays and lower costs compared to open surgery. Maori and Pacific Island patients had similar or higher rates of laparoscopic use compared to the rest of the population. The COVID-19 pandemic did not affect laparoscopic surgery rates significantly.

Journal Article by Kirkpatrick J, Wang Y (…) Koea J et 3 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Family Perspectives on End-of-Life Care After Surgery: Unresolved Narratives & Disempowerment

Researchers analyzed 936 open-text responses from bereaved families to explore their experiences with end-of-life care after surgery. The results revealed a belief in unnecessary pain and distrust in treatment decisions among respondents. Limited communication about disease severity and surgical risks led to conflicting narratives about the cause of death. Families expressed feelings of disempowerment when not involved in decision-making and their wishes were not respected. Timely and sensitive conversations, acknowledging uncertainty, were suggested to improve the experience for bereaved families.

Journal Article by Vitous CA, Shabet C (…) Suwanabol PA et 3 al. in Am J Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Effects of Endovac Therapy on Gastric Conduit Perfusion: Porcine Model Study

The study aimed to assess the effects of endoluminal vacuum sponge therapy (endovac) on gastric conduit perfusion in a porcine model for esophagectomy. The researchers induced ischemia in the gastric conduit and measured tissue perfusion over time. The findings showed that endovac therapy with a pressure of -125 mmHg significantly increased tissue oxygenation and improved gastric conduit perfusion. The study suggests that endovac therapy can be used effectively to enhance tissue perfusion in gastric conduits, which could have implications for postoperative anastomotic leakage prevention and management.

Journal Article by Felinska EA, Studier-Fischer A (…) Nickel F et 4 al. in Surg Endosc

© 2024. The Author(s).

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Impact of Patient Transfer on Perforated Peptic Ulcer Disease Outcomes: Prolonged Hospital Stay

A study examined the impact of patient transfer for definitive surgical intervention in cases of perforated peptic ulcer disease (PPUD). The analysis found that transferred patients had a significantly longer length of stay compared to non-transfer patients. The average length of hospital stay for transferred patients was over twice as long, with an average of 41 days compared to 20 days for non-transfer patients. Although not statistically significant, transfer patients had higher rates of intensive care unit (ICU) care requirement. Further investigation is needed to identify modifiable variables that can improve outcomes and reduce hospital stay in transferred patients.

Journal Article by Schneider R, Perugini R (…) Carroll JE et 6 al. in Surg Endosc

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

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Comparison of Subtotal and Total Cholecystectomy for Difficult Gallbladders

Subtotal cholecystectomy (SC) is a reasonable alternative to total cholecystectomy (TC) for difficult gallbladders with severe inflammation. A meta-analysis of ten studies revealed that SC significantly reduces the risk of common bile duct (CBD) injuries compared to TC. However, it increases the risk of bile leaks, postoperative ERCP, intraabdominal collections, and reoperation. Understanding both approaches is crucial for managing difficult gallbladders while minimizing harm. Further research is needed to fully understand the value of SC in difficult cholecystectomy.

Journal Article by Koo SS, Krishnan RJ (…) Kitamura RK et 4 al. in Am J Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Non-autologous reinforcement reduces postoperative pancreatic fistula after distal pancreatectomy: Meta-analysis of randomized clinical trials

Non-autologous reinforcement of the pancreatic stump following distal pancreatectomy significantly reduces the rate of postoperative pancreatic fistula (POPF), according to a meta-analysis of nine randomized clinical trials. The pooled analysis found a lower rate of POPF in the non-autologous reinforcement group compared to the non-reinforcement group. Heterogeneity was observed in the 95% predictive interval, but subgroup analysis showed that non-autologous reinforcement, excluding “Tachosil®,” was effective. There were no significant differences between the two groups regarding secondary outcomes.

Review by Chaouch MA, Dziri C, Uranues S and Fingerhut A in Am J Surg

Copyright © 2024 Elsevier Inc. All rights reserved.

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Multinational Registry Study Reveals Increasing Use of Minimally Invasive Surgery for Rectal Cancer

The surgical approach to rectal cancer resection has evolved over the past decade, with an overall increase in minimally invasive surgery (MIS) techniques. The study analyzed data from four countries and found that the proportion of MIS varied between countries initially but became more consistent over time. The use of local excision showed inconsistent trends.

Journal Article by Sijmons JML, Dekker JWT (…) Tanis PJ et 7 al. in Int J Colorectal Dis

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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