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Prognostic Value of Lymph Node Distribution in Colorectal Cancer

Patients with lymph node distribution detected during laparoscopic colectomy with Japanese D3 dissection were divided into two groups: those with central vessel metastasis (LND3 group) and those without (LND1/2 group). After adjusting for background factors, the study found that LND3-positive patients had a worse prognosis compared to LND1/2 patients. Additionally, adjuvant chemotherapy improved the prognosis of LND3-positive patients. These findings suggest that lymph node distribution is an important prognostic indicator in colorectal cancer, and appropriate perioperative treatment strategies should be applied for LND3-positive patients.

Journal Article by Noda K, Tominaga T (…) Nagayasu T et 9 al. in Langenbecks Arch Surg

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

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Advances in the Management of Pancreatic Cancer: Recent Developments and Future Strategies

Despite improvements in survival over the years, pancreatic cancer continues to have poor outcomes compared to other malignancies. Multimodal treatment approaches involving chemotherapy, surgery, and radiotherapy have been studied extensively. Emphasis is now placed on selecting appropriate treatments based on local extension into major vessels. Recent advancements in treatment regimens offer new strategies for managing pancreatic cancer, but further research is needed to address pressing questions. This review provides an overview of current management approaches and highlights the integration of translational and clinical research in future treatment pathways.

Review by Del Chiaro M, Sugawara T, Karam SD and Messersmith WA in BMJ

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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Oral Antibiotics as Effective as Intravenous Antibiotics for Complicated Appendicitis

In a pilot noninferiority randomized trial, 104 patients with complicated appendicitis were randomly assigned to receive 24-hour intravenous or oral antibiotics after appendectomy. The study found that there were no significant differences in 30-day postoperative complications or hospital length of stay between the two groups. The findings suggest that oral administration of antibiotics is as effective as intravenous administration in treating complicated appendicitis, providing a potential alternative option for postoperative antibacterial therapy.

Journal Article by Lipping E, Saar S (…) Talving P et 4 al. in Ann Surg

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

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Perioperative Lymphopenia Increases Risk of Recurrence and Impairs Survival After Hepatectomy for Hepatocellular Carcinoma

A new study investigated the prognostic value of perioperative lymphopenia on short- and long-term outcomes in patients undergoing resection of hepatocellular carcinoma (HCC). Researchers found that perioperative lymphopenia, particularly severe lymphopenia on postoperative day 5, was associated with worse 5-year overall survival and disease-free survival. Patients with severe lymphopenia also had a higher incidence of overall and major complications. Prolonged lymphopenia was independently associated with increased hazards of death and recurrence. These findings suggest that perioperative lymphopenia has significant prognostic implications for individuals undergoing hepatectomy for HCC.

Journal Article by Tsilimigras DI, Endo Y (…) Pawlik TM et 15 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Video-based self-assessment improves trainee performance in laparoscopic cholecystectomy

A pilot study examined the effectiveness of video-based self-assessment in enhancing surgical skills of general surgery trainees performing laparoscopic cholecystectomy. Trainees in the intervention group, who had access to video recordings of their surgeries for self-assessment, showed improved operative performance compared to the control group that received traditional teaching alone. Feasibility criteria were not fully met, but the study provides valuable data to design a comprehensive randomized controlled trial, and automated video capture and storage could enhance adherence in future trials.

Journal Article by Balvardi S, Kaneva P (…) Feldman LS et 6 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Financial incentives do not significantly increase smoking cessation before surgery

Offering small financial incentives to smokers on surgery wait-lists was not found to significantly increase smoking cessation before surgery, according to a randomised feasibility trial at an Australian public hospital. Of the 620 participants, 21.9% registered to quit when offered a $a70 supermarket voucher, increasing to 32.6% with a $a140 incentive. However, the proportion of participants who successfully quit at least 24 hours before surgery was similar between the intervention and control groups. Therefore, a single offer of financial rewards for perioperative cessation was found to be feasible but did not achieve clinically significant quit differences.

Journal Article by Webb A, Coward L (…) Leong S et 2 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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Improved bowel movements and normal anal defecatory function observed in UC patients after total proctocolectomy and ileal pouch-anal anastomosis

A prospective cohort study assessed the anal defecatory function in ulcerative colitis patients undergoing total proctocolectomy (tpc) followed by ileal pouch-anal anastomosis (ipaa). The study included 20 consecutive patients who were evaluated using high-resolution anorectal manometry. After surgery, the mean number of bowel movements decreased significantly, symptoms of fecal incontinence were eliminated, and the quality of life improved. Furthermore, there were no significant changes in anal resting and squeeze pressures, indicating that the anorectal function remained intact after the procedure.

Journal Article by Viazis N, Manolakis A (…) Papakonstantinou I et 5 al. in Eur J Gastroenterol Hepatol

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

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Minimally Invasive Surgery Shows Promise for Small Intestinal Neuroendocrine Neoplasms

A retrospective study compared minimally invasive (MIS) and open surgery for treating small intestinal neuroendocrine neoplasms. Out of 65 patients, 54% underwent MIS and 46% underwent open surgery. The study found no significant difference in the frequency of successful resections or the number of lymph nodes removed between the two groups. However, a post-operative paralytic ileus occurred more frequently in the MIS group. The study suggests that MIS may be a viable alternative to open surgery, with the potential for higher lymph node resections. Further research is needed for confirmation.

Journal Article by Eneholm J, Beka E, Kotán R and Gimm O in Eur J Surg Oncol

© 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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Changes in General Surgery Trainee Operative Experience Over Time: Shifts in Case Distribution and Increase in Minimally Invasive Surgery

The analysis of general surgery trainee cases over a decade revealed that there was a preservation of operative volume, although with changes in case distribution based on trainee level. There was an increase in cases with more than one trainee and a rise in minimally invasive surgery, accompanied by a decrease in open cases. These findings suggest that resident operative experience has evolved over time, potentially impacting trainee competency and readiness for practice.

Journal Article by Ore AS, Liu BS (…) Narula N et 3 al. in Am Surg

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Subtotal cholecystectomy (LSTC) shows better outcomes than open cholecystectomy (COC) as a bailout procedure for severe cholecystitis.

Subtotal cholecystectomy (LSTC) is associated with better outcomes compared to open cholecystectomy (COC) as bailout procedures for severe cholecystitis. LSTC resulted in shorter operative time, fewer ICU admissions, and shorter length of stay. It also had fewer complications, such as biliary injury, bleeding, ileus, and ICU admission. COC, on the other hand, had higher rates of these complications and longer hospital stay.

Journal Article by Grossman H, Holder KG (…) Dissanaike S et 2 al. in Am Surg

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