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Identification of Clinical Parameters and Evaluation Methods for Anastomotic Leaks in Upper Gastrointestinal Surgery

Researchers conducted a retrospective cohort study on 592 patients who underwent upper gastrointestinal surgeries with an anastomosis. The study aimed to identify clinical parameters that predict anastomotic leaks (AL) and evaluate the effectiveness of investigations in diagnosing AL. The overall occurrence of AL was 6.4%. The presence of a triad including desaturation, tachycardia, and leucocytosis predicted AL following surgery. Furthermore, evaluating high-risk anastomosis before feeding reduced the need for surgical intervention and improved the success of conservative treatment.

Journal Article by Law JH, Ng CZ (…) Shabbir A et 3 al. in Surgeon

Copyright © 2023. Published by Elsevier Ltd.

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Impact of Omitting Additional Surgery on Prognosis of High-Risk T1 Colorectal Cancer

Results from analyzing patients with high-risk T1 colorectal cancer who either received additional surgery or not after local excision (LE) showed that while regional lymph node metastasis was observed in the group that underwent additional surgery, the incidence of oncologic adverse events was significantly lower in the LE-alone group. The difference in 5-year cancer-specific survival was minimal between the two groups, but overall survival was significantly higher in the group that received additional surgery. This suggests that risk assessment is crucial in deciding whether to omit surgery for high-risk T1 tumors.

Journal Article by Ouchi A, Komori K (…) Ueno H et 30 al. in Ann Surg

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

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Primary tumor sidedness not prognostically relevant in early-stage colorectal cancer

Prognostic relevance of primary tumor sidedness (pts) in early-stage colorectal cancer was investigated by analyzing four randomized controlled trials. The study found that pts had no impact on the risk of recurrence for stage II/III colorectal cancer and that treatment stratification based on pts is unnecessary. However, pts was significantly associated with overall survival after recurrence, indicating its relevance in this context. Therefore, the main result of this study is that primary tumor sidedness does not have prognostic relevance in early-stage colorectal cancer, except for survival after recurrence.

Journal Article by Ouchi A, Sadachi R (…) Kanemitsu Y et 17 al. in Ann Surg

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

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Elective Laparoscopic Paraesophageal Hernia Repair Increases Life Expectancy in Asymptomatic Patients

Elective laparoscopic hernia repair (ELHR) offers a greater increase in life expectancy compared to watchful waiting, particularly in women aged 40 to 90, according to a new markov analysis. The analysis identifies ELHR as the preferred strategy for patients with asymptomatic paraesophageal hernia (PEH) in terms of life-years gained. Sensitivity analysis demonstrates the robustness of the results, while probabilistic analysis supports ELHR as the optimal management strategy across various age groups. All patients with PEH, irrespective of symptoms, should be considered for elective repair to maximize their life expectancy.

Journal Article by DeMeester SR, Bernard L (…) Roth JS et 2 al. in Ann Surg

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

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Suturing the hernia aperture in laparoscopic ventral hernia repair does not increase postoperative pain or hernia-site complications

Researchers conducted a randomized controlled study on 192 patients undergoing laparoscopic ventral hernia repair to assess the effects of suturing the hernia aperture before mesh placement. The study found that suturing the hernia aperture did not lead to an increase in postoperative pain or hernia-site complications, such as seroma, infection, pseudohernia, or mesh migration, three months after the surgery. These findings suggest that suturing the hernia aperture can be considered without significant risks, potentially leading to lower recurrence and complication rates in the long term.

Journal Article by Silfvenius AUK, Lindmark ME (…) Gunnarsson US et 4 al. in Br J Surg

© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.

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Impact of Prolonged Operative Time on Minimally Invasive Colorectal Surgery Outcomes

Prolonged operative time was found to be associated with longer length of stay and higher probability of complications in minimally invasive colorectal surgery. However, the negative impact of prolonged operative time on outcomes was less pronounced in minimally invasive approaches compared to open surgery. Each additional hour of operative time above the median for a given operation was associated with a relative risk of longer length of stay for both open and minimally invasive approaches.

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

Copyright © The ASCRS 2023.

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Postoperative Oral Rehydration and Regimented Follow-up Reduce Readmissions After Colorectal Surgery with Ileostomies

A retrospective analysis of a prospective database revealed that postoperative oral rehydration solution and standardized clinic visits significantly decreased readmissions and emergency department visits among patients who underwent new ileostomies after colorectal surgery. The rate of readmission due to dehydration/acute kidney injury decreased from 45.7% to 16.5%, emergency department visits for the same reasons decreased from 12.0% to 1.7%, and all-cause readmissions decreased from 24.33% to 10.6%. Average stoma output before and after discharge also significantly decreased. These findings highlight the effectiveness of this intervention in preventing complications and improving patient outcomes in this population.

Journal Article by Westfall KM, Rivard SJ (…) Cleary RK et 3 al. in Dis Colon Rectum

Copyright © The ASCRS 2023.

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Colorectal cancer survival inequalities linked to area-level deprivation in a country with universal healthcare

This study aimed to identify inequalities in colorectal cancer care in a country with universal healthcare. Results showed that patients living in deprived areas experienced worse survival rates and faced barriers in accessing timely and quality healthcare. The association between area-level deprivation and a longer time from primary care presentation to diagnosis was significant. Socioeconomic inequalities were observed in surgery and chemotherapy but not radiotherapy treatments. Further research is required to understand and address these inequalities through evidence-based actions.

Journal Article by Pickwell-Smith BA, Spencer K (…) Macleod U et 3 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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Incidence and Distribution of Appendiceal Tumors in Acute Appendicitis Patients

During a study of 1694 appendectomies performed between January 2001 and December 2019, researchers identified 24 appendiceal neoplasms (1.43%). These neoplasms included low-grade appendiceal mucinous neoplasms (LAMNs), neuroendocrine tumors (NETs), mucoceles, adenocarcinoma, endometrioma, and neurofibroma. Two age peaks were observed with LAMNs being prominent in individuals over the age of 50. The findings suggest that non-operative management of appendicitis may overlook the presence of appendiceal neoplasms, highlighting the need for careful consideration and evaluation during appendectomy procedures.

Journal Article by Lieb DA, Shah S (…) Mariadason J et 4 al. in Am Surg

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Music in the Operating Room: Perspectives of Surgical Team Members

Most operating room (OR) personnel have positive attitudes towards music in the OR, perceiving it as calming, helpful for focus, and not distracting or unsafe, according to a survey of 222 surgeons, anesthesiologists, and nurses. Surgeons tended to believe that the decision to play music should be theirs, while anesthesiologists and nurses supported collaborative decision-making. These findings align with the goal of creating a safe OR culture and highlight the importance of considering the opinions of all team members when it comes to music in the OR.

Journal Article by Lamberton T, de Virgilio C (…) Yetasook A et 7 al. in Am Surg

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