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Racial Disparities and Socioeconomic Factors Shape Pancreaticoduodenectomy Hospital Choices in the U.S.

In the U.S., racial disparities exist in the choice of high- or low-volume hospitals for pancreaticoduodenectomy (PD) surgeries, impacting outcomes. A review of 30 studies reveals that more racial minorities undergo PD in low-volume hospitals. Additionally, disparities in travel distance, education levels, and median income between high- and low-volume hospitals were noted. This study underscores the need for future research to comprehensively explore socioeconomic differences in patients undergoing PD surgery, shedding light on factors influencing healthcare access and outcomes.

Review by Ikram M, Shen C and Pameijer CR in Am Surg

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Innovative Flap Technique Excels in Three-Dimensional Sacrococcygeal Defect Reconstruction

Researchers introduced a novel approach using rotational V-Y fasciocutaneous advancement island flaps to address deep sacrococcygeal defects caused by conditions like pilonidal disease and pressure ulcers. By considering the three-dimensional nature of the defects, the technique provides robust reconstruction, preventing dead space and wound disruption. In a study of 12 patients from March 2016 to July 2022, successful surgeries resulted in no observed complications or recurrences. Notably, patients exhibited a smaller intercoccygeal angle, emphasizing the method’s significance in addressing sacrococcygeal pathology.

Journal Article by Baek SO, Kim SR, Kim HS and Lee JY in Am Surg

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Tissue Adhesives and Sealants Show Promise in Preventing Anastomotic Leakage

For colorectal cancer patients, anastomotic leakage (AL) poses a significant risk despite efforts to reduce it. A scoping review of seven studies explored the role of tissue adhesives and sealants in preventing AL-related complications. Five studies reported reduced AL rates in the intervention group, suggesting a positive impact. While secondary outcomes were minimally reported, the findings highlight the potential benefits of adhesives and sealants in colorectal anastomosis healing. However, the sparse literature underscores the need for further clinical studies.

Review by Valsamidis TN, Rasmussen T, Eriksen JD and Iversen LH in Int J Colorectal Dis

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Comparing Total Thyroidectomy Methods: Emphasizing EOA’s Superiority in Surgical Integrity and Patient Comfort

In treating differentiated thyroid cancer, various surgical methods were compared for integrity, safety, efficacy, and patient experience. The study, including 7042 patients, found that the endoscopic transoral approach (EOA) excelled in maintaining surgical integrity and minimizing pain. Robotic bilateral axillo-breast approach (RBABA) protected parathyroid glands and the recurrent laryngeal nerve but had the longest operative time. Open thyroidectomy (OT) performed quickest. EOA and OT are ideal for central lymph node metastasis risk, while RBABA may suit those prioritizing nerve protection.

Journal Article by Yuan Y, Pan B (…) Zhang F et 9 al. in Int J Surg

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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Enhanced Lymph Node Retrieval: Two-Port Robotic Gastrectomy Outperforms Conventional Laparoscopy in Gastric Cancer

In a nonrandomized trial comparing robotic gastrectomy with fluorescence guidance and a two-port system (IRG) to conventional laparoscopic gastrectomy (CLG) for early gastric cancer, researchers found that IRG yielded more retrieved lymph nodes (42.1 vs. 35.1). The study suggests that the integrated robotic approach enhances lymphadenectomy and offers better perioperative outcomes, including shorter hospital stays and improved postoperative body image.

Journal Article by Choi S, Kim NY (…) Kim HI et 6 al. in Ann Surg Open

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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Arterial Resection in Pancreatic Cancer: Weighing Feasibility, Morbidity, and Necessity in High-Volume Centers

In the quest for curative pancreatectomy for pancreatic cancer, researchers delve into arterial resection’s (AR) feasibility and outcomes. Analyzing 259 patients, they find AR, despite longer operation times, rivals venous resection in morbidity. Surprisingly, arterial infiltration’s likelihood is questioned, suggesting AR might be replaceable by less invasive techniques. This study at a high-volume pancreatic surgery center challenges the controversy surrounding AR, emphasizing its potential viability with comparable outcomes to venous resection.

Journal Article by Ren L, Jäger C (…) Demir IE et 9 al. in Ann Surg Open

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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The Acinar Score Categorizes Patients into High or Low Risk for Pancreas-Specific Complications

A cohort of 761 patients revealed that the acinar score, based on pancreatic acinar content and fibrosis, effectively dichotomized the risk spectrum into high and low risk. This new stratification tool improved predictions compared to the conventional isgps classification, leading to better-targeted mitigation strategies for pancreas-specific complications in cases with intermediate macroscopic features.

Journal Article by Perri G, Marchegiani G (…) Bassi C et 9 al. in Ann Surg

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

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Volume Doesn’t Rule: No Link Between Hospital Case Load and Outcomes in Heated Intraperitoneal Chemotherapy (HIPEC) for Carcinomatosis

In a study covering 5165 cases across 149 hospitals, ranging from low to high volume, no significant differences emerged in post-operative outcomes, including morbidity, mortality, length of stay, readmissions, or total cost. These findings challenge the notion that hospital volume influences patient outcomes in HIPEC procedures for peritoneal carcinomatosis, suggesting comparable results across academic medical centers with HIPEC programs.

Journal Article by Chatani PD, Manzella A (…) Alexander HR et 5 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Debunking the Myth: Femoral Hernias in Women Not So Rare

In the realm of inguinal hernia repairs, the belief that females rarely have femoral hernias gets a reality check. A study diving into minimally invasive and Lichtenstein repairs found femoral hernias more frequently during minimally invasive surgeries. Most were small, and recurrence rates between approaches and genders were similar. This challenges the prevalent notion, suggesting that advocating for minimally invasive repairs in females might be overemphasized, reshaping the narrative around inguinal hernia recommendations.

Journal Article by Maskal SM, Ellis RC (…) Prabhu AS et 7 al. in Am J Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Laparoscopic HIPEC Triumph: Shorter Recovery in Ovarian Cancer Battle

In the clash of surgical approaches for advanced epithelial ovarian cancer, laparoscopic interval cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (L-CRS-HIPEC) outshone the open approach. With a significantly shorter hospital stay and faster return to systemic chemotherapy, L-CRS-HIPEC demonstrated comparable oncological outcomes. This study hints at the potential superiority of the laparoscopic approach in selected cases, paving the way for future research to solidify its status as a game-changer in ovarian cancer treatment.

Journal Article by Manuel DM, Gonzalo GD (…) Álvaro AS et 10 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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