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Emergence of Predictive Models and Gallbladder-Preserving Polypectomy Procedures in the Management of Gallbladder Polyps

Researchers have made advances in the management of gallbladder polyps through the establishment of predictive models and the use of gallbladder-preserving polypectomy procedures. These procedures allow for the eradication of lesions while preserving a functional gallbladder, providing benefits to patients with benign polyps. However, further large-scale clinical studies are needed to address limitations such as small sample sizes and unknown long-term efficacy. The emergence of these predictive models and procedures highlights the increasing attention given to the clinical management of gallbladder polyps.

Review by Liu H, Lu Y (…) Li R et 3 al. in BMC Gastroenterol

© 2023. The Author(s).

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Progressive Reduction in Preventable Mortality in Arkansas Trauma System Through Provider Education

In analyzing 1,979 trauma deaths from 2015 to 2022, researchers assessed the impact of quarterly preventable mortality reviews (PMR) on reducing preventable or potentially preventable deaths in the Arkansas Trauma System (ATS). Results showed a progressive decrease in preventable deaths and opportunities for improvement (OFIs). Education targeting five specific OFI types accounted for a significant reduction in preventable deaths, particularly in cases of “delay in treatment.” Ongoing PMR studies targeting provider education led to a 43% decrease in preventable mortality, showcasing the effectiveness of education-based interventions in trauma systems.

Journal Article by Mabry CD, Davis B (…) Kalkwarf K et 6 al. in J Am Coll Surg

Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Empiric cryoprecipitate transfusion does not improve survival or reduce transfusion requirements in severely injured bleeding trauma patients

Empiric cryoprecipitate transfusion as an adjunct to a balanced transfusion strategy did not improve survival or reduce transfusion requirements in severely injured bleeding trauma patients. The study found no significant differences in demographics, arrival physiology, laboratory values, or injury severity between the groups receiving cryoprecipitate and standard treatment. There were also no differences in post-transfusion complications, Glasgow outcome score, or mortality. Cryoprecipitate should therefore be used on-demand guided by laboratory values rather than given empirically.

Journal Article by Van Gent JM, Kaminski CW (…) Cotton BA et 6 al. in J Am Coll Surg

Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Predictive Factors for Early Recurrence in Metastatic Colorectal Cancer Treated with Combined Liver Resection and HIPEC

The study aimed to identify predictive factors for early recurrence and survival outcomes in colorectal cancer patients with liver and peritoneal metastases who underwent combined liver resection, cytoreductive surgery, and hyperthermic intraperitoneal chemotherapy. The results showed that patients with advanced primary tumors (PT4 and/or PN2 status) had a higher risk of early recurrence, while retroperitoneal lymph node metastasis was associated with poor overall survival. These findings can help improve patient selection and guide treatment strategies for this specific group of patients.

Journal Article by Grange R, Rousset P (…) Kepenekian V et 7 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Elevated Serum CEA Predicts Worse Survival in Pancreatic Adenocarcinoma Patients with Normal CA19-9

A retrospective cohort study investigated the use of serum carcinoembryonic antigen (CEA) as an alternative prognostic marker for overall survival in patients with localized pancreatic adenocarcinoma and non-elevated levels of carbohydrate antigen 19-9 (CA19-9). The study found that elevated CEA at baseline was independently associated with worse overall survival, and CEA normalization following preoperative therapy was associated with longer median overall survival. These findings suggest that serum CEA may be a valuable tool for decision-making in patients with non-elevated CA19-9 levels.

Journal Article by Doppenberg D, Stoop TF (…) Besselink MG et 10 al. in Ann Surg Oncol

© 2024. Society of Surgical Oncology.

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Increased Mortality and Complications Associated with Care Fragmentation in Ileostomy Patients

A study analyzing hospitalizations for ileostomy creation found that care fragmentation, defined as receiving care at a different facility than where the index ileostomy was performed, was associated with higher mortality rates and increased risk of postoperative complications such as cardiac, respiratory, infectious, and thromboembolic complications. Patients experiencing care fragmentation also had higher hospitalization costs. The findings underscore the importance of improving care continuity and inter-hospital communication to mitigate risks and optimize healthcare delivery for care-fragmented populations.

Journal Article by Kim S, Hadaya J (…) Lee H et 5 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Distinct Trajectories of Quality of Life Following Pelvic Exenteration for Advanced Cancers

Results from a prospective cohort study conducted at a highly specialized pelvic exenteration referral center revealed distinct trajectories of quality of life following surgery for advanced cancers within the pelvis. Two trajectory classes were identified for physical component score, three for mental component score, and three for functional assessment of cancer therapy-colorectal total score. Patients in the optimal trajectory classes generally had higher overall survival probabilities. Significant predictors of quality of life trajectories included age, repeat exenteration, neoadjuvant therapy, surgical margin, length of operation, and hospital stay.

Journal Article by Steffens D, Blake J (…) Koh C et 5 al. in Dis Colon Rectum

Copyright © The ASCRS 2023.

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Telehealth Follow-Up After General Surgery Procedures is Safe and Effective: Study Highlights Lower Complication Rates

Telehealth utilization for postoperative care in general surgery has rapidly increased during the pandemic, but its usage among the veteran surgical population remains limited. A retrospective review of veterans undergoing general surgery found that telehealth follow-up after qualifying procedures was safe and effective. Among the 1075 patients included in the study, 56% followed up in-person and 44% via telehealth. Telehealth patients had a lower complication rate of 6% compared to 12% in-person follow-up. The study suggests considering postoperative telehealth care, particularly for low-risk general surgery procedures.

Journal Article by Abbitt D, Choy K (…) Jones EL et 7 al. in Am J Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Availability and Variation of Parental Leave Policies for General Surgery Residency Programs

Only 6% of general surgery residency program websites and 52% of graduate medical education (GME) websites provide information about parental leave policies. Family Medical Leave Act policies are most commonly reported, followed by maternity, paternity, and adoption/other clauses. The study found that academic programs, program location in the southeastern US, and larger program size were predictors of online policy availability. These results highlight the need for surgery residency programs to improve the disclosure of parental leave policy information.

Journal Article by Engelbrecht-Wiggans EA, Sundel MH (…) Brown RF et 2 al. in Am J Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Development and Evaluation of the Kenya Hospital Assessment Tool (K-HAT) for Surgical Capacity in Kenyan Hospitals

The study developed and tested the Kenya Hospital Assessment Tool (K-HAT) to assess surgical capacity in Kenyan hospitals. The K-HAT collected comprehensive and detailed information, presenting a significant improvement over the World Health Organization’s tools. The pilot test team found the K-HAT easy to administer and understand, taking approximately 1 hour to collect data from each facility. The collected data will support the development of Kenya’s national surgical, obstetric, and anesthesia plan (NSOAP).

Journal Article by Henry JA, Madiraju SK (…) Nthumba P et 6 al. in J Surg Res

Copyright © 2023 Elsevier Inc. All rights reserved.

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