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Impaired liver function after major hepatectomy affects feasibility of adjuvant chemotherapy for biliary tract cancers

The study explored the feasibility of S-1 adjuvant chemotherapy after major hepatectomy for biliary tract cancers. Comparing major hepatectomy (mh) with non-major hepatectomy (nmh), researchers found that mh had a lower treatment completion proportion and dose intensity. Additionally, caution should be exercised to prevent biliary tract infections and gastrointestinal disorders during adjuvant S-1 chemotherapy after mh for biliary tract cancers.

Journal Article by Kobayashi S, Nakachi K (…) Furuse J et 17 al. in Eur J Surg Oncol

© 2023 Published by Elsevier Ltd.

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Robot-assisted retromuscular repair offers superior short-term outcomes for ventral hernias compared to laparoscopic IPOM

Robot-assisted retromuscular repair of ventral hernias yields better short-term outcomes compared to laparoscopic intraperitoneal onlay mesh (IPOM) repair. A nationwide study found that patients who underwent robot-assisted repair had significantly lower rates of hospitalization for more than 2 days and 90-day readmission compared to those who underwent laparoscopic IPOM. However, there was no difference in the incidence of patients requiring operative intervention within the first 90 days postoperatively between the two approaches.

Journal Article by Jensen KK, Helgstrand F and Henriksen NA in Ann Surg

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

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Synthetic Mesh Shows Cost Advantage and Pain Reduction in Hernia Repair

The study compared patient-reported quality of life scores and costs after ventral hernia repair surgeries using either biologic or synthetic mesh. There were no significant differences between the two mesh types in terms of overall quality of life measures. However, the synthetic mesh group showed a greater reduction in disability, specifically in the physical role limitations and pain domains of the SF-36 survey. Additionally, overall costs per patient were lower for synthetic mesh. These findings suggest that synthetic mesh may have advantages over biologic mesh in terms of pain reduction and cost-effectiveness for ventral hernia repair.

Journal Article by Diab MM, Patel S (…) Harris HW et 2 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Validation of a New Silicone Model for Robotic TAPP Inguinal Hernia Repair

The study aimed to validate a new low-cost silicone model for simulating robotic TAPP inguinal hernia repair. A TAPP-specific fidelity questionnaire and assessment scale were developed to compare the performance of novices and experts in the simulated procedure. The participants included residents and specialists from across the country. The study found that seniors outperformed juniors in execution, quality, and global performance. The model demonstrated high face, content, and construct validity for inguinal TAPP simulation, making it a valuable tool for learning and practicing the technique prior to real surgeries.

Journal Article by Gonçalves MR, Morales-Conde S (…) Castelo-Branco Sousa M et 6 al. in Surg Endosc

© 2023. The Author(s).

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Preoperative prediction model identifies risk factors for gallbladder adenoma

Researchers conducted a retrospective analysis to identify risk factors for gallbladder adenoma, a precancerous lesion. They analyzed data from patients who underwent cholecystectomy and found that age, gallbladder wall thickness, polyp size, echogenicity, pedunculation, and adenosine deaminase (ada) levels were independent predictors of gallbladder adenoma. Using these factors, they developed a preoperative prediction model with an area under the curve value of 0.894, sensitivity of 89.20%, specificity of 79.40%, and overall accuracy of 84.41% for adenoma detection. These findings provide valuable insights for informed diagnosis and treatment by clinicians.

Journal Article by Wang Y, Peng J (…) Hu W et 7 al. in Eur J Surg Oncol

© 2023 Published by Elsevier Ltd.

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Comparative Study Shows Comparable FLR Growth with RPVL and RPVE for Bilobar Liver Metastases

The results of a comparative study using a propensity score between right portal vein ligation (RPVL) and embolization (RPVE) for bilobar liver metastases from colorectal cancer show that RPVL and RPVE are both effective in providing left hemi-liver hypertrophy before right hepatectomy. There was no significant difference in future liver remnant (FLR) growth between the two techniques. However, the RPVL group required fewer invasive procedures compared to the RPVE group. RPVL should be considered for simultaneous treatment of liver metastases and the primary tumor.

Journal Article by Werey F, Dembinski J (…) Regimbeau JM et 4 al. in Langenbecks Arch Surg

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

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Comparison of Ampulla-Guided Realignment and Conventional Anatomy in Laparoscopic Cholecystectomy

The study compared the effects of ampulla-guided realignment and conventional gallbladder triangle anatomy in difficult laparoscopic cholecystectomy. Data from 100 patients undergoing the procedure were retrospectively analyzed. The experimental group (ampulla-guided realignment) showed shorter operation time, reduced blood loss, lower postoperative complications, shorter hospitalization, and decreased bile duct injury compared to the control group. The ampulla-guided alignment technique was found to promote postoperative recovery, reduce pain, and decrease the incidence of complications in laparoscopic cholecystectomy.

Journal Article by Wang Y and Chen XP in Langenbecks Arch Surg

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

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Rectal Indomethacin Reduces Post-Operative Hyperamylasemia in Pancreatoduodenectomy

A randomized controlled trial assessed the efficacy of rectal indomethacin in preventing post-operative hyperamylasemia (POH) following pancreatoduodenectomy (PD). The study included 44 patients who either received 100mg of indomethacin per-rectally or standard care. The intervention arm had a significantly lower incidence of POH (28.6% vs. 60.9%) and reduced severity of delayed gastric emptying (DGE) compared to the control arm. While other variables showed a trend towards improvement, they did not reach statistical significance. The study concludes that perioperative per-rectal indomethacin administration effectively decreases the incidence of POH following PD.

Journal Article by Kumar AH, Pamecha V (…) Sinha PK et 3 al. in Langenbecks Arch Surg

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

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Somatic symptom severity and depression are more prevalent in surgical inpatients with pancreatitis

This study aimed to assess the prevalence of somatic symptom severity (sss), depression, and anxiety in surgical inpatients with different diagnostic groups of abdominal pain. The results showed that somatic symptoms were common, with 52% having moderate and 19.6% having severe sss. There was a significant association between moderate sss and pancreatitis, and between depressive symptoms and chronic pancreatitis. However, no significant association was found between the mental health categories and undifferentiated abdominal pain. These findings suggest a higher need for psychological assessment and intervention in patients with pancreatitis.

Journal Article by Stieler M, Carter G (…) Pockney P et 2 al. in ANZ J Surg

© 2023 The Authors. ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons.

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Direct Tumor Involvement in Resection Margin Signals Worse Prognosis in Rectal Cancer

Rectal cancer patients with a positive circumferential resection margin (CRM) due to direct tumor involvement face a worse prognosis than those with indirect causes. Analyzing 1460 cases, 85 had positive CRMs, with direct involvement linked to increased local recurrence. Kaplan-Meier analysis showed better overall and disease-free survival in indirect cases. The study emphasizes the need for improved stratification to guide treatment decisions based on the mode of CRM positivity.

Journal Article by Sadien ID, Ari K (…) Shaikh IA et 6 al. in ANZ J Surg

© 2023 The Authors. ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons.

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