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Impact of Smoking on Elective Hernia Repair Outcomes

The Cleveland Clinic evaluated the effect of active smoking on surgical outcomes for patients undergoing elective abdominal wall reconstruction. They found that while active smokers showed a slight increase in wound complications and higher pulmonary issues, these differences didn’t reach statistical significance. Importantly, there were no mesh infections in the smoking group during early follow-up. This data can guide shared decision-making for patients contemplating elective hernia repair while actively smoking. The study suggests that surgical delays for smokers may not be necessary.

Journal Article by Messer N, Melland MS (…) Rosen MJ et 8 al. in Am J Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Hernia Repair Techniques and Male Fertility: Lichtenstein vs. TAPP

A clinical trial compared Lichtenstein and laparoscopic transabdominal preperitoneal (TAPP) techniques for bilateral inguinal hernia repair’s impact on male fertility. The study, involving 37 adult patients, examined hormonal levels, testicular health, semen quality, sexual activity, and quality of life before and after surgery. Although patients experienced improved quality of life after surgery, neither technique had a long-term negative impact on male fertility. Sperm morphology was even better in the Lichtenstein group after 180 days. The findings offer reassurance to men undergoing these hernia repair procedures.

Journal Article by Damous SHB, Damous LL (…) Utiyama EM et 6 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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Reducing Parathyroid Tissue Removal: Near-Infrared Autofluorescence in Thyroid Surgery

This study explored the impact of near-infrared autofluorescence imaging during thyroid surgery on the inadvertent removal of parathyroid tissue. Comparing patients who underwent total thyroidectomy with or without this imaging tool, the results showed a lower rate of accidental parathyroid tissue removal in the near-infrared autofluorescence group. The reduction was more significant when this technology was used for both identification and confirmation, particularly for early-career surgeons. This suggests that near-infrared autofluorescence can be valuable in decreasing the unintended removal of parathyroid tissue during thyroid surgery.

Journal Article by Romero-Velez G, Avci SN (…) Berber E et 9 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Thyroid Surgery After Radiofrequency Ablation: Safe and Effective

Researchers assessed the impact of radiofrequency ablation on subsequent thyroid surgery. They compared outcomes and complications between patients who had thyroidectomy after radiofrequency ablation and those without prior ablation. The study included 96 patients, with no significant differences in operative time or complications between the groups. Importantly, no permanent complications were reported. This study suggests that radiofrequency ablation is a safe treatment for thyroid nodules, potentially offering reassurance to both clinicians and patients considering this approach.

Journal Article by Hussein M, Toraih E (…) Kandil E et 10 al. in BMC Surg

Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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Radiofrequency Ablation May Benefit Younger Patients with Thyroid Microcarcinoma

Researchers examined the best approach for treating papillary thyroid microcarcinoma, offering choices like radiofrequency ablation, active surveillance, or surgery. Their mathematical model assessed the likelihood of cancer progression, the need for thyroid replacement therapy, and treatment complications. Radiofrequency ablation outperformed active surveillance in averting progression and the need for lifelong thyroid therapy. Yet, the cost per progression-avoided was quite high, making radiofrequency ablation more practical for younger patients, while cost issues may limit its routine use among those with thyroid microcarcinomas.

Journal Article by Carlisle KM, Brown JP (…) Hu Y et 5 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Social Determinants Impact Thyroid Cancer Outcomes

This study delves into the influence of social determinants of health on thyroid cancer patients. Researchers scrutinized data from over 142,000 cases and discovered that longer delays in treatment resulted in higher mortality rates. Moreover, patients facing adverse social determinants of health, such as low income, education, and lack of insurance, experienced delayed treatment. The study highlights the cumulative impact of these determinants, indicating that the more adverse factors patients faced, the longer their treatment delays and, consequently, the greater their risk of mortality. This underscores the need to address social disparities in thyroid cancer care.

Journal Article by Collins RA, McManus C (…) Kuo JH et 3 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Single-Use Negative Pressure Wound Therapy Reduces Surgical Site Infections

Analyzing 19 studies, researchers reviewed whether single-use negative pressure wound therapy (sNPWT) could diminish surgical site infections (SSIs) in at-risk patients with closed surgical incisions. The meta-analysis indicated a significant reduction in composite, superficial, and deep SSIs with sNPWT compared to standard care across diverse surgical specialties. The -80 mmHg sNPWT device emerged as an effective approach, displaying reduced SSI rates in a heterogeneous surgical population, highlighting its potential impact on infection prevention.

Review by James K, Glasswell A and Costa B in Am J Surg

Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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Improving Patient Outcomes in Gallbladder Stone Management

A study investigated the impact of simulator-based training on laparoscopic cholecystectomy with common bile duct exploration (LCBDE) utilization and patient outcomes. After implementing training, LCBDE utilization increased significantly. Patients treated with LCBDE experienced shorter hospital stays without significant differences in readmission rates or post-procedure complications. In comparison to alternative strategies, LCBDE proved safe and efficient, making the case for broader implementation to optimize healthcare for patients with gallbladder stones.

Journal Article by VanDruff VN, Santos BF (…) Ujiki MB et 19 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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Unraveling the Complexity of Appendicitis Diagnosis and Treatment

This systematic review and meta-analysis delved into the often-debated realm of diagnosing and treating appendicitis in both adults and children. A comprehensive examination of 261 studies revealed nuances in care. For adults, CT scans showed high sensitivity and specificity. Uncomplicated appendicitis had varied outcomes with non-operative management, affecting readmission rates, the need for surgery, and return to daily life. In complicated cases, antibiotic treatment showed promise, while pediatric patients with complicated appendicitis faced higher odds of abscess formation. Personalized approaches and further research are essential for optimal care.

Journal Article by Lamm R, Kumar SS (…) Slater B et 12 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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Minimally Invasive Surgery Benefits Pancreatoduodenectomy Patients Post-Neoadjuvant Treatment

This study delves into the impact of surgical approach on the 30-day outcomes of pancreatic cancer patients after neoadjuvant treatment (NAT). Researchers compared minimally invasive pancreatoduodenectomy (MIPD) and open pancreatoduodenectomy (OPD) within NAT groups. Among the 5,588 patients analyzed, MIPD after neoadjuvant chemotherapy alone resulted in lower complication rates, shorter hospital stays, and fewer complications compared to OPD. These findings suggest that MIPD is a safe and feasible option for patients who undergo NAT, potentially improving their postoperative recovery.

Journal Article by Al Abbas AI, Meier J (…) Polanco PM et 9 al. in J Gastrointest Surg

© 2023. The Society for Surgery of the Alimentary Tract.

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