Blog

Optimal Inferior Mesenteric Artery Ligation in Colorectal Cancer Surgery

In colorectal cancer surgery, the debate about whether to perform high or low ligation of the inferior mesenteric artery (IMA) continues. This study compared the outcomes of both approaches and examined the extent of lymph node dissection of the IMA. The results, after matching patient groups, showed that high ligation was associated with better recurrence-free survival. However, it’s crucial to ensure thorough lymph node dissection even with high ligation. Positive IMA lymph nodes were linked to advanced cancer stages, and the location of IMA lymph node recurrences differed between the two ligation groups.

Journal Article by Nakamura Y, Yamaura T (…) Kuroda N et 6 al. in Dig Surg

© 2023 S. Karger AG, Basel.

read the whole article in Dig Surg

open it in PubMed

ERCP Vital in Managing Post-COVID-19 Cholangiopathy with Dismal Prognosis

Endoscopic findings reveal that post-COVID-19 cholangiopathy resembles secondary sclerosing cholangitis, affecting critically ill patients. It emerges early during intensive care, causing significant and often irreversible damage to bile ducts. Typical cholangiographic features include a centripetal pattern of bile duct destruction, “vanishing bile ducts,” and intraductal biliary casts. This condition is associated with peribiliary liver abscesses. The prognosis is grim, with a 1-year liver transplant-free survival rate of 44%. Endoscopic procedures, especially ERCP with cast removal, are invaluable for diagnosis, prognosis, and treatment.

Journal Article by Silke L, Donata G (…) Christian J et 11 al. in Am J Gastroenterol

Copyright © 2023 by The American College of Gastroenterology.

open it in PubMed

Pretreatment Pan-Immune-Inflammation Value Predicts Neoadjuvant Immunochemotherapy Outcomes for Esophageal Cancer

Researchers assessed the Pan-Immune-Inflammation Value (PIV) as an indicator of neoadjuvant immunochemotherapy (NICT) response in esophageal squamous cell carcinoma. Among 218 patients, PIV was linked to achieving a pathological complete response. High PIV predicted poorer 3-year overall survival and disease-free survival compared to low PIV. PIV independently forecasted outcomes. A novel risk stratification model improved prognosis accuracy. This suggests that pretreatment PIV is a sensitive predictor for NICT effectiveness in esophageal cancer. Further prospective studies are needed to confirm these prognostic results.

Journal Article by Feng J, Wang L (…) Cheng X et 2 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

open it in PubMed

Gender Bias in Colorectal Surgery Fellowship Recommendation Letters

An analysis of recommendation letters for colorectal surgery fellowship candidates revealed gender-based differences. Women applicants received longer short answer responses, while men applicants had lengthier letters. Furthermore, the study uncovered that men were often described with more technical skill-related terms, while women’s letters contained emotional and cognitive language. Recognizing these discrepancies is crucial for addressing gender bias in the surgical field and ensuring a more equitable application process for aspiring surgeons.

Journal Article by Oslock WM, Lansing SS (…) Husain S et 4 al. in Am J Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

open it in PubMed

Understanding the Impact of Second Victim Syndrome (SVS) on Surgeons: A Scoping Review

A Scoping Review unpacked the underexplored realm of Second Victim Syndrome (SVS) in surgeons. SVS, affecting 50% of healthcare providers, often leads to enduring emotional turmoil, impacting personal lives and professional practices. The review emphasized that surgeons, due to their high-stress profession, also grapple with SVS. The study examined SVS’s prevalence, its psychological, physical, and professional consequences, and factors influencing surgeons’ responses. It underscores the need to enhance support systems for surgeons facing SVS and to tackle this issue head-on, considering its profound impact.

Journal Article by Chong RIH, Yaow CYL (…) Tan HK et 4 al. in Am J Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

open it in PubMed

Active Learning Enhances Automated Recognition of Surgical Features in Esophageal Surgery

This study delves into “surgomics,” a method that customizes surgical outcome predictions using machine learning and real-time surgical data. The challenge? Gathering high-quality annotations from experts. To address this, the researchers investigated active learning (AL) to make annotation more efficient. They chose ten video-based features linked to intraoperative bleeding complications during robot-assisted esophagectomies. AL significantly improved the recognition of surgical instruments compared to traditional equidistant sampling. This work showcased the potential of AL to streamline the annotation process without compromising machine learning performance in recognizing crucial surgical features.

Journal Article by Brandenburg JM, Jenke AC (…) Wagner M et 22 al. in Surg Endosc

© 2023. The Author(s).

open it in PubMed

Preoperative Weight Loss Program in Hepatocellular Carcinoma Patients with High BMI

Researchers investigated the impact of a weight-loss program (WLP) on patients with a high body mass index (BMI) before undergoing liver resection for hepatocellular carcinoma (HCC). In a study of 19 patients with a BMI of 25.0 or higher, WLP successfully led to weight loss without affecting short- or long-term surgical outcomes. The program improved liver function and immune-nutrition status while preserving skeletal muscle mass, offering a promising strategy for optimizing HCC patient health before surgery.

Journal Article by Saito Y, Morine Y (…) Shimada M et 8 al. in World J Surg

© 2023. The Author(s) under exclusive licence to Société Internationale de Chirurgie.

open it in PubMed

Malnutrition Linked to Colorectal Cancer Outcomes

Researchers delved into the relationship between malnutrition, assessed by the Geriatric Nutritional Risk Index (GNRI), and the outcomes of patients who had undergone curative surgery for colorectal cancer (CRC). Those with lower GNRI scores had reduced overall survival and higher risk of recurrence, particularly within the first three years post-surgery. Importantly, this malnutrition also predicted a higher likelihood of non-CRC-related deaths over a five-year period. The findings underscore the importance of addressing preoperative nutritional status alongside cancer staging in CRC patient care.

Journal Article by Nakamura Y, Kawase M (…) Kuroda N et 5 al. in J Surg Oncol

© 2023 Wiley Periodicals LLC.

open it in PubMed

Factors Linked to Reduced Surgical Training Experience for General Surgery Residents

A study involving 20 institutions and over 1,300 general surgery residents found that those with the lowest logged case volume were more likely to be female, identify as underrepresented in medicine, and pursue fellowships. Additionally, they were more likely to have graduated from low-volume programs and institutions with lower National Institutes of Health funding. Understanding these disparities is essential for promoting equity in surgical education, potentially improving the operative experience for residents in the bottom quartile of case volume.

Journal Article by Price AD, Foote DC (…) Cortez AR et 9 al. in J Surg Res

Copyright © 2023 Elsevier Inc. All rights reserved.

open it in PubMed

Embolization Reduces Failure of Nonoperative Management in Blunt Splenic Trauma

Researchers compared outcomes in patients with splenic pseudoaneurysms (PSAs) following blunt trauma, some treated with splenic artery embolization (Embo) and others without (No-Embo). Patients who underwent embolization had a significantly lower rate of failure of nonoperative management (FNOM) compared to the No-Embo group (3.1% vs. 13.3%). The study suggests that embolization may play a crucial role in improving outcomes for patients with splenic PSAs after blunt trauma, though the exact mechanism behind this effect remains unclear.

Journal Article by Dhillon NK, Harfouche MN (…) Scalea TM et 3 al. in J Surg Res

Copyright © 2023 Elsevier Inc. All rights reserved.

open it in PubMed