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MRI Scoring Sheds Light on Post-Op Anorectal Function in Rectal Cancer

In a two-center study, researchers established a postoperative MRI-based scoring system for fibrosis in locally advanced rectal cancer patients who received neoadjuvant chemoradiotherapy (NCRT). They found a positive correlation between anastomotic and perirectal fibrosis scores (AFS and PFS) and anorectal function, measured using the Wexner score. Age, tumor height, AFS, and PFS were identified as independent predictors of anorectal function. This innovative scoring system demonstrated its effectiveness in predicting anorectal function, offering a valuable tool for clinicians managing post-NCRT rectal cancer patients.

Journal Article by Yuan Y, Yu Y (…) Shen F et 9 al. in Ann Med

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Consensus-Based Prioritization of Simulation Procedures for General Surgery Trainee Assessment

This study aimed to create a ranked list of surgical procedures for high-stakes simulation assessments in general surgery training. Using a Delphi consensus approach, a diverse group of 30 surgical trainers and a steering committee evaluated procedures based on perceived importance, risk, frequency, and feasibility. The study produced prioritized lists for two key training stages: the end of ‘phase 2’ and the end of training. A total of 21 and 16 procedures, respectively, were identified as suitable for assessment. These lists serve as a foundation for future high-stakes assessments in surgical training.

Journal Article by Toale C, Morris M (…) Kavanagh DO et 4 al. in Ann Surg

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

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Elective Hernia Repair Boosts Life Expectancy for Asymptomatic Paraesophageal Hernia Patients

This study reevaluated the best approach for asymptomatic paraesophageal hernia (PEH) patients: elective laparoscopic hernia repair (ELHR) or watchful waiting (WW). The conventional wisdom, based on older analyses, favored WW. However, updated research shows that ELHR leads to increased life expectancy, especially for women aged 40-90. Sensitivity and probabilistic analyses supported this shift, indicating that all PEH patients, regardless of symptoms, should consider elective repair for optimized life expectancy. This update challenges previous recommendations and could prevent avoidable hospitalizations and enhance survival.

Journal Article by DeMeester SR, Bernard L (…) Roth JS et 2 al. in Ann Surg

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

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Comparing Strategies for Anastomotic Leak After Rectal Cancer Surgery

A worldwide study investigated the treatment of anastomotic leaks following rectal cancer surgery, categorizing strategies into salvage surgery, passive or active drainage, and no initial faecal diversion. Among 2470 patients, the study found that primary salvage surgery and omitting faecal diversion represented the most severe and least severe cases, respectively. In patients with diverted leaks, stoma-free survival didn’t significantly differ between passive and active drainage. However, active drainage resulted in more secondary surgeries, longer hospital stays, and increased ICU admissions.

Journal Article by Greijdanus NG, Wienholts K (…) de Wilt JHW et 18 al. in Br J Surg

© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.

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Exploring the Connection Between Social Media and Violent Crime

Researchers conducted a cross-sectional study utilizing data from the Prince George’s County police department to investigate the link between social media engagement, crime, and violence. In a society where over 70% of Americans use various social media platforms, it’s essential to comprehend how online interactions may contribute to real-world conflict and violence. This study aims to quantify this association, offering insights into the potential for using social media as a tool for intervention and violence prevention amid increasing violence rates across the United States.

Journal Article by Garcia Whitlock AE, Gill BP (…) Kaufman EJ et 4 al. in JAMA Surg

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Implementing Trauma Resilience and Recovery Program for Mental Health After Injuries

Trauma centers can effectively promote mental health recovery by introducing the Trauma Resilience and Recovery Program (TRRP). This scalable model offers early mental health intervention after traumatic injuries. The study successfully implemented TRRP in three level I-II trauma centers. Engaging stakeholders, including patients, providers, and hospital administrators, in the early stages of implementation enhanced its acceptability and sustainability. This work showcases the feasibility of integrating cost-effective and sustainable mental health interventions into trauma programs, emphasizing the importance of active monitoring, evaluation, and adaptation.

Journal Article by Davidson TM, Espeleta HC (…) Ruggiero KJ et 10 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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Hepatic Arterial Infusion Pump (HAIP) Chemotherapy Improves Survival in Liver-Confined Intrahepatic Cholangiocarcinoma (ICCA)

Researchers compared the outcomes of liver-confined unresectable intrahepatic cholangiocarcinoma (ICCA) patients receiving systemic chemotherapy (gemcitabine and cisplatin) with those given hepatic arterial infusion pump (HAIP) chemotherapy. The study, involving 268 patients, revealed that HAIP chemotherapy significantly outperformed systemic treatment. Median survival for HAIP was 27.7 months compared to 11.8 months with gem-cis. Notably, HAIP resulted in a 3-year survival rate of 34.3%, while gem-cis showed only 3.5%. HAIP chemotherapy presents a substantial advantage for ICCA patients.

Journal Article by Franssen S, Holster JJ (…) Groot Koerkamp B et 16 al. in Ann Surg Oncol

© 2023. The Author(s).

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Factors Affecting 1-Year Mortality in Elderly Cancer Patients After Major Abdominal Surgery

In a study involving 378 elderly cancer patients aged 80 or older who underwent major abdominal surgery, researchers found that 24.3% of them died within a year. Various factors were linked to this one-year mortality, including preoperative performance status, significant weight loss, the use of vasopressors during surgery, and postoperative blood transfusions. Encouragingly, adherence to enhanced recovery after surgery (ERAS) protocols and specific surgical approaches were associated with improved survival. These findings emphasize the importance of optimizing pre-, intra-, and postoperative care for this vulnerable population.

Journal Article by Canac J, Faucher M (…) Mokart D et 15 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Poor Mental Health Access Linked to Worse Outcomes in Gastrointestinal Cancer Patients

Mental health significantly impacts cancer care. Researchers analyzed Medicare data on patients with gastrointestinal cancer and mental illness from 2004 to 2016. They found that those with limited access to psychiatric services faced higher risks of postoperative complications, extended hospital stays, 90-day readmissions, and poorer overall outcomes. Patients with mental illness and restricted access to mental health services encountered worse postoperative results. This highlights the need for policymakers and healthcare providers to prioritize mental health support to bridge disparities among gastrointestinal cancer patients.

Journal Article by Katayama ES, Woldesenbet S (…) Pawlik TM et 5 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Clinical Calculator Accurately Predicts Freedom from Colon Cancer Recurrence

In a study validating the Memorial Sloan Kettering clinical calculator for predicting freedom from colon cancer recurrence, results demonstrated its accuracy. The calculator, based on clinical and molecular variables, was originally developed with selective microsatellite instability testing. However, when tested with data from patients thoroughly examined for instability, it remained reliable. The concordance index was 0.748, signifying good discrimination and calibration, and even in a secondary analysis considering tumor deposits, it maintained a high concordance index of 0.755. This confirms the calculator’s precision in predicting colon cancer recurrence.

Journal Article by Khan A, Thompson H (…) Weiser MR et 10 al. in Dis Colon Rectum

Copyright © The ASCRS 2023.

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