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Revolutionizing Colon Surgery: Laser Speckle Imaging Enhances Perfusion Visualization

A game-changing tool has emerged in the world of colon surgery. Laparoscopic laser speckle contrast imaging (LSCI) provides real-time, dye-free visualization of intestinal perfusion. This study, involving 64 patients, revealed LSCI’s potential to accurately image colonic perfusion without disrupting surgery. Operating surgeons found it easy to interpret, and 17% indicated it could change their anastomosis placement. Additionally, non-operating surgeons showed an 80% agreement when assessing LSCI images. Perfusix-imaging, the laparoscopic LSCI system, promises to guide surgeons in optimizing anastomosis placement during colon surgery.

Journal Article by Heeman W, Calon J (…) Boerma EC et 4 al. in Surg Endosc

© 2023. The Author(s).

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The Lancet: Two Centuries of Impact on Medicine and Society

The Lancet, celebrating its 200th anniversary in 2023, reflects on its historical journey of shaping the medical landscape in the UK and globally. This survey explores how the journal has championed “the best science for better lives” through pioneering articles on medical advancements and healthcare organization. It also delves into the journal’s advocacy and campaigns in various domains where science and policy intersect, ranging from professional standards and surgery to vaccination and global health. While acknowledging historical colonial biases, The Lancet’s commitment to advancing medicine for social betterment shines through.

Review by Gorsky M and Arnold-Forster A in Lancet

Copyright © 2023 Elsevier Ltd. All rights reserved.

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Surgery Timing for Low-Risk Thyroid Microcarcinoma: Immediate or Delayed?

A study explored the outcomes of treating low-risk papillary thyroid microcarcinoma (PTMC) through immediate surgery (IOP) or delayed surgery after active surveillance (DOP). DOP was an alternative to immediate surgery. Among the 516 patients undergoing surgery, DOP patients had larger tumors, more lymphatic invasion, and multifocality. However, rates of complications didn’t significantly differ. Disease progression was observed in the DOP group, associated with lymph node metastasis and radioiodine therapy. Active surveillance might be a valid choice for low-risk PTMC but warrants further oncological assessment over time.

Journal Article by Hwang H, Choi JY (…) Jung YS et 15 al. in Ann Surg

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

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Circumferential ESD Shows Promise in Barrett’s Neoplasia Treatment

In North America, where esophageal cancers often stem from Barrett’s esophagus, researchers are exploring the effectiveness of endoscopic submucosal dissection (ESD) for treatment. This study analyzed eleven patients who underwent 100% circumferential esophageal ESD. Impressively, all procedures were technically successful with clear margins in most cases, indicating the potential for ESD as an alternative to esophagectomy. However, careful consideration is needed due to the risk of post-procedure strictures, requiring further investigation into preventive measures.

Journal Article by Motomura D and Bechara R in Gastrointest Endosc

Copyright © 2023 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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Using Autofluorescence in Thyroidectomy: Impact on Parathyroid Hormone Levels Examined

This multicenter study investigated the use of autofluorescence, specifically the Fluobeam® LX device, in thyroid surgery. Researchers aimed to determine if it helps identify and protect parathyroid glands during total thyroidectomy, potentially reducing low parathyroid hormone (PTH) levels after surgery. Among 535 patients, autofluorescence didn’t significantly lower low PTH levels in the entire group, but it did so in a subgroup undergoing central lymph node clearance. More parathyroid glands were identified during surgery with Fluobeam® LX, with no reported harm. Further research may reveal its full potential.

Journal Article by Bergenfelz A, Barczynski M (…) Hermann M et 9 al. in Br J Surg

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

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Centralization Key for Small Intestinal Neuroendocrine Tumor Surgery: CentralChirSINET Study

Centralizing surgical care, this study investigated small intestinal neuroendocrine tumor (SI-NET) resections’ outcomes based on procedure volume. High-volume centers (HVCs) performed over five SI-NET resections annually, while low-volume centers (LVCs) did fewer. HVCs showcased better surgical quality, with more lymph nodes resected, advanced techniques, and higher success rates. Optimal SI-NET resection was prevalent in HVCs, supporting the centralization of SI-NET surgical care for improved outcomes.

Journal Article by Kalifi M, Deguelte S (…) Walter T et 8 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Endoscopic Retrograde Appendicitis Therapy vs. Surgery or Antibiotics: Balancing Act for Appendicitis Treatment

In the debate over how to treat appendicitis, a systematic review compared endoscopic retrograde appendicitis therapy (ERAT) with surgery and antibiotics. While ERAT resulted in shorter procedural times and hospital stays, it posed a higher risk of appendicitis recurrence at one year. The study found no significant differences in technical success during the initial admission. These results, while informative, come with a risk of imprecision. This analysis emphasizes the need for careful consideration when choosing an appendicitis treatment strategy, weighing benefits and risks.

Review by Pata F, Nardo B (…) Podda M et 8 al. in BMC Surg

Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.

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High-Volume Endocrine Surgeons Achieve Cost-Effective Thyroid Surgery

A study exploring healthcare cost-efficiency in thyroid surgeries found that high-volume endocrine surgeons, performing over 50 cases annually, managed thyroidectomies at significantly lower costs compared to their low-volume counterparts. The cost reduction was even more pronounced when cases were categorized by relative value units, demonstrating that experienced surgeons can deliver cost-effective care without compromising quality. This finding supports the potential for healthcare systems to improve value-based care by harnessing the expertise of high-volume surgeons.

Journal Article by Romero-Velez G, Noureldine SI, Burneikis T and Siperstein A in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Robotic Surgery May Reduce Complications for Minority Patients in Colon Cancer Resection

In a study analyzing over 64,000 patients undergoing elective colon cancer resection, it was found that robotic colectomy led to fewer complications in minority patients compared to laparoscopic colectomy. After adjusting for various factors, there were no significant differences in mortality based on surgical approach or race. However, Black patients who had laparoscopic surgery experienced higher complication rates compared to their white counterparts who underwent the same procedure, as well as those who had robotic surgery. Further research is needed to understand the reasons behind these disparities.

Journal Article by Ahuja V, Paredes LG (…) King JT et 4 al. in Am J Surg

Published by Elsevier Inc.

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Referrals to Non-Surgical Providers Delay Treatment for Cholelithiasis and Cholecystitis

Researchers investigated if referrals to non-surgical providers, following the initial presentation of symptomatic cholelithiasis, lead to delays in surgical management. Their study included 482 patients who had cholecystectomies from 2015 to 2019. Among these patients, 61.2% received direct surgical referrals, while 38.8% were referred to non-surgical providers. The latter group experienced significantly longer delays from initial symptom presentation to surgical evaluation (65.7 days vs. 10.3 days) and cholecystectomy (102.0 days vs. 39.1 days). These delays impact patient symptoms and healthcare resource use.

Journal Article by Cook LB, Gunasingha MRMKD (…) Gosztyla LC et 3 al. in Am J Surg

Published by Elsevier Inc.

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