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Augmented Reality Improves Outcomes in Laparoscopic Segmentectomy for Hepatocellular Carcinoma

In a retrospective analysis of 98 hepatocellular carcinoma patients undergoing laparoscopic segmentectomy, augmented reality navigation (ARN) combined with fluorescence imaging (FI) significantly reduced intraoperative blood loss and remnant liver ischemia compared to non-ARN-FI cases. The ARN-FI group exhibited higher 1-year and 3-year disease-free survival rates, indicating improved oncological prognosis. The study concludes that ARN-FI enhances the precision of laparoscopic liver resection, providing safer procedures and better clinical outcomes for hepatocellular carcinoma patients.

Journal Article by Wang D, Hu H (…) Fang C et 4 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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Multidisciplinary Clinics Improve Pancreatic Cancer Treatment and Equity

Examining 4141 pancreatic cancer patients, this study in a high-volume hospital system found that Multidisciplinary Clinics (MDCs) significantly boost comprehensive treatment rates, such as neoadjuvant chemotherapy, surgery, palliative care, and clinical trial participation. MDC management effectively eliminates socioeconomic disparities in treatment access, particularly benefiting disadvantaged patients. The study underscores the crucial role of multidisciplinary team-based care in improving overall treatment outcomes and reducing socioeconomic inequities for individuals with pancreatic cancer.

Journal Article by Hoehn RS, Zenati M (…) Zureikat AH et 4 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Biochemical Response Predicts Survival in FOLFIRINOX-Treated Pancreatic Cancer

Evaluating 150 non-metastatic pancreatic ductal adenocarcinoma patients undergoing neoadjuvant FOLFIRINOX chemotherapy, researchers compared biochemical (CA 19-9 normalization) and radiologic responses. Three groups were identified: biochemical responders (BR+), radiology-only responders (BR-/RR+), and non-responders (BR-/RR-). BR+ showed the highest 3-year overall survival (71.0%), significantly better than BR-/RR+ (53.6%) and BR-/RR- (33.1%). Regardless of neoadjuvant response, completing adjuvant chemotherapy improved survival. This study advocates the feasibility of biochemical response assessment for prognosis prediction and highlights the potential benefit of adjuvant chemotherapy post neoadjuvant treatment.

Journal Article by Yun WG, Han Y (…) Jang JY et 4 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Optimal Lymph Node Removal Improves Survival in Gastric Signet-Ring Cell Cancer

Analyzing 1020 patients with gastric signet-ring cell cancer (GSRCC), researchers investigated the relationship between the number of examined lymph nodes (ELNs) and prognosis. X-tile analysis determined the optimal ELN cutoff as 22. Patients with more than 22 ELNs demonstrated higher 5-year overall survival (66.9% vs. 74.9%). Multivariate analyses revealed that a higher number of ELNs (44-52) was associated with superior overall survival, emphasizing the importance of thorough lymph node examination for improved prognosis in GSRCC.

Journal Article by Jiang Y, Shao X (…) Tian Y et 4 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Comprehensive Preoperative Sarcopenia Evaluation Predicts Poor Prognosis in Esophageal Cancer Patients

Examining 115 elderly esophageal cancer patients, researchers assessed preoperative sarcopenia comprehensively using skeletal mass index, handgrip strength, and gait speed. Sarcopenia, identified in 20% of patients, correlated with older age and advanced cancer stage. Although postoperative complications showed no significant difference, slow gait speed was associated with more severe complications. The sarcopenia group exhibited significantly worse overall survival, emphasizing the prognostic relevance of evaluating muscle mass, strength, and physical function in preoperative assessments for esophageal cancer patients.

Journal Article by Kanemura T, Takeoka T (…) Miyata H et 15 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Radiomic Model Enhances Gastric Cancer Prognostic Prediction After Neoadjuvant Chemotherapy

A cohort study involving 205 gastric adenocarcinoma patients treated with neoadjuvant chemotherapy aimed to improve prognosis prediction. The developed radiomic model, incorporating pre- and post-treatment features, outperformed pathological T stage models. The final radiomic model, integrating radiomic and clinicopathological data, demonstrated superior accuracy in predicting 3-year survival. Results suggest the radiomic model could serve as a valuable decision aid tool in clinical practice, offering enhanced prognostic differentiation for patients with gastric cancer post-neoadjuvant chemotherapy.

Journal Article by Wang Y, Tang L (…) Ji J et 9 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Strategic Planning for Surgical Departments: Building Effective Clinic Programs

Navigating change in a large healthcare entity, like a major surgical department, poses challenges. This study emphasizes aligning projects with institutional and departmental strategic plans. Key steps involve defining missions, setting short- and long-term goals, resource analysis, and understanding expectations. Careful project design is crucial for successful implementation. The study explores considerations and challenges in developing clinics that robustly support and advance both departmental and institutional missions within the dynamic healthcare landscape.

Journal Article by Richmond BK in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Optimal Liver Remnant Volume for Safer Hepatobiliary Resection

In right hepatic trisectionectomy with bile duct resection, this study explored the impact of Future Liver Remnant volume-to-body weight ratio (FLR/BW) and indocyanine green plasma clearance rate (ICGK-F) on posthepatectomy liver failure. Among 91 patients, a FLR/BW ≥ 0.65% significantly reduced the risk of liver failure, while ICGK-F < 0.05 did not. Age, blood loss, and FLR/BW < 0.65% were independent predictors. Establishing FLR/BW ≥ 0.65% as a volumetric criterion may enhance safety in extended hepatobiliary resection.

Journal Article by Hayashi D, Mizuno T (…) Ebata T et 7 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Sacral Neuromodulation Triumphs Over Conservative Treatment for Refractory Slow-Transit Constipation

In the No.2-Trial, comparing sacral neuromodulation (SNM) to personalized conservative treatment (PCT) for refractory idiopathic slow-transit constipation, SNM demonstrated significant success (53.7%) compared to PCT (3.8%) after six months. SNM patients reported lower constipation severity and fatigue, along with improved quality of life. Serious adverse events were minimal (6 SNM, 2 PCT), supporting SNM as a promising surgical option for refractory slow-transit constipation.

Journal Article by Heemskerk SCM, Dirksen CD (…) Breukink SO et 5 al. in Ann Surg

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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Logica Trial’s Impact: Evolution of Laparoscopic Gastrectomy in the Netherlands

Analyzing data from the Logica randomized controlled trial (RCT) and the Dutch Upper Gastrointestinal Cancer Audit (DUCA), researchers explored the influence of the Logica RCT on laparoscopic gastrectomy practice in the Netherlands (2012-2021). While the Logica RCT showed no significant impact on outcomes, the DUCA nationally revealed a shift, indicating laparoscopic gastrectomy’s benefits, significantly reducing overall, severe, and cardiac complications post-Logica trial. The study emphasizes safe dissemination facilitated by a robust surgical quality assurance program following the Logica trial.

Journal Article by Markar SR, Visser M (…) van Hillegersberg R et 16 al. in Ann Surg

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

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