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Recalibrating Drain Fluid Amylase Cutoffs for Safer Early Removal and Fewer Complications after Pancreatoduodenectomy

Researchers recalibrated drain fluid amylase (DFA) cutoffs for early removal post-pancreatoduodenectomy (PD) in a study of 267 patients. For low-risk patients, maintaining 100% sensitivity, DFA1 < 286 and DFA3 < 97 ensured no clinically relevant postoperative pancreatic fistulas (CR-POPF). In high-risk patients, DFA1 < 137 and DFA3 < 56 achieved 100% sensitivity. The recalibrated thresholds, implemented in a learning health system, provide institution-specific criteria for optimizing safe early drain removal after PD, potentially applicable to other centers.

Journal Article by Boyev A, Azimuddin A (…) Tzeng CD et 11 al. in J Gastrointest Surg

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

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Cutting Costs and Boosting Recovery: Perioperative APPs Slash Readmissions in Hepatopancreatobiliary Surgery

Dedicated perioperative Advanced Practice Providers (APPs) substantially decrease readmissions by almost 50%, saving $900 per case. Financially self-sustaining with 113 to 139 annual cases, these APPs prove pivotal in optimizing outcomes, minimizing resource utilization, and cost savings for high-volume hepatopancreatobiliary centers.

Journal Article by Smith SR, Blair CM (…) Sarmiento JM et 3 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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The Art of Branding in Surgery Departments

The Ohio State University Wexner Medical Center’s Department of Surgery shares insights on building a robust national brand. In a digital age flooded with health choices, establishing a standout brand is crucial. Focusing on mission, visual elements, voice, and consistent messaging, the department strategically promotes its renowned residency program, clinical excellence, and research prowess. This study unveils the tactics behind their success, offering a blueprint for surgery departments aiming to carve a distinctive national identity.

Journal Article by Balasubramanian C, Leemaster J, Basar P and Pawlik TM in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Ambulance Bays as Innovative Learning Spaces for EMS Practitioners

OhioHealth’s simulation team revolutionizes EMS education with drive-thru sessions in hospital ambulance bays. Over three days, 171 learners achieved objectives, and 90% agreed the environment fostered learning. This approach, utilizing existing infrastructure, effectively overcomes barriers like cost and equipment access, offering a feasible solution to enhance simulation-based education for emergency medical services practitioners.

Journal Article by Simmons L, Kube E (…) Gable B et 2 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Decoding HCC Recurrence: LI-RADS Morphologic Type II Gets Risk Score Upgrade

Unraveling the mystery of early recurrence in hepatocellular carcinoma (HCC), researchers crafted a risk scoring system based on tumor morphology. Analyzing 124 patients, they pinpointed age, histological grade, AFP, and intratumoral hemorrhage as key factors. The scoring system accurately stratified patients into low and high-risk categories, offering clinicians a powerful tool. The high-risk group exhibited significantly lower recurrence-free survival, underlining the system’s efficacy in predicting early HCC recurrence.

Journal Article by Sun Y, Yu C (…) Zhou Y et 3 al. in J Gastrointest Surg

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

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Racial and Gender Disparities in Emergency General Surgery Transfers

In a groundbreaking study on emergency general surgery (EGS) transfers, researchers unveil stark racial and gender disparities. Analyzing over 28,000 interhospital transfers, they found higher odds of complications for EGS patients transferred between hospitals. Black patients faced increased minor complications, while Native Hawaiian, Pacific Islander, and female patients encountered unique challenges. These findings emphasize the urgency of targeted interventions to rectify disparities and enhance the safety of emergency procedures.

Journal Article by Abella M, Hayashi J (…) Elkbuli A et 4 al. in J Surg Res

Copyright © 2023 Elsevier Inc. All rights reserved.

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Tumor Markers Speak: Dynamic CEA and CA19-9 Monitoring Predicts Fate in Stage II Colon Cancer

A game-changing study dives into stage II colon cancer, revealing the power of dynamic carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) monitoring. With 1,517 patients in play, researchers uncovered that postoperative elevation in CEA/CA19-9 spells trouble, signaling a poor prognosis. Strikingly, normal pre- and post-operative CEA levels correlate with superior survival. Notably, adjuvant chemotherapy proved a game-changer, substantially improving outcomes. This study charts a promising course for tailored therapies based on tumor marker dynamics.

Journal Article by Wang R, Xu B (…) Lu H et 5 al. in Eur J Surg Oncol

© 2023 Published by Elsevier Ltd.

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Asian American Surgeons: Narrating Immigrant Journeys through American History

Unraveling the immigrant tapestry, this study delves into the backstories of Asian American surgeons. From Chinese laborers shaping the landscape to post-1965 policy shifts, the narrative weaves struggles and triumphs. Discrimination and restrictive acts clashed with contributions, yet resilience prevailed. The study spotlights pivotal moments like World War II and the 1965 immigration policy, emphasizing the evolving landscape of Asian immigrant experiences, culminating in the diverse tapestry of Asian American surgeons in the United States.

Journal Article by Nakayama DK in Am Surg

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Robotic Gastrectomy Takes the Crown: Boosting Textbook Oncologic Outcomes in Gastric Cancer Surgery

In the realm of gastric cancer surgery, a study flexes the stats on surgical approaches. Analyzing 21,015 patients, the research spotlights robotic gastrectomy (RG) as the champ, significantly elevating the likelihood of achieving Textbook Oncologic Outcome (TOO). Minimally invasive gastrectomy (MIG) emerges as a key player, linked to better lymph node evaluation, shorter hospital stays, and a sweet bonus—improved overall survival. In this surgical showdown, RG steals the spotlight, promising superior outcomes in the fight against gastric cancer.

Journal Article by Avila A, Cibulas MA (…) Llaguna OH et 2 al. in Am Surg

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Mindful Eating and Sleep Crucial in Preventing Weight Recurrence after Bariatric Surgery

A survey of 169 post-bariatric surgery individuals reveals a 23.1% significant weight recurrence rate. Sleeve gastrectomy increases risk (OR = 12.99). Anxiety, depression, and maladaptive eating patterns correlate with recurrence. Mindful eating and adequate sleep emerge as key protective factors, significantly reducing recurrence risk (OR = 4.84 and 7.30, respectively). The study underscores the pivotal role of lifestyle behaviors—specifically, mindful eating and quality sleep—in preventing weight regain post-bariatric surgery, urging clinicians to prioritize screening and monitoring these factors.

Journal Article by Miller-Matero LR, Haley EN (…) Carlin AM et 4 al. in Surg Obes Relat Dis

Copyright © 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

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