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Big Data Shapes Future of Hepatopancreatobiliary Cancer Surgery

In the realm of surgical oncology, randomized controlled trials (RCTs) often face recruitment and standardization challenges. This study dives into hepatopancreatobiliary (HPB) cancer surgery, spotlighting the pivotal role of large databases. While RCTs provide crucial evidence, big data steps in where they fall short. Beyond justifying current practices, this research maps the future of HPB oncology, leveraging expansive datasets to unravel complexities, inform health policies, and address gaps inaccessible to traditional trials.

Review by Shrikhande SV, Kunte AR (…) Bhandare MS et 2 al. in J Surg Oncol

© 2023 Wiley Periodicals LLC.

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Survival in the Spotlight: 3-Year Encore for TPF Therapy in Esophageal Cancer

Researchers belted out a 3-year follow-up tune on the NEOCRTEC-1601 stage, where docetaxel, cisplatin, and fluorouracil (TPF) took the spotlight. For those with borderline-resectable esophageal squamous cell carcinoma (BR-ESCC), the act featured 54.4% survival rates at the 3-year mark. Surgery danced into the spotlight for 57.4% of patients, confirming TPF’s encore as a promising rhythm in the survival score for BR-ESCC.

Journal Article by Wu JD, Wang ZQ (…) Yang H et 7 al. in Ann Surg Oncol

© 2023. The Author(s).

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Omentectomy Dilemma: Radical Move or Not for Gastric Cancer?

Researchers staged a retrospective showdown between total omentectomy (TO) and partial omentectomy (PO) in the radical gastrectomy arena for advanced gastric cancer (AGC) with serosal invasion. The verdict? No VIP pass for TO in preventing peritoneal recurrence. PO stole the spotlight with comparable recurrence-free survival and a better 5-year overall survival. Turns out, for T4a gastric cancer, a little less radical might still be radical enough.

Journal Article by Jeong SA, Kim S (…) Kim BS et 2 al. in Surg Endosc

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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RoboSlim: Navigating Bariatric Revisions with Robotics

In the quest for post-bariatric excellence, researchers dived into the robotic realm for revisional bariatric surgery (RBS). Surveying 106 patients who embarked on this robotic journey, the results spoke volumes. With a focus on patients experiencing insufficient weight loss, the team uncovered a success story—significant weight loss, improved comorbidities, and relieved symptoms. The RoboSlim saga demonstrates that robotic-assisted RBS is not just feasible; it’s a game-changer in sculpting a healthier post-bariatric future.

Journal Article by Castillo-Larios R, Cornejo J (…) Elli EF et 2 al. in Obes Surg

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Hepatic Vagotomy: A Lipid Makeover for Obesity

In the battle against the expanding empire of obesity, researchers delved into hepatic vagotomy’s (HV) potential to rewrite the cholesterol story. Following laparoscopic sleeve gastrectomy, the HV squad at the six-month checkpoint showcased a significant victory with lower total cholesterol/high-density lipoprotein (TC/HDL) ratios. While not all hypotheses stood strong, the study unveiled a promising narrative of improved lipid profiles in the HV realm. Ready for a lipid makeover? HV might hold the key in the fight against obesity’s metabolic consequences.

Journal Article by Catinis AM, Hinojosa AJ, Leonardi C and Cook MW in Obes Surg

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Cholangiocarcinoma Unveiled: Early-Onset Warriors’ Triumph

In the epic battle against cholangiocarcinoma, researchers scoured the SEER database (1975-2020) for insights. Early-onset warriors (EOC), comprising 274 out of 4037 fighters, emerged with a distinct profile—often non-white, intrahepatic warriors. Despite facing a more advanced enemy at diagnosis, EOCs defied the odds. They opted for surgery, radiotherapy, and chemotherapy, influencing their fate. Cox analysis and Kaplan-Meier survival plots painted a victory for EOCs, showcasing better overall survival, especially in the surgical arena. In this cholangiocarcinoma saga, early onset brought resilience and a more favorable prognosis.

Journal Article by Gao F, Xu X and Sun Y in Scand J Gastroenterol

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COVID-19 Impact on Surgeons’ Pockets: A Payment Plunge

As the COVID-19 storm hit, the financial tango between surgeons and industry partners took a hit. Examining payments from 2014 to 2021, researchers found a 47% drop in general payments and a 26.5% dip in research payments from 2019 to 2020. All surgical subspecialties felt the squeeze, with travel/lodging payments witnessing the most significant shake-up. Surgeons’ wallets felt the pandemic pinch, raising questions about the lasting effects on the physician-industry dance.

Journal Article by McMullin JL, Wang R (…) Chen H et 2 al. in J Surg Res

Copyright © 2023 Elsevier Inc. All rights reserved.

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Navigating Blunt Trauma: CT Scores’ Quest for Bowel Injury Truth

In the realm of blunt trauma, researchers unleashed the Faget Score and Bowel Injury Prediction Score (BIPS) to unmask the mystery of surgical need for bowel and mesenteric injuries. Scrutinizing 62 warriors from a sea of 14,897, the Faget and BIPS scores showed decent specificity but modest sensitivity. However, when an attending radiologist took the reins using BIPS criteria, accuracy soared. The battle for operative intervention truth in blunt bowel injuries saw the attending radiologist emerge as the hero.

Journal Article by Sethi I, Aicher AE (…) Jawa RS et 4 al. in J Surg Res

Copyright © 2023 Elsevier Inc. All rights reserved.

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Strategic Growth: Portal Vein Boost for Liver Resection in Cholangiocarcinoma

When facing borderline resectable intrahepatic cholangiocarcinoma (ICC), inducing hypertrophy pre-resection is a game-changer. In this single-center study, researchers found that portal vein embolization (PVE) prepped the battleground without raising perioperative issues. Overall survival (OS) matched non-PVE cases, but additional risks (multifocal tumors, lymph node involvement) threw a curveball, slashing OS notably. The takeaway? PVE proves a surgical ally for borderline ICC, but watch out for extra foes that might dim the long-term victory glow.

Journal Article by Nevermann N, Bode J (…) Schöning W et 8 al. in Eur J Surg Oncol

© 2023 Published by Elsevier Ltd.

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A Deep Dive into Anti-Obesity Medications

The battle against obesity is no one-size-fits-all, and this study delves into the arsenal—lifestyle tweaks, anti-obesity meds (AOMs), gadgets, and surgery. Researchers stress the need for a personalized approach, factoring in patient quirks, goals, and health hiccups. In this trial-and-error game, no crystal ball predicts the perfect AOM match. The takeaway? Prescribe sequentially, maybe mix and match, to hit that sweet spot in the fight against the bulge.

Review by Schmitz SH and Aronne LJ in Gastroenterol Clin North Am

Copyright © 2023 Elsevier Inc. All rights reserved.

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