Blog

Navigating Complications in Laparoscopic vs. Open D2-Gastrectomy (LOGICA Trial): Comprehensive Index Offers No Extra Perks

Researchers delved into the LOGICA trial, scrutinizing complications after gastric cancer surgery. Comparing Comprehensive Complication Index (CCI) and Clavien-Dindo Classification (CDC), they discovered no significant difference in complication burden between laparoscopic and open D2-gastrectomy. The verdict? While both indices correlated for hospitalization, ICU-stay, and reoperations, the CCI brought no extra flair, advising against its use post-gastrectomy. In the realm of gastric battles, CDC remains the reigning champ for assessing postoperative complications.

Journal Article by Triemstra L, de Jongh C (…) Ruurda JP et 6 al. in Eur J Surg Oncol

© 2023 Published by Elsevier Ltd.

read the whole article in Eur J Surg Oncol

open it in PubMed

Anterior Sacrectomy Improves Pelvic Exenteration Outcomes

Researchers compare sacrectomy approaches in pelvic exenteration for advanced pelvic malignancies. Shifting from prone sacrectomy (PS) to anterior techniques (ALS, HACS), they find ALS and HACS reduce operating time, blood loss, and complications compared to PS. HACS involves more nerve and vascular resections. Despite this, adopting anterior sacrectomy enhances surgical and perioperative outcomes while maintaining oncological effectiveness. Surgeons are encouraged to embrace these safer, anterior approaches for improved pelvic exenteration outcomes.

Journal Article by van Kessel CS, Waller J (…) Solomon MJ et 4 al. in Ann Surg

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

read the whole article in Ann Surg

open it in PubMed

Liver Transplant Impact on Ileal Pouch Outcomes in PSC-IBD

For patients with primary sclerosing cholangitis and inflammatory bowel disease (PSC-IBD), this study explores the influence of liver transplantation (LT) on ileal pouch-anal anastomosis (IPAA) outcomes. Among 160 patients, LT correlated with higher chronic pouchitis rates but didn’t affect overall and pouch survival. Nontransplanted patients had more PSC-related deaths. IPAA timing regarding LT didn’t impact short- or long-term pouch outcomes. Results suggest LT’s link to increased pouchitis but emphasize its minimal impact on IPAA and overall survival in PSC-IBD patients.

Journal Article by Maspero M, Holubar SD (…) Hull TL et 7 al. in Ann Surg

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

read the whole article in Ann Surg

open it in PubMed

Privilege Disparities Shape Access to Cancer Surgery

A study of 25,070 cancer surgery patients reveals that community privilege significantly influences access to high-volume surgical centers. Residents in less privileged areas (lower income, non-white) faced longer travel distances and were less likely to choose high-volume hospitals. Individuals in the least privileged communities had over 70% greater odds of bypassing high-volume centers. The findings underscore privilege as a crucial social determinant impacting patient access to and utilization of complex oncologic surgical care resources.

Journal Article by Munir MM, Endo Y (…) Pawlik TM et 10 al. in Ann Surg

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

read the whole article in Ann Surg

open it in PubMed

Resident Autonomy: A Vital Key to Wellness in Surgical Training

In a survey of 7,233 residents across 324 programs, 82.2% reported appropriate autonomy, linking to lower burnout, suicidality, and thoughts of leaving. Female residents were less likely to report adequate autonomy. Satisfaction with workload, work-life balance, faculty engagement, camaraderie, and resources correlated with perceived autonomy. Qualitative insights highlighted autonomy’s crucial role in residency, identified barriers, and emphasized the need for residents to “earn” autonomy. The study calls for equitable resource allocation to support autonomy and well-being in surgical training.

Journal Article by Abahuje E, Smith KS (…) Hu YY et 12 al. in Ann Surg

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

read the whole article in Ann Surg

open it in PubMed

Major Surgery, Silent Threat: Myocardial Injury’s Hidden Impact

In a global study of 22,552 major general surgery patients, 16.3% experienced myocardial injury after noncardiac surgery (MINS). Shockingly, 89.9% of MINS cases showed no symptoms, emphasizing the hidden danger. Those with MINS faced a nearly 5-fold increase in 30-day mortality (6.8% vs. 1.2%), underlining its prognostic importance. This exposes the need for routine postoperative troponin monitoring to unveil asymptomatic MINS, potentially saving lives after major surgery.

Journal Article by Jacka MJ, Youngson E (…) Devereaux PJ et 11 al. in Ann Surg

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

read the whole article in Ann Surg

open it in PubMed

Gastric Bypass: A Shield Against Esophageal Adenocarcinoma in Obesity

In a Nordic cohort study, researchers explored if bariatric surgery lowers esophageal and cardia adenocarcinoma risks linked to obesity. Of 748,932 participants, mainly undergoing gastric bypass, the surgery showed a significant decrease in esophageal adenocarcinoma risk over time, suggesting it may counteract its development in morbidly obese individuals. The study implies gastric bypass as a potential preventive measure against esophageal adenocarcinoma in the long term for those struggling with obesity.

Journal Article by Hardvik Åkerström J, Santoni G (…) Lagergren J et 7 al. in Ann Surg

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

read the whole article in Ann Surg

open it in PubMed

Revolutionizing Surgeon Onboarding: A Success Story in Community Hospitals

Surgeons often face inadequate introductions to new practice settings. This study, implementing a tailored onboarding program in an academic-affiliated community hospital, showed outstanding process adherence, user satisfaction, and improved readiness to practice. Results affirm the feasibility and effectiveness of local teams implementing robust onboarding, ensuring smooth transitions for surgeons practicing across diverse settings in the evolving landscape of academic-community hospital collaborations.

Journal Article by Etheridge JC, Goldstone RN (…) Haas S et 4 al. in Ann Surg

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

read the whole article in Ann Surg

open it in PubMed

Assessing Pouch Function After Ileal Pouch Anal Anastomosis: Beyond Manometry

In evaluating post-proctocolectomy patients with ileal pouch anal anastomosis (IPAA), anopouch manometry (APM) highlights defecatory symptoms. Less than 10% of symptomatic IPAA patients undergo APM. Dyssynergic defecation, prevalent in 47.0% to 100% of cases, associates with fecal incontinence. APM alone proves imperfect for pouch function assessment, prompting the need for confirmatory dynamic imaging. This study emphasizes expanding diagnostic approaches, recognizing dyssynergic defecation and fecal incontinence in symptomatic IPAA patients.

Journal Article by Luo Y, Schmidt N (…) Kayal M et 2 al. in Inflamm Bowel Dis

© The Author(s) 2022. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
© The Author(s) 2022. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

read the whole article in Inflamm Bowel Dis

open it in PubMed

Balancing Act: Bariatric Surgery and Anticoagulation’s Bleeding Dilemma

In a study spanning 2008–2022, researchers delved into the post-bariatric bleeding risks for patients on chronic anticoagulation (CAT). Examining 132 cases (82 Roux-en-Y gastric bypass, 50 sleeve gastrectomy), the incidence of long-term bleeding was significantly higher in the Roux-en-Y group (18.3%) than the sleeve gastrectomy group (4%). Notably, bleeding marginal ulcer (MU) prevailed in the Roux-en-Y group (13.4%). The study urges informed counseling on bleeding risks for CAT patients considering metabolic and bariatric surgery.

Journal Article by Abi Mosleh K, Belluzzi A (…) Ghanem OM et 4 al. in Obes Surg

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

read the whole article in Obes Surg

open it in PubMed