Outcomes of a Multicenter Training Program in Robotic Pancreatoduodenectomy (LAELAPS-3)
Conclusions:
This multicenter RPD training program in centers with sufficient surgical volume was found to be feasible without a negative impact of the learning curve on clinical outcomes. (Source: Annals of Surgery)
Source: Annals of Surgery - November 14, 2022 Category: Surgery Tags: Original Articles Source Type: research
Transcriptomic Profiling Identifies an Exosomal microRNA Signature for Predicting Recurrence Following Surgery in Patients With Pancreatic Ductal Adenocarcinoma
Objective:
We performed genome-wide expression profiling to develop an exosomal miRNA panel for predicting recurrence following surgery in patients with PDAC.
Summary of Background Data:
Pretreatment risk stratification is essential for offering individualized treatments to patients with PDAC, but predicting recurrence following surgery remains clinically challenging.
Methods:
We analyzed 210 plasma and serum specimens from 4 cohorts of PDAC patients. Using a discovery cohort (n = 25), we performed genome-wide sequencing to identify candidate exosomal miRNAs (exo-miRNAs). Subsequently, we trained and vali...
Source: Annals of Surgery - November 14, 2022 Category: Surgery Tags: Original Articles Source Type: research
Serous Cystic Neoplasms of the Pancreas Management in the Real-world: Still Operating on a Benign Entity
Objective:
Our aim is to provide a real-life picture of serous cystic neoplasms (SCNs) management once a presumptive diagnosis is made.
Summary of Background Data:
SCNs of the pancreas are invariably benign entities. While consensus about their management is lacking, surgical resection still plays a role.
Methods:
Presumed SCNs evaluated from 1990 to 2018 were included. Indications for surgery, predictors of resection, rate, and predictors of misdiagnosis in the surgical cohort and time trends of management strategies were the main outcomes.
Results:
A total of 672 presumed SCNs were included. Pres...
Source: Annals of Surgery - November 14, 2022 Category: Surgery Tags: Original Articles Source Type: research
Circulating Cell-free DNA in Patients With Acute Biliary Pancreatitis: Association With Disease Markers and Prolonged Hospitalization Time—A Prospective Cohort Study
Objective:
To evaluate cfDNA as an indicator of pancreatitis severity.
Background:
Acute pancreatitis severity scores have limited proficiency, and are complex and challenging to use clinically. Elevation of circulating cfDNA concentration has been shown to be associated with hospital length of stay (LOS) and mortality.
Methods:
In a prospective study, cfDNA concentration was measured by a simple fluorometric test, at admission and for 2 consecutive days, in patients with acute biliary pancreatitis (ABP). Ranson and APACHE II scores were used as measures of pancreatitis severity. Hospital LOS and mortalit...
Source: Annals of Surgery - November 14, 2022 Category: Surgery Tags: Original Articles Source Type: research
Long-term Dependency Outcomes in Older Adults Following Hepato-Pancreato-Biliary Surgery for Cancer: A Population-based Analysis
Conclusions:
Following hepatopancreatobiliary cancer surgery, there is a high rate of long-term healthcare dependency for OA. There is an immediate high need for homecare that reaches a new baseline after 6 months, and the majority of OA will have at least 1 year with low time at home, most commonly the first year. These findings can aid in preoperative preparation and transitional care planning. (Source: Annals of Surgery)
Source: Annals of Surgery - November 14, 2022 Category: Surgery Tags: Original Articles Source Type: research
Blood Salvage and Autotransfusion With Single Leukoreduction Does Not Increase the Risk of Tumor Recurrence After Liver Transplantation for Advanced Hepatocellular Carcinoma
Conclusions:
When allogeneic transfusion was matched, autotransfusion was not significantly related to HCC recurrence, with more favorable probabilities for autotransfusion, in patients with advanced HCC. Thus, blood salvage and autotransfusion could be safely used with single leukoreduction, without double-filtered leukoreduction, during liver transplantation for HCC with potential benefits from avoiding allogeneic red blood cell transfusion. (Source: Annals of Surgery)
Source: Annals of Surgery - November 14, 2022 Category: Surgery Tags: Original Articles Source Type: research
Application of Proximal Splenic Vein Embolization to Interrupt Complicated Large Splenorenal Shunts in Adult Living Donor Liver Transplantation
Conclusions:
PSVE is an effective and safe procedure to secure adequate portal flow without portal steal for patients with complicated large SRS arising from multiple sites of the splenic vein or escaping to multiple terminal ends. (Source: Annals of Surgery)
Source: Annals of Surgery - November 14, 2022 Category: Surgery Tags: Original Articles Source Type: research
Renoportal Anastomosis During Liver Transplantation in Patients With Portal Vein Thrombosis: First Long-term Results From a Multicenter Study
Conclusions:
Despite a high rate of PHT-related complications, excellent long-term patient and graft survival could be achieved. RPA could be considered successful in the vast majority of patients. The expanded use of RPA is warranted. (Source: Annals of Surgery)
Source: Annals of Surgery - November 14, 2022 Category: Surgery Tags: Original Articles Source Type: research
Total Neoadjuvant Therapy Versus Standard Neoadjuvant Chemoradiation in Patients with Locally Advanced Rectal Cancer: A Comparison of Short- and Long-term Oncologic Outcomes
Objective:
To evaluate the impact of neoadjuvant multi-agent systemic chemotherapy and radiation (TNT) vs neoadjuvant single-agent chemoradiation (nCRT) and multi-agent adjuvant chemotherapy on overall survival (OS), tumor downstaging, and circumferential resection margin (CRM) status in patients with locally advanced rectal cancer.
Summary of Background Data:
Outside of clinical trials and small institutional reports, there is a paucity of data regarding the short and long-term oncologic impact of TNT as compared to nCRT.
Methods:
Adult patients with stage II-III rectal adenocarcinoma were identified in ...
Source: Annals of Surgery - November 14, 2022 Category: Surgery Tags: Original Articles Source Type: research
Enhanced Recovery 2.0 – Same Day Discharge With Mobile App Follow-up After Minimally Invasive Colorectal Surgery
Conclusions and Relevance:
Findings from this study support the feasibility of a SDD protocol in select patients undergoing minimally-invasive colorectal resection. SDD colectomy protocols may represent the next evolution of ERP and postoperative recovery. (Source: Annals of Surgery)
Source: Annals of Surgery - November 14, 2022 Category: Surgery Tags: Original Articles Source Type: research
Development and Validation of a Patient-reported Outcome Measure for Gastrointestinal Obstruction in the Setting of Advanced Malignancy
Objective:
We sought to construct a valid and reliable patient-reported outcome measure for patients with advanced malignancy and GIO.
Background:
Bowel obstruction is the most common indication for palliative surgical consultation in patients with advanced cancer; however, no validated patient-reported outcome measures exist for this population.
Methods:
A total of 125 patients with GIO and 64 patients without GIO who underwent palliative surgical consultation completed the MDASI-GIO questionnaire and a single global quality-of-life question. Summary statistics were used to assess the symptom burden of G...
Source: Annals of Surgery - November 14, 2022 Category: Surgery Tags: Original Articles Source Type: research
Impact of Age on Obesity-related Comorbidity After Gastric Bypass: A Cohort Study From the Scandinavian Obesity Surgery Registry (SOReg)
Conclusions:
Although to somewhat lower rates compared to younger patients, marked and sustained improvements in obesity-related comorbidities are seen after gastric bypass in patients>60 years. This, together with the finding that bariatric surgery is safe in this group of patients, suggests that age should not be considered an exclusion criterion by itself. (Source: Annals of Surgery)
Source: Annals of Surgery - November 14, 2022 Category: Surgery Tags: Original Articles Source Type: research
Patient-reported Comorbidity Assessment After Bariatric Surgery: A Potential Tool to Improve Longitudinal Follow-up
Conclusions:
Patient-reported comorbidity assessment has high levels of agreement with medical chart audit for many comorbidities and can improve understanding of long-term outcomes. This will better inform patients and providers with hopes of 1 day moving beyond the 1%. (Source: Annals of Surgery)
Source: Annals of Surgery - November 14, 2022 Category: Surgery Tags: Original Articles Source Type: research
Bariatric Surgery and Risk of Death in Persons With Chronic Kidney Disease
Objective:
A retrospective cohort study investigated the association between having surgery and risk of mortality for up to 5 years and if this association was modified by incident ESRD during the follow-up period. Summary of Background Data: Mortality risk in individuals with pre-dialysis CKD is high and few effective treatment options are available. Whether bariatric surgery can improve survival in people with CKD is unclear.
Methods:
Patients with class II and III obesity and pre-dialysis CKD stages 3–5 who underwent bariatric surgery between January 1, 2006 and September 30, 2015 (n = 802) were matched to ...
Source: Annals of Surgery - November 14, 2022 Category: Surgery Tags: Original Articles Source Type: research
Associations Between Physical Activity and Changes in Depressive Symptoms and Health-related Quality of Life Across 7 Years After Roux-en-Y Gastric Bypass Surgery: A Multicenter Prospective Cohort Study
Conclusion:
Among adults who underwent RYGB, multiple objective PA measures were associated with decreases in depressive symptoms and improvements in mental and physical HRQoL throughout 7 years, independent of weight loss, indicating PA is a modifiable behavior to augment outcomes. (Source: Annals of Surgery)
Source: Annals of Surgery - November 14, 2022 Category: Surgery Tags: Original Articles Source Type: research
