Prognosis and Adherence with the National Comprehensive Cancer Network Guidelines of Patients with Biliary Tract Cancers: an Analysis of the National Cancer Database
AbstractBackgroundThe National Comprehensive Cancer Network (NCCN) guidelines recommend chemotherapy for patients with inoperable biliary tract cancers (BTC), as well as patients following resection of BTC with lymph node metastasis (N1)/positive margins (R1). We sought to define overall adherence, as well as long-term outcomes, with the NCCN guidelines for BTC using the National Cancer Database (NCDB).MethodsA total of 176,536 patients diagnosed with BTC at a hospital participating in the NCDB between 2004 and 2015 were identified.ResultsAmong all patients, 63% of patients received medical therapy (chemotherapy or best su...
Source: Journal of Gastrointestinal Surgery - August 15, 2018 Category: Surgery Source Type: research

Oncologic Impact of Lymph Node Dissection for Intrahepatic Cholangiocarcinoma: a Propensity Score-Matched Study
ConclusionRadical surgery including an adequate lymph node dissection area and suitable harvested lymph nodes appears to improve oncologic outcomes for intrahepatic cholangiocarcinoma. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - August 15, 2018 Category: Surgery Source Type: research

Current Approaches in the Management of Hepatic Adenomas
ConclusionFuture genomic-based multicenter studies are required to provide a strong basis for formulating an evidence-based risk-adapted model that guides individualized management strategies for patients with HA. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - August 14, 2018 Category: Surgery Source Type: research

The 5-HT4 Receptor Agonist Prucalopride Stimulates Mucosal Growth and Enhances Carbohydrate Absorption in the Ileum of the Mouse
ConclusionParenteral administration of the 5-HT4 receptor specific agonist, prucalopride, results in morphologic and functional changes in the murine small intestine that are most prominent in the distal small bowel. While further studies are necessary to delineate the mechanism, it is plausible that the effects are mediated by 5-HT4 receptors on enterocytes. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - August 14, 2018 Category: Surgery Source Type: research

Distal Pancreatectomy with Celiac Axis Resection (DP-CAR) for Pancreatic Cancer. How I do It
This article proposes a standardized approach to DP-CAR, including routine neoadjuvant (FOLFIRINOX) chemotherapy. This approach to selecting patients and performing DP-CAR has the potential to improve short-term outcomes and overall surviv al in selected patients, but it should be reserved for high-volume centers. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - August 13, 2018 Category: Surgery Source Type: research

Technical Aspects of Orthotopic Liver Transplantation —a Survey-Based Study Within the Eurotransplant, Swisstransplant, Scandiatransplant, and British Transplantation Society Networks
ConclusionTechnical aspects of OLT vary widely among European centers. The extent to which center-specific variation of techniques affect transplant outcomes in Europe should be elucidated further in prospective multicenter trials. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - August 10, 2018 Category: Surgery Source Type: research

Clinical Feasibility of Large Gastrotomy Closure Using a Flexible Tissue Glue Based on N-Butyl-2-Cyanoacrylate: Experimental Study in Pigs
ConclusionsOur results suggest that flexible cyanoacrylates could be a feasible alternative to improve the clinical outcome of the closure of hollow viscera through more efficient sutureless procedures. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - August 10, 2018 Category: Surgery Source Type: research

Factors Associated with Long-Term Quality of Life After Restorative Proctocolectomy with Ileal Pouch Anal Anastomosis
ConclusionPatient ’s characteristics and minimal perioperative complications impact patient’s QoL following IPAA not only in the short term, but also in the long term. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - August 10, 2018 Category: Surgery Source Type: research

Evaluating Surgeons on Intraoperative Disposable Supply Costs: Details Matter
ConclusionsEvaluating surgeons based on intraoperative supply costs is sensitive to analytic methods. Surgeons who were  initially considered cost outliers became the least expensive within a given site. Auto-generated cost report cards may require additional analyses to produce accurate comparative assessments. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - August 10, 2018 Category: Surgery Source Type: research

Presentation and Survival of Gastric Cancer Patients at an Urban Academic Safety-Net Hospital
AbstractIntroductionGastric cancer is decreasing nationally but remains pervasive globally. We evaluated our experience with gastric cancer at a safety-net hospital with a substantial immigrant population.MethodsDemographics, pathology, and treatment were analyzed for gastric adenocarcinoma at our institution (2004 –2017). Chi-square analyses were performed for dependence of staging on demographics. Survival was evaluated with Kaplan-Meier and Cox regression analyses.ResultsWe identified 249 patients (median age 65  years). Patients were predominantly born outside the USA or Canada (74.3%), non-white (70.7%), an...
Source: Journal of Gastrointestinal Surgery - August 10, 2018 Category: Surgery Source Type: research

Minimally Invasive Debridement for Infected Pancreatic Necrosis
AbstractNecrotizing pancreatitis has historically been treated with open necrosectomy, which carries a high morbidity and mortality rate. More recently, there has been a shift towards endoscopic and percutaneous approaches employed as part of a minimally invasive step-up approach. Herein, we describe the technical approaches to video-assisted retroperitoneal debridement and sinus tract endoscopic debridement of pancreatic necrosis. Additionally, we review important patient selection considerations and the strengths and weaknesses of each of the approaches. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - August 10, 2018 Category: Surgery Source Type: research

Mental Illness Has a Negative Impact on Weight Loss in Bariatric Patients: a 4-Year Follow-up
ConclusionPreoperative mental illness leads to lower long-term weight loss and an increased risk of weight regain after bariatric surgery. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - August 8, 2018 Category: Surgery Source Type: research

Simultaneous Serial Transverse Enteroplasty (STEP) in Size Mismatch Small Bowel Transplantations
ConclusionsWe have demonstrated that a simultaneous STEP and SBTX procedure is technically feasible and clinically useful in overcoming the challenges associated with size mismatched SBTX. Our short-term findings justify further investigation in a larger series to elucidate the long-term outcomes of this procedure. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - August 8, 2018 Category: Surgery Source Type: research

Duct-To-Duct Biliary Anastomosis with Removable Internal Biliary Stent During Major Hepatectomy Extended to the Biliary Confluence
ConclusionDuct-to-duct biliary anastomosis with RIBS insertion after resection of the biliary confluence represents a feasible and safe alternative to the HJ. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - August 8, 2018 Category: Surgery Source Type: research

Underutilization of Surgery in Periampullary Cancer Treatment
ConclusionsSurgery is still underutilized in the treatment of periampullary cancers. Patients with cancers originating from the duodenum or the ampulla of Vater benefit most from resectional surgery. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - August 7, 2018 Category: Surgery Source Type: research

The Feasibility and Safety of Preoperative Fluorescence Marking with Indocyanine Green (ICG) in Laparoscopic Gastrectomy for Gastric Cancer
AbstractBackgroundSecuring the surgical margin is the most essential and important task in curative surgery. However, it is difficult to accurately identify the tumor location during laparoscopic surgery for gastric cancer, and existing methods, such as preoperative endoscopic marking with tattooing and clipping, have multiple disadvantages.AimsWe investigated the feasibility and safety of indocyanine green (ICG) fluorescence marking for determining the tumor location during laparoscopic gastrectomy.MethodsWe retrospectively analyzed preoperative and perioperative data from consecutive patients with gastric cancer undergoi...
Source: Journal of Gastrointestinal Surgery - August 6, 2018 Category: Surgery Source Type: research

Surgical Resection for Recurrence After Two-Stage Hepatectomy for Colorectal Liver Metastases Is Feasible, Is Safe, and Improves Survival
This study aimed to determine the feasibility, safety, and prognostic impact of surgical resection for recurrence after TSH and the prognostic role ofRAS mutation in this cohort.MethodsThe study included 137 patients intended to undergo TSH for bilateral colorectal metastases during 2003 –2016. Clinicopathologic factors were compared using univariate and multivariate analyses.ResultsOne hundred eleven patients (81%) completed TSH. The median recurrence-free survival in these patients was 12  months. Of the 83 patients with subsequent recurrence, 31 (37%) underwent resection for recurrence, and 11 underwent multi...
Source: Journal of Gastrointestinal Surgery - August 6, 2018 Category: Surgery Source Type: research

Hepatosteatosis from Lysosomal Acid Lipase Deficiency
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - August 6, 2018 Category: Surgery Source Type: research

Pilot Study of Dumbbell-Type Covered Self-Expandable Metal Stent Deployment for Benign Pancreatic Duct Stricture (with Videos)
ConclusionsDeployment of a dumbbell-type FCSEMS seems feasible for MPD stricture, and the rate of adverse events is acceptable. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - August 6, 2018 Category: Surgery Source Type: research

Intercostal and Glissonian Pedicle Approach in Laparoscopic Liver Resection for Bilobar Tumors
ConclusionsIntercostal approach is useful for subphrenic liver tumors, and glissonian pedicle approach is also useful for major lobectomy for laparoscopic liver resection. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - August 6, 2018 Category: Surgery Source Type: research

Anastomotic Location Predicts Anastomotic Leakage After Elective Colonic Resection for Cancer
AbstractBackgroundAnastomotic leakage (AL) is a potential feared complication after colorectal resection, which is associated with an increased risk of postoperative mortality and frequently requires additional surgery. The aim of this study was to assess major independent risk factors for AL after elective colonic resection for cancer, including anastomotic location.MethodsAmong 1940 consecutive patients referred to our institution for colorectal adenocarcinoma, 1025 patients had elective colonic resection with intraperitoneal anastomosis without diverting stoma. Risk factors were assessed among preoperative, operative, a...
Source: Journal of Gastrointestinal Surgery - August 3, 2018 Category: Surgery Source Type: research

Clinical Value of Inflammation-Based Prognostic Scores to Predict the Resectability of Hyperbilirubinemia Patients with Potentially Resectable Hilar Cholangiocarcinoma
ConclusionPatients with higher GPS, CA 125, and PLR levels, and a larger tumor size, tend to have unresectable tumors even if they were judged as potentially resectable using preoperative radiological examinations. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - August 3, 2018 Category: Surgery Source Type: research

Response to: “Colonic Interposition After Adult Oesophagectomy: Systematic Review and Meta-analysis of Conduit Choice and Outcome”
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - August 3, 2018 Category: Surgery Source Type: research

Letter to the Editor Concerning the Publication: “Meta-Analysis of Enhanced Recovery Protocols in Bariatric Surgery”
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 31, 2018 Category: Surgery Source Type: research

Analyzing the Impact of Compliance with National Guidelines for Pancreatic Cancer Care Using the National Cancer Database
This study analyzed national rates of compliance with National Comprehensive Cancer Network recommendations, assessed factors affecting compliance, and evaluated whether compliance with evidence-based guidelines improved overall survival.DesignThis is a retrospective review of adults diagnosed with pancreatic cancer entered into the National Cancer Database. Patients included had stage I and II pancreatic cancer, and complete data in the database. Patients were classified as compliant if they underwent both surgery and a second treatment modality (chemotherapy, radiation, or chemoradiation). Clinico-pathologic variables we...
Source: Journal of Gastrointestinal Surgery - July 31, 2018 Category: Surgery Source Type: research

Surgeon Assessment of Gastric Cancer Lymph Node Specimens with a Video of Technique
ConclusionSurgeon assessment of gastric LN specimens was feasible and effective to provide high-quality pathologic LN assessment after gastrectomy in gastric adenocarcinoma patients. Standardization of the technical methods for gastric LN evaluation is needed to improve the accuracy and quality of gastric cancer staging in the US. The provided video can help inform standardization of gastric LN assessment. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 27, 2018 Category: Surgery Source Type: research

Evolving Management Strategies in Patients with Adhesive Small Bowel Obstruction: a Population-Based Analysis
AbstractBackgroundIn patients with adhesive small bowel obstruction (aSBO), the decision to operate as well as the timing and technique of surgery have significant impacts on clinical outcomes. Trends in the management of aSBO have not been described at the population level and guideline adherence is unknown. We sought to evaluate the secular trends in the management of aSBO in a large North American population.MethodsWe used administrative data to identify patients admitted to hospital for their first episode of aSBO over 2005 –2014. We evaluated temporal trends in admission for aSBO and in management practices usin...
Source: Journal of Gastrointestinal Surgery - July 26, 2018 Category: Surgery Source Type: research

Mesenteric Lymphatic Vessel Density Is Associated with Disease Behavior and Postoperative Recurrence in Crohn ’s Disease
ConclusionsIn addition to its correlation with disease behavior, bowel thickness, and the presence of intestinal granulomas and creeping fat, increased mesenteric lymphatic vessel density in the proximal margin is predictive of early clinical recurrence after surgery in patients with Crohn ’s disease. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 24, 2018 Category: Surgery Source Type: research

A Comparison of Open and Minimally Invasive Surgery for Hepatic and Pancreatic Resections Among the Medicare Population
AbstractIntroductionMinimally invasive surgery (MIS) has become standard of care for many gastrointestinal surgical procedures. Despite possible clinical benefits, MIS may be underutilized in some populations. The aim of this study was to access the utilization of MIS among Medicare patients undergoing hepatopancreatic procedures and define clinical outcomes, as well as costs, of minimally invasive techniques compared with the conventional open approach.MethodsThe Medicare Provider Analysis and Review (MEDPAR) Inpatient Files were reviewed to identify Medicare patients who underwent pancreatic and liver procedures between ...
Source: Journal of Gastrointestinal Surgery - July 23, 2018 Category: Surgery Source Type: research

Index versus Non-index Readmission After Hepato-Pancreato-Biliary Surgery: Where Do Patients Go to Be Readmitted?
AbstractIntroductionThe Center for Medicare and Medicaid Services (CMS) has identified readmission as an important quality metric. With an increased emphasis on regionalization of complex hepato-pancreato-biliary (HPB) surgery to high-volume centers, care of readmitted HPB patients may be fragmented if readmission occurs at a non-index hospital. We sought to define the proportion of HPB readmissions, as well as evaluate outcomes, that occur at an index versus non-index hospitals and to identify factors associated with non-index hospital readmission.MethodsThe National Readmissions Database (NRD) was used to identify patien...
Source: Journal of Gastrointestinal Surgery - July 23, 2018 Category: Surgery Source Type: research

A Rare, Giant, Cystic, and Cavernous Lymphangioma Originated from the Stomach in a Young Woman
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 23, 2018 Category: Surgery Source Type: research

Prophylactic, Synthetic Intraperitoneal Mesh Versus No Mesh Implantation in Patients with Fascial Dehiscence
ConclusionImplantation of a polypropylene but not polyester-based mesh in patients with FD decreases incisional hernia with a low rate of mesh-related morbidity. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 23, 2018 Category: Surgery Source Type: research

Specific Medicare Severity-Diagnosis Related Group Codes Increase the Predictability of 30-Day Unplanned Hospital Readmission After Pancreaticoduodenectomy
AbstractBackgroundThe Medicare Severity-Diagnosis Related Group coding system (MS-DRG) is routinely used by hospitals for reimbursement purposes following pancreatic surgery. We aimed to determine whether specific pancreatectomy MS-DRG codes, when combined with distinct clinicopathologic and perioperative characteristics, increased the accuracy of predicting 30-day readmission after pancreaticoduodenectomy (PD).MethodsDemographic, clinicopathologic, and perioperative factors were compared between readmitted and non-readmitted patients atBrigham and Women ’s Hospital following PD. Different pancreatectomy DRG codes, c...
Source: Journal of Gastrointestinal Surgery - July 23, 2018 Category: Surgery Source Type: research

Outcomes of Living Donor Liver Transplantation for Patients with Preoperative Portal Vein Problems
ConclusionPreoperative PVT increases the complexity of LDLT operation, but it does not reduce the OS rates of such patients. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 23, 2018 Category: Surgery Source Type: research

The Importance of Safety-Net Hospitals in Emergency General Surgery
AbstractIntroductionSafety-net hospitals provide care to an inherently underprivileged patient population. These hospitals have previously been shown to have inferior surgical outcomes after complex, elective procedures, but little is known about how hospital payer-mix correlates with outcomes after more common, emergent operations.MethodsThe University HealthSystem Consortium database was queried for all emergency general surgery procedures performed from 2009 to 2015. Emergency general surgery was defined as the seven operative procedures recently identified as contributing most to the national burden. Only urgent and em...
Source: Journal of Gastrointestinal Surgery - July 23, 2018 Category: Surgery Source Type: research

Precise Navigation of the Surgical Plane with Intraoperative Real-time Virtual Sonography and 3D Simulation in Liver Resection
In conclusion, RVS in combination with 3D simulation is a feasible, safe, and promising technique for the precise intraoperative navigation of liver resection for primary liver cancer. It could be applied to other resecta ble liver diseases and may be utilized in other centers. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 23, 2018 Category: Surgery Source Type: research

Reflux and Belching after Laparoscopic 270 degree Posterior Versus 180 degree Anterior Partial Fundoplication
ConclusionLTF and LAF provide similar reflux control, with a comparable effect on acidic, liquid, and gas reflux. Both procedures equally reduced the number of belches and supragastric belches. This study provides the physiological evidence for the published randomized trials reporting similar symptomatic outcome after both types of partial fundoplication. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 20, 2018 Category: Surgery Source Type: research

A Novel Pathological Prognostic Score (PPS) to Identify “Very High-Risk” Patients: a Multicenter Retrospective Analysis of 506 Patients with High Risk Gastrointestinal Stromal Tumor (GIST)
AbstractBackgroundTo determine the better risk stratification based on surgical pathology and to assess the clinical outcomes after curative resection with a new scoring system in high risk gastrointestinal stromal tumor (GIST) patients.MethodsWe retrospectively evaluated 506 high-risk GIST patients who underwent curative resection as initial treatment at four centers from 2001 to 2015.ResultsMultivariate analysis revealed that only Ki-67 labeling index (LI) and mitotic index were independent prognostic factors of overall survival (OS). For the two tumor-related pathological factors, Ki-67 LI  >  7% and mi...
Source: Journal of Gastrointestinal Surgery - July 20, 2018 Category: Surgery Source Type: research

Improved Survival in Surgically Resected Distal Cholangiocarcinoma Treated with Adjuvant Therapy: a Propensity Score Matched Analysis
This study aimed to determine the role of AT in resected dCCA and identify subgroups that benefit from AT.MethodsWe conducted a retrospective review of surgically resected dCCA in the NCDB from 2004 to 2013. Patients who received AT or observation (OB) were matched by propensity score. Log-rank test was used to compare OS.ResultsOf 1782 patients with resected dCCA, 840 (47%) were in the OB group and 942 (53%) in the AT group. AT was younger (64.0 vs. 68.7  years,p 
Source: Journal of Gastrointestinal Surgery - July 20, 2018 Category: Surgery Source Type: research

Platelet-Albumin Score as a Sensitive Measure for Surgical Risk Prediction and Survival Outcomes of Patients with Hepatocellular Carcinoma
AbstractBackgroundGiven that patients with hepatocellular carcinoma (HCC) usually suffer from dual diseases (i.e., HCC and underlying liver disease), a complete survival estimation model is difficult to establish because both the oncological stage and the underlying liver function affect the survival outcome.MethodsA new surgical risk model for estimating the survival of patients undergoing resection for HCC was created using a cohort treated between 1995 and 2013 (training set,n = 889), and its efficacy was then validated using a cohort treated between 2014 and 2017 (validation set,n = 310).Res...
Source: Journal of Gastrointestinal Surgery - July 18, 2018 Category: Surgery Source Type: research

An Interview with Dr. John L. Cameron, the Hall of Famer of Pancreatic Cancer
AbstractThe Society of Surgical Alimentary Tract (SSAT) Resident Education Committee aim is to facilitate resident participation in the annual meeting and foster the education of the next generation of gastrointestinal. The SSAT “Residents Corner” was developed as a video-blog highlighting areas of interest for surgical trainees looking to focus on a career in gastrointestinal surgery. The topics covered are to make surgical education more accessible, one way is to highlight leaders in the field who discuss their journe y. A 10-min video of a surgical mentor is recorded and archived on the SSAT site under a vid...
Source: Journal of Gastrointestinal Surgery - July 18, 2018 Category: Surgery Source Type: research

Association Between Juxtapapillary Duodenal Diverticula and Risk of Choledocholithiasis: a Systematic Review and Meta-analysis
ConclusionsA significantly increased risk of choledocholithiasis among individuals with JDD was observed in this study. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 18, 2018 Category: Surgery Source Type: research

Indocyanine Green Tissue Angiography Can Reduce Extended Bowel Resections in Acute Mesenteric Ischemia
DiscussionICG tissue angiography is feasible and technically reliable for evaluating intestinal perfusion in acute mesenteric ischemia and led to a significant clinical benefit in 11% of our patients. A relevant discrepancy between surgical visual assessment and fluorescence angiography was found in 35% of the cases, which may help to define resection margins more accurately and thus support surgical decision-making. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 10, 2018 Category: Surgery Source Type: research

Postoperative Infectious Complications Impact Long-Term Survival in Patients Who Underwent Hepatectomies for Colorectal Liver Metastases: a Propensity Score Matching Analysis
ConclusionInfectious complications are associated with decreased overall and disease-free survival rates. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 10, 2018 Category: Surgery Source Type: research

Predictive Value of Preoperative Sarcopenia in Patients with Gastric Cancer: a Meta-analysis and Systematic Review
AbstractPurposeThe impact of preoperative sarcopenia on postoperative complications and overall survival has been recently debated. Our meta-analysis aims to ascertain whether preoperative sarcopenia increases the risk of poor outcomes and to attempt to provide new ideas for the prognosis of outcomes for patients with gastric cancer.MethodsWe searched for all relevant articles on PubMed, the EMBASE database, and Web of Science (up to September 1, 2017). Data synthesis and statistical analysis were carried out using RevMan 5.3 software.ResultsThirteen studies involving 4262 patients who underwent gastrectomy for gastric can...
Source: Journal of Gastrointestinal Surgery - July 9, 2018 Category: Surgery Source Type: research

Alvimopan, Regardless of Ileus Risk, Significantly Impacts Ileus, Length of Stay, and Readmission After Intestinal Surgery
ConclusionsAlvimopan, regardless of ileus risk, improves ileus, hospital stay, and ileus-related readmission after intestinal resection and these effects are sustained over the long term. Since fewer than a third of patients currently receive alvimopan, its routine adoption with small and large intestinal resection will significantly impact patients and health systems. (Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 9, 2018 Category: Surgery Source Type: research

Slipped Liver Segment Mimicking an Esophageal Stromal Tumor
(Source: Journal of Gastrointestinal Surgery)
Source: Journal of Gastrointestinal Surgery - July 9, 2018 Category: Surgery Source Type: research

Effect of Delay to Operation on Outcomes in Patients with Acute Appendicitis: a Systematic Review and Meta-analysis
AbstractBackgroundMany studies have investigated the association between time interval and incidence of complicated appendicitis and post-operative surgical site infection (SSI), but the results are controversial.MethodsA systematic search of the electronic databases identified studies that investigated the association of appendectomy delay with complicated appendicitis and SSI among patients with acute appendicitis. Qualitative and quantitative meta-analysis of the results was conducted.ResultsTwenty-one studies were included in the final analysis. Meta-analysis showed no significant difference in complicated appendicitis...
Source: Journal of Gastrointestinal Surgery - July 6, 2018 Category: Surgery Source Type: research

The Presence of an Advanced Gastrointestinal (GI)/Minimally Invasive Surgery (MIS) Fellowship Program Does Not Impact Short-Term Patient Outcomes Following Fundoplication or Esophagomyotomy
This study looks at two representative foregut surgeries (laparoscopic fundoplication and esophagomyotomy) performed in New York State (NYS), comparing hospitals which do and do not possess a GI/MIS fellowship program, to examine the effect of such a program on perioperative outcomes. We also aimed to identify any patient or hospital factors which might influence perioperative outcomes.MethodsThe SPARCS database was examined for all patients who underwent a foregut procedure (specifically, either an esophagomyotomy or a laparoscopic fundoplication) between 2012 and 2014. We compared the following outcomes between instituti...
Source: Journal of Gastrointestinal Surgery - July 6, 2018 Category: Surgery Source Type: research

The Impact of Extent of Liver Resection Among Patients with Neuroendocrine Liver Metastasis: an International Multi-institutional Study
AbstractBackgroundLiver resection in patients with neuroendocrine liver metastasis (NELM) provides a survival benefit, yet the optimal extent of resection remains unknown. We sought to examine outcomes of patients undergoing non-anatomic (NAR) versus anatomic liver resection (AR) for NELM using a large international cohort of patients.MethodsTwo hundred and fifty-eight patients who underwent curative intent liver resection from January 1990 to December 2016 were identified from eight institutions. Patients were excluded if they underwent concurrent ablation, had extrahepatic disease, underwent a debulking operation, or had...
Source: Journal of Gastrointestinal Surgery - July 6, 2018 Category: Surgery Source Type: research