Meaning of ACR-TIRADS recommendation in favor of follow-up rather than FNAC in thyroid nodules
AbstractThyroid Imaging Reporting and Data Systems (TIRADSs) have been largely diffused for their high accuracy in risk stratification of thyroid nodules (TNs) and their selection for fine-needle aspiration cytology (FNAC). The most popular TIRADSs are ACR-, EU-, and K-TIRADS, with some discrepancies each other. One major difference is that ACR-TIRADS includes a recommendation in favor of follow-up in TNs having a major diameter insufficient to indicate FNAC. The present study aimed to explore prevalence and significance of this recommendation. EU- and K-TIRADS were used as comparator. A retrospective series of thyroidecto...
Source: Updates in Surgery - May 21, 2024 Category: Surgery Source Type: research

Intraoperative left-sided colorectal anastomotic testing in clinical practice: a multi-treatment machine-learning analysis of the iCral3 prospective cohort
ConclusionsThis study showed that the surgeons ’ perception of both anastomotic perfusion and integrity (WPI subgroup) was associated to a significantly higher risk of AL and related morbidity, notwithstanding the extensive use of both ICG-FA and ALT testing. (Source: Updates in Surgery)
Source: Updates in Surgery - May 20, 2024 Category: Surgery Source Type: research

Association between the expression of epithelial –mesenchymal transition (EMT)-related markers and oncologic outcomes of colorectal cancer
ConclusionAbnormal expression of each marker was associated with lower OS, whereas abnormal expression of Vimentin and SMAD4 only was associated with lower DFS. (Source: Updates in Surgery)
Source: Updates in Surgery - May 18, 2024 Category: Surgery Source Type: research

Psychological strategies to optimise patient experience of plastic surgery: lessons from a Nobel prize winner
(Source: Updates in Surgery)
Source: Updates in Surgery - May 18, 2024 Category: Surgery Source Type: research

Retroauricular endoscopic thyroidectomy: initial single-institution experiences
AbstractConventional thyroidectomy often results in visible scarring postoperatively. Endoscopic thyroidectomy offers the advantage of scarless surgery, especially beneficial for young adult women. The retroauricular approach uses a facelift incision well-known among surgeons and eliminates the need for gas insufflation due to the large working space. An early retrospective analysis was conducted on thirty-one individuals who underwent gasless retroauricular endoscopic thyroidectomy approach, focusing on isthmolobectomies (n = 26) and lobectomies (n = 5), with one case necessitating conversion to open thyroidectomy...
Source: Updates in Surgery - May 18, 2024 Category: Surgery Source Type: research

The effect of coffee/caffeine on bowel recovery following colorectal surgery: an updated meta ‑analysis of randomized controlled trials
(Source: Updates in Surgery)
Source: Updates in Surgery - May 18, 2024 Category: Surgery Source Type: research

Laparoscopic assisted colectomy versus laparoscopic complete colectomy: a cost analysis
AbstractTo compare the short-term outcomes and explore the potential economic benefits of laparoscopic-assisted colectomy with extracorporeal anastomosis (LAC/EA) vs. laparoscopic complete colectomy with intracorporeal anastomosis (LCC/IA) for patients with non-metastatic resectable colon cancer. Data of patients who underwent laparoscopic hemicolectomy from January 2017 to March 2023 were collected and analyzed. Propensity score matching (PSM) analyses was carried out to minimize the selection bias. Before PSM, a total of 113 patients met the inclusion criteria (39 in the LCC/IA vs. 74 in the LAC/EA). Clinicopathologic ch...
Source: Updates in Surgery - May 17, 2024 Category: Surgery Source Type: research

Robotic spleen ‑preserving suprapancreatic and splenic hilar lymph node dissection using the preemptive retropancreatic approach in total gastrectomy for gastric cancer
We report our experience with nine patients with gastric cancer who underwent spleen-preserving splenic hilar LND using PRA during RTG at Hokkaido University from October 2018 to November 2021. The PRA involves initial dissection of the left side of the retropancreatic space, followed by the release of the adherence between the retroperitoneum surface and the pancreas (fusion fascia), which provides a good operative field and prevents contact with the pancreas during the suprapancreatic and splenic hilar LND in RTG. The median operating time was 488  min (254–564 min). The median intraoperative bleeding was 55 mL (0...
Source: Updates in Surgery - May 17, 2024 Category: Surgery Source Type: research

Comparison of short-term outcomes of laparoscopic surgery, robot-assisted laparoscopic surgery, and open surgery for lateral lymph-node dissection for rectal cancer: a network meta-analysis
This study attempted to compare short-term outcomes of laparoscopic surgery (LS), robot-assisted laparoscopic surgery (RS), and open surgery (OS) for lateral lymph-node dissection (LLND) in treatment of rectal cancer through network meta-analysis.  Embase, Web of Science, PubMed, and The Cochrane Library databases were searched to collect cohort studies on outcomes of LS, RS, and OS for LLND for rectal cancer. Newcastle–Ottawa Scale (NOS) was utilized to evaluate the quality of cohort studies. Primary outcomes should at least include one o f the following clinical outcome measures: operative time, blood loss, total lymp...
Source: Updates in Surgery - May 15, 2024 Category: Surgery Source Type: research

Impact of bariatric surgery on circulating irisin levels: a systematic review and meta ‑analysis
AbstractThis systematic review and meta-analysis evaluated changes in circulating irisin levels after bariatric surgery. A systematic search was performed across Embase, Scopus, PubMed, and Web of Science for this study. The meta-analysis was conducted using Comprehensive Meta-Analysis (CMA) V4 software. The overall effect size was depicted through a random-effects meta-analysis and the leave-one-out method. The meta-analysis, which included 13 studies with a total of 407 participants, showed a statistically non-significant reduction in circulating irisin levels following bariatric surgery (SMD:  – 0.089, 95% CI  ...
Source: Updates in Surgery - May 14, 2024 Category: Surgery Source Type: research

First report of robotic retromuscular incisional hernia repair with Hugo Ras ™ surgical system
In this study, we present the first transabdominal retromuscular incisional hernia repair performed with the new Hugo RAS ™ system (Medtronic, Minneapolis, MN, USA). The surgical team had previous robotic experience and completed an official 2-day session running incisional hernia repair on human cadaver lab. Operating room setting and trocar layout were planned. The patient presented a 4 × 4 cm midline incisio nal hernia and was scheduled for transabdominal retromuscular incisional hernia repair at our Institution. A description of the operative room setup, robotic arm configuration and docking/tilt angles is prov...
Source: Updates in Surgery - May 11, 2024 Category: Surgery Source Type: research

To close, not to close, or to act bigger? Managing the defect of large direct inguinal hernia to reduce the risk of recurrence during laparoscopic TAPP repair: a retrospective cohort study
AbstractHernia recurrence is a common complication after inguinal hernia repair. Recent studies suggest that laparoscopic mesh repair with closure of direct hernia defects can reduce recurrence rates. Our study examines the effectiveness of this approach. A retrospective, multi-center cohort study was conducted on cases performed from January 2013 to April 2021. Patients with direct inguinal hernias (M3 according to EHS classification) undergoing TAPP were included. Three groups were present: closed-defect group, non-closed placing a standard-sized mesh group or non-closed placing an XL-sized mesh group. A 2-year follow-up...
Source: Updates in Surgery - May 11, 2024 Category: Surgery Source Type: research

Conditional survival nomogram for patients with colon mucinous adenocarcinoma to predict prognosis: a dynamic survival analysis
AbstractThe aim was to assess conditional survival for colon mucinous adenocarcinoma (MAC) patients, and to construct nomograms to predict conditional survival probability. Survival analysis was done using conditional survival, which was defined as the probability of surviving additional y years for patients who have survived for x years. The mathematical definition was express as: CS (y|x)  = S (x + y)/S (x). Cox regression analyses were used to identify prognostic factors. A nomogram is constructed to predict conditional disease-free survival (DFS) and overall survival (OS) probability according to years that alr...
Source: Updates in Surgery - May 10, 2024 Category: Surgery Source Type: research

Development and validation of a 30-day point-scoring risk calculator for small bowel obstruction surgery
This study developed and validated a concise yet robust 10-point risk scoring system for patients undergoing SBO surgery. It can be informative to determine treatment plans and to prepare for potential perioperative complications in patients undergoing SBO surgery. (Source: Updates in Surgery)
Source: Updates in Surgery - May 10, 2024 Category: Surgery Source Type: research

How I do it. Pancreatojejunostomy: surgical tips to mitigate the severity of postoperative pancreatic fistulas after open or minimally invasive pancreatoduodenectomy
AbstractPancreatoduodenectomy is the most appropriate technique for the treatment of periampullary tumors. In the past, this procedure was associated with high mortality and morbidity, but with improvements in patient selection, anesthesia, and surgical technique, mortality has decreased to less than 5%. However, morbidity remains increased due to various complications such as delayed gastric emptying, bleeding, abdominal collections, and abscesses, most of which are related to the pancreatojejunostomy leak. Clinically relevant postoperative pancreatic fistula is the most dangerous and is related to other complications inc...
Source: Updates in Surgery - May 9, 2024 Category: Surgery Source Type: research