Evolution of transplant oncology indications: a single-institution experience over 40 Â years
AbstractLiver transplantation (LT) for uncommon tumoral indications has changed across the decades, with impaired results reported in the first historical series mainly for non-tumoral-related causes. Recently, renewed interest in liver transplant oncology has been reported. The study aims to analyze a mono-center experience exploring the evolution and the impact on patient survival of LT in uncommon tumoral indications. A retrospective analysis of 851 LT performed during 1982 –2023 was investigated. 33/851 (3.9%) uncommon tumoral indications were reported: hepatocellular carcinoma (HCC) on non-cirrhotic liver (n = 1...
Source: Updates in Surgery - April 8, 2024 Category: Surgery Source Type: research
Patients undergoing liver resection for non-alcoholic fatty liver disease-related hepatocellular carcinoma and those for viral hepatitis-related hepatocellular carcinoma have similar survival outcomes
AbstractNumerous studies have compared outcomes of liver resection (LR) of patients with non-alcoholic fatty liver disease (NAFLD)-related hepatocellular carcinoma (HCC) to those of patients with non-NAFLD-related HCC. However, results have been inconsistent. We aim to clarify this issue. We enrolled 801 patients with hepatitis B virus (HBV)-related HCC, 433 patients with hepatitis C virus (HCV)-related HCC, and 128 patients with NAFLD-related HCC undergoing LR. Overall survival (OS) and disease-free survival (DFS) of patients with different etiologies of chronic liver disease was compared using the Kaplan –Meier estimat...
Source: Updates in Surgery - April 7, 2024 Category: Surgery Source Type: research
Recent advances in lung cancer research: unravelling the future of treatment
AbstractLung cancer, a multifaceted disease, demands tailored therapeutic approaches due to its diverse subtypes and stages. This comprehensive review explores the intricate landscape of lung cancer research, delving into recent breakthroughs and their implications for diagnosis, therapy, and prevention. Genomic profiling and biomarker identification have ushered in the era of personalised medicine, enabling targeted therapies that minimise harm to healthy tissues while effectively combating cancer cells. The relationship between pulmonary tuberculosis and lung cancer is examined, shedding light on potential mechanisms lin...
Source: Updates in Surgery - April 6, 2024 Category: Surgery Source Type: research
Extraperitoneal lateral pelvic sidewall excision: a novel rectal-sparing approach for lateral locally recurrent rectal cancer
AbstractLocally recurrent rectal cancer (LRRC) involving the lateral pelvic sidewall requires a complex approach to maximize the likelihood of R0 resection, which is the only predictor of survival. The purpose of this report is to describe a novel technique to resect a localized lateral pelvic sidewall LRRC. A 63-year-old male patient was referred for a 15-mm LRRC near the right internal iliac vessels. Endoscopic ultrasound and magnetic resonance imaging excluded any involvement of the pelvic colon or residual rectum. A combined extraperitoneal antero-lateral approach and gluteal access were used to optimize vascular contr...
Source: Updates in Surgery - April 6, 2024 Category: Surgery Source Type: research
Retrospective observational cohort study of laparoscopic surgical strategies for gastrointestinal stromal tumors
This study involved 55 patients who underwent laparoscopic surgery between April 2014 and March 2021. We classified the patients into two groups: laparoscopy-assisted surgery group (non-LECS group,n = 30) and LECS group (n = 25). LECS was performed in the upper stomach, in the greater curvature of the lower stomach, and in both intraluminal and intramural locations in the middle stomach. Non-LECS was selected for extraluminal and intramural tumors in the greater curvature of the upper stomach. There were no sever e complications associated with the operation. There was one postoperative complication in the LECS gro...
Source: Updates in Surgery - April 5, 2024 Category: Surgery Source Type: research
A modified pancreaticojejunostomy anastomotic technique using double U-sutures for laparoscopic pancreaticoduodenectomy
AbstractAlthough recent advances in laparoscopic technology have popularized laparoscopic pancreatoduodenectomy (LPD), laparoscopic pancreaticojejunostomy anastomosis (PJA) still presents a major technical challenge. From February 2021 to January 2023, 42 patients underwent LPD with modified double U-suture PJA. Data on the demographic characteristics and clinical results of these patients were investigated. The median operation time was 316  min (249–596 min). The median PJA time was 32 min (25–40 min). The median intraoperative blood loss was 150 mL (50–500 mL). The median postoperative stay was 12 days (7â€...
Source: Updates in Surgery - April 5, 2024 Category: Surgery Source Type: research
The learning curve of a bronchus-first method in bi-port video-assisted thoracoscopic surgery for left upper lobe lung cancer
In this study, the learning curve was obtained while ensuring favorable oncological outcomes using bronchus-first method for VATS LUL. First, retrospective data of 148 consecutive patients who underwent VATS LUL (bronchus-first method) for non-small cell lung cancer (NSCLC) from March 2018 to October 2020 were analyzed. The learning curve was then assessed via cumulative sum (CUSUM) analysis. Moreover, data at different stages of the learning curve, including operation time, blood loss, postoperative hospital stay, lymph node harvested, thoracotomy conversion, postoperative complications, endoscopic stapler consumptions, a...
Source: Updates in Surgery - April 4, 2024 Category: Surgery Source Type: research
Liraglutide effectiveness in preoperative weight-loss for patients with severe obesity undergoing bariatric-metabolic surgery
AbstractPreoperative management of patients living with severe obesity can be challenging; in this context, the preoperative weight loss may help to obtain better outcomes and less morbidity  for bariatric surgery. Therefore, we evaluated the effectiveness of GLP-1 analogue Liraglutide in preoperative weight loss. We performed a single-center, quasi-experimental prospective study. Eligible participants were adults in preoperative management for bariatric-metabolic surgery with body-m ass index ≥ 48 kg/m2. All patients were assigned liraglutide treatment, with an initial dose of 0.6  mg subcutaneous per day, the...
Source: Updates in Surgery - April 4, 2024 Category: Surgery Source Type: research
LIFT procedure: postoperative outcomes, risk factors for fistula recurrence and continence impairment
This study aimed to assess postoperative outcomes related to this procedure and evaluate the potential influence of preoperative and intraoperative features. Patients who underwent LIFT procedure between June 2012 and September 2021 were retrospectively analyzed. Patients were divided according to whether they developed fistula recurrence and on the history of a surgery prior to the LIFT. Preoperative features, postoperative outcomes, and risk factors adverse outcomes were analyzed. Forty-eight patients were included, of which 25 received primary LIFT, being the high transsphincteric fistula pattern the most frequent (62.5...
Source: Updates in Surgery - April 4, 2024 Category: Surgery Source Type: research
Robotic modified Sugarbaker technique for parastomal hernia repair: a standardized approach
In conclusion, paras tomal hernia, a common complication post-stoma creation, demands surgical intervention. The robotic-assisted modified Sugarbaker repair technique, as outlined in this paper, offers promising results in terms of feasibility and outcomes. (Source: Updates in Surgery)
Source: Updates in Surgery - April 4, 2024 Category: Surgery Source Type: research
Comparison of the efficacy, safety and postoperative quality of life between modified side overlap anastomosis and double-tract anastomosis after laparoscopic proximal gastrectomy
ConclusionThe efficacy and safety of LPG with mSOA for PGC were comparable. When compared with the DTA group, the mSOA group seems to show reduced incidence of gastroesophageal reflux and improved QOL, which makes mSOA one of the ideal surgical methods for PGC. (Source: Updates in Surgery)
Source: Updates in Surgery - April 3, 2024 Category: Surgery Source Type: research
Propensity-score matched outcomes of resection of stage IV primary colon cancer with and without simultaneous resection of liver metastases
This study aimed to compare short-term and survival outcomes of simultaneous resection of CLM and primary colon cancer compared to resection of only colon cancer. This retrospective matched cohort study included patients from the National Cancer Database (2015 –2019) with stage IV colon adenocarcinoma and synchronous liver metastases who underwent colectomy. Patients were divided into two groups: colectomy-only (resection of primary colon cancer only) and colectomy-plus (simultaneous resection of primary colon cancer and liver metastases). The groups we re matched using the propensity score method. The primary outcome wa...
Source: Updates in Surgery - April 3, 2024 Category: Surgery Source Type: research
Effect of in-hospital delay on acute appendicitis severity: does time really matter?
This study aimed to clarify if in-hospital surgical delay significantly affected the proportion of complicated appendicitis in a large prospective cohort of patients treated with appendectomy for acute appendicitis. Patients were grouped into low, medium, and high preoperative risk for acute appendicitis based on the Alvarado scoring system. Appendicitis was defined as complicated in cases of perforation, abscess, or diffuse peritonitis. The primary outcome was correlation of in-hospital delay with the proportion of complicated appendicitis. The study includes 804 patients: 278 (30.4%) had complicated appendicitis and medi...
Source: Updates in Surgery - April 2, 2024 Category: Surgery Source Type: research
Application of bridging mesh repair in giant ventral incisional hernia
This study aimed to verify the safety and efficacy of bridging repair by comparing it with primary fascial closure (PFC) repair in the treatment of giant ventral incisional hernia. We retrospectively analyzed the clinical data of 92 patients with giant ventral incisional hernia who underwent mesh repair at our medical institution from January 1, 2014 to December 31, 2020. Patients were divided into 2 groups: the bridging repair group with 40 patients in whom repair was completed using the bridging technique and the PFC group with 52 patients in whom primary fascial closure was achieved and all patients underwent mesh reinf...
Source: Updates in Surgery - March 31, 2024 Category: Surgery Source Type: research
Outcomes of severely injured pregnant trauma patients: a multicenter analysis
AbstractNearly 10% of pregnant women suffer traumatic injury. Clinical outcomes for pregnant trauma patients (PTPs) with severe injuries have not been well studied. We sought to describe outcomes for PTPs presenting with severe injuries, hypothesizing that PTPs with severe injuries will have higher rates of complications and mortality compared to less injured PTPs. A post-hoc analysis of a multi-institutional retrospective study at 12 Level-I/II trauma centers was performed. Patients were stratified into severely injured (injury severity score [ISS]  >  15) and not severely injured (ISS <  15) and compared wi...
Source: Updates in Surgery - March 30, 2024 Category: Surgery Source Type: research
