Saketh R Guntupalli, Daniel Spinosa, Stephanie Wethington, Ramez Eskander, Alok A Khorana
Venous thromboembolism (VTE) is a major cause of both morbidity and mortality in patients with cancer. Venous thromboembolism, which includes both deep vein thrombosis and pulmonary embolism, affects a sizable portion of patients with malignancy and can have potentially life threatening complications. Accurate assessment of risk as well as diagnosis and treatment of this process is paramount to preventing death in this high risk population. Various risk models predictive of venous thromboembolism in patients with cancer have been developed, and knowledge of these rubrics is essential for the treating oncologist...
June 1, 2023: BMJ: British Medical Journal
Maxwell S Renna, Mariusz T Grzeda, James Bailey, Alison Hainsworth, Sebastien Ourselin, Michael Ebner, Tom Vercauteren, Alexis Schizas, Jonathan Shapey
BACKGROUND: Anastomotic leak is one of the most feared complications of colorectal surgery, and probably linked to poor blood supply to the anastomotic site. Several technologies have been described for intraoperative assessment of bowel perfusion. This systematic review and meta-analysis aimed to evaluate the most frequently used bowel perfusion assessment modalities in elective colorectal procedures, and to assess their associated risk of anastomotic leak. Technologies included indocyanine green fluorescence angiography, diffuse reflectance spectroscopy, laser speckle contrast imaging, and hyperspectral imaging...
May 30, 2023: British Journal of Surgery
Jessica Roelands, Peter J K Kuppen, Eiman I Ahmed, Raghvendra Mall, Tariq Masoodi, Parul Singh, Gianni Monaco, Christophe Raynaud, Noel F C C de Miranda, Luigi Ferraro, Tatiana C Carneiro-Lobo, Najeeb Syed, Arun Rawat, Amany Awad, Julie Decock, William Mifsud, Lance D Miller, Shimaa Sherif, Mahmoud G Mohamed, Darawan Rinchai, Marc Van den Eynde, Rosalyn W Sayaman, Elad Ziv, Francois Bertucci, Mahir Abdulla Petkar, Stephan Lorenz, Lisa Sara Mathew, Kun Wang, Selvasankar Murugesan, Damien Chaussabel, Alexander L Vahrmeijer, Ena Wang, Anna Ceccarelli, Khalid A Fakhro, Gabriele Zoppoli, Alberto Ballestrero, Rob A E M Tollenaar, Francesco M Marincola, Jérôme Galon, Souhaila Al Khodor, Michele Ceccarelli, Wouter Hendrickx, Davide Bedognetti
The lack of multi-omics cancer datasets with extensive follow-up information hinders the identification of accurate biomarkers of clinical outcome. In this cohort study, we performed comprehensive genomic analyses on fresh-frozen samples from 348 patients affected by primary colon cancer, encompassing RNA, whole-exome, deep T cell receptor and 16S bacterial rRNA gene sequencing on tumor and matched healthy colon tissue, complemented with tumor whole-genome sequencing for further microbiome characterization...
May 18, 2023: Nature Medicine
Laura L Meijer, Ninos Ayez, Charlotte S van Kessel
No abstract text is available yet for this article.
May 13, 2023: British Journal of Surgery
Charlotte Jl Molenaar, Stefan J van Rooijen, Hugo Jp Fokkenrood, Rudi Mh Roumen, Loes Janssen, Gerrit D Slooter
BACKGROUND: Surgery is the cornerstone in curative treatment of colorectal cancer. Unfortunately, surgery itself can adversely affect patient health. 'Enhanced Recovery After Surgery' programmes, which include multimodal interventions, have improved patient outcomes substantially. However, these are mainly applied peri- and postoperatively. Multimodal prehabilitation includes multiple preoperative interventions to prepare patients for surgery with the aim of increasing resilience, thereby improving postoperative outcomes...
May 10, 2023: Cochrane Database of Systematic Reviews
Peter Malfertheiner, M Constanza Camargo, Emad El-Omar, Jyh-Ming Liou, Richard Peek, Christian Schulz, Stella I Smith, Sebastian Suerbaum
Helicobacter pylori infection causes chronic gastritis, which can progress to severe gastroduodenal pathologies, including peptic ulcer, gastric cancer and gastric mucosa-associated lymphoid tissue lymphoma. H. pylori is usually transmitted in childhood and persists for life if untreated. The infection affects around half of the population in the world but prevalence varies according to location and sanitation standards. H. pylori has unique properties to colonize gastric epithelium in an acidic environment...
April 20, 2023: Nature Reviews. Disease Primers
Anja Domenghino, Carmen Walbert, Dominique Lisa Birrer, Milo A Puhan, Pierre-Alain Clavien
Postoperative complications represent a major public health burden worldwide. Without standardized, clinically relevant and universally applied endpoints, the evaluation of surgical interventions remains ill-defined and inconsistent, opening the door for biased interpretations and hampering patient-centered health care delivery. We conducted a Jury-based consensus conference incorporating the perspectives of different stakeholders, who based their recommendations on the work of nine panels of experts. The recommendations cover the selection of postoperative outcomes from the perspective of patients and other stakeholders, comparison and interpretation of outcomes, consideration of cultural and demographic factors, and strategies to deal with unwarranted outcomes...
April 17, 2023: Nature Medicine
Michael I D'Angelica, Ryan J Ellis, Jason B Liu, Brian C Brajcich, Mithat Gönen, Vanessa M Thompson, Mark E Cohen, Susan K Seo, Emily C Zabor, Michele L Babicky, David J Bentrem, Stephen W Behrman, Kimberly A Bertens, Scott A Celinski, Carlos H F Chan, Mary Dillhoff, Matthew E B Dixon, Carlos Fernandez-Del Castillo, Sepideh Gholami, Michael G House, Paul J Karanicolas, Harish Lavu, Shishir K Maithel, John C McAuliffe, Mark J Ott, Bradley N Reames, Dominic E Sanford, Umut Sarpel, Courtney L Scaife, Pablo E Serrano, Travis Smith, Rebecca A Snyder, Mark S Talamonti, Sharon M Weber, Adam C Yopp, Henry A Pitt, Clifford Y Ko
IMPORTANCE: Despite improvements in perioperative mortality, the incidence of postoperative surgical site infection (SSI) remains high after pancreatoduodenectomy. The effect of broad-spectrum antimicrobial surgical prophylaxis in reducing SSI is poorly understood. OBJECTIVE: To define the effect of broad-spectrum perioperative antimicrobial prophylaxis on postoperative SSI incidence compared with standard care antibiotics. DESIGN, SETTING, AND PARTICIPANTS: Pragmatic, open-label, multicenter, randomized phase 3 clinical trial at 26 hospitals across the US and Canada...
April 20, 2023: JAMA
Marianne Krogsgaard, Trine Bolette Borglit, Jens Ravn Eriksen
No abstract text is available yet for this article.
April 10, 2023: British Journal of Surgery
Jacob Ghotbi, Sheraz Yaqub, Kjetil Søreide
No abstract text is available yet for this article.
April 20, 2023: British Journal of Surgery
Niclas Dohrn, Mads Falk Klein
No abstract text is available yet for this article.
April 20, 2023: British Journal of Surgery
Dana Arad, Ariel Rosenfeld, Racheli Magnezi
BACKGROUND: A surgical "Never Event" is a preventable error occurring immediately before, during or immediately following surgery. Various factors contribute to the occurrence of major Never Events, but little is known about their quantified risk in relation to a surgery's characteristics. Our study uses machine learning to reveal and quantify risk factors with the goal of improving patient safety and quality of care. METHODS: We used data from 9,234 observations on safety standards and 101 root-cause analyses from actual, major "Never Events" including wrong site surgery and retained foreign item, and three random forest supervised machine learning models to identify risk factors...
March 31, 2023: Patient Safety in Surgery
Cynthia Mardinger, Alexander Drover, Eric Hyndman, Mary Brindle, Frankie Fraulin, Lea Austen, John Kortbeek, Dean Yergens
Scoping reviews of innovations in health care characterized by large numbers and types of publications present a unique challenge. A novel software application, Synthesis, can efficiently scan the literature to map the evidence and inform practice. We applied Synthesis to the National Surgical Quality Improvement Program (NSQIP), a high-quality database designed to measure risk-adjusted 30-day surgical outcomes for national and international benchmarking. The scoping review describes the breadth of studies in the NSQIP literature...
2023: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Wim Ceelen, Kjetil Soreide
Surgery is central to the cure of most solid cancers and an integral part of modern multimodal cancer management for early and advanced stage cancers. Decisions made by surgeons and multidisciplinary team members are based on best available knowledge for the defined clinical situation at hand. While surgery is both an art and a science, good decision-making requires data that are robust, valid, representative and, applicable to most if not all patients with a specific cancer. Such data largely comes from clinical observations and registries, and more preferably from trials conducted with the specific purpose of arriving at new answers...
March 6, 2023: European Journal of Surgical Oncology
Sofieke J D Temmink, Koen C M J Peeters, Renu R Bahadoer, Elma Meershoek-Klein Kranenbarg, Annet G H Roodvoets, Jarno Melenhorst, Jacobus W A Burger, Albert Wolthuis, Andrew G Renehan, Nuno L Figueiredo, Oriol Pares, Anna Martling, Rodrigo O Perez, Geerard L Beets, Cornelis J H van de Velde, Per J Nilsson
BACKGROUND: In rectal cancer, watch and wait for patients with a cCR after neoadjuvant treatment has an established evidence base. However, there is a lack of consensus on the definition and management of a near-cCR. This study aimed to compare outcomes in patients who achieved a cCR at first reassessment versus later reassessment. METHODS: This registry study included patients from the International Watch & Wait Database. Patients were categorized as having a cCR at first reassessment or at later reassessment (that is near-cCR at first reassessment) based on MRI and endoscopy...
March 27, 2023: British Journal of Surgery
Simran Asawa, Manuel Nüesch, Ana Gvozdenovic, Nicola Aceto
Gastrointestinal (GI) cancers account for 35% of cancer-related deaths, predominantly due to their ability to spread and generate drug-tolerant metastases. Arising from different locations in the GI system, the majority of metastatic GI malignancies colonise the liver and the lungs. In this context, circulating tumour cells (CTCs) are playing a critical role in the formation of new metastases, and their presence in the blood of patients has been correlated with a poor outcome. In addition to their prognostic utility, prospective targeting of CTCs may represent a novel, yet ambitious strategy in the fight against metastasis...
March 17, 2023: British Journal of Cancer
Maria A Willis, Ingrid Toews, Sophia Lv Soltau, Jörg C Kalff, Joerg J Meerpohl, Tim O Vilz
BACKGROUND: The success of elective colorectal surgery is mainly influenced by the surgical procedure and postoperative complications. The most serious complications include anastomotic leakages and surgical site infections (SSI)s, which can lead to prolonged recovery with impaired long-term health.  Compared with other abdominal procedures, colorectal resections have an increased risk of adverse events due to the physiological bacterial colonisation of the large bowel. Preoperative bowel preparation is used to remove faeces from the bowel lumen and reduce bacterial colonisation...
February 7, 2023: Cochrane Database of Systematic Reviews
Hugo C Temperley, Niall J O'Sullivan, Richard Grainger, Jarlath C Bolger
INTRODUCTION: Although laparoscopic cholecystectomy (LC) has been standard of care for symptomatic gallstone disease for almost 30 years, the use of routine intraoperative cholangiogram (IOC) remains controversial. There are marked variations in the use IOC during LC internationally. Debate has continued about its benefit, in part because of inconsistent benefit, time, and resources required to complete IOC. This literature review is presented as a debate to outline the arguments in favour of and against routine IOC in laparoscopic cholecystectomy...
January 27, 2023: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Constantinos Simillis, Amulya Khatri, Nick Dai, Thalia Afxentiou, Catherine Jephcott, Sarah Smith, Rashmi Jadon, Demetris Papamichael, Jim Khan, Michael P Powar, Nicola S Fearnhead, James Wheeler, Justin Davies
AIM: Multiple neoadjuvant therapy strategies have been used and compared for rectal cancer and there has been no true consensus as to the optimal neoadjuvant therapy regimen. The aim is to identify and compare the neoadjuvant therapies available for stage II and III rectal cancer. DESIGN: A systematic literature review was performed, from inception to August 2022, of the following databases: MEDLINE, EMBASE, Science Citation Index Expanded, Cochrane Library. Only randomized controlled trials comparing neoadjuvant therapies for stage II and III rectal cancer were considered...
March 2023: Critical Reviews in Oncology/hematology
Kushal T Kadakia, Adam L Beckman, Harlan M Krumholz
No abstract text is available yet for this article.
January 25, 2023: Nature Medicine
2023-01-27 15:15:09
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