(no author information available yet)
The sixth edition of the Japanese Gastric Cancer Treatment Guidelines was completed in July 2021, incorporating new evidence that emerged after publication of the previous edition. It consists of a text-based "Treatments" part and a "Clinical Questions" part including recommendations and explanations for clinical questions. The treatments parts include a comprehensive description regarding surgery, endoscopic resection and chemotherapy for gastric cancer. The clinical question part is based on the literature search and evaluation by an independent systematic review team...
November 7, 2022: Gastric Cancer
Karolina Gimberg, Lars Enochsson, Gabriel Sandblom
No abstract text is available yet for this article.
November 10, 2022: British Journal of Surgery
(no author information available yet)
BACKGROUND: Surgical site infection (SSI) remains the most common complication of surgery around the world. WHO does not make recommendations for changing gloves and instruments before wound closure owing to a lack of evidence. This study aimed to test whether a routine change of gloves and instruments before wound closure reduced abdominal SSI. METHODS: ChEETAh was a multicentre, cluster randomised trial in seven low-income and middle-income countries (Benin, Ghana, India, Mexico, Nigeria, Rwanda, South Africa)...
October 31, 2022: Lancet
Chad G Ball, Alex Lee, Matthew Kaminsky, S Morad Hameed
Penetrating cardiac injuries require rapid diagnosis, efficient exposure and nuanced technical approaches, within a framework of highly coordinated and integrated multidisciplinary care. Acute care surgeons, with both strategic and technical expertise, are ideally positioned to address the potentially devastating consequences of these injuries. The aim of this narrative review is to offer a technical approach to the rapid evaluation, exposure, operative repair and postoperative care of penetrating cardiac injuries...
2022: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Miklosh Bala, Fausto Catena, Jeffry Kashuk, Belinda De Simone, Carlos Augusto Gomes, Dieter Weber, Massimo Sartelli, Federico Coccolini, Yoram Kluger, Fikri M Abu-Zidan, Edoardo Picetti, Luca Ansaloni, Goran Augustin, Walter L Biffl, Marco Ceresoli, Osvaldo Chiara, Massimo Chiarugi, Raul Coimbra, Yunfeng Cui, Dimitris Damaskos, Salomone Di Saverio, Joseph M Galante, Vladimir Khokha, Andrew W Kirkpatrick, Kenji Inaba, Ari Leppäniemi, Andrey Litvin, Andrew B Peitzman, Vishal G Shelat, Michael Sugrue, Matti Tolonen, Sandro Rizoli, Ibrahima Sall, Solomon G Beka, Isidoro Di Carlo, Richard Ten Broek, Chirika Mircea, Giovanni Tebala, Michele Pisano, Harry van Goor, Ronald V Maier, Hans Jeekel, Ian Civil, Andreas Hecker, Edward Tan, Kjetil Soreide, Matthew J Lee, Imtiaz Wani, Luigi Bonavina, Mark A Malangoni, Kaoru Koike, George C Velmahos, Gustavo P Fraga, Andreas Fette, Nicola de'Angelis, Zsolt J Balogh, Thomas M Scalea, Gabriele Sganga, Michael D Kelly, Jim Khan, Philip F Stahel, Ernest E Moore
Acute mesenteric ischemia (AMI) is a group of diseases characterized by an interruption of the blood supply to varying portions of the intestine, leading to ischemia and secondary inflammatory changes. If untreated, this process may progress to life-threatening intestinal necrosis. The incidence is low, estimated at 0.09-0.2% of all acute surgical admissions, but increases with age. Although the entity is an uncommon cause of abdominal pain, diligence is required because if untreated, mortality remains in the range of 50%...
October 19, 2022: World Journal of Emergency Surgery: WJES
Peter Szatmary, Tassos Grammatikopoulos, Wenhao Cai, Wei Huang, Rajarshi Mukherjee, Chris Halloran, Georg Beyer, Robert Sutton
Acute pancreatitis is a common indication for hospital admission, increasing in incidence, including in children, pregnancy and the elderly. Moderately severe acute pancreatitis with fluid and/or necrotic collections causes substantial morbidity, and severe disease with persistent organ failure causes significant mortality. The diagnosis requires two of upper abdominal pain, amylase/lipase ≥ 3 ×upper limit of normal, and/or cross-sectional imaging findings. Gallstones and ethanol predominate while hypertriglyceridaemia and drugs are notable among many causes...
September 8, 2022: Drugs
Zaiba Shafik Dawood, Laura Alaimo, Henrique A Lima, Zorays Moazzam, Chanza Shaikh, Ahmed Sayed Ahmed, Muhammad Musaab Munir, Yutaka Endo, Timothy M Pawlik
BACKGROUND: Almost one-third of colorectal cancer (CRC) patients experience recurrence after resection; nevertheless, follow-up strategies remain controversial. We sought to systematically assess and compare the accuracy of carcinoembryonic antigen (CEA), imaging [positron emission tomography (PET) and computed tomography (CT) scans], and circulating tumor DNA (CtDNA) as surveillance strategies. PATIENTS AND METHODS: PubMed, Medline, Embase, Scopus, Cochrane, Web of Science, and CINAHL were systematically searched...
October 11, 2022: Annals of Surgical Oncology
Ronnie Fass
New England Journal of Medicine, Volume 387, Issue 13, Page 1207-1216, September 2022.
September 29, 2022: New England Journal of Medicine
Yonathan Freund, Fleur Cohen-Aubart, Ben Bloom
IMPORTANCE: Pulmonary embolism (PE) is characterized by occlusion of blood flow in a pulmonary artery, typically due to a thrombus that travels from a vein in a lower limb. The incidence of PE is approximately 60 to 120 per 100 000 people per year. Approximately 60 000 to 100 000 patients die from PE each year in the US. OBSERVATIONS: PE should be considered in patients presenting with acute chest pain, shortness of breath, or syncope. The diagnosis is determined by chest imaging...
October 4, 2022: JAMA
Samuel M Miller, Nupur Nagarkatti, Vanita Ahuja, Eric B Schneider, Sanjay Mohanty, Ronnie A Rosenthal, Lisa M Kodadek
BACKGROUND: Surrogate consent for surgery is sought when a patient lacks capacity to consent for their own operation. The purpose of this study is to describe older adults who underwent surgical interventions with surrogate consent. METHODS: A descriptive analysis was performed using data from the American College of Surgeons National Surgical Quality Improvement Program Geriatric Surgery Pilot collected from 2014 to 2018. All patients included were ≥65 years old and underwent a surgical procedure...
September 16, 2022: Surgery
Jack Cuzick, Peter Sasieni
Noninferiority trials are becoming increasing common, but are often poorly reported and misunderstood. A better understanding of the new components of a noninferiority trial and their interpretation is needed. Noninferiority trials are an extension of conventional superiority trials, which provide a basis for determining if a new treatment, which may have advantages other than efficacy, has sufficient efficacy to be useful in certain situations. A key feature is the need to specify a clinical noninferiority margin above which the lower boundary of the confidence interval for the difference between the new treatment and the conventional treatment must lie...
September 15, 2022: British Journal of Cancer
James Lucocq, Aaron Taylor, Peter Driscoll, Syed Naqvi, Alasdair MacMillan, Stephen Bennett, Andreas Luhmann, Andrew G Robertson
BACKGROUND: Where the critical view of safety cannot be established during cholecystectomy, certain salvage techniques are indicated to reduce the likelihood of bile duct injury. The present study describes a salvage technique termed the "laparoscopic lumen-guided cholecystectomy" (LLC) and reports its peri-operative outcomes. METHOD: A summary of the technique is as follows: (1) Hartmann's pouch is incised and stones are evacuated; (2) the cystic anatomy is inspected from the inside of the gallbladder; (3) the lumen is used to guide retrograde dissection towards the cystic pedicle; (4) cystic duct control is achieved if deemed safe...
August 25, 2022: Surgical Endoscopy
Allison E Berndtson, Todd W Costantini, Alan M Smith, Sara B Edwards, Leslie Kobayashi, Jay J Doucet, Laura N Godat
BACKGROUND: Current guidelines recommend that patients with choledocholithiasis undergo same-admission cholecystectomy. The compliance with this guideline is poor in elderly patients. We hypothesized that elderly patients treated with endoscopic retrograde cholangiopancreatography (ERCP) alone would have higher complication and readmission rates than the patients treated with cholecystectomy. METHODS: The Nationwide Readmissions Database was queried for all patients aged ≥65 years with admission for choledocholithiasis January to June 2016...
August 18, 2022: Surgery
Marie T Grönroos-Korhonen, Laura E Koskenvuo, Panu J Mentula, Selja K Koskensalo, Ari K Leppäniemi, Ville J Sallinen
BACKGROUND: As complications inevitably occur, minimizing the failure-to-rescue rate is of paramount interest. Most of the failure-to-rescue research in colorectal surgery has previously focused on elective surgery and anastomotic dehiscence. The aim of this study was to characterize and compare the major postoperative complications demanding reoperation after elective versus emergency colorectal surgery, and to the identify risk factors for failure-to-rescue. METHODS: In this population-based retrospective multicenter cohort study, adult patients undergoing a reoperation for colorectal surgery complication between 2006 and 2017 in 10 hospitals were included...
August 1, 2022: Surgery
Arturo J Rios-Diaz, Jessica R Cunning, Ankoor A Talwar, Adrienne Christopher, Robyn B Broach, Jesse Y Hsu, Jon B Morris, John P Fischer
Importance: Prosthetic reinforcement of critically sized incisional hernias is necessary to decrease hernia recurrence, but long-term prosthetic-mesh footprint may increase complication risk during subsequent abdominal operations. Objective: To investigate the association of prior incisional hernia repair with mesh (IHRWM) with postoperative outcomes and health care utilization after common abdominal operations. Design, Setting, and Participants: This was a population-based, retrospective cohort study of patients undergoing inpatient abdominal surgical procedures during the period of January 2009 to December 2016, with at least 1 year of follow-up within 5 geographically diverse statewide inpatient/ambulatory databases (Florida, Iowa, Nebraska, New York, Utah)...
October 1, 2022: JAMA Surgery
F Lordick, F Carneiro, S Cascinu, T Fleitas, K Haustermans, G Piessen, A Vogel, E C Smyth
No abstract text is available yet for this article.
July 29, 2022: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Anna Kramvis, Kyong-Mi Chang, Maura Dandri, Patrizia Farci, Dieter Glebe, Jianming Hu, Harry L A Janssen, Daryl T Y Lau, Capucine Penicaud, Teresa Pollicino, Barbara Testoni, Florian Van Bömmel, Ourania Andrisani, Maria Beumont-Mauviel, Timothy M Block, Henry L Y Chan, Gavin A Cloherty, William E Delaney, Anna Maria Geretti, Adam Gehring, Kathy Jackson, Oliver Lenz, Mala K Maini, Veronica Miller, Ulrike Protzer, Jenny C Yang, Man-Fung Yuen, Fabien Zoulim, Peter A Revill
Globally, 296 million people are infected with hepatitis B virus (HBV), and approximately one million people die annually from HBV-related causes, including liver cancer. Although there is a preventative vaccine and antiviral therapies suppressing HBV replication, there is no cure. Intensive efforts are under way to develop curative HBV therapies. Currently, only a few biomarkers are available for monitoring or predicting HBV disease progression and treatment response. As new therapies become available, new biomarkers to monitor viral and host responses are urgently needed...
July 20, 2022: Nature Reviews. Gastroenterology & Hepatology
Mariam Saeed, Stephanie Bass, Neal F Chaisson
Critically ill patients are at an increased risk for developing stress ulcers of the mucosa of the upper gastrointestinal (GI) tract. Bleeding from stress ulcers was previously associated with a longer stay in the intensive care unit and an increased risk of death. Thus, most patients admitted to the intensive care unit receive stress ulcer prophylaxis. However, there is a growing concern that acid-suppression drugs may be associated with increased frequency of nosocomial pneumonia and Clostridioides difficile infection...
July 1, 2022: Cleveland Clinic Journal of Medicine
Sander Ubels, Moniek Verstegen, Bastiaan Klarenbeek, Stefan Bouwense, Mark van Berge Henegouwen, Freek Daams, Marc J van Det, Ewen A Griffiths, Jan W Haveman, Joos Heisterkamp, Renol Koshy, Grard Nieuwenhuijzen, Fatih Polat, Peter D Siersema, Pritam Singh, Bas Wijnhoven, Gerjon Hannink, Frans van Workum, Camiel Rosman
BACKGROUND: Anastomotic leak (AL) is a common but severe complication after oesophagectomy. It is unknown how to determine the severity of AL objectively at diagnosis. Determining leak severity may guide treatment decisions and improve future research. This study aimed to identify leak-related prognostic factors for mortality, and to develop a Severity of oEsophageal Anastomotic Leak (SEAL) score. METHODS: This international, retrospective cohort study in 71 centres worldwide included patients with AL after oesophagectomy between 2011 and 2019...
June 27, 2022: British Journal of Surgery
David M Maslove, Benjamin Tang, Manu Shankar-Hari, Patrick R Lawler, Derek C Angus, J Kenneth Baillie, Rebecca M Baron, Michael Bauer, Timothy G Buchman, Carolyn S Calfee, Claudia C Dos Santos, Evangelos J Giamarellos-Bourboulis, Anthony C Gordon, John A Kellum, Julian C Knight, Aleksandra Leligdowicz, Daniel F McAuley, Anthony S McLean, David K Menon, Nuala J Meyer, Lyle L Moldawer, Kiran Reddy, John P Reilly, James A Russell, Jonathan E Sevransky, Christopher W Seymour, Nathan I Shapiro, Mervyn Singer, Charlotte Summers, Timothy E Sweeney, B Taylor Thompson, Tom van der Poll, Balasubramanian Venkatesh, Keith R Walley, Timothy S Walsh, Lorraine B Ware, Hector R Wong, Zsolt E Zador, John C Marshall
Research and practice in critical care medicine have long been defined by syndromes, which, despite being clinically recognizable entities, are, in fact, loose amalgams of heterogeneous states that may respond differently to therapy. Mounting translational evidence-supported by research on respiratory failure due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-suggests that the current syndrome-based framework of critical illness should be reconsidered. Here we discuss recent findings from basic science and clinical research in critical care and explore how these might inform a new conceptual model of critical illness...
June 2022: Nature Medicine
2022-06-24 15:42:59
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