Volume 7, Issue 4, August 2023

Results from this meta-analysis of 62 studies suggest a possible ‘obesity paradox’ and challenges the assumption that patients with obesity have higher postoperative mortality compared with patients with normal range BMI. Increased BMI alone is not associated with increased perioperative mortality in gastrointestinal surgery, highlighting the importance of more accurate body composition assessment, such as computed tomography anthropometrics, to support perioperative risk stratification and decision-making.

In patients with pathological nipple discharge without radiological and clinical abnormalities, the malignancy rate after duct excision surgery was 8.1 per cent. The recurrence rate of pathological nipple discharge after surgery ranged from 0 to 12 per cent. Improvement of the diagnostic and therapeutic workup is needed to prevent patients from undergoing exploratory surgery.

Although several studies have reported the outcomes of using ProGlide and Prostar during transcatheter aortic valve replacement procedures, the results have been inconsistent. The aim of this study was to integrate the evidence to date and focus on the outcome of vascular complications. The pooled results demonstrate that ProGlide has superior safety and efficacy over Prostar, with decreased risks of major vascular complications, device failures, and additional surgical treatments. ProGlide has a lower risk of bleeding complications, but a higher risk of ischaemia complications. These findings could help clinicians to choose suture-based vascular closure devices, thereby reducing the incidence of vascular complications.

Incisional hernia is a common brief and long-term complication of laparotomy and can lead to significant morbidity. Our systematic review and meta-analysis aimed to provide an up-to-date overview of the laparotomy closure method in elective and emergency settings with the prophylactic mesh augmentation technique. Midline laparotomy closure with prophylactic mesh augmentation can be considered safe and effective in reducing the incidence of incisional hernia.

The consensus definition of sarcopenia was recently updated to emphasize both low muscle strength and mass. Based on this definition, sarcopenic patients had higher postoperative complication rates, higher mortality in hospital and to 3 months, and poorer overall survival after any elective abdominal surgery. Development of targeted exercised-based interventions that minimize sarcopenia may improve prognostic outcomes for patients with sarcopenia.

This network meta-analysis compared the effects of bariatric surgery, novel glucose-lowering medications, and conventional anti-diabetes treatments among 149 824 patients with diabetes and obesity from 376 randomized controlled trials. Bariatric surgery showed superiority in glycaemic control and weight management compared to all non-surgical approaches. GLP1RA demonstrated reduced HbA1c and body weight at 12 months, and was preferable over other non-surgical treatment options.

In the present study, we performed a systematic review and meta-analysis to investigate the influence of perioperative allogeneic blood transfusions on the recurrence and overall survival in gastric cancer and colorectal cancer after radical surgery using observational studies that applied propensity score analysis. We found that perioperative allogeneic blood transfusions were not associated with recurrence but were associated with worse overall survival in gastric cancer and colorectal cancer.

A systematic review of studies investigating the long-term effects of severe acute pancreatitis on patients’ quality of life.

The aim of this study was to evaluate the safety of early initiation of adjuvant chemotherapy within 2 weeks after surgery in patients with stage III colon cancer. Findings revealed that there was no statistically significant difference in overall toxicity, surgical complications, and quality of life between the early and conventional adjuvant chemotherapy arms.

Oncologic right-sided colectomy is demanding and central lymphadenectomy varies. We compared open and laparoscopic approaches, and found no difference in bleeding, postoperative complications, or removed lymph nodes.

The frequency of error rates in intraoperative neuromonitoring raw data as well as device-specific normal ranges for amplitude and latency of electromyograms generated during thyroid and parathyroid surgery have not been evaluated until now. We established an R-based application (the Mainz IONM Quality Assurance and Analysis tool) that enables data quality assessment of intraoperative neuromonitoring raw data. A total of 1138 out of 1935 intraoperative neuromonitoring raw data files (approximately 60 per cent) contained potential labelling errors or inconsistencies necessitating manual review; 915 files (48 per cent) were indeed erroneous. Based on the cleaned data, normal ranges were calculated, which revealed device-specific differences.

By the end of this decade, 70 per cent of all diagnosed pancreatic ductal adenocarcinomas (PDACs) will be in the elderly. Pancreatoduodenectomy is the only curative option, however, the benefit of curative resection in the elderly is difficult to determine from the literature. Octogenarians with PDAC of the head and uncinate process may benefit from comparable oncological outcomes to younger patients with surgical treatment after careful preoperative assessment and patient selection.

This nationwide population-based study of surgery for carotid artery disease in England, which has a National Health Service, examined data from 2006 to 2018. It found that patients having carotid endarterectomy who were living in more socioeconomically deprived areas were more likely to have presented with symptomatic carotid artery disease and have worse survival following surgery.

Whilst population-based surgery rates were higher in more deprived areas in the middle-aged population, this diminished and reversed with increasing age, with lower rates in more deprived areas in the population aged 85+ years. Clear policies and guidelines are needed to address these disparities.

The primary aim of this study was to investigate the efficacy of a protocol based on a quadruple intraoperative anastomotic assessment (4-Check) during transanal TME.

4-Check increased the intraoperative detection and repair of defects with a significant reduction in complications.

We describe, at a population level, the management of cholecystitis in Emergency General Surgery in Scotland, UK. Herein, we observe that only 60 per cent of individuals will have an emergency cholecystectomy on index admission. We also describe the risk factors associated with 90-day mortality after admission.