Volume 9, Issue 1, February 2025

In this epidemiological investigation, the study reports significant variation in the rates of organ-specific malperfusion among acute type A aortic dissection patients, with cerebral and coronary malperfusion occurring in approximately one in every ten patients presenting with acute type A aortic dissection. This data highlights the importance of considering specific malperfusion types when treating acute type A aortic dissection patients, aiding vigilant decision-making and surgical planning.

This systematic review reports on outcomes of minimally invasive (MIS-LPJ) and open lateral pancreaticojejunostomy (LPJ) in 1286 patients with symptomatic chronic pancreatitis.

This study explores the feasibility, patient interest and cost-effectiveness of opportunistic salpingectomy during non-gynaecological surgeries as a preventive measure for ovarian cancer. Thirteen included studies highlight its low implementation rates but demonstrate high success rates and patient willingness, particularly in procedures like bariatric surgery and cholecystectomies. Despite time constraints, the procedure shows promise in reducing ovarian cancer incidence and mortality rate, advocating for its consideration in non-gynaecological surgical settings.

This systematic review identifies and evaluates surgery-specific patient-reported experience measures, highlighting key patient experience themes, such as communication, care coordination, and waiting time. The study underscores the need for rigorous psychometric assessments of patient-reported experience measures to enhance overall patient care in surgical contexts.

The faecal immunochemical test has poor sensitivity (36%) for advanced adenoma detection, with a significant number of patients being missed. Volatile organic compound analysis offers higher sensitivity with the flexibility of measuring it in breath, stool or urine samples. The meta-analysis also demonstrated that combining the faecal immunochemical test-volatile organic compounds enhances the polyp detection rate, with combined sensitivity up to 89%.

This comprehensive review gives an overview of the classification, diagnosis, preoperative considerations, treatment strategies, and the most used surgical procedures for primary ventral and incisional hernias.

In a randomized clinical trial evaluating the effect of an eHealth intervention on anxiety in patients undergoing surgical treatment of abdominal aortic aneurysm, the positive short-term results of the intervention were not sustained at the 1-year follow-up. The study provides data on the natural trajectory of physical and psychological symptoms following abdominal aortic aneurysm repair, and can serve as a basis for future interventions to improve abdominal aortic aneurysm care.

In this RCT that included 52 patients, patients who underwent gastric partitioning were more able to ingest a normal diet after the procedure (96.3% versus 72%, P = 0.022) with similar postoperative complications and survival. Gastric partitioning should be considered as the primary option for the treatment of malignant gastric outlet obstruction.

This study aimed to determine the role of aggressive intravenous hydration with lactated Ringer’s solution (LRS) at a specific volume with 20% human albumin before ERCP in reducing the incidence of post-ERCP pancreatitis (PEP). The participants were randomly assigned to two groups: those who received aggressive intravenous hydration with 20% human albumin and LRS (intervention group), and those who received standard-volume intravenous hydration with LRS (control group). There was no significant difference in the PEP rate between the intervention and control groups.

Under enhanced recovery after surgery protocols, patients who undergo lung resection with an intraoperative completely tubeless protocol have shorter durations of postoperative drainage, shorter durations of hospital stay, milder systemic inflammatory reactions, and better immune protection than patients who undergo lung resection with an intraoperative partially tubeless protocol. The severity of mediastinal shift may be mainly related to weight.

In this randomized, controlled, parallel-group, double-blind, multicentre trial, 290 participants with a primary umbilical hernia less than or equal to 2 cm were randomly assigned to either suture or small onlay mesh repair. Thirty days after surgery, 279 participants were analysed and no significant increase in surgical-site occurrences was observed for mesh repair compared with suture repair. The trial provides evidence supporting the safety of using onlay mesh repair for umbilical hernias less than or equal to 2 cm.

This is a proof-of-concept study which demonstrates for the first time the potential of circulating extracellular vesicles to discriminate between non-cancer and cancerous indeterminate thyroid nodules. Mir-195-3p was upregulated, while five other microRNAs were downregulated (mir-3176, mir-205-5p, mir-3529-3p, let-7i-3p and novel-hsa-mir-208-3p) in patients with cancer compared to non-cancerous nodules. Furthermore, three large extracellular vesicle proteins were significantly upregulated (kallikrein-related peptidase11, alpha-1-acid glycoprotein 2 and small integral membrane protein 1), while 20 proteins were significantly downregulated. The top two downregulated proteins were chemokine (C-X-C motif) ligand 7 and tubulin β-1 chain. These findings pave the way to a new non-invasive test that could identify patients with malignant thyroid nodules without diagnostic surgery, potentially saving cost, healthcare outcomes and quality of life.

This study investigated risk factors for the development of desmoid tumours in patients with familial adenomatous polyposis after prophylactic colorectal surgery. The findings suggest that minimally invasive rectal-sparing surgery and non-malignant histology can protect against desmoid tumours. A dedicated surveillance regimen is needed to improve the early detection and management of desmoid tumours in patients with familial adenomatous polyposis.

Contrary to the impact of screening, the effect of long-term surveillance on the quality of life of patients with an abdominal aortic aneurysm is not well known. Therefore, by means of repeatedly collected questionnaires (the EuroQol 5-dimension 5-level questionnaire, the Hospital Anxiety and Depression Scale questionnaire, and the short version of the Patient Health Questionnaire) over time in a prospective cohort of patients with an abdominal aortic aneurysm, it was found that patients with an abdominal aortic aneurysm under surveillance have a stable, slightly lower health-related quality of life than previously reported in the general population, but comparable anxiety and depression scores, which decrease as the date of surgery approaches. Additionally, patients with a first-degree relative with an abdominal aortic aneurysm or a primary education alone experience more anxiety and/or depression, and might therefore benefit from a tailored approach throughout surveillance.

This study reviews the evolution of proctocolectomy with ileal pouch-anal anastomosis surgery and its outcomes over three decades at the University Hospitals of Leuven. Findings indicate an increase in laparoscopic procedures and delayed ileal pouch-anal anastomosis, leading to a significant decrease in anastomotic leakage rates over time, while anastomotic leakage was identified as a key risk factor for pouch failure.

This prospective multicentre observational study included patients who, following neoadjuvant treatment for rectal cancer, obtained a clinical complete response and were followed in a watch-and-wait programme. Two hundred and eleven patients were included, and this article presents short-term outcomes at 6 months. Thirty-three patients (16%) developed local regrowth, and 31 patients were salvaged with curative intent.

A man can die but once, but the surgical community have used different metrics for postoperative fatalities. In this registry-based study, we refined a statistical framework using declining hazards. Applying this to elective colorectal cancer surgery, a data-driven postoperative fatality window at 24 days was established, after which the death rate transitioned to a stable rate.

This large multicentre registry study evaluates the impact of case-mix adjustment when comparing complication rates after breast cancer surgery across hospitals. The results show that for valid comparisons of complication rates, stratification by surgery type is crucial. Subsequently, the evaluated patient and tumour characteristics have a negligible effect on hospital variation.

Frailty is significantly associated with adverse short-term and long-term outcomes after resection in elderly hepatocellular carcinoma patients. The findings suggest that frailty assessment should be incorporated into perioperative and postoperative evaluation for elderly patients undergoing hepatocellular carcinoma resection.

Intraoperative videos and images can be utilized to develop a deep learning-based perigastric blood vessel recognition model in laparoscopic radial gastrectomy with D2 lymphadenectomy. The performance of the perigastric blood vessel recognition model was evaluated using four metrics (precision, recall, intersection over union, and F1 score) and dynamic videos. The evaluation outcomes were satisfactory and suggested that the model has promising applications in surgical recognition, education, and surgical skill communication.

Machine learning models bridge intraoperative performance indicators (OPIs) with postoperative outcomes in robotic ventral hernia repair. This study demonstrates how OPIs elucidate operator-specific behaviours influencing short- and medium-term post-herniorrhaphy complications. Results show high-fidelity predictions of complications and recurrence.

This is an international survey and case-vignette study including 1283 participants from 55 countries. Interrater variability regarding the ASA classification in patients undergoing HPB surgery was observed, which may impact perioperative strategy. Additional guidance to classify patients according to ASA is urgently needed. Until then, more objective measurements should be considered for case-mix adjustment within research.