Gastrointestinal Surgery (all articles)
Cohort Study | Long-term quality of life and functional outcome of patients with rectal cancer following a watch-and-wait approach
3 Apr, 2023 | 13:31h | UTCLong-term Quality of Life and Functional Outcome of Patients With Rectal Cancer Following a Watch-and-Wait Approach – JAMA Surgery (free for a limited period)
Invited Commentary: Guiding Patients Through a “Watch-and-Wait” Approach for Rectal Cancer—Understanding the Functional Outcomes – JAMA Surgery (free for a limited period)
Related:
Commentary on Twitter
Results of this study suggest that patients with rectal cancer who were observed by a watch-and-wait approach had good quality of life, with some patients reporting bowel and sexual dysfunction. https://t.co/zaK3bjJA8n
— JAMA Surgery (@JAMASurgery) March 31, 2023
Update on the management of acute pancreatitis
30 Mar, 2023 | 14:10h | UTCUpdate on the management of acute pancreatitis – Current Opinion in Critical Care
Related:
Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis – New England Journal of Medicine
Acute Pancreatitis: Diagnosis and Treatment – Drugs
Evidence-Based Disposition of Acute Pancreatitis – emDocs
Pancreatitis – National Institute for Health and Care Excellence
Research: Endoscopic or Surgical Step-up Approach for Infected Necrotising Pancreatitis
Evidence-Based Approach to the Surgical Management of Acute Pancreatitis – The Surgery Journal
RCT | Efficacy and safety of colesevelam for the treatment of bile acid diarrhea
30 Mar, 2023 | 14:06h | UTCEfficacy and safety of colesevelam for the treatment of bile acid diarrhoea: a double-blind, randomised, placebo-controlled, phase 4 clinical trial – The Lancet Gastroenterology & Hepatology (link to abstract – $ for full-text)
Commentary on Twitter
New research – Borup et al – Efficacy and safety of colesevelam for the treatment of bile acid diarrhoea: a double-blind, randomised, placebo controlled, phase 4 clinical trialhttps://t.co/m1r0heRgjX#gitwitter #BAD #diarrhoea pic.twitter.com/zk1TnZFS6b
— The Lancet Gastroenterology & Hepatology (@LancetGastroHep) February 7, 2023
Brief Review | Acute mesenteric ischemia
30 Mar, 2023 | 13:44h | UTCAcute mesenteric ischaemia – British Journal of Surgery
M-A | Aggressive IV hydration may increase mortality risk in severe acute pancreatitis
29 Mar, 2023 | 13:26h | UTCSummary: This systematic review and meta-analysis investigated the outcomes of aggressive and non-aggressive intravenous hydration in patients with severe and non-severe acute pancreatitis (AP). The study included nine randomized controlled trials with a total of 953 participants.
The findings revealed that aggressive intravenous hydration significantly increased mortality risk in severe AP cases, and fluid-related complication risk in both severe and non-severe AP cases. However, the study has some limitations, as only one study with 249 participants was judged to have a low risk of bias in all domains, while the remaining eight studies had non-low risk of bias, raising concerns about the reliability of the findings.
Despite these concerns, the findings still suggest that more conservative intravenous fluid resuscitation protocols for AP may be preferable. Further research with more rigorous study designs is needed to provide robust evidence on the effectiveness of different intravenous hydration strategies in treating acute pancreatitis.
Perspective | The use of ChatGPT and other large language models in surgical science
28 Mar, 2023 | 15:01h | UTCThe use of ChatGPT and other large language models in surgical science – BJS Open
RCT | No reduction in parastomal hernia rate 3 years after stoma construction with prophylactic Mesh
27 Mar, 2023 | 13:07h | UTC
RCT | Topical lidocaine or lidocaine/diltiazem ointment following rubber band ligation of hemorrhoids
27 Mar, 2023 | 13:05h | UTCTopical Lidocaine or Lidocaine/Diltiazem Ointment Following Rubber Band Ligation of Hemorrhoids: A Prospective Three-Armed Randomized Controlled Trial – Diseases of the Colon & Rectum (link to abstract – $ for full-text)
Study reveals overuse of surveillance colonoscopy in older adults with limited life expectancy
23 Mar, 2023 | 13:11h | UTCSummary: This study investigated the association between estimated life expectancy, surveillance colonoscopy findings, and follow-up recommendations among older adults. The study utilized data from the New Hampshire Colonoscopy Registry and included adults over 65 who underwent colonoscopy for surveillance after prior polyps.
Life expectancy was estimated using a validated prediction model and categorized into three groups: less than 5 years, 5 to less than 10 years, and 10 or more years.
Out of the 9,831 adults included in the study, 8% had advanced polyps or CRC. Among the 5,281 patients with available recommendations, 86.9% were advised to return for a future colonoscopy. Surprisingly, 58.1% of older adults with less than 5 years of life expectancy were also recommended to return for future surveillance colonoscopy.
The study concluded that many older adults with limited life expectancy are still recommended for future surveillance colonoscopy. This data could help refine decision-making about pursuing or stopping surveillance colonoscopy in older adults with a history of polyps.
Article: Association of Life Expectancy With Surveillance Colonoscopy Findings and Follow-up Recommendations in Older Adults – JAMA Internal Medicine (link to abstract – $ for full-text)
JAMA Patient Page: What Should I Know About Stopping Routine Cancer Screening?
Commentary on Twitter
Findings suggest that recommending against future surveillance colonoscopy in older adults with low-risk colonoscopy findings and/or limited life expectancy should be considered more frequently than is currently practiced. https://t.co/7jKpYyuZON
— JAMA Internal Medicine (@JAMAInternalMed) March 13, 2023
Guidelines for Gastric Cancer | An evidence-based, multidisciplinary approach
22 Mar, 2023 | 13:33h | UTC
Guidelines for post polypectomy colonoscopic surveillance
22 Mar, 2023 | 13:31h | UTCRelated:
USPSTF Statement: Start colorectal cancer screening at 45 years for most patients.
ACG Clinical Guidelines: Start colorectal cancer screening at 45
RCT | Comparable 5-year relapse-free survival for laparoscopic vs. open distal gastrectomy in advanced gastric cancer
22 Mar, 2023 | 13:27h | UTCSummary: The JLSSG0901 randomized clinical trial aimed to compare the 5-year survival outcomes of laparoscopy-assisted distal gastrectomy (LADG) and open distal gastrectomy (ODG) with D2 lymph node dissection for locally advanced gastric cancer.
The study involved 507 patients from 37 institutes in Japan. The primary endpoint was 5-year relapse-free survival. The results showed that the 5-year relapse-free survival rates were 73.9% and 75.7% for the ODG and LADG groups, respectively, confirming the noninferiority of LADG, and no significant differences were observed in severe postoperative complications between the two groups.
The study concluded that LADG with D2 lymph node dissection, when performed by qualified surgeons, was proven noninferior to ODG, and could become a standard treatment for locally advanced gastric cancer.
Article: Five-Year Survival Outcomes of Laparoscopy-Assisted vs Open Distal Gastrectomy for Advanced Gastric Cancer: The JLSSG0901 Randomized Clinical Trial – JAMA Surgery (link to abstract – $ for full-text)
Related:
Commentary on Twitter
Study results provide robust evidence suggesting that laparoscopic gastrectomy for locally advanced gastric cancer may be an appropriate treatment approach when performed by skilled surgeons. https://t.co/Dvnzk5YI9u pic.twitter.com/GDCdT4DJhp
— JAMA Surgery (@JAMASurgery) March 15, 2023
M-A | Analgesic effect of erector spinae plane block in adults undergoing laparoscopic cholecystectomy
21 Mar, 2023 | 13:06h | UTC
RCT | Intermittent IV ibuprofen reduces morphine consumption and provides pain relief after surgery
20 Mar, 2023 | 13:39h | UTCSummary: The article describes a randomized, placebo-controlled, double-blind clinical trial to evaluate the efficacy and safety of different doses of intravenous ibuprofen (IVIB) in treating acute postoperative pain. The trial involved patients who underwent abdominal or orthopedic surgery and were randomized to placebo, IVIB 400 mg, or IVIB 800 mg. The first dose was given intravenously 30 minutes before surgery ended, followed by IV administration every 6 hours for a total of 8 doses.
The study found that IV administration of ibuprofen 400 mg or 800 mg significantly reduced morphine consumption and relieved pain without increasing the incidence of adverse events.
The study’s strengths were its multicenter, randomized, controlled, and prospective design. However, the extensive list of exclusion criteria suggests that the study was made in a relatively healthy population, making it difficult to extrapolate the safety results for more fragile patients.
Review | Choosing the best endoscopic approach for post-bariatric surgical leaks and fistulas
20 Mar, 2023 | 13:23h | UTC
ESGE Position Statement | Curriculum for bariatric endoscopy and endoscopic treatment of the complications of bariatric surgery
17 Mar, 2023 | 13:06h | UTC
Consensus Paper | Small intestinal bacterial overgrowth in gastrointestinal disorders
16 Mar, 2023 | 13:23h | UTC
Review | Evidence-based approach to diagnosis and management of abdominal tuberculosis
16 Mar, 2023 | 13:17h | UTCEvidence-based approach to diagnosis and management of abdominal tuberculosis – Indian Journal of Gastroenterology (if the link is paywalled, try this one)
Commentary from the author on Twitter
Our review on abdominal tuberculosis, where we summarise all the evidence on gastrointestinal tuberculosis and peritoneal tuberculosis, has been published in @ijg_journal
Great effort by @JhaDayakrishna and @menon_mythilihttps://t.co/spPXILGNw2 pic.twitter.com/SxnGs0n9DE— Vishal Sharma (@drvishal82) March 11, 2023
Review | Surveillance strategies following curative resection and non-operative approach of rectal cancer: how and how long?
15 Mar, 2023 | 14:59h | UTC
M-A | Laparoscopic vs. open distal gastrectomy for locally advanced gastric cancer
15 Mar, 2023 | 14:52h | UTCRelated:
Brief Review | Enhanced recovery after emergency laparotomy
13 Mar, 2023 | 14:37h | UTCEnhanced recovery after emergency laparotomy – British Journal of Surgery
Minimum platelet count threshold before invasive procedures in cirrhosis: evolution of the guidelines
13 Mar, 2023 | 14:36h | UTC
Cohort Study | A simple classification of pancreatic duct size and texture predicts the risk of postoperative pancreatic fistula
10 Mar, 2023 | 14:10h | UTCRelated:
M-A | Perioperative interventions to reduce pancreatic fistula following pancreatoduodenectomy.
Commentary on Twitter
NEW classification from @ISGPS_news for reporting of pancreatoduodenectomy trials:
A – not-soft (hard) texture and duct >3 mm ?
B – not-soft (hard) texture and duct ≤3 mm ?
C – soft texture and duct >3 mm ?
D – soft texture and duct ≤3 mm ?https://t.co/sZeL3MAva2— Pascal Probst (@ProbstPascal) May 1, 2021
RCT | Tranexamic acid did not significantly reduce blood loss in pancreaticoduodenectomy
10 Mar, 2023 | 14:05h | UTCTranexamic acid and blood loss in pancreaticoduodenectomy: TAC-PD randomized clinical trial – British Journal of Surgery (link to abstract – $ for full-text)
RCT | Transanal vs. laparoscopic total mesorectal excision for mid and low rectal cancer
10 Mar, 2023 | 14:03h | UTCTransanal versus laparoscopic total mesorectal excision for mid and low rectal cancer (Ta-LaTME study): multicentre, randomized, open-label trial – British Journal of Surgery (link to abstract – $ for full-text)