Gastrointestinal Surgery (all articles) | Page 6 of 67 | Links Medicus Content Curation & Alerts in Medicine

Infection with Helicobacter pylori is known to confer a risk of gastric cancer. In this study, persons who carried certain genetic variants and were infected with H. pylori had an excess risk of gastric cancer. https://t.co/jIcUiYu14G #genetics pic.twitter.com/jY4H1Mq6dO

— NEJM (@NEJM) March 29, 2023

RCT | Vedolizumab for the treatment of chronic pouchitis

3 Apr, 2023 | 13:49h | UTC

Vedolizumab for the Treatment of Chronic Pouchitis – New England Journal of Medicine (link to abstract – $ for full-text)

News Release: New hope for patients after vedolizumab found effective to treat Chronic Pouchitis – University of Oxford

Commentary on Twitter

In a phase 4, double-blind, randomized trial, vedolizumab therapy was more effective than placebo in inducing remission in patients with chronic pouchitis after ileal pouch–anal anastomosis for ulcerative colitis. Full results of EARNEST trial: https://t.co/5OnC72j2Ik pic.twitter.com/RcH1uAB1AI

— NEJM (@NEJM) March 29, 2023

Overcoming size disparity in liver transplant access: prioritizing smaller donors for smaller candidates

3 Apr, 2023 | 13:41h | UTC

Association of Body Surface Area With Access to Deceased Donor Liver Transplant and Novel Allocation Policies – JAMA Surgery (free for a limited period)

Invited Commentary: Addressing Size-Based Disparities in Liver Transplant – JAMA Surgery (free for a limited period)

Commentary on Twitter

In this study, liver waitlist candidates with the smallest body surface areas had a disadvantage due to size. Prioritizing allocation of smaller liver donors to smaller candidates may help overcome this disparity. https://t.co/p5F76Hgzm0

— JAMA Surgery (@JAMASurgery) March 30, 2023

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 | UTC

Long-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)

Guidelines for the surveillance and survivorship care of patients after curative treatment of colon and rectal cancer.

Study: Assessment of a Watch-and-Wait Strategy for Rectal Cancer in Patients With a Complete Response After Neoadjuvant Therapy

Study suggests the intensity of active surveillance in patients with rectal cancer managed by a watch-and-wait approach could be reduced if they maintain a complete clinical response within the first 3 years

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 | UTC

Update on the management of acute pancreatitis – Current Opinion in Critical Care

Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis – New England Journal of Medicine

Acute Pancreatitis: Diagnosis and Treatment – Drugs

Revised Clinical Practice Guidelines of the Korean Pancreatobiliary Association for Acute Pancreatitis – Gut and Liver

Guidelines for the management of patients with severe acute pancreatitis, 2021 – Anaesthesia Critical Care & Pain Medicine

Evidence-Based Disposition of Acute Pancreatitis – emDocs

2019 WSES guidelines for the management of severe acute pancreatitis – World Journal of Emergency Surgery

American Gastroenterological Association Institute Guideline on Initial Management of Acute Pancreatitis

Pancreatitis – National Institute for Health and Care Excellence

The optimal timing and intervention to reduce mortality for necrotizing pancreatitis: a systematic review and network meta-analysis – World Journal of Emergency Surgery

Long-term follow-up of a RCT | Endoscopic versus surgical step-up approach for infected necrotizing pancreatitis.

RCT: Immediate drainage did not improve outcomes compared to postponed intervention in patients with infected necrotizing pancreatitis.

An Endoscopic Transluminal Approach, Compared With Minimally Invasive Surgery, Reduces Complications and Costs for Patients With Necrotizing Pancreatitis – Gastroenterology

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 | UTC

Efficacy 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 | UTC

Acute mesenteric ischaemia – British Journal of Surgery

M-A | Aggressive IV hydration may increase mortality risk in severe acute pancreatitis

29 Mar, 2023 | 13:26h | UTC

Summary: 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.

Article: Comparison of clinical outcomes between aggressive and non-aggressive intravenous hydration for acute pancreatitis: a systematic review and meta-analysis – Critical Care

Perspective | The use of ChatGPT and other large language models in surgical science

28 Mar, 2023 | 15:01h | UTC

The 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

No Reduction in Parastomal Hernia Rate 3 Years After Stoma Construction With Prophylactic Mesh: Three-year Follow-up Results From STOMAMESH—A Multicenter Double-blind Randomized Controlled Trial – Annals of Surgery

RCT | Topical lidocaine or lidocaine/diltiazem ointment following rubber band ligation of hemorrhoids

27 Mar, 2023 | 13:05h | UTC

Topical 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 | UTC

Summary: 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

Korean Practice Guidelines for Gastric Cancer 2022: An Evidence-based, Multidisciplinary Approach – Journal of Gastric Cancer

Guidelines for post polypectomy colonoscopic surveillance

22 Mar, 2023 | 13:31h | UTC

Korean Guidelines for Postpolypectomy Colonoscopic Surveillance: 2022 revised edition – Intestinal Research

British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England post-polypectomy and post-colorectal cancer resection surveillance guidelines – Gut

Consensus Statement: U.S. Multi-Society Task Force on Colorectal Cancer now suggests average-risk CRC screening begins at age 45.

USPSTF Statement: Start colorectal cancer screening at 45 years for most patients.

ACG Clinical Guidelines: Start colorectal cancer screening at 45

Evidence-based clinical practice guidelines for management of colorectal polyps – Journal of Gastroenterology

Meta-analysis: Risk of colorectal cancer and cancer related mortality after detection of low-risk or high-risk adenomas, compared with no adenoma, at index colonoscopy

Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer – Gastroenterology

Endoscopic surveillance after surgical or endoscopic resection for colorectal cancer: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Digestive Oncology (ESDO) Guideline – Endoscopy

RCT | Comparable 5-year relapse-free survival for laparoscopic vs. open distal gastrectomy in advanced gastric cancer

22 Mar, 2023 | 13:27h | UTC

Summary: 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)

Laparoscopic vs Open Distal Gastrectomy for Locally Advanced Gastric Cancer: 5-Year Outcomes of the KLASS-02 Randomized Clinical Trial – JAMA Surgery

Short-and long-term outcomes of laparoscopic versus open gastrectomy in patients with gastric cancer: a systematic review and meta-analysis of randomized controlled trials – World Journal of Surgical Oncology

Laparoscopic versus open distal gastrectomy for gastric cancer: A systematic review and meta-analysis – Surgery

Laparoscopic vs Open Distal Gastrectomy for Locally Advanced Gastric Cancer: Five-Year Outcomes From the CLASS-01 Randomized Clinical Trial – JAMA Surgery

Laparoscopic Versus Open Gastrectomy for Gastric Cancer (LOGICA): A Multicenter Randomized Clinical Trial – Journal of Clinical Oncology

Morbidity and Mortality of Laparoscopic vs Open Total Gastrectomy for Clinical Stage I Gastric Cancer: The CLASS02 Multicenter Randomized Clinical Trial – JAMA Oncology

Survival outcomes after laparoscopy-assisted distal gastrectomy versus open distal gastrectomy with nodal dissection for clinical stage IA or IB gastric cancer (JCOG0912): a multicentre, non-inferiority, phase 3 randomised controlled trial – The Lancet Gastroenterology & Hepatology

Effect of Laparoscopic Distal Gastrectomy vs Open Distal Gastrectomy on Long-term Survival Among Patients With Stage I Gastric Cancer: The KLASS-01 Randomized Clinical Trial – JAMA Oncology

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

Analgesic effect of erector spinae plane block in adults undergoing laparoscopic cholecystectomy: a systematic review and meta-analysis of randomized controlled trials – BMC Anesthesiology

RCT | Intermittent IV ibuprofen reduces morphine consumption and provides pain relief after surgery

20 Mar, 2023 | 13:39h | UTC

Summary: 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.

Article: Analgesic Efficacy of Intravenous Ibuprofen in the Treatment of Postoperative Acute Pain: A Phase III Multicenter Randomized Placebo-Controlled, Double-Blind Clinical Trial – Pain Research and Management