Showing papers in "Surgery in 2017"

TL;DR: This new definition and grading system of postoperative pancreatic Fistula should lead to a more universally consistent evaluation of operative outcomes after pancreatic operation and will allow for a better comparison of techniques used to mitigate the rate and clinical impact of a pancreatic fistula.

TL;DR: This classification and grading system for chyle leak after pancreatic resection allows for comparison of outcomes between series and should facilitate communication and evaluation of different approaches to the prevention and treatment of this complication.

TL;DR: An international panel of pancreatic surgeons working in well‐known, high‐volume centers reviewed the best contemporary literature concerning pancreatico‐enteric anastomosis and worked to develop a position statement on pancreatic anstomosis after pancreatoduodenectomy, finding no specific technique can eliminate development of clinically relevant postoperative pancreatic fistula.

TL;DR: It is demonstrated that the extent of operation is increasing for patients with medullary thyroid cancer and disease‐specific survival is also improving, primarily in patients with regional and distant disease.

TL;DR: The increase of postoperative overall complications and wound infections urges for precise indications for preoperative biliary drainage and against routine preoperatively biliary decompression.

TL;DR: The findings suggest that a solid training program based on the learning curve should be considered for beginners of robotic hepatectomy, and the learning effects were underlined by shorter operation time and hospital stay after phase 1 and less blood loss after phase 2.

TL;DR: Liver transplantation may provide a survival benefit among patients with diffuse neuroendocrine tumors metastases to the liver, however, due to high recurrence rates, strict selection of patients is critical.

TL;DR: Prophylactic mesh placement is associated with an 85% postoperative incisional hernia risk reduction when compared to primary suture closure in at‐risk patients undergoing elective, midline laparotomy closure.

TL;DR: A successful C difficile prevention and eradication program requires a multidisciplinary approach that includes early disease recognition, implementation of guidelines for monitoring adherence to environmental control, judicious hand hygiene, evidence-based treatment and management strategies, and a focused antibiotic stewardship program.

TL;DR: Gaps in access to emergency general surgery services exist across the United States, disproportionately affecting underserved, rural communities and policy initiatives need to be increased.

TL;DR: In ALPPS, volumetry overestimates liver function as measured by hepatobiliary scintigraphy and may be responsible for the high rate of liver failure.

TL;DR: A large, prospective study of patients who underwent radical gastrectomy for gastric cancer from August 2014 to December 2015 found that patients had worse postoperative outcomes after Gastric cancer operation with advancing sarcopenia stages.

TL;DR: It is suggested that anastomotic leak can serve as a valid metric that can identify opportunities for quality improvement in colorectal operations and risk factors including male sex, obesity, tobacco use, immunosuppression, thrombocytosis, greater operative duration, and urgent/emergency operation predict most of the variation in anastOMotic leak rates.

TL;DR: Indocyanine green fluorescence angiography is a promising operative adjunct in determining residual parathyroid glands function and predicting postoperative hypocalcemia risk after total thyroidectomy.

TL;DR: Percutaneous transhepatic biliary drainage increases the incidence of seeding metastasis and shortens the postoperative survival in patients with perihilar cholangiocarcinoma.

TL;DR: Lateral lymph node dissection outcomes observed at the 2 high‐volume centers in Japan demonstrate high reproducibility with good results in terms of prognosis and local control.

TL;DR: Symptomatic anastomotic leakage impairs function and quality of life after laparoscopic, sphincter‐saving operative intervention for rectal cancer and the Low Anterior Resection Syndrome score and the disease‐specific questionnaire.

TL;DR: This study shows that pharmacologically induced hypoxic signaling accelerates liver regeneration similar to portal vein ligation and parenchymal transection and prolyl‐hydroxylase inhibitors may be used to enhance liver regeneration pharmaceutically.

TL;DR: Although no significant association was observed between the presence of occult lymph node metastasis and regional recurrence, lymph node ratio ≥ 0.26 was an independent predictor of regional lymph node recurrence in papillary thyroid cancer patients who underwent total thyroidectomy and bilateral prophylactic central neck dissection.

TL;DR: The development of postoperative infectious complications is a major determinant of outcome after pancreaticoduodenectomy and the reliable negative predictors of the outcome include preoperative biliary drain, site of infection, multidrug‐resistant bacteria infections and type of bacteria.

TL;DR: Because recurrence in the contralateral remnant lobe can be managed safely by completion thyroidectomy, lobectomy may be a safe operative option for select patients with papillary thyroid microcarcinoma without multifocality.

TL;DR: Strategies to encourage weight loss may need to be considered seriously prior to open ventral hernia repair, especially for patients with body mass index >40 kg/m2, which is a risk factor for operative, medical, and respiratory complications after open ventralsnia repair.

TL;DR: The incidence of port‐site metastasis in incidental gallbladder cancer has decreased but remains high relative to other primary tumors.

TL;DR: Psoas muscle density is a significant predictor of poor outcomes after traumatic injury and can identify patients requiring aggressive nutritional and physical therapy to improve prognosis, prevent recurrent traumatic injury, and aid in discharge planning.

TL;DR: This study validated an intraoperative bleeding severity scale that was usable, clear, and clinically relevant with excellent reliability and fulfills requirements of the Food and Drug Administration for a clinician‐reported scale and can be used to generate clinically meaningful labeling claims.

TL;DR: Neoadjuvant peptide receptor radionuclide therapy for resectable or potentially resectability pancreatic neuroendocrine neoplasms in patients with high‐risk features of recurrence seems to be beneficial, but well‐designed and much larger prospective trials are needed to confirm the safety and the oncologic value of this approach.

TL;DR: In selected patients undergoing liver resection for hepatocellular carcinoma, transient elastography is an easy and effective test to predict persistent hepatic decompensation preoperatively.

TL;DR: SDHB status and primary tumor size are more predictive of patient outcome than Ki67% or mitotic index and should be part of any clinically relevant, prognostic scoring system.

TL;DR: In the population of primarily cancer patients at MD Anderson Cancer Center bridged repair for abdominal wall reconstruction is associated with worse outcomes than mesh‐reinforced abdominal wall Reconstruction, particularly when employing acellular dermal matrix.