Ejso最新文献

{"title":"Minimally invasive and open distal pancreatectomy: Equally safe in terms of VTE risk","authors":"Jacob Kadamapuzha, Francesco Lancellotti, Agastya Patel, Ajith K. Siriwardena, Saurabh Jamdar","doi":"10.1016/j.ejso.2024.109465","DOIUrl":"10.1016/j.ejso.2024.109465","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 1","pages":"Article 109465"},"PeriodicalIF":3.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing surgical margins in oral cancer without frozen section: A single center retrospective study","authors":"Prachi M. Goyal ,&nbsp;Meghna Kumar ,&nbsp;Megha Kiran ,&nbsp;Swati Srivastava ,&nbsp;Soumya K. Roy ,&nbsp;Srinjeeta Garg ,&nbsp;Srishti Salunke ,&nbsp;Sangeeta Lader ,&nbsp;Khadeja Quadri ,&nbsp;Ayesha Ansari ,&nbsp;Zikki Hasan Fatima ,&nbsp;Burhanuddin Qayyumi ,&nbsp;Vidisha Tuljapulkar ,&nbsp;Pankaj Chaturvedi","doi":"10.1016/j.ejso.2024.109360","DOIUrl":"10.1016/j.ejso.2024.109360","url":null,"abstract":"<div><h3>Purpose</h3><div>Frozen section analysis has been a cornerstone in intraoperative pathological evaluation for oral cancer surgeries, aiding in achieving tumor-free margins. However, its utility and availability are subjects of ongoing debate and research. This study evaluates the efficacy of a guideline-based approach to surgical resection margins in the absence of frozen section analysis in a resource-constrained setting.</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective audit of 490 oral cavity cancer patients treated from December 2021 to December 2023 at our center, where frozen section analysis was not available. Surgical resections adhered to the guidelines of maintaining 1 cm mucosal soft tissue and base margins, and a 7 mm specimen-driven margin assessment intraoperatively. The outcomes measured were the rates of close (between 1 mm and 5 mm) and involved (less than or equal to 1 mm) margins in final histopathology reports (HPR).</div></div><div><h3>Results</h3><div>448 patients were included in our audit. On final HPR, a gross margin of 7 mm or more achieved intraoperatively translated into safe (more than 5 mm) margins in 410 patients (91.1 %). 25 (5.1 %) had at least one close margin, of which 11 were technical due to the desire to minimize functional morbidity. 15 (3.1 %) had involved margins, where R0 resection was not achieved due to anatomical constraints. An additional finding was the correlation of compromised margins with worst pattern of invasion (WPOI) 4&amp;5 on Chi-square analysis (p = 0.021) and depth of invasion (DOI) more than 5 mm (OR 3.81, p = 0.010).</div></div><div><h3>Conclusion</h3><div>This study indicates that a margin of 7 mm or more intraoperatively translates into safe margins on final HPR, and calls for a pragmatic and judicious use of FS in the interest of choosing wisely.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 1","pages":"Article 109360"},"PeriodicalIF":3.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of treatment intervals on prognosis in young breast cancer patients: Insights from the French National cohort","authors":"Enora Laas ,&nbsp;Elise Dumas ,&nbsp;Anne-Sophie Hamy ,&nbsp;Thomas Gaillard ,&nbsp;Paul Gougis ,&nbsp;Fabien Reyal ,&nbsp;François Husson ,&nbsp;Anne-Sophie Jannot","doi":"10.1016/j.ejso.2024.109373","DOIUrl":"10.1016/j.ejso.2024.109373","url":null,"abstract":"<div><h3>Background</h3><div>Suboptimal treatment delays is known to impact prognosis of patients with cancer but optimal timing in specific subgroups remains poorly studied. This study aimed to analyze treatment delays in young women treated for a breast cancer (BC) on and its impact on their prognosis using French Nationwide Data.</div></div><div><h3>Methods</h3><div>Using the CAREPAT-YBC Cohort based on the French National Healthcare System Database, we analyzed disease-free survival (DFS) in 22,093 young women (18–45 years) who underwent either surgery-chemotherapy-radiotherapy pathway (adjuvant setting, 15,433 patients) or chemotherapy-surgery-radiotherapy pathway (neoadjuvant setting, 6660 patients), according to delays between the different pathways.</div></div><div><h3>Results</h3><div>For the adjuvant chemotherapy-radiotherapy interval, the best timing was 17–31 days with increased risk above this delay. For the neoadjuvant setting, the optimal neoadjuvant chemotherapy-surgery interval was 17–31 days, while ≤15 days (HR 1.44, 95%CI 1.21–1.71) or ≥62 days (HR 2.07, 95%CI 1.36–3.15) showed poorer prognosis. Combining best timing into an \"optimal pathway\" was associated with respectively a 1.2-fold decreased risk for recurrence or mortality.</div></div><div><h3>Conclusion</h3><div>Optimizing treatment intervals enhance BC survival in younger age.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 1","pages":"Article 109373"},"PeriodicalIF":3.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional status of early oral feeding for gastric cancer patients after laparoscopic total gastrectomy: A retrospective cohort study.","authors":"Leyao Han, Yihan Zhou, Yingqiao Wang, Haixia Chen, Weiping Li, Meishan Zhang, Juanjuan Zhou, Liping Zhang, Xinman Dou, Xinglei Wang","doi":"10.1016/j.ejso.2024.109379","DOIUrl":"https://doi.org/10.1016/j.ejso.2024.109379","url":null,"abstract":"<p><strong>Background: </strong>After Laparoscopic total gastrectomy (LTG), gastric cancer (GC) patients often face malnutrition. Early oral feeding (EOF) has emerged as a key strategy in enhanced recovery after surgery (ERAS) protocols. However, the impact of EOF on post-LTG nutritional status requires further investigation. This study aimed to compare the nutritional status of EOF, nasogastric tube (NGT) and nasojejunal tube (NJT) to figure out the status of EOF.</p><p><strong>Methods: </strong>A retrospective comparative analysis of a single center (Second Hospital of Lanzhou University) of a total of 116 patients with LTG was performed. These included 40 NGT patients, 40 patients with NJT and 36 patients with EOF. Postoperative (7 days after surgery) nutritional status was examined as the primary endpoint, including weight, BMI, total protein, albumin, hemoglobin and total lymphocyte count (TLC). In addition, bowel sounds, abdominal distension and pain were evaluated as secondary endpoints.</p><p><strong>Results: </strong>The collective shows no significant differences between the three groups regarding various demographic and clinical information (All, p > 0.05). There was no significant difference in the patients' nutritional status and bowel sound recovery 7 days after surgery (All, p > 0.05). The rate of abdominal distension shows to be significantly reduced with EOF compared to NJT (mean difference = 0.342; p < 0.001). The incidence of abdominal pain was significantly different between EOF and NGT groups (mean difference = 0.228; p < 0.001).</p><p><strong>Conclusion: </strong>Among GC patients after LTG, EOF and traditional tube feeding had a similar risk of postoperative nutritional status. However, EOF was associated with a lower risk of abdominal distension.</p>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":" ","pages":"109379"},"PeriodicalIF":3.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a comprehensive predictive model for surgical planning in patients with renal cell carcinoma and inferior vena cava tumor thrombus","authors":"Xiaodong Hao ,&nbsp;Hao Peng ,&nbsp;Zheng Chao ,&nbsp;Yanan Wang ,&nbsp;Qiugong Xiao ,&nbsp;Chunyu Zhang ,&nbsp;Xiangdong Guo ,&nbsp;Zezhong Xiong ,&nbsp;Qiang Zhou ,&nbsp;Sheng Ma ,&nbsp;Junbiao Zhang ,&nbsp;Jing Wang ,&nbsp;Le Li ,&nbsp;Zhihua Wang","doi":"10.1016/j.ejso.2024.109381","DOIUrl":"10.1016/j.ejso.2024.109381","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate preoperative predictors for selecting different surgical approaches in patients with renal cell carcinoma with inferior vena cava (IVC) tumor thrombus (RCC-IVCTT), and to establish and validate corresponding predictive models.</div></div><div><h3>Methods</h3><div>Clinical data of 583 RCC-IVCTT patients were retrospectively analyzed. Of these, 465 cases were used to construct predictive models, and 118 cases were used for validation. Univariate and multivariate analyses identified independent predictors for surgical strategies. Two nomogram prediction models were established based on relevant independent factors to predict surgical approach.</div></div><div><h3>Results</h3><div>In the development cohort, 342 patients underwent IVC thrombectomy (IVCT), 91 underwent IVC cavectomy (IVCC), and 32 underwent IVC reconstruction (IVCR). Multivariate logistic regression analysis identified the following predictors for inability to perform IVCT: higher Mayo classification of tumor thrombus (TT), IVC wall invasion, presence of bland thrombus, pan-immune-inflammation value (PIV) &gt; 358 × 10⁹, and maximum anteroposterior (AP) diameter of IVC at renal vein ostium (RVo) &gt; 24 mm. Platelet &gt;170 × 10⁹/L and inadequate collateral circulation were predictors for IVCR. The developed model predicted capacity of the nomogram was evaluated in terms of its calibration, discrimination, and clinical utility. The validation set confirmed these findings.</div></div><div><h3>Conclusion</h3><div>The comprehensive preoperative predictive model for RCC-IVCTT patients aids in preoperative determination of the required surgical approach and necessity for IVC angiography, facilitating perioperative preparation and reducing unnecessary invasive examinations.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 1","pages":"Article 109381"},"PeriodicalIF":3.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of immediate lymphatic reconstruction after axillary lymph node dissection – A meta-analysis","authors":"Allen Wei-Jiat Wong ,&nbsp;Nadia Hui Shan Sim ,&nbsp;Stella Jinran Zhan ,&nbsp;Jung-Ju Huang","doi":"10.1016/j.ejso.2024.109377","DOIUrl":"10.1016/j.ejso.2024.109377","url":null,"abstract":"<div><div>Breast cancer related lymphedema (BCRL) is a common complication following mastectomy and axillary lymph node dissection (ALND). Patients with BCRL are often fraught with restricted mobility of the upper limb and higher risk of infections which negatively impact their quality of life. Immediate lymphatic reconstruction (ILR) has gained popularity in recent years due to its positive results in lowering BCRL rates. The objective of this study is to summarize evidence from the current available literature on the efficacy of ILR in preventing BCRL following ALND. A comprehensive search across PubMed and Web of Science was conducted. Studies involving ILR performed at the time of ALND for breast cancer were included. Exclusion criteria included secondary lymphatic reconstruction for established BCRL, literature reviews, animal studies, case reports and studies detailing surgical technique. To evaluate the efficacy of ILR, only studies with both intervention groups (ILR) and control groups were included. A systematic search yielded data from 10 studies and 1487 breast cancer patients who underwent ALND at the time of surgery. Meta-analysis revealed that in the ILR group, 50 of 637 (7.85 %) patients developed BCRL whereas in the control group, 177 of 850 patients (20.8 %) developed BCRL. Patients treated with ILR in this analysis had a relative risk of 0.31 (95 % CI, 0.19 to 0.51) for developing BCRL when compared to the controls (p &lt; 0.0001). ILR decreases the risk of developing lymphedema following ALND for breast cancer.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 1","pages":"Article 109377"},"PeriodicalIF":3.5,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic versus laparoscopic repeat hepatectomy: A comparative single-center study of perioperative outcomes","authors":"S. Vancoillie ,&nbsp;E. Willems ,&nbsp;C. De Meyere ,&nbsp;I. Parmentier ,&nbsp;C. Verslype ,&nbsp;Mathieu D'Hondt","doi":"10.1016/j.ejso.2024.109376","DOIUrl":"10.1016/j.ejso.2024.109376","url":null,"abstract":"<div><h3>Purpose</h3><div>A repeat liver resection is considered a technically challenging procedure and therefor an open approach is frequently preferred. With the introduction of minimally invasive liver surgery, laparoscopic repeat liver resection demonstrates favorable results, however, limited data on robotic repeat liver resections exists. Our aim is to compare the robotic approach with the laparoscopic one for a repeat liver resection.</div></div><div><h3>Methods</h3><div>In a single-center retrospective analysis, we report the data of all minimally invasive repeat liver resections performed between September 2011 and August 2023. Short-term outcomes – including procedure time, blood loss, conversion rate, morbidity and mortality – were compared for a laparoscopic and a robotic approach.</div></div><div><h3>Results</h3><div>A total of 136 minimally invasive repeat liver resections were performed, of which 56 robotic procedures and 80 laparoscopic procedures. Both groups were similar in baseline demographics, diagnosis and surgical procedure. While the mean procedure time was slightly longer in the robotics group by 15 min (145min and 130min, p = 0.04), the median blood loss was significantly lower in the robotic group (30 ml and 80 ml, p &lt; 0.001). Additionally, there was a trend towards less conversions in the robotic group (n = 0 and n = 6, p = 0.42). Post-operative morbidity and mortality were similar in both groups.</div></div><div><h3>Conclusion</h3><div>The robotic approach for minimally invasive repeat liver surgery is both safe and feasible, while also demonstrating favorable short-term outcomes. In our experience, the ‘tunnel technique’ – which avoids dissection of intra-abdominal adhesions – is a key advantage of this approach.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 1","pages":"Article 109376"},"PeriodicalIF":3.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to editor: Optimized machine learning model for predicting unplanned reoperation after rectal cancer anterior resection","authors":"Hajra Asad,&nbsp;Owais Ahmad,&nbsp;Enjizab Fatima","doi":"10.1016/j.ejso.2024.109371","DOIUrl":"10.1016/j.ejso.2024.109371","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 1","pages":"Article 109371"},"PeriodicalIF":3.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stair climbing outperforms gait speed in predicting postoperative outcomes in patients undergoing radical gastrectomy for gastric cancer: A prospective study","authors":"Chen-Hao He ,&nbsp;Zong-Ze Li ,&nbsp;Hao-Wen Ke ,&nbsp;Wen-Bo Zhai ,&nbsp;Xia-Lin Yan ,&nbsp;Wen-Tao Xi ,&nbsp;Gao-Feng Wu ,&nbsp;Yue-Yue Zheng ,&nbsp;Xian Shen ,&nbsp;Dong-Dong Huang","doi":"10.1016/j.ejso.2024.109378","DOIUrl":"10.1016/j.ejso.2024.109378","url":null,"abstract":"<div><h3>Background</h3><div>Stair climbing test (SCT) and gait speed test (GST) are two physical performance measures, both of which are associated with postoperative outcomes. However, few studies have compared these two tests for the prognostic value.</div></div><div><h3>Methods</h3><div>A prospective study was conducted in patients undergoing radical gastrectomy for gastric cancer. Handgrip strength (HGS) test, 7-steps SCT and 6-m GST were performed before surgery. Body compositions were analyzed using abdominal computed tomography (CT). Sarcopenia was diagnosed by low HGS plus either low muscle mass or quality.</div></div><div><h3>Results</h3><div>A total of 548 patients were included in this study. Time of GST and SCT were both significantly correlated with HGS, skeletal muscle index and skeletal muscle density, but not with subcutaneous or visceral fat area. Low SCT performance (SCT time ≥12.65s) was associated with higher incidence of postoperative complications and longer postoperative length of stay, whereas low GST performance (GST time ≥5.45s) did not. Low performance in SCT and GST were both associated with worse overall survival (OS) and disease-free survival (DFS) after surgery. Low SCT performance was an independent predictor for postoperative complications, OS, and DFS, whereas low GST performance was not significant in multivariate analyses adjusting for the same covariates. The combination of sarcopenia with low SCT performance showed higher accuracy in predicting postoperative complications and mortality compared with sarcopenia combined with low GST performance.</div></div><div><h3>Conclusion</h3><div>SCT outperformed GST in predicting outcomes after radical gastrectomy for gastric cancer, either as a singular indicator or in combination with sarcopenia assessments.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 1","pages":"Article 109378"},"PeriodicalIF":3.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognosis predictors of hepatocellular carcinoma after hepatectomy following conversion therapy","authors":"Shaoru Liu ,&nbsp;Zongfeng Wu ,&nbsp;Chenwei Wang ,&nbsp;Liang Qiao ,&nbsp;Zhenkun Huang ,&nbsp;Yichuan Yuan ,&nbsp;Ruhai Zou ,&nbsp;Wei He ,&nbsp;Binkui Li ,&nbsp;Yunfei Yuan ,&nbsp;Jiliang Qiu","doi":"10.1016/j.ejso.2024.109375","DOIUrl":"10.1016/j.ejso.2024.109375","url":null,"abstract":"<div><h3>Background</h3><div>Hepatectomy is the optimal treatment for less than 20 % patients with hepatocellular carcinoma (HCC). A combination of hepatic artery infusion chemotherapy and systemic therapy-based conversion therapy provides a chance of resection for those with unresectable HCC. Yet, the prognosis for those successfully conversion resection is still unknown. The study is to determine the factors predicted prognosis of patients after conversion hepatic resection.</div></div><div><h3>Methods</h3><div>A total of 343 HCC patients underwent hepatectomy following conversion therapy from August 2018 to April 2023. Univariate and multivariate analysis were used to screen for independent factors affecting patients’ prognosis.</div></div><div><h3>Results</h3><div>One hundred and fifty-seven (45.8 %) patients developed recurrence or metastasis at a median time of 16.7 months (95 % CI 12.4–21.0 months) from hepatectomy. Univariate and multivariate analysis identified tumor number, alpha fetoprotein (AFP) response, tumor response, and successful downstaging were independent recurrent-free survival related predictors. Albumin bilirubin (ALBI) score and AFP response were independent death related predictors.</div></div><div><h3>Conclusions</h3><div>Clinical parameters reflecting the depth of conversion therapy response, were promising in predicting prognosis for HCC patients after conversion hepatic resection.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 1","pages":"Article 109375"},"PeriodicalIF":3.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}