Annals of surgery
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To evaluate the efficacy and safety of combined vascular resection (VR) in advanced perihilar cholangiocarcinoma (PHC). ⋯ VR salvages a large number of patients from having locally advanced PHC that is otherwise unresectable and is recommended if the hilar hepatic inflow vessels are reconstructable, providing acceptable surgical outcomes and substantial survival benefits.
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Investigate the association between neoadjuvant treatment strategy and perioperative complications in patients undergoing proctectomy for nonmetastatic rectal cancer. ⋯ In rectal cancer patients treated with SC-TNT and proctectomy, we found no significant association with POM compared to patients undergoing CRT. SC-TNT does not significantly increase the risk of POM compared to CRT.
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To determine whether genomic risk groups identified by somatic mutation testing of colorectal liver metastasis (CRLM) can be used for "molecularly-guided" selection for adjuvant systemic chemotherapy and hepatic artery infusion of FUDR (SYS+HAI-FUDR). ⋯ Genomic alterations in RAS/RAF, SMAD4, and EGFR may be useful to guide treatment selection in resectable CRLM patients and warrant external validation and integration in future clinical trial design.
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Surgical complications have substantial impact on healthcare costs. We propose an analysis of the financial impact of postoperative complications. ⋯ Decreasing complication rates through preoperative optimization will improve patient outcomes and lead to substantial cost savings.
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This Surgical Perspective presents the case for leveraging the surgical episode to impact population health. We describe a novel screening and referral pilot and propose several policy changes aimed at delivering population-health focused surgical care.