Annals of surgery
-
The efficacy of enhanced recovery after surgery (ERAS) to improve the prognosis of patients who undergo laparoscopic distal gastrectomy (LDG) for gastric cancer is uncertain. This randomized study compared oncological outcomes in LDG after ERAS or conventional care. ⋯ Patients undergoing ERAS LDG had fewer overall complications, shorter hospital stay, decreased medical expenses, and improved 3-year OS and DFS rates, particularly in cases with stage III gastric cancer.
-
The present study aimed to assess the efficacy of this approach and establish the criteria that identify LAPC patients who may achieve survival benefits from RRCIA. ⋯ This study suggests that RRCIA appears to be effective and associated with improved outcomes for LAPC patients with favorable response to systemic treatment. LAPC patients Should have at least 8 cycles of systemic treatment and CA19-9 normalization to be considered for RRCIA.
-
To characterize the association between type of fellowship training and patient outcomes following hepatopancreatic (HP) surgery across different surgeon career stages using a national representative cohort of Medicare beneficiaries. ⋯ Achievement of TO following an HP procedure was higher among surgeons who had completed a dedicated HPB fellowship, especially during early and middle career stages. Further efforts should be made to enhance HP surgery exposure and training for CGSO fellows interested in a career in HPB surgery.
-
To identify the risk factors, manifestations, and clinical implications of chyle leak (CL) after pancreatic surgery, and to reappraise the International Study Group for Pancreatic Surgery (ISGPS) definition and classification of CL. ⋯ Minimally invasive approach and daily maximum drainage volume were independent risk factors for CL in this cohort. Post-pancreatectomy patients with large-volume, TG-rich but non-milky drainage should be treated like clinically relevant CL.