Hyperthermic intrathoracic chemotherapy modulates the immune microenvironment of pleural mesothelioma and improves the impact of dual immune checkpoint inhibition.

Pleural mesothelioma (PM) is a fatal disease with limited treatment options. Recently, PM management has improved with the development of immune checkpoint inhibitors (ICIs). In first-line therapy, dual PD-1 and CTLA-4 blockade enhances tumor control and patient survival compared with chemotherapy.

Early Bleeding After Laparoscopic Roux-en-Y Gastric Bypass: Incidence, Risk Factors, and Management - a 21-Year Experience.

Purpose: Morbidity and mortality associated with bariatric surgery are considered low. The aim of this study is to assess the incidence, clinical presentation, risk factors, and management of early postoperative bleeding (POB) after laparoscopic Roux-en-Y gastric by-pass (RYGB).

Materials And Methods: Retrospective analysis of prospectively collected data of consecutive patients who underwent RYGB in 2 expert bariatric centers between January 1999 and April 2020, with a common bariatric surgeon.

[Obstructed colon cancer: which strategy in 2022?].

The key priority for obstructed colon cancer (OCC) is urgent resolution of the large bowel obstruction with ideally no compromise of oncological outcomes and low initial and permanent ostomy rates. Proactive management is pivotal to decrease the risk of perforation and septic shock. Staged procedures have an important place to provide optimal treatment and offer similar treatment and outcomes as in the elective setting.

Impact of an Operating Room Nurse Preoperative Dialogue on Anxiety, Satisfaction and Early Postoperative Outcomes in Patients Undergoing Major Visceral Surgery-A Single Center, Open-Label, Randomized Controlled Trial.

Background: Anxiety is common before surgery and known to negatively impact recovery from surgery. The aim of this study was to evaluate the impact of a preoperative nurse dialogue on a patient’s anxiety, satisfaction and early postoperative outcomes. Method: This 1:1 randomized controlled trial compared patients undergoing major visceral surgery after a semistructured preoperative nurse dialogue (interventional group: IG) to a control group (CG) without nursing intervention prior to surgery.

[Surgery Sustainability in surgical practice : the "green surgery" concept and its innovations].

Awareness of climate change grows in the population and people develop eco-responsible habits in their daily and professional life. The health care system is nowadays responsible for 4.6% of global greenhouse gases emissions, and most of them comes from hospital activity.

Consensus statement on safety measures for pressurized intraperitoneal aerosol chemotherapy.

Objectives: Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a promising treatment for peritoneal cancer that entails, however, potential risks for the caregivers in the operating room (OR). This study aimed to reach a consensus within the PIPAC community on a comprehensive safety protocol.

Methods: Active PIPAC centers were invited to participate in a two-round Delphi process on 43 predefined items: concise summaries of the existing evidence were presented together with questions formulated using the population, intervention, comparator, and outcome framework.

Challenges Related to Surgical Site Infection Prevention-Results after Standardized Bundle Implementation.

Aim: The aim of this study was to assess the implementation of an intraoperative standardized surgical site infection (SSI) prevention bundle.

Methods: The multimodal, evidence-based care bundle included nine intraoperative items (antibiotic type, timing, and re-dosing; disinfection; induction temperature control > 36.5°; glove change; intra-cavity lavage; wound protection; and closure strategy).

Interobserver reliability of the Tile classification system for pelvic fractures among radiologists and surgeons.

Objectives: To assess the interobserver reliability (IOR) of the Tile classification system, and its potential influence on outcomes, for the interpretation of CT images of pelvic fractures by radiologists and surgeons.

Methods: Retrospective data (1/2008-12/2016) from 238 patients with pelvic fractures were analyzed. Mean patient age was 44 years (SD 20); 66% were male.

Comparison of Partial Hepatectomy and Transarterial Chemoembolization in Intermediate-Stage Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.

Introduction: According to the Barcelona Clinic Liver Cancer (BCLC) algorithm, transarterial chemoembolization (TACE) is recommended in patients with hepatocellular carcinoma (HCC) of intermediate stage (BCLC-B), whereas partial hepatectomy (PH) is restricted to early stage A. Expanding the indication for PH to intermediate stage remains debated.

Objective: This meta-analysis aimed to analyze short- and long-term outcomes of PH compared to TACE in patients with intermediate-stage HCC.

[Update in surgical oncology].

The main novelties in 2019 are about colorectal surgery and oncologic surgery. Acute diverticulitis and mechanical bowel obstruction are frequently diagnosed in primary care medicine. In 2019, EAES (European Association for Endoscopic Surgery) and SAGES (Society of American Gastrointestinal and Endoscopic Surgeons) published their recommendations for the management of diverticulitis.

[Functional disorders in digestive surgery : an update].

Surgical management of oncologic situations in visceral surgery is increasing. Overall survival and related quality of life are improved, due to enhanced perioperative care, improvement in strategies like surgical technique and oncological therapy. Functional disorders, whether or not related to oncologic disease, are not to be forgotten.

[Screening for anal cancer : is it the same as for cervical cancer ?].

Anal dysplasia is usually caused by HPV infection and can lead to squamous anal cancer. The purpose of this article is to describe the classification of these precursor lesions but above all to identify the groups of patients at risk and to clarify the screening and follow-up that must be initiated.

[Update in Surgical Oncology].

In 2017, data from large multicentre randomized controlled trials assessed the safety of minimally invasive techniques for liver or esophagus resection with similar oncologic outcome compared to open approach. Patients also benefit from progress in medical oncology in particular with the development of new targeted therapies, offering surgery to patients with initially non-resectable disease. The increase in complete tumor response after neoadjuvant treatment allows more conservative approaches, like organ preserving surgery for rectal cancer.

[Current surgical treatment for hepatocellular carcinoma : critical appraisal of current guidelines].

Hepatocellular carcinoma (HCC) management has evolved in the last decades. Current available treatments include interventional radiology like radiofrequency ablation, transarterial chemoembolization or Yttrium 90 radioembolization. Surgery, when possible, has been proven to be the most effective treatment in reducing the risk of long-term local recurrence.

Lower gastrointestinal bleeding-Computed Tomographic Angiography, Colonoscopy or both?

Background: Lower endoscopy (LE) is the standard diagnostic modality for lower gastrointestinal bleeding (LGIB). Conversely, computed tomographic angiography (CTA) offers an immediate non-invasive diagnosis visualizing the entire gastrointestinal tract. The aim of this study was to compare these 2 modalities with regards to diagnostic value and bleeding control.

Prospective Evaluation of Discharge Trends after Colorectal Surgery within an Enhanced Recovery after Surgery Pathway.

Introduction: Enhanced recovery after surgery (ERAS) pathways proved to reduce complications, length of hospital stay and costs after colorectal surgery. Standardized discharge criteria have been established that are fulfilled after complete medical recovery is achieved. This study aimed to assess the timing of complete medical recovery in relation to the timing of actual discharge, and to assess reasons for prolonged hospital stay within an ERAS pathway.

Sagittal abdominal diameter is a better predictor than body mass index for duration of laparoscopic left colectomy.

Background: Visceral obesity (VO) increases technical difficulty in laparoscopic surgery. The body mass index (BMI) does not always correlate to intra-abdominal fat distribution. Our hypothesis was that simple anthropometric measures that reflect VO, could predict technical difficulty in laparoscopic colorectal surgery, as reflected by the operative time, more accurately than the BMI.

Pursestring closure of the stoma site leads to fewer wound infections: results from a multicenter randomized controlled trial.

Background: Surgical site infection after stoma reversal is common. The optimal skin closure technique after stoma reversal has been widely debated in the literature.

Objective: We hypothesized that pursestring near-complete closure of the stoma site would lead to fewer surgical site infections compared with conventional primary closure.

[Clostridial colitis: diagnosis and strategies for management].

C. difficile is transmitted in a faecal-oral mode and is widespread in hospital environment. Symptoms of Clostridial infection range from asymptomatic carriage to life-threatening toxic colitis.

[Update in thyroid and parathyroid surgery: the role for minimally invasive surgery].

Thyroid and parathyroid surgery takes an important place in general surgery. Preservation of essential cervical structures and cosmetic of outcomes of cervical incisions are major concern. Several minimally invasive strategies have been developed recently but their acceptance in the surgical community is low.