Similar Rates of Symptomatic Marginal Ulcers After One-Anastomosis-Gastric Bypass Compared to Roux-en-Y Gastric Bypass.

Purpose: One-anastomosis-gastric-bypass (OAGB) has become a common bariatric procedure worldwide. Marginal ulcers (MU) are a significant non-immediate complication of gastric bypass surgeries. There seems to be concern among surgeons that MU are more common after OAGB compared with Roux-en-Y gastric bypass (RYGB) due to the constant and extensive exposure of the anastomosis to bile.

Incidence and Risk Factors for Low Anterior Resection Syndrome following Trans-Anal Total Mesorectal Excision.

Background: Trans-anal total mesorectal excision (Ta-TME) is a novel approach for the resection of rectal cancer. Low anterior resection syndrome (LARS) is a frequent functional disorder that might follow restorative proctectomy. Data regarding bowel function after Ta-TME are scarce.

Higher Rates of Complicated Appendicitis During the COVID-19 Pandemic: A Year-to-Year Analysis.

Introduction: The COVID-19 pandemic impacted presentation, management strategies, and patient outcomes of numerous medical conditions. The aim of this study is to perform a year-to-year comparison of clinical outcomes of patients with acute appendicitis (AA) before and during the pandemic.

Methods: Patients treated for AA during the initial 12-mo period of the pandemic at our institute were compared to those treated for AA during the 12-mo period before.

A patient tailored approach to the surgical treatment of hemorrhoids leads to equal satisfaction following hemorrhoidectomy, stapled hemorrhoidopexy or a combination of both.

Purpose: Up to 20% of patients suffering from symptomatic hemorrhoids will require surgery. Excisional hemorrhoidectomy (EH) and stapled hemorrhoidopexy (SH) are both standard and safe procedures. While SH has a short-term advantage of faster recovery and lower postoperative pain, its long-term efficacy is debatable.

The biophysical property of the limbal niche maintains stemness through YAP.

The cell fate decisions of stem cells (SCs) largely depend on signals from their microenvironment (niche). However, very little is known about how biochemical niche cues control cell behavior in vivo. To address this question, we focused on the corneal epithelial SC model in which the SC niche, known as the limbus, is spatially segregated from the differentiation compartment.

A Comparison of Outcomes in Medullary Thyroid Carcinoma Patients With and Without a Preoperative Diagnosis: A Multicenter Retrospective Cohort Study.

Cytological limitations pose a challenge to preoperative diagnosis of medullary thyroid carcinoma (MTC) and therefore, a significant subset of patients is only diagnosed postoperatively. The objective of this study was to investigate the impact of knowledge of a preoperative MTC diagnosis on disease management and outcomes. Multicenter, retrospective, cohort study of MTC patients treated in Israel from January 2000 to June 2021.

A DNA methylation atlas of normal human cell types.

DNA methylation is a fundamental epigenetic mark that governs gene expression and chromatin organization, thus providing a window into cellular identity and developmental processes. Current datasets typically include only a fraction of methylation sites and are often based either on cell lines that underwent massive changes in culture or on tissues containing unspecified mixtures of cells. Here we describe a human methylome atlas, based on deep whole-genome bisulfite sequencing, allowing fragment-level analysis across thousands of unique markers for 39 cell types sorted from 205 healthy tissue samples.

Existing Scores Fail to Predict Bowel Ischemia in Patients With Adhesive Small Bowel Obstruction.

Introduction: Early recognition of bowel ischemia is critical in patients suffering from acute adhesive small bowel obstruction (ASBO). Recent studies attempted to propose a score combining clinical and radiological factors to predict the risk of bowel ischemia in patients with ASBO. This study aimed to compare and validate the existing clinical scores with a cohort of surgical patients.

Use of fluorescence imaging and indocyanine green during colorectal surgery: Results of an intercontinental Delphi survey.

Background: Fluorescence imaging with indocyanine green is increasingly being used in colorectal surgery to assess anastomotic perfusion, and to detect sentinel lymph nodes.

Methods: In this 2-round, online, Delphi survey, 35 international experts were asked to vote on 69 statements pertaining to patient preparation and contraindications to fluorescence imaging during colorectal surgery, indications, technical aspects, potential advantages/disadvantages, and effectiveness versus limitations, and training and research. Methodological steps were adopted during survey design to minimize risk of bias.

Long-term Outcomes of Endoscopic Thoracoscopic Sympathectomy for Primary Focal Palmar Hyperhidrosis: High Patient Satisfaction Rates Despite Significant Compensatory Hyperhidrosis.

Background: Endoscopic thoracoscopic sympathectomy (ETS) is the gold standard therapy for primary focal palmar hyperhidrosis (PFPH), resulting in high patient satisfaction rates. The most common side effect of ETS is compensatory hyperhidrosis (CH). Previous studies followed patients' satisfaction degree of surgery and the incidence of CH during a limited follow-up period of 1 to 3 years.

Minimally Invasive Parathyroidectomy: Can Intraoperative Parathyroid Hormone Monitoring be Omitted?

Background: Intraoperative PTH (ioPTH) monitoring has become widely accepted in the era of minimally invasive parathyroidectomy (MIP). The purpose of this study was to evaluate the need for ioPTH during parathyroidectomy in patients with positive preoperative imaging.

Methods: The charts of patients who underwent parathyroidectomy at three tertiary centers between the years 2012 and 2021 were retrospectively reviewed.

Composite Criteria for Non-Operative Management of Acute Non-Complicated Appendicitis Result in Low Failure Rates.

Background: The aim of this study is to investigate the outcomes of conservative management of non-complicated acute appendicitis (AA) using our unique institutional protocol, and to compare between these and the outcomes of operative management.

Methods: Patients admitted to our institution between March 2016 and October 2019 with non-complicated AA were grouped according to their initial management: non-operative versus surgical. Our unique protocol for non-operative management includes: pain < 3 days; afebrile upon admission; non-gravid; WBC <15,000 (× 10/L); CRP < 5 mg/dl; appendix diameter < 1 cm; no appendicolith on imaging; no prior episode of AA; no history of Inflammatory Bowel Disease; no evidence of peritonitis on physical examination.

Ultrasonographic features can predict outcome of conservative management of acute appendicitis in children.

Purpose: To determine whether specific ultrasonographic features can predict failure of conservative treatment of acute appendicitis.

Methods: A 2-year retrospective study was conducted on children admitted with acute appendicitis. Those with uncomplicated appendicitis diagnosed solely by ultrasound, and treated conservatively, were followed 18-24 m to assess treatment outcome.

Elective minimally invasive surgery for sigmoid diverticulitis: operative outcomes of patients with complicated versus uncomplicated disease.

Aim: The aim of this work was to compare the results of elective minimally invasive surgery between patients with complicated sigmoid diverticulitis and those with uncomplicated disease.

Method: An institutional review board-approved database was searched for all consecutive patients who underwent elective minimally invasive surgery, including laparoscopic, hand-assisted and robotic sigmoidectomy, for diverticulitis between 2010 and 2017; they were classified according to the modified Hinchey classification as having complicated (abscess, fistula, stricture, obstruction, bleeding or previous perforation) versus uncomplicated disease. Data recorded included baseline demographics, indications for surgery, operative details and complications.

Staple Line Leaks Following Laparoscopic Sleeve Gastrectomy: Low Efficacy of the Over-the-Scope Clip.

Purpose: The over-the-scope clip (OTSC) enables non-surgical management of gastrointestinal defects. The aim of this study was to report our experience with OTSC for patients with staple line leaks following laparoscopic sleeve gastrectomy (LSG).

Materials And Methods: A prospectively maintained IRB-approved institutional database was queried for all patients treated with OTSC for staple line leaks following LSG from 2010 to 2018.

Routine Upper Gastrointestinal Fluoroscopy Before Laparoscopic Sleeve Gastrectomy: Is It Necessary?

Background: Controversy exists regarding the clinical utility of routine preoperative upper gastrointestinal (GI) fluoroscopy in morbid obese patients undergoing laparoscopic sleeve gastrectomy (LSG). The aim of our study was to determine the efficacy of these studies in detecting hiatal hernias (HH).

Methods: The institution's prospectively maintained, IRB-approved database was retrospectively queried to identify all consecutive patients who underwent LSG between 2011 and 2017.

Results of conversion of gastric banding to gastric bypass in patients between 50 and 60 years of age are similar to those observed in younger patients.

Background: The effect of age and gender on outcomes of revisional bariatric surgery has not been assessed.

Methods: A retrospective analysis of patients undergoing revision from laparoscopic adjustable gastric banding (LAGB) to laparoscopic roux en Y gastric bypass (LRYGB) between 2007 and 2017 was performed. Patients were divided according to gender and age (<50 and ≥ 50 years), and the outcomes of the subgroups were compared.

A comparison between one- and two-stage revisional gastric bypass.

Background: The safety of performing a one-stage revision from laparoscopic adjustable gastric banding (LAGB) to laparoscopic Roux-en-Y gastric bypass (LRYGB) has been questioned. The objective of this study was to compare safety and outcomes of one-stage versus two-stage revisional LRYGB performed after failed LAGB.

Methods: A retrospective analysis of all patients undergoing revisional LRYGB after failed LAGB between January 2007 and March 2017 was performed.

How accurate is preoperative colonoscopic localization of colonic neoplasia?

Introduction: Preoperative colonoscopic localization for resection of colonic neoplasia, with or without tattooing for guidance, has been extensively used with variable accuracy. Difficulty in intraoperative identification of the lesion may lead to resection of an incorrect segment or to a more extensive resection than originally planned. The aim of this study was to evaluate the accuracy of preoperative colonoscopy in determining the site of the lesion.

Next-Generation Sequencing Identifies a Highly Accurate miRNA Panel That Distinguishes Well-Differentiated Thyroid Cancer from Benign Thyroid Nodules.

Fine needle aspiration biopsy (FNAB) is the gold-standard procedure for diagnosing malignant thyroid nodules. Indeterminate cytology is identified in 10% to 40% of cases, and molecular testing may guide management in this setting. Current commercial options are expensive, and are either sensitive or specific.

Outcomes of Sleeve Gastrectomy in Septuagenarians.

Background: Few previous studies have assessed the safety of bariatric surgery in septuagenarians.

Methods: A retrospective analysis of all patients 70 years or older who underwent laparoscopic sleeve gastrectomy at our institution between 2012 and 2017 was performed. This group was compared to a matched cohort of younger LSG patients (18-50 years) who were operated during the same time period.

Not All Leaks Are Created Equal: a Comparison Between Leaks After Sleeve Gastrectomy and Roux-En-Y Gastric Bypass.

Introduction: It is commonly stated in bariatric surgical forums that leaks following laparoscopic sleeve gastrectomy (LSG) are more difficult to manage than those following laparoscopic roux-en-Y gastric bypass (LRYGB). However, no previous study has provided a thorough comparison of leak management following these two operations.

Methods: Our database was retrospectively reviewed to identify patients with leak following LSG and LRYGB performed between January 2007 and December 2017.

Preoperative localization modalities in primary hyperparathyroidism: Correlation with postoperative cure.

Background: Accurate preoperative localization is critical to the success of minimally invasive parathyroidectomy. This investigation aimed to assess the correlation among preoperative imaging results, intraoperative findings, and postoperative cure rates in patients undergoing operation for primary hyperparathyroidism.

Methods: A retrospective review of all patients who underwent operation for primary hyperparathyroidism between June 2010 and March 2016 was performed.