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2021 Scientific Session of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), Las Vegas, Nevada, 31 August–3 September 2021: Video Loops

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… There were no conversion to open surgery. Median operative time and blood loss was 215 min and 75 ml respectively. There were 2 cases with complicatons of Clavian-Dindo Grade of greater than III. Conclusion: Laparoscopic resection for CVF is safe and feasible. …

Mid-term outcomes for Endoscopic versus Open Vein Harvest: a case control study.

BackgroundSaphenous vein remains the most common conduit for coronary artery bypass grafting with increasing uptake of minimally invasive harvesting techniques. While Endoscopic Vein Harvest (EVH) has been demonstrated to improve early morbidity compared to Open Vein Harvest (OVH), recent literature suggests that this may be at the expense of graft patency at one year and survival at three years.MethodsWe undertook a retrospective single-centre, single-surgeon, case-control study of EVH (n = 89) and OVH (n = 182). The primary endpoint was death with secondary endpoints including acute coronary

2023 Scientific Session of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), Montréal, Canada, 19 March–April 1 2023: Posters

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Implantation of a peritoneal dialysis catheter in patients with ESRD using local anesthesia and Remifentanil.

Study objectiveThe main objective of this study is to test the feasibility of the local anesthetic (LA) Mepivacaine 1% and sedation with Remifentanil as the primary anesthetic technique for the insertion of a peritoneal dialysis (PD) catheter, without the need to convert to general anesthesia.MethodsWe analyzed 27 consecutive end-stage renal disease (ESRD) patients who underwent the placement of a peritoneal catheter at our center between March 2015 and January 2019. The procedures were all performed by a general or vascular surgeon, and the postoperative care and follow-up were all conducted

Proximal femur replacement in oncologic lesion: hemiarthroplasty vs total hip arthroplasty-a multicentric retrospective study.

IntroductionThis study aimed to evaluate the outcomes and complications associated with proximal femur replacement (PFR) in patients undergoing treatment for primary bone tumors or metastatic lesions. This research specifically compared modular hemiarthroplasty (HA) and total hip arthroplasty (THA) to ascertain the optimal approach regarding functionality and postoperative complications.Materials and methodsA retrospective multicenter review was conducted involving 85 patients who underwent prosthetic femoral reconstruction (PFR) between the years 2015 and 2022 at two specialized medical cente

The 2024 revised clinical guidelines on the management of thyroid tumors by the Japan Association of Endocrine Surgery.

The Japan Association of Endocrine Surgery published the first edition of the "Clinical guidelines on the management of thyroid tumors" in 2010 and the revised edition in 2018. The guideline presented herein is the English translation of the revised third edition, issued in 2024. The aim is to enhance health outcomes for patients suffering from thyroid tumors by facilitating evidence-based shared decision-making between healthcare providers and patients, as well as standardizing the management of thyroid tumors. The focus is on adult patients with thyroid tumors, addressing clinically signific

How long do endoprosthetic reconstructions for proximal femoral tumors last?

BackgroundAs the life expectancy of patients with musculoskeletal tumors improves, long-term studies of endoprosthetic reconstructions are necessary to establish realistic expectations for the implants and compare them to other reconstruction approaches.Questions/purposes(1) What is the long-term survival of cemented bipolar proximal femoral replacements? (2) How does prosthesis survival compare to patient survival among patients with Stage I, II, and III disease? (3) Do modular implants outperform custom-built prostheses? (4) Do some proximal femoral replacements require conversion to THA?Pat

A Patient-Specific Fracture Risk Assessment Tool for Femoral Bone Metastases: Using the Bone Strength (BOS) Score in Clinical Practice.

Patients with femoral metastases are at risk of fracturing bones. It is important to prevent fractures in order to maintain mobility and quality of life. The BOne Strength (BOS) score is based on a computed tomography (CT)-based patient-specific finite element (FE) computer model that objectively calculates bone strength. In this pilot study, the added clinical value of the BOS score towards treatment-related decision making was assessed. In December 2019, the BOS score was implemented in four radiotherapy centers. The BOS scores and fracture risks of individual patients were calculated and re

Seroprevalence study prior and post vaccination in cancer patients in principality of Andorra (COVONCO study).

BackgroundCOVID-19 serologic response in patients with cancer may be lower than in the general population and may be influenced by the type of tumor or anticancer treatment. This study aims to analyze serological response prior and after vaccination of COVID-19 within the oncological population in Andorra. We set out to identify risk factors for a higher or lower serological response.Patients and methodsObservational, unicentric, prospective cohort study of oncologic patients in Andorra. We calculated the seroprevalence of antibodies against SARS-CoV-2 (May 2020-June 2021) and analyzed the mai

Beyond surgical radicality in intramedullary spinal cord metastases: neurological function and systemic disease burden drive patient outcomes.

PURPOSE: Intramedullary spinal cord metastases (ISCM) are rare, clinically challenging lesions with limited evidence-based guidance. Optimal surgical management remains controversial, particularly regarding the ideal extent of resection (EOR) and associated prognostic factors. This study systematically evaluates perioperative outcomes, neurological function, and short-term survival according to biopsy-only, subtotal, or gross total resection (GTR) approaches. METHODS: This retrospective single-center study included 16 patients treated surgically for histologically confirmed ISCM between 2015

Quantitative preoperative patient assessments are related to survival and procedure outcome for osseous metastases.

AimsOur objective was to determine if preoperative patient-reported assessments are associated with survival after surgery for stabilization of skeletal metastases.Patients and methodsAll patients with metastatic cancer to bone and indications for skeletal stabilization surgery were approached to participate in a prospective cohort study at a tertiary care center from 2012 to 2017. Of the 208 patients who were eligible, 195 (94%) completed the 36-item Short Form Health Survey (SF-36) preoperatively and underwent surgical treatment of skeletal metastases with complete or impending fractures; th

A Review of Clinical Practice Guidelines and Treatment Recommendations for Cancer Care in the COVID-19 Pandemic.

The COVID-19 pandemic has inevitably caused those involved in cancer care to change clinical practice in order to minimize the risk of infection while maintaining cancer treatment as a priority. General advice during the pandemic suggests that most patients continue with ongoing therapies or planned surgeries, while follow-up visits may instead be delayed until the resolution of the outbreak. We conducted a literature search using PubMed to identify articles published in English language that reported on care recommendations for cancer patients during the COVID-19 pandemic from its inception u

Determinants of Overall and Readmission-Free Survival in Patients with Metastatic Epidural Spinal Cord Compression.

BACKGROUND: The aim of this study was to assess the surgical outcomes and survival of patients surgically treated for metastatic epidural spinal cord compression (MESCC), with a specific focus on identifying factors that influence overall survival and readmission-free survival. METHODS: All patients who underwent surgery for spine metastases at our department in the period 2018-2022 were included in the study. RESULTS: A total of 175 patients (n = 71 females, median age 67.15 years) were included. The most common primary tumors were lung carcinoma (n = 31), prostate carcinoma (n = 31), breas

Durotomy During Outpatient Lumbar Discectomy Should Not Preclude Same-Day Discharge: A Case Series.

Background and objectivesWith advances in surgical techniques over the past 40 years, single-level lumbar hemilaminectomy and microdiscectomy (HLMD) has become a standard outpatient surgery. Incidental durotomy is a common complication of lumbar decompression surgeries and often precludes same-day discharge based on preexisting paradigms, involving bedrest that have no empirical support, but often lead to increased complications in available evidence-based studies. Limited data exist regarding the safety of same-day discharge after lumbar decompression involving an incidental durotomy. The obj

Clinical context and communication in shared decision-making about major surgery: Findings from a qualitative study with colorectal, orthopaedic and cardiac patients.

Increasing numbers of older people undergo major surgery in the United Kingdom (UK), with many at high risk of complications due to age, co-morbidities or frailty. This article reports on a study of such patients and their clinicians engaged in shared decision-making. Shared decision-making is a collaborative approach that seeks to value and centre patients' preferences, potentially addressing asymmetries of knowledge and power between clinicians and patients by countering medical authority with greater patient empowerment. We studied shared decision-making practices in the context of major su

The Evolving Landscape of Immune Regulation and Immunotherapy in Cholangiocarcinoma and Biliary Tract Cancer.

Cholangiocarcinoma (CCA) is an aggressive and molecularly heterogeneous malignancy characterized by a profoundly immunosuppressive tumor microenvironment (TME) and historically limited therapeutic options. Recent advances have redefined the treatment paradigm, with phase III trials establishing chemoimmunotherapy as a standard of care and multi-omic profiling elucidating the interplay between tumor genomics, stromal architecture, and immune regulation. Despite these gains, durable clinical benefit remains confined to a minority of patients, reflecting convergent mechanisms of primary and acqui

Artificial intelligence across the cancer care continuum.

Artificial intelligence (AI) holds significant potential to enhance various aspects of oncology, spanning the cancer care continuum. This review provides an overview of current and emerging AI applications, from risk assessment and early detection to treatment and supportive care. AI-driven tools are being developed to integrate diverse data sources, including multi-omics and electronic health records, to improve cancer risk stratification and personalize prevention strategies. In screening and diagnosis, AI algorithms show promise in augmenting the accuracy and efficiency of medical image ana

Oral Presentations

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Apixaban for Primary Prevention of Venous Thromboembolism in Patients With Multiple Myeloma Receiving Immunomodulatory Therapy.

Immunomodulatory drugs (IMiDs), including thalidomide, lenalidomide, and pomalidomide, have improved survival of patients with multiple myeloma (MM). However, these therapies are associated with an increased risk of venous thromboembolism (VTE). Apixaban has been approved for treatment of acute VTE and for risk reduction of recurrent VTE following initial therapy. In this phase IV single-arm study (NCT02958969), we aim to prospectively evaluate the safety and efficacy of apixaban for primary prevention of VTE in patients with MM. The primary efficacy objective of this trial is to determine the

Euthanasia as a safeguard for living: Anticipation and incurable cancer in a Colombian context.

This article builds on years of ethnographic conversations I sustained with my father, 89, who lives in Colombia. Soon after getting diagnosed with an incurable Multiple Myeloma-a cancer known for unleashing prolonged and painful agonies-he withdrew from oncology treatments and secured access to euthanasia (assisted-dying) on his own, bypassing medico-insurance guidelines created to regulate this medical practice and prevent abuses. Eight years after withdrawing treatments, my dad is still alive. His case shines a light on how securing access to euthanasia may have had unintended therapeutic e