#ERAS #DDLT #Kims

@Manishbhandare4 @AnnalsofSurgery @Shrikhande_SV @TataMemorial @DrVAChaudhari @AnantRamaswamy @bhargava611 @Dr_AkshayBaheti @Subhash_YadavMD @DrRaviChandra Key findings of the study....Thread👇

@Manishbhandare4 @AnnalsofSurgery @Shrikhande_SV @TataMemorial @DrVAChaudhari @AnantRamaswamy @bhargava611 @Dr_AkshayBaheti @Subhash_YadavMD @DrRaviChandra How well did CA 19-9 perform in predicting recurrence? Static as well as dynamic CA 19-9 parameters used ‘Serial rise’ or ‘first raised value > 200’ are almost always associated with recurrence Relative rise of CA 19-9 is an important dynamic parameter.

@Manishbhandare4 @AnnalsofSurgery @Shrikhande_SV @TataMemorial @DrVAChaudhari @AnantRamaswamy @bhargava611 @Dr_AkshayBaheti @Subhash_YadavMD @DrRaviChandra Rise in CA 19-9 precedes radiological recurrence by 4.04 months Recurrence detected by CA 19-9 rise -->Early therapy -->survival benefit Recurrence detection after CA 19-9 elevation has better survival than recurrence detection without elevation (12.8 vs 7.6 months, p – 0.005)

@Manishbhandare4 @AnnalsofSurgery @Shrikhande_SV @TataMemorial @DrVAChaudhari @AnantRamaswamy @bhargava611 @Dr_AkshayBaheti @Subhash_YadavMD @DrRaviChandra Factors for poor OS T stage, Margin +, LN +, PNI, poor diff, PB subtype Factors for poor RFS T stage, LN +, poor diff, PNI, adj tissue invol Recurrences high [251/572 (61.7%), distant > local) Adjuvant therapy benefits 5-year OS (adj vs no adj) - 40.4%, vs. 32.3% (p – 0.012)

OCEAN study: The first randomized controlled study to compare octreotide treatment with standard of care in patients with angiodysplasia-related bleeding @Joostphdrenth @LiaGoltstein @LucasBernts https://t.co/1Os96EgXPV

Prognostic Implications of Lateral Lymph Nodes in Rectal Cancer: A Population-Based Cross-sectional Study With Standardized Radiological Evaluation After Dedicated Training: https://t.co/z1dSj1GFr7 @jendavidsmd @ScottRSteeleMD @Swexner @me4_so @ACPGBI @drtracyhull @ASCRS_1

#TBT for our coffee lovers ⚡️ ☕️ 🗣️! @SWexner @juliomayol @PipeCabreraV @herbchen @Cirbosque @pferrada1 @TopKniFe_B @rbarbosa91 @drdevirgilio @TraumaDocSF @salo75

Double-blinded MOBILE2-trial found that mechanical bowel preparation and oral antibiotics reduced the rate of overall morbidity, surgical site infections and anastomotic leaks compared to mechanical bowel preparation only prior anterior rectal resection. https://t.co/1mVNqwWmMx

PRODIGE 23 included pts with cT3-4 disease Randomized: CRT➡️FOLFOX vs. mFOLFIRINOX ➡️CRT➡️S ➡️FOLFOX Key results improved with TNT! ✅Improved DFS ✅Decreased DM ✅✅✅Improved OS!!! 9/

The UK has the best hyperkalaemia guidelines in the world, and they’ve just been updated. No one can cover all 171 pages, but here are 3 quick important bits in a thread👇 https://t.co/pZpyHhXjJX

Distal pancreatectomy for IPMN 🍇 with or without splenectomy ?! 🦀 Malignancy 30% out of 700 🫘 Spleen preserving ⬇️ blood loss, OR time, hospital stay but 🟰 overall survival 🍒 Node mets 7% Once malignancy not suspected spleen can be preserved 👌 👉 https://t.co/RAzWAYh51A

👋 Hi friends! 📌3 RCTs have shown negative results for TARE, specifically 2 comparing TARE and Sorafenib (SARAH, SIRveNIB), and 1 studying Sorafenib ± TARE (SORAMIC). 📌Concerns about these studies include potentially 📉 doses and historic techniques. 1/10 #LiverTwitter #HCC

The first milestone 💫 of 2024 is out! Updated IAP Guidelines 🍇 for IPMN 🔑 New key role of EUS 🔴 HRS remain same 🟡 WF slightly revised / dynamically evaluated 🟢 Possible STOP surveillance for Trivial BD-IPMN! 🫵 Are you going to apply them?! 🧐 https://t.co/RbX2iNYBNb

Good illustration of a technique that ACS surgeons should be aware of, either to use themselves or when re-operating on such patients.

The most challenging procedure of HBP 🗼Left Trisectionectomy🗼 From NCD of Japan🇯🇵 Cases 👉 increasing Mortality 👉 Still high (5% vs. 1% of others) Severe morbidity 👉Portal vein resection, Blood loss ≥30 mL/kg, ASA 2 https://t.co/KggqhdXj0n

🎄 Pancreas wrapped 2023 🍾 4⃣ April 2023 - Piperacillin/Tazobactam as prophylaxis for pancreatoduodenectomy 💉 Reduced 30-day postoperative surgical site infection (32% vs. 20%), sepsis and POPF 🧐 Did YOU change your practice accordingly? 🫵

Early cholecystectomy 🫛 after moderate and severe acute biliary pancreatitis !? 😨 Mortality as high as 15% 🫸 Elderly and fragile patients manifesting severe complications are at relevant risk of morbidity and might not benefit! 👉 https://t.co/82yKSArNhl

#Hydroxocobalamin was associated with a greater reduction in vasopressor requirements when compared to methylene blue in refractory vasoplegic #shock. https://t.co/IJFn2Z4YD9

Neoadjuvant Immune Checkpoint Inhibition Improves Organ Preservation in T4bM0 Colorectal Cancer With Mismatch Repair Deficiency: A Retrospective Observational Study: https://t.co/j0VB2BoOBH