Article
Gastroenterology & Hepatology
Fernanda Romero-Hernandez, Phoebe Miller, Rosa Mora, Dorothy Hughes, Susanne Warner, Adnan Alseidi, Brendan Visser, Michele Babicky
Summary: This study examined a survey of recent fellowship graduates in Hepato-Pancreato-Biliary (HPB) surgery programs in North America. The study identified concerns about the lack of standardization between HPB fellowship curricula, job market oversaturation, the need to emphasize the value of HPB fellowship training, and the importance of diversity, inclusion, and equity in HPB training. The strengths of AHPBA-certified HPB programs include superior case volume and technical training. Further improvements can be made in standardizing training experiences and providing strong job placement sponsorship and investments in diversity, equity, and inclusion.
Article
Oncology
Camille C. Baumrucker, Samantha R. Spring, Brianna L. Cohen, Janelle-Cheri Millen, Francis I. Macedo, Dido Franceschi
Summary: There is a direct association between hospital volume and outcomes of patients with occult breast cancer (OBC). Patients with OBC treated at academic centers (AC) were more likely to undergo breast-conserving approaches and had better survival outcomes than those treated at community centers (CC).
ANNALS OF SURGICAL ONCOLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
Karl F. Welke, Tara Karamlou, Sean M. O'Brien, Joseph A. Dearani, James S. Tweddell, S. Ram Kumar, Jennifer C. Romano, Carl L. Backer, Sara K. Pasquali
Summary: There is a relationship between surgical volume and outcomes in congenital heart surgery. This relationship is strongest for high-risk surgeries. These findings can guide initiatives to improve care in congenital heart surgery.
ANNALS OF THORACIC SURGERY
(2023)
Article
Oncology
Praveen D. Chatani, Alexander Manzella, Yelizaveta Y. Gribkova, Brett L. Ecker, Toni Beninato, Timothy Kennedy, Henry A. Pitt, Henry Richard Alexander
Summary: No association was found between hospital volume for CRS/HIPEC and post-operative outcomes. These data suggest that in academic medical centers with HIPEC programs, outcomes for commonly treated cancers are not associated with hospital volume.
ANNALS OF SURGICAL ONCOLOGY
(2023)
Article
Pediatrics
Mingyang Sun, Wan-Ming Chen, Szu-Yuan Wu, Jiaqiang Zhang
Summary: This study, using nationwide data, found that high and middle hospital-volume groups had significantly lower rates of major complications within 30 and 90 days after surgery. High-volume hospitals also demonstrated a substantial decrease in the risk of 90-day postoperative mortality. The study underscores the importance of specialized pediatric surgical centers and advocates for clear guidelines for hospital selection, potentially improving outcomes and informing future health policies.
EUROPEAN JOURNAL OF PEDIATRICS
(2023)
Article
Gastroenterology & Hepatology
Yutaka Endo, Zorays Moazzam, Selamawit Woldesenbet, Henrique A. Lima, Laura Alaimo, Muhammad Musaab Munir, Chanza F. Shaikh, Jason Yang, Lovette Azap, Erryk Katayama, Minoru Kitago, Timothy M. Pawlik
Summary: A study found that hospital volume affects outcomes of patients undergoing resection for hepatocellular carcinoma. Higher volume hospitals are more likely to achieve better surgical outcomes and improve long-term survival rates for patients.
JOURNAL OF GASTROINTESTINAL SURGERY
(2023)
Review
Gastroenterology & Hepatology
Povilas Ignatavicius, Christian E. Oberkofler, Jan Philipp Jonas, Beat Mullhaupt, Pierre-Alain Clavien
Summary: The concept of a centre approach in treating complex disorders like HPB diseases is widely used, but the requirements for HPB centres to achieve high-quality outcomes are unclear. A literature review showed limited information linking centre structure or process to outcome data. An international survey of 107 HPB centres found that most centres are "virtual" without dedicated space or personnel. An analysis of the Swiss HPB centre revealed that budget priorities set by the hospital administration may hinder the development of a fully integrated centre. The study proposes essential requirements for HPB centres to deliver high-quality outcomes, limiting the concept of a reference centre to actual centres.
JOURNAL OF HEPATOLOGY
(2022)
Article
Medicine, Research & Experimental
Josef Madrigal, Laith Mukdad, Albert Y. Han, Zachary Tran, Peyman Benharash, Maie A. St John, Keith E. Blackwell
Summary: High-volume centers for head and neck cancer resection with flap reconstruction are associated with lower rates of surgical and medical complications, shorter hospital stays, and reduced costs for patients. However, hospital volume does not impact 90-day readmission rates.
Article
Surgery
Kevin Tian, Peter D. Baade, Joanne F. Aitken, Aaditya Narendra, B. Mark Smithers
Summary: The study assessed the impact of resection volume and service capability on operative mortality, morbidity and surgical quality in gastric cancer surgery patients. Centralisation to high-volume high-service centers was associated with lower operative mortality for total gastrectomy and improved surgical quality for partial gastrectomy.
ANZ JOURNAL OF SURGERY
(2021)
Article
Gastroenterology & Hepatology
Heikki Huhta, Minna Nortunen, Sanna Merilainen, Olli Helminen, Joonas H. Kauppila
Summary: Higher annual hospital volume of pancreatic surgery is associated with improved short- and long-term survival for pancreatic ductal adenocarcinoma.
Article
Surgery
Julie Hallet, Angela Jerath, Pablo Perez d'Empaire, Antoine Eskander, Francois M. Carrier, Daniel I. McIsaac, Alexis F. Turgeon, Chris Idestrup, Alana M. Flexman, Gianni Lorello, Gail Darling, Biniam Kidane, Yosuf Kaliwal, Victoria Barabash, Natalie Coburn, Rinku Sutradhar
Summary: This study aimed to examine the association between high-volume anesthesiology care and postoperative major morbidity. A population-based retrospective cohort study of adult cancer patients undergoing esophagectomy, pancreatectomy, or hepatectomy from 2007 to 2018 revealed that hospitals providing high-volume anesthesiology care had lower rates of major morbidity.
Article
Surgery
Ambar Mehta, Priya Patel, Adham Elmously, James Iannuzzi, Karan Garg, Jeffrey Siracuse, Hiroo Takayama, Marc L. Schermerhorn, Thomas F. X. O'Donnell, Virendra I. Patel
Summary: This study aimed to investigate whether there are differences in outcomes among low-volume surgeons for open abdominal aortic surgeries in different hospital settings. The results showed that low-volume surgeons operating at high-volume hospitals had lower rates of perioperative death and failure-to-rescue, but similar rates of complications. For aorto-iliac occlusive disease, patient outcomes did not vary by hospital setting for low-volume surgeons.
JOURNAL OF VASCULAR SURGERY
(2023)
Review
Oncology
Jiafu Ji, Leiyu Shi, Xiangji Ying, Xinpu Lu, Fei Shan
Summary: The study found that gastric cancer patients who underwent surgery in high-volume centers had better overall survival, lower short-term mortality, more adequate lymphadenectomy, and shorter length of stay. However, hospital volume was not significantly associated with surgical complications, negative margin resection, or disease-free survival.
ANNALS OF SURGICAL ONCOLOGY
(2022)
Article
Medicine, General & Internal
Wouter van der Schors, Ron Kemp, Jolanda van Hoeve, Vivianne Tjan-Heijnen, John Maduro, Marie-Jeanne Vrancken Peeters, Sabine Siesling, Marco Varkevisser
Summary: This study aimed to analyze the association between hospital volume, competition from neighboring hospitals, and outcomes for invasive breast cancer surgery patients. The results showed that there was no significant association between hospital volume, competition, and surgical outcomes. However, slightly higher survival rates were observed in hospitals with higher surgical volumes and more competitors nearby.
Article
Oncology
Michelle R. Ju, James-Michael Blackwell, Herbert J. Zeh, Adam C. Yopp, Sam C. Wang, Matthew R. Porembka
Summary: Higher annual hospital gastrectomy volume is associated with improved surgical outcomes, with 17 cases/year identified as a clinically meaningful distinction between high-volume (HV) and low-volume (LV) centers. Treatment at a high-volume gastrectomy center leads to increased likelihood of adequate nodal examination, R0 resection, and decreased 30- and 90-day postoperative mortality.
ANNALS OF SURGICAL ONCOLOGY
(2021)
Article
Oncology
Marco Baia, Samuel J. Ford, Sinziana Dumitra, Laura Sama, David N. Naumann, Gaya Spolverato, Dario Callegaro
Summary: Retroperitoneal sarcomas (RPS) are rare malignancies that can be cured by surgical resection. After surgery, regular surveillance is recommended due to the risk of local recurrence (LR) and distant metastasis (DM). Despite the lack of definitive evidence, dynamic nomograms can predict recurrence patterns to tailor surveillance and relieve patient anxiety. A proposed randomized controlled study aims to provide clarity on the optimal follow-up protocol for RPS patients.
Article
Gastroenterology & Hepatology
Valentina Mari, Valentina Angerilli, Giada Munari, Marco Scarpa, Quoc Riccardo Bao, Salvatore Pucciarelli, Matteo Fassan, Gaya Spolverato
Summary: This review outlines the molecular pathways involved in peritoneal metastatic dissemination in gastric cancer, highlighting the lack of comprehensive understanding of the complex molecular landscape of this disease. The integration of molecular profiling and histological evaluation is recommended for risk prediction assessment of peritoneal dissemination.
DIGESTIVE DISEASES
(2023)
Article
Surgery
Gianluca Businello, Valentina Angerilli, Sara Lonardi, Francesca Bergamo, Michele Valmasoni, Fabio Farinati, Edoardo Savarino, Gaya Spolverato, Matteo Fassan
Summary: The comprehensive molecular characterization of gastric and gastroesophageal junction adenocarcinomas has improved targeted and effective treatments, introducing biomarkers into clinical practice. The evaluation mainly relies on limited biopsy material, making pathologists essential in patient selection for precision medicine approaches.
UPDATES IN SURGERY
(2023)
Article
Medical Laboratory Technology
Francesca Sensi, Edoardo D'angelo, Andrea Biccari, Asia Marangio, Giulia Battisti, Sara Crotti, Matteo Fassan, Cecilia Laterza, Monica Giomo, Nicola Elvassore, Gaya Spolverato, Salvatore Pucciarelli, Marco Agostini
Summary: Pancreatic cancer is expected to be one of the leading causes of cancer-related deaths in many countries in the next decade. Surgery is the potential cure for pancreatic ductal adenocarcinoma (PDAC), although only a small percentage of patients are eligible for surgery. The lack of a suitable model to reflect the tumor microenvironment is a major issue at the pre-clinical level. Here, we present a tissue engineering approach using decellularized human biopsies to create a realistic 3D in vitro model for PDAC.
TRANSLATIONAL RESEARCH
(2023)
Review
Gastroenterology & Hepatology
Dajana Glavas, Quoc Riccardo Bao, Marco Scarpa, Cesare Ruffolo, Zachary J. Brown, Timothy M. Pawlik, Gaya Spolverato
Summary: This study aimed to review the latest evidence on the treatment and prognosis of Fibrolamellar hepatocellular carcinoma (FL-HCC). The results showed that surgical resection has good therapeutic effect for FL-HCC patients, but with high recurrence rates and poor long-term outcomes. However, there is still a lack of specific treatment for advanced and recurrent disease of FL-HCC.
JOURNAL OF GASTROINTESTINAL SURGERY
(2023)
Article
Oncology
David J. Fei-Zhang, Zorays Moazzam, Aslam Ejaz, Jordan Cloyd, Mary Dillhoff, Joal Beane, David J. Bentrem, Timothy M. Pawlik
Summary: The study aimed to develop the Digital Inequity Index (DII) to assess the impact of digital inequity on gastrointestinal cancer care and prognosis. The results showed that digital inequity was associated with late-stage disease, non-receipt of surgery, shorter postoperative surveillance time, and overall survival time. Therefore, access to digital resources should be targeted as a contributor to surgical oncologic disparities.
JOURNAL OF SURGICAL ONCOLOGY
(2023)
Article
Oncology
Natalie M. Bath, Angela Sarna, Marilly Palettas, Christina Monsour, Lena Stevens, Heena Santry, Aslam Ejaz, Alex Kim, Timothy Pawlik, Jordan M. Cloyd
Summary: IntroductionNeoadjuvant therapy (NT) is increasingly used before surgery for patients with gastrointestinal (GI) cancers. Treatment burden is a patient-centered measure defined as the work of being a patient and characterizes the impact of medical treatment on one's functioning and well-being. While treatment burden has previously been studied in chronic diseases and cancer survivorship, the treatment burden of undergoing NT is unknown.
JOURNAL OF SURGICAL ONCOLOGY
(2023)
Article
Clinical Neurology
Aron Emmi, Michele Sandre, Francesco Paolo Russo, Giulia Tombesi, Federica Garri, Marta Campagnolo, Miryam Carecchio, Roberta Biundo, Gaya Spolverato, Veronica Macchi, Edoardo Savarino, Fabio Farinati, Piero Parchi, Andrea Porzionato, Luigi Bubacco, Raffaele De Caro, Gabor G. Kovacs, Angelo Antonini
Summary: This study revealed the presence of neuronal dysfunction and reactive gliosis in the duodenum of patients with Parkinson's disease, suggesting that the enteric nervous system is involved in the pathophysiology of the disease.
MOVEMENT DISORDERS
(2023)
Article
Gastroenterology & Hepatology
Quoc Riccardo Bao, Isabella Frigerio, Marzia Tripepi, Stefano Marletta, Guido Martignoni, Alessandro Giardino, Paolo Regi, Filippo Scopelliti, Valentina Allegrini, Roberto Girelli, Salvatore Pucciarelli, Gaya Spolverato, Giovanni Butturini
Summary: This study aimed to evaluate the impact of major pathological response on overall survival in patients with borderline resectable and locally advanced pancreatic ductal adenocarcinoma following neoadjuvant treatment, and to identify predictors of major pathological response. The study included 200 patients who underwent surgical resection after neoadjuvant treatment. The results showed that patients with major pathological response had higher overall survival rates compared to those without major pathological response. CA19-9 normalization and radiological post-treatment tumor size were found to be independent predictors of major pathological response.
Article
Surgery
Zorays Moazzam, Henrique A. Lima, Yutaka Endo, Laura Alaimo, Aslam Ejaz, Mary Dillhoff, Jordan Cloyd, Timothy M. Pawlik
Summary: This study investigates the impact of the rate of fragmented practice on surgical outcomes. The results show that patients operated on by surgeons with higher rates of fragmented practice have lower odds of achieving a textbook outcome. This adverse effect is significant even in socially vulnerable populations.
Article
Oncology
Philip S. Bauer, Adriana C. Gamboa, Ebunoluwa E. Otegbeye, William C. Chapman, Samantha Rivard, Scott Regenbogen, Maryam Mohammed, Jennifer Holder-Murray, Jason T. Wiseman, Aslam Ejaz, Kamren Edwards-Hollingsworth, Alexander T. Hawkins, Steven R. Hunt, Glen Balch, Matthew L. Silviera
Summary: A US Center study showed that the risk of surgical complications is comparable after neoadjuvant short-course radiation with consolidation chemotherapy (SC TNT) and long-course chemoradiation (LCRT) for rectal cancer.
JOURNAL OF SURGICAL ONCOLOGY
(2023)
Article
Oncology
Belisario Ortiz Rueda, Yutaka Endo, Diamantis I. Tsilimigras, Henrique Araujo Lima, Muhammad Musaab Munir, Selamawit Woldesenbet, Mary Dillhoff, Aslam Ejaz, Jordan Cloyd, Timothy M. Pawlik
Summary: This study evaluated the impact of Medicaid expansion on patients with biliary tract cancer who received multimodal treatment. The results showed that in states that adopted Medicaid expansion, there was an increase in the utilization of surgery and multimodal treatment. Uninsured/Medicaid patients in Medicaid expansion states had higher utilization rates and lower long-term death risk.
JOURNAL OF SURGICAL ONCOLOGY
(2023)
Article
Surgery
Marissa Guo, Thomas Leuschner, Alexandra Lopez-Aguiar, Mary Dillhoff, Aslam Ejaz, Timothy M. Pawlik, Jordan M. Cloyd
Summary: Aborted cancer surgery was associated with poor outcomes, particularly in patients with aggressive cancer types and those who did not receive further cancer-directed therapy. Palliative care consultation may improve patient-centered outcomes.
Article
Clinical Neurology
Aron Emmi, Michele Sandre, Francesco Paolo Russo, Giulia Tombesi, Federica Garri, Marta Campagnolo, Miryam Carecchio, Roberta Biundo, Gaya Spolverato, Veronica Macchi, Edoardo Savarino, Fabio Farinati, Piero Parchi, Andrea Porzionato, Luigi Bubacco, Raffaele De Caro, Gabor G. Kovacs, Angelo Antonini
Summary: This study investigated the alterations of alpha-synuclein and glial responses in duodenum biopsies of Parkinson's disease (PD) patients. The findings provide evidence of synuclein pathology and gliosis in the duodenum of PD patients, including early cases, suggesting the important role of the gut in PD pathogenesis.
MOVEMENT DISORDERS
(2023)
Letter
Surgery
Giulia Battisti, Alessandro De Cassai, Giulia Capelli, Paolo Navalesi, Gaya Spolverato
BRITISH JOURNAL OF SURGERY
(2023)