Surgery, Gastroenterology and Oncology

Highlights:

A randomized controlled study (RCT) that discusses the impact of biliopancreatic limb length, gastric pouch length, and total small bowel length on weight loss and nutritional parameters after One-anastomosis gastric bypass (OAGB).

Longer BPL lengths (200 cm) in OAGB are associated with greater %TWL and %EWL compared to shorter limb lengths (150 cm).

Patients with longer BPL lengths (170 cm and 200 cm) exhibit significantly higher rates of postoperative nutritional deficiencies, particularly in serum albumin, calcium, iron, and fe....[more]

Background. This study aimed to compare the efficacy of laparoscopically guided transversus abdominis plane (L-TAP) block and ultrasound-guided erector spinae plane (ESP) block in the alleviation of postoperative pain and need for postoperative narcotics in patients undergoing laparoscopic bariatric surgery.

Methods. In this randomized controlled trial, we included adult morbidly obese patients undergoing laparoscopic bariatric surgery. After induction of anesthesia, participants received either L-TAP block or ultrasound-guided ESP block. ....[more]

Vascular Endothelial Growth Factor (VEGF-C) as a Perioperative Serum Biomarker for Gastric Cancer Prognostication

Alok Dubey1, Pravindhira Sozhamadevi Narendhira1, Arunkumar Ramachandran2,

Arun Kasiviswanathan1, Sugumar Chidambaranathan1, Nagnath babu O L1, Chitra Ayyappan2, Karthick Rajendran2, Priyadarshini Panneerselvam2, Muthukumaran Rajaram2

1Institute of Surgical Gastroenterology, Madras Medical College, Tamil Nadu, Chennai, India

2Multidisciplinary Research Unit, Madras Medical College, Tamil Nadu, Chennai, India

Background: Rectal cancer is a common malignancy worldwide. Management of rectal cancer is multimodal. Preoperative chemoradiotherapy, particularly for low rectal cancer, plays an important role in downstaging and facilitating surgery. Objective: This study aimed to evaluate the outcomes of preoperative chemoradiotherapy in patients with low rectal

cancer at Hanoi Medical University Hospital.

Materials and Methods: A retrospective study of 56 patients with low rectal cancer who received preoperative chemoradiotherapy at Hanoi Medica....[more]

Background: Tailored axillary surgery (TAS) is a technique for clinically node-positive breast cancer (BC) that selectively removes nodal disease to convert a positive axilla to a negative, customizing surgery based on disease extent. Radiological assessment and ultrasound on the axilla have been used to identify suspicious LNs. Carbon ink injection tattooing is one popular method for axillary LNs. Objective: We evaluated the feasibility and validity of ultrasound-guided marking of metastatic axillary LNs in BC patients followed by TAS exhibiting as a method for r....[more]

Background: Breast cancer is still the most common cancer incident and the leading cause of death in women. Chemotherapy, as the primary therapeutic modality, currently has both short-term and long-term side effects that affect the patient's quality of life. Body Mass Index (BMI), Fat Mass Index (FMI), and Fat-Free Mass Index (FFMI) reflect nutritional status that is thought to be related to quality of life. This study aims to analyze the correlation between BMI, FMI, and FFMI on the quality of life of breast cancer patients undergoing chemotherapy.

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Background: The Alvarado score is a widely used clinical tool for diagnosing acute appendicitis, especially in emergency settings. However, its diagnostic accuracy in patients with intermediate scores (5–7) remains uncertain. Aim: To assess the incidence of confirmed acute appendicitis in patients with Alvarado scores between 5 and 7 and to evaluate the reliability of the Alvarado scoring system in this diagnostic range.

Patients and Methods: A prospective observational study was conducted 228 patients

presenting with symptoms and....[more]

Background: Blunt abdominal trauma (BAT) is a common cause of intra-abdominal injury, with the spleen being the most frequently affected organ. In resource-limited settings, understanding injury patterns and management strategies is crucial for improving outcomes. Objective: To assess the prevalence, injury patterns, and clinical management of splenic injuries in patients with BAT.

Methods: A cross-sectional study was conducted at Al Nasiriya Teaching Hospital between April 1, 2024, and April 1, 2025. A total of 93 patients with splenic inj....[more]

Introduction: Uterine artery embolization (UAE) is a minimally invasive interventional technique that has found increasingly widespread application in modern obstetric and gynecological practice. Initially introduced for the management of postpartum hemorrhage, the procedure has gradually established its role in the treatment of gynecological conditions such as uterine fibroids, adenomyosis, arteriovenous malformations, and ectopic pregnancy. Objective: This review aims to present the current indications, contraindications, efficacy, and limitations of UAE in bot....[more]

Introduction: Anorectal cancer (ARC) associated with Crohn’s disease (CD) is a rare but serious complication, with limited data available in the literature. Objective: To evaluate the incidence and clinical characteristics of ARC in patients with CD.

Methods: A systematic review was conducted following PRISMA guidelines. A PubMed search (2014–2024) identified studies using the keywords “anorectal cancer”, “Crohn’s disease”, and “inflammatory bowel disease”. Articles in English and Portuguese, or with an English abstract co....[more]

Background: Traumatic Brain Injury (TBI) is a major global health concern, frequently leading to cerebral edema, a critical factor in secondary brain injury and poor outcomes. Aquaporin-4 (AQP-4), an astrocytic water channel protein, and Tumor Necrosis Factor-alpha (TNF-a), a proinflammatory cytokine, are well-established mediators in the pathophysiology of cerebral edema and neuroinflammation following TBI. Given the limitations of current treatments, exploring novel adjunctive therapies is crucial. Objectives: This literature review aims to comprehensively inves....[more]

Background: Inguinal hernias continue to be a significant surgical issue due to their prevalence. Males are estimated to have a lifetime risk of 27% inguinal hernia, while females have a lifetime risk of 3%. Our objective was to assesss the surgical outcomes of the combined modified Guarnieri Desarda technique and the Lichnichtien tension-free mesh hernioplasty for inguinal hernia.

Methods: This comparative prospective randomized clinical trial was carried out on forty adult male patients who presented with inguinal hernia at General Surger....[more]

Calcified fibrous tumor (CFT), also known as calcified fibrous pseudotumor, is a rare benign mesenchymal lesion characterized by dense hyalinized fibrous tissue, lymphoplasmacytic inflammatory infiltrate, and distinctive calcifications. Although it can occur in various locations, the gastrointestinal tract is an increasingly recognized site. We present the case of a 29-year-old patient who developed intestinal obstruction. Imaging studies identified a calcified mesenteric lesion as the probable cause. An exploratory laparotomy was performed, revealing a mesenteric-dependent small....[more]