Comparative 30-day mortality and complications in robotic vs. open pancreaticoduodenectomy with portal-mesenteric vein resection: a systematic review and meta-analysis.

Background: Portal-mesenteric vein resection (PMVR) is often necessary for pancreatic ductal adenocarcinoma (PDAC) with vascular invasion. While open pancreaticoduodenectomy (OPD) is the standard approach, robotic pancreaticoduodenectomy (RPD) offers a minimally invasive alternative with potential benefits but faces challenges related to technical complexity and safety. This meta-analysis compares perioperative outcomes of RPD with PMVR versus OPD with PMVR in PDAC.

Mortality and complications in patients with obesity after open, robotic or laparoscopic pancreaticoduodenectomy: A systematic review and meta-analysis.

Objectives: This meta-analysis compares outcomes of pancreaticoduodenectomy (PD) using open (OPD), robotic (RPD), and laparoscopic (LPD) techniques in patients with and without obesity and resectable pancreatic cancer.

Methods: Thirteen observational studies evaluating 30-day mortality and postoperative complications in patients that underwent PD were included. Outcomes included mortality, major complications (Clavien-Dindo classification), and specific surgical complications: postoperative pancreatic fistula (POPF), post-PD hemorrhage (PPH), delayed gastric emptying (DGE), and surgical site infections (SSI).

Management of the Disconnected Pancreatic Duct in Pancreatic Necrosis.

Disconnected pancreatic duct (DPD) and the associated syndrome are increasingly recognized as complications of severe pancreatitis. Despite the increased appreciation for this disorder and its treatment, there remain many questions regarding definition, diagnosis, and management. We utilized the expertise of the U.

Impact of Etiology on Predictive Models for Acute Pancreatitis Severity: A Retrospective Study.

Objectives: This study aimed to evaluate whether predictive variables differ by acute pancreatitis (AP) etiology and clinical outcomes.

Methods: This retrospective study included 845 AP patients diagnosed from January 2015 to December 2022 at a tertiary care hospital. Patient characteristics, scoring systems, and biomarkers were assessed to determine AP severity, with regression analysis used to identify predictor-outcome associations.

Predictors of tract hemorrhage after external ventricular drain placement: a single-center retrospective study.

External ventricular drain (EVD) placement is often associated with complications; however, predictors of adverse outcomes after EVD placement are not well understood. This study aimed to identify predictors of EVD tract hemorrhage and to compare post-EVD hemorrhage rates between computer-assisted navigation and freehand technique EVD placement. This retrospective study included 147 consecutive patients who presented with increased intracranial pressure (ICP) requiring an EVD.

Albumin-Bilirubin (ALBI) Score and Systemic Immune-Inflammation Indexes Used As Pretreatment Outcome Predictors in Patients With Pancreatic Ductal Adenocarcinoma Undergoing Robotic or Open Whipple Procedures: A Logistic Regression Analysis.

Background Pancreatic ductal adenocarcinoma (PDAC) is the most common type of pancreatic cancer (PC) in the United States. In patients with resectable PC, identification of pretreatment biomarkers before surgery can help in the decision-making process by weighing the benefits of neo-adjuvant therapy, surgical procedure, and adjuvant therapy. The purpose of this study was to determine if the albumin-bilirubin (ALBI) score and immune-inflammatory marker levels can be used in combination as pretreatment predictors of mortality risk in patients undergoing the Whipple procedure (alternatively, pancreatoduodenectomy (PD)) for PDAC.

Development of multidisciplinary, evidenced-based protocol recommendations and implementation strategies for anterior lumbar interbody fusion surgery following a literature review.

The anterior lumbar interbody fusion (ALIF) procedure involves several surgical specialties, including general, vascular, and spinal surgery due to its unique approach and anatomy involved. It also carries its own set of complications that differentiate it from posterior lumbar fusion surgeries. The demonstrated benefits of treatment guidelines, such as Enhanced Recovery after Surgery in other surgical procedures, and the lack of current recommendations regarding the anterior approach, underscores the need to develop protocols that specifically address the complexities of ALIF.

Severe Acute Pancreatitis Prediction: A Model Derived From a Prospective Registry Cohort.

Background Severe acute pancreatitis (SAP) has a mortality rate as high as 40%. Early identification of SAP is required to appropriately triage and direct initial therapies. The purpose of this study was to develop a prognostic model that identifies patients at risk for developing SAP of patients managed according to a guideline-based standardized early medical management (EMM) protocol.

Outcomes in patients with pancreatic ductal adenocarcinoma (PDAC) undergoing robotic (RPD) or open pancreaticoduodenectomies (OPD): a propensity score-weighted survival analysis.

The purpose of this study was to compare the survival, recurrence, and complication rates in patients with pancreatic ductal adenocarcinoma (PDAC) who underwent robotic pancreaticoduodenectomy (RPD) or open pancreaticoduodenectomy (OPD) and who received adjuvant therapy. The study was a single-center retrospective analysis of consecutive PDAC patients who underwent RPD/OPD. Patient characteristics, tumor findings, neoadjuvant therapy, adjuvant therapies, overall survival (OS) and recurrence-free survival (RFS) were compared between the OPD and RPD cohorts.

Peptide receptor radionuclide therapy implementation and results in a predominantly gastrointestinal neuroendocrine tumor population: A two-year experience in a nonuniversity setting.

Neuroendocrine tumors (NETs) are rare, but the incidence and prevalence of NETs are increasing in the United States. While surgery is the preferred treatment for NETs, it is not a viable option for metastatic disease. Lutathera (177Lu-DOTATATE) is approved by the United States Food and Drug Administration and the European Medicines Agency for the treatment of gastroenteropancreatic (GEP)-NETs in adults.

Investigating the Relationship between Ambulatory and Hospital Patient Experience Scores in a Neurosurgery Practice.

Patient experience is critically important on both clinical and business levels to healthcare organizations, medical groups, and physician practices. We sought to understand whether a relationship exists between patient satisfaction scores in different settings for medical providers who practice in multiple settings (such as in the ambulatory setting and the hospital) within a system. Press Ganey (PG) ambulatory and hospital-based patient satisfaction surveys of a neurosurgery practice were retrospectively compared.

Improving the Standard of Care for All-A Practical Guide to Developing a Center of Excellence.

Pancreatic surgery is one of the more challenging procedures performed by surgeons. The operations are technically complex and have historically been accompanied by a substantial risk for mortality and postoperative complications. Other pancreatic pathologies require advanced therapeutic procedures that are highly endoscopist-dependent, requiring specific, knowledge-based training for optimal outcomes.

Mindfulness at Methodist-A Prospective Pilot Study of Mindfulness and Stress Resiliency Interventions in Patients at a Tertiary Care Medical Center.

Individuals with chronic medical conditions like cancer often experience heightened stress levels that can impact medical decision-making. The aim of this study was assess the impact of mindful stress-reduction interventions in cancer patients and support group participants (which included current and former cancer patients and their caregivers). A pilot study was conducted in which participants were provided a mindful stress-reduction intervention to determine whether they reduced stress, anxiety, and communication issues.

Analysis of 102 Fully Robotic Pancreaticoduodenectomies: Clinical and Financial Outcomes.

Objectives: The value of robotic pancreaticoduodenectomy (RPD) remains undefined. The aim of this retrospective study was to compare and assess clinical outcomes and financial variables of patients undergoing RPD versus open pancreaticoduodenectomy (OPD) at a single high-volume center.

Methods: The study design is a retrospective analysis of a prospectively maintained database of consecutive PD patients from 2013 to 2019.

A Cross-Sectional Study of Stress and the Perceived Style of Decision-Making in Clinicians and Patients With Cancer.

Background And Aims: Perceived stress and mindfulness can impact medical decision-making in both patients and clinicians. The aim of this study was to conduct a cross-sectional evaluation of the relationships between stress, mindfulness, self-regulation, perceptions of treatment conversations, and decision-making preferences among clinicians. Also, perceptions of treatment conversations and decision-making preferences among patients with cancer were evaluated.

Minimally invasive liver resection in the era of robotics: analysis of 214 cases.

Background: Minimally Invasive Liver Resection (MILR) techniques range from a hybrid-technique to full robotic approaches. When compared with open techniques, MILR has been shown to be advantageous by reducing pain, complications, length of stay and blood loss. The aim of this study was to compare clinical outcomes and hospital resource utilization between full laparoscopic, hand-assisted, and robotic liver resections among major (≥ 3 segments) and minor (≤ 2 segments) resections.

A Cross-Sectional Study of Perceived Stress, Mindfulness, Emotional Self-Regulation, and Self-Care Habits in Registered Nurses at a Tertiary Care Medical Center.

Introduction: Workplace stress and burnout may influence nurses' physical and emotional well-being, which can impact the quality of care patients receive and their overall satisfaction with their hospitalization.

Objectives: The objectives of the study were to evaluate whether there are significant statistical relationships between nurses' perceived stress, frequency of stressors, mindfulness, emotional self-regulation, self-care habits, and patient satisfaction scores.

Methods: The study took place over the course of 4 weeks.

Factors Associated With Parents' Intent to Vaccinate Adolescents for Human Papillomavirus: Findings From the 2014 National Immunization Survey-Teen.

Introduction: While factors associated with receipt of human papillomavirus (HPV) vaccination have been well characterized, less is known about the characteristics associated with parents' intent to have their adolescent children vaccinated. This study aimed to examine factors associated with parental intention toward HPV vaccination.

Methods: We analyzed data on 10,354 adolescents aged 13 to 17 years from the 2014 National Immunization Survey-Teen.