Leandro Feo

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Leandro Feo

Leandro Feo

@LeandroJFeo

Colorectal surgeon in Boca Raton, FL. colorectal surgical oncology. Loves football (soccer) tweets=mine

Boca Raton, FL Katılım Haziran 2011
124 Takip Edilen101 Takipçiler
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Sean Langenfeld
Sean Langenfeld@SeanLangenfeld·
Interesting new Finnish RCT in @JAMASurgery evaluating ICG's impact on anastomotic leak in colon surgery. The results won't make you switch camps, regardless of which one you're in, but they're important: -No difference in AL rates, reoperations, or overall complications between the ICG and control groups. -Trend toward decreased AL in left-sided anastomoses for ICG (interpret with caution) -No patients received oral abx, and the group was mixed on no prep vs mechanical vs enemas. -LARs excluded, which would have presumably been at a higher risk of compromised perfusion and leak, and were the focus of previous studies. -Anastomotic configurations varied, with a lot of isoperistaltic linear right-sided anastomoses, and 20% of left-sided anastomoses either linear or handsewn (vs circular stapled). -More than 50% of surgeons in their first 10 years of practice, and about 30% with less than 50 previous lap colon cases. -Overall leak rates of 6-10%, which is probably higher than what a lot of us quote patients. Take home point (IMHO): perfusion is but one of many contributors to anastomotic leak, and ICG may make you feel better, but it won't bring your leak rate below 5%. jamanetwork.com/journals/jamas…
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Steven D Wexner MD, PhD
Steven D Wexner MD, PhD@SWexner·
Transition to lateral lymph node dissection in rectal cancer: Forty-five years of outcomes data surgjournal.com/article/S0039-… @SurgJournal from 🇯🇵 “The impact of lateral lymph node dissection on rectal cancer treatment may not have changed in 45 years, given the lack of difference in relapse-free survival.”
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Sean Langenfeld
Sean Langenfeld@SeanLangenfeld·
Excellent @DCRjournal study from @JonVogel7 and team looking at 545 US patients with rectal cancer undergoing watch-and-wait after a cCR. Only 18 (3%) were MMR deficient. As much as we all hope to find dMMR rectal cancers to treat with immunotherapy, they're very uncommon. pubmed.ncbi.nlm.nih.gov/39508482/
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