Surgery
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The neutrophil-to-lymphocyte ratio (neutrophil count divided by lymphocyte count) is a marker of inflammation associated with poor cancer outcomes. The role of neutrophil-to-lymphocyte ratio in borderline resectable pancreatic ductal adenocarcinoma is unknown. We hypothesized that increased neutrophil-to-lymphocyte ratio in patients with borderline resectable pancreatic ductal adenocarcinoma after neoadjuvant therapy is inversely associated with survival. ⋯ This investigation shows an independent, inverse association between survival and decreased neutrophil-to-lymphocyte ratio in patients with borderline resectable pancreatic ductal adenocarcinoma. These findings support exploring predictive inflammatory biomarkers, such as neutrophil-to-lymphocyte ratio, to investigate inflammation and improve outcomes.
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Comparative Study
Surgical skill in bariatric surgery: Does skill in one procedure predict outcomes for another?
Recent data establish a strong link between peer video ratings of surgical skill and clinical outcomes with laparoscopic gastric bypass. Whether skill for one bariatric procedure can predict outcomes for another related procedure is unknown. ⋯ Video ratings of surgical skill with laparoscopic gastric bypass do not predict outcomes of laparoscopic sleeve gastrectomy. Evaluation of surgical skill with one procedure may not apply to other related procedures and may require independent assessment of surgical technical proficiency.
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Mediastinal involvement in resected non-small-cell lung cancer mandates adjuvant therapy and affects survival. This study investigated lymph node dissection efficacy, lymph node metastasis detection, and survival after robotic-assisted lobectomy for non-small-cell lung cancer. ⋯ Mediastinal lymph node dissection during robotic-assisted lobectomy adequately assesses lymph node stations and detects occult lymph node metastasis. Stage-specific survival is affected by upstaging.
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On October 3, 2015, a United States airstrike hit Médecins Sans Frontières (Doctors Without Borders) Trauma Centre in Kunduz, Afghanistan. Our aim was to describe the care provided and estimate the health burden averted by surgical care at the hospital. We also report the benefit rendered by the Trauma Centre to the health of the local population prior to its destruction. ⋯ The health burden averted by the surgical care provided at the Trauma Centre was large; it is critically felt by those still living in the region. Access to essential trauma care for all victims of armed conflict is a human right; as directed by International Humanitarian Law, we must guarantee special protection for the wounded, sick, and medical personnel and facilities during war.