Dr Lankarani : July 2025

Friday, July 25, 2025

Surgical Pioneering and Surgical Innovation Podcast Intro by Dr Reza Lankarani, General Surgeon and Founder of Surgical Pioneering Newsletter and Podcast Series

https://www.podchaser.com/podcasts/surgical-pioneering-podcast-6147720"Surgical Pioneering and Surgical Innovation Podcast Intro by Dr Reza Lankarani, General Surgeon and Founder of Surgical Pioneering Newsletter and Podcast Series" The Surgical Pioneering Podcast, hosted by Dr. Reza Lankarani, explores advancements and debates in general surgery, featuring discussions on topics like GLP1 agonists versus bariatric surgery and bridging anticoagulation.• The podcast is available on multiple platforms, including Apple Podcasts, Audible, Amazon Music, and YouTube, offering accessibility to a wide audience interested in surgical innovation.• The podcast's mission statement emphasizes its role as a global hub for 'Surgical Frontiers: Pioneering Tech Transforming Surgical Care,' highlighting its focus on cutting-edge surgical techniques and technologies.• Listeners can find episodes discussing various surgical topics, including the Triglyceride-Glucose (TyG) index in relation to breast cancer, the Vagilangelo® Procedure Scientific Weaknesses and Limitations, and perioperative hydrocortisone use."Surgical Pioneering Surgical Frontiers: Pioneering Tech Transforming Surgical Care” Mission Statement: Welcome to Surgical Frontiers, a global nexus for surgeons, researchers, engineers, and healthcare innovators dedicated to advancing surgical care through groundbreaking technology. This group is not just a platform—it’s a movement. Here, we explore, debate, and champion the innovations redefining the art and science of surgery. From AI-driven diagnostics to robotic-assisted procedures, augmented reality (AR) surgical navigation, and bioengineered implants, we are the vanguard of a new era in medicine. If you’re driven by curiosity, excellence, and the relentless pursuit of better patient outcomes, you belong here. --- Our Core Values: 1. Innovation First Surgery is no longer confined to scalpels and sutures—it’s a fusion of biology, engineering, and data science. We prioritize discussions on emerging technologies (e.g., nanorobotics, AI-powered predictive analytics, 3D bioprinting) and their real-world applications. Share prototypes, clinical trial results, or even bold hypotheses—if it pushes boundaries, we want to hear it. 2. Collaboration Over Competition Breakthroughs happen when diverse minds unite. Surgeons, engineers, ethicists, and entrepreneurs are all equal stakeholders here. Whether you’re a seasoned robotic surgeon or a startup founder developing smart OR tools, your perspective matters. Let’s dismantle silos and co-create solutions. 3. Evidence-Based Excellence Pioneering doesn’t mean reckless. We demand rigor. Posts about new tools or techniques should be grounded in peer-reviewed research, clinical data, or transparent case studies. Anecdotes are welcome, but they must spark deeper inquiry, not replace it. 4. Patient-Centric Ethics Technology is a means, not an end. Every innovation must answer: How does this improve patient safety, accessibility, or outcomes? We encourage tough conversations about cost, equity, and unintended consequences. Glorifying ”tech for tech’s sake” has no place here. 5. Global Perspective Surgical challenges vary wildly between a high-resource urban hospital and a rural clinic. Share insights from low-income regions, disaster zones, or underserved communities. Innovation thrives when we solve for the margins, not just the mainstream. --- What You’ll Find Here : - Breakthrough Technologies: Deep dives into robotics, AI/ML applications, AR/VR surgical training, IoT-enabled devices, and beyond. - Expert Insights: Q&As with thought leaders, interviews with FDA regulators, and AMAs (Ask Me Anything) with pioneers. - Case Studies: How a hospital in Kenya adopted portable robotic tools, or how a Boston team used AI to reduce post-op infections by 40%. - Ethical Debates: Should AI diagnose surgical complications? Who owns data from smart implants? - Resource Sharing: Grants, conferences (e.g., SAGES, AACR), and regulatory updates. --- Why Join? - Learn: Weekly summaries of JAMA Surgery or Annals of Surgery highlights. - Influence: Shape the future by beta-testing tools, joining global consortia, or advising startups. - Grow: Mentorship threads for residents, grants for underrepresented innovators, and hackathons. --- The Future We’re Building: Imagine a world where: - A surgeon in Mumbai receives real-time AR guidance from a specialist in Toronto. - Bioprinted organs eliminate transplant waitlists. - AI predicts surgical complications before the first incision. ”This isn’t science fiction—it’s the horizon we’re sprinting toward.” Let’s pioneer responsibly. Let’s operate fearlessly. Post, comment, and collaborate. The next surgical revolution starts here. — Dr Reza Lankarani, General Surgeon and Founder of Surgical Pioneering Newsletter and Podcast Series #SurgicalPioneering #SurgicalInnovation #DrRezaLankarani #podcastseries

Monday, July 21, 2025

"Does perioperative hydrocortisone reduce morbidity after pancreatoduodenectomy? A propensity score matched analysis"

"Does perioperative hydrocortisone reduce morbidity after pancreatoduodenectomy? A propensity score matched analysis" Reviewed by Dr. Reza Lankarani, General Surgeon and Founder of Surgical Pioneering Series Published: 20 July 2025 https://doi.org/10.1007/s13304-025-02280-4 Updates in Surgery, Springer This propensity score-matched analysis by Radulova-Mauersberger et al. investigates whether perioperative hydrocortisone (HC) reduces morbidity after pancreatoduodenectomy (PD). The study leverages a decade-long database (2012–2022), matching 110 HC-treated patients (100 mg IV for 48h) with 110 non-HC controls. The primary finding—no significant reduction in overall morbidity, POPF, PPAP, or major complications (CDC ≥3) with HC—challenges prior hypotheses about HC’s anti-inflammatory benefits in pancreatic surgery. Notably, HC did not mitigate postoperative hyperamylasemia (POH) or PPAP incidence, even after stratifying by FRS risk. However, HC was associated with significantly reduced in-hospital mortality (1.8% vs. 9.1%, p=0.03) and shorter ICU stays (p=0.05), suggesting potential systemic protective effects unrelated to fistula or pancreatitis. Strengths Assessment : The study’s principal strength lies in its robust methodology. The 1:1 propensity score matching effectively balanced critical confounders (e.g., FRS, pancreatic texture, duct diameter, ISGPS-POPF risk), minimizing selection bias inherent to retrospective designs. The authors further enhanced rigor through comprehensive subgroup analyses (e.g., FRS stratification) and adherence to standardized outcome definitions (ISGPS, CDC), ensuring clinical relevance. Additionally, the large matched cohort (n=220) derived from a high-volume center provides substantial statistical power. The discussion thoughtfully contextualizes contradictory literature (e.g., Finnish RCTs vs. Chinese dexamethasone trials), highlighting the nuanced role of HC in mortality reduction despite null effects on primary endpoints. Key Limitation : The retrospective, single-center design limits causal inference, and unmeasured confounders (e.g., surgeon experience, evolving perioperative protocols) may persist. The omission of acinar cell quantification (a biomarker in prior RCTs) precludes direct mechanistic comparisons. Nevertheless, this study offers pivotal real-world evidence that HC’s purported anti-inflammatory benefits may not translate to reduced pancreatic-specific complications, urging caution in clinical adoption and underscoring the need for biomarker-driven RCTs. Final Comment: This analysis excels in methodological rigor and clinical nuance, contributing critical equipoise to the steroid-prophylaxis debate in pancreatic surgery. While HC failed its primary endpoint, its mortality benefit warrants deeper mechanistic exploration. Conclusion: This study provides valuable real-world evidence but underscores the complexity of inflammation modulation in PD. While HC does not reduce POPF/PPAP, its association with lower mortality merits validation in prospective trials. Future research should prioritize: Multicenter RCTs with biomarker stratification. Integration with minimally invasive techniques . Comparative efficacy studies of HC vs. dexamethasone. The findings align with the broader trend of refining perioperative care through precision medicine and technological advancements in surgery. #pancreatoduodenectomy #hydrocortisone #perioperativecare #surgicalmorbidity #pancreaticsurgery #post-oprecovery #inflammationreduction #corticosteroids #surgerycomplications #morbidityprevention #pancreaticoduodenectomy #steroidtherapy #surgicaloutcomes #postoperativemanagement #clinicalresearch