Upstream factors in the enhanced recovery after surgery (ERAS) pathway significantly influence postoperative compliance in liver resection patients, suggesting that focusing on these elements can improve outcomes. Compliance increased from 32.4% at baseline to higher levels as upstream elements like avoiding bowel prep and preoperative carbohydrate loading were successfully implemented. Four key preoperative interventions were […]

A significant 41.1% of surgical faculty are seriously considering leaving their jobs, primarily due to dissatisfaction with leadership, burnout, and poor work-life balance. First-job surgeons report a higher turnover intention (47.2%) compared to their more experienced colleagues (32.1%). Long clinical hours correlate with increased turnover intentions (working 50 hours per week vs. 40 hours significantly […]

Postoperative venous thromboembolism (VTE) incidence, timing, and thromboprophylaxis practices differ significantly across surgical subspecialties, impacting patient management strategies. Of 1,520 patients with VTE, medians were 4 days to VTE development, with pulmonary embolism occurring significantly earlier than deep vein thrombosis (3 vs 6 days). Neurosurgery had the highest incidence of VTE (0.23%), while orthopedic surgery […]

Patients with common cancers treated at centralized hub hospitals are more likely to receive evidence-aligned care compared to those treated at spoke hospitals within decentralized health systems. 70.9% adherence to evidence-aligned surgical care was observed overall, but this varied significantly between highly adopted (77.4%) and poorly adopted practices (29.9%). For poorly adopted practices, hubs in […]

Only 40.4% of surgical residents participate as members of the American College of Surgeons, with significant disparities based on training pathways and specialties. Specialties with dual training pathways (integrated and independent) had much higher ACS representation than those with integrated-only pathways (19.1% vs 4.2%). Highest ACS membership was seen in vascular surgery (26.5%) and lowest […]

Surgical fellows demonstrate significant stringency in self-assessment of their technical skills compared to faculty evaluations, which has implications for surgical training and professional development. Fellows rated their entrustment levels at 2.98, while faculty rated them at 3.28 (p < 0.001), indicating fellows are generally more critical of their own performance. Accuracy of self-assessment improved with […]

Electrocautery-incorporated smoke evacuation significantly reduces harmful surgical smoke exposure compared to traditional hose-type systems, particularly with an 8 mm tip distance. The 8 mm system achieved a 96-97% reduction in particle counts across sizes from 0.3 to 5.0 μm. Acetaldehyde and formaldehyde levels were also significantly lower in the electrocautery groups compared to hose evacuation. […]

A novel classification system, DISH (Dehiscence, Infection, Seroma, Hematoma), standardizes the reporting of surgical site outcomes and has achieved very high inter-rater reliability. Consensus definitions for five grades of clinical intervention and four grades of clinical presentation were established through a modified Delphi study involving global experts. Mean inter-rater agreement was 0.93, with intra-rater scores […]

Postoperative pulmonary complications (PPCs) occur in over 33% of patients after laparoscopic gastrointestinal cancer surgery, but modifiable factors can help reduce risk. Identified independent risk factors include upper abdominal surgery (OR 5.609), higher smoking intensity (OR 1.025), and minilaparotomy-assisted plateau pressure above 16 cmH₂O (OR 1.574). Maintaining plateau pressure between 12-14 cmH₂O significantly lowers the […]

Patients report that readiness for discharge after cancer surgery involves complex, evolving factors, and operational readiness often lags behind physiological and psychosocial recovery. In a study of 2,828 discharge milestones, physiological and psychosocial readiness reached 88% in the hours before discharge, while operational readiness only reached 58%. This asynchronous recovery highlights significant barriers in the […]