Among 989,354 opioid-naïve patients, initial opioid prescription size dropped from 282 mg to 164 mg morphine equivalents, and new persistent opioid use declined from 2.7% in 2013 to 1.1% in 2021. These changes suggest effective opioid stewardship practices. Increases in prescription size correlated with higher persistent use, with every 30 mg increase linked to a […]

Findings indicate that older veterans living in deprived neighborhoods and identifying as black experience poorer surgical outcomes and higher care fragmentation. The study analyzed 93,644 veterans and identified that black veterans had worse outcomes (adjusted odds ratio, 1.06) and those with increased non-VA care days exhibited higher doors scores (adjusted odds ratio per 20%, 1.01). […]

Results indicate that performance in simulated robotic gastrojejunostomy correlates significantly with intraoperative outcomes. The study surveyed 27 general surgery residents, revealing a strong positive relationship between simulated and actual scores (r=0.74, p

A high-dose amino acid supplementation in patients undergoing gastrointestinal tumor surgery was associated with a significant reduction in infection incidence during hospitalization and within 30 days post-surgery compared to standard care. The amino acid intake was higher in the supplementation group (1.81 g/kg vs. 0.94 g/kg, p

A study involving 3,778 older adults showed significant associations between depression, resilience, and perceived control of health with mortality and functional decline following surgery. Postoperative mortality was 18.5%, while 9.4% experienced a decline in instrumental activities of daily living (IADL). Depression increased mortality risk (26% vs. 16%), while high resilience and perceived control lowered it […]

A Blue Ribbon Committee II has identified key challenges in surgical education and proposed recommendations to improve medical student training. The subcommittee conducted a comprehensive literature review to inform its strategies, which address recruitment, surgical engagement, and the transition from undergraduate to graduate medical education. Major shifts in medical education and surgical practice over the […]

Findings indicate that team member familiarity directly enhances perceived team effectiveness in operating rooms. This relationship is significantly mediated by shared mental models and mutual trust among team members. Data from two hospitals reveal that individual variance primarily drives perceived effectiveness, with a smaller portion (12%) attributed to operating room level factors. To improve overall […]

Intraperitoneal ropivacaine significantly reduced opioid consumption and pain scores, enhancing postoperative recovery following laparoscopic digestive surgery. The analysis of 24 randomized controlled trials (RCTs) with 1705 patients revealed decreased total opioid use within the first 24 hours (mean difference = -21.93) and shorter hospital stays (mean difference = -0.20 days). Additionally, it lessened shoulder pain […]

A novel simulation-based assessment of operative competence was developed, demonstrating high inter-station reliability (α = 0.81) and acceptable inter-rater reliability (0.77). Significant differences emerged in mean scores between junior and senior trainees (44.82 vs 58.18, p = 0.004), with mean scores moderately correlating with training years (rs = 0.74, p = 0.004). The assessment resulted […]