Level I and II centers frequently operate at over 80% bed occupancy, especially in the South and West, where nearly 80% exceeded this for 75 weeks or more. Under simulated scenarios, a patient influx of 1500–2000 daily leads to a deficit of over 20,000 beds within 45 days. Surgeons must consider these limits when planning […]
Category: Appendix, Gallbladder and Surgical Emergencies
Laparoscopic Surgery Reduces Complications for Strangulated SBO
Laparoscopic surgery may significantly lower postoperative complications in patients with strangulated small bowel obstruction (SSBO). Complications (Clavien-Dindo grade ≥ II) were 7.4% with laparoscopy versus 29.6% for open surgery (p = 0.036). Conversion to open surgery occurred in 25.6% of laparoscopic cases, primarily in those with prior laparotomies or gastrointestinal surgeries. Surgeons should consider laparoscopic […]
Navigating Challenges in Emergency Surgery for Older Adults
Surgeons need to recognize unique diagnostic hurdles when treating older adults in emergency general surgery, as these can lead to worse outcomes. Key challenges identified include atypical presentations, multiple comorbidities, and age-related complications. Emphasis on non-diagnostic factors like functional health, patient preferences, and family involvement must not be overlooked. Tailoring strategies, like using surgical risk […]
Surgeons Gain Ground in Choledocholithiasis Management
Surgeons can now effectively manage choledocholithiasis using a streamlined laparoscopic common bile duct exploration (LCBDE) pathway. Overall duct clearance improved from 70.6% to 87.0% after full implementation (p=0.042). Median hospital stay dropped significantly from 72.1 hours to 40 hours (p=0.01) without increasing operative time. This surgeon-led approach supports a more efficient, one-stop surgical solution for […]
New Guidelines Transform Acute Appendicitis Management
Updated recommendations for managing acute appendicitis focus on improving surgical outcomes and patient selection. Clinical risk scores and imaging enhance diagnostic accuracy, lowering negative appendectomy rates. Nonoperative treatment with antibiotics is safe for select patients with uncomplicated appendicitis. Delay appendectomy for uncomplicated cases by up to 24 hours without raising adverse outcomes. Laparoscopic appendectomy remains […]
Single-port robotic cholecystectomy shows clear patient benefits.
Patients undergoing robotic cholecystectomy experienced lower postoperative pain scores and needed fewer opioids compared to laparoscopic patients. Mean operative times were similar: 59.0 minutes for laparoscopic versus 54.3 minutes for robotic (p=0.134). Gallbladder perforation rates were higher in the laparoscopic group. Robotic approaches may enhance patient recovery and comfort without affecting safety or complication rates. […]
Emergency Colorectal Cancer Presentation in Africa: A Call for Action
Emergency presentations of colorectal cancer in Africa are variable and poorly understood, impacting surgical outcomes and patient management. Reported rates of emergency presentations range from 8.3% to 64.9%. Limited data on early mortality and no long-term outcome data post-surgery. Surgeons should note the clinical signs: bowel obstruction, perforation, and peritonitis. Treatment largely relies on surgery; […]
Emergency Surgery Models Cut Deaths for High-Risk Patients
A study finds that emergency general surgery models improve outcomes significantly for high-risk patients. Patients with high-risk conditions in these models had a 15% lower risk of dying within 30 days (adjusted risk ratio 0.85) compared to standard surgeon on-call care. For the same group, 90-day mortality was reduced by 18% (adjusted risk ratio 0.82). […]
Pre-Hospital Whole Blood Shows Promise for Blunt Trauma Resuscitation
Whole blood (WB) transfusion in pre-hospital settings may enhance survival for blunt trauma patients compared to packed red blood cells (PRBCs). Patients needing transfusions saw lower in-hospital blood requirements with WB (2 units vs. 3 PRBCs, p < 0.001). No significant differences in overall mortality at 24 hours (3.5% for WB vs. 6.25% for PRBCs, […]
Gun Policy Impacts on Firearm-Related Deaths and Suicides
Surgeons should be aware that specific gun policies can significantly lower firearm-related death and suicide rates. Safety training requirements lead to a 29% reduction in death rates (p < .01). Permit requirements decrease suicide rates by 15.9% (p < .05). Targeting these policies in surgical practice may enhance patient safety and community health outcomes. The […]