A consensus led by ESTES has produced the first cohesive framework for polytrauma care in Europe. Experts evaluated 139 recommendations from the German S3 guidelines, resulting in 135 remaining proposals, of which 128 were deemed appropriate for implementation across diverse healthcare systems. This foundational tool aims to standardize care for polytrauma patients, spanning pre-hospital to […]
Category: Appendix, Gallbladder and Surgical Emergencies
AI Successfully Predicts Major Surgery Needs in Trauma Patients
An artificial intelligence model demonstrated a significant ability to predict the need for major surgery in trauma patients, achieving an ROC-AUC of 0.80-0.86. Specifically, predictions for neurosurgery reached an ROC-AUC of 0.90-0.95, while vascular and abdominal surgeries had scores of 0.69-0.88 and 0.77-0.84, respectively. This predictive capability, utilizing prehospital data, could enhance the early triage […]
New guidelines standardize appendicitis management in Sweden
A comprehensive set of national guidelines for acute appendicitis management has been developed in Sweden, addressing significant practice variations. The guidelines, created by a working group of experts and informed by a national survey, provide evidence-based recommendations encompassing pathology, diagnosis, treatment, and special considerations for children and pregnant women. By consolidating the latest research and […]
Predictive factors for complicated acute appendicitis identified
A study of 1196 acute appendicitis patients revealed that 38.9% had complicated cases. Key predictive factors include male gender, age, duration of abdominal pain, temperature, abdominal tension, neutrophil count, and the presence of appendiceal fecaliths. The research developed a predictive nomogram that aids clinicians in distinguishing between complicated and uncomplicated cases, potentially improving surgical outcomes […]
Standardized protocols reduce opioid use in surgical patients
Standardized electronic order sets significantly decreased inpatient opioid use for emergency general surgery patients from January 2019 to June 2023. The total morphine milligram equivalents (mme) per patient and average mme per opioid dose decreased notably, demonstrating sustained effects across administration routes. Additionally, lower mme medications were increasingly ordered, and multimodal regimens expanded, all while […]
Cholecystectomy effectively resolves symptoms in biliary dyskinesia patients
A study of 415 patients identified that 89 (21%) had biliary dyskinesia, primarily affecting younger women (median age 46, BMI 28). Abdominal pain was the most common symptom. Pathological evaluations showed chronic cholecystitis in 84% of cases. Importantly, all patients with biliary dyskinesia experienced symptom resolution after cholecystectomy, suggesting this procedure is a first-line treatment […]
Robotic cholecystectomy shows better outcomes than laparoscopic method
A multihospital study analyzed 4,316 cholecystectomy patients, comparing robotic and laparoscopic techniques. Results indicated that robotic cholecystectomy was linked to significantly lower conversion rates to open surgery and overall favorable clinical outcomes. This research represents one of the largest retrospective analyses highlighting the benefits of robotic assistance in gallbladder surgery. The findings suggest a shift […]
ACS model enhances trauma care and surgeon satisfaction in Taiwan
The implementation of the acute care surgery (ACS) model at Chang Gung Memorial Hospital has revolutionized trauma care in Taiwan. This comprehensive approach, covering all stages from admission to discharge, has significantly improved patient outcomes. By broadening the role of trauma surgeons, the model not only ensures high-quality care but also fosters professional satisfaction among […]
High appendiceal tumor rate linked to periappendicular abscess
The research highlights a significant appendiceal tumor prevalence of 14.3% among patients with periappendicular abscess, markedly higher compared to 1.5% in those with uncomplicated appendicitis. Notably, age is a key risk factor, with patients over 35 years exhibiting increased tumor rates. The study proposes routine interval appendectomy for this demographic, emphasizing improved outcomes in terms […]
Sarcopenia and frailty predict poor outcomes after emergency surgery
A study involving 101 patients over 55 years undergoing emergency laparotomy revealed that sarcopenia, myosteatosis, and frailty are critical in predicting adverse outcomes. Notably, low grip strength and positive sarc-f questionnaire scores significantly associated with increased rehabilitation admission risk and likelihood of not returning home. Frailty was linked to fewer days alive outside the hospital […]