In a retrospective study spanning 25 years, researchers evaluated laparoscopic surgery’s role in diagnosing and treating anterior abdominal stab wounds (AASWs). Among 142 surgical patients, laparoscopy (62.7%) proved safe, with only 2 cases of overlooked injuries. For stable patients without significant injuries, laparoscopy demonstrated advantages, including reduced blood loss and shorter hospital stays compared to […]
Category: Appendix, Gallbladder and Surgical Emergencies
Deep Neuromuscular Blockade Mitigates Working Space Issues in Low-Pressure Pneumoperitoneum during Laparoscopic Cholecystectomy
In a non-inferiority RCT comparing low-pressure pneumoperitoneum (LPP) with deep neuromuscular blockade (NMB) to standard pressure pneumoperitoneum (SPP) with moderate NMB for laparoscopic cholecystectomy, researchers found similar surgeon satisfaction scores between groups. This suggests that LPP with deep NMB is not inferior to SPP with moderate NMB, indicating a potential approach to address working space […]
Surgery in Acute Lower Gastrointestinal Bleeding
In a cohort study of 10,342 acute lower gastrointestinal bleeding (ALGIB) cases, surgery was performed in 1.3%. Colonoscopy (87.7%) and endoscopic hemostasis (26.7%) were common. Surgery indications included diverticular bleeding (24%) and colorectal cancer (22%). Sixty-four percent were for severe refractory bleeding. Postoperative rebleeding rates were 22% (presumptive/obscure source) and 12% (definitive identification). Thirty-day mortality […]
Optimal Outcomes in Emergency Intra-Abdominal Surgery: Surgeon Volume Trumps Hospital Volume
A meta-analysis scrutinizing 33 cohort studies explores the impact of hospital and surgeon volume on mortality in intra-abdominal emergency surgery. High hospital volume proves beneficial overall, except for low-complexity procedures, while high surgeon volume consistently associates with lower mortality. Notably, mortality is significantly lower when high-volume surgeons operate in low-volume hospitals. The findings advocate prioritizing […]
Comparable Medium-Term Outcomes: Robotic vs. Laparoscopic Cholecystectomy
Researchers compared medium-term outcomes between robotic-assisted cholecystectomy (RC) and laparoscopic cholecystectomy (LC) using quality of life (QOL) and pain assessments. In a cohort from 2012 to 2017, 122 patients completed surveys in 2019. Both groups were similar in demographics. No overall QOL difference was found, but LC patients reported higher severity in specific pain categories. […]
Intraoperative Swab Impact in Appendectomy for Uncomplicated and Complicated Appendicitis
In a study of 1570 adult appendectomy patients, intraoperative swabs were taken in 29%, revealing a 51% bacterial isolation rate, higher in complicated appendicitis. A positive swab correlated significantly with worse postoperative outcomes, increased morbidity, re-surgery, and longer hospital stay. Positive swabs were independent risk factors for morbidity and the need to adjust postoperative antibiotics. […]
Appendectomy vs. Hemicolectomy for 1- to 2-cm Appendix Neuroendocrine Tumors: A Survival Analysis
Examining 3,189 patients with 1- to 2-cm neuroendocrine tumors of the appendix, researchers found that while the appendectomy rate increased over the years, it wasn’t linked to improved survival compared to right hemicolectomy. Grade 2 and 3 tumors were associated with a lower likelihood of appendectomy. Despite differences in tumor grades and patient travel distance, […]
Prophylactic Negative Pressure Wound Therapy in Emergency Laparotomy: No Significant Reduction in Surgical Site Infections
Examining 65,803 emergency laparotomy patients, researchers found no significant difference in surgical site infection (SSI) rates when comparing prophylactic negative pressure wound therapy (NPWT) to standard dressings. Propensity-matched cohorts with completely or partially closed incisions showed similar SSI rates (13.4% vs. 11.9% and 3.6% vs. 4.4%, respectively). Secondary outcomes, including postoperative complications and hospital length […]
Refining Training Guidelines for Laparoscopic Cholecystectomy Safety Assessment: Expert Perspectives on “Unsafe” Practices
A multinational study involving 11 expert laparoscopic cholecystectomy surgeons aimed to enhance the Laparoscopic Cholecystectomy Critical View of Safety (LC-CVS OPSA). By analyzing ratings of “unsafe” practices, the study identified three major categories: failure to achieve critical view, suboptimal technique despite safe completion, and safe completion with potential future risks. Findings informed modifications to enhance […]
Decline in Pelvic Floor Integrity Linked to Escalating Grades of Rectal Intussusception: A Comprehensive Analysis of Contributing Factors.
Study Finds Decline in Pelvic Floor Integrity Associated with Increased Rectal Intussusception Grades, Independently of Obstetric and Surgical History. The analysis of 238 women revealed that factors like age, vaginal delivery, and pelvic surgery correlated with higher Oxford grades of rectal intussusception. Abnormal levator ani laxity and concurrent pelvic floor issues were independently linked to […]