The study examined postoperative ambulation using accelerometers in outpatient abdominal surgeries and its impact on 30-day readmissions and ED utilization. Out of 106 patients, those who failed to reach their preoperative step count within one week were 6× more likely to visit the ED. Geriatric patients had a lower likelihood of meeting their preoperative baseline […]
Category: Appendix, Gallbladder and Surgical Emergencies
Remote Triage of General Surgery Patients in Freestanding Emergency Departments: Low Undertriage and Overtriage Rates
During a 6-year analysis, this study examined the outcomes of general surgery patients who received remote triage and disposition in freestanding emergency departments. Of the 1,105 patients, 15% were discharged home, 27% were transferred to trauma centers, and 58% were transferred to community hospitals. Patients admitted to trauma centers were older and had higher acuity […]
Increased Incidence of Gastrostomy Tube Placement in Surgical Necrotizing Enterocolitis
Approximately 56.3% of infants with surgical necrotizing enterocolitis (NEC) required gastrostomy tube (GT) placement after ostomy reversal. GT placement may be safely performed concurrently with ostomy reversal, reducing the need for an additional procedure. Gestational age and birth weight did not significantly differ between patients who did and did not require GT placement. The hospital […]
No significant difference in patient outcomes between trainee-led and consultant-led emergency laparotomy
Based on a population dataset analysis, this study compared the outcomes of trainee-led emergency laparotomy surgeries with consultant-led surgeries. The study included 111,583 patients and found that mortality rates at discharge were equivalent between the two groups after adjusting for various factors. Trainee-led operations reported fewer cases of significant blood loss, and the length of […]
Laparoscopy Safely Manages Anterior Abdominal Stab Wounds
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 […]
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. […]