Surgeons involved in global surgery face significant barriers that impact engagement and outcomes. Early mentorship and community networks were vital for sustained commitment. Financial and institutional recognition obstacles hinder career development. To cultivate competent global surgery leaders, focus on improving training pathways and addressing funding challenges. Emphasizing humility and long-term impact is crucial for effective […]
Category: General Surgery
Hepatic artery infusion pump improves survival in cholangiocarcinoma.
Patients with unresectable, liver-confined intrahepatic cholangiocarcinoma treated with HAIP chemotherapy showed notable outcomes. Median overall survival was 26 months; 3-year survival rate was 28%, and 5-year survival rate was 15%. Partial response on imaging was achieved in 53% of patients, with a disease control rate of 96%. Consider HAIP chemotherapy for selected patients, particularly since […]
Surgeons Achieve Higher Resection Rates in Pancreatic Cancer
A nationwide protocol led to significantly increased resection rates for locally advanced pancreatic cancer (LAPC) in the Netherlands, improving potential long-term survival. Resection rates jumped to 86%, nearly three times the expected number. In-hospital major morbidity was 44%, while mortality was just 0.6%, both within safety benchmarks. Implementing international best practices is feasible and could […]
Disparities in Liver Cancer Outcomes Demand Local Guidelines
A study reveals stark differences in hepatocellular carcinoma outcomes between South Africa and Sweden, highlighting the need for region-specific treatment protocols. Patients in South Africa were significantly younger (median 50 vs. 71 years) and had more advanced disease. Only 9.2% received curative treatments in South Africa versus 42.5% in Sweden. Survival rates were drastically lower: […]
Cholecystectomy Beats ERCP for Gallstone-Related Pancreatitis
Same-admission cholecystectomy lowers recurrence of acute pancreatitis compared to ERCP or no intervention. Recurrence rates post-discharge: 3.4% (cholecystectomy), 4.9% (ERCP), and 17.5% (no intervention). Other gallstone complications: 1.6% in the cholecystectomy group versus 19.9% (ERCP) and 16.3% (no intervention). Prioritizing immediate cholecystectomy can improve long-term outcomes in suitable patients. Risk of recurrence surged 8 to […]
Liver Transplant for Unresectable Biliary Cancers Shows Clear Survival Metrics
Liver transplantation can provide significant outcomes for unresectable biliary tract cancers, but patient selection is critical. 1-, 3-, and 5-year survival rates are 88%, 68%, and 58%, respectively. Recurrence occurs in 40.8% of patients, with a median time to recurrence of 16 months. Consider lymph node positivity, ICCA subtype, and tumor size as key predictors […]
Automated Quality Assessment in Distal Gastrectomy
A new computer vision model shows that the Critical View of Quality (CVQ) can enhance lymphadenectomy quality in gastric cancer surgery. CVQ correlates positively with lymph node yield (r=0.485, p<0.001), with retrieval increasing from 28.9 to 47.6 nodes across quartiles (p<0.001). Lower CVQ scores link to older age, higher BMI, ASA classification, male sex, and […]
Robotic Liver Surgery: Learning Curves Show Improving Outcomes
Robotic liver resection is safe and shows better outcomes as surgeons gain experience. Operative time decreases significantly after 62 cases, from 240 to 220 minutes. Progress to mastery increases textbook outcomes from 76% to 87%. High complexity cases still meet benchmark standards, indicating robust performance. Major complications plateau at 9% during proficiency, with low conversion […]
Navigating Canada’s Physician Job Market: Challenges and Insights
Surgeons need to know that securing employment in resource-intensive specialties in Canada remains challenging due to a complicated hiring process. The study involved 20 physicians across 15 specialties, highlighting a nebulous and opaque hiring landscape. Participants noted hiring decisions often depend on subjective perceived fit, raising concerns about bias and inequity. Structured national guidelines could […]
Governance Framework for AI in Surgery Established
A new framework guides the ethical adoption of AI in surgical practice. AI-enabled decision support systems can now match or exceed human performance in certain tasks. A 19-item consensus framework developed through expert consensus highlights key governance areas: technical design, implementation, ethics, and bias. Addressing these themes is crucial for ensuring AI adoption enhances care […]