A novel wearable device significantly outperforms metoclopramide in managing moderate to severe postoperative nausea and vomiting (PONV). The TEAS group achieved a 2-hour remission rate of 77.6% vs. 55.2% for controls (p < 0.001). 24-hour relapse rates were 12.2% for TEAS compared to 56.3% for metoclopramide (p < 0.001). This suggests wearable TEAS could enhance […]
Category: General Surgery
Liver Fibrosis Increases Recurrence Risk in Colorectal Metastases
Background liver fibrosis intensifies the risk of intrahepatic recurrence after surgery for colorectal liver metastases, impacting surgical decision-making. Intrahepatic recurrence occurred in 36.3% of patients post-surgery, with 58.3% in the fibrosis group vs. 29.5% in the non-fibrosis group (p = 0.019). Each 1% increase in fibrotic area raised recurrence risk by 45% (hazard ratio 1.45; […]
Identifying Risks After Pancreatoduodenectomy
In-hospital mortality after pancreatoduodenectomy reveals critical timing for interventions impacting patient outcomes. 3.5% of patients (156 of 4474) died in the hospital, primarily from three complication clusters: postpancreatectomy-specific (51.9%), vascular (25.6%), and cardiopulmonary (17.9%). Complications emerge at different postoperative intervals: median 9 days for postpancreatectomy, 4.5 days for vascular, and 3 days for cardiopulmonary issues. […]
Reducing Water Waste at OR Scrub Sinks
Surgeons are wasting an estimated 337,596 liters of water annually during surgical scrubs, representing 34.2% of total usage. The median water wasted per wet scrub at timer-controlled sinks is 10 liters. Wet scrubs are performed in 25.9% of cases by attending surgeons and OR staff. Optimizing scrub practices could lead to significant water conservation without […]
CA 19-9 Testing Improves Survival in Resected Ampullary Cancer
Routine CA 19-9 surveillance detects recurrences early and enhances survival in resected ampullary cancer patients. Five-year overall survival stands at 56.4% in 572 patients, with 43.88% experiencing recurrences, predominantly distant. A serial rise in CA 19-9 is a strong predictor for recurrence, showing 71.05% sensitivity and 91.67% specificity. Detecting recurrences early through CA 19-9 testing […]
Active Surveillance Offers Quality of Life Benefits in Oesophageal Cancer
Active surveillance after neoadjuvant chemoradiotherapy provides similar survival to surgery while significantly enhancing quality of life for patients with locally advanced oesophageal cancer. Active surveillance patients reported significantly better scores for dysphagia, dyspnoea, fatigue, and physical functioning at 6 months (Cohen’s d of -1.09, -0.63, -0.70, and 0.77, all p ≤ 0.001). Dysphagia improvements were […]
Intrathoracic Side-Overlap Anastomosis Reduces Pain and Reflux
Intrathoracic side-overlap esophagogastrostomy (SOE) shows promise as a viable alternative to circular stapled (CSE) technique in esophagectomy for Siewert type I/II adenocarcinoma. SOE leads to significantly lower postoperative pain scores: 3.49 vs. 4.04 on day one (p=0.002). Severe gastroesophageal reflux is lower with SOE (14.5%) compared to CSE (34.0%) (p=0.019). Dysphagia symptoms are reduced with […]
10-Year Outcomes: Distal vs. Standard Roux-en-Y Bypass
Distal Roux-en-Y gastric bypass results in greater long-term weight loss but carries higher risks of nutritional deficiencies. Mean BMI reduction after standard RYGB was 12.0 kg/m2 vs. 14.7 kg/m2 for distal RYGB, a significant difference of 2.7 kg/m2. Total weight loss percentage was 23.0% for standard vs. 28.2% for distal, a difference of 5.3% (p […]
Predicting Opioid Needs After Surgery
Machine learning can help personalize opioid-sparing strategies for outpatient surgeries. In a study of 223 patients, 42% required opioids, using a median of 4 doses post-surgery. The machine learning model identified key risk factors like active cancer and age, achieving an AUC of 0.674, with 70% sensitivity and 68% specificity. Adoption of this model could […]
Limited knowledge of CoC Standards in surgical trainees
Surgical trainees show significant gaps in understanding critical cancer surgery standards, impacting surgical outcomes. Only 30% of trainees received formal training on CoC operative standards. Correct response rates were just 30% for CoC standards versus 50% for core cancer principles. Incorporating education on these standards is crucial for improving surgical quality and documentation practices. 71% […]