Histopathologic response predicts better survival in pancreatic cancer patients despite imaging showing stable or progressive disease. 89% of patients completed neoadjuvant therapy; 73% underwent resection. Radiographic response was low: 27% had tumor regression, while 66% had stable disease. 83% achieved significant serum CA 19-9 reduction, and 74% showed histopathologic response after resection, including 8% with […]
Category: General Surgery
Non-technical Errors Contribute to 68% of Surgical Deaths
Non-technical errors during emergency general surgery significantly impact patient mortality, revealing critical areas for improvement. Non-technical errors were found in 67.9% of 1,164 surgical deaths, totaling 1,053 unique mistakes. Situational awareness errors were most common (49.3%), followed by decision-making errors (40.9%). Improving non-technical skills should target behaviors both in and outside the operating room. Nearly […]
Global Consensus on Robotic Training for GI Surgery
An international consensus has established a structured training curriculum for robotic surgery, addressing critical gaps for GI surgical trainees. 82 out of 106 training items reached consensus across diverse stakeholders, ensuring comprehensive knowledge and skills. This curriculum covers essential areas: bedside assistance, console operation, performance assessment, and certification standards. Standardized training enhances patient safety and […]
Trauma Center Level Impacts Mortality in Shock Patients
Trauma outcomes differ significantly based on treatment at level I versus level II centers, impacting patient selection for serious injuries. Analyzing 363,470 trauma patients, level I centers had a higher unadjusted mortality (8.2%) compared to level II (6.9%), but adjusted outcomes showed no overall difference. Level I centers had lower adjusted mortality for shock patients […]
New Score Improves Safe Discharge in GI Bleeding Patients
Risk scores outperform clinical judgment for safe discharge in lower gastrointestinal bleeding—better patient selection can enhance outcomes. The Oakland score showed the highest accuracy (AUC 0.77) for predicting safe discharge, compared to clinical judgment (AUC 0.76). Overall, 76.7% of patients achieved safe discharge within 28 days; however, 41 needed transfusions, 24 required endoscopic intervention, and […]
Organ Preservation in Rectal Cancer: Promising Results
Organ preservation methods, like watch and wait, show high feasibility and safety in rectal cancer treatment. 26% of patients opted for organ preservation, predominantly through watch and wait (78%). 2-year overall survival rates exceeded 95% across all treatment strategies. No significant differences in oncologic outcomes between watch and wait and local excision were observed. Surgeons […]
Declining IVC filter use in trauma patients raises flags
IVC filter placement in trauma patients is declining but shows wide variation among hospitals, affecting patient outcomes. Among 2.3 million trauma patients, only 0.81% had IVC filters placed, down from 1.15% in 2017 to 0.59% in 2024 (p<0.001). 22.5% of centers had insertion rates ≥1%, highlighting significant interhospital differences. Higher IVC filter use did not […]
Understanding Recurrence Patterns in Intrahepatic Cholangiocarcinoma
Post-surgery tumor features impact recurrence patterns in intrahepatic cholangiocarcinoma, affecting long-term outcomes and follow-up strategies. Among 1,328 patients, 57.5% experienced recurrence; 23% had both intra- and extrahepatic recurrence. Three or more metastatic lymph nodes increased the chance of combined recurrence (adjusted odds ratio 3.47). Patients with combined recurrence had worse survival outcomes (hazard ratio 1.63) […]
High Accuracy in Simplified Triage for Military Trauma
A simplified triage system shows promise for prioritizing trauma care in combat settings, but surgeons must be aware of its overtriage rate. Undertriage for major trauma (ISS ≥16) was just 3.6% with a sensitivity of 96.4%. Overall undertriage was 8.5% for all injuries with an AIS score of 3 or greater, with a sensitivity of […]
Local Therapies Improve Survival in Recurrent Pancreatic Cancer
Surgeons should consider local therapies for recurrent pancreatic ductal adenocarcinoma as they show significant survival benefits. For liver-only recurrence, local therapy leads to longer survival than chemotherapy alone (HR 0.26). Surgical resection for lung-only recurrence offers better survival compared to conventional treatment (HR 0.35). Careful patient selection and tailored approaches could enhance outcomes in recurrence […]