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Best Papers in General Surgery
The five that matter, every day.
A meta-analysis of 40 studies involving over 183,000 patients reveals midline incisions significantly elevate the risk of incisional hernias, exhibiting rates up to 18.7%. In colorectal surgery, midline approaches show an alarming odds ratio of 11.7 for hernia formation versus transverse methods. Key risk factors…
Primary liver cancer (PLC) incidents surged 74% from 2000 to 2021 among adults aged 55+, with deaths rising 67% and disability-adjusted life years (DALYs) increasing 59%. While the annual incidence rates are projected to initially fall, projections indicate continuous case increases through 2050, especially in…
A two-week hypofractionated chemoradiotherapy regimen yielded similar tumor responses to conventional long-course treatment in locally advanced rectal cancer. Analyses showed comparable rates of downstaging and tumor response between the two approaches. Notably, the two-week regimen significantly reduced gastrointestinal toxicity, with only 5.8% experiencing grade 2…
Gastrectomy significantly lowers the risk of cardiovascular diseases and obesity-related cancers compared to endoscopic resection in gastric cancer survivors. An analysis of 74,367 matched patients revealed that those who underwent gastrectomy experienced fewer major adverse cardiovascular events, lower incidences of conditions like hypertension and ischemic…
Hepatic arterial infusion pump (HAIP) chemotherapy delivers targeted therapy directly to the liver, markedly improving survival outcomes in liver-confined colorectal metastases (CRLM) and intrahepatic cholangiocarcinoma (ICCA). In unresectable CRLM, five-year overall survival rates reach 50%. Adjuvant HAIP after tumor resection shows two-year survival of 86%,…
Within 30 days of major abdominal surgery in low- and middle-income countries (LMICs), 65.3% of patients reported returning to normal activities. Factors influencing recovery included the type of surgery: patients undergoing benign procedures (67%) and minor operations (71%) experienced higher return rates than those with…
Adjuvant therapy markedly enhances overall survival (OS) and disease-free survival (DFS) in patients post-pancreaticoduodenectomy for distal cholangiocarcinoma. A meta-analysis of 22 studies involving 7,078 patients revealed an OS hazard ratio of 0.80 and a DFS hazard ratio of 0.84 for adjuvant therapy compared to follow-up…
A prospective study of 1,133 patients undergoing colorectal endoscopic mucosal resection (EMR) using the Perfect Closure (PC) technique reported zero instances of delayed bleeding. This innovative method involved secure clipping without gaps and avoided clip-on-clip placements. The average number of clips used was 4.71 per…
Metabolic bariatric surgery markedly enhances glycemic control and liver histology in patients with metabolic dysfunction-associated steatohepatitis (MASH). A scoping review of 14 studies reveals substantial reductions in fasting glucose, insulin resistance, and liver enzymes, alongside histological improvements, including decreased steatosis and fibrosis. These changes, observed…
Patients with prior gastrointestinal infections face a significantly elevated risk of post-endoscopic retrograde cholangiopancreatography (ERCP) biliary tract infections (PEBTI). In a cohort study of 1,507 individuals, the incidence was 5.4% among those with prior infections versus 4.2% without. After adjusting for confounders, the hazard ratio…
