Patients undergoing surgeries immediately before the weekend face higher risks of death, readmission, and complications compared to those treated afterwards. An analysis of over 429,000 patients in Ontario revealed a consistent increase in adverse outcomes at 30 days, 90 days, and one year post-surgery for those in the preweekend group, with adjusted odds ratios indicating […]
Category: General Surgery
Pembrolizumab shows promise for rare microsatellite-high intrahepatic cholangiocarcinoma
A 65-year-old man with unresectable, microsatellite-high intrahepatic cholangiocarcinoma experienced significant tumor shrinkage after receiving pembrolizumab, following a failed combination therapy. The comprehensive cancer genomic profiling identified an mlh1 pathogenic mutation, suggesting the microsatellite instability was somatic rather than inherited. Remarkably, the response was maintained for over 30 months, indicating pembrolizumab’s potential effectiveness in treating this […]
Erector spinae plane block reduces opioid use after surgery
In a study evaluating ultrasound-guided erector spinae plane block (ESPB) for post-operative analgesia in laparoscopic cholecystectomy, researchers found that the ESPB group required significantly less tramadol within the first 24 hours compared to controls (p=0.005). Additionally, pain scores measured by visual analogue scale (VAS) were lower in the ESPB group at various intervals. The time […]
Improved visualization of surgical needle tips enhances accuracy
A novel model was developed to visualize hidden surgical needle tips within organs, addressing challenges in laparoscopic procedures that could lead to complications like anastomotic leakage. Testing revealed real-time image inference at 33.4 frames per second and a mean needle misalignment of just 1.03 mm, well below the 1.8 mm threshold. These findings suggest that […]
Radiation-emitting metallic stents improve survival in cholangiocarcinoma
A multicenter trial demonstrated that radiation-emitting metallic stents (REMS) combined with hepatic arterial infusion chemotherapy (HAIC) significantly outperformed self-expandable metallic stents (SEMS) in patients with unresectable Bismuth type III or IV perihilar cholangiocarcinoma. The median overall survival was 10.2 months for REMS compared to 6.7 months for SEMS (p=0.002). Additionally, median time to symptomatic progression […]
In-hospital delays worsen outcomes in acute appendicitis cases
A meta-analysis of 28 studies involving 512,881 patients has revealed that preoperative in-hospital delays exceeding 24 hours significantly increase the risk of complicated appendicitis, postoperative complications, and mortality. Specifically, these delays are associated with a 60% higher risk of complicated appendicitis and a 51% increased likelihood of postoperative issues, alongside an 81% heightened risk of […]
Triple therapy enhances survival in advanced hepatocellular carcinoma.
In high-risk advanced hepatocellular carcinoma patients, triple therapy involving FOLFOX-based hepatic arterial infusion, tyrosine kinase inhibitors, and PD-1 inhibitors significantly improved median overall survival to 24.6 months compared to 11.9 months with dual therapy (HR=0.43, p
New model predicts postpancreatectomy hemorrhage risk accurately
A novel predictive model using lasso-logistic regression has been developed to assess the risk of postpancreatectomy hemorrhage. Analyzing data from over 9,600 patients, the model identifies nine independent risk factors, including preoperative BMI and ASA scores. Its predictive accuracy reached an area under the ROC curve of 0.87 during external validation, outperforming previous models significantly. […]
Delaying surgery post-COVID-19 improves patient outcomes.
A study involving 4,953 patients revealed that delaying surgery for at least two weeks post-COVID-19 infection can significantly lower the risks of short-term complications and mortality. Patients who postponed their procedures for over seven weeks experienced enhanced long-term functional recovery, as indicated by reduced disability rates at both six and twelve months. These findings underline […]
Advances in managing gastric cancer with peritoneal metastasis
Recent insights into gastric cancer with peritoneal metastasis (gcpm) reveal dismal outcomes, underscoring the need for improved management strategies. A growing body of clinical trials investigates the efficacy of cytoreductive surgery (crs) combined with hyperthermic intraperitoneal chemotherapy (hipec), recognized in new national guidelines. Enhanced understanding of gcpm’s mechanisms and novel therapeutic targets could lead to […]