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Best Papers in General Surgery
The five that matter, every day.
A meta-analysis involving over 24 million patients reveals that lower income and wealth levels significantly correlate with worse postoperative outcomes within 90 days of surgery. Those with Medicaid, Medicare, or uninsured status exhibited higher odds of complications, mortality, and readmission compared to privately insured individuals.…
A novel surgical technique for low rectal cancer, intersphincteric resection combined with rectal eversion and total extra-abdominal resection (ISrer), shows promise in enhancing anal preservation rates without raising postoperative complications. In a study involving 74 patients, ISrer achieved a 94.3% anal preservation rate compared to…
Analysis of over 3,100 patients revealed that 35.3% experienced delays in colorectal cancer (CRC) treatment. Key predictors included older age, with those aged 80 and above having an 81% higher likelihood of delay, as well as being on Medicaid or uninsured, which increased the odds…
Rural Americans face significant challenges in accessing surgical care, with a 29% decline in general surgeon availability from 2001 to 2019 intensifying disparities. The article presents actionable policy recommendations to enhance surgical care access in rural areas. Key initiatives include bolstering the rural surgical workforce,…
Accurate diagnosis of pancreatic cystic lesions (PCLs) is critical to avoiding unnecessary surgeries. Despite existing guidelines, many patients with benign cysts still undergo major resections. New endoscopic methods, including advanced imaging and minimally invasive treatments, show promise for enhancing diagnostic precision and offering organ-sparing options.…
Evidence from 36 studies reveals that multidisciplinary team meetings (MDMs) for pancreatic cancer significantly affect care decisions, influencing initial diagnoses in 3.4%-21.7% of cases and altering treatment plans in 18.2%-72.2%. These meetings improve clinical trial participation but incur substantial preparation time (16.5 hours weekly) and…
A meta-analysis of 14 studies involving 1,078 patients indicates that biliary stenting combined with intraluminal 125I seed brachytherapy significantly improves overall survival and stent patency compared to standard biliary stenting alone. The study found no increase in complications or severe liver damage associated with the…
A meta-analysis found that using reinforcement sutures during double-stapling anastomosis in rectal cancer surgery effectively reduced the incidence of anastomotic leakage (AL) and reoperation rates. The analysis included one randomized controlled trial and eight observational studies, yielding an odds ratio of 0.29 for AL, indicating…
A novel interpretable machine learning model has been developed to predict post-ERCP cholangitis (PEC) in patients with malignant biliary obstruction (MBO). The model, utilizing data from 2831 patients, identified key risk factors including radiofrequency ablation and white blood cell count. Among various machine learning methods,…
A Delphi survey revealed 37 essential variables for adult trauma registries in low-middle-income countries, with demographic data, injury details, and clinical assessments leading the list. Following a two-round expert consensus process, additional optional variables emerged, including education and income levels. Birthplace was excluded. These insights…
