A systematic scoping review reveals that surgeons face significant emotional turmoil while caring for dying patients and their families. The study, analyzing 26 articles, found that without personalized and timely support, surgeons are at risk of depression, burnout, and substance abuse, impacting patient safety and satisfaction. Key themes identified include the effects on personal identity […]
Category: General Surgery
Explainable machine learning model predicts mortality in infected pancreatic necrosis
An explainable machine learning model for predicting 90-day mortality in patients with infected pancreatic necrosis (IPN) has shown promising results. The final model, developed from a cohort of 344 patients, achieved a c-index of 0.863 in internal validation and 0.857 in external validation, outperforming nine other models. Key mortality predictors included multiple organ failure and […]
High prevalence of combat injuries in Ukraine demands better prevention
A qualitative assessment revealed that complex polytrauma is the norm among Ukrainian combatants, with significant injuries such as blast wounds, traumatic brain injuries, and spinal cord trauma prevalent. Limited injury prevention measures were identified, primarily relying on combat body armor. Despite the need, respondents noted a lack of formal processes to use data for injury […]
KRAS mutations in duodenal fluid improve pancreatic cancer detection
KRAS mutations identified in duodenal lavage fluid after secretin stimulation demonstrated a high diagnostic accuracy for detecting resectable pancreatic ductal adenocarcinoma (pdac). With an area Under the Curve (AUC) of 0.934, the method achieved a sensitivity of 83.1% at 100% specificity, significantly outperforming traditional serum biomarkers. This innovative approach enhances early detection, which is crucial […]
Dual-time-point radiomic models enhance prognosis prediction for colorectal liver metastasis
The dual-time-point radiomic models, developed using pre- and post-neoadjuvant therapy MRI features, effectively stratified colorectal liver metastasis patients undergoing surgery. In a study with 100 cases, post-neoadjuvant therapy models showed superior predictive power in overall and disease-free survival compared to pre-neoadjuvant therapy models. Fong score models did not perform as well. The integration of radiomic […]
AI framework quantifies clinical influences on posthepatectomy length of stay
An innovative artificial intelligence framework was developed to quantify the impact of clinical factors on posthepatectomy length of stay (LOS), explaining 75% of its variability. The study analyzed 21,039 patients, revealing that clinical influences are significant while nonclinical factors account for the remaining 25%. Notably, major resections had a longer mean LOS of 6.9 days […]
High acute postoperative pain increases risk of chronic pain
Analysis of 1170 elective abdominal surgery patients revealed two acute pain trajectory clusters: high and low. Those in the high pain groups experienced almost double the likelihood of developing chronic postsurgical pain (cpsp), along with a significantly poorer recovery quality. Mediation analysis indicated that the quality of recovery within the first five days and subacute […]
New guidelines enhance prehospital bleeding control strategies
A systematic review produced fourteen new consensus-based recommendations for prehospital bleeding control in patients with multiple and/or severe injuries. Analyzing fifteen studies on interventions such as tourniquets and pelvic binders, researchers highlighted the importance of bleeding control as a treatment objective. Despite the strong consensus on these recommendations, the review reveals a significant gap in […]
Advanced MRI strategies improve diagnostic accuracy in gastric cancer
Multiparametric MRI (mpmri) demonstrated superior diagnostic accuracy for restaging locally advanced gastric cancer after neoadjuvant therapy, with significant inter-reader agreement noted. The accuracy for T restaging reached 0.586 for mpmri, outperforming other imaging methods. Importantly, mpmri achieved an area under the curve of 0.879 for distinguishing patients with good responses to neoadjuvant treatment, highlighting its […]
Indocyanine Green Fluorescence Angiography Reduces Colorectal Surgery Leak Rates
Indocyanine green fluorescence angiography (ICGFA) significantly lowers anastomotic leak rates during colorectal surgery. Analysis of 45 studies involving 14,333 patients revealed overall leak rates of 4.5% with ICGFA compared to 8.5% without it (OR: 0.47, p < 0.001). Notably, in rectal resections, leaks occurred at 4.7% with ICGFA versus 11.5% without (OR: 0.38, p < […]