This study assessed shared decision-making among thousands of surgeons, revealing critical insights for improving patient outcomes. Only 1.2% of surgeons achieved top scores in shared decision-making, while 64% of patients felt their surgeons performed adequately. Male surgeons, those in cardiothoracic specialties, and surgeons with over 31 years of practice were linked to lower decision-making scores. […]
Category: General Surgery
Enhanced Radiomics Predicts Pathological Response in HCC
Dynamic radiomic features from MRI can predict complete response in hepatocellular carcinoma (HCC) post-immune therapy, critical for surgical planning. A delta radiomic model achieved an AUC of 0.835 in predicting lesion-level complete response compared to 0.483 for baseline models. Combining radiomics with serum AFP response boosted predictive accuracy, yielding AUCs of 0.920 in the test […]
Long-term Atezolizumab-Bevacizumab Outcomes in HCC
Atezolizumab-bevacizumab shows promising long-term survival for patients with unresectable hepatocellular carcinoma. Median overall survival is 19.7 months with a 36-month survival rate of 30%. 36.8% experienced grade ≥3 adverse events; 14.1% had liver decompensation not related to tumor progression. Surgeons should consider multidisciplinary approaches, as 14.9% of patients underwent additional surgical or locoregional procedures post-treatment. […]
Surgical Sabermetrics Framework Enhances Training Outcomes
This study develops a practical implementation framework for integrating data-driven surgical metrics into training, improving assessment reliability and trainee outcomes. Engaged 54 trainees and trainers from 13 countries through workshops to inform framework development. Prioritized real-time feedback for technical skills and dashboards for non-technical skills to provide objective performance insights. Making surgical training more data-driven […]
Prognostic Model Predicts Wound Complications After Internal Hemipelvectomy
Surgeons can now preoperatively assess wound complication risk using a newly validated scoring model for internal hemipelvectomy. Wound complications requiring surgery occurred in 34% of patients overall, with rates of 7.4%, 40%, and 67% in low-, intermediate-, and high-risk groups in the training cohort. Similar results were observed in the validation cohort: 7.1%, 32%, and […]
Addressing Cancer Disparities in Surgical Oncology
Surgeons play a crucial role in tackling persistent cancer care disparities among marginalized populations. Marginalized groups experience higher cancer risks but often miss essential screenings and guidelines. Continued efforts are necessary to identify root causes and craft targeted interventions. Implementing these strategies can lead to more equitable oncologic outcomes for all patients. Collaboration with multidisciplinary […]
Guidelines for EUS-Guided Gastroenterostomy Standardized
A consensus among experts highlights vital technical practices for EUS-guided gastroenterostomy (EUS-GE) that can improve patient outcomes in gastric outlet obstruction. 31 key statements were approved, showing strong agreement on essentials like fluoroscopy and managing complications. Over 90% consensus on sedation, patient positioning, and saline use as a distension solution. Surgeons should adopt these recommendations […]
Cholecystectomy Outcomes: Complications Down, Complexity Up
Surgical complications in minimally invasive cholecystectomy have significantly decreased despite rising patient complexity. Overall complication rates fell from 21.5% in 2011 to 16.5% in 2021. Serious complications dropped from 12.3% to 7.0% in the same period. Surgery has improved, with specific gains in intraoperative hemorrhage (1.07% to 0.54%) and blood transfusions (5.47% to 1.87%). However, […]
Cost-Saving Insights from Enhanced Recovery Programs in Colorectal Surgery
High adherence to enhanced recovery program components can significantly cut costs in colorectal surgery. Patients with ≥70% adherence had total costs of $17,576 versus $22,343 for those with <70% adherence (p<0.001). Key cost-saving components included avoiding nasogastric tubes (-$16,036), early mobilization (-$3,476), and discontinuing maintenance intravenous fluids (-$4,460). Targeting specific ERP components could enhance outcomes […]
Surgeon compensation models impact productivity and quality of care.
Productivity-focused models (WRVU and fee-for-service) incentivize higher volume but overlook case complexity and outcomes. Hybrid models blend base salary with incentives for quality and academic contributions, offering flexibility but requiring more management. Value-based models are underused and may have unintended consequences. Surgeons must be aware of these models to optimize practice, support broader responsibilities, and […]