A protocol to eliminate routine opioid prescriptions for patients after major intra-abdominal surgery resulted in a significant decrease in post-discharge opioid use. Only 17% of patients in the intervention group received opioids within thirty days compared to 46% in the control group (p
Category: General Surgery
ChatGPT-4o is superior in aiding gastric cancer decisions
ChatGPT-4o significantly outperformed Gemini Advanced in generating treatment recommendations for advanced gastric cancer, as evidenced by a structured evaluation of responses to ten clinical questions. It provided superior recommendations in surgical suggestions and chemotherapy options during multidisciplinary team discussions. Additionally, it excelled in analyzing rare cases from PubMed, demonstrating increased accuracy and consistent evaluator agreement. […]
Complete closure reduces delayed postpolypectomy bleeding risk.
In a study analyzing 1,259 colorectal polyps from 1,025 patients, complete closure using titanium clips significantly reduced the incidence of delayed postpolypectomy bleeding (DPPB) to 3.6%. Factors influencing DPPB included male gender and polyp size, both immutable, while incomplete closure presented a higher risk. Logistic regression supported these findings, underscoring the importance of full closure […]
Minimally invasive endoscopic interventions outperform traditional surgery for pancreatic fluid collections
A review highlights a shift toward minimally invasive endoscopic interventions for managing symptomatic pancreatic fluid collections linked to acute pancreatitis. Endoscopic transmural drainage and necrosectomy show comparable effectiveness to traditional surgery but with fewer adverse effects. Early intervention may be warranted in cases of suspected infection and organ dysfunction. Key findings support ongoing evolution and […]
Operative management improves survival among frail patients.
An observational study of 49,169 patients revealed that operative management resulted in lower mortality rates overall (1.3% vs 2.5%, p
Interventional EUS improves biliary drainage success in patients
In a retrospective multicenter study of 432 patients with surgically altered anatomy, endoscopic biliary drainage (BD) achieved technical and clinical success rates of 80.3% and 79.9%, respectively. Adverse events were more common in those with Billroth-II reconstruction (14.4%). Notably, the last two years showed increased use of interventional EUS, leading to significantly better clinical outcomes […]
Enhanced risk adjustment improves hospital benchmarking accuracy
A new methodology allows for risk adjustments using multiple CPT codes instead of just the principal code in hospital benchmarking. Analysis of 994,332 patient cases revealed that hospitals reporting more CPT codes generally had improved benchmarking outcomes across 13 of 14 measures. In contrast, hospitals using only the principal code had advantages when assessed solely […]
Enhanced recovery protocols improve outcomes in gastrointestinal surgery
In a systematic review of 27 studies involving 1,864 patients, clinicians found that enhanced recovery after surgery (ERAS) and fast-track surgery (FTS) markedly improved postoperative outcomes for acute gastrointestinal perforation. The ERAS/FTS group exhibited significantly reduced complications and inflammatory responses, along with earlier mobility and resumption of eating compared to traditional methods. Additionally, these protocols […]
Deep learning effectively identifies pathologic complete response in esophageal cancer.
A deep neural network-based endoscopic evaluation accurately detected pathologic complete response (PCR) in esophageal cancer patients after neoadjuvant chemotherapy, achieving median sensitivity, specificity, and accuracy rates of 80%, 90%, and 85%, respectively. Among 1041 patients, 354 demonstrated PCR, correlating with significantly improved overall and recurrence-free survival. The findings suggest the potential for this AI technology […]
Tranexamic acid is most effective when administered within 2 hours of injury.
Analysis of data from over 28,000 trauma patients reveals that tranexamic acid significantly reduces 24-hour mortality, particularly when administered within 2 hours of injury. The effectiveness diminishes quickly after this window. While benefits may extend beyond 2 hours for patients with severe traumatic brain injuries, the strongest results were noted in individuals with low blood […]