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
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General Surgery
Best Papers in General Surgery
The five that matter, every day.
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…
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…
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…
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…
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,…
Enhanced supervision improves surgical complication reporting and care
A comprehensive adverse event self-reporting platform significantly improved complication rates and overall quality of surgical care across three hospitals. The study, involving 83,885 surgical cases, found a remarkable 54% and 59% reduction in complication and mortality rates, respectively, at the most rigorously supervised site, compared…
AI Advances in Laparoscopic Skill Assessment Show High Accuracy
AI applications in laparoscopic surgery simulation demonstrate significant promise, achieving concordance rates of 42%-100% with human assessments. The study tested AI trained on multiple procedures, revealing 100% accuracy for the appendectomy in the five-class scoring system and also high accuracy in the two-class system across…
Timely surgery after neoadjuvant therapy improves survival rates.
A multicenter analysis of 893 gastric cancer patients revealed that surgery within 28 days of neoadjuvant therapy significantly enhances overall survival rates. Delays beyond 28 days correlated with poorer outcomes and diminished tumor regression effectiveness. Notably, patients with inadequate responses to therapy benefited most from…
Endoscopic stenting effectively treats Boerhaave’s syndrome
A systematic review of endoscopic stenting for Boerhaave's syndrome highlights its effectiveness, achieving a closure success rate of 72.4% and a leak occlusion rate of 93%. Despite the advantages of this minimally invasive approach, researchers noted significant methodological and patient diversity contributing to high heterogeneity…