Endoscopic ultrasound (EUS) demonstrated significant diagnostic yield for patients with unexplained common bile duct (CBD) dilation, particularly among those with negative prior imaging. In a cohort of 109 patients, 41 tested positive for various conditions, including choledocholithiasis and chronic pancreatitis. Factors such as older age and symptoms like jaundice increased the likelihood of positive findings. […]
Category: General Surgery
Neoadjuvant chemotherapy shows promise for survival in rectal cancer
A national database study of locally advanced rectal adenocarcinoma patients reveals that neoadjuvant chemotherapy (NAC) combined with chemoradiation (CRT) leads to better overall survival (OS) outcomes than CRT alone. Those receiving NAC alone exhibited poorer pathologic outcomes, specifically lower rates of R0 resection and pathologic complete response. The results underscore the potential benefits of an […]
Intracorporeal anastomosis enhances recovery in laparoscopic surgeries
A systematic review of 720 patients revealed that while intracorporeal and extracorporeal anastomosis in laparoscopic right hemicolectomy presented no significant differences in anastomotic leakage (RR 0.93), the former showcased notable advantages. Intracorporeal anastomosis led to reduced postoperative ileus and surgical site infections, alongside quicker bowel function recovery and shorter hospital stays. This suggests that intracorporeal […]
Increased NSAID use correlates with higher marginal ulcer risk.
A retrospective study of 6,888 patients with gastrojejunostomy revealed a dose-dependent relationship between nonsteroidal anti-inflammatory drug (NSAID) prescriptions and the development of marginal ulcers. Among those studied, 45.2% were exposed to NSAIDs, with 10.12% developing ulcers. The odds of ulcer increased significantly with the number of NSAID exposures, from 1.67 for 1-2 prescriptions to 2.42 […]
ERAS reduces hospitalization time for trauma patients post-laparotomy
A randomized controlled trial demonstrated that modified enhanced recovery after surgery (ERAS) significantly decreased length of hospitalization (LOH) for trauma patients undergoing laparotomy, with a median LOH of 6 days compared to 8 days in conventional care (p = 0.007). The ERAS group also experienced quicker recovery of bowel function and earlier removal of catheters […]
MRI effectively assesses peritoneal cancer index in patients.
Results indicate that diffusion-weighted MRI (dw-MRI) demonstrates significant accuracy in evaluating the peritoneal cancer index (PCI) in colorectal cancer patients with peritoneal metastases. In a cohort of 87 patients, a strong correlation was found between MRI-derived PCI and histopathology (0.77), with surgical PCI showing excellent agreement with histopathology at 0.87. These findings support MRI’s potential […]
A novel nomogram improves prediction of HCC recurrence post-surgery
A new prognostic nomogram has been developed to predict tumor recurrence in hepatocellular carcinoma (HCC) patients post-liver resection. Analyzing 726 patients, the research identified independent factors such as alpha-fetoprotein and portal vein tumor thrombosis affecting recurrence-free survival (RFS). The nomogram achieved strong predictive performance, with 1-year and 3-year AUCs of 0.813 and 0.739, respectively. Kaplan-Meier […]
HALP score effectively predicts complicated acute diverticulitis
In a study involving 190 patients, the HALP score demonstrated significant potential in assessing the severity of acute diverticulitis. Key inflammatory markers and HALP scores were notably higher in complicated cases compared to uncomplicated ones, indicating robust prognostic value. ROC analysis revealed that the HALP score can reliably identify disease complexity, achieving an AUC of […]
Delirium is the most common complication in older surgical patients.
In a study of over 9,000 older adults undergoing inpatient general surgery, delirium emerged as the leading complication, occurring in 11.9% of patients. Including geriatric-pertinent complications raised the overall complication rate by 20.4%. Key findings revealed significant ties between complications like delirium and pressure ulcers, with both contributing to over 50% of postoperative functional decline […]
Preoperative risk assessment benefits from accounting for liver condition
The study assessed the ACS NSQIP Risk Calculator’s accuracy in predicting postoperative complications based on surgery type and underlying liver disease. In a cohort of 376 patients, the calculator effectively predicted outcomes such as surgical site infections and mortality, but its accuracy diminished for those with cirrhosis, fibrosis, and steatosis, particularly undergoing major liver resections. […]