A scoping review of 3,674 citations identified 129 relevant articles on implementation science in surgical care. It highlighted major innovations in peri-operative care and safety. Six key constructs emerged as both facilitators and barriers: leadership support, surgeon and staff expertise, team building, environmental context, data availability, and resource allocation. Understanding these factors is crucial to […]
Category: General Surgery
Patient-derived organoids enhance treatment outcomes for pancreatic cancer.
A novel approach to matching patients with pancreatic ductal adenocarcinoma (PDAC) to effective chemotherapy has shown significant promise. Patient-derived organoids (PDOs) matched 91% of patients to standard treatments, improving CA 19-9 markers and lymph node staging. Notably, those who received therapies well-aligned with their PDO chemosensitivity experienced better recurrence-free and overall survival compared to misaligned […]
Simultaneous robot-assisted esophagectomy reduces surgery time.
A novel approach to robot-assisted cervical esophagectomy combining cervical and abdominal procedures has shown significant advantages. In a study of 30 patients, this simultaneous procedure, utilizing nerve integrity monitoring without muscle relaxants, resulted in a total operative time of 291.2 minutes, markedly shorter than the sequential group’s 453.8 minutes. No intraoperative adverse events or postoperative […]
C-reactive protein and albumin ratio may aid cholecystitis diagnosis
An analysis of 170 patients with acute cholecystitis revealed that 37.1% had gallbladder perforation, correlated with higher rates of complications. Key biomarkers, including C-reactive protein (CRP) and the CRP/albumin ratio (CAR), demonstrated significant differences between perforated and non-perforated cases. Despite their low specificity and sensitivity, these biomarkers can assist clinicians in making timely diagnoses and […]
ERAS protocols significantly shorten hospital stays after colorectal surgery
Implementation of enhanced recovery after surgery (ERAS) protocols at 15 Ontario hospitals resulted in a significant 1.05-day reduction in length of stay (13.7%) for colorectal surgeries. Notably, left-sided colorectal surgeries saw an even greater decrease of 1.17 days (15.6%). This reduction remained consistent over time and was more pronounced after adjusting for various predictors. The […]
Stool-based surveillance reduces colonoscopies after polypectomy
Stool-based surveillance strategies may safely decrease colonoscopy demand by 15-41% following polypectomy, according to the MOCCAS study. Conducted on 3,453 individuals, the study demonstrated that multitarget stool DNA tests and fecal immunochemical tests (FIT) were effective alternatives, especially for those at lower risk. Long-term simulations indicated that while multitarget stool DNA testing incurred higher costs, […]
Endoscopic Vacuum Therapy effectively treats Boerhaave’s syndrome.
A multicenter analysis demonstrates that Endoscopic Vacuum Therapy (EVT) has a high success rate for treating Boerhaave’s syndrome, yielding an 80% treatment success in 25 patients. Mortality rates were significantly lower for EVT patients (8.0%) compared to those undergoing other methods (25.0%). Moreover, treatment success with EVT was statistically superior to non-EVT approaches (43.8%). These […]
Omission of drains reduces complications and hospital stays in surgery
Patients undergoing minimally invasive distal pancreatectomy without abdominal drains experienced significantly lower rates of postoperative pancreatic fistula (3.4% vs. 27.6%) and abdominal collections (3.4% vs. 31.0%), along with a shorter hospital stay (5 days vs. 9 days). These findings suggest that not using drains during this type of surgery may enhance recovery without increasing severe […]
Multidisciplinary case conference enhances management of benign hepatopancreatobiliary disease
A study reviewing 56 cases presented at the novel benign liver and pancreas rounds highlights the effectiveness of a multidisciplinary case conference in managing benign hepatopancreatobiliary diseases. The discussions resulted in a change or adjustment in the proposed management plan for 82% of cases, with 71% of these recommendations being implemented. Most cases addressed pancreatic […]
Endoscopic submucosal dissection proves more effective than EMR
A systematic review and meta-analysis involving 9,352 patients reveals that endoscopic submucosal dissection (ESD) outperforms endoscopic mucosal resection (EMR) in effectively treating early Barrett’s neoplasia. ESD achieved significantly higher en-bloc resection rates (odds ratio 25.96) but was associated with greater incidence of adverse events. The findings highlight the need for careful consideration of the balance […]