Using explainable AI, we can significantly improve predictions for 90-day mortality and anastomotic leakage after oesophagectomy. The 90-day mortality rate was 6.0%, with anastomotic leakage at 12.4%. Explainable AI achieved an AUC of 0.95 for predicting mortality, compared to 0.88 for traditional methods. This technology allows for personalized risk assessments, improving decision-making for surgical candidates. […]
Category: General Surgery
Revisiting Resection Criteria for Hepatocellular Carcinoma
Tumor markers may improve patient selection for liver resection in HCC. In a study of 803 patients, 32.3% of resectable tumors had high tumor markers (AFP > 500 ng/ml or DCP > 1000 mau/ml). TM-high patients had a median survival of 120.7 months, significantly lower than non-TM-high patients at 160.8 months (p = 0.008). Incorporating […]
New Prognostic Model for Pancreatic Cancer Outcomes
A novel risk model using stress granule-related gene signatures (sgrgs) shows promise for improving prognostic accuracy in pancreatic ductal adenocarcinoma (PDAC). Four key sgrgs (lama3, itga6, col17a1, top2a) were identified as significant predictors of PDAC prognosis. A nomogram combining age, N stage, and risk score demonstrated strong predictive capacity. Understanding these markers can enhance patient […]
Colorectal Cancer Burden Rising in East Asia: Key Trends and Projections
Colorectal cancer (CRC) incidence and mortality are sharply increasing in East Asia, necessitating targeted surgical interventions and screening. South Korea leads with a 5.29% annual increase in CRC incidence, followed by China at 4.11%. Projections indicate a continued rise in China by 2050, while South Korea’s incidence stabilizes and Japan’s growth slows. Males, particularly in […]
Endoscopic Ultrasound for Acute Cholecystitis Shows Strong Results
EUS-guided gallbladder drainage is a viable option for high-risk patients with acute cholecystitis, offering both safety and effectiveness. Technical and clinical success rates were high at 95.8%. The study analyzed data from 701 patients across 18 studies with over a year of follow-up. Surgeons can consider EUS-GBD as a first-line treatment for patients unfit for […]
Endoscopic Pyloromyotomy Outperforms Laparoscopic Stimulation for Gastroparesis
Endoscopic peroral pyloromyotomy (pop/g-poem) shows superior outcomes compared to laparoscopic gastric electrical stimulation (ges) for treating medically refractory gastroparesis. Mean operative time was significantly shorter for pop/g-poem (28.9 minutes vs 95.6 minutes, p < 0.001). Length of stay was reduced with pop/g-poem (0.5 days vs 2.4 days, p < 0.001) and it had a lower […]
Transforming Rectal Cancer Care: Upfront Surgery Wins
Selected rectal cancer patients can safely skip neoadjuvant therapy and proceed directly to total mesorectal excision. Among 94 patients, 100% had local recurrence-free survival at 3 years; 97% at 5 years. R0 resection achieved in 99%, leading to substantial overall survival rates of 97% at 3 years and 95% at 5 years. This evidence supports […]
Predicting Post-Hepatectomy Liver Failure with Machine Learning
A new machine learning model improves prediction of liver failure after major hepatectomy, enhancing surgical decision-making. The pilot model achieved AUCs as high as 0.904, significantly outperforming traditional models (AUCs 0.502-0.644). The model integrates 55 variables, including novel biomarkers, across preoperative, intraoperative, and postoperative datasets. This innovation allows surgeons to identify high-risk patients within hours […]
Diminished Infection Rates with Biodegradable Temporizing Matrix
Using a biodegradable temporizing matrix (BTM) can lead to low infection rates in complex wounds, changing how surgeons approach non-graftable cases. Only 14% of patients in a diverse cohort of 22 experienced clinical infection after BTM application. Microbial growth was found in 76% of pre-BTM swabs, but this did not correlate with infection rates post-application. […]
Robotic Hepatectomy Surpasses Laparoscopy for Liver Cancer
Robotic hepatectomy enhances surgical options for high-risk liver cancer patients with comparable oncologic outcomes to laparoscopic methods. Robotic techniques show similar length of hospital stay and complication rates to laparoscopic approaches but may offer better precision. Patients experience shorter recovery times and can start adjuvant therapy sooner. Surgeons should consider robotic hepatectomy as a viable […]