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General Surgery

Best Papers in General Surgery

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BMJ Open13 Oct 2024

Circulating biomarkers predict peritoneal metastasis in gastric cancer

A prospective clinical study evaluates the predictive effects of circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) in peritoneal lavage fluid for metachronous peritoneal metastasis (PM) in gastric cancer patients following radical resection. A total of 200 patients will be monitored over two years,…

Hepatol Res13 Oct 2024

Persistent acute kidney injury worsens outcomes in liver surgery

In a study involving 990 liver resection patients, persistent acute kidney injury (AKI) was linked to significantly worse postoperative outcomes, including increased morbidity, extended hospital stays, and higher 90-day mortality rates. Among 384 patients with hepatocellular carcinoma, persistent AKI correlated with poorer overall survival, identified…

Hepatobiliary Pancreat Dis Int13 Oct 2024

Robot-assisted hemihepatectomy shows improved outcomes over laparoscopic approach

In a comparative study involving 96 patients, robot-assisted hemihepatectomy (rob-hh) demonstrated significant advantages over laparoscopic hemihepatectomy (lap-hh) via dorsal approach. Rob-hh resulted in reduced estimated blood loss (median: 100 ml vs. 300 ml), lower blood transfusion rates (4.9% vs. 29.1%), and fewer postoperative complications (26.8%…

Ann Med Surg (Lond)13 Oct 2024

Dexamethasone reduces postoperative pain and nausea in surgery.

Dexamethasone combined with bupivacaine significantly decreased postoperative pain and the incidence of nausea and vomiting in patients undergoing laparoscopic cholecystectomy. A randomized clinical trial involving 104 patients revealed a mean visual analog scale score of 3.5 in the dexamethasone group compared to 6.2 in the…

BMC Surg12 Oct 2024

Nearly half of T2N0 gastric cancer patients experience upstaging

Among 4,076 patients with clinical T2N0 gastric adenocarcinoma undergoing upfront resection, 47.4% were pathologically upstaged. Factors increasing upstaging included tumor size over 3.0 cm and poor differentiation. In patients upstaged, adjuvant chemotherapy correlated with significantly improved survival, whereas it had no survival benefit in non-upstaged…

Surg Obes Relat Dis12 Oct 2024

Same-day discharge for anastomotic bariatric surgeries shows promising outcomes

A study involving 208 patients from a high-volume Canadian center assessed early outcomes of same-day discharge (SDD) following various anastomotic metabolic and bariatric surgeries. Results demonstrated low rates of unplanned overnight stays, readmissions, and reinterventions. With a mean patient age of 41.4 years and a…

Ann R Coll Surg Engl12 Oct 2024

Laparoscopic repair reduces mortality for peptic ulcer perforation

In a systematic review of nine randomized controlled trials involving 670 patients, laparoscopic repair for peptic ulcer perforation (PUP) demonstrated significantly lower mortality rates (risk ratio 0.37) and morbidity, alongside a reduced length of hospital stay compared to open surgery. The findings suggest that laparoscopic…

Tech Coloproctol12 Oct 2024

Outpatient management is effective for acute uncomplicated diverticulitis

In a study involving 688 patients with acute uncomplicated diverticulitis, outpatient management proved to be effective, showing no significant differences in treatment failure, pain recurrence, or elective surgery needs compared to inpatient care. Inpatients had higher rates of severe symptoms such as elevated CRP levels…

Eur Surg Res12 Oct 2024

Laparoscopic Appendectomy Conversion Rates Continue to Decline

In a study of 3,411 laparoscopic appendectomies over nearly three decades, researchers identified a conversion rate of 0.96%, decreasing to around 0.4% after the initial learning curve. The primary causes of conversion included perforation, adhesions, and pneumoperitoneum intolerance. Notably, age over 65 and symptom duration…

Surg Endosc11 Oct 2024

Re-examining the entire colon enhances polyp detection rates.

A randomized controlled trial involving 406 patients demonstrated that re-examination of the entire colon significantly improves the detection of concealed polyps and adenomas compared to standard colonoscopic methods. While polyp detection rates were generally similar between the study and control groups, the second withdrawal significantly…