In an international cohort study of 1,874 patients with perforated peptic ulcer (PPU), researchers found a 30-day morbidity rate of 48.5% and a mortality rate of 9.3%. Key factors affecting these rates included age over 50, female gender, shock on admission, and acute kidney injury, all significantly associated with increased morbidity and mortality. Delayed presentation […]
Category: General Surgery
Anticoagulants significantly increase postoperative bleeding risks
An analysis of 37,973 patients undergoing ventral hernia repair revealed that while 11.5% were on antiplatelet therapy and 5.8% on anticoagulants, the latter category exhibited a considerably heightened risk for postoperative bleeding complications. Anticoagulant use was linked to a 2.4 times higher risk for transfusion, a 6.3 times greater likelihood of reoperation for bleeding, and […]
Inadequate surgical treatment affects non-functioning pancreatic neuroendocrine tumours.
A retrospective study of 384 patients undergoing surgery for non-functioning pancreatic neuroendocrine tumours revealed that 40% received potentially inadequate treatment. Of these, 34% experienced potential overtreatment while 6% were potentially undertreated. Key predictors of overtreatment included smaller tumour sizes and earlier surgical intervention, while larger tumour diameter indicated potential undertreatment. Patients facing undertreatment exhibited significantly […]
Small-bite fascial closure reduces hernia rates after surgery
A randomized clinical trial found that small-bite fascial closure significantly decreased the incidence of incisional hernia in open colorectal cancer surgery patients. At one year, hernia rates were 7% for the small-bite group versus 27% for the conventional group (p < 0.001). This disparity persisted into the second year (9% vs 31%, p < 0.001). […]
Endoscopic sleeve gastroplasty shows cost-effectiveness for obesity treatment
Endoscopic sleeve gastroplasty (ESG) demonstrated cost-effectiveness compared to lifestyle modification in adults with class I/II obesity within a five-year horizon, achieving an incremental cost-effectiveness ratio of $23,432 per quality-adjusted life year (QALY). ESG remained cost-effective across sensitivity analyses and was dominant over longer timeframes. The findings suggest ESG as a viable treatment alternative for individuals […]
Foley catheter balloon compression effectively controls hemorrhage in trauma.
A retrospective review of 18,303 trauma patients in Venezuela revealed that 45% of 1,757 patients with vascular injuries utilized Foley catheter balloon compression for hemorrhage control. The majority (75%) of catheter placements occurred in emergency departments, while 53.2% were employed in non-compressible anatomical junctions. This method proves effective across various trauma care settings, preserves collateral […]
A new technique may reduce bile duct injury during surgery
The shoeshine technique enhances safety in laparoscopic cholecystectomy by achieving atraumatic exposure of the hepatocystic area and improving visibility in Calot’s triangle. This method, utilized in over 2,000 cases by the authors, demonstrated effectiveness in reducing risks of bile duct injuries. By employing a blunt dissection tool along with gauze for traction, this approach facilitates […]
Sequential bundles significantly reduce surgical site infections.
In a multicentre cohort study involving 32,205 patients, two sequential preventive bundles led to a 50% reduction in surgical site infection rates, decreasing from 18.16% to 8.19%. Bundle-2 notably reduced both superficial and deep surgical site infections but was ineffective for organ/space infections in rectal surgery. Compliance with preventive measures improved with the addition of […]
Enhanced recovery protocols promote better outcomes after emergency laparotomy
A systematic review and meta-analysis of six randomized clinical trials involving 509 patients evaluated the effects of enhanced recovery after surgery (ERAS) protocols following emergency laparotomy. Findings indicated that ERAS significantly reduced postoperative nausea and vomiting (odds ratio: 0.32), time to ambulation (mean difference: 1.67 days), length of stay (mean difference: -2.92 days), and various […]
Three-day antibiotic regimen shows non-inferiority to seven-day regimen
A study involving 256 patients undergoing left-sided colorectal surgery assessed the effectiveness of a three-day versus a seven-day selective digestive decontamination (SDD) regimen. Results indicated anastomotic leakage rates of 1.2% for the three-day group compared to 5.2% for the seven-day group, and surgical site infections were 3.6% and 5.8%, respectively. The shortened three-day regimen was […]