A retrospective analysis of 66,326 patients revealed that 25.3% of pancreaticoduodenectomies (PD) for non-metastatic pancreatic ductal adenocarcinoma were futile, defined as death within 12 months. Factors increasing futility included macroscopically positive margins, poor tumor differentiation, and N2 nodal stage. Conversely, systemic therapy, radiation, and neoadjuvant therapy reduced the likelihood of futility. In the subgroup receiving […]
Category: General Surgery
Higher surgical volume significantly reduces postoperative morbidity in Crohn’s surgery
Analysis of 4,205 patients revealed that postoperative morbidity (POM) following ileocolic resection (ICR) for Crohn’s disease is significantly lower in high-surgical-volume centers (6.2%) compared to low-surgical-volume centers (9.1%) with a p-value of 0.0004. Independent factors influencing major POM include surgical hospital volume, male sex, Elixhauser Comorbidity Index ≥ 1, and minor POM. Findings advocate for […]
Investigational 4F-PCC Shows Noninferiority for VKA Reversal
Findings from this randomized clinical trial demonstrated that the investigational 4-factor prothrombin complex concentrate (4F-PCC) is statistically noninferior to the control 4F-PCC for rapid reversal of vitamin K antagonists (VKAs) in patients at substantial risk for bleeding during urgent surgeries. Effective hemostasis was achieved in 94.3% of patients receiving the investigational 4F-PCC compared to 94.2% […]
More PIPAC treatments correlate with improved patient survival
Conducting three or more pressurized intraperitoneal aerosol chemotherapy (PIPAC) procedures significantly enhances survival among patients with unresectable peritoneal surface malignancies. In a cohort of 346 patients undergoing 1200 treatments, approximately two-thirds completed at least three procedures. Disease progression was the primary reason for treatment cessation in over half of cases. The findings suggest that increasing […]
Social determinants significantly impact surgical outcomes in veterans
Findings indicate that older veterans living in deprived neighborhoods and identifying as black experience poorer surgical outcomes and higher care fragmentation. The study analyzed 93,644 veterans and identified that black veterans had worse outcomes (adjusted odds ratio, 1.06) and those with increased non-VA care days exhibited higher doors scores (adjusted odds ratio per 20%, 1.01). […]
Neoadjuvant chemotherapy significantly improves survival in gastric cancer.
Findings indicate that neoadjuvant chemotherapy (ctx) for resectable gastric cancer results in significantly longer overall survival (OS) compared to neoadjuvant chemoradiation (crtx). Analysis of 14,266 patients revealed a 20%-30% improvement in 5-year OS for the ctx group, despite a higher prevalence of complete pathological response in the crtx cohort. The study posits that current AJCC […]
Vacuum-assisted wound closure with mesh shows better outcomes
Findings indicate that vacuum-assisted wound closure with mesh-mediated fascial traction (vawcm) significantly improves primary fascial closure success rates (70% vs. 36%) and reduces in-hospital mortality (26% vs. 72%) compared to traditional vacuum-assisted wound closure (vawc) only. Multivariate analysis confirms vawcm’s role as an independent factor linked to lower mortality (odds ratio, 0.14; p = 0.004). These results […]
Core indicators established for oesophagogastric cancer management
A consensus reached by experts identified key quality performance indicators for management of oesophagogastric cancer, enhancing patient care and outcomes. The two-round modified Delphi process resulted in a standardized list which includes specialized multi-disciplinary discussions, pertinent imaging and staging procedures, as well as specific surgical benchmarks. Notably, indicators unique to gastric and oesophageal cancers were […]
Simulation Training Predicts Surgical Performance in Robotic Procedures
Results indicate that performance in simulated robotic gastrojejunostomy correlates significantly with intraoperative outcomes. The study surveyed 27 general surgery residents, revealing a strong positive relationship between simulated and actual scores (r=0.74, p
Small bowel resection has higher wound complications in surgery.
Outcomes from a review of 2,578 patients show that while various surgical approaches for Crohn’s disease offer comparable 30-day readmission and reoperation rates, small bowel resection is linked to the longest hospital stays and the highest rates of superficial/deep wound infections (44%) and sepsis (3.5%). This method also presents significantly higher odds of wound complications […]