In a study of 2368 patients undergoing minimally invasive colorectal cancer surgery, prolonged postoperative ileus (PPOI) occurred in 9.5% of cases. Six independent risk factors were identified for PPOI: advanced age, male sex, comorbidity index ≥6, preoperative sarcopenia, prognostic nutritional index, and intraoperative fluid overload. A nomogram was developed, achieving area under the curve (AUC) […]
Category: General Surgery
Laparoscopic techniques reduce chronic postoperative pain in hernia repair
Laparoscopic approaches to inguinal hernia repair significantly reduce chronic postoperative pain compared to the Lichtenstein technique. A meta-analysis of 13 studies revealed a relative risk of 0.49 (95% CI: 0.32, 0.75) for lower inguinodynia incidence in patients undergoing laparoscopic transabdominal preperitoneal or total extraperitoneal repairs. This finding underscores the advantages of laparoscopic methods, suggesting they […]
ALGC index predicts survival in hepatocellular carcinoma post-surgery
Findings reveal the albumin-lymphocyte-globulin-C-reactive protein (ALGC) index as a significant prognostic biomarker for hepatocellular carcinoma (HCC) after hepatectomy. In a cohort of 178 patients, a low ALGC index (
Recommendations for Enhancing Surgical Education
A Blue Ribbon Committee II has identified key challenges in surgical education and proposed recommendations to improve medical student training. The subcommittee conducted a comprehensive literature review to inform its strategies, which address recruitment, surgical engagement, and the transition from undergraduate to graduate medical education. Major shifts in medical education and surgical practice over the […]
Guidelines for Metabolic and Bariatric Surgeons
A consensus was achieved among 89 international metabolic and bariatric surgeons on 29 of 30 statements regarding the prerequisites for practicing metabolic and bariatric surgery (MBS). Key criteria include holding a general surgery degree, completing a dedicated fellowship, and proficiency in managing postoperative complications. The learning curve for various MBS procedures was defined, ranging from […]
No-drainage policy enhances patient outcomes after distal pancreatectomy
A systematic review covering 3,610 patients undergoing distal pancreatectomy reveals that a no-drainage approach significantly reduces complications. The odds of postoperative pancreatic fistula decreased to 0.38, while major morbidity, readmissions, and reinterventions also showed considerable reduction (odds ratios of 0.64, 0.69, and 0.70, respectively). Additionally, patients experienced a shorter hospital stay by an average of […]
Bile microRNAs can effectively distinguish between disease types.
A cohort study identified specific bile microRNAs (miRNAs) that differentiate malignant from benign pancreaticobiliary diseases. Among 111 patients, 14 differentially-expressed miRNAs were identified, with bile miR-340 and miR-182 significantly validated. The study achieved an area under the curve (AUC) of 0.79, demonstrating sensitivity of 65% and specificity of 82% in predicting malignancy. These findings underscore […]
Biodegradable prosthesis shows promise for bile duct replacement
Development of a biodegradable prosthesis utilizing electrospun poly(d,l-lactide-co-glycolide)-polycaprolactone-gelatin nanofibers successfully demonstrated mechanical strength, biocompatibility, and biodegradability in a pig model. This innovative scaffold maintained bile duct permeability and facilitated cell adhesion and growth without adversely affecting liver function over two years. Notably, immunohistochemical evaluations confirmed the presence of biliary epithelium, showcasing the scaffold’s potential for […]
A grading system improves patient selection for minimally-invasive pancreatoduodenectomy
The ISGPS developed a complexity and experience grading system for minimally-invasive pancreatoduodenectomy (MIPD), aimed at enhancing patient selection. This system categorizes patient risk factors and surgeon experience, enabling optimal decision-making for safe MIPD implementation. It assesses anatomical and conditional risks alongside surgeon experience and center volume. By employing this evidence-based approach, the grading system facilitates […]
Alvimopan reduces postoperative ileus and hospital stay duration.
A systematic review and meta-analysis analyzing 94,833 patients revealed that alvimopan significantly lowers the risk of postoperative ileus (odds ratio: 0.57) and shortens hospital stays in individuals undergoing bowel resection. These findings strongly support the routine incorporation of alvimopan into enhanced recovery after surgery programs for open bowel resections. Further investigation is required to explore […]