A randomized trial involving 89 patients undergoing elective anal fistula or hemorrhoid surgery revealed that an enhanced recovery protocol utilizing multimodal analgesia substantially decreased oral opioid consumption in the first postoperative week. Patients in the enhanced recovery group reported median oral morphine milligram equivalent (mme) use of 8 mg versus 79 mg in the standard […]
Category: General Surgery
Implementation of the ACS model enhances acute appendicitis outcomes
The acute care surgery (ACS) model significantly improved patient management for acute appendicitis over a five-year study at a Seoul tertiary hospital. Key findings included reduced time intervals for surgical decision-making, decreased perforation rates, and higher discharge rates within 24 or 48 hours post-surgery. Comparisons between 447 pre-ACS and 453 post-ACS patients revealed statistically significant […]
Intraperitoneal ropivacaine effectively aids postoperative pain management.
Intraperitoneal ropivacaine significantly reduced opioid consumption and pain scores, enhancing postoperative recovery following laparoscopic digestive surgery. The analysis of 24 randomized controlled trials (RCTs) with 1705 patients revealed decreased total opioid use within the first 24 hours (mean difference = -21.93) and shorter hospital stays (mean difference = -0.20 days). Additionally, it lessened shoulder pain […]
Machine learning model surpasses clinical risk scores for GI bleeding
In a comparative analysis of an electronic health record-based machine learning model and established clinical risk scores for gastrointestinal bleeding, researchers found the model significantly outperformed the Glasgow-Blatchford Score and Oakland Score. With an area under the receiver-operating-characteristic curve (AUC) of 0.92 versus 0.89 (p
AI Model Effectively Quantifies Residual Pancreatic Cancer Post-Treatment
Development and validation of the ISGPP model marks a significant advancement in automating residual pancreatic cancer (RPC) quantification. The model demonstrated robust performance across diverse scanners, achieving mean F1 scores of 0.81-0.71 upon validation. A comprehensive dataset of 528 unique H&E slides from 528 patients facilitated training the model, which is now publicly available. This […]
Preoperative dexamethasone enhances recovery in emergency laparotomy
A single high dose of intravenous dexamethasone prior to emergency laparotomy significantly reduces postoperative inflammatory responses, as shown by lower C-reactive protein levels (median 170 vs. 220 mg/l, p = 0.015). This administration correlates with enhanced recovery indicators, such as improved hemodynamics and earlier mobilization. The dexamethasone group also experienced a notable decrease in 90-day […]
Simulation assessment effectively distinguishes surgical trainee competence levels
A novel simulation-based assessment of operative competence was developed, demonstrating high inter-station reliability (α = 0.81) and acceptable inter-rater reliability (0.77). Significant differences emerged in mean scores between junior and senior trainees (44.82 vs 58.18, p = 0.004), with mean scores moderately correlating with training years (rs = 0.74, p = 0.004). The assessment resulted […]
Screening Patients Reduces Pancreatic Cancer Mortality Rates
Elevated-risk patients for pancreatic ductal adenocarcinoma (PDAC) who underwent guideline-based screening achieved significantly improved overall survival compared to non-screened counterparts. Among 826 patients, those in the high-risk clinic experienced longer median survival rates, with 68% diagnosed at stage 0 versus 31% in the surgical oncology group. Overall survival post-resection was also notably higher in high-risk […]
Cold snare resection is safer than hot methods for polyps.
In a randomized controlled trial involving 363 patients with large nonpedunculated colorectal polyps, cold endoscopic mucosal resection (EMR) demonstrated a significantly lower rate of major adverse events (1.0%) compared to hot EMR (7.9%, p = .001). While cold resection did result in a higher rate of residual adenoma (23.7% vs 13.8%, p = .020), safety […]
New technique offers safer, simpler treatment for fissures
Transmucosal internal sphincterotomy demonstrates significant advantages in treating fissure in ano compared to traditional methods. The procedure had a median operative time of 7 minutes, yielding a mere 2.5% infection rate and 3% transient incontinence rate. Postoperative pain was notably lower, with a majority of patients healing within 9 weeks and only 1.6% experiencing recurrence. […]