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Best Papers in General Surgery
The five that matter, every day.
A retrospective analysis involving 645 patients with cT2 staged adenocarcinomas indicated that neoadjuvant treatment followed by surgery (nat/s) yields significantly better overall survival compared to primary surgery (ps). Median overall survival was 114.0 months for nat/s versus 51.0 months for ps in the cT2cnany cohort.…
A population-based analysis of 2,515 patients undergoing adrenalectomy for metastatic cancer revealed a one-year survival rate of 84.3%. Thirty-day mortality and morbidity rates were low at 1.3% and 29.9%, respectively. The study highlighted that prior radiotherapy correlated with increased complication rates. Laparoscopic procedures comprised 85.3%,…
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,…
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 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…
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…
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…
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…
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…
