Newsletter
Best Papers in General Surgery
The five that matter, every day.
Among 989,354 opioid-naïve patients, initial opioid prescription size dropped from 282 mg to 164 mg morphine equivalents, and new persistent opioid use declined from 2.7% in 2013 to 1.1% in 2021. These changes suggest effective opioid stewardship practices. Increases in prescription size correlated with higher…
A study involving 195 patients revealed that cap-assisted endoscopic polidocanol foam sclerobanding (EFSB) significantly reduced hemorrhoid severity scores (HSS) compared to endoscopic rubber band ligation (ERBL) at eight weeks. While post-procedural pain was notably lower in the EFSB group, long-term satisfaction and effective relief from…
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…
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…
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…
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…
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…
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…
• Why it matters: Open abdomen management often leads to high mortality rates.
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…
