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Best Papers in General Surgery
The five that matter, every day.
Laparo-endoscopic hernia surgery shows a lower likelihood of chronic inguinal pain compared to lichtenstein repair, with similar recurrence rates. This systematic review and meta-analysis of eight randomized controlled trials involving 1,469 patients provides robust evidence supporting the effectiveness of laparo-endoscopic mesh repair (TAPP and TEP)…
The simplified three-factor risk assessment model for venous thromboembolism (VTE) in inguinal hernia patients resulted in higher prophylaxis rates, reduced assessment time, and lower d-dimer levels compared to the Caprini score. Patients identified as high-risk saw significant improvements in prophylaxis. The model did not increase…
Thyroglobulin wash-out after fine-needle aspiration cytodiagnosis effectively evaluates lymph node metastasis in papillary thyroid carcinoma. A cutoff value of 3.2 ng/ml for FNA-TG offers higher accuracy and lower false negatives than single diagnoses. Combining FNAC with FNA-TG increases sensitivity, though specificity decreases slightly. Ultrasonography provides…
Extended pharmacologic prophylaxis after colon cancer surgery is associated with improved overall and cancer-specific survival. Results suggest a potential anti-neoplastic effect from heparin derivatives in preventing post-surgical venous thromboembolism. A large database study of 20,102 patients showed significantly higher survival rates in patients who received…
Metabolic surgery significantly reduces kidney impairment progression and lowers the risk of kidney failure or death by 60% and 44%, respectively, when compared to GLP-1 receptor agonists in patients with type 2 diabetes, obesity, and established chronic kidney disease. This highlights the potential of metabolic…
Frail patients undergoing liver resections exhibit increased rates of major complications, postoperative liver failure, mortality, and readmission compared to nonfrail patients. Frailty emerges as a robust predictive factor for adverse surgical outcomes, emphasizing the necessity of considering frailty as a critical selection criterion for liver…
Study of over 570,000 patients reveals that the type of index complication in noncardiac surgeries significantly impacts patients' outcomes. Patients with specific complications like bleeding, cardiac, or graft issues are more likely to experience secondary complications, failure to rescue, longer hospital stays, or reoperations. Tailoring…
Analysis of 7,474,298 patients revealed decreasing preoperative risk and unadjusted postoperative complication rates from 2005 to 2018 within ACS-NSQIP. While mortality levels remained stable, other complications saw reductions, except for cardiac issues. Hospitals in the program experienced enhanced risk-adjusted outcomes, indicating a positive trend in…
Preoperative C-reactive protein-to-albumin ratio (CAR) ≥ 0.049 was identified as an independent risk factor for anastomotic leakage (AL) in rectal cancer patients undergoing surgery with intraoperative indocyanine green fluorescence imaging (ICG-FI). CAR could serve as a criterion for early surgical intervention or consideration of interventions…
Aprepitant significantly reduces postoperative nausea and vomiting in patients undergoing metabolic bariatric surgery, improving recovery and patient satisfaction. Meta-analysis of six studies involving 929 patients showed a significant decrease in ponv incidence with aprepitant, particularly at 0, 6, and 12 hours postoperatively. Administering aprepitant within…
