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Best Papers in General Surgery
The five that matter, every day.
Higher one-year mortality rates were observed in elderly patients undergoing surgery for clinical T4 and locally recurrent rectal cancer. Factors associated with increased mortality included preoperative anemia, total pelvic exenteration, pulmonary complications, and higher grade complications. The main causes of death were failure to recover…
Emergency colonic resection has long been the standard treatment for left-sided malignant colonic obstruction, but self-expanding metallic stenting and decompressing stomas are emerging as viable alternatives. A systematic review and network meta-analysis of randomized controlled trials and propensity score matching studies found that stenting and…
Epiploic appendagitis (EPA) is a rare, self-limiting acute abdominal disorder that is mostly treated non-operatively. A retrospective analysis of 156 cases in a Middle Eastern country showed that EPA primarily affects males with a mean age of 33 years. Computerized tomographic scans were the main…
Patients with local recurrence of esophageal cancer following Ivor-Lewis esophagectomy have a significantly decreased overall survival. A retrospective study at a high-volume center showed that patients who underwent resection had better survival outcomes compared to those who did not. Chemoradiotherapy also showed promise in selected…
Primary ileal pouch leaks after IPAA procedures are infrequent but challenging complications. Despite attempts at nonoperative management, success rates are limited. Salvage surgery has a high pouch retention rate, emphasizing its importance in leak management. A retrospective study at Cleveland Clinic over 27 years found…
After analyzing 26 studies with 4055 patients, the pooled incidence of nonalcoholic fatty liver disease after pancreatectomy was 29%. Female sex, pancreatic ductal adenocarcinoma, portal vein or superior mesenteric vein resection, dissection of nerve plexus around the superior mesenteric artery, and adjuvant chemotherapy were significantly…
Among over 1 million patients with gastrointestinal cancer, only a small percentage were enrolled in clinical trials, with significantly lower enrollment rates among patients treated at minority-serving hospitals and black individuals. The odds of enrollment in a clinical trial were much lower for patients at…
Patients with preoperative sarcopenia, identified using skeletal muscle index, had higher rates of major complications, including cardiac arrhythmia and mortality. They also had significantly lower overall survival and disease-free survival compared to non-sarcopenic patients. Sarcopenia was found to be an independent risk factor for lower…
Healthcare providers at a high-volume academic institution lack training on addressing religious beliefs impacting patients undergoing stoma surgery, with only 35% reporting training on how stomas interact with faith practices. Religious services are rarely present during counseling sessions, and interviewees note difficulties in discussing religious…
Program factors such as residency length, resident class size, number of total physician faculty, average hours of didactics per week, and the percentage of residents graduating from US MD programs are associated with improved American Board of Surgery examination pass rates. Older programs, as well…
