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Best Papers in General Surgery
The five that matter, every day.
Researchers developed preliminary body composition guidelines for post-surgical patients based on gender-specific goals, leading to significant fat mass reduction and lean mass-sparing outcomes below obesity thresholds. Serial body composition analysis and evidence-based nutrition practices consistently influenced patient outcomes, supporting the effectiveness of the guidelines in…
Hybrid oesophagectomy with minimally invasive gastric mobilization and thoracotomy did not result in faster recovery or greater cost-effectiveness compared to open surgery for patients with oesophageal cancer. Physical function and complication rates over the first 3 months post-randomization were similar between the two groups. Surgeons…
Clinicians inaccurately estimate future liver remnant volume visually, tending to overestimate it, especially in cases with small remnants leading to higher risk of post-hepatectomy liver failure. Accuracy is lower for right hepatectomy (mean percent overestimation of 22%) and right trisectionectomy (mean percent overestimation of 25%),…
Researchers demonstrated the feasibility of using risk-adjusted cumulative sum to monitor outcomes after colorectal operations and identify performance variations. This method accurately tracked surgeon-specific outcomes, adjusting for patient-level risk factors. Outliers in performance were promptly identified at the surgeon, divisional, and institutional levels, contributing to…
Patients with KRAS-mutated colorectal liver metastases had shorter overall and disease-free survival after liver resection. In these cases, the resection margin did not affect oncologic outcomes. However, for KRAS wild-type tumors, achieving an R0 resection was crucial for prolonged overall and disease-free survival. Primary tumor…
Analysis of 1,701 patients with hepatocellular carcinoma after curative resection revealed 38.4% experienced late recurrence, with median time to recurrence of 4.0 years. Risk factors for late recurrence included age >60, chronic hepatitis C, cirrhosis, high albumin-bilirubin grade, absence of family history, and specific tumor…
Interval laparoscopic cholecystectomy for cholecystitis with gallstones poses challenges due to factors like impacted stones, post-choledocholithiasis, and older age. A study of 269 patients found that these factors were independent risk factors for conversion to bailout procedures. While bile duct injuries were rare (0.4%), caution…
Readmission post-robotic hepatectomy correlates with hypertension, higher Child-Pugh scores, and R1 margins. Neoadjuvant chemotherapy is associated with lower readmission rates due to less diffuse liver disease. While not affecting five-year survival, readmissions elevate hospital costs significantly. The study found 44 out of 244 patients were…
Ileosigmoid knotting, a severe form of bowel obstruction, carries high mortality in low-resource settings. A retrospective cohort study at Jimma University Medical Center revealed a 27.5% death rate among 40 patients, with shock at presentation and comorbidities significantly impacting survival. Age and intra/postoperative pulse rates…
Endoscopic cuffitis occurred in approximately 60% of patients who underwent restorative proctocolectomy with stapled ileal pouch–anal anastomosis, and was significantly associated with extensive disease and exposure to multiple biologics before colectomy. Older age, extensive disease, exposure to biologics before colectomy, and exposure to at least…
