Preoperative glucose dysregulation, including hyperglycemia, hypoglycemia, or both, was associated with a higher incidence of delirium within 30 days after non-cardiac surgery. The hazard ratios for the development of delirium were increased in patients with hyperglycemia, hypoglycemia, and both types of dysregulation. Interestingly, hyperglycemia was consistently associated with postoperative delirium in all patients, regardless of […]
Category: General Surgery
Octreotide does not improve outcomes in adult patients with post-esophagectomy chylothorax
Octreotide’s efficacy in managing intrathoracic chyle leak post-esophagectomy in adults was investigated in a cohort study. Among 74 patients, 27 received octreotide, but there was no significant difference in chest tube duration, hospital length of stay, or overall survival compared to non-octreotide group. Multivariable analysis confirmed that octreotide did not affect clinical outcomes. The study […]
Effect of Perioperative Dexamethasone on Postoperative Complications after Pancreaticoduodenectomy
Perioperative dexamethasone did not significantly reduce postoperative complications within 30 days after pancreaticoduodenectomy, as evidenced by similar comprehensive complication index scores, major complications, and pancreatic fistula rates between the dexamethasone and placebo groups. However, in patients with a main pancreatic duct ≤3 mm, the dexamethasone group showed a significantly lower complication index score. Journal Article […]
Improving End-of-Life Care for Veterans Undergoing Surgery
Researchers examined trends in end-of-life care services and satisfaction among veterans undergoing surgery. Over the study period, palliative care consultation and hospice use rates more than doubled, while satisfaction scores increased. Hospital location and accreditation were associated with the most significant changes. Improvements in satisfaction with end-of-life care corresponded with increased service usage, suggesting the […]
Privacy-Proof Live Surgery Streaming: Development of a Reliable Robotic Anonymization Algorithm
Researchers developed a pioneer surgical anonymization algorithm, validated across various robotic platforms, to remove out-of-body images in real-time. The algorithm successfully achieved a framewise anonymization roc auc-score of 99.46% on unseen procedures, increasing to 99.89% after post-processing. The deep learning model, ROBAN, offers safe real-time anonymization during complex surgical procedures on different robotic platforms, outperforming […]
Prognostic value of tumour response and nodal status in oesophageal adenocarcinoma
Researchers found that higher Mandard score and residual nodal disease were associated with increased recurrence rates and worse overall survival in patients with oesophageal adenocarcinoma. Patients with better tumour response (trg1) had lower recurrence rates and longer overall survival compared to those with poorer response (trg>1). Residual nodal disease had a more negative impact on […]
Prognostic Significance of CA19-9 in Resectable Pancreatic Cancer
In a nationwide study on resectable pancreatic ductal adenocarcinoma (PDAC), researchers found that elevated preoperative CA19-9 levels (≥500 U/ml) significantly reduced overall survival after upfront resection, unlike Eastern Cooperative Oncology Group performance status. This highlights the prognostic value of incorporating CA19-9 into the preoperative staging of anatomically resectable PDAC, emphasizing the importance of considering both […]
Identification of Promising Prediction Models for Morbidity and Mortality After Esophagectomy
A systematic review identified 33 prediction models for morbidity and mortality after esophagectomy, with 18 newly developed. Prognostic accuracy ranged from 0.51 to 0.85, with some models showing promise for further development. Performance status emerged as a potential modifiable risk factor, but none of the models are ready for clinical implementation. Two models for mortality […]
Task-Specific Metrics for Laparoscopic Fundoplication in Hiatal Hernia Repair
Researchers successfully developed and validated task-specific metrics (TSM) for laparoscopic Nissen fundoplication, a critical phase in laparoscopic hiatal hernia repair (LHHR). Utilizing structured interviews with expert foregut surgeons and a simulation involving participants with varying surgical expertise, the study demonstrated high interrater reliability and significant validity evidence for both global and TSM assessments. These LHHR-specific […]
Bariatric Surgery-Related Small Bowel Obstruction: Impact of Age, Gender, and Procedure Type
Patients who developed small bowel obstruction (SBO) after bariatric surgery were older, with lower BMI, and more likely female. Serious complications at 30 days post-operation were increased in SBO patients, with Roux-en-Y gastric bypass being the largest independent predictor of SBO development. COPD, prior DVT, lower BMI, and female sex were also predictive factors. SBO […]