Results show that fine-needle aspiration cytology results influence surgical planning in thyroid cancer, with intermediate categories leading to more partial thyroidectomies. Inadequate procedures due to inconclusive cytology are encountered in up to 15% of cases. Completion thyroidectomies after initial partial procedure do not significantly increase morbidity. Primary partial thyroidectomy is safer than total thyroidectomy in […]
Category: General Surgery
Preoperative pancreatic radiologic characteristics predict postoperative pancreatic complications
High acinar pancreatic content on preoperative CT scans is associated with increased risk of postpancreatectomy acute pancreatitis and pancreatic fistula formation. A simple radiological score combining pancreatic density, wirsung caliber, and pancreatic thickness predicts patients at higher risk for these complications, with male gender and obesity also contributing to the risk. Understanding these radiologic factors […]
Perioperative Risk Stratification: Cirrhosis-Hospital Frailty Risk Score Outperforms Original in Predicting Mortality
Creating a modified tool, the Cirrhosis-Hospital Frailty Risk Score (CHFRS), for improved perioperative risk stratification in cirrhosis patients undergoing abdominal operations. This simplified index, based on 12 icd-10 codes within the existing Hospital Frailty Risk Score, was found to have superior predictive accuracy for in-hospital mortality compared to the original 109-component score. The CHFRS more […]
Impact of Private Equity on Surgical Practice Consolidation: Analysis of 1,542 Transactions
Private equity investments have substantially impacted surgical specialties, leading to increased practice consolidation. Among 1,542 transactions involving surgical practices from 2015-2019, 539 were financed by private equity. Activity peaked in 2017 with 63 practices involved, predominantly in digestive disease, urology, and orthopedic surgery. Anesthesiology, ambulatory surgery centers, and surgical staffing firms were also affected, with […]
Roux-en-Y Gastric Bypass Shows Continued Diabetes Remission Despite Weight Recurrence
Roux-en-Y gastric bypass (RYGB) patients display higher rates of continued diabetes remission (CDR) compared to sleeve gastrectomy (SG) patients, even with weight recurrence (WR). The odds of Type 2 diabetes mellitus (T2DM) recurrence were 5.5 times higher in the SG group. Baseline insulin use, higher preoperative HbA1c, and longer preoperative T2DM duration were associated with […]
Novel SLE Index Enhances Prognostic Evaluation in Pancreatic Cancer Post Neoadjuvant Treatment
Patients with modest radiologic response to neoadjuvant treatment (NAT) for pancreatic cancer face operative eligibility uncertainties. A novel Sialyl-Lewis Antigen-related Index (SLE Index) combining CA19-9 and Dupan-II reveals significant prognostic value. An SLE Index below 45.25 correlates with favorable disease-free survival, proving superior in predicting recurrence within 24 months compared to individual tumor markers. This […]
Disparities in Presentation and Treatment of Medullary Thyroid Cancer by Sex and Race/Ethnicity
Male and non-white patients with medullary thyroid cancer (MTC) are more likely to present with advanced disease, including larger tumors and distant metastases. They also experience longer delays in receiving surgical treatment and are less likely to undergo guideline-concordant surgery. Black patients, in particular, are at a higher risk of disparities in disease presentation and […]
Incidence and Risk Factors of Marginal Ulcers Post-Pancreaticoduodenectomy
Researchers analyzed data from 190 post-pancreaticoduodenectomy patients with upper gastrointestinal symptoms and found a 10.5% incidence of marginal ulcers. Factors associated with an increased risk of marginal ulcers included advanced age, alcohol consumption, smoking, longer surgery time, and postoperative bleeding, while regular use of antacids was a protective factor. This study highlights the importance of […]
Endoscopic Treatment Outperforms Surgery in Necrotizing Pancreatitis
The study compared endoscopic and surgical treatment in acute necrotizing pancreatitis, showing that endoscopic treatment resulted in lower peri-interventional morbidity, shorter hospital stays, and lower mortality rates. Endoscopic treatment also led to better long-term outcomes with reduced renal insufficiency, ventilation dependency, and recurrence rates, along with improved exocrine functionality. These findings suggest a preference for […]
Can a Crosshair Improve Communication in Laparoscopic Surgeries?
Using a crosshair on the video monitor during laparoscopic surgeries improved novices’ understanding of anatomical structures, as shown by better global operative assessment scores. Although operating time and confidence levels did not significantly change, participants found the crosshair to be non-disruptive and beneficial. The simple, inexpensive tool can enhance communication between instructors and novices in […]