Perioperative fluid management in colorectal surgery is discussed within enhanced recovery after surgery (ERAS) pathways. The review highlights the lack of standardized definitions for restrictive or liberal fluid regimens, with challenges related to patient selection. Goal-directed fluid therapy is suggested for more complex cases. Critical thresholds for total intravenous fluids and weight gain are identified, […]
Category: General Surgery
Repeat Resection for Recurrent Intrahepatic Cholangiocarcinoma Can Lead to Improved Survival
Repeat resection for recurrent intrahepatic cholangiocarcinoma in select patients can lead to improved survival compared to locoregional or palliative therapy alone. A 3-year post-recurrence survival rate of 47% was observed in surgically treated patients. Independent predictors of post-recurrence death included time to recurrence, site of recurrence, macrovascular invasion, and size of recurrence. Repeat resection was […]
Low Adherence to Guidelines for Extended Thromboprophylaxis in Colorectal and Anal Cancer Patients Undergoing Surgery
Researchers found that despite recommendations for extended thromboprophylaxis, only 63% of patients received appropriate treatment in the inpatient setting. Additionally, only 2% of patients received recommended prophylaxis post-discharge, resulting in no thromboembolic events. Adherence to risk-guided prophylaxis led to decreased rates of venous thromboembolism without increasing bleeding complications, highlighting the need for improved guideline adherence […]
Identification of Teaching Frameworks for Surgical Residents in Intraoperative Settings
Effective intraoperative teaching in surgery is crucial for resident education. A scoping review of 66 studies reveals the BID model (Briefing, Intraoperative Teaching, and Debriefing) as a foundational framework for organizing teaching interactions. Preoperative briefing, intraoperative teaching, and postoperative debriefing enhance learning experiences, with emphasis on goal setting and communication. Teaching tools like OpTrust and […]
Comparing Postoperative Quality of Life: Proximal vs. Total Gastrectomy
A multi-institutional observational study compared postoperative quality of life between patients undergoing total or proximal gastrectomy for early gastric cancer. Postoperative weight loss rate over 3 years was lower in the proximal gastrectomy group, showing a trend towards better quality of life, particularly in indigestion symptoms. No significant differences were found between the groups using […]
Drain Clamping Technique: Effective Management of Persistent Biliary Fistulas After Liver Hydatid Cyst Surgeries
Researchers successfully treated persistent biliary fistulas post-liver hydatid cyst surgeries in 14 patients using a noninvasive drain clamping technique. All fistulas closed within 8-20 days without complications. This novel approach eliminated the need for surgical reoperation and resulted in complete recovery in patients, providing a safe and effective alternative to endoscopic procedures. Journal Article by […]
How can the Retained Surgical Items Risk Assessment Scale impact the reduction of medical errors in operating rooms?
An effective measurement tool, the Retained Surgical Items Risk Assessment Scale, was developed and validated to assess risk factors for retained surgical items in operating rooms. It showed high content validity, internal consistency, and accuracy in identifying high-risk patients. The scale’s cut-off point, specificity, and sensitivity values suggest it can significantly reduce the incidence of […]
Enhancing Adherence to Opioid Prescribing Guidelines in a Hospital Setting
Adherence to opioid prescribing guidelines in a hospital setting was higher for total morphine milligram equivalents (mme) prescribed compared to number of days prescribed. Surgeons showed higher adherence for severe predicted pain cases in both mme and days prescribed. Attending physicians had higher adherence rates than residents/fellows. While improvements were noted from previous reports, further […]
Portal Vein Stenting for Peri-hilar Cholangiocarcinoma: Clinical Benefits and Safety
Portal vein stenting in peri-hilar cholangiocarcinoma patients led to 100% technical success, improvement in 75% of clinical symptoms, and enabled anticancer therapy in 69% of cases. Complications occurred in 13%, including biliary injury and cholangitis, but patency was high at 86% after one year. Stent occlusion for tumor progression was managed successfully. This palliative treatment […]
Increasing Standardization of Hepato-pancreato-biliary Surgery Fellowships in Europe
Results of an international survey show substantial variability in European hpb surgery fellowship programs, highlighting the need for a more standardized clinical curriculum. Fellowships typically last one or two years, with funding provided in 70% of cases. Fellows commonly perform pancreatic and liver resections as first surgeons, while minimally invasive procedures make up less than […]