Nissen fundoplication yields lasting relief for GERD, with high satisfaction rates over a decade or more. Heartburn decreased from 94.2% to 33.7%, regurgitation from 68.7% to 13.4%, and esophagitis from 61.7% to 7.4%. Only 17% experienced symptom recurrence, while 87% reported they would choose the procedure again. Postoperative challenges include gas-bloating (53%) and dysphagia (26%), […]
Category: General Surgery
Sustainability’s Role in Surgical Practice
Integrating environmental sustainability into operating room guidelines is feasible and necessary. Surgical practices significantly contribute to healthcare’s environmental impact, driven by disposables, energy use, and anesthetic emissions. A systematic review of 42 studies found the evidence quality was “very low” to “low,” yet consistent environmental threats were identified. Surgical teams should consider actionable sustainability practices […]
Emergency Surgery Outcomes Worse at Non-Transplant Centers
Emergency surgeries in solid-organ transplant patients fare worse at non-transplant centers, particularly for kidney transplants. Among 2,679 cases, 30-day mortality was 4%, with 31% facing complications or mortality. Kidney transplant patients showed 3.52 times higher mortality at academic centers compared to transplant centers. Urgent surgical care for transplant patients should prioritize treatment at transplant centers […]
Pyloroplasty reduces complications in minimally invasive esophagectomy
Adding pyloroplasty during esophagectomy significantly lowers the risk of short-term complications. Patients undergoing pyloroplasty had a pneumonia or anastomotic leak rate of 18% compared to 27% in those without the procedure. The trial led to early stopping when superiority of pyloroplasty was confirmed with a 90% probability. Surgeons can confidently incorporate pyloroplasty to enhance patient […]
Multimodal Prehabilitation Doesn’t Cut Surgical Complications
Multimodal prehabilitation didn’t show significant benefits for postoperative outcomes in a diverse surgical population. No notable reduction in major complications (adjusted risk ratio 1.02) or length of stay (adjusted incidence rate ratio 1.04). In high-risk GI oncological surgery patients, a non-significant 9% reduction in complications was observed. Surgeons should consider targeted prehabilitation for high-risk patients, […]
Gas Bloat Syndrome Post-Nissen Fundoplication Linked to Failures
Gas bloat syndrome significantly worsens outcomes after Nissen fundoplication, revealing critical insights for surgical practice. 24.7% of patients experienced gas bloat syndrome one year post-surgery. Those with gas bloat reported higher GERD-HRQL scores, lower satisfaction, and increased PPI use (p < 0.01). By year five, 46.7% of gas bloat patients had anatomical failures vs. 15.3% […]
Minimally invasive surgery cuts costs in liver and pancreatic procedures
Minimally invasive approaches in liver and pancreatic surgery show significant cost advantages. Laparoscopic ($77,657) and robotic ($89,713) surgeries have lower median hospital charges compared to open surgery ($111,051) (p < .001). In liver resections, laparoscopic surgery results in adjusted charge reductions of $23,564 overall, and $14,140 for early discharges. Surgeons should consider minimally invasive techniques […]
Colovac 2 device shows promise for colorectal surgery
Colovac 2 may reduce the need for diverting ostomies after low anterior resection. 100% of Colovac devices were successfully placed and removed without complications. Only 8.3% experienced clinically significant migration, all retrieved successfully with no ostomy conversions. Surgeons can potentially avoid diverting ostomies in 87.5% of patients within 10 days post-surgery. 95.8% achieved fecal diversion […]
AI Platform Boosts Safety in Laparoscopic Cholecystectomy
An AI-based tool shows promise in improving the critical view of safety during laparoscopic cholecystectomy, reducing bile duct injury risks. The AI platform achieved impressive accuracy scores: 0.91 for CVS I, 0.86 for CVS II, and 0.73 for CVS III. Significant improvement in CVS assessment was observed post-deployment (p < 0.01). Surgeons reported high satisfaction, […]
New Robotic Procedure Shows Promise for Colorectal Lesions
Endorobotic submucosal dissection (ERSD) using the da Vinci SP system is a safe and effective option for resecting distal colorectal lesions. En-bloc resection rate was 96%, with a median procedure time of 73 minutes. Patients had a median hospital stay of 0 days and minimal long-term complications. This indicates ERSD could expand surgical options for […]