General Surgery
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Da Vinci-Assisted vs Laparoscopic Nissen Fundoplication for GERD: A Critical Systematic Review and Meta-Analysis
Four RCTs comparing robotic and laparoscopic Nissen fundoplication for GERD show equivalent patient outcomes but longer operative times and higher costs with robotics, questioning its routine use.
Prophylactic Synthetic Mesh at Stoma Reversal Significantly Reduces Incisional Hernia Risk: A Paradigm Shift in Surgical Practice
A randomized clinical trial demonstrates that placing synthetic mesh during stoma reversal virtually eliminates stomal site incisional hernias and improves hernia-related quality of life without increasing complications.
Postoperative Pulmonary Complications in Conventional Laparoscopic vs Robot-Assisted Abdominal Surgery: Incidence, Risk Factors, and Clinical Implications
This review synthesizes evidence comparing postoperative pulmonary complications (PPCs) between robot-assisted surgery (RAS) and conventional laparoscopic surgery (CLS) in abdominal procedures, highlighting the pivotal role of ventilation d
Harnessing Pragmatic Clinical Trial Designs to Advance Surgical Research
Pragmatic clinical trials offer innovative solutions to overcome unique challenges in surgical research, enhancing evidence quality and applicability by integrating flexible, routine-care-based trial designs and leveraging real-world data.
Prehabilitation in Sarcopenic Patients Undergoing Major Hepatectomy: Evidence from the PREHEP Trial
A 6-week multimodal prehabilitation program combining exercise and nutrition significantly reduces postoperative morbidity in sarcopenic patients undergoing major liver resection, highlighting a promising strategy to improve surgical outcom
Patterns and Predictors of GLP-1 Agonist Use After Bariatric Surgery in US Adults
A large US cohort study reveals that 14% of bariatric surgery patients start GLP-1 receptor agonists postoperatively, with higher use seen among women, sleeve gastrectomy recipients, and those with greater BMI regain.
Assessing the Long-Term Risk of Mesh Removal Due to Infection After Elective Ventral Hernia Repair
A decade-long Medicare study shows low overall risk of mesh removal from infection after open ventral hernia repair, with a slightly higher risk in patients experiencing early wound complications.
Biological vs Synthetic Mesh in Laparoendoscopic Inguinal Hernia Repair: Insights from the BIOLAP Randomized Clinical Trial
The BIOLAP trial demonstrates that biological meshes do not reduce postoperative pain in laparoendoscopic inguinal hernia repair and are associated with higher recurrence and seroma rates compared to synthetic meshes, underscoring synthetic
Minimally Invasive Surgery for Left-Sided Pancreatic Cancer: Long-Term Safety Confirmed by DIPLOMA Trial
The DIPLOMA trial demonstrates that minimally invasive left pancreatectomy for resectable pancreatic cancer offers comparable long-term survival outcomes to open surgery, validating its oncologic safety and supporting its use in clinical pr
Defining Cure in Stage II-III Colon Cancer: Insights from a Pooled Analysis of 15 Randomized Trials
A rigorous pooled analysis of over 35,000 patients identifies a recurrence risk below 0.5% at 6 years post-surgery, providing a practical benchmark for defining cure in stage II-III colon cancer and refining patient management strategies.
Non-β-Lactam Antibiotics, β-Lactam Allergy, and Surgical Site Infections: Implications for Prophylaxis and Stewardship
This study evaluates how reported β-lactam allergy and choice of prophylactic antibiotics impact surgical site infection rates, revealing non-β-lactam use increases SSI risk while allergy alone does not independently predict infections.
Optimizing Empiric Antibiotic Selection in Hospitalized Patients with Skin and Abdominal Infections: Insights from the INSPIRE 3 and 4 Cluster Randomized Clinical Trials
The INSPIRE 3 and 4 trials demonstrate that computerized provider order entry (CPOE) prompts with patient-specific MDRO risk estimates, combined with education and feedback, significantly reduce empiric extended-spectrum antibiotic use in s
Cutting through the p-value: Assessing Clinical Relevance in Inguinal Hernia Repair Surgical Literature
This analysis reveals pervasive underreporting of clinical relevance thresholds in studies comparing open, laparoscopic, and robotic inguinal hernia repairs, urging a shift beyond p-values to improve evidence-based surgical decisions.
Circulating Trimethylamine N-Oxide: A Novel Biomarker for Predicting Abdominal Aortic Aneurysm Progression and Surgical Risk
Elevated plasma TMAO levels are associated with higher risk of abdominal aortic aneurysm development, rapid aneurysm growth, and need for surgical repair, providing a promising tool for risk stratification and personalized surveillance.
Efficacy and Safety of Shunt Surgery in Idiopathic Normal-Pressure Hydrocephalus: Insights from a Rigorous Randomized Controlled Trial
A double-blind, placebo-controlled trial demonstrates that shunt surgery significantly improves gait velocity and balance in patients with idiopathic normal-pressure hydrocephalus who respond to temporary CSF drainage, with mixed safety out
Minimally Invasive Surgery versus Medical Management for Supratentorial Intracerebral Hemorrhage: Insights from the MIND Trial
The MIND trial compared minimally invasive surgery using the Artemis device to standard medical management for supratentorial intracerebral hemorrhage, finding no significant improvement in 180-day functional outcomes or 30-day mortality wi
Minimally Invasive Surgery vs Medical Management in Supratentorial Intracerebral Hemorrhage: Insights from the MIND Randomized Trial
The MIND trial found no significant functional benefit or mortality reduction with minimally invasive surgery compared to medical management alone in supratentorial intracerebral hemorrhage patients at 180 days.
Hyperbaric Oxygen Therapy Enhances Recovery After Intracranial Aneurysm Surgery
A meta-analysis of 11 RCTs involving over 2000 patients shows hyperbaric oxygen therapy significantly improves neurologic function, independence, and quality of life post-intracranial aneurysm surgery.
Combined Liver–Kidney Transplantation: Four Decades of Transformative Impact and Future Horizons
Since the landmark combined liver–kidney transplant in 1984, advances in surgical techniques, immunosuppression, and donor allocation have revolutionized care for patients with dual organ failure. Emerging innovations, including gene-edited
Optimizing Treatment Selection for Hepatocellular Carcinoma: Machine Learning Guidance in Choosing Liver Transplantation versus Surgical Resection
A machine learning model accurately stratifies patients with hepatocellular carcinoma to guide individualized selection between liver transplantation and surgical resection, improving survival outcomes while addressing donor scarcity and pa
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