In the USA alone, around 22 million patients annually discuss the need for surgical procedure with their surgeon. On a global scale, more than 200 million patients are exposed to the risk of undergoing a surgical procedure every year. A crucial part of the informed consent process for surgery is the understanding of risk, the probability of complications, and the predicted occurrence of adverse events. Ironically, risk quantification, risk stratification, and risk management are not necessarily part of a surgeon's core skillset, considering the lengthy surgical training curriculum towards technical excellence. The present review was designed to provide a concise historic perspective on the evolution of our current understanding of risk and probability, which represent the key underlying pillars of the shared decision-making process between surgeons and patients when discussing surgical treatment options.
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http://dx.doi.org/10.1186/s13017-017-0125-6 | DOI Listing |
Background: To investigate the effectiveness of different bariatric metabolic surgeries in improving metabolic syndrome indicators in patients.
Methods: A retrospective analysis was conducted on obese patients who underwent laparoscopic sleeve gastrectomy (LSG), laparoscopic sleeve gastrectomy + jejunojejunal bypass (LSG + JJB), and laparoscopic Roux-en-Y gastric bypass (LRYGB). Patients were categorized into groups based on their surgical procedure: LSG (N = 199), LSG + JJB (N = 242), and LRYGB (N = 288).
Arch Orthop Trauma Surg
January 2025
Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, 4710-057, Portugal.
Introduction: Total joint arthroplasties generally achieve good outcomes, but chronic pain and disability are a significant burden after these interventions. Acknowledging relevant risk factors can inform preventive strategies. This study aimed to identify chronic pain profiles 6 months after arthroplasty using the ICD-11 (International Classification of Diseases) classification and to find pre and postsurgical predictors of these profiles.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, South Korea.
Introduction: There is a lack of clinical evidence supporting the decision-making process between high tibial osteotomy (HTO) and unicomparmental knee arthroplasty (UKA) in gray zone indication, such as moderate medial osteoarthritis with moderate varus alignment. This study compared the outcomes between HTO and UKA in such cases and assessed the risk factor for not maintaining clinical improvements.
Materials And Methods: We retrospectively reviewed 65 opening-wedge HTOs and 55 UKAs with moderate medial osteoarthritis (Kellgren-Lawrence grade ≥ 3 and Ahlback grade < 3) and moderate varus alignment (5°< Hip-Knee-Ankle angle < 10°) over 3 years follow-up.
Hernia
January 2025
Department of Surgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1259, New York, NY, 10029, USA.
Purpose: While surgeons agree that perioperative field blocks should be performed for open inguinal hernia surgery, there lacks consensus in the minimally invasive context. Prior small-scale randomized trials study pain scores only up to 24 h postoperatively. Thus, we sought to investigate the analgesic benefits of a bupivacaine transversus abdominis plane (TAP) block in the first 4 postoperative days.
View Article and Find Full Text PDFJ Cancer Res Clin Oncol
January 2025
Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, 17489, Greifswald, Germany.
Introduction: The objective of this study is to compare the 5 year overall survival of patients with stage I-III colon cancer treated by laparoscopic colectomy versus open colectomy.
Methods: Using Mecklenburg-Western Pomerania Cancer Registry data from 2008 to 2018, we will emulate a phase III, multicenter, open-label, two-parallel-arm hypothetical target trial in adult patients with stage I-III colon cancer who received laparoscopic or open colectomy as an elective treatment. An inverse-probability weighted Royston‒Parmar parametric survival model (RPpsm) will be used to estimate the hazard ratio of laparoscopic versus open surgery after confounding factors are balanced between the two treatment arms.
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