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Guidelines on general surgical emergencies in pregnancy

These guidelines bring together the available evidence in supporting decision-making for the general surgeon, covering emergency care of pregnant people in their investigative and operative approach.

JC Kenington, Pellino G, Iqbal MR et al. ASGBI Emergency general surgery guidelines steering group. Br J Surg 2024; 111(3): znae051

Real-world practice and outcomes in pilonidal surgery (PITSTOP)

This UK-wide pilonidal sinus treatment study included 667 patients undergoing 12 interventions (59.5% major excision and 40.5% minimally invasive surgery). Complications were common (45%). Minimally invasive surgery had fewer complications and a more rapid return to activity, but at the expense of a higher risk of treatment failure.

Brown SR, Hind D, Strong E et al. Br J Surg 2024; 111(3): znae009

Development and validation of a deep-learning model to predict total hip replacement 

This study assessed 736 patients’ hip joints on weight-bearing AP pelvic radiographs. Imaging and symptom data were passed through a deep-learning model to predict probability and time to total hip arthroplasty (THA). The model achieved an overall accuracy, sensitivity and specificity of 91.35%, 92.59% and 86.96%, respectively, for THA within nine years. Authors concluded the model is a valid method to predict the probability of THA and could assist clinicians in patient counselling and decision-making regarding the timing of the intervention.

Xu Y, Xiong H, Liu W et al. J Bone Joint Surg Am 2024; 106(5): 389–396

How much time do surgeons spend operating?

This electronic survey from 225 predominantly general/upper-GI surgeons from 47 countries assessed the variation in amount of time per week that surgeons spend elective operating. There was significant variation: UK one day; North America 2.5 days; Europe three days; Asia two days; Africa two days; South America one day; Oceania one day. All surgeons worldwide preferred to spend three days a week performing elective surgery except UK surgeons, who preferred two days.

Fu K, Walmsley J, Abdelrahman M, Chan DSY. The Surgeon 2024; 22: 1–5

Anxiety and depression in surgeons: a systematic review

This systematic review evaluated anxiety and depression among surgeons. Thirty-one citations included 11,399 participants. The median anxiety was 20% and median depression was 24%. Risk factors included gender, younger age and concurrent burnout. Protective factors included institutional support and a sense of social belonging. Authors concluded it is imperative to develop strategies to mitigate the effect of anxiety and depression in surgeons.

Egbe A, El Boghdady, ME. The Surgeon 2024; 22: 6–17

Mortality and severe complications among newly graduated surgeons in the US

Medicare data of more than 1.3 million core operations performed by over 14,000 surgeons were used to evaluate 30-day severe complications and mortality between surgeons in their first and 15th year of practice. Rates of mortality (5.5% vs 4.7%) and severe morbidity (7.5% vs 6.9%) were higher among newly graduated surgeons compared with later-career surgeons.

Howard RA, Thelen AE, Chen X et al. Ann Surg 2024; 279(4): 555–560