Surgery
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The coronavirus disease 2019 pandemic has disrupted the delivery of safe surgical care worldwide. One specific aspect of global surgical care that has been severely limited is the ability for physicians and trainees to participate in global surgical outreach programs in low- and middle-income countries. ⋯ With careful consideration, global surgical outreach programs may begin to be safely restarted in the near future. The current article evaluates individual factors that must be considered to safely restart global surgical outreach programs as the coronavirus disease 2019 pandemic is better controlled.
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Review Meta Analysis
Ambulatory laparoscopic cholecystectomy: Systematic review and meta-analysis of predictors of failure.
Outpatient laparoscopic cholecystectomy has proven to be a safe and cost-effective technique; however, it is not yet a universally widespread procedure. The aim of the study was to determine the predictive factors of outpatient laparoscopic cholecystectomy failure. ⋯ Our meta-analysis allowed us to identify the predictors of outpatient laparoscopic cholecystectomy failure. The knowledge of these factors could help surgeons in their decision-making process for the selection of patients who are suitable for outpatient laparoscopic cholecystectomy.
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Review Meta Analysis
Ambulatory laparoscopic cholecystectomy: Systematic review and meta-analysis of predictors of failure.
Outpatient laparoscopic cholecystectomy has proven to be a safe and cost-effective technique; however, it is not yet a universally widespread procedure. The aim of the study was to determine the predictive factors of outpatient laparoscopic cholecystectomy failure. ⋯ Our meta-analysis allowed us to identify the predictors of outpatient laparoscopic cholecystectomy failure. The knowledge of these factors could help surgeons in their decision-making process for the selection of patients who are suitable for outpatient laparoscopic cholecystectomy.
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This review describes the steps and conclusions from the development and validation of an artificial intelligence algorithm (the Hypotension Prediction Index), one of the first machine learning predictive algorithms used in the operating room environment. The algorithm has been demonstrated to reduce intraoperative hypotension in two randomized controlled trials via real-time prediction of upcoming hypotensive events prompting anesthesiologists to act earlier, more often, and differently in managing impending hypotension. ⋯ Clinical validation of such algorithms is relatively new and requires more standardization, as guidelines are lacking or only now start to be drafted. Before adaptation in clinical practice, impact of artificial intelligence algorithms on clinical behavior, outcomes and economic advantages should be studied too.
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Alvimopan is a Food and Drug Administration-approved treatment to accelerate gastrointestinal recovery after abdominal surgery; however, benefits may vary across different procedures and contexts of care. The purpose of this study is to summarize the evidence regarding the effect of alvimopan on postoperative outcomes after abdominal surgery. ⋯ Evidence supports that alvimopan improves outcomes after open bowel resection and open radical cystectomy. Benefits for patients undergoing minimally invasive surgery and treated in contemporary enhanced recovery pathway settings remain uncertain. These findings contribute important new knowledge to inform evidence-based alvimopan prescribing.