General Surgery

ML models show moderate pooled accuracy for postoperative complications and early recurrence across cancers

A systematic review and meta-analysis pooled 31 studies of ML for cancer postoperative complications and early recurrence. Pooled AUCs were moderate: 0.83–0.88 for complications and 0.80–0.84 for early recurrence. Sensitivity and specificity varied substantially by model type, tumor type, sample size, publication year, and country. Authors conclude ML can predict outcomes with moderate accuracy but recommend larger, standardized studies before clinical deployment. 1

Preoperative dementia in adults ≥75 is associated with higher 30‑day mortality mediated largely by delirium

In 547,310 US surgeries, 7.9% had preoperative dementia and dementia was associated with higher 30‑day mortality (aRR 1.64). Dementia markedly increased postoperative delirium (aRR 3.09) and modestly increased loss of independence (aRR 1.24). Mediation analysis attributed ~46% of dementia-related mortality to delirium and ~26% to loss of independence. Dementia effects were strongest in patients with lower frailty and in elective operations, suggesting targeted prevention opportunities. 2

Centers performing ≥40 posterior deep infiltrating endometriosis surgeries/year have fewer severe complications

A nationwide French cohort included 15,364 hospital stays for posterior deep infiltrating endometriosis surgery. Severe complications (Clavien III–V) occurred in 4.3% overall, with 3.6% at high-volume centers versus 5.3% at lower-volume centers. Analyses adjusted for surgical approach, case mix, comorbidity, and hospital clustering and reported lower adjusted complication odds in high-volume centers. Findings support centralizing complex endometriosis surgery when feasible to reduce severe postoperative morbidity. 3