Our Summary
The research paper discusses the use of machine learning to predict the risk of ureteral injury (UI) during colorectal surgery. This injury is rare but can cause serious complications. In the past, medical professionals used ureteral stents to prevent this, but they also carry their own risks. So, researchers have been trying to predict who’s at risk using logistic regression, but the results haven’t been very accurate.
In this study, researchers used machine learning, a type of artificial intelligence that learns from data, to predict the risk of UI. They used a large database of patients who had undergone colorectal surgery and divided them into three groups for training, testing, and validation. They tried three machine learning techniques and compared them to the old method of logistic regression.
The machine learning method called gradient boosting (XGB) performed the best, while the other two (random forest and neural networks) also did better than logistic regression. The factors that had the most influence on the predictions were the type of surgery, the complexity of the work, the reason for the surgery, and the use of a mechanical bowel preparation.
In simpler terms, machine learning was better at predicting who was most likely to get injured during colorectal surgery. This could help doctors decide who needs a ureteral stent before surgery, reducing the risks associated with these procedures.
FAQs
- How does machine learning help in predicting the risk of ureteral injury during colorectal surgery?
- What factors are most influential in predicting the risk of ureteral injury during colorectal surgery according to the machine learning model?
- How does the machine learning method called gradient boosting compare to other methods in predicting the risk of ureteral injury?
Doctor’s Tip
One helpful tip a doctor might give to a patient undergoing colorectal surgery is to discuss with their healthcare provider the possibility of using machine learning to predict the risk of ureteral injury. By utilizing this technology, doctors can better assess the patient’s individual risk factors and potentially take preventive measures to ensure a safer surgical outcome. It’s important for patients to stay informed and communicate openly with their healthcare team to make the best decisions for their care.
Suitable For
Patients who are typically recommended colorectal surgery include those with colorectal cancer, inflammatory bowel disease, diverticulitis, and other conditions affecting the colon and rectum. Additionally, patients with colorectal polyps that are at high risk of developing into cancer may also be recommended for surgery. Patients with severe symptoms such as bowel obstruction, bleeding, or perforation may also require surgery as a treatment option.
Timeline
Before surgery: The patient undergoes preoperative tests and consultations with their medical team to determine the need for surgery and discuss the risks and benefits. They may also need to prepare for the surgery by following specific dietary and lifestyle guidelines.
Day of surgery: The patient is admitted to the hospital and undergoes the surgery under general anesthesia. The surgery may involve the removal of part of the colon or rectum, depending on the condition being treated.
After surgery: The patient is monitored in the recovery room and then transferred to a hospital room for further observation. They may need to stay in the hospital for a few days to a week, depending on the complexity of the surgery and their recovery progress.
Postoperative care: The patient will be given pain medications, antibiotics, and instructions on how to care for their surgical incision. They may also need to follow a specific diet and gradually increase their physical activity as they recover.
Follow-up appointments: The patient will need to have regular follow-up appointments with their medical team to monitor their recovery and address any complications that may arise. They may also need to undergo additional tests, such as CT scans or colonoscopies, to ensure the success of the surgery.
What to Ask Your Doctor
Some questions a patient should ask their doctor about colorectal surgery include:
- What is the purpose of the surgery and what are the expected outcomes?
- What are the potential risks and complications associated with colorectal surgery?
- Will I need a ureteral stent before surgery to prevent ureteral injury?
- How will the decision be made to use a ureteral stent, and what are the risks associated with it?
- How will my risk for ureteral injury be assessed before surgery?
- Are there any alternative treatments or procedures that could be considered?
- What is the recovery process like after colorectal surgery?
- What can I do to prepare for surgery and optimize my recovery?
- How often will I need follow-up appointments after surgery?
- Are there any specific lifestyle changes or precautions I should take after surgery to prevent complications?
Reference
Authors: Chen KA, Joisa CU, Stem JM, Guillem JG, Gomez SM, Kapadia MR. Journal: Am Surg. 2023 Dec;89(12):5702-5710. doi: 10.1177/00031348231173981. Epub 2023 May 3. PMID: 37133432