# Surgical Management of Complex Abdominal Pathologies: A Multidisciplinary Approach

## TL;DR

This study shows that multidisciplinary team care improves outcomes for complex abdominal surgeries in Pakistan.

## Contribution

Demonstrates the clinical benefits of multidisciplinary team (MDT) care in high-risk abdominal surgeries in a Pakistani context.

## Key findings

- MDT care reduced in-hospital mortality and 30-day readmission rates significantly.
- Patients under MDT care had shorter ICU and hospital stays compared to conventional management.
- ERAS adherence further improved outcomes, including lower pain scores.

## Abstract

This study evaluated the impact of multidisciplinary team (MDT) involvement on clinical outcomes in 300 patients (N=300) undergoing surgical management of complex abdominal pathologies at tertiary care hospitals in Pakistan. Surgical procedures included open surgery in 131 patients (43.7%), laparoscopic in 103 (34.3%), and robotic in 66 (22%), with emergency operations accounting for 183 cases (61%). MDT care was provided to 171 patients (57%), while 129 (43%) received conventional surgical management. In-hospital mortality was significantly lower in the MDT group (14/171, 8.2%) compared to the non-MDT group (24/129, 18.6%; p=0.013). Thirty-day readmission was also reduced (19/171, 11.1% vs. 29/129, 22.5%; p=0.008). ICU admission was required in 168 patients (56%), with a shorter mean stay in the MDT group (3.9 vs. 5.7 days; p=0.004). The mean hospital stay was 9.8 days overall, significantly shorter among MDT-managed patients (8.3 vs. 11.5 days; p=0.001). Multivariate logistic regression identified MDT care (OR=0.42, p=0.029), serum albumin, and lower APACHE II scores as independent predictors of survival. Enhanced recovery after surgery (ERAS) adherence (n=81) significantly improved outcomes, including reduced pain scores (3.1 vs. 5.2; p<0.001). These results highlight the clinical benefits of MDT-led care in high-risk abdominal surgeries.