Nicole A Bilbro, Allison Hirst, Arsenio Paez, Baptiste Vasey, Maria Pufulete, Art Sedrakyan, Peter McCulloch
OBJECTIVE: The aim of this study was to define reporting standards for IDEAL format studies. BACKGROUND: The IDEAL Framework and Recommendations establish an integrated pathway for evaluation of new surgical techniques and complex therapeutic technologies. However guidance on implementation has been incomplete, and incorrect use is commonly seen. We describe the consensus development of reporting guidelines for the IDEAL stages, and plans for their dissemination and evaluation...
July 7, 2020: Annals of Surgery
Kristin Oliveira, Raymond A Jean, Radha Gonsai, Richard C Maduka, Courtney E Gibson, Alexander S Chiu, Vanita Ahuja
BACKGROUND: Appendicitis has traditionally been treated surgically. Recently, nonoperative management is emerging as a viable alternative to the traditional operative approach. This raises the question of what are the unintended consequences of nonoperative management of appendicitis with respect to cost and patient burden. METHODS: National Readmissions Database was queried between 2010 and 2014. Patients who were admitted with acute appendicitis between January and June of each year were identified...
June 30, 2020: Journal of Surgical Research
H L Simon, T Reif de Paula, M M Profeta da Luz, S K Nemeth, S J Moug, D S Keller
BACKGROUND: Frailty is associated with advancing age and may result in adverse postoperative outcomes. A suspected growing elderly population needing emergency colorectal surgery stimulated this study of the prevalence and impact of frailty. METHODS: Elderly patients (defined as aged at least 65 years by Medicare and the United States Census Bureau) who underwent emergency colorectal resection between 2012 and 2016 were identified from the American College of Surgeons National Surgical Quality Improvement Program population database...
July 8, 2020: British Journal of Surgery
Pauline Parent, Romain Cohen, Elie Rassy, Magali Svrcek, Julien Taieb, Thierry André, Anthony Turpin
Colon cancer (CC) has the highest incidence rate among gastrointestinal cancers and ranks the third in mortality among all cancers, which contributes to the current CC burden and constitutes a major public health issue. While therapeutic strategies for stage I, III, and IV CC are standardized, those for stage II CC remain debatable. The choice of adjuvant chemotherapy for patients with stage II CC depends on stage (pT4) and grade (high) of the disease, the presence of venous, perinervous, and/or lymphatic emboli, or the need of suboptimal surgery (tumor with initial occlusion or perforation needing emergency surgeries, <12 lymph nodes harvested)...
June 23, 2020: Cancer Treatment Reviews
Maria Abou-Khalil, Richard Garfinkle, Mohammed Alqahtani, Nancy Morin, Carol-Ann Vasilevsky, Marylise Boutros
INTRODUCTION: Diverting loop ileostomy (DLI) and colonic lavage has emerged as a valid alternative to total abdominal colectomy (TAC) for the surgical management of Clostridioides difficile colitis (CDC). However, little data are available on outcomes beyond the index admission. The objective of this study was to compare post-discharge outcomes between patients who underwent DLI and TAC for CDC. METHODS: Adult patients who underwent DLI or TAC for CDC between 2011 and 2016 were identified from the Nationwide Readmissions Database, and only discharges between January and September in each calendar year were included to allow for a 90-day follow-up period for all cases...
June 29, 2020: Surgical Endoscopy
Michael T LeCompte, Keenan J Robbins, Greg A Williams, Dominic E Sanford, Chet W Hammill, Ryan C Fields, William G Hawkins, Steven M Strasberg
INTRODUCTION: Subtotal cholecystectomy (SC) is a technique to manage the difficult gallbladder and avoid hazardous dissection and biliary injury. Until recently it was used infrequently. However, because of reduced exposure to open total cholecystectomy in resident training, we recently adopted subtotal cholecystectomy as the bail-out procedure of choice for resident teaching. This study reports our experience and outcomes with subtotal cholecystectomy in the years immediately preceding adoption and since adoption...
June 29, 2020: Surgical Endoscopy
Jesus M Banales, Jose J G Marin, Angela Lamarca, Pedro M Rodrigues, Shahid A Khan, Lewis R Roberts, Vincenzo Cardinale, Guido Carpino, Jesper B Andersen, Chiara Braconi, Diego F Calvisi, Maria J Perugorria, Luca Fabris, Luke Boulter, Rocio I R Macias, Eugenio Gaudio, Domenico Alvaro, Sergio A Gradilone, Mario Strazzabosco, Marco Marzioni, Cédric Coulouarn, Laura Fouassier, Chiara Raggi, Pietro Invernizzi, Joachim C Mertens, Anja Moncsek, Sumera Rizvi, Julie Heimbach, Bas Groot Koerkamp, Jordi Bruix, Alejandro Forner, John Bridgewater, Juan W Valle, Gregory J Gores
Cholangiocarcinoma (CCA) includes a cluster of highly heterogeneous biliary malignant tumours that can arise at any point of the biliary tree. Their incidence is increasing globally, currently accounting for ~15% of all primary liver cancers and ~3% of gastrointestinal malignancies. The silent presentation of these tumours combined with their highly aggressive nature and refractoriness to chemotherapy contribute to their alarming mortality, representing ~2% of all cancer-related deaths worldwide yearly. The current diagnosis of CCA by non-invasive approaches is not accurate enough, and histological confirmation is necessary...
June 30, 2020: Nature Reviews. Gastroenterology & Hepatology
Jonathan D Mizrahi, Rishi Surana, Juan W Valle, Rachna T Shroff
Pancreatic cancer is a highly fatal disease with a 5-year survival rate of approximately 10% in the USA, and it is becoming an increasingly common cause of cancer mortality. Risk factors for developing pancreatic cancer include family history, obesity, type 2 diabetes, and tobacco use. Patients typically present with advanced disease due to lack of or vague symptoms when the cancer is still localised. High quality computed tomography with intravenous contrast using a dual phase pancreatic protocol is typically the best method to detect a pancreatic tumour and to determine surgical resectability...
June 27, 2020: Lancet
Daniel Sokol, Rupen Dattani
No abstract text is available yet for this article.
June 30, 2020: BMJ: British Medical Journal
R Patel, A J Hainsworth, K Devlin, J H Patel, A Karim
INTRODUCTION: The COVID-19 pandemic has put significant stress on healthcare systems globally. This study focuses on emergency general surgery services at a major trauma centre and teaching hospital. We aimed to identify whether the number of patients and the severity of their presentation has significantly changed since the implementation of a national lockdown. MATERIALS AND METHODS: This study is a retrospective review of acute referrals (from general practice and accident and emergency) to the emergency general surgery team over a 14-day period before (group 1) and during (group 2) lockdown...
June 27, 2020: Annals of the Royal College of Surgeons of England
Manish A Shah, Erin B Kennedy, Daniel V Catenacci, Dana C Deighton, Karyn A Goodman, Narinder K Malhotra, Christopher Willett, Brendon Stiles, Prateek Sharma, Laura Tang, Bas P L Wijnhoven, Wayne L Hofstetter
PURPOSE: To develop an evidence-based clinical practice guideline to assist in clinical decision making for patients with locally advanced esophageal cancer. METHODS: ASCO convened an Expert Panel to conduct a systematic review of the more recently published literature (1999-2019) on therapy options for patients with locally advanced esophageal cancer and provide recommended care options for this patient population. RESULTS: Seventeen randomized controlled trials met the inclusion criteria...
June 22, 2020: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Daniël Pv Lambrichts, Pim P Edomskis, Ruben D van der Bogt, Gert-Jan Kleinrensink, Willem A Bemelman, Johan F Lange
PURPOSE: The optimal surgical approach for perforated diverticulitis with purulent or fecal peritonitis (Hinchey grade III or IV) remains debated. In recent years, accumulating evidence comparing sigmoid resection with primary anastomosis (PA) with the Hartmann's procedure (HP) was presented. Therefore, the aim was to provide an updated and extensive synthesis of the available evidence. METHODS: A systematic search in Embase, MEDLINE, Cochrane, and Web of Science databases was performed...
June 5, 2020: International Journal of Colorectal Disease
Marco Lanzillotta, Gaia Mancuso, Emanuel Della-Torre
IgG4 related disease was recognized as a unified disease entity only 15 years ago. Awareness of IgG4 related disease has increased worldwide since then, and specialists are now familiar with most of its clinical manifestations. Involvement of the pancreato-biliary tract, retroperitoneum/aorta, head and neck, and salivary glands are the most frequently observed disease phenotypes, differing in epidemiological features, serological findings, and prognostic outcomes. In view of this multifaceted presentation, IgG4 related disease represents a great mimicker of many neoplastic, inflammatory, and infectious conditions...
June 16, 2020: BMJ: British Medical Journal
Derek K Chu, Elie A Akl, Stephanie Duda, Karla Solo, Sally Yaacoub, Holger J Schünemann
BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and is spread person-to-person through close contact. We aimed to investigate the effects of physical distance, face masks, and eye protection on virus transmission in health-care and non-health-care (eg, community) settings. METHODS: We did a systematic review and meta-analysis to investigate the optimum distance for avoiding person-to-person virus transmission and to assess the use of face masks and eye protection to prevent transmission of viruses...
June 1, 2020: Lancet
Syed Z Kaleem, Sachin Parikh, Kevin Yang, Juan L Poggio
BACKGROUND: The Physician Payments Sunshine Act of 2010 mandated publication of all financial relationships between companies and physicians on the Centers for Medicare and Medicaid Services' Open Payments Data to elucidate potential conflicts of interest. This study seeks to illuminate the financial relationships that the pharmaceutical, medical device, biologics, and medical supply industries maintained with colon and rectal surgeons across the United States from 2014 to 2018. MATERIALS AND METHODS: We extracted and analyzed all colon and rectal surgeon data from the Open Payments Data for 2014-2018 using Microsoft Excel 2018 and JMP PRO 13...
June 10, 2020: Journal of Surgical Research
Mohammed Abdul-Latif, Katherine Townsend, Charles Dearman, Kai-Keen Shiu, Khurum Khan
Gastrointestinal cancers include colorectal, gastric, oesophageal, pancreatic and liver cancers. They continue to be a significant cause of mortality and morbidity worldwide. Current treatment strategies include chemotherapy, surgery, radiotherapy and targeted therapies. Immunotherapy has recently been incorporated in treatment regimens for some gastrointestinal malignancies and research into different immune modifying treatments is being carried out in this context. Approaches to immune modulation such as vaccination, adoptive cell therapy and checkpoint inhibition have shown varying clinical benefit, with most of the benefit seen in checkpoint inhibition...
May 28, 2020: Cancer Treatment Reviews
Yize I Wan, Akshaykumar Patel, Tom E F Abbott, Cheryl Achary, Neil MacDonald, Emmanuelle Duceppe, Daniel I Sessler, Wojtek Szczeklik, Gareth L Ackland, Philip J Devereaux, Rupert M Pearse
BACKGROUND: Infection is a frequent cause of postoperative morbidity and mortality. The incidence, risk factors, and outcomes for postoperative infections remain poorly characterised. METHODS: This is a secondary analysis of a prospective international cohort study of patients aged ≥45 yr who had noncardiac surgery (VISION), including data describing infection within 30 days after surgery. The primary outcome was postoperative infection. The secondary outcome was 30 day mortality...
May 29, 2020: British Journal of Anaesthesia
Yu-Wei Wayne Chang, Daniel Davenport, Adam Dugan, Jitesh A Patel
BACKGROUND: The value of proximal fecal diversion for patients undergoing colectomies is an ongoing debate. Previous studies have shown a benefit in decreased anastomotic leak rates and mitigation of the morbidity of a leak, especially in high-risk populations. However, more recent data suggests increased morbidity with fecal diversion, creating a complication with an unknown degree of anastomotic leak reduction. Therefore, we aimed to determine the impact on morbidity of a diverting loop ileostomy (DLI) in patients with a high risk of anastomotic leak...
May 18, 2020: American Journal of Surgery
Behnood Bikdeli, Mahesh V Madhavan, Aakriti Gupta, David Jimenez, John R Burton, Caroline Der Nigoghossian, Taylor Chuich, Shayan Nabavi Nouri, Isaac Dreyfus, Elissa Driggin, Sanjum Sethi, Kartik Sehgal, Saurav Chatterjee, Walter Ageno, Mohammad Madjid, Yutao Guo, Liang V Tang, Yu Hu, Laurent Bertoletti, Jay Giri, Mary Cushman, Isabelle Quéré, Evangelos P Dimakakos, C Michael Gibson, Giuseppe Lippi, Emmanuel J Favaloro, Jawed Fareed, Alfonso J Tafur, Dominic P Francese, Jaya Batra, Anna Falanga, Kevin J Clerkin, Nir Uriel, Ajay Kirtane, Claire McLintock, Beverley J Hunt, Alex C Spyropoulos, Geoffrey D Barnes, John W Eikelboom, Ido Weinberg, Sam Schulman, Marc Carrier, Gregory Piazza, Joshua A Beckman, Martin B Leon, Gregg W Stone, Stephan Rosenkranz, Samuel Z Goldhaber, Sahil A Parikh, Manuel Monreal, Harlan M Krumholz, Stavros V Konstantinides, Jeffrey I Weitz, Gregory Y H Lip
Coronavirus disease 2019 (COVID-19), currently a worldwide pandemic, is a viral illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The suspected contribution of thrombotic events to morbidity and mortality in COVID-19 patients has prompted a search for novel potential options for preventing COVID-19-associated thrombotic disease. In this article by the Global COVID-19 Thrombosis Collaborative Group, we describe novel dosing approaches for commonly used antithrombotic agents (especially heparin-based regimens) and the potential use of less widely used antithrombotic drugs in the absence of confirmed thrombosis...
May 30, 2020: Thrombosis and Haemostasis
Shannon M Fan, Areg Grigorian, Brian R Smith, Catherine M Kuza, Michael Lekawa, Sebastian D Schubl, Ninh T Nguyen, Jeffry Nahmias
BACKGROUND: The number of geriatric patients is expected to grow 3-fold over the next 30 years, and as many as 50% of the surgeries done in the United States may occur in geriatric patients. Geriatric patients often have increased comorbidities and more often present in a delayed manner for acute appendicitis. The aim of this study was to evaluate outcomes between geriatric patients and younger patients undergoing appendectomy, hypothesizing that geriatric patients will have a higher risk of abscess and/or perforation, conversion to open surgery, postoperative intra-abdominal abscess, and 30-day readmission...
May 24, 2020: Surgery
2020-06-02 19:10:49
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