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Essential Surgical Knowledge

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2250 papers 1000+ followers Papers from the recent literature which are of interest to residents and practicing surgeons
Justin G Wilkes, Jessica L Evans, B Stephen Prato, Steven A Hess, Dougald C MacGillivary, Timothy L Fitzgerald
BACKGROUND: Frailty in the surgical patient has been associated with increased morbidity, mortality, and failure-to-rescue. However, there is little understanding of the economic impact of frailty. STUDY DESIGN: A prospective database of elective surgery patients at an academic medical center was utilized to create a modified version of the Risk Analysis Index, a validated frailty index. This included 10,257 patients undergoing elective surgery from 2016-2017. Patients were classified as not frail (RAI = 0), somewhat frail (RAI = 1-10), or significantly frail (RAI > 10)...
February 8, 2019: Journal of the American College of Surgeons
Mauro Podda, Chiara Gerardi, Nicola Cillara, Nicola Fearnhead, Carlos Augusto Gomes, Arianna Birindelli, Andrea Mulliri, Richard Justin Davies, Salomone Di Saverio
MINI: The present meta-analysis demonstrates that, although limited by a lower efficacy compared to surgery, NOM with antibiotics could be considered a safe option for adults and pediatric patients with uncomplicated appendicitis, as it is successful in almost 75% of cases, and does not statistically increase the perforation rate. OBJECTIVE: The aim of this meta-analysis was to summarize the current available evidence on nonoperative management (NOM) with antibiotics for uncomplicated appendicitis, both in adults and children...
January 31, 2019: Annals of Surgery
Marion Piñeros, D Maxwell Parkin, Kevin Ward, Eric Chokunonga, Morten Ervik, Helen Farrugia, Mary Gospodarowicz, Brian O'Sullivan, Isabelle Soerjomataram, Rajaraman Swaminathan, Ariana Znaor, Freddie Bray, James Brierley
Accurate information on the extent of disease around the time of diagnosis is an important component of cancer care, in defining disease prognosis, and evaluating national and international cancer control policies. However, the collection of stage data by population-based cancer registries remains a challenge in both high-income and low and middle-income countries. We emphasise the lack of availability and comparability of staging information in many population-based cancer registries and propose Essential TNM, a simplified staging system for cancer registries when information on full Tumour, Node, Metastasis (TNM) is absent...
February 2019: Lancet Oncology
Priya Vijayvargiya, Michael Camilleri, Victor Chedid, Aditya Mandawat, Patricia J Erwin, M Hassan Murad
BACKGROUND & AIMS: Studies have reported a lack of association between improvements in gastric emptying (GE) and upper gastrointestinal (UGI) symptoms with promotility drugs. However, GE test methods were suboptimal in some studies. We assessed improvements in GE and UGI symptoms in patients given promotility agents in studies with optimal or moderate test methods (scintigraphy or breath test, solid meal, >2 hr duration) compared to studies with suboptimal GE test methods. METHODS: With an expert librarian, we completed an extensive search of publications in the Ovid MEDLINE (1946 to present), EMBASE (1988-January 2018), and EBM Reviews Cochrane Central Register of Controlled Trials, without restrictions on language or year...
January 31, 2019: Gastroenterology
Ramy Behman, Avery B Nathens, Stephanie Mason, James P Byrne, Nicole Look Hong, Petros Pechlivanoglou, Paul Karanicolas
Importance: Adhesive small-bowel obstruction (aSBO) is a potentially chronic, recurring surgical illness. Although guidelines suggest trials of nonoperative management, the long-term association of this approach with recurrence is poorly understood. Objective: To compare the incidence of recurrence of aSBO in patients undergoing operative management at their first admission compared with nonoperative management. Design, Setting, and Participants: This longitudinal, propensity-matched, retrospective cohort study used health administrative data for the province of Ontario, Canada, for patients treated from April 1, 2005, through March 31, 2014...
January 30, 2019: JAMA Surgery
Laura Beyer-Berjot, Léon Maggiori, Didier Loiseau, Jean-Dominique De Korwin, Jean-Pierre Bongiovanni, Philippe Lesprit, Nathalie Salles, Pascal Rousset, Thomas Lescot, Aymeric Henriot, Magalie Lefrançois, Eddy Cotte, Yann Parc
BACKGROUND: Acute diverticulitis is a common disease with public health significance. Many studies with a high level of evidence have been published recently on the surgical management of acute diverticulitis. OBJECTIVE: The aim of this systematic review was to define the accurate surgical management of acute diverticulitis. DATA SOURCES: Medline, Embase, and the Cochrane Library were sources used. STUDY SELECTION: One reviewer conducted a systematic study with combinations of key words for the disease and the surgical procedure...
January 25, 2019: Diseases of the Colon and Rectum
C Andolfi, P M Fisichella
BACKGROUND: The introduction of high-resolution manometry and the Chicago classification has made it possible to diagnose achalasia and predict treatment response accurately. The aim of this study was to compare the effect of the different treatments available on symptomatic outcomes across all achalasia subtypes. METHODS: The study was conducted according to PRISMA and MOOSE guidelines. A literature search of PubMed and MEDLINE databases was undertaken to identify all relevant articles reporting clinical outcomes of patients with achalasia after botulinum toxin injection, pneumatic dilatation, laparoscopic Heller myotomy (LHM) and peroral endoscopic myotomy (POEM) based on manometric subtypes...
January 28, 2019: British Journal of Surgery
Angelena Crown, Hagen Kennecke, Richard Kozarek, Alexandra G Lopez-Aguiar, Mary Dillhoff, Eliza W Beal, George A Poultsides, Eleftherios Makris, Kamran Idrees, Paula Marincola Smith, Hari Nathan, Megan Beems, Daniel Abbott, Alexander V Fisher, Ryan C Fields, Jesse Davidson, Shishir K Maithel, Flavio G Rocha
BACKGROUND: Gastric carcinoids are rare neuroendocrine tumors of the gastrointestinal tract. They are typically managed according to their etiology. However, there is little known about the impact of surgical strategy on the long-term outcomes of these patients. METHODS: All patients who underwent resection of gastric carcinoids at 8 institutions from 2000 to 2016 were analyzed retrospectively. Tumors were stratified according to subtype (I, II, III, IV) and resection type (local resection, LR or formal gastrectomy, FG)...
December 28, 2018: American Journal of Surgery
Michael P Kim, Matthew H G Katz
No abstract text is available yet for this article.
January 24, 2019: Annals of Surgical Oncology
J André Knottnerus, Peter Tugwell
No abstract text is available yet for this article.
February 2019: Journal of Clinical Epidemiology
Robert Challen, Joshua Denny, Martin Pitt, Luke Gompels, Tom Edwards, Krasimira Tsaneva-Atanasova
No abstract text is available yet for this article.
January 12, 2019: BMJ Quality & Safety
Rebecca L Siegel, Kimberly D Miller, Ahmedin Jemal
Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data, available through 2015, were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data, available through 2016, were collected by the National Center for Health Statistics...
January 8, 2019: CA: a Cancer Journal for Clinicians
Nicholas P McKenna, John R Bergquist, Elizabeth B Habermann, Heidi K Chua, Scott R Kelley, Kellie L Mathis
PURPOSE: Anal adenocarcinoma (AAC) is a rare disease with treatment protocols that mimic both that of rectal adenocarcinoma (RAC) and anal squamous cell carcinoma (ASCC). Due to its rarity, data regarding outcomes are lacking. We sought to determine outcomes of patients with AAC compared to RAC and ASCC and to evaluate risk factors for mortality in AAC. METHODS: The United States' National Cancer Database was queried for all adult patients presenting with nonmetastatic AAC, RAC, or ASCC from 2003 to 2011...
January 11, 2019: International Journal of Colorectal Disease
Alma L Moekotte, Sanne Lof, Stijn Van Roessel, Martina Fontana, Stephan Dreyer, Alaaeldin Shablak, Fabio Casciani, Vasileios K Mavroeidis, Stuart Robinson, Khalid Khalil, George Gradinariu, Nicholas Mowbray, Bilal Al-Sarireh, Giuseppe Kito Fusai, Keith Roberts, Steve White, Zahir Soonawalla, Nigel B Jamieson, Roberto Salvia, Marc G Besselink, Mohammed Abu Hilal
OBJECTIVE: The aim of the study was to define histopathologic characteristics that independently predict overall survival (OS) and disease-free survival (DFS), in patients who underwent resection of an ampullary adenocarcinoma with curative intent. SUMMARY BACKGROUND DATA: A broad range of survival rates have been described for adenocarcinoma of the ampulla of Vater, presumably due to morphological heterogeneity which is a result of the different epitheliums ampullary adenocarcinoma can arise from (intestinal or pancreaticobiliary)...
January 7, 2019: Annals of Surgery
M C White, K Randall, N F E Capo-Chichi, F Sodogas, S Quenum, K Wright, K L Close, S Russ, N Sevdalis, A J M Leather
BACKGROUND: The WHO Surgical Safety Checklist improves surgical outcomes, but evidence and theoretical frameworks for successful implementation in low-income countries remain lacking. Based on previous research in Madagascar, a nationwide checklist implementation in Benin was designed and evaluated longitudinally. METHODS: This study had a longitudinal embedded mixed-methods design. The well validated Consolidated Framework for Implementation Research (CFIR) was used to structure the approach and evaluate the implementation...
January 2019: British Journal of Surgery
Lisa M Schwartz, Steven Woloshin
Importance: Manufacturers, companies, and health care professionals and organizations use an array of promotional activities to sell and increase market share of their products and services. These activities seek to shape public and clinician beliefs about laboratory testing, the benefits and harms of prescription drugs, and some disease definitions. Objective: To review the marketing of prescription drugs, disease awareness campaigns, health services, and laboratory tests and the related consequences and regulation in the United States over a 20-year period (1997-2016)...
January 1, 2019: JAMA: the Journal of the American Medical Association
Wendy A Rogers, Katrina Hutchison, Angus McNair
No abstract text is available yet for this article.
February 2019: Annals of Surgery
Vinaya Simha, Pankaj Shah
No abstract text is available yet for this article.
January 7, 2019: JAMA: the Journal of the American Medical Association
Rajshri M Gartland, Jordan P Bloom, Zhi Ven Fong, Courtney DeRoo, Kathy Dwyer, Gene Quinn, Keith Lillemoe, Elizabeth Mort
OBJECTIVE: We aimed to study the contributing factors and costs of malpractice claims involving the surgical management of benign biliary disease given the emotional, physical, and financial toll of these claims on patients, providers, and the healthcare system. SUMMARY BACKGROUND DATA: Cholecystectomy complications carry significant morbidity and rank among the leading sources of surgical malpractice claims. METHODS: Using the CRICO Strategies' Comparative Benchmarking System database, representing approximately 30% of all paid and unpaid malpractice claims in the United States, 4081 closed claims filed against general surgeons from 1995 to 2015 were reviewed to isolate 745 cholecystectomy-related claims...
December 20, 2018: Annals of Surgery
Marc Carrier, Alon D Altman, Normand Blais, Artemis Diamantouros, Deanna McLeod, Uthaman Moodley, Christine Nguyen, Stephanie Young, Frank Schwenter
BACKGROUND: Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE). Certain abdominopelvic cancer surgeries are associated with a six to 14-fold increased risk of DVT versus surgeries for benign disease, and extended thromboprophylaxis using perioperative LMWHs may further reduce VTE rates over standard duration administration. This review assesses the value of extended low molecular weight heparin (LMWH) thromboprophylaxis as a recommended strategy after abdominopelvic cancer surgery...
December 16, 2018: American Journal of Surgery
2019-01-02 14:54:19
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