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Essential Surgical Knowledge

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2413 papers 1000+ followers Papers from the recent literature which are of interest to residents and practicing surgeons
https://read.qxmd.com/read/32157697/fibrin-sealants-for-the-prevention-of-postoperative-pancreatic-fistula-following-pancreatic-surgery
#1
REVIEW
Yilei Deng, Sirong He, Yao Cheng, Nansheng Cheng, Jianping Gong, Junhua Gong, Zhong Zeng, Longshuan Zhao
BACKGROUND: Postoperative pancreatic fistula is one of the most frequent and potentially life-threatening complications following pancreatic resections. Fibrin sealants have been used in some centers to reduce postoperative pancreatic fistula. However, the use of fibrin sealants during pancreatic surgery is controversial. This is an update of a Cochrane Review last published in 2018. OBJECTIVES: To assess the safety, effectiveness, and potential adverse effects of fibrin sealants for the prevention of postoperative pancreatic fistula following pancreatic surgery...
March 11, 2020: Cochrane Database of Systematic Reviews
https://read.qxmd.com/read/32203843/broadening-the-therapeutic-horizon-of-advanced-biliary-tract-cancer-through-molecular-characterisation
#2
REVIEW
Avani Athauda, Caroline Fong, David K Lau, Milind Javle, Ghassan K Abou-Alfa, Chigusa Morizane, Keith Steward, Ian Chau
Biliary tract cancers (BTC) comprise a group of rare and heterogeneous poor-prognosis tumours with the incidence of intrahepatic cholangiocarcinoma increasing over recent years. Combination chemotherapy with gemcitabine and cisplatin is the established first-line treatment for advanced BTC with a significant but modest survival advantage over monotherapy. There remains no accepted standard treatment in the second-line setting, although recent results from a randomised study have shown a survival benefit with 5-fluorouracil and oxaliplatin chemotherapy...
March 12, 2020: Cancer Treatment Reviews
https://read.qxmd.com/read/32167730/the-next-step-in-surgical-quality-improvement-outcome-situational-awareness
#3
William B. Lyman, Michael Passeri, Keith Murphy, Allyson Cochran, David A. Iannitti, John B. Martinie, Erin H. Baker, Brent D. Matthews, Dionisios Vrochides
A similar theme unites proposed solutions for stagnant improvement in outcomes and rising health care costs: eliminate unnecessary variation in the care of surgical patients. While large quality-improvement projects like the Americal College of Surgeons National Surgical Quality Improvement Program have historically led to improved patient outcomes at the hospital level, the next step in surgical quality improvement is to eliminate unnecessary variation at the level of the individual surgeon. Critical examination of individualized clinical, financial and patient-reported outcomes — outcome situational awareness — along with peer group comparison will help surgeons to identify variation in patient care...
March 13, 2020: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://read.qxmd.com/read/32187680/optimizing-the-design-of-invasive-placebo-interventions-in-randomized-controlled-trials
#4
S Cousins, N S Blencowe, C Tsang, K Chalmers, A Mardanpour, A J Carr, M K Campbell, J A Cook, D J Beard, J M Blazeby
BACKGROUND: Placebo-controlled trials play an important role in the evaluation of healthcare interventions. However, they can be challenging to design and deliver for invasive interventions, including surgery. In-depth understanding of the component parts of the treatment intervention is needed to ascertain what should, and should not, be delivered as part of the placebo. Assessment of risk to patients and strategies to ensure that the placebo effectively mimics the treatment are also required...
March 18, 2020: British Journal of Surgery
https://read.qxmd.com/read/32172223/methodological-quality-of-oncology-noninferiority-clinical-trials
#5
REVIEW
Cole Wayant, Andrew Ross, Matt Vassar
INTRODUCTION: Noninferiority trials can show that new treatments with slightly less efficacy are safer, cheaper, or easier to administer. However, the conclusions of noninferiority trials depend on robust methodology. METHODS: We conducted a 6 year cross-sectional investigation of the methodological quality of oncology noninferiority trials published in the top 10 oncology journals. Four key quality criteria were investigated. RESULTS: Nonefficacy benefits of the new treatment were stated in 88/110 (80...
March 5, 2020: Critical Reviews in Oncology/hematology
https://read.qxmd.com/read/32133645/colorectal-cancer-statistics-2020
#6
Rebecca L Siegel, Kimberly D Miller, Ann Goding Sauer, Stacey A Fedewa, Lynn F Butterly, Joseph C Anderson, Andrea Cercek, Robert A Smith, Ahmedin Jemal
Colorectal cancer (CRC) is the second most common cause of cancer death in the United States. Every 3 years, the American Cancer Society provides an update of CRC occurrence based on incidence data (available through 2016) from population-based cancer registries and mortality data (through 2017) from the National Center for Health Statistics. In 2020, approximately 147,950 individuals will be diagnosed with CRC and 53,200 will die from the disease, including 17,930 cases and 3,640 deaths in individuals aged younger than 50 years...
March 5, 2020: CA: a Cancer Journal for Clinicians
https://read.qxmd.com/read/32160103/informing-patients-about-expected-outcomes-the-efficacy-effectiveness-gap
#7
Arnoud J Templeton, Christopher M Booth, Ian F Tannock
No abstract text is available yet for this article.
March 11, 2020: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://read.qxmd.com/read/32029004/a-rapid-advice-guideline-for-the-diagnosis-and-treatment-of-2019-novel-coronavirus-2019-ncov-infected-pneumonia-standard-version
#8
Ying-Hui Jin, Lin Cai, Zhen-Shun Cheng, Hong Cheng, Tong Deng, Yi-Pin Fan, Cheng Fang, Di Huang, Lu-Qi Huang, Qiao Huang, Yong Han, Bo Hu, Fen Hu, Bing-Hui Li, Yi-Rong Li, Ke Liang, Li-Kai Lin, Li-Sha Luo, Jing Ma, Lin-Lu Ma, Zhi-Yong Peng, Yun-Bao Pan, Zhen-Yu Pan, Xue-Qun Ren, Hui-Min Sun, Ying Wang, Yun-Yun Wang, Hong Weng, Chao-Jie Wei, Dong-Fang Wu, Jian Xia, Yong Xiong, Hai-Bo Xu, Xiao-Mei Yao, Yu-Feng Yuan, Tai-Sheng Ye, Xiao-Chun Zhang, Ying-Wen Zhang, Yin-Gao Zhang, Hua-Min Zhang, Yan Zhao, Ming-Juan Zhao, Hao Zi, Xian-Tao Zeng, Yong-Yan Wang, Xing-Huan Wang
In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province; and then named "2019 novel coronavirus (2019-nCoV)" by the World Health Organization (WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world's attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed...
February 6, 2020: Military Medical Research
https://read.qxmd.com/read/32139142/gastrointestinal-tract-reconstruction-in-adults-with-ultra-short-bowel-syndrome-surgical-and-nutritional-outcomes
#9
R J Cruz, J McGurgan, L Butera, K Poloyac, M Roberts, W Stein, M Minervini, D R Jorgensen, A Humar
BACKGROUND: Historically, adults with ultra short bowel syndrome (USBS) have been considered candidates for lifetime parenteral nutrition (PN) or are referred for visceral transplantation. We examined the surgical and nutritional outcomes of adult patients with USBS managed at a single intestinal rehabilitation center. METHODS: We retrospectively reviewed data on 588 adult patients referred to our center between January 2013 and December 2018. USBS was defined as residual small bowel (SB) length ≤ 50 cm...
March 2, 2020: Surgery
https://read.qxmd.com/read/32113818/colorectal-family-polyadenomatous-diseases-what-management-in-2019
#10
B Menahem, A Alves, J M Regimbeau, C Sabbagh
Nearly 5% of colorectal cancers are hereditary colorectal cancers, including adenomatous polyposis. The aim of this review was to highlight the current management of adenomatous polyposis. The two main genetic conditions responsible for adenomatous polyposis are familial adenomatous polyposis (FAP) (caused by an autosomal dominant mutation of the APC gene) and MUTYH-associated polyposis (MAP) (caused by bi-allelic recessive mutations of the MUTYH (MutY human homolog) gene). FAP is characterized by the presence of >1000 polyps and a young age at diagnosis (mean age of 10)...
February 26, 2020: Journal of Visceral Surgery
https://read.qxmd.com/read/32111644/beyond-clabsi-and-cauti-broadening-our-vision-of-patient-safety
#11
EDITORIAL
Kaveh G Shojania
No abstract text is available yet for this article.
February 28, 2020: BMJ Quality & Safety
https://read.qxmd.com/read/32079593/your-results-may-vary-the-imprecision-of-medical-measurements
#12
REVIEW
James P McCormack, Daniel T Holmes
No abstract text is available yet for this article.
February 20, 2020: BMJ: British Medical Journal
https://read.qxmd.com/read/32039404/beta-blockers-in-cirrhosis-evidence-based-indications-and-limitations
#13
REVIEW
Susana G Rodrigues, Yuly P Mendoza, Jaime Bosch
Non-selective beta-blockers (NSBBs) are the mainstay of treatment for portal hypertension in the setting of liver cirrhosis. Randomised controlled trials demonstrated their efficacy in preventing initial variceal bleeding and subsequent rebleeding. Recent evidence indicates that NSBBs could prevent liver decompensation in patients with compensated cirrhosis. Despite solid data favouring NSBB use in cirrhosis, some studies have highlighted relevant safety issues in patients with end-stage liver disease, particularly with refractory ascites and infection...
February 2020: JHEP reports: innovation in hepatology
https://read.qxmd.com/read/32065827/effect-of-a-machine-learning-derived-early-warning-system-for-intraoperative-hypotension-vs-standard-care-on-depth-and-duration-of-intraoperative-hypotension-during-elective-noncardiac-surgery-the-hype-randomized-clinical-trial
#14
Marije Wijnberge, Bart F Geerts, Liselotte Hol, Nikki Lemmers, Marijn P Mulder, Patrick Berge, Jimmy Schenk, Lotte E Terwindt, Markus W Hollmann, Alexander P Vlaar, Denise P Veelo
Importance: Intraoperative hypotension is associated with increased morbidity and mortality. A machine learning-derived early warning system to predict hypotension shortly before it occurs has been developed and validated. Objective: To test whether the clinical application of the early warning system in combination with a hemodynamic diagnostic guidance and treatment protocol reduces intraoperative hypotension. Design, Setting, and Participants: Preliminary unblinded randomized clinical trial performed in a tertiary center in Amsterdam, the Netherlands, among adult patients scheduled for elective noncardiac surgery under general anesthesia and an indication for continuous invasive blood pressure monitoring, who were enrolled between May 2018 and March 2019...
February 17, 2020: JAMA: the Journal of the American Medical Association
https://read.qxmd.com/read/32074396/the-views-and-experiences-of-patients-and-health-care-professionals-on-the-disclosure-of-adverse-events-a-systematic-review-and-qualitative-meta-ethnographic-synthesis
#15
Raabia Sattar, Judith Johnson, Rebecca Lawton
OBJECTIVE: To synthesize the literature on the views and experiences of patients/family members and health-care professionals (HCPs) on the disclosure of adverse events. METHODS: Systematic review of qualitative studies. Searches were conducted in MEDLINE, Embase, PubMed, CINAHL and PsycINFO. Study quality was evaluated using the Critical Appraisal Skills Programme tool. Qualitative data were analysed using a meta-ethnographic approach, comprising reciprocal syntheses of 'patient' and 'health-care professional' studies, combined to form a lines-of-argument synthesis embodying both perspectives...
February 19, 2020: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://read.qxmd.com/read/32061026/the-use-of-oral-antibiotics-and-mechanical-bowel-preparation-in-elective-colorectal-resection-for-the-reduction-of-surgical-site-infection
#16
S E Duff, C L F Battersby, R J Davies, L Hancock, J Pipe, S Buczacki, J Kinross, A G Acheson, C J Walsh
No abstract text is available yet for this article.
February 14, 2020: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://read.qxmd.com/read/32029088/postsurgical-neuropathy-a-descriptive-review
#17
REVIEW
Ruple S Laughlin, Rebecca L Johnson, Christopher M Burkle, Nathan P Staff
Postsurgical neuropathies represent an infrequent but potentially devastating complication of surgery that may result in significant morbidity with medicolegal implications. Elucidation of this phenomenon has evolved over the past few decades, with emerging evidence for not only iatrogenic factors contributing to this process but also inflammatory causes. This distinction can be important; for instance, cases in which inflammatory etiologies are suspected may benefit from further investigations including nerve biopsy and may benefit from treatment in the form of immunotherapy...
February 2020: Mayo Clinic Proceedings
https://read.qxmd.com/read/32014592/legal-ethical-dilemmas-in-incidental-findings-during-surgery-review-article
#18
REVIEW
Sudip K Sarker
BACKGROUND: Discovering IF (incidental findings) during surgery results in ethical and legal dilemmas for the surgeon, especially those in training or recently qualified. The situation is further compounded as these can occur in an emergency. The immediacy of making the correct decision can be paramount for both the surgeon and the patient. METHODS: Firstly, this article will review the ethical and legal frameworks of IF during surgery for those unfamiliar on the literature...
January 31, 2020: International Journal of Surgery
https://read.qxmd.com/read/32012414/anastomotic-leak-after-surgery-for-colon-cancer-and-effect-on-long-term-survival
#19
Kjartan Stormark, Peter-Martin Krarup, Annika Sjövall, Kjetil Søreide, Jan Terje Kvaløy, Anders Nordholm-Carstensen, Bjørn Steinar Nedrebø, Hartwig Kørner
BACKGROUND: An anastomotic leak after surgery for colon cancer is a recognized complication but how it may adversely affect long-term survival is less clear because data is scarce. The aim of the study was to investigate the long-term impact of Grade C anastomotic leak in a large, population-based cohort. METHODS: Data on patients undergoing resection for stage I-III colon cancer between 2008 and 2012 were collected from the Swedish, Norwegian and Danish Colorectal Cancer Registries...
February 3, 2020: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://read.qxmd.com/read/31911452/thyroid-nodules-diagnostic-evaluation-based-on-thyroid-cancer-risk-assessment
#20
REVIEW
Naykky Singh Ospina, Nicole M Iñiguez-Ariza, M Regina Castro
Thyroid nodules are extremely common and can be detected by sensitive imaging in more than 60% of the general population. They are often identified in patients without symptoms who are undergoing evaluation for other medical complaints. Indiscriminate evaluation of thyroid nodules with thyroid biopsy could cause a harmful epidemic of diagnoses of thyroid cancer, but inadequate selection of thyroid nodules for biopsy can lead to missed diagnoses of clinically relevant thyroid cancer. Recent clinical guidelines advocate a more conservative approach in the evaluation of thyroid nodules based on risk assessment for thyroid cancer, as determined by clinical and ultrasound features to guide the need for biopsy...
January 7, 2020: BMJ: British Medical Journal
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