Michael I D'Angelica, Ryan J Ellis, Jason B Liu, Brian C Brajcich, Mithat Gönen, Vanessa M Thompson, Mark E Cohen, Susan K Seo, Emily C Zabor, Michele L Babicky, David J Bentrem, Stephen W Behrman, Kimberly A Bertens, Scott A Celinski, Carlos H F Chan, Mary Dillhoff, Matthew E B Dixon, Carlos Fernandez-Del Castillo, Sepideh Gholami, Michael G House, Paul J Karanicolas, Harish Lavu, Shishir K Maithel, John C McAuliffe, Mark J Ott, Bradley N Reames, Dominic E Sanford, Umut Sarpel, Courtney L Scaife, Pablo E Serrano, Travis Smith, Rebecca A Snyder, Mark S Talamonti, Sharon M Weber, Adam C Yopp, Henry A Pitt, Clifford Y Ko
IMPORTANCE: Despite improvements in perioperative mortality, the incidence of postoperative surgical site infection (SSI) remains high after pancreatoduodenectomy. The effect of broad-spectrum antimicrobial surgical prophylaxis in reducing SSI is poorly understood. OBJECTIVE: To define the effect of broad-spectrum perioperative antimicrobial prophylaxis on postoperative SSI incidence compared with standard care antibiotics. DESIGN, SETTING, AND PARTICIPANTS: Pragmatic, open-label, multicenter, randomized phase 3 clinical trial at 26 hospitals across the US and Canada...
April 20, 2023: JAMA
Marianne Krogsgaard, Trine Bolette Borglit, Jens Ravn Eriksen
No abstract text is available yet for this article.
April 10, 2023: British Journal of Surgery
Jacob Ghotbi, Sheraz Yaqub, Kjetil Søreide
No abstract text is available yet for this article.
April 20, 2023: British Journal of Surgery
Niclas Dohrn, Mads Falk Klein
No abstract text is available yet for this article.
April 20, 2023: British Journal of Surgery
Dana Arad, Ariel Rosenfeld, Racheli Magnezi
BACKGROUND: A surgical "Never Event" is a preventable error occurring immediately before, during or immediately following surgery. Various factors contribute to the occurrence of major Never Events, but little is known about their quantified risk in relation to a surgery's characteristics. Our study uses machine learning to reveal and quantify risk factors with the goal of improving patient safety and quality of care. METHODS: We used data from 9,234 observations on safety standards and 101 root-cause analyses from actual, major "Never Events" including wrong site surgery and retained foreign item, and three random forest supervised machine learning models to identify risk factors...
March 31, 2023: Patient Safety in Surgery
Cynthia Mardinger, Alexander Drover, Eric Hyndman, Mary Brindle, Frankie Fraulin, Lea Austen, John Kortbeek, Dean Yergens
Scoping reviews of innovations in health care characterized by large numbers and types of publications present a unique challenge. A novel software application, Synthesis, can efficiently scan the literature to map the evidence and inform practice. We applied Synthesis to the National Surgical Quality Improvement Program (NSQIP), a high-quality database designed to measure risk-adjusted 30-day surgical outcomes for national and international benchmarking. The scoping review describes the breadth of studies in the NSQIP literature...
2023: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Wim Ceelen, Kjetil Soreide
Surgery is central to the cure of most solid cancers and an integral part of modern multimodal cancer management for early and advanced stage cancers. Decisions made by surgeons and multidisciplinary team members are based on best available knowledge for the defined clinical situation at hand. While surgery is both an art and a science, good decision-making requires data that are robust, valid, representative and, applicable to most if not all patients with a specific cancer. Such data largely comes from clinical observations and registries, and more preferably from trials conducted with the specific purpose of arriving at new answers...
August 2023: European Journal of Surgical Oncology
Sofieke J D Temmink, Koen C M J Peeters, Renu R Bahadoer, Elma Meershoek-Klein Kranenbarg, Annet G H Roodvoets, Jarno Melenhorst, Jacobus W A Burger, Albert Wolthuis, Andrew G Renehan, Nuno L Figueiredo, Oriol Pares, Anna Martling, Rodrigo O Perez, Geerard L Beets, Cornelis J H van de Velde, Per J Nilsson
BACKGROUND: In rectal cancer, watch and wait for patients with a cCR after neoadjuvant treatment has an established evidence base. However, there is a lack of consensus on the definition and management of a near-cCR. This study aimed to compare outcomes in patients who achieved a cCR at first reassessment versus later reassessment. METHODS: This registry study included patients from the International Watch & Wait Database. Patients were categorized as having a cCR at first reassessment or at later reassessment (that is near-cCR at first reassessment) based on MRI and endoscopy...
March 27, 2023: British Journal of Surgery
Simran Asawa, Manuel Nüesch, Ana Gvozdenovic, Nicola Aceto
Gastrointestinal (GI) cancers account for 35% of cancer-related deaths, predominantly due to their ability to spread and generate drug-tolerant metastases. Arising from different locations in the GI system, the majority of metastatic GI malignancies colonise the liver and the lungs. In this context, circulating tumour cells (CTCs) are playing a critical role in the formation of new metastases, and their presence in the blood of patients has been correlated with a poor outcome. In addition to their prognostic utility, prospective targeting of CTCs may represent a novel, yet ambitious strategy in the fight against metastasis...
March 17, 2023: British Journal of Cancer
Maria A Willis, Ingrid Toews, Sophia Lv Soltau, Jörg C Kalff, Joerg J Meerpohl, Tim O Vilz
BACKGROUND: The success of elective colorectal surgery is mainly influenced by the surgical procedure and postoperative complications. The most serious complications include anastomotic leakages and surgical site infections (SSI)s, which can lead to prolonged recovery with impaired long-term health.  Compared with other abdominal procedures, colorectal resections have an increased risk of adverse events due to the physiological bacterial colonisation of the large bowel. Preoperative bowel preparation is used to remove faeces from the bowel lumen and reduce bacterial colonisation...
February 7, 2023: Cochrane Database of Systematic Reviews
Hugo C Temperley, Niall J O'Sullivan, Richard Grainger, Jarlath C Bolger
INTRODUCTION: Although laparoscopic cholecystectomy (LC) has been standard of care for symptomatic gallstone disease for almost 30 years, the use of routine intraoperative cholangiogram (IOC) remains controversial. There are marked variations in the use IOC during LC internationally. Debate has continued about its benefit, in part because of inconsistent benefit, time, and resources required to complete IOC. This literature review is presented as a debate to outline the arguments in favour of and against routine IOC in laparoscopic cholecystectomy...
January 27, 2023: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Constantinos Simillis, Amulya Khatri, Nick Dai, Thalia Afxentiou, Catherine Jephcott, Sarah Smith, Rashmi Jadon, Demetris Papamichael, Jim Khan, Michael P Powar, Nicola S Fearnhead, James Wheeler, Justin Davies
AIM: Multiple neoadjuvant therapy strategies have been used and compared for rectal cancer and there has been no true consensus as to the optimal neoadjuvant therapy regimen. The aim is to identify and compare the neoadjuvant therapies available for stage II and III rectal cancer. DESIGN: A systematic literature review was performed, from inception to August 2022, of the following databases: MEDLINE, EMBASE, Science Citation Index Expanded, Cochrane Library. Only randomized controlled trials comparing neoadjuvant therapies for stage II and III rectal cancer were considered...
March 2023: Critical Reviews in Oncology/hematology
Kushal T Kadakia, Adam L Beckman, Harlan M Krumholz
No abstract text is available yet for this article.
March 2023: Nature Medicine
Natalie Schudrowitz, C Patrick Shahan, Tovah Moss, John E Scarborough
BACKGROUND: Although strong evidence exists for combined mechanical and oral antibiotic bowel preparation before elective colorectal resection, the utility of preoperative bowel preparation for patients undergoing sigmoid resection after endoscopic decompression of sigmoid volvulus has not been previously examined. The goal of this study was to evaluate the association between bowel preparation and postoperative outcomes for patients undergoing semielective, same-admission sigmoid resection for acute volvulus...
April 1, 2023: Journal of the American College of Surgeons
James L Buxbaum, Martin Freeman, Stuart K Amateau, Jean M Chalhoub, Nayantara Coelho-Prabhu, Madhav Desai, Sherif E Elhanafi, Nauzer Forbes, Larissa L Fujii-Lau, Divyanshoo R Kohli, Richard S Kwon, Jorge D Machicado, Neil B Marya, Swati Pawa, Wenly H Ruan, Sunil G Sheth, Nikhil R Thiruvengadam, Nirav C Thosani, Bashar J Qumseya
No abstract text is available yet for this article.
December 12, 2022: Gastrointestinal Endoscopy
Claudia Zaharia, Kjetil Søreide
No abstract text is available yet for this article.
February 15, 2023: British Journal of Surgery
Tommaso Pollini, Paul Wong, Ajay V Maker
Modern series report a prevalence of pancreatic cysts in the general population of up to 50% in prospective studies. Of these, about half will be pancreatic cystic neoplasms (PCNs) that have varying degrees of malignant potential. Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are the most common PCNs and are known predecessors of pancreatic adenocarcinoma. Critically, they are one of the only radiographically identifiable precursors of pancreatic cancer and thus provide an opportunity for early cancer detection and surgical resection with curative intent...
March 2023: Annals of Surgical Oncology
Daichi Kitaguchi, Masaaki Ito
Complications after colorectal surgery remain inevitable, and anastomotic leakage is one of the most severe and potentially fatal complications. Generally, anastomotic leakage is associated with severe peritonitis, the need for emergency reoperation, and an increased mortality rate. Additionally, particularly after rectal cancer surgery, it has a negative impact on long-term outcomes, including postoperative anorectal function, local recurrence, and survival. To prevent anastomotic leakage, understanding the characteristics of each anastomotic technique and establishing a stable anastomotic procedure are important...
January 3, 2023: Annals of Coloproctology
Natasha L Larivée, Jacob B Michaud, Keigan M More, Jo-Anne Wilson, Karthik K Tennankore
It is well established that an elevated potassium level (hyperkalemia) is associated with a risk of adverse events including morbidity, mortality and healthcare system cost. Hyperkalemia is commonly encountered in many chronic conditions including kidney disease, diabetes and heart failure. Furthermore, hyperkalemia may result from the use of renin-angiotensin-aldosterone system inhibitors (RAASi), which are disease-modifying treatments for these conditions. Therefore, balancing the benefits of optimizing treatment with RAASi while mitigating hyperkalemia is crucial to ensure patients are optimally treated...
December 12, 2022: Cardiology and Therapy
Jennifer L Irani, Traci L Hedrick, Timothy E Miller, Lawrence Lee, Emily Steinhagen, Benjamin D Shogan, Joel E Goldberg, Daniel L Feingold, Amy L Lightner, Ian M Paquette
The American Society of Colon and Rectal Surgeons (ASCRS) and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) are dedicated to ensuring high-quality innovative patient care for surgical patients by advancing the science, prevention, and management of disorders and diseases of the colon, rectum, and anus as well as minimally invasive surgery. The ASCRS and SAGES society members involved in the creation of these guidelines were chosen because they have demonstrated expertise in the specialty of colon and rectal surgery and enhanced recovery...
January 2023: Surgical Endoscopy
2022-12-16 15:48:30
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