What if you can't get prior RT records??
Saw a patient with a new diagnosis of high risk prostate cancer who had colectomy and adjuvant chemoradiation 30 years ago for an adenocarcinoma of the rectosigmoid flexure. According to the institution that treated him, all of his records were destroyed. He wants RT for his prostate cancer. How would you proceed? (Source: Student Doctor Network)
Source: Student Doctor Network - August 27, 2022 Category: Universities & Medical Training Authors: thesauce Tags: Radiation Oncology Source Type: forums

DVT Prophylaxis …?
Jeopardy! Champion's Parents Sue Doctors, Hospital When Patient Dies After Colectomy How did a routine colectomy end in a young man's death? www.medscape.com Thought this was interesting. Tragic case but … idk that I’ve seen a lot of 20 year olds postop (besides ortho cases ) show up on DVT ppx? (Source: Student Doctor Network)
Source: Student Doctor Network - February 5, 2022 Category: Universities & Medical Training Authors: CoolDoc1729 Tags: Emergency Medicine Source Type: forums

Bit of a rant...anyone have a similar experience?
I work (academic subspecialist) with a malignant narcissist who has effectively trained our oncologists that any pathologist who doesn't order at least IHC on a given case is incompetent (slight exaggeration, but not too far off the mark). Generally this hasn't effected me too much...usually can fend off stupid requests for IHC from clinicians ("can you please run ER/PR on this papillary thyroid carcinoma?"). Yesterday, I get a case of met colon CA to a lymph node. Patient had a colectomy... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - December 12, 2021 Category: Universities & Medical Training Authors: pianoguy05 Tags: Pathology Source Type: forums

PO Tylenol superior to Ofirmev
Impact of Intravenous Acetaminophen on Perioperative Opioid Utilization and Outcomes in Open Colectomies: A Claims Database Analysis. - PubMed - NCBI (Source: Student Doctor Network)
Source: Student Doctor Network - May 9, 2018 Category: Universities & Medical Training Authors: linkin06 Source Type: forums

undecided
I have a sense of what I want my career to look like, but in 2017 it's not clear how to get there after completing residency (nearly there...). I'm looking to "do" general surgery (gasp!) -- private vs. local hospital/network -- with a broad swathe of bread and butter as well as more complex cases: Hernias incisional and inguinal, gallbladders, appendectomies, venous access, and a spectrum of thyroid, melanoma, and breast surgery. I'd like to do elective colectomies and rectal resections... undecided (Source: Student Doctor Network)
Source: Student Doctor Network - October 30, 2017 Category: Universities & Medical Training Authors: Deckard_9139 Source Type: forums

What's the point of intraoperative narcotics?
Lets take 1 case and provide the anesthetic 2 different ways. Case: 45 year old elective lap colectomy, healthy with no cardiac history. Anesthetic option #1: Induction: prop only + paralytic. Maintenance: Volatiles at a MAC titrated up to 1.5 with neo drip or PRN squirts. Emergence: Drive off gas, give 100 mcg fentanyl at closure, reverse, extubate. Anesthetic option#2 Induction: 150 mcg fentanyl, prop, paralytic. Maintenance: Volatile at MAC 1, 50 mcg fentanyl every 30 minutes for... What's the point of intraoperative narcotics? (Source: Student Doctor Network)
Source: Student Doctor Network - August 9, 2016 Category: Universities & Medical Training Authors: RxBoy Source Type: forums

What IV fluid do you give post operatively after an elective hemi-colectomy?
I'm curious what peeps at other institutions in the country routinely prescribe after standard general surgery procedures for patients who are admitted. Lots of literature sorta tip-toeing around the issue, lots of debate in critical care about colloids, crystaloids, etc..... but when it comes down to WHAT ARE YOU ACTUALLY DOING for your patient who has an ELECTIVE (i.e. not septic, etc) hemicolectomy (say for cancer or whatever), what do you do? Lets assume the case was run-of-the-mill,... What IV fluid do you give post operatively after an elective hemi-colectomy? (Source: Student Doctor Network)
Source: Student Doctor Network - July 9, 2016 Category: Universities & Medical Training Authors: europeman Source Type: forums

walking epidurals
Anyone doing these in L&D or for regular OR's. One of our general surgeons asked about this for an open colectomy patient. Our policy is no ambulation with epidurals but we are running 0.1% bupivacaine +/- fentanyl 2mcg/ml (yeah an odd dose but it comes from a compounding pharmacy and that's the concentration they had available). She's like "My patients need to ambulate". She has a point. Anyone doing this at their place? I told her it's o.k. at that low dose and if motor involvement... walking epidurals (Source: Student Doctor Network)
Source: Student Doctor Network - June 25, 2016 Category: Universities & Medical Training Authors: GA8314 Source Type: forums

Today's Anesthesia Consult
70 yo obese (120kg) male with schizophrenia, 4pk/day smoking history times 40yrs, ex-miner without respiratory precautions, and HTN. HE is scheduled for a colectomy secondary to recurrent polyp which has changed color but is not yet cancer per GI. Airway is a Gr III with large full beard as well. Sitting in the pre-op clinic he is SOB and has to take a couple big breaths before answering questions. He has been sitting for an hour. Work up includes PFT's which show severe COPD and... Today's Anesthesia Consult (Source: Student Doctor Network)
Source: Student Doctor Network - May 18, 2016 Category: Universities & Medical Training Authors: Noyac Source Type: forums