Upfront Small Bowel Resection for Small Bowel Neuroendocrine Tumors With Synchronous Metastases: A Propensity-score Matched Comparative Population-based Analysis
We examined the impact of upfront small bowel resection (USBR) for metastatic small bowel neuroendocrine (SB-NET) compared to nonoperative management (NOM) on long-term healthcare utilization and survival outcomes.
Summary of Background Data:
The role of early resection of the primary tumor in metastatic SB-NET remains controversial. Conflicting data exist regarding its clinical and survival benefits.
Methods:
This is a population-based retrospective matched comparative cohort study of adults diagnosed with synchronous metastatic SB-NET between 2001 and 2017 in Ontario. USBR was defined as resection within 6 ...
Source: Annals of Surgery - October 15, 2022 Category: Surgery Tags: Original Articles Source Type: research
Living Donor Intestinal Transplantation: Recipient Outcomes
Objective:
To examine outcomes of living-donor intestinal transplant (LDITx) recipients.
Background:
LDITx is not routinely performed because of surgical risks to the donor and the potential inferior physiologic performance of the segmental graft. However, data on the effectiveness of LDITx are scarce.
Design:
This retrospective cohort study included patients undergoing LDITx between May 1999 and December 2021 in intestinal transplant programs in 2 university-affiliated hospitals in China.
Results:
Actuarial survival rates were 80%, 72.7%, 66.7% for patient and 72.4%, 63.6%, 60% for graft at 1, 3, ...
Source: Annals of Surgery - October 15, 2022 Category: Surgery Tags: Original Articles Source Type: research
Surgical Outcomes, Technical Performance, and Surgery Burden of Robotic Total Gastrectomy for Locally Advanced Gastric Cancer: A Prospective Study
Objective:
To compare the short-term outcomes, surgery burden, and technical performance of robotic total gastrectomy (RTG) and laparoscopic total gastrectomy (LTG) for gastric cancer (GC).
Summary of Background Data:
The impact of robotic systems on total gastrectomy remains obscure.
Methods:
This prospective study included 50 patients with advanced proximal GC underwent RTG combined with spleen-preserving splenic hilar lymphadenectomy between March 2018 and February 2020. Patients who underwent LTG in the FUGES-002, http://links.lww.com/SLA/C929 study were enrolled to compare the outcomes between RTG an...
Source: Annals of Surgery - October 15, 2022 Category: Surgery Tags: Original Articles Source Type: research
Long-term Satisfaction with Roux-en-Y Gastric Bypass Surgery: Results From a Multicenter Prospective Cohort Study
Objective:
The aim of this study was to examine change in overall satisfaction with Roux-en-Y gastric bypass (RYGB) surgery over 3 to 7 years post-surgery and identify pre-surgery predictors and post-surgery factors associated with not being satisfied.
Background:
It is unclear how satisfaction with RYGB surgery changes over time following surgery and factors associated with not being satisfied are not well understood.
Methods:
Participants of a multicenter prospective cohort study of bariatric surgery were followed annually (Source: Annals of Surgery)
Source: Annals of Surgery - October 15, 2022 Category: Surgery Tags: Original Articles Source Type: research
Bariatric Surgery Lowers the Risk of Major Cardiovascular Events
Conclusions:
Bariatric surgery is associated with decreased risk of significant cardiovascular events compared to nonsurgical controls. In this exploratory analysis, gastric bypass was associated with a lower risk of all cardiovascular events than sleeve gastrectomy. (Source: Annals of Surgery)
Source: Annals of Surgery - October 15, 2022 Category: Surgery Tags: Original Articles Source Type: research
Pathophysiological Mechanisms of Gastro-esophageal Reflux After Sleeve Gastrectomy
Objective:
To evaluate the mechanisms associated with reflux events after sleeve gastrectomy (SG).
Summary Background Data:
Gastro-esophageal reflux (GERD) post-SG is a critical issue due to symptom severity, impact on quality of life, requirement for reoperation, and potential for Barrett esophagus. The pathophysiology is incompletely delineated.
Methods:
Post-SG patients, stratified into asymptomatic and symptomatic, underwent protocolized nuclear scintigraphy (n = 83), 24-hour esophageal pH monitoring, and stationary manometry (n = 143) to characterize reflux patterns. Ten patients underwent fasting an...
Source: Annals of Surgery - October 15, 2022 Category: Surgery Tags: Original Articles Source Type: research
The Complexity of Defining Postoperative Pneumonia After Esophageal Cancer Surgery: A Spectrum of Lung Injury Rather Than a Simple Infective Complication?
Objective:
To analyze the spectrum of Centers for Disease Control and Prevention (CDC)-defined pneumonia after esophageal cancer surgery.
Summary Background Data:
Pneumonia is commonly documented after esophageal cancer surgery, and reducing its incidence is central to both ERAS development and to the evidence-base for minimally invasive approaches. The existing definitions of pneumonia based on hospital acquired pneumonia classifications may be suboptimal in this context and merits strict academic scrutiny.
Methods:
Patients (2013-2018) treated with curative intent by open surgery were studied. Pneumonia...
Source: Annals of Surgery - October 15, 2022 Category: Surgery Tags: Original Articles Source Type: research
Association Between Preoperative HbA1c Levels and Complications after Esophagectomy: Analysis of 15,801 Esophagectomies From the National Clinical Database in Japan
Objective:
To elucidate the association between preoperative hemoglobin A1c (HbAlc) levels and short-term outcomes after oncologic esophagectomy.
Summary Background Data:
Although diabetes mellitus is associated with an increased risk of postoperative morbidity in several types of surgery, the association of diabetes mellitus with short-term outcomes after esophagectomy has shown conflicting results.
Methods:
We analyzed 15,801 patients who underwent oncologic esophagectomy between 2015 and 2017 from the National Clinical Database. We evaluated the associations between preoperative HbA1c levels and short-...
Source: Annals of Surgery - October 15, 2022 Category: Surgery Tags: Original Articles Source Type: research
Worldwide Techniques and Outcomes in Robot-assisted Minimally Invasive Esophagectomy (RAMIE): Results From the Multicenter International Registry
Conclusion:
This study is the first to provide an overview of the current techniques and outcomes of transthoracic RAMIE worldwide. Although these results indicate high quality of the procedure, the optimal approach should be further defined. (Source: Annals of Surgery)
Source: Annals of Surgery - October 15, 2022 Category: Surgery Tags: Original Articles Source Type: research
Alzheimer’s Dementia After Exposure to Anesthesia and Surgery in the Elderly: A Matched Natural Experiment Using Appendicitis
This study examines elderly patients with appendicitis, a common condition that strikes mostly at random after controlling for some known associations.
Methods:
A matched natural experiment of patients undergoing appendectomy for appendicitis versus control patients without appendicitis using Medicare data from 2002 to 2017, examining 54,996 patients without previous diagnoses of ADRD, cognitive impairment, or neurological degeneration, who developed appendicitis between ages 68 through 77 years and underwent an appendectomy (the ‘‘Appendectomy’’ treated group), matching them 5:1 to 274,980 controls, examini...
Source: Annals of Surgery - October 15, 2022 Category: Surgery Tags: Original Articles Source Type: research
Factors Influencing US Physician and Surgeon Suicide Rates 2003 to 2017: Analysis of the CDC-National Violent Death Reporting System
Conclusions:
The prevalence of physician suicide increased over the 2003 to 2017 time-frame with over a third of deaths occurring from 2015 to 2017. Among surgeons, orthopedics has the highest prevalence of reported suicide.
Risk factors for surgeon suicide include Asian/Pacific Islander race/ethnicity, older age, history of mental disorder, alcohol use, and civil/legal issues. (Source: Annals of Surgery)
Source: Annals of Surgery - October 15, 2022 Category: Surgery Tags: Original Articles Source Type: research
Defining Microbiome Readiness for Surgery: Dietary Prehabilitation and Stool Biomarkers as Predictive Tools to Improve Outcome
Objectives:
Determine whether preoperative dietary prehabilitation with a low-fat, high-fiber diet reverses the impact of Western diet (WD) on the intestinal microbiota and improves postoperative survival
Background:
We have previously demonstrated that WD fed mice subjected to an otherwise recoverable surgical injury (30% hepatectomy), antibiotics, and a short period of starvation demonstrate reduced survival (29%) compared to mice fed a low-fat, high-fiber standard chow (SD) (100%).
Methods:
Mice were subjected to 6 weeks of a WD and underwent dietary pre-habilitation (3 days vs 7 days) with a SD prior ...
Source: Annals of Surgery - October 15, 2022 Category: Surgery Tags: Original Articles Source Type: research
Better Operating Room Ventilation as Determined by a Novel Ventilation Index is Associated With Lower Rates of Surgical Site Infections
Conclusions:
Better ventilation properties, assessed with our ventilation index, are associated with lower rates of superficial and deep incisional SSIs in orthopedic and cardiac procedures. OR ventilation quality appeared to be less relevant for other surgery types. (Source: Annals of Surgery)
Source: Annals of Surgery - October 15, 2022 Category: Surgery Tags: Original Articles Source Type: research
Errors in Surgery: A Case Control Study
This study characterized errors in the care of surgical patients and examined the association of errors with morbidity and mortality.
Background:
Errors have been reported to cause 60% of adverse events. Such discordant results underscore the need for further exploration of the relationship between error and adverse events.
Methods:
Patients with operations performed at a single institution and abstracted into the American College of Surgeons National Surgical Quality Improvement Program from January 1, 2018, to December 31, 2018 were examined. This matched case control study comprised cases who experienced a...
Source: Annals of Surgery - October 15, 2022 Category: Surgery Tags: Original Articles Source Type: research
The Safety and Efficacy of Tracheostomy in Patients Diagnosed With COVID-19: An Analysis of 143 Patients at a Major NYC Medical Center
Conclusion and Relevance:
The rapid formation of a multi-disciplinary team allows for the efficient evaluation and performance of a large volume of tracheostomies in a resource-limited setting. Bedside tracheostomy in COVID-19 does not cause additional harm to patients if performed after 2 weeks from intubation. It also seems to be safe for proceduralists to perform in this timeframe. The manner of tracheostomy does not change outcomes significantly if it is performed safely and efficiently. (Source: Annals of Surgery)
Source: Annals of Surgery - October 15, 2022 Category: Surgery Tags: COVID-19 Source Type: research
