Cumulative 5-year Results of a Randomized Controlled Trial Comparing Biological Mesh With Primary Perineal Wound Closure After Extralevator Abdominoperineal Resection (BIOPEX-study)
Conclusions: Symptomatic perineal hernia rate at 5-year follow-up after abdominoperineal resection for rectal cancer was significantly lower after biological mesh closure. Biological mesh closure did not improve quality of life or functional outcomes. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Intravenous Local Anesthetic Compared With Intraperitoneal Local Anesthetic in Laparoscopic Colectomy: A Double-blind Randomized Controlled Trial
Introduction: Controlling perioperative pain is essential to improving patient experience and satisfaction following surgery. Traditionally opioids have been frequently utilized for postoperative analgesia. Although they are effective at controlling pain, they are associated with adverse effects, including postoperative nausea, vomiting, ileus, and long-term opioid dependency. Following laparoscopic colectomy, the use of intravenous or intraperitoneal infusions of lidocaine (IVL, IPL) are promising emerging analgesic options. Although both techniques are promising, there have been no direct, prospective randomized c...
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

A Randomized Controlled Trial Examining the Impact of an Anorectal Surgery Multimodal Enhanced Recovery Program on Opioid Use
Background: Anorectal cases may be a common gateway to the opioid epidemic. Opioid reduction is inherent in enhanced recovery after surgery (ERAS) protocols, but little work has evaluated ERAS in these cases. Objective: To determine if ERAS could reduce postoperative opioid utilization in ambulatory anorectal surgery without sacrificing patient pain or satisfaction. Methods: A randomized controlled trial assigned ambulatory anorectal patients to ERAS (experimental) or routine care (surgeon's choice) for pain management (control) over 30-days postoperatively. Primary outcome was overall days of opioid use....
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Randomized Controlled Trial Comparing the Short-term Outcomes of Enhanced Recovery After Surgery and Conventional Care in Laparoscopic Distal Gastrectomy (GISSG1901)
This study aimed to compare the effects of ERAS and conventional programs on short-term outcomes after LDG. Summary of Background Data: Currently, the ERAS program is broadly applied in surgical areas. Although several benefits of LDG with the ERAS program have been covered, high-level evidence is still limited, specifically in advanced gastric cancer. Methods: The present study was designed as a randomized, multicenter, unblinded trial. The enrollment criteria included histologically confirmed cT2-4aN0-3M0 gastric adenocarcinoma. Postoperative complications, mortality, readmission, medical costs, recovery, a...
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Enhancing the Biopsychosocial Approach to Perioperative Care: A Pilot Randomized Trial of the Perioperative Pain Self-management (PePS) Intervention
Objective: The current study aimed to pilot the PePS intervention, based on principles of cognitive behavioral therapy (CBT), to determine feasibility and preliminary efficacy for preventing chronic pain and long-term opioid use. Summary Background Data: Surgery can precipitate the development of both chronic pain and long-term opioid use. CBT can reduce distress and improve functioning among patients with chronic pain. Adapting CBT to target acute pain management in the postoperative period may impact longer-term postoperative outcomes. Methods: This was a mixed-methods randomized controlled trial in a m...
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Cross-mentorship: A Unique Lens Into the Realities and Challenges of Diversity in Surgery
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Intersectionality and the Surgical Patient: Expanding the Surgical Disparities Framework
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Safe and Supported Pregnancy: A Call to Action for Surgery Chairs and Program Directors
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

The Effect of Beta-lactam Allergy Status on the Rate of Surgical Site Infections: A Retrospective Cohort Study
Conclusion: Reported BL allergic patients have an increased odds of developing SSI in comparison to NBL allergic patients. The increased risk is likely related to administration of NBL antibiotic regimens in comparison to BL-based regimens. Thorough antibiotic allergy history collection can be a valuable SSI prevention tool to safely increase the proportion of patients receiving BL regimen. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

HLA-A Locus is Associated With Sepsis and Septic Shock After Traumatic Injury
Conclusions: This is the first study to apply next-generation sequencing techniques to evaluate associations between immunogenetic factors and post-traumatic sepsis and septic shock. Associations with class I HLA variants are novel as they implicate adaptive immunity in post-traumatic sepsis. These findings are a step towards developing a panel of genetic markers assessing risk of infection-related complications as we move towards more personalized medicine. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Improving Serious Illness Care for Surgical Patients: Quality Indicators for Surgical Palliative Care
Conclusions: This set of quality indicators provides a comprehensive set of process measures that possess the potential to measure high quality PC for seriously ill surgical patients throughout the surgical episode (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Important Issues to Severe Trauma Survivors: A Qualitative Study
Conclusions: This qualitative study explored trauma survivors’ experiences of the long-term effect of their injury and allowed for identifying a set of issues that they consider important, including dimensions that seem overlooked in trauma research. Our findings confirm that trauma is a chronic medical condition that demands new approaches to post-discharge and long-term care. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Oncological Resection for Liver Malignancies: Can the Laparoscopic Approach Provide Benefits?
Laparoscopic surgery has become an increasingly popular alternative approach to open surgery, resulting in a paradigm shift in liver surgery. Although laparoscopic liver resection (LLR) was initially indicated for small benign and peripheral tumors, at present more than half of LLRs are performed in malignant tumors. Several studies have reported the feasibility of LLR in malignant disease and suggested various short-term benefits compared to open liver resection, including decreased blood loss and postoperative complications and a shorter hospital stay. Although these benefits are important to surgeons, patients, and prov...
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Prognosis Based Definition of Resectability in Pancreatic Cancer: A Road Map to New Guidelines
Conclusion: This new PDAC nomogram, based solely on preoperative variables, could be a useful tool to patients and counseling physicians in selecting therapy. This model suggests a new concept of resectability that is meant to reflect the biology of the tumor, thus partially overcoming existing definitions, that are mainly based on tumor anatomic features. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Minimally Invasive Donor Hepatectomy for Adult Living Donor Liver Transplantation: An International, Multi-institutional Evaluation of Safety, Efficacy and Early Outcomes
Conclusions: This study shows favorable early postoperative outcomes in more than 400 MIV donor hepatectomy from 10 experienced centers. These results are comparable to those of benchmarking series of open standard donor hepatectomy. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

What Constitutes a Clear Margin in Patients With Locally Recurrent Rectal Cancer Undergoing Pelvic Exenteration?
Conclusions: A microscopically clear resection margin is most important in predicting overall survival. Margins up to 0.5 mm offers a local recurrence benefit but does not confer survival benefit. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Is Adjuvant Chemotherapy Necessary for Obstructing Stage II Colon Cancer? Results From a Propensity Score Analysis of the French Surgical Association Database
Conclusion: This study suggests that adjuvant chemotherapy after curative resection of stage II OCC may improve oncological outcomes. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Textbook Outcome and Survival in Patients With Gastric Cancer: An Analysis of the Population Registry of Esophageal and Stomach Tumours in Ontario (PRESTO)
Objective: To examine the association between Textbook Outcome (TO)—a new composite quality measurement—and long-term survival in gastric cancer surgery. Background: Single-quality indicators do not sufficiently reflect the complex and multifaceted nature of perioperative care in patients with gastric adenocarcinoma. Methods: All patients undergoing gastrectomy for nonmetastatic gastric adenocarcinoma registered in the Population Registry of Esophageal and Stomach Tumours of Ontario (PRESTO) between 2004 and 2015 were included. TO was defined according to negative margins;>15 lymph nodes sa...
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Changes in Smoking Behavior Before and After Gastric Bypass: A 7-year Study
Objective: To evaluate smoking history and change in smoking behavior, from 1 year before through 7 years after Roux-en-Y gastric bypass (RYGB) surgery, and to identify risk factors for post-surgery smoking. Background: Smoking behavior in the context of bariatric surgery is poorly described. Methods: Adults undergoing RYGB surgery entered a prospective cohort study between 2006 and 2009 and were followed up to 7 years until ≤2015. Participants (N = 1770; 80% female, median age 45 years, median body mass index 47 kg/m2) self-reported smoking history pre-surgery, and current smoking behavior annually....
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Development of a Reliable Surgical Quality Assurance System for 2-stage Esophagectomy in Randomized Controlled Trials
Conclusions: A reliable surgical quality assurance system for 2-stage esophagectomy has been developed for surgical oncology randomized controlled trials. Ethical approval: 11/NW/0895 and confirmed locally as appropriate, 12/SW/0161, 16/SW/0098. Trial registration number: ISRCTN59036820, ISRCTN10386621. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

How to Establish Benchmarks for Surgical Outcomes?: A Checklist Based on an International Expert Delphi Consensus
Conclusions: This multinational Delphi survey represents the first expert-led process for developing a standardized approach for establishing benchmarks for relevant outcome measures in surgery. The provided consensual checklist customizes the methodology of outcome reporting in surgery and thus improves reproducibility and comparability of data and should ultimately serve to improve quality of care. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

The Long Road to Parenthood: Assisted Reproduction, Surrogacy, and Adoption Among US Surgeons
Objective: We sought to characterize demographics, costs, and workplace support for surgeons using assisted reproductive technology (ART), adoption, and surrogacy to build their families. Summary Background Data: As the surgical workforce diversifies, the needs of surgeons building a family are changing. ART, adoption, and surrogacy may be used with greater frequency among female surgeons who delay childbearing and surgeons in same-sex relationships. Little is known about costs and workplace support for these endeavors. Methods: An electronic survey was distributed to surgeons through surgical societies a...
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

The Impact of Medicare Coverage on Downstream Financial Outcomes for Adults Who Undergo Surgery
Conclusions: Medicare may reduce the economic burden of healthcare spending and delays in care for older adult surgical patients. These findings have important implications for policy discussions regarding changing insurance eligibility thresholds for the older adult population. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Role of Adjuvant Therapy in Esophageal Cancer Patients After Neoadjuvant Therapy and Esophagectomy: A Systematic Review and Meta-analysis
Objective: The aim of this study was to analyze esophageal cancer patients who previously underwent neoadjuvant therapy followed by a curative resection to determine whether additional adjuvant therapy is associated with improved survival outcomes. Summary Background Data: Neoadjuvant therapy followed by surgery is the standard of care for locally advanced esophageal cancer, whereas adjuvant therapy is typically employed for patients with residual disease. However, the role of adjuvant therapy after a curative resection is still uncertain. Methods: MEDLINE, EMBASE, and CENTRAL databases were searched for ...
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: REVIEW PAPERS Source Type: research

A Review of PROM Implementation in Surgical Practice
Conclusions: The identified studies suggest that implementation metrics including minimum standards of collection pre- and postintervention, reporting for response rates in the context of patient eligibility and analysis of respondents and nonrespondents, in addition to transparency regarding the resources utilized and cost, can facilitate adoption of PROMs in clinical care and accountability for surgical outcomes. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: REVIEW PAPERS Source Type: research

Coaching in Surgical Education: A Systematic Review
Conclusions: Coaching is being used inconsistently within the surgical education literature. Our hope is that with establishing criteria for coaching, future studies will implement this intervention more consistently and allow for better comparison and generalization of results. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: REVIEW PAPERS Source Type: research

IDEAL-D Framework for Device Innovation: A Consensus Statement on the Preclinical Stage
Conclusions: The proposed recommendations for preclinical evaluation of medical devices represent a proportionate and pragmatic approach that balances the de-risking of first-in-human translational studies against the benefits of rapid translation of new devices into clinical practice. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: REVIEW PAPERS Source Type: research

Laparoscopic Paraesophageal Hernia Repair: To Mesh or not to Mesh. Systematic Review and Meta-analysis
This study aimed to compare outcomes after laparoscopic paraesophageal hernia repair (LPEHR) with mesh or primary repair alone. Summary of Background Data: High recurrence rates after LPEHR have been reported. Whether the use of mesh improves outcomes remains elusive. Methods: A systematic literature search was performed to identify randomized controlled trials (RCTs) comparing LPEHR with mesh repair versus suture repair alone. Early (≤6 months) and late (>6 months) recurrence rates were used as primary endpoints to assess efficacy. Intraoperative complications, overall morbidity, and reoperation ra...
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: META-ANALYSES Source Type: research

Long-term Metabolic Morbidity and Steatohepatosis Following Standard Pancreatic Resections and Parenchyma-sparing, Local Extirpations for Benign Tumor: A Systematic Review and Meta-analysis
Objective: To assess metabolic dysfunctions and steatohepatosis after standard and local pancreatic resections for benign and premalignant neoplasms. Summary of Background Data: Duodenopancreatectomy, hemipancreatectomy, and parenchyma-sparing, limited pancreatic resections are currently in use for nonmalignant tumors. Methods: Medline, Embase, and Cochrane libraries were searched for studies reporting measured data of metabolic functions following PD, pancreatic left resection (PLR), duodenum-sparing pancreatic head resection (DPPHR), pancreatic middle segment resection (PMSR), and tumor enucleation (TEN...
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: META-ANALYSES Source Type: research

A Phase 3 Randomized Clinical Trial of Chemotherapy With or Without Algenpantucel-L (HyperAcute-Pancreas) Immunotherapy in Subjects With Borderline Resectable or Locally Advanced Unresectable Pancreatic Cancer
Conclusions: Algenpantucel-L immunotherapy did not improve survival in patients with borderline resectable or locally advanced unresectable PDAC receiving SOC neoadjuvant chemotherapy and chemoradiation. Trial Registration: ClinicalTrials.gov Identifier: NCT01836432 (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Randomized Trial of Laparoscopic Nissen Versus Anterior 180 Degree Partial Fundoplication – Late Clinical Outcomes at 15 to 20 years
Conclusions: At 15 to 20 years follow-up Nissen and anterior 180-degree partial fundoplication achieved similar success, but with trade-offs between better reflux control versus more side-effects after Nissen fundoplication. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

“Women as Deficit”: Re-evaluating Interventions to Establish Gender Equity
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: DISPARITIES, DIVERSITY AND SOCIAL JUSTICE Source Type: research

COVID-19 Vaccination Associated With Reduced Postoperative SARS-CoV-2 Infection and Morbidity
Conclusion: COVID-19 vaccination is associated with lower rates of postoperative morbidity. The benefit is most pronounced among individuals who have never had a COVID-19 infection before surgery. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: COVID-19 Source Type: research

Optimizing Venous Thromboembolism Prophylaxis After Injury: An Evidence-based Approach
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: FEATURES Source Type: research

Efficacy and Safety of Low Molecular Weight Heparin Versus Unfractionated Heparin for Prevention of Venous Thromboembolism in Trauma Patients: A Systematic Review and Meta-analysis
Conclusions: Among adult trauma patients, LMWH is superior to UFH for deep vein thrombosis and VTE prevention and may additionally reduce pulmonary embolism and mortality. The impact on adverse events and heparin induced thrombocytopenia is uncertain. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: FEATURES Source Type: research

Quality Improvement in Robotic-assisted Ventral Hernia Repair: The Impact of Personal Data on Practice
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: FEATURES Source Type: research

Robotic Ventral Hernia Repair: Lessons Learned From a 7-year Experience
Conclusions: This study provides an in-depth perspective of the largest series of RVHR. Based on this experience, rTAPP is no longer recommended due to its limited applicability and high recurrence rate. Both rIPOM and rRS offer encouraging short- and long-term outcomes, while rTAR is associated with the highest perioperative morbidity. Longer follow-up is needed to assess rTAR durability, despite a promising recurrence profile. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: FEATURES Source Type: research

Does Bariatric Surgery Prevent Cancer?
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: FEATURES Source Type: research

Association of Bariatric Surgery and Risk of Cancer in Patients With Morbid Obesity
Conclusion: Postoperative rates of any cancer type, lung, ovarian, and uterine cancer were significantly lower in obese patients undergoing either vertical sleeve gastrectomy (VSG) or RYGB compared to bariatric-eligible patients without any surgical intervention. (Source: Annals of Surgery)
Source: Annals of Surgery - December 21, 2021 Category: Surgery Tags: FEATURES Source Type: research

Learning Curve From 450 Cases of Robot-Assisted Pancreaticoduocectomy in a High-Volume Pancreatic Center: Optimization of Operative Procedure and a Retrospective Study
Objective: We aimed to describe our experience and the learning curve of 450 cases of robot-assisted pancreaticoduodenectomy (RPD) and optimize the surgical process so that our findings can be useful for surgeons starting to perform RPD. Summary Background Data: Robotic surgical systems were first introduced 20 years ago. Pancreaticoduodenectomy (PD) is a challenging surgery because of its technical difficulty. RPD may overcome some of these difficulties. Methods: The medical records of 450 patients who underwent RPD between May 2010 and December 2018 at the Shanghai Ruijin Hospital were retrospectively...
Source: Annals of Surgery - November 23, 2021 Category: Surgery Tags: ORIGINAL ARTICLE Source Type: research

En-Bloc Simultaneous Heart–Liver Transplantation in Adult Patients
Conclusion: En-bloc HLTx technique is a safe and effective strategy, decreasing operative times, and allograft ischemic times, whereas offering protection of implanted allografts during early stages of reperfusion while patient is hemodynamically supported on cardiopulmonary bypass. (Source: Annals of Surgery)
Source: Annals of Surgery - November 23, 2021 Category: Surgery Tags: SURGICAL TECHNIQUE Source Type: research

Weight Outcomes of Sleeve Gastrectomy and Gastric Bypass Compared to Nonsurgical Treatment
Conclusions: In this study, patients with severe obesity who underwent SG and RYGB lost significantly more weight at 5 years than nonsurgical patients. Weight regain was common after surgery but regain to within 5% of baseline was rare. (Source: Annals of Surgery)
Source: Annals of Surgery - November 23, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

The Risk of Going Small: Lowering GRWR and Overcoming Small-For-Size Syndrome in Adult Living Donor Liver Transplantation
Objective: The aim of this study was to determine the outcomes of living donor liver transplantation (LDLT) according to various graft-to-recipient weight ratio (GRWR). Background: The standard GRWR in LDLT is>0.8%. Our center accepted predicted GRWR ≥0.6% in selected patients. Methods: Data from patients who underwent LDLT from 2001 to 2017 were included. Patients were stratified according to actual GRWR (Group 1:GRWR ≤0.6%; Group 2: 0.6%0.8%). Results: There were 545 LDLT (group 1 = 39; group 2 = 159; group 3 = 347) performed. Pretransplant predicted GRWR showed good correlation to actua...
Source: Annals of Surgery - November 23, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Impact of the Affordable Care Act Insurance Marketplaces on Out-of-Pocket Spending Among Surgical Patients
Conclusions: The ACA's insurance Marketplaces were associated with improved financial protection among low-income surgical patients eligible for both cost-sharing and premium subsidies, but not in middle-income patients eligible for only premium subsidies. (Source: Annals of Surgery)
Source: Annals of Surgery - November 23, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Patient-reported Outcomes at 6 to 12 Months Among Survivors of Firearm Injury in the United States
Conclusions: This study highlights the need for targeted long-term follow-up care, physical rehabilitation, mental health screening, and interventions for survivors of firearm violence. (Source: Annals of Surgery)
Source: Annals of Surgery - November 23, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Mixed Reality and 3D Printed Models for Planning and Execution of Face Transplantation
Conclusion: Time efficiency, low-cost biomodel production, provision of unlimited preoperative surgical rehearsal, and potential for intraoperative surgical guidance makes holographic VSP and MR highly promising technology for use in complex craniofacial surgery. (Source: Annals of Surgery)
Source: Annals of Surgery - November 23, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Clinical Utility of the Risk Analysis Index as a Prospective Frailty Screening Tool within a Multi-practice, Multi-hospital Integrated Healthcare System
Objective: The goal of this project was to first address barriers to implementation of the Risk Analysis Index (RAI) within a large, multi-hospital, integrated healthcare delivery system, and to subsequently demonstrate its utility for identifying at-risk surgical patients. Background: Prior studies demonstrate the validity of the RAI for evaluating preoperative frailty, but they have not demonstrated the feasibility of its implementation within routine clinical practice. Methods: Implementation of the RAI as a frailty screening instrument began as a quality improvement initiative at the University of Pit...
Source: Annals of Surgery - November 23, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

The Incidence of Low Anterior Resection Syndrome as Assessed in an International Randomized Controlled Trial (MRC/NIHR ROLARR)
Conclusions: LARS is a common after rectal cancer surgery and patients should be appropriately counselled preoperatively, particularly before surgery for low tumors or in comorbid populations. (Source: Annals of Surgery)
Source: Annals of Surgery - November 23, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Robotic Surgery for Rectal Cancer Provides Advantageous Outcomes Over Laparoscopic Approach: Results From a Large Retrospective Cohort
Objective: To compare short term outcomes of patients undergoing laparoscopic or robotic rectal cancer surgery. Background: Significant benefits of robotic rectal cancer surgery over laparoscopy have yet to be demonstrated. Operative time and direct institutional cost seem in favor of the laparoscopic approach. Methods: We performed a retrospective review of consecutive patients operated on for rectal cancer with a mini-invasive approach at Mayo Clinic from 2005 to 2018. The primary aim of this study was to investigate the difference in postoperative morbidity between the laparoscopic and robotic approach...
Source: Annals of Surgery - November 23, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Development and Validation of a Nomogram to Preoperatively Estimate Post-hepatectomy Liver Dysfunction Risk and Long-term Survival in Patients With Hepatocellular Carcinoma
Conclusions: The nomogram showed good performance in predicting both SPLD and OS. It could help surgeons select suitable HCC patients for hepatectomy. (Source: Annals of Surgery)
Source: Annals of Surgery - November 23, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research