Parenteral Nutrition for the Infrequent Utilizer
AbstractPurpose of ReviewParenteral nutrition (PN) allows clinicians the ability to provide nutritional support to patients that are unable to meet their nutritional needs through oral or enteral nutrition alone. Therefore, PN is a lifesaving and/or life-sustaining therapy for patients. Most clinicians will encounter patients on PN at some point, but for the infrequent utilizer of PN, PN management can seem complicated and overwhelming. Therefore, the purpose of this review is to provide a succinct review of PN for the infrequent utilizer.Recent FindingsThe impact and use of PN is multifaceted and can be identified through...
Source: Current Surgery Reports - October 13, 2022 Category: Surgery Source Type: research
The Brain –Gut Axis in Traumatic Brain Injury: Implications for Nutrition Support
AbstractPurpose of ReviewEarly enteral nutrition improves outcomes following traumatic brain injury (TBI). This can prove difficult due to TBI-induced feeding intolerance secondary to disruption of the brain-gut axis, a network composed of central nervous system (CNS) input, autonomic signaling, and immunologic regulation that controls gut and CNS homeostasis. Here, we discuss the pathophysiology of brain –gut axis dysregulation and outline nutrition strategies in patients with TBI.Recent FindingsFeeding intolerance following TBI is multifactorial; complex signaling between the CNS, sympathetic nervous system, parasympat...
Source: Current Surgery Reports - September 22, 2022 Category: Surgery Source Type: research
The Role of Indirect Calorimetry in Care of the Surgical Patient
AbstractPurpose of ReviewThis is a review of recent literature on the role of indirect calorimetry in surgical nutrition.Recent FindingsAll critical care societal guidelines recommend the use of indirect calorimetry as the standard of care to determine energy needs. Recent studies confirm discrepancy between measured and equation-predicted energy expenditure and further demonstrate improved outcomes with indirect calorimetry-guided nutrition. Patients that undergo ECMO, CRRT and those with COVID-19 would benefit from the use of indirect calorimetry.SummaryIndirect calorimetry-guided nutrition is the standard of care in mec...
Source: Current Surgery Reports - September 14, 2022 Category: Surgery Source Type: research
Robotic Thymectomy: An Update
AbstractPurpose of ReviewIn the last two decades, minimally invasive approaches for thoracic surgery have become widely adopted. Open thymectomy was previously considered the gold standard; however, minimally invasive techniques including robotic approaches are becoming routine for a variety of pathologies. We review the robotic techniques and approaches to thymectomy currently being performed as well as novel approaches in development.Recent FindingsRobot-assisted thoracoscopic surgery (RATS) has been developed to increase the accessibility of minimally invasive surgery. Better flexibility and transmission and the surgeon...
Source: Current Surgery Reports - September 2, 2022 Category: Surgery Source Type: research
Small Bowel Neuroendocrine Tumors: Focus on Pathologic Aspects and Controversial Surgical Issues
AbstractPurpose of the ReviewThe aim of the review is to present an updated overview on the pathologic aspects and the surgical approach to small bowel neuroendocrine tumors, focusing on the following debated issues: role of laparoscopic surgery, lymph node dissection, prophylactic cholecystectomy, mesenteric fibrosis, and surgery of distant metastases.Recent FindingsNeuroendocrine tumors of the small intestine, formerly known as midgut carcinoid tumors, are a rather rare disease with an incidence of less than 1 per 100,000 in the general population. However, the neuroendocrine tumors of the small intestine are among the m...
Source: Current Surgery Reports - August 28, 2022 Category: Surgery Source Type: research
Robotic Rectal Cancer Surgery: Current Practice, Recent Developments, and Future Directions
AbstractPurpose of ReviewThe robotic surgical platform is increasingly used for rectal cancer surgeries. However, whether the long-term clinical and oncological outcomes are significantly better, considering the high costs of this approach, is still debated.Recent FindingsROLARR trial did not demonstrate lower conversion rates with robotic compared to laparoscopic rectal cancer surgery, except in a subgroup. Recent large-scale observational studies state otherwise, reporting outcomes favoring the robotic approach. Additionally, functional and long-term oncological outcomes are yet to be thoroughly evaluated. The costline...
Source: Current Surgery Reports - August 24, 2022 Category: Surgery Source Type: research
Robotic Lateral Trans-Abdominal Adrenalectomy: Current Status
AbstractPurpose of ReviewAdrenal tumor surgery is routinely performed by minimal invasive surgery. We aim to over-view of updates on lateral approach for robotic adrenalectomy.Recent UpdatesIn the era of robotic surgery with the feasibility and the ability to provide the surgeon of three-dimensional view, which allows maximum range of motion and precision with the different approaches in adrenalectomy. The lateral robotic approach was the most frequently performed.SummaryRobotic system is safe and effective approach that can be used for adrenalectomy and can be alternative to laparoscopic depending on patient ’s selectio...
Source: Current Surgery Reports - July 15, 2022 Category: Surgery Source Type: research
Robotic Versus Endoscopic Transoral Thyroidectomy with Vestibular Approach: A Literature Review Focusing on Differential Patient Suitability
AbstractPurpose of ReviewThe purpose of this study was to evaluate the characteristics of patients who underwent transoral robotic thyroidectomy (TORT) in the worldwide literature, especially in comparative studies with transoral endoscopic thyroidectomy by vestibular approach (TOETVA), to better define the ideal appropriate patient.Recent FindingsTORT allows a more precise and complete dissection due to the enlarged and three-dimensional surgical vision and the tremor filtering. Current inclusion criteria for TORT mainly concern ultrasonographically estimated nodules as having a maximum diameter ≤ 70 mm, the papil...
Source: Current Surgery Reports - June 25, 2022 Category: Surgery Source Type: research
Robotic Pancreatoduodenectomy: From the First Worldwide Procedure to the Actual State of the Art
AbstractPurpose of ReviewThe purpose of this review is to summarize the current experience and literature on robotic pancreatoduodenectomy and analyze its indications, surgical technique, and related peri- and postoperative outcomes.Recent FindingsComplex hepato-pancreatico-biliary (HPB) minimally invasive surgical procedures that were only attainable after a long learning curve by highly skilled laparoscopic surgeons are now robotically performed with a shorter learning curve by dedicated HPB surgeons. Image integration, fusion imaging, digital pathology, electronic tutoring, automation, telepresence, and telesurgery are ...
Source: Current Surgery Reports - June 22, 2022 Category: Surgery Source Type: research
Chest Wall Reconstruction: A Comprehensive Analysis
AbstractPurpose of ReviewChest wall reconstruction often includes complex defects requiring coordination with consulting services and attention to both skeletal and soft tissue defects. Through a review of the historical context of chest wall reconstruction, this article will address current considerations for both components of reconstruction. Special considerations related to reconstruction of the chest wall will be reviewed.Recent FindingsExciting advancements have been made in the past decade in solving the ongoing challenge to find optimal materials for use in skeletal reconstruction and stabilization. Biologic meshes...
Source: Current Surgery Reports - May 26, 2022 Category: Surgery Source Type: research
Open Globe Injuries
AbstractPurpose of ReviewTo review the epidemiology, classification, diagnosis, and management of open globe injuries.Recent FindingsTo date ocular injuries are a common cause of vision loss that can affect many age groups with serious socioeconomic impacts. Around 1.6 million people become blind from penetrating ocular trauma. Proper examination and intervention can lead to a better visual prognosis for the affected individuals. Here in, we review the classification of ocular trauma, the epidemiology, the diagnosis, and the management of open globe injuries based on their anatomic classification as well as their potential...
Source: Current Surgery Reports - May 16, 2022 Category: Surgery Source Type: research
Splenectomy of Immune Thrombocytopenic Purpura in the Era of New Medical Therapies: A Retrospective Cohort Study from a Tertiary Cancer Center in Egypt
ConclusionSplenectomy, especially the laparoscopic approach, is a safe and effective line of treatment for refractory ITP patients, despite newer lines of therapy have been evolved and becoming more widely used in recent years. (Source: Current Surgery Reports)
Source: Current Surgery Reports - May 14, 2022 Category: Surgery Source Type: research
Reconstruction of Complex Lower Extremity Defects
AbstractPurpose of ReviewInsults to the lower extremity have the potential to be highly detrimental to patient function and are associated with significant psychological morbidity. Complex defects of the leg, in particular, pose many reconstructive challenges requiring extensive collaboration between reconstructive surgeons and other care teams. This review details the basic principles of managing patients with lower extremity defects and discusses reconstructive options available to surgeons.Recent FindingsNovel reconstructive techniques and wound care technologies have largely improved outcomes in patients undergoing low...
Source: Current Surgery Reports - April 5, 2022 Category: Surgery Source Type: research
Gender Diversity in Surgery: A Review
AbstractPurpose of ReviewThis review aims to describe the gender disparity in surgery by highlighting the disparate treatment and experiences of women and men in both surgical practice and training. This review will discuss disparities in career advancement and compensation, leadership positions, and recognition in achievement, as well as the mistreatment of women, and challenges related to pregnancy and motherhood. Additionally, this review will provide individuals, hospitals, and societies with actionable advice on how to improve the surgical environment for female surgeons, and work toward gender parity in surgery.Recen...
Source: Current Surgery Reports - March 25, 2022 Category: Surgery Source Type: research
Wellness in Graduate Surgical Medical Education
AbstractPurpose of ReviewBurnout disproportionately affects healthcare providers and impacts patient care and providers ’ quality of life (QoL). This review sought to define and dissect techniques used across the country to combat burnout during graduate surgical medical education.Recent FindingsGrowing literature exploring the effects of burnout interventions demonstrate the increased commitment and importance placed on these topics by residency programs and the Accreditation Council for Graduate Medical Education. Resiliency training, mindfulness teachings, mentorship, and other strategies have had measurable success o...
Source: Current Surgery Reports - February 26, 2022 Category: Surgery Source Type: research
