Trends in the adoption of diverting loop ileostomy for acute complicated diverticulitis in the United States
Acute complicated diverticulitis poses a substantial burden to individual patients and the health care system. A significant proportion of the cases necessitate emergency operations. The choice between Hartmann ’s procedure and primary anastomosis with diverting loop ileostomy remains controversial. (Source: Surgery)
Source: Surgery - April 19, 2024 Category: Surgery Authors: Nam Yong Cho, Nguyen K. Le, Shineui Kim, Ayesha Ng, Saad Mallick, Nikhil Chervu, Hanjoo Lee, Peyman Benharash Source Type: research
Postoperative bleeding after complex abdominal wall reconstruction: A post hoc analysis of a randomized clinical trial
Abdominal wall reconstruction requires extensive dissection of the abdominal wall, exposure of the retroperitoneum, and aggressive chemoprophylaxis to reduce the risk of thromboembolic complications. The need for early anticoagulation puts patients at risk for bleeding. We aimed to quantify postoperative blood loss, incidence of transfusion and reoperation, and associated risk factors in patients undergoing complex abdominal wall reconstruction. (Source: Surgery)
Source: Surgery - April 19, 2024 Category: Surgery Authors: Vyacheslav Lenkov, Lucas R.A. Beffa, Benjamin T. Miller, Sara M. Maskal, Ryan C. Ellis, Chao Tu, David M. Krpata, Michael J. Rosen, Ajita S. Prabhu, Clayton C. Petro Source Type: research
Upfront laparotomy versus conversion from minimally invasive surgery to open surgery in colon cancer: Is there a difference in outcomes?
In this study, we aimed to assess the implications of transitioning from minimally invasive surgery to laparotomy in patients with colon cancer compared with patients undergoing upfront laparotomy. (Source: Surgery)
Source: Surgery - April 18, 2024 Category: Surgery Authors: Nir Horesh, Sameh Hany Emile, Zoe Garoufalia, Rachel Gefen, Peige Zhou, Steven D. Wexner Source Type: research
Root cause analysis of mortality after esophagectomy for cancer: a multicenter cohort study from the FREGAT database
Esophagectomy is associated with significant mortality. A better understanding of the causes leading to death may help to reduce mortality. A root cause analysis of mortality after esophagectomy was performed. (Source: Surgery)
Source: Surgery - April 18, 2024 Category: Surgery Authors: Guillaume Levenson, Maxime Coutrot, Thibault Voron, Caroline Gronnier, Pierre Cattan, Christian Hobeika, Xavier Beno ît D’Journo, Damien Bergeat, Olivier Glehen, Muriel Mathonnet, Guillaume Piessen, Diane Goéré Source Type: research
A caution against KRAS-guided margin width during hepatectomy for colorectal liver metastases
In this issue of Surgery, Rhaiem et al characterized the association of R0 or R1 margins with outcomes for patients undergoing hepatectomy for KRAS wild-type (KRAS-wt) and mutated (KRAS-mut) colorectal liver metastases (CLM) between 2010 to 2015.1 Among 593 patients included in this retrospective study from 9 institutions across mul tiple countries, 71% were KRAS-wt. There were no differences in most patient characteristics based on KRAS status. R1 resection, defined as the presence of tumor cells within 1 mm of the resection margin or the presence of microscopic residual disease, was reported in 32.7% of patients overal...
Source: Surgery - April 16, 2024 Category: Surgery Authors: Antony Haddad, Jean-Nicolas Vauthey, Timothy E. Newhook Source Type: research
Invited commentary for “Meta-analysis of adjuvant chemotherapy versus no adjuvant chemotherapy for resected stage I pancreatic cancer
Evans et al performed a meta-analysis of 6 observational studies published over a 5-year period ending in 2022 in an attempt to capture associations between adjuvant systemic chemotherapy and overall survival for nearly 7,000 patients with stage IA and IB pancreatic ductal adenocarcinoma who underwent cura tive-intent resection. Using proper statistical analysis with Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards and Risk Of Bias In Non-randomised Studies - of Interventions assessment tools for bias, the authors demonstrated that the use of adjuvant systemic chemotherapy was associated with ...
Source: Surgery - April 15, 2024 Category: Surgery Authors: Michael G. House Source Type: research
An explainable long short-term memory network for surgical site infection identification
Currently, surgical site infection surveillance relies on labor-intensive manual chart review. Recently suggested solutions involve machine learning to identify surgical site infections directly from the medical record. Deep learning is a form of machine learning that has historically performed better than traditional methods while being harder to interpret. We propose a deep learning model, a long short-term memory network, for the identification of surgical site infection from the medical record with an attention layer for explainability. (Source: Surgery)
Source: Surgery - April 13, 2024 Category: Surgery Authors: Amber C. Kiser, Jianlin Shi, Brian T. Bucher Source Type: research
The impact of county-level food access on the mortality and post-transplant survival among patients with steatotic liver disease
The impact of county-level food access on mortality associated with steatotic liver disease, as well as post –liver transplant outcomes among individuals with steatotic liver disease, have not been characterized. (Source: Surgery)
Source: Surgery - April 12, 2024 Category: Surgery Authors: Yutaka Endo, Diamantis I. Tsilimigras, Mujtaba Khalil, Jason Yang, Selamawit Woldesenbet, Kazunari Sasaki, Ashley Limkemann, Austin Schenk, Timothy M. Pawlik Source Type: research
Education and training of prehospital first responders in low- and middle-income countries
Prehospital emergency medical services play a vital role in providing essential emergency medical and trauma care. However, in many low- and middle-income countries, there is a significant lack of adequate emergency medical services coverage, a problem compounded by a profound deficit of first responder training programs. The African Federation of Emergency Medicine classifies prehospital emergency care into 2 categories: tier-1, which includes laypersons, and tier-2, consisting of professionals equipped with dispatch capabilities. (Source: Surgery)
Source: Surgery - April 12, 2024 Category: Surgery Authors: Zachary J. Eisner, Ken Diango, Jared H. Sun Source Type: research
The overlooked factor: The impact of disability on postoperative complications after emergency general surgery procedures surgery
Thank you for the opportunity to submit a commentary on this article, in which the authors employ sound methodology to address the question of how the presence of disability impacts outcomes after emergency surgery. Although the National Readmissions Database is a useful tool, it is subject to several limitations that may compromise generalizability and determination of causality. There is a complex interplay between the presence of disability, socioeconomic status, and race that cannot be fully addressed by these data, though the observations made by the authors elucidate the physical, financial, and social obstacles that...
Source: Surgery - April 12, 2024 Category: Surgery Authors: Gregory Sigler, Daniel E. Abbott Source Type: research
Association of rurality with short-term outcomes of peripheral vascular trauma
Peripheral vascular trauma is a major contributing factor to long-term disability and mortality among patients with traumatic injuries. However, an analysis focusing on individuals at a high risk of experiencing limb loss due to rural and urban peripheral vascular trauma is lacking. (Source: Surgery)
Source: Surgery - April 12, 2024 Category: Surgery Authors: Nam Yong Cho, Amulya Vadlakonda, Joanna Curry, Zachary Tran, Areti Tillou, Christian de Virgilio, Peyman Benharash Source Type: research
Risk factors for emergency surgery for diverticulitis: A retrospective multicentric French study at 41 hospitals
This study aimed to assess the rate and risk factors of emergency surgery for sigmoid diverticulitis. (Source: Surgery)
Source: Surgery - April 11, 2024 Category: Surgery Authors: Camille Godet, Charles Sabbagh, Laura Beyer-Berjot, Mehdi Ouaissi, Philippe Zerbib, Bridoux Val érie, Gilles Manceau, Yves Panis, Etienne Buscail, Aurélien Venara, Iman Khaoudy, Martin Gaillard, Manon Viennet, Alexandre Thobie, Benjamin Menahem, Clariss Source Type: research
Cultural competency and ethical behavior for collaboration in limited-resource settings: Guidelines from the Society of University Surgeons Academic Global Surgery Committee and the Association for Academic Global Surgery
There are an increasing number of global surgery activities worldwide. With such tremendous growth, there is a potential risk for untoward interactions between high-income country members and low-middle income country members, leading to programmatic failure, poor results, and/or low impact. (Source: Surgery)
Source: Surgery - April 11, 2024 Category: Surgery Authors: George Yang, Abebe Bekele, Sanjay Krishnaswami, Emmanuel Ameh, Ziad Sifri, Oseremen Aisuodionoe-Shadrach, Mamta Swaroop, Susan Orloff, Fizan Abdullah, Benedict Nwomeh, Mike Chen, Anthony Charles, Constantine Ezeme, Catherine Juillard, Catarina Menezes, Mu Source Type: research
Emergency medical dispatch technologies: Addressing communication challenges and coordinating emergency response in low and middle-income countries
A majority of emergency response in low and middle-income countries (LMICs) without formal emergency medical services (EMS) rely on uncoordinated layperson first responders (LFRs) to respond to emergencies using readily available mobile phones and private transport. Although formally trained LFRs are an important foundation for nascent emergency medical services (EMS) development, without coordination by standardized emergency medical dispatch (EMD) systems, LFR response is limited to witnessed emergencies, which provides significant but incomplete coverage. (Source: Surgery)
Source: Surgery - April 11, 2024 Category: Surgery Authors: Jason Friesen, Ramu Kharel, Peter G. Delaney Source Type: research
Emergency medical services (EMS) infrastructure development and operations in low- and middle-income countries: Formal, professional-driven (Tier-2) systems
The World Health Organization recognized timely healthcare as a human right and called for the expansion of two-tiered prehospital and out-of-hospital emergency care systems in low- and middle-income countries. Tier-1 systems involve community-based first responder care, and Tier-2 systems involve more formalized emergency medical services designed as a sustainable system of services, including dedicated ambulances, personnel, and equipment. Tier-2 systems can play a crucial role in reducing mortality and disability due to emergency medical and surgical conditions worldwide. (Source: Surgery)
Source: Surgery - April 10, 2024 Category: Surgery Authors: Jared H. Sun, Shaheem de Vries, Nee-Kofi Mould-Millman Source Type: research
