Invited Commentary. Selective lateral pelvic lymph node dissection in low rectal cancer —Planning for future directions
Treatment for locally advanced rectal cancer has improved over recent years. The advent of several novel oncologic agents and improvements in preoperative imaging and surgical technology means that patients with locally advanced diseases can be offered an increasing number of treatment options, all to better survival outcomes. However, one conundrum that continues to elude consensus is the issue of pelvic sidewall metastasis and the appropriateness of lateral pelvic lymphadenectomy. (Source: Surgery)
Source: Surgery - December 4, 2023 Category: Surgery Authors: Tom Pampiglione, Tsuyoshi Konishi, Manish Chand Source Type: research
Impact of frailty on complications and length of stay after minimally invasive adrenalectomy surgery
This study evaluates the perioperative outcomes of elective adrenalectomies when performed in older patients and how frailty affects such outcomes. (Source: Surgery)
Source: Surgery - December 3, 2023 Category: Surgery Authors: Vanita Ahuja, Courtney Gibson, Nikita Machado, Joseph T. King Source Type: research
Beyond research dissemination: The unrealized power of visual abstracts to improve health care delivery
Since the introduction of the visual abstract in 2016, more than 100 journals have adopted its use to disseminate scientific research. To date, 7 randomized cross-over trials have consistently reproduced its ability to disseminate research effectively. During the adoption of the visual abstract, there has also been a learning curve that has moved journals to dedicate more resources to it and create more formal guidelines. In parallel, the visual abstract has also had secondary gains of promoting clear communication and diversifying our editorial boards. (Source: Surgery)
Source: Surgery - December 3, 2023 Category: Surgery Authors: Andrew M. Ibrahim Source Type: research
Communication in your department and beyond
Technical skills and clinical acumen are necessary for success in a surgical career. However, these skills alone are not sufficient. A surgeon ’s emotional intelligence and ability to communicate, manage conflict, and cultivate relationships may be even more critical to success. Health care environments are increasingly complex. An individual surgeon’s or surgical department’s success depends highly on the teams around them, includin g anesthesia, nursing, hospital administration, clinic teams, and many more. (Source: Surgery)
Source: Surgery - December 3, 2023 Category: Surgery Authors: Taylor S. Riall, Stephanie G. Worrell Source Type: research
Creating an integrated strategic plan
The modern surgical leader now requires many tools for successful leadership. One critical tool is developing an integrated strategic plan where team and culture are developed with a directed common mission. This mission or strategic plan must fit within certain constraints, such as the larger institutional goals and constrained resources. To help develop this strategic plan, the surgical leader has many resources to use. The most common strategic planning tool is the Strengths, Weaknesses, Opportunities, and Threats analysis. (Source: Surgery)
Source: Surgery - December 3, 2023 Category: Surgery Authors: Christopher DuCoin, Paul C. Kuo Source Type: research
Preoperative ultrasound elastography for postoperative pancreatic fistula prediction after pancreatoduodenectomy: A prospective study
Postoperative pancreatic fistulas are the most frequent major complications after pancreatoduodenectomy. The soft pancreatic texture is a critical, independent risk factor for postoperative pancreatic fistulas after pancreatoduodenectomy. The current gold standard for postoperative pancreatic fistula risk evaluation consists of the surgeon's intraoperative palpation of the pancreatic texture and, thus, lacks objectivity. In this prospective study, we used ultrasound-based shear-wave elastography, image data analysis, and a fistula risk score calculator to correlate the stiffness of pancreatic tissue with the occurrence of ...
Source: Surgery - December 2, 2023 Category: Surgery Authors: Viktor H. von Ehrlich-Treuenst ätt, Michael Guenther, Matthias Ilmer, Mathilda M. Knoblauch, Dominik Koch, Dirk-Andre Clevert, Steffen Ormanns, Frederik Klauschen, Hanno Niess, Jan D‘Haese, Martin K. Angele, Jens Werner, Bernhard W. Renz Source Type: research
Comment on “A phase IB/IIA study of ex vivo expanded allogeneic bone-marrow-derived mesenchymal stem cells for the treatment of rectovaginal fistulizing Crohn disease.”
We read with great interest the study by Lightner et al,1 who aimed to determine the safety and efficacy of mesenchymal stem cells (MSCs) for refractory rectovaginal fistulizing Crohn disease (CD). They found that bone-marrow-derived MSCs offer a safe alternative treatment approach for rectovaginal fistulas in the setting of CD. Complete healing was achieved in half of the patients. We appreciate the authors’ hard work. However, we have a few comments on the article. Meanwhile, we recommend additional propensity score matching to balance the baseline information. (Source: Surgery)
Source: Surgery - December 2, 2023 Category: Surgery Authors: Fang Cheng Source Type: research
Strategies to reduce ileus after colorectal surgery: A qualitative umbrella review of the collective evidence
Various strategies were proposed to reduce postoperative ileus after colorectal surgery. This umbrella review aimed to provide a comprehensive overview of current evidence on measures to reduce the incidence and severity of postoperative ileus after colorectal surgery. (Source: Surgery)
Source: Surgery - December 1, 2023 Category: Surgery Authors: Sameh Hany Emile, Nir Horesh, Zoe Garoufalia, Rachel Gefen, Emeka Ray-Offor, Steven D. Wexner Source Type: research
Managing your human capital in a department of surgery
Human capital management in the department of surgery represents a heterogeneous array of operational and strategic activities that focus on enhancing the well-being and productivity of all team members. This is not an episodic or reactive effort but rather a constant one that occurs in an ongoing cycle. Awareness of all the human capital in one ’s department, tending to members with their own best interest in mind, and an approach that is communication-heavy and based on fairness and transparency will serve to elevate the productivity and wellness of the department of surgery members and the organization as a whole. (Source: Surgery)
Source: Surgery - December 1, 2023 Category: Surgery Authors: Andrew M. Cameron Source Type: research
Inivited Commentary: The first steps are always the hardest —leveraging technology to better quantify the earliest phases of postoperative mobility
In this issue of Surgery, Fuchita et al1 leveraged research-grade accelerometers (activPALs) to compare mobility detected by the device to mobility as documented by staff in the medical record. This is a new take on a very old problem. Indeed, the dangers of excess bed rest during hospitalization are well known.2–4 Early mobility a fter surgery is especially important, and patients with lower levels of mobility are at higher risk for complications.5,6 Some populations, such as those undergoing major abdominal surgery, may be at particularly high risk for low mobility after surgery. (Source: Surgery)
Source: Surgery - November 30, 2023 Category: Surgery Authors: S. Ryan Greysen, Daniel J. Lee Source Type: research
Is nonoperative management of appendicitis safe and effective in multi-morbid patients?
The purpose of this study was to (1) compare post-treatment outcomes of operative and nonoperative management of acute appendicitis in multi-morbid patients and (2) evaluate the generalizability of prior clinical trials by determining whether outcomes differ in multi-morbid patients compared to the young and healthy patients who resemble prior clinical trial participants. (Source: Surgery)
Source: Surgery - November 30, 2023 Category: Surgery Authors: Nicole Lunardi, Jennie Meier, Thai H. Pham, Ben L. Zarzaur, Suresh Agarwal, Sherene Sharath, Panos Kougias, Courtney J. Balentine Source Type: research
Increases in pediatric cholecystectomy during the COVID-19 pandemic: An interrupted time series analysis
Historically, cholecystectomy is infrequently performed in children. Lifestyle changes, delays in healthcare access, and increases in childhood obesity occurred during the COVID-2019 pandemic. It is unclear whether these changes impacted pediatric gallbladder disease and the need for cholecystectomy. (Source: Surgery)
Source: Surgery - November 30, 2023 Category: Surgery Authors: Olivia A. Keane, Shadassa Ourshalimian, MaKayla O ’Guinn, Madeleine Ing, Marjorie Odegard, Romeo Ignacio, Lorraine I. Kelley-Quon Source Type: research
Impact of tumor stage and neoadjuvant chemotherapy in fluorescence-guided lymphadenectomy during laparoscopic gastrectomy for gastric cancer: A propensity score-matched study in a western center
The use of indocyanine green fluorescence has been shown to be a safe and effective method for improving lymph node retrieval in patients with gastric cancer. However, previous studies have focused on early-stage tumors and/or the Asian population and excluded patients who received neoadjuvant treatment. (Source: Surgery)
Source: Surgery - November 30, 2023 Category: Surgery Authors: Ana Senent-Boza, Noelia Garc ía-Fernández, Isaías Alarcón-del Agua, María Socas-Macías, Ángela de Jesús-Gil, Salvador Morales-Conde Source Type: research
Letter to the Editor —Better late than never: The significance of health equity education in the core surgical clerkship
In surgical education and practice, health equity education plays an important role in shaping the future of health care by emphasizing the importance of providing equitable and quality care to all patients. Undoubtedly, we have come a long way in making significant changes to the curriculum. However, more work needs to be done to address this disparity. We commend Goodsell et al for not only calling attention to this issue but also demonstrating a productive way to address it.1 We would like to further elaborate on their conclusions by highlighting the significance of health equity education earlier in the surgical cler...
Source: Surgery - November 30, 2023 Category: Surgery Authors: Rahim Hirani, John T. Mullen Source Type: research
Persistent challenges in pancreatic surgery: Postoperative pancreatic fistula prediction in the machine learning era —Response to: Machine learning versus logistic regression for the prediction of complications after pancreaticoduodenectomy
Pancreaticoduodenectomy (PD) surgery is the only curative treatment for periampullary pancreatic cancers. Despite advancements in surgical techniques and medical care, the morbidity associated with this procedure remains high.1 This holds particularly true for clinically relevant postoperative pancreatic fistula (POPF), which affects nearly 18.4% of patients after PD surgery.2 The emergence of predictive tools empowers clinicians to administer timely care, allowing for earlier diagnosis and interventions and for actionable preemptive measures to mitigate associated morbidity. (Source: Surgery)
Source: Surgery - November 30, 2023 Category: Surgery Authors: Hala Muaddi, Hojjat Salehinejad, Cornelius A. Thiels Source Type: research
