In exploring the perspectives of 22 experienced medical interpreters, the study unveiled key elements for improving surgical informed consent discussions, especially for patients with limited English proficiency. Interpreters emphasized their roles as patient advocates and cultural brokers, revealing patient attributes that influence discussions based on cultural values. Recommendations included surgeons demonstrating compassion, using simple language, […]
Category: General Surgery
Improved Outcomes: Neoadjuvant Chemotherapy in Elderly Locally Advanced Gastric Cancer Patients
Examining elderly gastric cancer patients (>75 years) in the U.S., this study, using propensity score matching, reveals that neoadjuvant chemotherapy (NAC) utilization increased from 2013 to 2019 (21% to 42.7%). After matching, 1958 patients showed that those receiving NAC experienced enhanced oncological outcomes following resection for locally advanced gastric cancer. The findings advocate for the […]
Distance and Disparities in Cytoreductive Surgery
Analyzing 1614 cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) cases, researchers found that over 50% of patients traveled more than 100 miles for treatment. While regionalization showed no survival difference, those traveling further had fewer disparities but higher disease severity, raising concerns about access for the underserved, time to treatment, and surgical quality. Median […]
Robotic Surgery Triumphs: Meta-Analysis on Hernia Repair
In a comprehensive review encompassing 64 studies, including 227,242 patients for inguinal hernia repair (IHR) and 158,384 for ventral hernia repair (VHR), robotic surgery exhibited superiority. Robotic IHR significantly lowered hernia recurrence risk (OR 0.54), demonstrating its safety and efficacy. The meta-analysis underscores that robotic surgery emerges as a commendable alternative, offering intraoperative and postoperative […]
Unveiling Survival Insights: Radiotherapy Redundant for Stage III Mucinous Rectal Cancer
Contrary to the conventional recommendation, researchers analyzed SEER data (2004-2015) for stage III rectal mucinous adenocarcinoma (RMC) patients. RMC, distinct in T and N stage at diagnosis, emerged as an independent poor prognostic factor for overall and cancer-specific survival. Notably, adjuvant radiotherapy failed to confer survival benefits, with no significant difference found between chemotherapy alone […]
Decoding Aberrant Scarring: Unraveling Mechanisms and Implications
Skin wound healing often leads to abnormal scarring, such as keloids or hypertrophic scars, impacting millions globally. While the precise mechanisms remain elusive, evidence suggests ongoing inflammation in susceptible individuals perpetuates extracellular matrix changes, resulting in fibrotic lesions. Abnormal scarring, causing pain, functional impairment, and aesthetic concerns, lacks effective treatment. The study underscores the urgent […]
Limited Exploration of Feasibility in Surgical Placebo Trials
Examining 131 randomized placebo-controlled surgical trials, a systematic review revealed a scarcity of published pilot or feasibility studies to inform the design and execution of these challenging trials. Only four studies, focused on orthopedic and oral/maxillofacial surgery, conducted true pilot work. With a dearth of reported feasibility efforts, the study underscores the necessity for more […]
Best Practices in Regression Analysis for Surgical Oncology Research: A Practical Guide
Analyzing tissue expander breast reconstruction cases (n=1986), researchers offered practical insights into regression modeling in surgical oncology. For breast-Q physical well-being, linear regression identified age, marital status, and dissection type as significant factors. Logistic regression for complications found BMI, age, bilateral reconstruction, and dissection type impactful. The study provides focused directives, urging researchers to judiciously […]
Surgeon-Patient Sex Discordance Hinders Optimal Outcomes in Complex Cancer Surgery
Analyzing 495,628 patients undergoing complex cancer surgery, researchers found that sex discordance between surgeons and patients (51.2%) was linked to a decreased likelihood of achieving optimal postoperative outcomes. Such discordance correlated with higher risks of complications and 90-day mortality. Intriguingly, male patients treated by female surgeons exhibited outcomes comparable to female patients treated by male […]
Tailoring Prophylaxis in Crohn’s Disease Surgery: Real-world Insights into Risk Factors and Recurrence
Examining 1404 Crohn’s disease patients post-ileocecal resection, researchers identified high-risk factors for surgical recurrence (multiple surgeries, active smoking, penetrating or perianal disease). Biologic prophylaxis post-surgery lowered surgical recurrence in high-risk patients. Additionally, prophylaxis reduced endoscopic recurrence regardless of risk, suggesting its potential benefits across risk profiles. These findings emphasize the relevance of individualized prophylactic approaches […]