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Virtual Reality for Colorectal Cancer Surgery Consent

In a pilot trial, colorectal cancer patients undergoing elective surgery were randomized to receive standard consent (CT images) or virtual reality (VR) consent (CT images and immersive VR models). While not statistically significant, VR showed a trend toward improved patient-reported understanding, with most patients preferring VR as an educational tool. Well-tolerated and enjoyable, VR’s feasibility in outpatient clinics for colorectal cancer surgery suggests the need for a statistically powered study to assess its impact on patient understanding.

Journal Article by Shepherd T, Trinder M and Theophilus M in ANZ J Surg

© 2023 Royal Australasian College of Surgeons.

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Mental Health Challenges in US Academic Surgeons

A survey of 622 US academic surgeons, trainees, and medical students revealed concerning mental health issues. About 26.1% reported a prior mental health diagnosis, with 15.9% screening positive for depression, 18.4% for anxiety, 11.0% for alcohol use disorder, and 17.3% for PTSD. Those with a history of mental health disorders, depression, or PTSD had increased odds of suicidal ideation. Shockingly, nearly 1 in 7 respondents reported suicidal thoughts in the past year, highlighting significant mental health challenges within the US surgical workforce.

Journal Article by Collins RA, Herman T (…) Cunningham C et 24 al. in Ann Surg

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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Enhancing Surgical Informed Consent: Insights from Medical Interpreters

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, and providing context around consent. Interpreters stressed the need for reducing legal terminology on consent forms and facilitating translation, offering crucial insights for enhancing communication with diverse patient populations.

Journal Article by Allar BG, Ponce C (…) Kent TS et 5 al. in Ann Surg

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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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 potential benefits of NAC in improving overall survival and other outcomes in this elderly patient population.

Journal Article by Rawicz-Pruszyński K, Endo Y (…) Pawlik TM et 7 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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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 survival didn’t differ based on distance, suggesting regionalization’s appropriateness but emphasizing the need for equitable care and timely intervention for distant-traveling patients.

Journal Article by Solsky I, Patel A (…) Levine EA et 5 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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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 advantages compared to laparoscopy and open surgery in both IHR and VHR cases.

Review by de’Angelis N, Schena CA (…) Pessaux P et 13 al. in Surg Endosc

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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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 and chemotherapy plus radiotherapy groups. The study challenges the necessity of adjuvant radiotherapy for stage III RMC, emphasizing its limited efficacy in improving survival outcomes.

Journal Article by Liao H, Tang C (…) Lei X et 6 al. in J Gastrointest Surg

© 2023. The Society for Surgery of the Alimentary Tract.

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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 need for standardized and innovative approaches to enhance outcomes in patients with pathological scarring.

Review by Jeschke MG, Wood FM (…) Gauglitz GG et 4 al. in Nat Rev Dis Primers

© 2023. Springer Nature Limited.

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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 pilot studies to share crucial insights, aiding in the optimization of design for main randomized placebo-controlled surgical trials.

Journal Article by Cousins S, Gormley A (…) Blazeby JM et 4 al. in BMJ Open

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.

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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 select variables, confirm model fitting, and consider clinical plausibility for accurate interpretation in surgical oncology research.

Journal Article by Boe L, Vingan PS (…) Nelson JA et 5 al. in J Surg Oncol

© 2023 Wiley Periodicals LLC.

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