Blog

Advancing Surgical Oncology in Portuguese-Speaking Africa: Fellowship Outcomes

Addressing rising cancer rates in Portuguese-speaking African countries, a surgical oncology fellowship, led by the Portuguese Institute of Oncology and the Calouste Gulbenkian Foundation, trained residents and surgeons in Portugal. Following a standardized program, participants underwent hands-on training and assessments, with post-fellowship evaluations indicating enhanced knowledge, skills, and organizational abilities. Certified by a Portuguese university, the fellowship’s positive impact on fellows’ professional development underscores its potential recognition by local health and university authorities in Africa.

Journal Article by Santos LL, Nhampule R (…) Costa PM et 7 al. in Eur J Surg Oncol

© 2023 Published by Elsevier Ltd.

read the whole article in Eur J Surg Oncol

open it in PubMed

Decline in Pelvic Floor Integrity Linked to Escalating Grades of Rectal Intussusception: A Comprehensive Analysis of Contributing Factors.

Study Finds Decline in Pelvic Floor Integrity Associated with Increased Rectal Intussusception Grades, Independently of Obstetric and Surgical History. The analysis of 238 women revealed that factors like age, vaginal delivery, and pelvic surgery correlated with higher Oxford grades of rectal intussusception. Abnormal levator ani laxity and concurrent pelvic floor issues were independently linked to rising intussusception grades, suggesting a potential association with dyssynergic defecation and highlighting the complex interplay in pelvic floor dysfunction.

Journal Article by Neshatian L, Triadafilopoulos G (…) Gurland B et 4 al. in Am J Gastroenterol

Copyright © 2023 by The American College of Gastroenterology.

read the whole article in Am J Gastroenterol

open it in PubMed

Revitalizing Surgical Safety: A Comprehensive Checklist Reimplementation Boosts Team Performance and Patient Outcomes.

A Singapore-based prospective study transformed the surgical safety checklist through systematic reimplementation. Penetration and fidelity significantly improved, and team performance, assessed by the Oxford Non-Technical Skills system, rose substantially. Device-related interruptions decreased, safety culture surveys showed significant enhancements, and exploratory findings hinted at reduced patient safety events and complications. This study advocates for the impactful revitalization of established safety interventions to fortify patient safety culture and outcomes.

Journal Article by Etheridge JC, Moyal-Smith R (…) Havens JM et 6 al. in JAMA Surg

read the whole article in JAMA Surg

open it in PubMed

In Distal Gastric Poorly Cohesive Carcinoma, Total and Subtotal Gastrectomy Yield Comparable 5-Year Outcomes

A European multicenter study comparing total (TG) and subtotal gastrectomy (SG) for antropyloric poorly cohesive carcinoma found no significant difference in 5-year overall survival (TG: 53.8%, SG: 53.0%) or disease-free survival (TG: 46.0%, SG: 45.3%). Despite similar baseline characteristics, TG showed higher postoperative complications. This study supports subtotal gastrectomy as a viable option, offering comparable long-term outcomes with reduced surgical morbidity for distal poorly cohesive gastric cancer.

Journal Article by Boubaddi M, Teixeira Farinha H (…) Gronnier C et 7 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

read the whole article in Ann Surg Oncol

open it in PubMed

Comparative Analysis of Robotic Posterior Retroperitoneal and Lateral Transperitoneal Adrenalectomy

Robotic posterior retroperitoneal adrenalectomy and lateral transperitoneal adrenalectomy were compared using a 1:1 matched propensity analysis. In 154 matched cases, no significant differences were found in operative time, conversion to open surgery, postoperative pain, morphine use, length of stay, or 90-day complications. While posterior retroperitoneal adrenalectomy had lower estimated blood loss, it was not considered clinically significant. This study suggests that, when matched for tumor and patient parameters, the two robotic approaches exhibit similar perioperative outcomes, emphasizing their comparable effectiveness in adrenal surgery.

Journal Article by Romero-Velez G, Isiktas G (…) Berber E et 2 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

read the whole article in BMC Surg

open it in PubMed

Normocalcemic hyperparathyroidism presents a diagnostic challenge

A study introduced a preoperative calcium challenge for patients with elevated parathyroid hormone and normal calcium levels. Of 29 patients, 55% normalized parathyroid hormone with persistent normocalcemia, confirming secondary hyperparathyroidism. In 19%, classic primary hyperparathyroidism was diagnosed. Short-interval calcium supplementation revealed ∼50% resolved secondary hyperparathyroidism due to low calcium intake, avoiding unnecessary surgery. This approach, with 92% compliance, enhances diagnostic accuracy, prevents unwarranted procedures, and ensures timely intervention for primary hyperparathyroidism.

Journal Article by Baugh KA, McCoy KL (…) Yip L et 3 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

read the whole article in BMC Surg

open it in PubMed

Complex Bariatric Surgery Sequencing: Double Conversions from Adjustable Gastric Band to Sleeve Gastrectomy and Then to Roux-en-Y Gastric Bypass

Examining 276 cases, researchers found that patients undergoing double conversions from adjustable gastric band (AGB) to sleeve gastrectomy (SG) and then to Roux-en-Y gastric bypass (RYGB) primarily did so due to gastroesophageal reflux disease (GERD) or inadequate weight loss/weight regain. Those converted for weight issues had higher baseline body mass index and sleep apnea prevalence, while the “other reasons” group exhibited elevated complication rates and mortality, emphasizing the need for optimal primary surgery to minimize multiple conversions.

Journal Article by Dang JT, Hage K (…) Clapp B et 4 al. in Surg Endosc

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

read the whole article in Surg Endosc

open it in PubMed

Surgical Management of Esophageal Cancer in Patients with Right Aortic Arch or Double Aortic Arch: A Case Series

Analyzing 34 cases with right aortic arch (RAA) or double aortic arch (DAA) and esophageal cancer, the study found that esophagectomy, whether via thoracotomy or thoracoscopic surgery, can be safely performed for both conditions. Patients, predominantly Japanese males with squamous cell carcinoma, commonly underwent left thoracotomy for RAA and showed similar left and right approaches for DAA. An auxiliary incision or the left door open method is crucial for dissecting superior mediastinal lymph nodes, ensuring a safe postoperative course for most patients.

Journal Article by Zhang G, Wang Z (…) Li X et 9 al. in Surg Endosc

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

read the whole article in Surg Endosc

open it in PubMed

Video-Based Coaching in Surgery: Practical Implementation and Risk Mitigation

Video-based surgical coaching, recognized as a valuable tool for continuous professional growth, is explored further in this second part of the series. Researchers focus on its practical applications for team-based quality improvement, particularly in trauma bay settings. The paper delves into the associated risks, addressing legal and ethical concerns in video recording, storage, and distribution. A comprehensive framework is proposed to guide healthcare institutions in the effective and ethically sound implementation of video coaching, contributing to informed decision-making.

Journal Article by Keller DS, Alli VV (…) Ahuja V et 3 al. in J Gastrointest Surg

© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.

read the whole article in J Gastrointest Surg

open it in PubMed

Disparities and Challenges in Surgical Cancer Care at Safety-Net Hospitals

Analyzing 37 studies covering January 2000 to October 2021, researchers explored surgical cancer care in US safety-net hospitals (SNHs). Breast cancer (43%), colorectal (30%), and hepatopancreatobiliary (16%) cases were most represented. Barriers like financial constraints, cultural/language issues, and insurance limitations were common, contributing to advanced disease presentation (24-61% of patients). Limited data on cancer survival comparisons underscored variability in SNH care. The study emphasizes the need for enhanced access and quality in surgical oncology for safety-net hospital patients.

Review by Wong P, Victorino GP (…) Thornblade LW et 3 al. in J Gastrointest Surg

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

read the whole article in J Gastrointest Surg

open it in PubMed