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Guidelines Get a Hug: Boosted Adherence to Medullary Thyroid Cancer Treatment

Researchers scrutinized 3421 medullary thyroid cancer (MTC) cases to see if the 2009 American Thyroid Association (ATA) guidelines had a real impact. Post-2009, 72% of non-advanced MTC cases aligned with surgery guidelines, up from 67%. Discordant cases often featured females, older patients, and non-academic facilities. Most crucially, sticking to guidelines meant better survival odds. With 26% discordance (vs. 33% pre-2009), this study shows MTC care strides toward guideline harmony, hinting at improved survival prospects.

Journal Article by McMullin JL, Sharma J (…) Saunders ND et 3 al. in Ann Surg Oncol

© 2022. Society of Surgical Oncology.

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Esophageal Cancer Staging: Inaccuracy Impacts Attainment of Optimal Oncologic Outcomes

In clinical staging for early-stage esophageal cancer, 41.2% of patients experienced upstaging upon final pathology. Tumor size, histology, and delayed esophagectomy (>30 days) were linked to upstaging risk. The rate of achieving optimal oncologic outcomes dropped from 43.8% (reliable clinical staging) to 22.5% (considering upstaging). The study underscores the impact of inaccuracies in clinical staging on providers’ ability to attain favorable oncologic results in CT1bN0 esophageal cancer cases.

Journal Article by Swanson J, Roat-Shumway S (…) Baker MS et 3 al. in BMC Surg

Copyright © 2023. Published by Elsevier Inc.

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Enhanced Ultrasound Skills: Surgical Critical Care Fellows Benefit from Dedicated Curriculum

Surgical critical care fellows experienced enhanced comfort and skills in point-of-care ultrasound (POCUS) after participating in a dedicated ultrasound curriculum. The program, including lectures and hands-on training, led to improved fellow-reported comfort levels in various ultrasound-guided techniques. Technician evaluations confirmed significant progress in fellows’ probe orientation, location, image manipulation, machine adjustment, and overall image quality. This study marks the first to outline a structured ultrasound curriculum for surgical critical care, showcasing substantial skill development and increased comfort with POCUS.

Journal Article by Jalilvand A, Bhatt A, Kopanczyk R and Wahl W in BMC Surg

Published by Elsevier Inc.

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Extended Antibiotics Mitigate Postoperative Pancreatic Fistula in High-Risk Patients

In patients with an elevated risk of postoperative pancreatic fistula after pancreatoduodenectomy, a 10-day course of extended antibiotics significantly reduced the occurrence of clinically relevant fistulas, as well as associated complications like infections and drain placements. Patients on extended antibiotics had a shorter hospital stay compared to those on standard perioperative antibiotics. These findings support the potential benefits of extended antibiotic therapy in mitigating complications and provide a foundation for further investigation.

Journal Article by Ocuin LM, Loftus A (…) Hardacre JM et 5 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Robot-Assisted and Transanal Techniques Reduce Permanent Stoma Rates in Rectal Cancer Surgery

In rectal cancer surgery, laparoscopic, robot-assisted, and transanal approaches were compared for permanent stoma rates. Among 1198 patients, laparoscopic surgery had a 40.1% stoma rate, while robot-assisted and transanal surgeries showed lower rates of 21.3% and 25.6%, respectively. For low anterior resection, robot-assisted and transanal techniques significantly reduced permanent stoma rates. However, complications affected 45.4% of stoma patients. This study highlights the potential benefits of robot-assisted and transanal techniques in minimizing permanent stomas after rectal cancer surgery.

Journal Article by Burghgraef TA, Geitenbeek RTJ (…) Consten ECJ et 3 al. in Surg Endosc

© 2023. The Author(s).

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Enhancing Robotic Surgical Training: OCHRA Validates Novice Surgeons’ Skill Progression

Novice robotic surgeons, undergoing a 5-day course on da Vinci® X and Xi systems, demonstrated improved basic robotic skills. Using Objective Clinical Human Reliability Analysis (OCHRA) alongside established tools, the study found OCHRA highly reliable and concurrently valid. Performance enhancement, evidenced by reduced errors, was consistent across all assessment tools. OCHRA’s detailed error analysis suggests its potential as a robust evaluation tool for basic robotic surgical skills, warranting further exploration in advanced procedures.

Journal Article by Gorard J, Boal M (…) Francis N et 2 al. in Surg Endosc

© 2023. Crown.

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Treatment Disparities in Stage I Colorectal Cancers: Screening vs. Non-Screening Detection

When it comes to treating stage I colorectal cancers (CRCs), those detected through screening tend to receive less invasive treatment compared to non-screen-detected cases. The study, based in the Netherlands, analyzed data from 2008 to 2020. Screen-detected stage I CRCs were more frequently at T1 than T2, emphasizing a notable difference in treatment approaches based on the mode of detection. This raises questions about the factors influencing varied treatment strategies for stage I CRCs within and outside screening programs.

Journal Article by Toes-Zoutenkijk E, Breekveldt ECH (…) van Leerdam ME et 5 al. in Endoscopy

The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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Recalibrating Drain Fluid Amylase Cutoffs for Safer Early Removal and Fewer Complications after Pancreatoduodenectomy

Researchers recalibrated drain fluid amylase (DFA) cutoffs for early removal post-pancreatoduodenectomy (PD) in a study of 267 patients. For low-risk patients, maintaining 100% sensitivity, DFA1 < 286 and DFA3 < 97 ensured no clinically relevant postoperative pancreatic fistulas (CR-POPF). In high-risk patients, DFA1 < 137 and DFA3 < 56 achieved 100% sensitivity. The recalibrated thresholds, implemented in a learning health system, provide institution-specific criteria for optimizing safe early drain removal after PD, potentially applicable to other centers.

Journal Article by Boyev A, Azimuddin A (…) Tzeng CD et 11 al. in J Gastrointest Surg

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

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Cutting Costs and Boosting Recovery: Perioperative APPs Slash Readmissions in Hepatopancreatobiliary Surgery

Dedicated perioperative Advanced Practice Providers (APPs) substantially decrease readmissions by almost 50%, saving $900 per case. Financially self-sustaining with 113 to 139 annual cases, these APPs prove pivotal in optimizing outcomes, minimizing resource utilization, and cost savings for high-volume hepatopancreatobiliary centers.

Journal Article by Smith SR, Blair CM (…) Sarmiento JM et 3 al. in J Am Coll Surg

Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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The Art of Branding in Surgery Departments

The Ohio State University Wexner Medical Center’s Department of Surgery shares insights on building a robust national brand. In a digital age flooded with health choices, establishing a standout brand is crucial. Focusing on mission, visual elements, voice, and consistent messaging, the department strategically promotes its renowned residency program, clinical excellence, and research prowess. This study unveils the tactics behind their success, offering a blueprint for surgery departments aiming to carve a distinctive national identity.

Journal Article by Balasubramanian C, Leemaster J, Basar P and Pawlik TM in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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