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Decline in Surgery for Advanced Rectal Cancer Raises Concerns About Guideline Adherence

A study using the National Cancer Database analyzed trends in the treatment of locally advanced rectal cancers. Researchers found that despite the traditional treatment approach involving surgery, there was a concerning decrease in the number of patients undergoing surgery, along with a rise in patients declining surgery. Several factors associated with forgoing surgery included older age, race, and lower income. The study underscores the need to address disparities and encourage guideline-concordant surgical care to ensure optimal treatment for rectal cancer patients.

Journal Article by Chen SY, Radomski SN (…) Atallah C et 5 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Endoscopic Quality Assurance in Greenland: Positive Results from Surgical Coastal Expeditions

Surgical coastal expeditions (SCEs) brought endoscopic services to small coastal hospitals in Greenland, aiming to increase patient accessibility and reduce transport costs. A review of 89 endoscopies during two SCEs revealed satisfactory cecal intubation rates, adenoma detection rates, and advanced adenoma detection rates. However, attention to bowel preparation was needed, considering Greenland’s specific eating habits. The study underscored the importance of ongoing quality monitoring and highlighted how SCEs contribute to eco-friendly healthcare by reducing the need for patient air transport.

Journal Article by Rasmussen L, Krzak JM (…) Szura M et 3 al. in Surg Endosc

© 2023. The Author(s).

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Section 1557 of the Affordable Care Act Falls Short in Improving Surgical Outcomes for Non-English Speakers

Section 1557 of the Affordable Care Act, which mandated the use of qualified language interpreters, had an unintended impact. A study analyzing surgical outcomes in non-English primary language speakers (N-EPL) found that after Section 1557’s implementation, N-EPL patients experienced increased mortality, post-operative complications, and non-routine discharges. Contrary to expectations, the regulation did not lead to improved surgical outcomes for N-EPL patients.

Journal Article by Bakillah E, Finn CB, Sharpe J and Kelz RR in Am J Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Age No Barrier to Oesophagogastric Resection Success

Researchers explored the impact of age on post-operative outcomes for patients undergoing resection for oesophageal and gastric cancer. They analyzed data from a cohort of 466 patients over nearly two decades. Patients over 75 faced slightly higher post-operative complications, primarily cardiac or thromboembolic issues, when undergoing oesophagectomy, but no significant difference in outcomes was observed for those undergoing gastrectomy. Overall, the study showed that older patients can successfully undergo these surgeries with acceptable morbidity and mortality rates.

Journal Article by Law C, Bhimani N (…) Smith G et 4 al. in World J Surg

© 2023. The Author(s).

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Enhancing Surgical Ward Rounds: Checklists and More

A systematic review delved into strategies to improve surgical ward rounds. Checklists, technology, personnel, and well-being interventions were among the methods studied. Checklists were the most prevalent and demonstrated significant enhancements in documentation, staff understanding, and patient satisfaction. Other interventions also improved communication, patient safety, and reduced patient stress. The findings highlight the potential of these approaches to elevate surgical ward round quality, with a call for further research on implementation ease and long-term impact on patient outcomes.

Review by He R, Bhat S (…) Wells CI et 4 al. in World J Surg

© 2023. The Author(s).

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Bariatric Surgery’s Varied Impact on Gastrointestinal Cancer Risk

In a study using U.S. National Inpatient Sample data from 2016 to 2020, researchers delved into the connection between bariatric metabolic surgery (BMS) and hospital admissions for gastrointestinal (GI) cancers. They found that BMS was linked to a higher risk of gastric and pancreatic cancer hospital admissions but a lower risk of colorectal and liver cancer admissions. The study suggested that the impact of BMS on GI cancer risk is complex, emphasizing the need for further research to fully understand this association and its implications.

Journal Article by Esparham A, Shoar S (…) Modukuru VR et 2 al. in Obes Surg

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

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Nurturing Resident Autonomy for Future Surgeons

A decline in surgical resident autonomy is evident, with data revealing a drop from 12.5% to 3.7% in independent surgeries from 2004 to 2019. Contrary to concerns, there’s no proof that resident autonomy negatively impacts outcomes. This viewpoint advocates for preserving and enhancing resident autonomy as a crucial goal for surgical educators. Empowering trainees with autonomy fosters their growth into capable, independent surgeons, ensuring a smoother transition to independent practice post-graduation.

Journal Article by Schwed AC, Chen KT and de Virgilio CM in JAMA Surg

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Gender Disparities in Surgical Practice Development

Early-career surgeons often grapple with practice development hurdles, contributing to high burnout rates and attrition. A study across five academic medical centers found that both men and women surgeons face barriers like competition and resource allocation. However, women surgeons additionally confront gender-based discrimination, unequal referrals, and more extensive demands. Gender concordance with patients and referrers aids women’s practice growth. The study suggests institutions must address structural issues and policies to boost practice development and equity, offering strategies for resource allocation transparency and promotion of fairness.

Journal Article by Finn CB, Syvyk S (…) Kelz RR et 9 al. in JAMA Surg

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Optimizing Morbidity and Mortality Conferences for Quality Improvement and Education

In their quest to refine morbidity and mortality conferences (MMCs), a treasure trove of 59 studies revealed valuable insights. These MMC makeovers, assessed through the Medical Education Research Study Quality Instrument, struck a harmonious balance. They spotlighted the significance of pre-conference groundwork and post-event follow-up for quality improvement. The MMC success formula includes concise case presentations, a nurturing atmosphere for discussion, and, equally vital, fostering accountability and engagement. This study carves a clear path for surgical departments to reshape MMCs, aligning them with the goals of enhancing education, error prevention, and quality improvement.

Journal Article by Beaulieu-Jones BR, Wilson S (…) Pernar LI et 4 al. in JAMA Surg

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Innovative Approach for Pancreatic Cancer Surgery Yields Promising Outcomes

A novel cranial-to-caudal approach (CC approach) for minimally invasive distal pancreatectomy (MIDP) in pancreatic cancer was examined. The study included 94 patients, with 23 undergoing the CC approach. This approach aimed to identify Gerota’s fascia from the cranial side of the pancreas and ensure complete tumor removal. Results revealed similar operation times, blood loss, and complication rates between the CC and non-CC groups. Notably, all CC approach patients achieved R0 resection. The study suggests the CC approach may become a standard for left-sided pancreatic cancer surgeries.

Journal Article by Nakata K, Abe T (…) Nakamura M et 7 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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