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Positive Experience Found in Surgeons’ Perceptions of Online Surgical-Focused Learning During the COVID Pandemic

During the COVID pandemic, many surgeons and surgical trainees had a positive experience with online surgical-focused learning, according to a scoping review. The review included 44 studies, with the majority focused on the perception of newly developed e-learning platforms and surgeons’ attitudes towards remote learning. The United States was the most represented country, and general surgery was the most common surgical specialty. These findings suggest that the positive experiences reported may lead to the development and evaluation of more blended learning curriculums in the future.

Review by McHugh SM, Kheirelseid E, Hyde S and Conway PF in Surgeon

Copyright © 2023 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

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Conservative management as effective as surgery in uncomplicated symptomatic gallstone disease: C-GALL trial

The C-GALL trial compared conservative management with laparoscopic cholecystectomy in adults with uncomplicated symptomatic gallstone disease. After 18 months, there was no significant difference in quality of life between the two groups. Furthermore, conservative management was found to be less costly and there was no significant difference in quality-adjusted life years. The study suggests that in the short term, conservative management could be considered as an alternative to surgery for these patients.

Journal Article by Ahmed I, Hudson J (…) Ramsay C et 14 al. in BMJ

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. No commercial re-use. See rights and permissions. Published by BMJ.

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Neoadjuvant Docetaxel-Based Chemotherapy Followed by En Bloc Resection: Effective Treatment for Locally Advanced Esophageal Adenocarcinoma with Comparable Survival Outcomes

Neoadjuvant docetaxel-based chemotherapy followed by en bloc resection is an effective treatment for locally advanced esophageal adenocarcinoma. Results from a 15-year retrospective analysis showed that both docetaxel/cisplatin/5FU and 5FU/leucovorin/oxaliplatin/docetaxel regimens achieved similar survival outcomes. A high percentage of patients completed the neoadjuvant cycles, and the majority achieved an R0 resection. Although the median lymph node yield was 32 and 60.6% of patients had positive lymph nodes, overall survival was comparable between the treatment groups.

Journal Article by Tankel J, Ahmed N (…) Ferri L et 16 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Unhoused Patients Experience Numerous Challenges in Surgical Care

Unhoused patients face significant barriers in receiving surgical care, leading to poorer outcomes compared to the general population. This qualitative analysis of 26 interviews with clinicians revealed five key themes: challenges in meeting preoperative requirements, housing status influencing minor care decisions, negative postoperative experiences for unhoused patients, imperfect discharge options leading to inadequate postoperative care, and communication difficulties between surgeons and non-surgeons. Clinicians reported utilizing both formal and informal methods to mitigate these challenges, underscoring the need for interventions to improve surgical care access for this vulnerable group.

Journal Article by Decker H, Raguram M (…) Wick E et 2 al. in BMC Surg

Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.

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Robotic Approach for Ventral Hernia Repair Lowers Wound Morbidity in High-Risk Patients

A propensity score analysis was conducted using the abdominal core health quality collaborative (ACHQC) database to evaluate the impact of robotic approach on wound morbidity in high-risk patients undergoing retromuscular ventral hernia repair. After matching patients for each approach, it was found that the robotic approach resulted in decreased rates of surgical site infections (SSIs) and surgical site occurrences requiring procedural intervention (SSOPI) compared to open repair. Although seroma rates were higher in patients who developed surgical site occurrences, the robotic approach demonstrated improved wound morbidity in this high-risk patient population.

Journal Article by Gaskins J, Huang LC, McPhail L and O’Connor S in Surg Endosc

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

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Risk-stratified Pathways Improve Post-Hepatectomy Outcomes

Risk-stratified post-hepatectomy pathways (rsphps) were analyzed in a study of 1,354 patients. The pathways effectively stratified hepatectomy patients based on their risk of early postoperative events. The results showed that post-pathway implementation led to shorter hospital stays and decreased the need for readmission and interventional radiology procedures. rsphps can reliably predict the most frequent time period for these events, providing personalized discharge planning for patients undergoing hepatectomy.

Journal Article by Martin AN, Newhook TE (…) Tzeng CD et 8 al. in Am J Surg

Copyright © 2023. Published by Elsevier Inc.

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Incidentally detected T2 gallbladder cancer associated with poorer outcomes compared to upfront surgery

Incidentally detected T2 gallbladder cancer (pt2 GBC) has been found to have significantly worse outcomes compared to similarly staged patients who undergo upfront radical cholecystectomy. A retrospective analysis of 425 cases revealed that patients with incidentally detected tumors had higher rates of locoregional, liver, and abdominal wall recurrences. The five-year disease-free survival rate was lower in the incidentally detected group. These findings highlight the importance of early detection and prompt treatment for better outcomes in pt2 GBC.

Journal Article by Patkar S, Kunte A, Chaudhari V and Goel M in J Surg Oncol

© 2023 Wiley Periodicals LLC.

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Comparison of outcomes between re-resected incidental gallbladder carcinoma and primary gallbladder carcinoma

Patients with re-resected incidental gallbladder carcinoma (rrigbc) had better prognosis and were at earlier tumor stage compared to those with primary radically resected gallbladder carcinoma (prgbc). Subgroup analysis revealed similar outcomes for patients with T1-2 tumors in both groups. However, patients with T3-4 tumors in the prgbc group had significantly worse prognosis. Incidental gallbladder carcinoma (igbc) was found to be a prognostic factor, but tumor stage played a more significant role in determining overall prognosis.

Journal Article by Lv TR, Liu F, Jin YW and Li FY in Langenbecks Arch Surg

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Calcium Channel Blockers Improve Survival in Pancreatic Cancer Patients Receiving Neoadjuvant Chemotherapy

Calcium channel blockers (CCB) were found to be associated with improved overall survival in pancreatic cancer patients undergoing neoadjuvant chemotherapy and resection. A retrospective study of 6,223 patients showed that CCB prescription was specifically beneficial in the subgroup receiving neoadjuvant chemotherapy, reflecting the chemosensitizing effect observed in laboratory studies. These findings suggest that patients receiving neoadjuvant chemotherapy could be a target population for prospective clinical trials of CCB in pancreatic cancer. This repurposing approach holds promise for more efficient, cost-effective, and safe oncological treatments.

Journal Article by Fong ZV, Severs G (…) Tingle S et 3 al. in HPB (Oxford)

Copyright © 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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Higher likelihood of non-home discharge in pancreatic cancer patients aged 80 years and above

In a study analyzing pancreatic cancer patients aged 80 years and above, it was found that non-home discharge after pancreatoduodenectomy (PD) was more than twice as likely to occur in this age group compared to those aged 65-79 years. Comorbidity factors such as COPD, hypertension, heart failure, and lower preoperative albumin were significantly associated with non-home discharge. Other factors included older age, female gender, higher ASA classification, preoperative dependent functional status, and transfer origin before PD. These findings suggest delayed or decreased return to baseline functional status for patients aged 80 years and above after PD.

Journal Article by Chumdermpadetsuk RR, Garland M (…) Kent TS et 2 al. in HPB (Oxford)

Copyright © 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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