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Remote Triage of General Surgery Patients in Freestanding Emergency Departments: Low Undertriage and Overtriage Rates

During a 6-year analysis, this study examined the outcomes of general surgery patients who received remote triage and disposition in freestanding emergency departments. Of the 1,105 patients, 15% were discharged home, 27% were transferred to trauma centers, and 58% were transferred to community hospitals. Patients admitted to trauma centers were older and had higher acuity pathology, while those admitted to community hospitals had higher operative rates with shorter lengths of stay and lower 30-day readmission and mortality rates. The study found low rates of undertriage and overtriage, indicating appropriate triage practices.

Journal Article by Jensen S, Baimas-George M (…) Schiffern L et 5 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Learning curve affects long-term quality of life after McKeown minimally invasive esophagectomy

The study investigated the impact of the learning curve on the long-term quality of life (QoL) of esophageal cancer survivors who underwent McKeown minimally invasive esophagectomy (MIE). The results showed that patients in the experienced learning phase had better QoL outcomes, with significant improvements in functional scales and symptom scales related to respiratory and digestive systems. Patients in the initial learning phase experienced more symptoms and a deterioration in long-term QoL, highlighting the importance of expertise and attention during MIE procedures.

Journal Article by Bao T, Chen P (…) Guo W 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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Advancements in the treatment of soft tissue sarcomas: A comprehensive update

Emerging innovations and advancements in the treatment of extremity and truncal soft tissue sarcomas are explored in this special edition update. The study covers classifications, emerging technologies, prognostic tools, radiation schemas, and treatment disparities. The results emphasize the importance of enhancing local control and reducing complications through innovative imaging, surgical guidance, and hypofractionated radiation. Additionally, advancements in systemic and immunotherapeutic treatments are reviewed. The study identifies disparities that affect this vulnerable population, and highlights the need for improved overall patient care.

Review by Walker K, Simister SK (…) Randall RL et 3 al. in J Surg Oncol

© 2023 Wiley Periodicals LLC.

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Increased Incidence of Gastrostomy Tube Placement in Surgical Necrotizing Enterocolitis

Approximately 56.3% of infants with surgical necrotizing enterocolitis (NEC) required gastrostomy tube (GT) placement after ostomy reversal. GT placement may be safely performed concurrently with ostomy reversal, reducing the need for an additional procedure. Gestational age and birth weight did not significantly differ between patients who did and did not require GT placement. The hospital length of stay was longer in the GT group, but the time from ostomy reversal to hospital discharge was shorter when performed concurrently with GT. No significant differences were observed in short-term or long-term GT-related complications.

Journal Article by Vaughn AE, Lyttle BD (…) Gien J et 3 al. in J Surg Res

Copyright © 2023 Elsevier Inc. All rights reserved.

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Comparison of Laparoscopic Parastomal Hernia Repair Techniques: Keyhole, Sugarbaker, Sandwich, and Hybrid

Parastomal hernia, a common complication after stoma formation, has been treated using various minimally invasive techniques. However, the optimal technique remains unclear. In this updated systematic review and meta-analysis, researchers analyzed 33 studies involving 1289 patients to compare the outcomes of four commonly used techniques. The keyhole technique showed the highest incidence of complications and recurrences, followed by the Sugarbaker technique. The 3D mesh technique had the shortest operative time, while the keyhole technique resulted in the shortest hospital stay. Although no definitive conclusion was reached, newer minimally invasive techniques showed promising results for parastomal hernia repair.

Journal Article by Kritharides N, Papaconstantinou D (…) Dimitroulis D et 4 al. in Langenbecks Arch Surg

© 2023. The Author(s).

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Identification of Lymph Node Stations Relevant to Pancreatic Cancer Using Sectioned Images and 3D Models

Researchers utilized true color and high-resolution sectioned images of a cadaver with pancreatic cancer to enhance the understanding of lymph node stations in pancreatic cancer surgery. Through the images and 3D models, they successfully identified 21 out of the known 28 lymph node stations based on location, size, and color. The remaining five stations were not clearly identified, while two near the splenic artery could not be distinguished from cancer tissue. The shape and location of lymph node stations were confirmed using surface models.

Journal Article by Kim CY, Jung Y and Park JS in J Korean Med Sci

© 2023 The Korean Academy of Medical Sciences.

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Healthcare Professionals Face Challenges in Making Surgical Oncology Decisions and Delivering COVID-19-Safe Care

A qualitative study on healthcare professionals’ experiences during the COVID-19 pandemic found that the redirection of medical attention towards COVID-19-affected patients had a significant impact on cancer service provision. The study identified three main challenges faced by healthcare professionals: multi-disciplinary team processes affected by limited in-person examination, increased complexity in surgical practice due to personal protective equipment, and the need for increased workload and decreased training time to deliver COVID-safe care. The study suggests integrating telemedicine into post-pandemic care to reduce workload and enhance training opportunities.

Journal Article by Shah S, Kapur A (…) Pompili C et 3 al. in Acta Chir Belg

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Identification of High-Risk Features for Residual Carcinoma in Esophageal Adenocarcinoma Patients

Esophageal cancer patients treated with neoadjuvant chemoradiation followed by esophagectomy were examined to identify high-risk predictors of residual carcinoma. The study found that the presence of stricture, positive biopsy, signet ring cell histology, and a maximum standardized uptake value (SUV max) >5.4 in the absence of esophagitis were associated with residual cancer. External validation confirmed these high-risk factors, indicating that esophagectomy should not be delayed in patients with these features.

Journal Article by Bayley EM, Ivy ML (…) Swisher SG et 14 al. in Ann Surg

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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Impact of Persistent Poverty on Cancer Diagnosis, Treatment, and Survival

Disparities in cancer outcomes were found in counties with persistent poverty since 1980, significantly affecting diagnosis, surgical resection, and survival rates for patients with non-small cell lung (nsclc), breast, and colorectal cancer. Patients in persistent poverty were more likely to present with advanced disease, less likely to undergo surgery, and had increased cancer-specific mortality compared to those without poverty. These effects were less pronounced in counties with current poverty and disappeared in counties that were no longer in poverty. Addressing persistent poverty could be a strategy to reduce disparities in cancer care and outcomes.

Journal Article by Papageorge MV, Woods AP (…) Sachs TE et 5 al. in Ann Surg

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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Improvement in Neighborhood Deprivation Exacerbates Surgical Disparities

A study examining the association between neighborhood deprivation and postoperative outcomes for Medicare beneficiaries found that while lower neighborhood deprivation is linked to improved outcomes for both white and black patients, the benefits disproportionately favor white patients. White beneficiaries experienced a significant decrease in mortality, complication rates, and readmission rates as neighborhood deprivation decreased. In contrast, black beneficiaries saw smaller improvements. The study highlights the potential disparate health impacts of neighborhood improvements and challenges the misconception of the protective effect of higher social class for black patients.

Journal Article by Diaz A, Valbuena VSM, Dimick JB and Ibrahim AM in Ann Surg

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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