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Factors Influencing Delayed Discharge in Enhanced Recovery after Bariatric Surgery

Patient and operative factors were examined to identify reasons for delayed discharge following bariatric surgery in an enhanced recovery setting. The study found that patient characteristics, such as ethnicity, did not significantly impact length of stay. Furthermore, the type of surgery, whether primary or revisional, did not affect discharge time. However, operations performed by trainee surgeons under consultant supervision were more likely to result in a quicker discharge. Unfortunately, logistic regression analysis was unable to predict patients with prolonged stays.

Journal Article by Katz-Summercorn AC, Arhi C (…) Al-Taan O et 14 al. in Surg Obes Relat Dis

Crown Copyright © 2023. Published by Elsevier Inc. All rights reserved.

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Entrustable Professional Activities in General Surgery Residency: Validity and Correlations with Milestones

Results from a national pilot study conducted at 28 general surgery programs revealed a moderate to strong positive correlation between entrustable professional activities (EPAs) and milestone subcompetencies. EPAs related to specific surgical procedures showed similar correlation values, while EPAs focusing on diagnosis and communication had higher correlations. Patient care, medical knowledge, and communication milestones were also positively correlated with EPAs. These findings suggest that EPAs are valid assessments in general surgery and can inform milestone ratings by clinical competency committees.

Journal Article by Montgomery KB, Mellinger JD (…) Lindeman B et 8 al. in J Am Coll Surg

Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Operating Room Supply Cost and Value of Care Improved by Sustainable Quality Intervention

Implementation of an automated, sustainable quality improvement intervention significantly reduced operating room supply costs without compromising patient outcomes. Median costs per case decreased, and the incidence of out-of-control cases was lower, demonstrating enhanced value of care. The intervention, utilizing a data pipeline, involved sharing performance data with surgeons, enabling modifications to supply instructions, resulting in improved resource use and cost-effectiveness.

Journal Article by Filiberto AC, Loftus TJ (…) Upchurch GR et 5 al. in J Am Coll Surg

Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Neoadjuvant Therapy Positively Impacts Pancreatic Cancer Treatment

The utilization of neoadjuvant therapy (nat) for pancreatic cancer varied widely among the United States, Canada, Germany, the Netherlands, and Sweden. However, the overall use of nat increased by 26% from 2018 to 2020. Nat was associated with improved short-term outcomes, including reduced rates of serious morbidity, pancreatic fistulae, and reoperations, as well as increased ideal outcomes. The study suggests that the introduction and increased adoption of neoadjuvant therapy have positively impacted the treatment of pancreatic cancer.

Journal Article by Davis CH, Augustinus S (…) Pitt HA et 14 al. in J Am Coll Surg

Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Calorie-restricted DASH diet improves weight loss and body composition in post-bariatric patients with weight regain.

Post-bariatric patients experiencing weight regain benefitted more from a 16-week low-calorie DASH diet than a low-calorie diet alone. The DASH group showed superior improvements in weight loss, body mass index, and fat mass reduction, compared to the control group. Both interventions led to significant reductions in anthropometric and body composition parameters, while changes in blood glucose, insulin, and HOMA-IR did not significantly differ between the groups.

Journal Article by Rashidbeygi E, Tabesh MR (…) Jahromi SR et 4 al. in Obes Surg

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Impact of neoadjuvant therapy on nodal harvest in clinical stage III rectal cancer: Optimum cut-offs for nodal staging

The study investigated the impact of neoadjuvant therapy on nodal harvest in clinical stage III rectal cancer. The current standard of a minimum lymph node harvest (lnh) of 12 for appropriate nodal staging in resectable rectal cancer was challenged as neoadjuvant therapy led to a decrease in the number of lnh. The results showed that the optimal lnh to achieve accurate nodal staging varied depending on the tumor response to neoadjuvant therapies, highlighting the need for individualized criteria for nodal evaluation.

Journal Article by Wehrle CJ, Woo K (…) Naffouje SA et 8 al. in J Surg Oncol

© 2024 Wiley Periodicals LLC.

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A Precise Robotic Technique Enhances Outcomes and Reduces Costs for Low Anterior Resection

Researchers present a novel robotic-assisted approach for intracorporeal rectal transection and hand-sewn anastomosis in low anterior resection. This technique addresses limitations of conventional methods by utilizing the advantages of the robotic platform, ensuring standardized exposure during rectal transection, and recognizing the significance of avoiding staple-related complications. The innovation holds promise to significantly improve patient outcomes and reduce costs for individuals with lower rectal tumors.

Journal Article by Stevanato Filho PR, Bezerra TS (…) Aguiar S et 5 al. in J Surg Oncol

© 2024 The Authors. Journal of Surgical Oncology published by Wiley Periodicals LLC.

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Socioeconomic and Racial Privilege Linked to Improved Postoperative Outcomes in Medicare Beneficiaries

Among 1,885,889 Medicare beneficiaries included in the study, those residing in areas of higher privilege had lower chances of experiencing surgical complications, prolonged length of stay, 90-day readmission, and 90-day mortality. Moreover, individuals in the most privileged areas had a 19% increased odds of achieving a textbook outcome following surgery and a 6% reduction in Medicare expenditures compared to those in the least privileged areas. These findings highlight the impact of privilege on disparities in surgical care.

Journal Article by Munir MM, Lima HA (…) Pawlik TM et 8 al. in J Surg Res

Copyright © 2023 Elsevier Inc. All rights reserved.

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Study Finds Significant Variation in Hospital Performance After Colorectal Cancer Surgery

Significant variations in hospital performance after colorectal cancer surgery were observed in a Dutch population-based study. The study analyzed data from over 44,000 colorectal cancer patients and found that two hospitals performed worse than expected in terms of 90-day mortality, while significant outliers were observed for anastomotic leakage in both colon cancer and rectal cancer cohorts. Lower case volume was significantly associated with anastomotic leakage in colon cancer patients. The study suggests that concentrating care may improve outcomes by enhancing individual surgical performance and optimizing care pathways, regardless of teaching status.

Journal Article by Greijdanus NG, van Erning FN (…) Vissers PAJ et 3 al. in Eur J Surg Oncol

© 2023 Published by Elsevier Ltd.

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Prophylactic Hyperthermic Intraperitoneal Chemotherapy Improves Prognosis in CT4N0-1M0 Colorectal Cancer

A propensity score matching study analyzed 220 colorectal cancer patients undergoing treatment in China. Prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) was associated with improved 3-year disease-free survival (DFS) compared to no HIPEC (HR 0.43). However, this benefit was not observed in patients with CT4N2M0 cancer. Laparoscopic surgery followed by HIPEC did not increase the risk of peritoneal metastasis. The study suggests that HIPEC may be an effective and safe curative treatment for selected patients with restricted peritoneal metastasis from colorectal cancer.

Journal Article by Zheng Y, Zhang J (…) Sun L et 11 al. in Eur J Surg Oncol

© 2024 Published by Elsevier Ltd.

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