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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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A Decade of Robotic Hepatectomies: Learning Curve and Outcomes

Over a 10-year span, a medical center’s experience with 100 major robotic liver resections was examined, showing the evolution of robotic surgery. The study found no significant differences in key parameters like operative time, blood loss, length of hospital stay, 90-day readmission, major complications, and mortality between early and late cases. Notably, the study revealed a learning curve, with improved ICU admission rates and higher difficulty indices in the latter half of the cases. This suggests that developing a successful robotic liver program is achievable over time, with the institutional learning curve stabilizing after approximately 50 cases.

Journal Article by McCarron F, Cochran A (…) Martinie J et 5 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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Quality of Care in Appendicitis: Regional Hospitals Outperform Tertiary Care Centers

A comparative study of 2,158 adult appendicitis patients in different hospital settings revealed notable differences in surgical outcomes. Patients in tertiary care hospitals experienced longer surgical waiting times, increased surgical delays, longer operation times, higher rates of appendix perforation, and greater hospital costs compared to those in regional hospitals. Factors linked to surgical delays were the hospital type and delayed diagnosis, while postoperative complications were associated with older age, male sex, surgical delay, and appendix perforation. The study suggests the need for an efficient referral system to enhance patient care and reduce medical costs.

Journal Article by Hsiao YW, Hsiao CY (…) Chen PY et 2 al. in World J Surg

© 2023. The Author(s) under exclusive licence to Société Internationale de Chirurgie.

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Transverse Coloplasty Pouch Improves Bowel Function After Rectal Cancer Surgery

Researchers compared two surgical techniques for rectal cancer patients who underwent intersphincteric resection (ISR): transverse coloplasty pouch (TCP) and straight coloanal anastomosis (SCAA). While oncological outcomes were similar, the study found that two years after ileostomy closure, the TCP group had significantly less major low anterior resection syndrome (LARS) and better Wexner scores compared to the SCAA group. TCP was identified as an independent factor in preserving postoperative bowel function. This suggests that TCP is a safer choice for reducing bowel dysfunction in low rectal cancer patients after ISR.

Journal Article by Pan H, Zhao Z (…) Huang S et 4 al. in J Gastrointest Surg

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

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Routine Visceral Branch Resection in Rectal Cancer Lymph Node Dissection: Safe and Efficient

Researchers investigated the safety and feasibility of a modified lymph node dissection (LLND) in mid-low-lying rectal cancer, involving routine resection of visceral branches of internal iliac vessels. The study compared two groups: one with routine resection (RVR) and one without (NVR). The RVR group saw reduced operative times without a significant difference in postoperative complications or the number of lateral lymph nodes harvested compared to the NVR group. This suggests that LLND with routine visceral branch resection is safe and feasible, offering no major complications or long-term urinary issues.

Journal Article by Xiao J, Zhang X (…) Wang Z et 4 al. in J Surg Oncol

© 2023 Wiley Periodicals LLC.

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Review Finds Combination of Mechanical Devices More Effective for Preventing VTE After Surgery

A systematic review compared the effectiveness of mechanical prophylaxis devices in preventing venous thromboembolism (VTE) during and after surgery. The study included 14 articles and found that intermittent pneumatic compression (IPC) was superior to graduated compression stockings (GCS) when used alone. Additionally, a combination of IPC and GCS showed greater efficacy compared to GCS alone, especially in high-risk patients. While IPC had a better safety profile, compliance was lower. The study suggests further high-quality research is needed, particularly in high-risk surgical settings where pharmacological prophylaxis is not an option.

Review by Herring B, Lowen D, Ho P and Hodgson R in Langenbecks Arch Surg

© 2023. The Author(s).

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