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gastroenterology vs surgery

Hiroyuki Konno, Kinji Kamiya, Hirotoshi Kikuchi, Hiroaki Miyata, Norimichi Hirahara, Mitsukazu Gotoh, Go Wakabayashi, Tetsuo Ohta, Norihiro Kokudo, Masaki Mori, Yasuyuki Seto
PURPOSE: The aim of this study is to evaluate the association between the participation of board-certified surgeons in gastroenterological surgery (BCS-Gs) and the surgical outcomes of gastroenterological surgery. METHODS: Data from the National Clinical Database on patients who underwent eight major gastroenterological procedures were analyzed retrospectively. First, the ratio of cases in which BCS-G were involved to the total cases was calculated for each procedure, and the impact of BCS-G involvement on surgical outcome was assessed by comparing mortality rates in the group with BCS-G involvement vs...
September 29, 2016: Surgery Today
Gary L Freed, Erin Turbitt, Amy Allen
Objectives The aim of the present study was to provide data to help clarify the public-private division of clinical care provision by doctors in Australia.Methods A secondary analysis was performed of data from the workforce survey administered by the Australian Health Practitioner Regulation Agency. The questionnaire included demographic and employment questions. Analysis included frequency distributions of demographic variables and mean and median calculations of employment data. Data were analysed from those currently employed in eight adult specialities chosen to provide a mix of surgical and medical fields...
September 5, 2016: Australian Health Review: a Publication of the Australian Hospital Association
Adam B Goldin, Kurt F Heiss, Matt Hall, David H Rothstein, Peter C Minneci, Martin L Blakely, Marybeth Browne, Mehul V Raval, Samir S Shah, Shawn J Rangel, Charles L Snyder, Charles D Vinocur, Loren Berman, Jennifer N Cooper, Marjorie J Arca
OBJECTIVES: To define the incidence of 30-day postdischarge emergency department (ED) visits and hospital readmissions following pediatric gastrostomy tube (GT) placement across all procedural services (Surgery, Interventional-Radiology, Gastroenterology) in 38 freestanding Children's Hospitals. STUDY DESIGN: This retrospective cohort study evaluated patients <18 years of age discharged between 2010 and 2012 after GT placement. Factors significantly associated with ED revisits and hospital readmissions within 30 days of hospital discharge were identified using multivariable logistic regression...
July 2016: Journal of Pediatrics
Toshie Tsuchida, Yoshio Takesue, Kaoru Ichiki, Takashi Uede, Kazuhiko Nakajima, Hiroki Ikeuchi, Motoi Uchino
BACKGROUND: There have been several recent studies on the correlation between intra-operative hypothermia and the occurrence of surgical site infection (SSI). Differences in the depth and timing of hypothermia and the surgical procedure may have led to conflicting results. METHODS: Patients undergoing gastroenterologic surgery with a duration of >3 h were analyzed. Hypothermia was defined as a core temperature <36°C and was classified as mild (35.5-35.9°C), moderate (35...
October 2016: Surgical Infections
R P Jones, N A Stylianides, A G Robertson, V S K Yip, G Chadwick
INTRODUCTION: Gastrointestinal (GI) endoscopy is an important skill for both gastroenterologists and general surgeons but concerns have been raised about the provision and delivery of training. This survey aimed to evaluate and compare the delivery of endoscopy training to gastroenterology and surgical trainees in the UK. METHODS: A nationwide electronic survey was carried out of UK gastroenterology and general surgery trainees. RESULTS: There were 216 responses (33% gastroenterologists, 67% surgeons)...
July 2015: Annals of the Royal College of Surgeons of England
Matthew R Williams, Joanna R Crossett, Elaine M Cleveland, Charles P Smoot, Kanayochukwu J Aluka, Lisa C Coviello, Kurt G Davis
BACKGROUND: In 2011, multiple gastroenterology societies published a position statement expressing concern over the American Board of Surgery guidelines regarding endoscopy education. Their position asserted that the American Board of Surgery's guidelines were inadequate to produce competency and the requirements should be similar to those adopted by the American Society for Gastrointestinal Endoscopy. This assertion failed to take into account the increasing use of simulation in surgical and endoscopic education...
July 2015: Journal of Surgical Education
Krzysztof Szmyt, Krokowicz Łukasz, Adam Bobkiewicz, Bartosz Cybułka, Witold Ledwosiński, Maciej Gordon, Ahmed Alammari, Tomasz Banasiewicz, Michał Drews
UNLABELLED: Open abdomen technique is a surgical treatment in which the fascia and skin are left open in order to reduce the value of the intra-abdominal pressure. According to the World Society of the Abdominal Compartment Syndrome (WSACS) normal values of the intra-abdominal pressure are between 5 and 7 mm Hg. Intra-abdominal hypertension occurs when the pressure value is equal to or exceeds 12 mm Hg. The aim of the study was to compare the results of the open abdomen treatment using standard methods and negative pressure wound therapy...
January 2015: Polski Przeglad Chirurgiczny
Hisaharu Oya, Masahiko Koike, Naoki Iwata, Daisuke Kobayashi, Koji Torii, Yukiko Niwa, Mitsuro Kanda, Chie Tanaka, Suguru Yamada, Tsutomu Fujii, Goro Nakayama, Hiroyuki Sugimoto, Shuji Nomoto, Michitaka Fujiwara, Yasuhiro Kodera
BACKGROUND: Nutritional support influences the outcome of gastroenterological surgery, and enteral nutrition effectively mitigates postoperative complications in highly invasive surgery such as resection of esophageal cancer. However, feeding via jejunostomy can cause complications including mechanical obstruction, which could be life threatening. From 2009, we began enteral feeding via duodenostomy to reduce the likelihood of complications. In this study, we compared duodenostomy with the conventional jejunostomy feeding, mainly looking at the catheter-related complications...
May 2015: World Journal of Surgery
Odo Gangl, Uwe Fröschl, Reinhold Függer
BACKGROUND: Although age is no contraindication for pancreatic cancer resections, there are conflicting reports of morbidity and mortality rates and only few data showing direct comparisons of survival for octogenarians and patients younger than 80 years. METHODS: Comparison of complication, reintervention, reoperation, and 30-day in-hospital mortality rates, length of stay, and survival of all octogenarians and patients younger than 80 years undergoing pancreatectomy for ductal adenocarcinoma during the study period from 2001 to 2010 was done...
December 2014: Wiener Klinische Wochenschrift
A Aziz Aadam, Sachin Wani, Charles Kahi, Tonya Kaltenbach, Young Oh, Steven Edmundowicz, Jie Peng, Alfred Rademaker, Swati Patel, Vladimir Kushnir, Mukund Venu, Roy Soetikno, Rajesh N Keswani
OBJECTIVES: The management of complex colorectal polyps varies in practice. Accurate descriptions of the endoscopic appearance by using a standardized classification system (Paris classification) and size for complex colon polyps may guide subsequent providers regarding curative endoscopic resection vs. need for surgery. The accuracy of this assessment is not well defined. Furthermore, the factors associated with decisions for endoscopic vs. surgical management are unclear. To characterize the accuracy of physician assessment of polyp morphology, size, and suspicion for malignancy among physician subspecialists performing colonoscopy and colon surgery...
September 2014: American Journal of Gastroenterology
Elisabetta Buscarini, Dario Conte, Renato Cannizzaro, Franco Bazzoli, Michele De Boni, Gianfranco Delle Fave, Fabio Farinati, Paolo Ravelli, Pier Alberto Testoni, Manola Lisiero, Paolo Spolaore
In 2011 the three major Italian gastroenterological scientific societies (AIGO, the Italian Society of Hospital Gastroenterologists and Endoscopists; SIED, the Italian Society of Endoscopy; SIGE, the Italian Society of Gastroenterology) prepared their official document aimed at analysing medical care for digestive diseases in Italy, on the basis of national and regional data (Health Ministry and Lombardia, Veneto, Emilia-Romagna databases) and to make proposals for planning of care. Digestive diseases were the first or second cause of hospitalizations in Italy in 1999-2009, with more than 1,500,000 admissions/year; however only 5-9% of these admissions was in specialized Gastroenterology units...
July 2014: Digestive and Liver Disease
Mitchell S Cappell, Kathleen Dass, Palaniappian Manickam
AIM: To quantitatively describe the syndrome of Mallory-Weiss tears associated (MWa) with antecedent transesophageal echocardiography (TEE) as a distinct syndrome. METHODS: Cases of MWa were identified by comprehensive, computerized literature search via PubMed and review of textbooks and monographs on TEE and gastroenterology. Statistical comparison of 17 identified MWa cases versus previously published series of 73 cases of Mallory-Weiss tears unassociated with TEE (MWu) was performed...
October 2014: Digestive Diseases and Sciences
Thomas D Walters, Mi-Ok Kim, Lee A Denson, Anne M Griffiths, Marla Dubinsky, James Markowitz, Robert Baldassano, Wallace Crandall, Joel Rosh, Marian Pfefferkorn, Anthony Otley, Melvin B Heyman, Neal LeLeiko, Susan Baker, Stephen L Guthery, Jonathan Evans, David Ziring, Richard Kellermayer, Michael Stephens, David Mack, Maria Oliva-Hemker, Ashish S Patel, Barbara Kirschner, Dedrick Moulton, Stanley Cohen, Sandra Kim, Chunyan Liu, Jonah Essers, Subra Kugathasan, Jeffrey S Hyams
BACKGROUND & AIMS: Standard therapy for children newly diagnosed with Crohn's disease (CD) includes early administration of immunomodulators after initial treatment with corticosteroids. We compared the effectiveness of early (≤3 mo after diagnosis) treatment with an anti-tumor necrosis factor (TNF)α with that of an immunomodulator in attaining clinical remission and facilitating growth of pediatric patients. METHODS: We analyzed data from the RISK study, an observational research program that enrolled patients younger than age 17 diagnosed with inflammatory (nonpenetrating, nonstricturing) CD from 2008 through 2012 at 28 pediatric gastroenterology centers in North America...
February 2014: Gastroenterology
K Büsch, J F Ludvigsson, K Ekström-Smedby, A Ekbom, J Askling, M Neovius
BACKGROUND: Regional studies on inflammatory bowel disease (IBD) suggest an increasing prevalence over time, but no nationwide estimate has been published so far. AIM: To estimate the IBD prevalence in 2010 in Sweden overall, by disease, and in specific patient segments. METHODS: Patients were identified according to international classification codes for ulcerative colitis and Crohn's disease in in-patient care (1987-2010), day surgery and nonprimary out-patient care (1997-2010) in the nationwide Swedish Patient Register...
January 2014: Alimentary Pharmacology & Therapeutics
Guo-ju Wu, Gang Xiao, Xin-ping Zhou, Gang Zhao, Wen-zhuo Jia, Tao Yu, Qi An, Hua Yang, Hai-kong Long, Mei-xiong Huang
OBJECTIVE: To explore the feasibility of laparoscopic with extralevator abdominoperineal excision (LELAPE group) for low rectal cancer. METHODS: From June 2011 to January 2013, 35 patients with low rectal cancer undergoing laparoscopic abdominoperineal excision at the Department of Gastroenterological Surgery, Beijing Hospital were analyzed retrospectively. Among them, 20 received laparoscopic abdominoperineal excision (LAPE group). There were 12 males and 8 females with an average age of (63 ± 6) years old...
June 25, 2013: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Omar Hyder, Rebecca M Dodson, Hari Nathan, Joseph M Herman, David Cosgrove, Ihab Kamel, Jean-Francois H Geschwind, Timothy M Pawlik
BACKGROUND: Patterns of care of physician specialists may differ for patients with hepatocellular carcinoma (HCC). Reasons underlying variations are poorly understood. One source of variation may be disparate referral rates to specialists, leading to differences in cancer-directed treatments. STUDY DESIGN: Surveillance, Epidemiology, and End Results (SEER)-linked Medicare database was queried for patients with HCC, diagnosed between 1998 and 2007, who consulted 1 or more physicians after diagnosis...
November 2013: Journal of the American College of Surgeons
Henry A Pitt, Stuart Sherman, Matthew S Johnson, Andrew N Hollenbeck, Jonathan Lee, Michael R Daum, Keith D Lillemoe, Glen A Lehman
OBJECTIVE: The objectives of this analysis were to compare the outcomes of bile duct injuries by specialist over time and the role of management timing and biliary stents. BACKGROUND: Postoperative bile duct injuries require multidisciplinary management. In recent years, advancements have occurred in patient evaluation and in timing and type of therapy. METHODS: A multidisciplinary team managed 528 patients over 18 years. Mean age was 52 years; 69% were women and 95% had a cholecystectomy and/or bile duct exploration...
September 2013: Annals of Surgery
S D Chowdhury, A Chacko, B S Ramakrishna, A K Dutta, J Augustine, A K Koshy, E G Simon, A J Joseph
OBJECTIVE: To evaluate the etiology, presentation, complications and management of chronic pancreatitis in children. DESIGN: Retrospective chart review. SETTING: Gastroenterology department at Christian Medical College and Hospital, Vellore, India between January 2005 and December 2010. PARTICIPANTS: 99 Children (>18 yrs) diagnosed with chronic pancreatitis based on clinical and imaging features. MAIN OUTCOME MEASURES: Etiology, clinical presentation, complications and management of chronic pancreatitis in children...
November 8, 2013: Indian Pediatrics
Sylvie Stacy, Omar Hyder, David Cosgrove, Joseph M Herman, Ihab Kamel, Jean-Francois H Geschwind, Ahmet Gurakar, Robert Anders, Andrew Cameron, Timothy M Pawlik
BACKGROUND: Management of hepatocellular carcinoma (HCC) often involves many subspecialist providers, as well as a broad range of treatment options. This study sought to evaluate referral and treatment patterns among patients with HCC at a large academic medical center. METHODS: Data from our cancer registry between 2003-2011 were abstracted on 394 patients who were primarily diagnosed/treated for HCC at Johns Hopkins Hospital (JHH); data on patients who were diagnosed/treated with HCC elsewhere and who received secondary treatment at JHH (n = 391) were also abstracted for comparison purposes...
September 2013: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
S T Ward, K K Li, P J Trivedi, R K Hejmadi, N Suggett, T Iqbal, T Ismail
AIM: The diagnosis and treatment of ulcerative colitis (UC) is traditionally the realm of gastroenterologists. However, the symptoms of UC overlap with those of bowel cancer and patients may be initially referred to colorectal surgery clinics. The aims of this study were to define which specialty most frequently diagnoses UC and to determine if there were differences in management between the two specialities. METHOD: The demographics, presenting symptoms and clinical management of patients with newly diagnosed UC were determined and compared by speciality clinic of initial referral...
July 2013: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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