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Essential Surgical Knowledge

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2138 papers 1000+ followers Papers from the recent literature which are of interest to residents and practicing surgeons
https://www.readbyqxmd.com/read/29929755/narrowing-of-the-surgical-resident-operative-experience-a-27-year-analysis-of-national-acgme-case-logs
#1
Alexander R Cortez, Gianna D Katsaros, Vikrom K Dhar, F Thurston Drake, Timothy A Pritts, Jeffrey J Sussman, Michael J Edwards, R Cutler Quillin
BACKGROUND: Although overall operative volume has remained stable since the implementation of duty hours, more detailed analyses suggest shifts in the resident operative experience. Understanding these differences allows educators to better appreciate the impact of the current training environment on resident preparation for practice. METHODS: National Accreditation Council for Graduate Medical Education case logs from 1990 to 2016 were reviewed. Statistical analysis was performed using analysis of variance and linear regression analysis...
June 18, 2018: Surgery
https://www.readbyqxmd.com/read/29920657/anticoagulation-for-the-long-term-treatment-of-venous-thromboembolism-in-people-with-cancer
#2
REVIEW
Lara A Kahale, Maram B Hakoum, Ibrahim G Tsolakian, Charbel F Matar, Irene Terrenato, Francesca Sperati, Maddalena Barba, Victor Ed Yosuico, Holger Schünemann, Elie A Akl
BACKGROUND: Cancer increases the risk of thromboembolic events, especially in people receiving anticoagulation treatments. OBJECTIVES: To compare the efficacy and safety of low molecular weight heparins (LMWHs), direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs) for the long-term treatment of venous thromboembolism (VTE) in people with cancer. SEARCH METHODS: We conducted a literature search including a major electronic search of the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1), MEDLINE (Ovid), and Embase (Ovid); handsearching conference proceedings; checking references of included studies; use of the 'related citation' feature in PubMed and a search for ongoing studies in trial registries...
June 18, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29914871/secondary-peritonitis-principles-of-diagnosis-and-intervention
#3
REVIEW
James T Ross, Michael A Matthay, Hobart W Harris
Secondary peritonitis accounts for 1% of urgent or emergent hospital admissions and is the second leading cause of sepsis in patients in intensive care units globally. Overall mortality is 6%, but mortality rises to 35% in patients who develop severe sepsis. Despite the dramatic growth in the availability and use of imaging and laboratory tests, the rapid diagnosis and early management of peritonitis remains a challenge for physicians in emergency medicine, surgery, and critical care. In this article, we review the pathophysiology of peritonitis and its potential progression to sepsis, discuss the utility and limitations of the physical examination and laboratory and radiographic tests, and present a paradigm for the management of secondary peritonitis...
June 18, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29896798/renal-effects-of-norepinephrine-induced-variations-in-mean-arterial-pressure-after-liver-transplantation-a-randomized-cross-over-trial
#4
J Skytte Larsson, G Bragadottir, B Redfors, S-E Ricksten
BACKGROUND: Acute kidney injury is commonly seen after liver transplantation. The optimal perioperative target mean arterial pressure (MAP) for renal filtration, perfusion and oxygenation in liver recipients is not known. The effects of norepinephrine-induced changes in MAP on renal blood flow (RBF), oxygen delivery (RDO2 ), glomerular filtration rate (GFR) and renal oxygenation (=renal oxygen extraction, RO2 Ex) were therefore studied early after liver transplantation. METHODS: Ten patients with an intra- and post-operative vasopressor-dependent systemic vasodilation were studied early after liver transplantation during sedation and mechanical ventilation...
June 12, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29902346/meta-analysis-of-in-hospital-delay-before-surgery-as-a-risk-factor-for-complications-in-patients-with-acute-appendicitis
#5
REVIEW
S T van Dijk, A H van Dijk, M G Dijkgraaf, M A Boermeester
BACKGROUND: The traditional fear that every case of acute appendicitis will eventually perforate has led to the generally accepted emergency appendicectomy with minimized delay. However, emergency and thereby sometimes night-time surgery is associated with several drawbacks, whereas the consequences of surgery after limited delay are unclear. This systematic review aimed to assess in-hospital delay before surgery as risk factor for complicated appendicitis and postoperative morbidity in patients with acute appendicitis...
July 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29890512/open-liver-resection-laparoscopic-liver-resection-and-percutaneous-thermal-ablation-for-patients-with-solitary-small-hepatocellular-carcinoma-%C3%A2-30-mm-review-of-the-literature-and-proposal-for-a-therapeutic-strategy
#6
REVIEW
Luca Viganò, Andrea Laurenzi, Luigi Solbiati, Fabio Procopio, Daniel Cherqui, Guido Torzilli
BACKGROUND: Patients with a single hepatocellular carcinoma (HCC) ≤3 cm and preserved liver function have the highest likelihood to be cured if treated. The most adequate treatment methods are yet a matter that is debated. METHODS: We reviewed the literature about open anatomic resection (AR), laparoscopic liver resection (LLR), and percutaneous thermal ablation (PTA). RESULTS: PTA is effective as resection for HCC < 2 cm, when they are neither subcapsular nor perivascular...
June 11, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29878949/the-american-society-of-colon-and-rectal-surgeons-clinical-practice-guidelines-for-anal-squamous-cell-cancers-revised-2018
#7
David B Stewart, Wolfgang B Gaertner, Sean C Glasgow, Daniel O Herzig, Daniel Feingold, Scott R Steele
No abstract text is available yet for this article.
July 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29868971/perioperative-myocardial-injury-and-the-contribution-of-hypotension
#8
REVIEW
Daniel I Sessler, Ashish K Khanna
Mortality in the month following surgery is about 1000 times greater than anesthesia-related intraoperative mortality, and myocardial injury appears to be the leading cause. There is currently no known safe prophylaxis for postoperative myocardial injury, but there are strong associations among hypotension and myocardial injury, renal injury, and death. During surgery, the harm threshold is a mean arterial pressure of about 65 mmHg. In critical care units, the threshold appears to be considerably greater, perhaps 90 mmHg...
June 4, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29191513/international-consensus-on-definition-and-criteria-of-borderline-resectable-pancreatic-ductal-adenocarcinoma-2017
#9
Shuji Isaji, Shugo Mizuno, John A Windsor, Claudio Bassi, Carlos Fernández-Del Castillo, Thilo Hackert, Aoi Hayasaki, Matthew H G Katz, Sun-Whe Kim, Masashi Kishiwada, Hirohisa Kitagawa, Christoph W Michalski, Christopher L Wolfgang
This statement was developed to promote international consensus on the definition of borderline resectable pancreatic ductal adenocarcinoma (BR-PDAC) which was adopted by the National Comprehensive Cancer Network (NCCN) in 2006, but which has changed yearly and become more complicated. Based on a symposium held during the 20th meeting of the International Association of Pancreatology (IAP) in Sendai, Japan, in 2016, the presenters sought consensus on issues related to BR-PDAC. We defined patients with BR-PDAC according to the three distinct dimensions: anatomical (A), biological (B), and conditional (C)...
January 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29793113/assessment-of-the-risk-of-antiangiogenic-agents-before-and-after-surgery
#10
REVIEW
Christina E Bailey, Alexander A Parikh
Angiogenesis plays a critical role in the growth, progression, and metastasis of numerous solid tumor types, and thus, antiangiogenic agents have been studied for many years as potential therapeutic agents. Many different antiangiogenic agents, including monoclonal antibodies and multi-targeted tyrosine kinase inhibitors (TKIs), have been approved for various oncology indications, and promising clinical activity has been demonstrated. However, some of these agents have also been associated with serious safety concerns...
May 8, 2018: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/29850954/melanoma-staging-american-joint-committee-on-cancer-ajcc-8th-edition-and-beyond
#11
EDITORIAL
Jeffrey E Gershenwald, Richard A Scolyer
No abstract text is available yet for this article.
May 30, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29806818/diagnostic-accuracy-of-transabdominal-ultrasonography-for-gallbladder-polyps-systematic-review
#12
Erin Martin, Richdeep Gill, Estifanos Debru
BACKGROUND: Previous research has shown variable but generally poor accuracy of transabdominal ultrasonography in the diagnosis of gallbladder polyps. We performed a systematic review of the literature with the aim of helping surgeons interpret and apply these findings in the preoperative assessment and counselling of their patients. METHODS: We searched PubMed, MEDLINE and the Cochrane database using the keywords "gallbladder," "polyp," "ultrasound," "pathology" and "diagnosis" for English-language articles published after 1990 with the full-text article available through our institutional subscriptions...
June 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29760538/gastrointestinal-stromal-tumors-a-multidisciplinary-challenge
#13
REVIEW
Juan Manuel Sanchez-Hidalgo, Manuel Duran-Martinez, Rafael Molero-Payan, Sebastian Rufian-Peña, Alvaro Arjona-Sanchez, Angela Casado-Adam, Antonio Cosano-Alvarez, Javier Briceño-Delgado
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors located in the alimentary tract. Its usual manifestation is gastrointestinal bleeding. However, small asymptomatic lesions are frequently detected as incidental finding. Characteristically, most GISTs (> 95%) are positive for the KIT protein (CD117) by IHC staining and approximately 80%-90% of GISTs carry a mutation in the c-KIT or PDGFRA genes. Mutational analysis should be performed when planning adjuvant and neoadjuvant therapy, due to its possible resistance to conventional treatment...
May 14, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29791286/metastatic-pancreatic-cancer-asco-clinical-practice-guideline-update
#14
Davendra P S Sohal, Erin B Kennedy, Alok Khorana, Mehmet S Copur, Christopher H Crane, Ignacio Garrido-Laguna, Smitha Krishnamurthi, Cassadie Moravek, Eileen M O'Reilly, Philip A Philip, Ramesh K Ramanathan, Joseph T Ruggiero, Manish A Shah, Susan Urba, Hope E Uronis, Michelle W Lau, Daniel Laheru
Purpose In 2016, ASCO published a guideline to assist in clinical decision making in metastatic pancreatic cancer for initial assessment after diagnosis, first- and second-line treatment options, palliative and supportive care, and follow-up. The purpose of this update is to incorporate new evidence related to second-line therapy for patients who have experienced disease progression or intolerable toxicity during first-line therapy. Methods ASCO convened an Expert Panel to conduct a systematic review of the literature on second-line therapy published between June 2015 and January 2018...
May 23, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29788041/do-older-and-younger-patients-derive-similar-survival-benefits-from-novel-oncology-drugs-a-systematic-review-and-meta-analysis
#15
Vanessa S Arciero, Sierra Cheng, Robert Mason, Erica McDonald, Ronak Saluja, Kelvin K W Chan
Background: older patients are commonly believed to derive less benefit from cancer drugs, even if they fulfil clinical trial eligibility [Talarico et al. (2004, J Clin Oncol, 22(22):4626-31)]. We aim to examine if novel oncology drugs provide differential age-based treatment outcomes for patients on clinical trials. Methods: a systematic review of randomised control trials (RCTs) cited for clinical efficacy evidence in novel oncology drug approvals by the Food and Drug Administration, European Medicines Agency and Health Canada between 2006 and 2017 was conducted...
May 19, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29754628/approach-to-the-patient-with-chronic-groin-pain
#16
REVIEW
Q Lina Hu, David C Chen
Chronic postoperative inguinal pain has become a primary outcome parameter after elective inguinal hernia repair with significant consequences affecting patient productivity, employment, and quality of life. A systematic and thorough preoperative evaluation is important to identify the etiologies and types of pain. Owing to the complex nature of chronic pain, a multimodal and multidisciplinary treatment approach is recommended. Patients with chronic pain refractory to conservative measures may be considered for surgical intervention...
June 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29776643/review-of-risk-assessment-tools-to-predict-morbidity-and-mortality-in-elderly-surgical-patients
#17
REVIEW
Gilgamesh Eamer, Mohamed J H Al-Amoodi, Jayna Holroyd-Leduc, Darryl B Rolfson, Lindsey M Warkentin, Rachel G Khadaroo
BACKGROUND: Informed surgical consent requires accurate estimation of risks and benefits. Multiple risk assessment tools are available; however, most are not widely used or are specific to certain interventions. Assessing surgical risk is especially challenging in elderly patients because of their range of comorbidities, level of frailty, or severity of illness and a number of available surgical interventions. DATA SOURCES: We searched MEDLINE from January 2014 to July 2017 for studies that used risk assessment tools in studies on elderly surgical patients...
April 18, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29770959/ten-years-of-the-surgical-safety-checklist
#18
T G Weiser, A B Haynes
No abstract text is available yet for this article.
May 17, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29756647/surgery-for-perihilar-cholangiocarcinoma
#19
B Groot Koerkamp, W R Jarnagin
No abstract text is available yet for this article.
June 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29742967/restrictive-versus-liberal-fluid-therapy-for-major-abdominal-surgery
#20
Paul S Myles, Rinaldo Bellomo, Tomas Corcoran, Andrew Forbes, Philip Peyton, David Story, Chris Christophi, Kate Leslie, Shay McGuinness, Rachael Parke, Jonathan Serpell, Matthew T V Chan, Thomas Painter, Stuart McCluskey, Gary Minto, Sophie Wallace
Background Guidelines to promote the early recovery of patients undergoing major surgery recommend a restrictive intravenous-fluid strategy for abdominal surgery. However, the supporting evidence is limited, and there is concern about impaired organ perfusion. Methods In a pragmatic, international trial, we randomly assigned 3000 patients who had an increased risk of complications while undergoing major abdominal surgery to receive a restrictive or liberal intravenous-fluid regimen during and up to 24 hours after surgery...
May 9, 2018: New England Journal of Medicine
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