Gastrointestinal Surgery

When Is the Surgeon Too Old to Operate? – The New York Times (free)

Related: Perspective: Assessing the Performance of Aging Surgeons (free for a limited period) AND Observational Study: Age and Sex of Surgeons and Mortality of Older Surgical Patients (free study and commentary) AND The Elderly and Driving: When Is It Time to Hit the Brakes? – The New York Times (10 articles per month are free)


Related Commentary on Twitter

Review: Hepatic Echinococcosis

20 Nov, 2018 | 15:11h | UTC

Early enteral nutrition within 24 hours of lower gastrointestinal surgery versus later commencement for length of hospital stay and postoperative complications – Cochrane Library (free)

Summary: The effect of having nutrition within the first 24 hours after bowel surgery on length of hospital stay and postoperative complications – Cochrane Library (free)

This review suggests that early enteral feeding is associated with a shorter length of hospital stay. For all other outcomes (postoperative complications, mortality, adverse events, and QoL) the findings are inconclusive.


Pantoprazole in Patients at Risk for Gastrointestinal Bleeding in the ICU – New England Journal of Medicine (free for a limited period)

Editorial: Proton-Pump Inhibitor Prophylaxis in the ICU — Benefits Worth the Risks? (free for a limited period)

“Proton pump inhibitors are minimally effective to reduce GI bleeding among the critically ill folks at high risk for stress ulcers. Takeaways: no role for routine PPI for any patients on the WARDS, and shouldn’t be considered ‘routine’ in the ICU” (via @AnilMakam see Tweet)


Association of Mechanical Bowel Preparation and Oral Antibiotics Before Elective Colorectal Surgery With Surgical Site Infection: A Network Meta-analysis – JAMA Network Open (free)

Invited Commentary: When Will the Surgical Community Acknowledge the Evidence Regarding Prophylaxis With Oral Antibiotics for Scheduled Colorectal Operations? (free)

“Bowel Preparation and Oral Antibiotics Before Elective Colorectal Surgery. Once again the combination of oral antibiotic and oral mechanical cathartic bowel preparation yields the lowest rates of surgical site infections” (via @SWexner see Tweet)


Laparoscopic cholecystectomy versus percutaneous catheter drainage for acute cholecystitis in high risk patients (CHOCOLATE): multicentre randomised clinical trial – The BMJ (free)

“Laparoscopic cholecystectomy compared with percutaneous catheter drainage reduced the rate of major complications in high risk patients with acute cholecystitis.”


NICE Guideline: Pancreatitis

14 Sep, 2018 | 01:30h | UTC

Guideline: Intestinal Failure in Adults

31 Aug, 2018 | 01:41h | UTC

NCCN Guideline Update: Rectal Cancer

20 Jul, 2018 | 01:47h | UTC

NCCN Guideline Update: Anal Carcinoma

20 Jul, 2018 | 01:46h | UTC

Cabozantinib in Patients with Advanced and Progressing Hepatocellular Carcinoma – New England Journal of Medicine (link to abstract – $ for full-text)

Commentary: Cabozantinib in Hepatocellular Carcinoma – NEJM Resident 360 (free)

Median overall survival was 10.2 months with cabozantinib and 8.0 months with placebo, but the rate of high-grade adverse events in the cabozantinib group was approximately twice that observed in the placebo group.

Review: Surgical Treatment of Obesity

22 Jun, 2018 | 02:14h | UTC

Review: Pancreatic Cystic Lesions

22 Jun, 2018 | 02:10h | UTC

Review: Secondary Peritonitis

18 Jun, 2018 | 23:21h | UTC

Guideline: Anal Squamous Cell Cancers

15 Jun, 2018 | 01:47h | UTC

Review: Surgery for Metastatic GISTs

3 May, 2018 | 19:20h | UTC

Pancreatitis: Pearls & Pitfalls

23 Apr, 2018 | 20:59h | UTC

Acid‐suppressive drugs and risk of kidney disease: A systematic review and meta‐analysis – Journal of Gastroenterology and Hepatology (link to abstract – $ for full-text)

Source: Hospital Medicine Virtual Journal Club

Proton pump inhibitors were associated with higher risks of acute interstitial nephritis (HR, 2.78; 95% CI, 1.25‐6.17), acute kidney injury (HR, 1.85; 95% CI, 1.33‐2.59), chronic kidney disease (HR, 1.47; 95% CI, 1.03‐2.09), and end‐stage renal disease (HR, 1.61; 95% CI, 1.26‐2.04) than non‐PPI therapy. Similar risks were not identified for H2RA therapy.


NCCN Guidelines Insights: Colon Cancer

13 Apr, 2018 | 00:49h | UTC

New guide to help children with ostomies

12 Apr, 2018 | 01:09h | UTC

Robot-assisted laparoscopic surgery versus conventional laparoscopic surgery in randomized controlled trials: A systematic review and meta-analysis – PLOS One (free)

“Despite higher operative cost, robot-assisted laparoscopic surgery does not result in statistically better treatment outcomes, with the exception of lower estimated blood loss. Operative time and total complication rate are significantly more favorable with conventional laparoscopic surgery”.


Review: Immunotherapy-Induced Colitis

27 Feb, 2018 | 15:42h | UTC

Risk of Recurrent Disease and Surgery Following an Admission for Acute Diverticulitis – Diseases of the Colon and Rectum (link to abstract – $ for full-text)

Commentary: Which Patients with Diverticulitis Require Surgery? – Diseases of the Colon & Rectum, via NewsWise (free)

In this large cohort of 65,162 patients identified with a first episode of acute diverticulitis, younger patients, women, smokers, obese individuals, and those who had diverticulitis with perforation and/or abscess were more likely to develop recurrent diverticulitis.


State of The Art Review: The role of robotics in colorectal surgery – The BMJ (free for a limited period)