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NEWS - Gastrointestinal Surgery

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.”

 


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.


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.

 


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”.

 


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)

 


Safety of hydroxyanthracene derivatives for use in food – EFSA Journal (free)

Press release: EFSA confirms health concerns for hydroxyanthracene derivatives in food – European Food Safety Agency (free)

Commentary: Europe’s safety watchdog says laxatives may increase cancer risk – Reuters (free)

“This group of substances naturally occurs in plants such as aloe or senna species. Extracts containing them are used in food supplements for their laxative effect”. (from Press Release)

 


Weekend Surgical Care and Postoperative Mortality: A Systematic Review and Meta-Analysis of Cohort Studies (free)

Commentary: Evidence Supports ‘Weekend Effect’ for Mortality after Surgery – Wolters Kluwer, via NewsWise (free)

“The odds of postoperative mortality were 27 percent higher for patients admitted to the hospital on Saturday or Sunday, compared to those hospitalized on a weekday” (from NewsWise).

 


The use of probiotics to prevent Clostridium difficile diarrhea associated with antibiotic use – Cochrane Library (free)

See related meta-analysis: Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection

“Based on this systematic review and meta-analysis of 31 randomized controlled trials including 8672 patients, moderate certainty evidence suggests that probiotics are effective for preventing C. difficile-associated diarrhea”

 


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