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General Surgery & Trauma

The Risk of Adverse Pregnancy Outcomes Following Nonobstetric Surgery During Pregnancy: Estimates From a Retrospective Cohort Study of 6.5 Million Pregnancies – Annals of Surgery (free)

Source: Journal Watch ($)

“we found that the risk associated with nonobstetric surgery was relatively low, confirming that surgical procedures during pregnancy are generally safe”

 


A meta-analysis of resuscitative endovascular balloon occlusion of the aorta (REBOA) or open aortic cross-clamping by resuscitative thoracotomy in non-compressible torso hemorrhage patients – World Journal of Emergency Surgery (free)

This meta-analysis, mainly from observational studies and including 1276 patients, suggests a positive effect of REBOA on mortality among non-compressible torso hemorrhage patients.

 


American College of Surgeons (ACS) 2017 Quality and Patient Safety Conference: Enhanced recovery pathway for colorectal surgical patients improves outcomes, reduces cost – ACS, via EurekAlert (free)

Related guideline: Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons (free)

See other Enhanced Recovery After Surgery (ERAS) Guidelines and Reviews in our collection and in the ERAS Society Website.

“Successful protocol shortens hospital stays, reduces patients’ risk of complications, and cuts costs up to $11,000 per procedure”

 


2017 ACS Quality and Safety Conference: “Strong for Surgery” Shows Promise in Reducing Smoking Rates for Patients Facing Surgery – American College of Surgeons, via NewsWise (free)

“Study suggests big drop in smoking rates when surgeons help patients quit before their operations”.

 


Viewpoint: The Evolving Story of Overlapping Surgery – JAMA (free) (RT @pash22 see Tweet)

Commentary: 3 steps to restore patient trust in overlapping surgeries – FierceHealthcare (free)

This interesting viewpoint discusses the practice of scheduling overlapping surgeries, in which a qualified practitioner finishes noncritical parts of the first operation while the primary surgeon moves to the next surgery.

 


Long-term health status and trajectories of seriously injured patients: A population-based longitudinal study – PLOS Medicine (free) (RT @karimbrohi see Tweet – “Trauma is a chronic disease”)

“The prevalence of reporting problems at 36-months postinjury was 37% for mobility, 21% for self-care, 47% for usual activities, 50% for pain/discomfort, and 41% for anxiety/depression… the prevalence of ongoing problems at 3-years postinjury is high, confirming that serious injury is frequently a chronic disorder”

 


A Meta-analysis of the Impact of Aspirin, Clopidogrel, and Dual Antiplatelet Therapy on Bleeding Complications in Noncardiac Surgery – Annals of Surgery (link to abstract – $ for full-text)

Source: EvidenceAlerts (free resource to find articles of interest)

“Antiplatelet therapy at the time of noncardiac surgery confers minimal bleeding risk with no difference in thrombotic complications. In many cases, it is safe to continue antiplatelet therapy in patients with important indications for their use”

 


Surgeon Variation in Complications With Minimally Invasive and Open Colectomy: Results From the Michigan Surgical Quality Collaborative – JAMA Surgery (free) (RT @MaryDixonWoods see Tweet)

Surgeon-level variation in complications among surgeons was nearly twice as great for Minimally Invasive Colectomy than for Open Colectomy, implying a need for improved training in adoption of minimally invasive techniques.

 


How to fall to your death and live to tell the tale – Mosaic Science (free)

“Falls—such as slipping in the shower or tripping down stairs—kill over 420,000 people worldwide each year” (RT @ghn_news see Tweet)

 


Antibiotics Versus Surgical Therapy for Uncomplicated Appendicitis: Systematic Review and Meta-analysis of Controlled Trials – Annals of Surgery (link to abstract – $ for full-text)

Commentary: Antibiotics Versus Surgery: Equally Effective in Treating Appendicitis? – Medscape (free registration required)

This meta-analysis and the author’s conclusions do not favor antibiotics alone for the treatment of uncomplicated appendicitis, contradiction the results of other recent meta-analysis, as well as a recent guideline on the subject, suggesting antibiotics might be an option in selected cases.

 


Effect of a Modified Hospital Elder Life Program on Delirium and Length of Hospital Stay in Patients Undergoing Abdominal Surgery: A Cluster Randomized Clinical Trial – JAMA Surgery (free) (RT @PreetiNMalani see Tweet)

Commentary: Anti-delirium strategy reduces after-surgery confusion in elderly – Reuters Health (free)

Multicomponent nonpharmacologic interventions, including orienting communications, oral and nutritional assistance, and early mobilization reduced postoperative delirium by 56% and length of stay by 2 days.

 


ACR Appropriateness Criteria Adds Topics, Covers More Clinical Variants Than Ever Before (free)

Browse Appropriateness Criteria Topics (free)

Source: Newswise

This comprehensive guide from American College of Radiology (ACR) covers 230 topics with more than 1,100 clinical indications and has just been updated. It is a very useful resource for doctors in all specialties to guide which exam is most appropriate in each clinical situation.

 


Comparison of Antibiotic Therapy and Appendectomy for Acute Uncomplicated Appendicitis in Children: A Meta-analysis – JAMA Pediatrics(free)

Editorial: Medical Treatment of Pediatric Appendicitis: Are We There Yet? (free)

See also a recent meta-analysis and related commentaries on the same subject (free)

Nonoperative treatment was successful in 90% of cases. Subgroup analysis indicated an increased risk for initial fails and recurrent appendicitis in those with appendicolith.

 


Going Under the Knife, With Eyes and Ears Wide Open – New York Times (free access to 10 articles per month)

“More and more surgeries are being performed with the patient awake and looking on, for financial and medical reasons”.

 


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