Seminars in Colon and Rectal Surgery最新文献_第2页

Consilience of healthcare legislation, complexity science & computational analysis 医疗保健立法、复杂性科学和计算分析的一致性

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Seminars in Colon and Rectal Surgery Pub Date : 2024-09-01 DOI: 10.1016/j.scrs.2024.101036

Don B. Colvin MD

引用次数: 0

Artificial intelligence for the colorectal surgeon in 2024 – A narrative review of Prevalence, Policies, and (needed) Protections 2024 年结肠直肠外科医生的人工智能--关于流行程度、政策和（必要）保护的叙述性评论

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Seminars in Colon and Rectal Surgery Pub Date : 2024-09-01 DOI: 10.1016/j.scrs.2024.101037

Kurt S. Schultz MD , Michelle L. Hughes MD , Warqaa M. Akram MD, FACS , Anne K. Mongiu MD, PhD

{"title":"Artificial intelligence for the colorectal surgeon in 2024 – A narrative review of Prevalence, Policies, and (needed) Protections","authors":"Kurt S. Schultz MD , Michelle L. Hughes MD , Warqaa M. Akram MD, FACS , Anne K. Mongiu MD, PhD","doi":"10.1016/j.scrs.2024.101037","DOIUrl":"10.1016/j.scrs.2024.101037","url":null,"abstract":"<div><p>Artificial Intelligence (AI) touches innumerable aspects of our lives today. It plays our music, turns on our lights, answers our weather questions, and even helps navigate our cars safely down the road - to name but a few capabilities. Review of the literature shows that AI applications are rapidly infiltrating most aspects of healthcare. For the microcosm of colorectal surgery, AI can assist in specimen acquisition, pathologic and radiologic diagnosis, selection of treatment modality, pre/postoperative risk stratification, and more globally in surgeon education, grantsmanship, and claims assessment. However, with such power comes the risk of its abuse, and subsequent harm to patients (and providers). Understanding a brief history of AI and the hierarchy of the predominant forms with which we interact, allow us to better understand the nature of these risks and how we can apply ethical frameworks to better understand and mitigate/prevent them. Finally, considering President Biden's October 2023 executive order, we can evaluate how US policy addresses these concerns.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 3","pages":"Article 101037"},"PeriodicalIF":0.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Physician burnout and impact of policy 医生职业倦怠与政策影响

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Seminars in Colon and Rectal Surgery Pub Date : 2024-09-01 DOI: 10.1016/j.scrs.2024.101042

Sowmya Sharma MD , Jonathan S. Abelson MD

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Vertical integration and market consolidation in healthcare: Policy drivers and impact on physicians and patient care 医疗保健领域的纵向一体化和市场整合：政策驱动因素及其对医生和患者护理的影响

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Seminars in Colon and Rectal Surgery Pub Date : 2024-09-01 DOI: 10.1016/j.scrs.2024.101038

Rachel Ekaireb MD , Anna Yap MD , Robert Kucejko MD MS MBA

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New Endoluminal platforms and advancements in technology: Should Gastroenterologists or Surgeons pave the way? 新型腔内平台和先进技术：应由消化内科医生还是外科医生铺平道路？

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Seminars in Colon and Rectal Surgery Pub Date : 2024-06-01 DOI: 10.1016/j.scrs.2024.101025

Alberto Arezzo , Filippo Pepe

{"title":"New Endoluminal platforms and advancements in technology: Should Gastroenterologists or Surgeons pave the way?","authors":"Alberto Arezzo , Filippo Pepe","doi":"10.1016/j.scrs.2024.101025","DOIUrl":"10.1016/j.scrs.2024.101025","url":null,"abstract":"<div><p>Nowadays, endoscopy has achieved amazing results in the treatment of benign and malignant pathologies, but it has yet to establish itself fully in the sense of an operative endoscopy. It is commonly believed that traditional endoscopy has reached its limits due to the intrinsic characteristics of existing platforms. Numerous robotic endoluminal platforms have been developed to overcome limitations in recent years. Existing robotic endoluminal platforms can be divided into three categories: fully robotic flexible endoscopic, robotic add-on systems, and traditional surgery-based platforms. These platforms are incredible pieces of technology, but in reality, they can only be considered a bridge to a genuinely robotic surgical system. Nowadays, both gastroenterologists and surgeons perform endoscopic procedures all over the world. We believe these platforms, leading to increased manipulation possibilities, may require an increasingly excellent knowledge of surgical techniques to develop their potential fully. Surgeons' unique training and experience push surgeons to take the lead in endoscopic operations over gastroenterologists due to the potential advantages in surgical precision and patient outcomes. However, gastroenterologists deeply understand gastrointestinal disorders and a collaborative effort between them and surgeons can lead to an efficient approach to endoscopic surgery.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 2","pages":"Article 101025"},"PeriodicalIF":0.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1043148924000241/pdfft?md5=1c7c82c30dfcb4e5d5dfe60fb76cba8e&pid=1-s2.0-S1043148924000241-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141026767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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The role of endoluminal surgery in a colorectal surgical practice. A global view 腔内手术在结直肠外科实践中的作用。全球视野。

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Seminars in Colon and Rectal Surgery Pub Date : 2024-06-01 DOI: 10.1016/j.scrs.2024.101023

Ilker Ozgur MD, FACS , Fevzi Cengiz MD

{"title":"The role of endoluminal surgery in a colorectal surgical practice. A global view","authors":"Ilker Ozgur MD, FACS , Fevzi Cengiz MD","doi":"10.1016/j.scrs.2024.101023","DOIUrl":"10.1016/j.scrs.2024.101023","url":null,"abstract":"<div><p>Patients with large colorectal polyps or mucosal neoplasms not amenable to standard polypectomy have traditionally undergone colon resection. However, minimally invasive surgical techniques have gained popularity over the past two decades. Transanal approaches such as transanal endoscopic microsurgery and transanal minimally invasive surgery have enabled surgeons to treat mucosal neoplasms located in the rectum. Later on, robotic surgery was incorporated into the transanal approach. Meanwhile, there was no such treatment option for more proximal colonic neoplasms then, and endoscopic mucosal resection and endoscopic submucosal dissection emerged in Japan to provide resection in treating such proximal lesions. Nowadays, all procedures performed in a hollow organ integrating standard surgical (dissection, resection, suturing, homeostasis) and oncological principles (<em>en-bloc</em> resection, clean surgical margins) are merged under endoluminal surgery. Within the scope of this review, we aimed to elaborate an overview of the role of endoluminal surgery in daily colorectal surgery practice while focusing on endoscopic procedures.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 2","pages":"Article 101023"},"PeriodicalIF":0.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141040713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Why every colorectal surgeon should learn endoluminal surgery 为什么每位结直肠外科医生都应学习腔内手术？

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Seminars in Colon and Rectal Surgery Pub Date : 2024-06-01 DOI: 10.1016/j.scrs.2024.101019

Jean Wong MBBS, Joshua Sommovilla MD

{"title":"Why every colorectal surgeon should learn endoluminal surgery","authors":"Jean Wong MBBS, Joshua Sommovilla MD","doi":"10.1016/j.scrs.2024.101019","DOIUrl":"10.1016/j.scrs.2024.101019","url":null,"abstract":"<div><p>Endoscopic submucosal dissection (ESD) is an advanced therapeutic technique used to remove non-malignant polyps (NMP) and early cancers. Benefits include reducing unnecessary colectomies, cost, and morbidity of NMP treatment. Other roles for ESD and associated skills are likely to expand in the future, including in the non-operative management of rectal cancer. The learning curve is feasible with established training methods. Colorectal surgeons already perform routine endoscopy and manage endoscopic complications and endoscopically incurable lesions- endoluminal surgery (ELS) is a natural extension of this. Expanding technologies will only improve our ability to resect these lesions endoluminally moving forward. Collaboration with gastroenterologists and acquiring, rather than abandoning, this skillset is important and obtainable. Colorectal surgeons have the tools and professional duty to stay at the forefront of managing colorectal diseases endoscopically. Despite substantial barriers to mastering ELS, the value to our patients and profession means all colorectal surgeons should learn these techniques.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 2","pages":"Article 101019"},"PeriodicalIF":0.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1043148924000186/pdfft?md5=9ca7ffdf857e3e36b0d307a0b5f6e255&pid=1-s2.0-S1043148924000186-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141033257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An approach to endoscopic submucosal dissection (ESD) and advanced colonoscopic skills training based on inanimate and ex vivo animal large bowel models 基于无生命和活体动物大肠模型的内镜黏膜下剥离术（ESD）和高级结肠镜技术培训方法

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Seminars in Colon and Rectal Surgery Pub Date : 2024-06-01 DOI: 10.1016/j.scrs.2024.101020

Neil Mitra MD, Pablo Palacios MD, Richard L. Whelan MD

引用次数: 0

Reimbursement and tips and tricks to make endoluminal surgery profitable 使腔内手术有利可图的报销及技巧和窍门

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Seminars in Colon and Rectal Surgery Pub Date : 2024-06-01 DOI: 10.1016/j.scrs.2024.101026

Sarah Choi MD, Kyle G. Cologne MD

引用次数: 0

Combined Endo-Laparoscopic Surgery (CELS) for the management of complex colorectal lesions 联合内镜-腹腔镜手术（CELS）治疗复杂结肠直肠病变

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Seminars in Colon and Rectal Surgery Pub Date : 2024-06-01 DOI: 10.1016/j.scrs.2024.101022

Brian Williams MD, Sang W. Lee MD

{"title":"Combined Endo-Laparoscopic Surgery (CELS) for the management of complex colorectal lesions","authors":"Brian Williams MD, Sang W. Lee MD","doi":"10.1016/j.scrs.2024.101022","DOIUrl":"10.1016/j.scrs.2024.101022","url":null,"abstract":"<div><p>Detection of colon polyps is common and is expected in 20–30 % of screening colonoscopies. As the number of colonoscopies performed increases, the detection of advanced and difficult to resect polyps will also rise. These polyps tend to be larger, greater than 2 cm, have flat morphology, and are in difficult anatomic locations behind haustral folds or at sharp flexures of the colon. Advanced endoscopic techniques such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are useful to remove these polyps. However, many polyps remain unresectable with these techniques. Combined endoscopic laparoscopic surgery (CELS) has shown to be an effective technique to facilitate safe removal of complex polyps. CELS encompasses a variety of techniques including laparoscopic assisted ESD/EMR and laparo-endoscopic full thickness excisions (FLEX). Success rate of CELS ranges from 70 to 100 %, with less than 5 % conversion to colectomy. Perioperative outcomes boast shorter hospital length of stay, with low rates of serious post-op complications when compared to colectomy. Malignancy rate after CELS in appropriately selected patients is low, ranging from 1.6 %-10 % of cases. Polyp recurrence rate after CELS is also low, usually less than 10 %. Use of CELS for early-stage cancers remains controversial but maybe adequate in appropriately selected patients. Further evaluation and long-term studies are needed to study its efficacy in cases of known cancer. The purpose of this review is to provide recommendations for use of CELS techniques, appropriate indications, describe technical tips, and review potential future applications.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 2","pages":"Article 101022"},"PeriodicalIF":0.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141027853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0