Seminars in Colon and Rectal Surgery最新文献

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The effects of current health policy on social determinants of health, implications in colon and rectal surgery 当前卫生政策对健康的社会决定因素的影响,对结肠和直肠外科的影响
IF 0.4
Seminars in Colon and Rectal Surgery Pub Date : 2024-09-01 DOI: 10.1016/j.scrs.2024.101041
Abdul S Hassan MD , David A Swift MD MPH , Courtney L Devin MD
{"title":"The effects of current health policy on social determinants of health, implications in colon and rectal surgery","authors":"Abdul S Hassan MD ,&nbsp;David A Swift MD MPH ,&nbsp;Courtney L Devin MD","doi":"10.1016/j.scrs.2024.101041","DOIUrl":"10.1016/j.scrs.2024.101041","url":null,"abstract":"<div><p>Despite decades of work on advancing outcomes in colon and rectal surgery, social determinants of health (SDOH) remain an unaddressed component in understanding these outcomes to ensure health equity. Consequently, there is evidence that SDOH have a negative impact on morbidity and mortality of those individuals with colorectal cancer and inflammatory bowel disease in comparison to their counterparts. We sought to elucidate the interplay between SDOH with the access and utilization of Medicaid and how best to improve patient care and outcomes through policy changes. Further education how to address SDOH is needed, as well as a continued push for policy makers to create legislation to improve these rampant inequities in medicine.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 3","pages":"Article 101041"},"PeriodicalIF":0.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851728","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
The importance of physician engagement in healthcare policy and advocacy 医生参与医疗政策和宣传的重要性
IF 0.4
Seminars in Colon and Rectal Surgery Pub Date : 2024-09-01 DOI: 10.1016/j.scrs.2024.101043
By Ross F. Goldberg MD
{"title":"The importance of physician engagement in healthcare policy and advocacy","authors":"By Ross F. Goldberg MD","doi":"10.1016/j.scrs.2024.101043","DOIUrl":"10.1016/j.scrs.2024.101043","url":null,"abstract":"<div><p>Advocacy is a key component to a physician's practice; we advocate on behalf of our patients daily. As important as those efforts are, it is equally important that physicians are engaged in health care policy and advocacy on the state and federal level, where decisions are made that can directly impact a physician's ability to care for patients. This article summarizes the importance of physician engagement in these activities, looking at both the legislative and regulatory processes. It reviews how both interact with one another, and the impact it has on the patient-physician relationship. Finally, this article reviews ways in which physicians can easily get involved with advocacy, including providing resources available to assist those who never participated in these efforts before.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 3","pages":"Article 101043"},"PeriodicalIF":0.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141853117","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
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
IF 0.4
Seminars in Colon and Rectal Surgery Pub Date : 2024-09-01 DOI: 10.1016/j.scrs.2024.101036
Don B. Colvin MD
{"title":"Consilience of healthcare legislation, complexity science & computational analysis","authors":"Don B. Colvin MD","doi":"10.1016/j.scrs.2024.101036","DOIUrl":"10.1016/j.scrs.2024.101036","url":null,"abstract":"<div><p>Our US Health Care System (HCS) has evolved from simple to complex and needs reform. Thus far, all legislative initiatives have failed to result in establishing a friendly, cost-effective, quality healthcare system. The question becomes, can Complexity Science (CS) and computational analytic platform modeling be used to help create better Health Care Policies (HCP) and reform our all too complex HCS? Modeling has been used in many diverse disciplines but has yet to be utilized in preemptive evaluation of major US legislative HCPs. Review of US Health Care Policy History (HCPH) viewed in the context of a Complex Adaptive System(CAS) reveals how, unanticipated historical events, politics, social, and personal leadership have tangentially shaped our US HCPs. Future construction of HCPs with the help of CS, and preemptive computational modeling (CM) techniques, will hopefully yield stronger conclusions in legislative HCP construction and advance our US HCS into one with dynamic resilience.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 3","pages":"Article 101036"},"PeriodicalIF":0.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839483","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
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
IF 0.4
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 ,&nbsp;Michelle L. Hughes MD ,&nbsp;Warqaa M. Akram MD, FACS ,&nbsp;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
IF 0.4
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
{"title":"Physician burnout and impact of policy","authors":"Sowmya Sharma MD ,&nbsp;Jonathan S. Abelson MD","doi":"10.1016/j.scrs.2024.101042","DOIUrl":"10.1016/j.scrs.2024.101042","url":null,"abstract":"<div><p>Physician burnout, characterized by exhaustion, depersonalization and reduced satisfaction, is an important and increasingly discussed issue. It has an impact across all specialties, with highest rates among surgery, neurology and other high-demand specialties. Risk factors for this epidemic are diverse and are seen as early as medical school. The impact of burnout is being noted in various studies in both physician personal lives and well-being, and quality of patient care. It is clear that this is an issue that needs to be addressed, and mitigation strategies are important at individual, institution and government level to optimize patient care, maintain the physician work force and protect physician well being.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 3","pages":"Article 101042"},"PeriodicalIF":0.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141847089","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
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
IF 0.4
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
{"title":"Vertical integration and market consolidation in healthcare: Policy drivers and impact on physicians and patient care","authors":"Rachel Ekaireb MD ,&nbsp;Anna Yap MD ,&nbsp;Robert Kucejko MD MS MBA","doi":"10.1016/j.scrs.2024.101038","DOIUrl":"10.1016/j.scrs.2024.101038","url":null,"abstract":"<div><p>As healthcare markets have become increasingly consolidated, the vertical integration of physician practices with hospital networks has drawn additional scrutiny. While vertical integration within healthcare was once predicted to improve efficiency and quality of healthcare delivery, empirical study has uncovered mixed results. In a review of existing literature, vertical integration has yielded inconsistent effects on health quality metrics, with modest improvements at best, but has consistently driven up prices. This article reviews economic theory and the real-world effects of vertical mergers within healthcare and discusses policies driving this trend. Given the impacts of vertical integration on healthcare outcomes, cost, patient choice and physician wellbeing, physicians should advocate for regulations that preserve sufficient competition in healthcare markets and diversity of practice settings.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 3","pages":"Article 101038"},"PeriodicalIF":0.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S104314892400037X/pdfft?md5=396abb7b9a537012cc159cc1f5bbea7b&pid=1-s2.0-S104314892400037X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141852075","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
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?
IF 0.3
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 ,&nbsp;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}
引用次数: 0
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。
IF 0.3
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 ,&nbsp;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?
IF 0.3
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,&nbsp;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
IF 0.3
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
{"title":"An approach to endoscopic submucosal dissection (ESD) and advanced colonoscopic skills training based on inanimate and ex vivo animal large bowel models","authors":"Neil Mitra MD,&nbsp;Pablo Palacios MD,&nbsp;Richard L. Whelan MD","doi":"10.1016/j.scrs.2024.101020","DOIUrl":"10.1016/j.scrs.2024.101020","url":null,"abstract":"<div><p>Endoscopic submucosal dissection is a challenging technique that allows en bloc removal of sessile colorectal polyps and constitutes definitive treatment for superficial T-1 cancers. To successfully complete ESD cases, the great majority of endoscopists need to acquire several new skill sets. Learning about, practicing, and becoming proficient with the advanced skills in the clinical setting is a huge challenge because of the fact that these are usually low volume cases and there may be weeks or months between cases.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 2","pages":"Article 101020"},"PeriodicalIF":0.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141130587","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
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