Surgery open science最新文献

{"title":"Early use of professional interpreters improves trauma outcomes: Results of a single-center retrospective study","authors":"Sydney C. Bertram ,&nbsp;F. Riley Nichols ,&nbsp;Lauren E. Cox ,&nbsp;Deepak K. Ozhathil ,&nbsp;Mike M. Mallah","doi":"10.1016/j.sopen.2024.09.006","DOIUrl":"10.1016/j.sopen.2024.09.006","url":null,"abstract":"<div><div>Patients with limited English proficiency (LEP) experience reduced pain assessment and treatment, less comprehensive physical exams, and fewer explanations of the next steps in care. These disparities persist in hospitals with staffed professional interpreters, raising questions about interpreter access and the impact on outcomes. A retrospective review of 1133 trauma activations at a single center Level 1 Trauma Center in 2021–2022 was conducted. Demographic, injury, and outcome data were drawn from the institutional trauma registry, and patient-preferred language was pulled from EMR data. Early interpreter use was defined as documentation of professional interpreter use within 24 h of arrival. LOS and ICU LOS were compared between language groups using Cox regression, and mortality was compared using Fischer's exact test. 1114 patients had data available on initial injury severity and preferred language. Of the 70 LEP patients, 62 (88.6 %) required an interpreter, and 41 of those (66.1 %) had evidence of professional interpreter use within 24 h of arrival. LEP patients who lacked early interpreter use had longer hospital stays than both English proficient (EP) patients (HR 0.59, <em>p</em> &lt; 0.05) and LEP patients with early interpreter use (HR 0.51, <em>p</em> &lt; 0.05) when stratified by ISS and controlling for GCS and patient age. There is no difference in LOS between LEP trauma patients who used an interpreter and EP patients, suggesting that early use of an interpreter may improve the length of stay in LEP trauma patients.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"21 ","pages":"Pages 52-57"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142323267","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}

{"title":"Analysis of neoadjuvant therapy effect on 30-day postoperative outcomes in gallbladder cancer","authors":"Nicole Martin MD, MPH ,&nbsp;Areg Grigorian MD ,&nbsp;Francesca A. Kimelman MD, MPH ,&nbsp;Zeljka Jutric MD ,&nbsp;Stephen Stopenski MD ,&nbsp;David K. Imagawa MD, PhD ,&nbsp;Ron F. Wolf MD ,&nbsp;Shimul Shah MD, MHCM ,&nbsp;Jeffry Nahmias MD, MHPE","doi":"10.1016/j.sopen.2024.08.001","DOIUrl":"10.1016/j.sopen.2024.08.001","url":null,"abstract":"<div><h3>Background</h3><p>The role of neoadjuvant therapy (NAT) in gallbladder cancer (GBC) is not well established. We sought to evaluate the effect of NAT on postoperative outcomes following surgical resection of GBC. We hypothesized that patients receiving NAT would have similar rates of 30-day mortality, readmission, and postoperative complications (e.g. bile leakage and liver failure) compared to those who did not receive NAT.</p></div><div><h3>Methods</h3><p>The 2014–2017 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Procedure-Targeted Hepatectomy database was queried for patients that underwent surgery for GBC. Propensity scores were calculated to match patients in a 1:2 ratio based on age, comorbidities, functional status, and tumor staging.</p></div><div><h3>Results</h3><p>A total of 37 patients undergoing NAT were matched to 74 patients without NAT. There was no difference in any matched characteristics. Compared to the NAT group, the no NAT cohort had similar rates of postoperative bile leakage (NAT 13.5 % vs. no NAT 10.8 %, <em>p</em> = 0.31), postoperative liver failure (5.4 %, vs. 8.1 %, <em>p</em> = 0.60), 30-day readmission (10.8 % vs. 10.8 %, <em>p</em> = 1.00), and 30-day mortality (10.8 % vs. 2.7 %, <em>p</em> = 0.075). All 30-day complications were similar except for a higher rate of postoperative blood transfusion (NAT 32.4 % vs. no NAT 10.8 %, <em>p</em> = 0.005).</p></div><div><h3>Conclusion</h3><p>In patients undergoing surgical resection for GBC, those with and without NAT had similar rates of readmission and 30-day mortality, however NAT was associated with an increased risk for transfusion. Despite use of a large national database, this study may be underpowered to adequately assess the effect of NAT on perioperative GBC outcomes and thus warrants further investigation.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"21 ","pages":"Pages 17-21"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024001118/pdfft?md5=9aa8a8ec2d9b1d9f6e321b27db3ed5ec&pid=1-s2.0-S2589845024001118-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122098","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}

{"title":"The hot spots and global trends of prevention and treatment in postoperative delirium (POD) from 2004 to 2023: A bibliometric analysis","authors":"Changshuo Jiang ,&nbsp;Zijun Tian ,&nbsp;Ming Jiang ,&nbsp;Chenyang Xu,&nbsp;Mingjie Mao,&nbsp;Shanwu Feng,&nbsp;Hongmei Yuan","doi":"10.1016/j.sopen.2024.09.005","DOIUrl":"10.1016/j.sopen.2024.09.005","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative delirium (POD) is an acute postoperative syndrome of the central nervous system that seriously affects the prognosis of patients. Many vital advances have been made in the study of the management of POD. We conducted a bibliometric analysis of research on the prevention and treatment of POD over the past 20 years to consolidate current research focal points and emerging trends in this domain.</div></div><div><h3>Methods</h3><div>We searched the Web of Science Core Collection database for literature published between 2004 and 2023. VOSviewer, CiteSpace, Microsoft Excel, Scimago Graphica, and the R tool “bibliometrix” were used to analyze and visualize annual publications, countries, organizations, journals, authors, keywords, and references.</div></div><div><h3>Results</h3><div>A total of 1848 eligible publications were identified, with a general uptrend observed in both annual publications and citations. The USA was the most profitable country, ranking first in total publications. The most active institution was Harvard Medical School. Inouye, Sharon K was the most prolific scholar due to her numerous publications and citations. According to the co-occurrence network, the strongest citation bursts and co-cited references analysis fresh hot topics included “dexmedetomidine,” “neuroinflammation,” “haloperidol prophylaxis,” and “guideline.”</div></div><div><h3>Conclusions</h3><div>Research on prevention and treatment of POD is gaining significant momentum worldwide. Current hot spots include early perioperative prevention strategies and integrated multi-method treatments. Effective drugs for it is one of the directions in the future. The management of pediatric patients with POD has caused concern in recent years. This bibliometric analysis is poised to guide future research trajectories in this field.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"21 ","pages":"Pages 35-44"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024001209/pdfft?md5=2e1d34c265e0347aab7bdf15e6e9c2db&pid=1-s2.0-S2589845024001209-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142310423","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}

{"title":"Lidocaine pre-treatment for Succinylcholine induced postoperative myalgia and associated factors: Longitudinal study","authors":"Fassil Mihretu ,&nbsp;Telake Azale ,&nbsp;Foziya Mohammed ,&nbsp;Amare Agumas ,&nbsp;Sara Timerga ,&nbsp;Aynalem Befikadu","doi":"10.1016/j.sopen.2024.09.004","DOIUrl":"10.1016/j.sopen.2024.09.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Postoperative myalgia in surgical patients is mainly caused by the routinely administered depolarizing muscle relaxant, Succinylcholine. There are many proposed strategies but no one were indicated as ideal preventive mechanisms for Succinylcholine induced post-operative myalgia. Even if data were sparse, Lidocaine pretreatment can reduce postoperative myalgia which requires further supportive evidences urging the initiation of this study.</div></div><div><h3>Methods</h3><div>Prospective longitudinal cohort study was conducted from March to May 2021 at Dessie Comprehensive Specialized Hospital on 208 adult surgical patients. Patients pretreated with Lidocaine preoperatively were grouped as exposed and others as unexposed. Patients meeting the inclusion criteria during the study period were selected sequentially from the daily operation schedule list. Postoperative myalgia level was measured using post-operative myalgia survey repeatedly. The result was analyzed by Cochran's Q test and generalized estimating equation (GEE). Adjusted odds ratio with 95 % confidence interval and <em>p</em> value &lt; 0.05 was used to show the difference, direction and strength of association.</div></div><div><h3>Result</h3><div>Exposure specific incidence rate showed that 22 %, 22 % and 29.8 % of patients exposed to Lidocaine and 40.6 %, 42.7 % and 34 % not exposed to Lidocaine developed myalgia at 12, 24, and 48 h respectively. There is no significant difference in the incidence of myalgia over time between the repeated measurements in Lidocaine exposed patients (<em>p</em> = 0.513) but in non-exposed patients (<em>p</em> = 0.003). Also, there is no difference in the distribution of other predictors between Lidocaine exposed and non-exposed groups (<em>p</em> &gt; 0.05). Exposure to Lidocaine reduces postoperative myalgia significantly [AOR = 0.33, 95 % CI = (0.17,0.66)]. Multimodal analgesia [AOR = 0.32, 95 % CI = (0.18,0.55)], non-steroidal anti-inflammatory drugs alone [AOR = 0.47, 95 % CI = (0.29,0.76)], postoperative immobility [AOR = 0.61, 95 % CI = (0.47,0.8)], and being male [AOR = 0.48, 95 % CI = (0.26,0.87)] were other determinants in reducing Succinylcholine induced postoperative myalgia.</div></div><div><h3>Conclusion</h3><div>Lidocaine pretreatment can significantly reduce the occurrence of Succinylcholine induced postoperative myalgia. Additionally, usage of multimodal analgesia with non-steroidal anti-inflammatory drugs or even only non-steroidal anti-inflammatory drugs in the intraoperative and postoperative period can reduce Succinylcholine induced postoperative myalgia.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"21 ","pages":"Pages 45-51"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024001180/pdfft?md5=21859384b67984b733588bdadcf7520e&pid=1-s2.0-S2589845024001180-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315034","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}

{"title":"Could virtual reality be a solution in surgical trainings in resource-restricted settings? A perspective","authors":"Olivier Sibomana","doi":"10.1016/j.sopen.2024.08.004","DOIUrl":"10.1016/j.sopen.2024.08.004","url":null,"abstract":"<div><p>Surgical conditions account for 11 % of the global burden of disease, with over 313 million surgical procedures performed worldwide each year. This underscores the critical need to train more surgeons, particularly in low- and middle-income countries (LMICs), where disparities in access to surgical services persist due to a limited number of trained professionals. However, in resource-restricted settings, surgical education is often hampered by ethical, logistical, and financial challenges associated with the use of cadavers, leading to significant skill gaps that can negatively impact patient outcomes and exacerbate healthcare disparities. The advent of advanced technologies, such as Virtual Reality (VR), offers a promising alternative for enhancing surgical training. This paper explores the potential of VR to revolutionize surgical education in resource-constrained environments and addresses key considerations for its effective implementation.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"21 ","pages":"Pages 14-16"},"PeriodicalIF":1.4,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024001143/pdfft?md5=3295df3781c5e54575810774055575fb&pid=1-s2.0-S2589845024001143-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142083630","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}

{"title":"Surgical skill analysis focused on tissue traction in laparoscopic wet lab training","authors":"Koki Ebina PhD ,&nbsp;Takashige Abe MD, PhD ,&nbsp;Madoka Higuchi MD, PhD ,&nbsp;Kiyohiko Hotta MD, PhD ,&nbsp;Jun Furumido MD, PhD ,&nbsp;Naoya Iwahara MD, PhD ,&nbsp;Taku Senoo PhD ,&nbsp;Shunsuke Komizunai PhD ,&nbsp;Teppei Tsujita PhD ,&nbsp;Kazuya Sase PhD ,&nbsp;Xiaoshuai Chen PhD ,&nbsp;Yo Kurashima MD, PhD ,&nbsp;Hiroshi Kikuchi MD, PhD ,&nbsp;Haruka Miyata MD, PhD ,&nbsp;Ryuji Matsumoto MD, PhD ,&nbsp;Takahiro Osawa MD, PhD ,&nbsp;Sachiyo Murai ,&nbsp;Atsushi Konno PhD ,&nbsp;Nobuo Shinohara MD, PhD","doi":"10.1016/j.sopen.2024.08.002","DOIUrl":"10.1016/j.sopen.2024.08.002","url":null,"abstract":"<div><h3>Background</h3><p>Tissue handling is one of the pivotal parts of surgical procedures. We aimed to elucidate the characteristics of experts' left-hand during laparoscopic tissue dissection.</p></div><div><h3>Methods</h3><p>Participants performed tissue dissection around the porcine aorta. The grasping force/point of the grasping forceps were measured using custom-made sensor forceps, and the forceps location was also recorded by motion capture system (Mocap). According to the global operative assessment of laparoscopic skills (GOALS), two experts scored the recorded movies, and based on the mean scores, participants were divided into three groups: novice (&lt;10), intermediate (10≤ to &lt;20), and expert (≤20). Force-based metrics were compared among the three groups using the Kruskal-Wallis test. Principal component analysis (PCA) using significant metrics was also performed.</p></div><div><h3>Results</h3><p>A total of 42 trainings were successfully recorded. The statistical test revealed that novices frequently regrasped a tissue (median total number of grasps, novices: 268.0 times, intermediates: 89.5, experts: 52.0, <em>p</em> &lt; 0.0001), the traction angle became stable against the aorta (median weighted standard deviation of traction angle, novices: 30.74°, intermediates: 26.80, experts: 23.75, <em>p</em> = 0.0285), and the grasping point moved away from the aorta according to skill competency [median percentage of grasping force applied in close zone (0 to 2.0 cm from aorta), novices: 34.96 %, intermediates: 21.61 %, experts: 10.91 %, <em>p</em> = 0.0032]. PCA showed that the efficiency-related (total number of grasps) and effective tissue traction-related (weighted average grasping position in Y-axis and distribution of grasping area) metrics mainly contributed to the skill difference (proportion of variance of first principal component: 60.83 %).</p></div><div><h3>Conclusion</h3><p>The present results revealed experts' left-hand characteristics, including correct tissue grasping, sufficient tissue traction from the aorta, and stable traction angle. Our next challenge is the provision of immediate and visual feedback onsite after the present wet-lab training, and shortening the learning curve of trainees.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"21 ","pages":"Pages 7-13"},"PeriodicalIF":1.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S258984502400112X/pdfft?md5=13bde8195065c48c12bdb4ef1663f2eb&pid=1-s2.0-S258984502400112X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142076203","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}

{"title":"Appendectomy: Cross-sectional study of the effects of COVID-19 in a hospital in South Brazil","authors":"Tierre Aguiar Gonçales ,&nbsp;Thiago Lucas Bastos de Melo Moszkowicz ,&nbsp;Mariana Severo Debastiani ,&nbsp;Marcos Souza Parreira ,&nbsp;Julia Kasali Lima ,&nbsp;Rafael José Vargas Alves ,&nbsp;Claudia Giuliano Bica","doi":"10.1016/j.sopen.2024.08.003","DOIUrl":"10.1016/j.sopen.2024.08.003","url":null,"abstract":"<div><h3>Background</h3><p>COVID-19 has further burdened the Brazilian healthcare system, especially emergencies. Patients may have delayed seeking care for surgical abdominal pain. Delays in the approach may have impacted clinical evolution and outcomes. This study evaluated appendectomies and their complications performed by the public system during one-year follow-up of COVID-19 in a hospital in southern Brazil.</p></div><div><h3>Materials and methods</h3><p>In this hospital-based cross-sectional study, we included adult patients who underwent appendectomy from March 2019 to April 2021 (n = 162). Patients were divided into pre-pandemic (n = 78) and pandemic (n = 84) groups based on the surgery date. The analyzed variables included hospitalization duration, intensive care unit (ICU) admission, surgical approach, histopathological findings, COVID-19 testing, patient outcomes, and 30-day survival rate.</p></div><div><h3>Results</h3><p>The cohorts exhibited similar epidemiology, with the sex ratio and average age being maintained. No statistical difference was found in the 30-day survival rate and clinical outcomes. Of the four patients admitted to the ICU, three belonged to the pandemic cohort and tested negative for COVID-19. Only 47.6 % of the patients in the pandemic cohort underwent COVID-19 polymerase chain reaction examination; one tested positive (2.5 %).</p></div><div><h3>Conclusion</h3><p>This study demonstrated that there was no increased risk for appendectomies during the first wave of the pandemic. Surgeries were safe during this period. Patients continued to access the emergency service despite surgical abdominal pain and restrictive measures imposed by health authorities. The similar results observed across cohorts are attributed to the readiness of the teams and the availability of medical surgical equipment in safe quantities.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"21 ","pages":"Pages 1-6"},"PeriodicalIF":1.4,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024001131/pdfft?md5=c5271b6fd984bfdd1db3b3a7eff21fa4&pid=1-s2.0-S2589845024001131-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044986","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}

{"title":"Improving adrenalectomies: Safe outcomes of partial adrenalectomies and suitable characteristics","authors":"Diana A. Hla ,&nbsp;Nafiye Busra Celik ,&nbsp;Enrique F. Elli","doi":"10.1016/j.sopen.2024.07.001","DOIUrl":"10.1016/j.sopen.2024.07.001","url":null,"abstract":"<div><h3>Background</h3><p>Partial adrenalectomy (PA) is increasingly used to treat benign tumors to lower the probability of adrenal insufficiency and reduce need for lifetime hormone replacement therapy. Currently, two major concerns are increased bleeding and non-functioning adrenal remnants. This paper examines these concerns and compares surgical approaches with novel findings.</p></div><div><h3>Methods</h3><p>Between 1993 and 2023, 72 patients underwent PA for primary adrenal disorders. Demographic, clinicopathologic and outcome data were analyzed for summary statistics, confidence intervals, and heteroscedastic <em>t</em>-test statistics.</p></div><div><h3>Results</h3><p>The patients were 17–76 years-old and were 59.7 % female. The PA was on the left 54.2 % and bilaterally 4.2 %. The indications were adrenal adenoma, pheochromocytoma, cyst, hyperplasia, and other. The mean tumor diameter was 2.7 cm (range 0.7-10 cm). 23 were performed open, 43 laparoscopically, and 6 with an intended robotic approach. Median follow-up was 9.3 years.</p><p>Robotic had the shortest length of stay (LOS) (<em>p</em>-value 0.01), then laparoscopic (p-value 0.00004), then open. The estimated blood loss (EBL) ranged from 5 to 500 mL (median 50 mL). The median LOS was two days.</p><p>Intra-operative complication rate was 1.4 % and readmission within 30 days occurred in 2.8 %. Out of 72 patients, 6.8 % needed hormone replacement; of the 14 patients with contralateral adrenalectomy, 28.6 % needed replacement.</p></div><div><h3>Conclusion</h3><p>PA appears to be safe with both laparoscopic and robotic-assisted techniques with superior perioperative outcomes. The functional results of PA prevent most patients from requiring ongoing steroid replacement treatment and recurrence rates were low. PA should be advised for more frequent use as the preferred treatment method of choice.</p></div><div><h3>Key message</h3><p>Partial adrenalectomies' perioperative and long-term outcomes over a median 9.3 year follow-up emphasized its safety and efficacy with 95 % CI of (2.7 cm, 3.6 cm) for masses with adrenal sufficiency post-resection. Additionally, as healthcare institutions decide whether to invest in surgical robots, robotic approach's outperformance of laparoscopic and open on LOS may be counterbalanced by laparoscopic's strong performance in low EBL.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"20 ","pages":"Pages 230-235"},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024000988/pdfft?md5=dc3a6ff388c0d5d6d6da2938bdaaaf6b&pid=1-s2.0-S2589845024000988-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141692801","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}

{"title":"Early adoption of robotic lung resection in an established video assisted thoracic surgery practice","authors":"Ashley L. Deeb MD ,&nbsp;Luis De Leon MD ,&nbsp;Emanuele Mazzola PhD ,&nbsp;Suden Kucukak MD ,&nbsp;Anupama Singh MD ,&nbsp;Miles McAllister BA ,&nbsp;Matthew Garrity BS ,&nbsp;Michael T. Jaklitsch MD ,&nbsp;Jon O. Wee MD ,&nbsp;Matthew M. Rochefort MD","doi":"10.1016/j.sopen.2024.07.004","DOIUrl":"10.1016/j.sopen.2024.07.004","url":null,"abstract":"<div><h3>Background</h3><p>Reported advantages to robotic thoracic surgery include shorter length of stay (LOS), improved lymphadenectomy, and decreased complications. It is uncertain if these benefits occur when introducing robotics into a well-established video-assisted thoracoscopy (VATS) practice. We compared the two approaches to investigate these advantages.</p></div><div><h3>Materials and methods</h3><p>IRB approval was obtained for this project. Patients who underwent segmentectomy or lobectomy from May 2016–December 2018 were propensity-matched 2: 1 (VATS: robotic) and compared using weighted logistic regression with age, gender, Charlson Comorbidity Index, surgery type, stage, Exparel, and epidural as covariates. Complication rates, operation times, number of sampled lymph nodes, pain level, disposition, and LOS were compared using Wilcoxon rank-sum and with Rao-Scott Chi-squared tests.</p></div><div><h3>Results</h3><p>213 patients (142 VATS and 71 robot) were matched. Duration of robotic cases was longer than VATS (median 186 min (IQR 78) vs. 164 min (IQR 78.75); <em>p</em> &lt; 0.001). Significantly more lymph nodes (median 11 (IQR 7.50) vs. 8 (IQR 7.00); <em>p</em> = 0.004) and stations were sampled (median 4 (IQR 2.00) vs. 3 (IQR 1.00); <em>p</em> &lt; 0.001) with the robot. Interestingly, robotic resections had higher 72-hour pain scores (median 3 (IQR 3.25) vs. 2 (IQR 3.50); <em>p</em> = 0.04) and 48-hour opioid usage (median 37.50 morphine milligram equivalents (MME) (IQR 45.50) vs. 22.50 MME (IQR 37.50); <em>p</em> = 0.01). Morbidity, LOS, and disposition were similar (all <em>p</em> &gt; 0.05).</p></div><div><h3>Conclusions</h3><p>The robotic approach facilitates better lymph node sampling, even in an established VATS practice.</p></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"20 ","pages":"Pages 189-193"},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024001027/pdfft?md5=dcac75967ffdd2b466f25ece1122c1dc&pid=1-s2.0-S2589845024001027-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141843389","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}

{"title":"Evidence-based management of the patient with synchronous colorectal cancer and liver metastases","authors":"Ajith K. Siriwardena MD FRCS","doi":"10.1016/j.sopen.2024.07.006","DOIUrl":"10.1016/j.sopen.2024.07.006","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"20 ","pages":"Pages 203-204"},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024001040/pdfft?md5=b93c6ba59f851f51f857cf8430253658&pid=1-s2.0-S2589845024001040-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844136","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}