Surgeon Should Research Articles

What Every Colorectal Surgeon Should Know About the Updated Medicare Access and Children's Healthcare Insurance Program Reauthorization Act and the Merit-Based Incentive Program System Legislation.

What Every Colorectal Surgeon Should Know About the Updated Medicare Access and Children's Healthcare Insurance Program Reauthorization Act and the Merit-Based Incentive Program System Legislation.

Commentary on: Social Determinants of Health: What Every Pediatric Surgeon Should Know

Commentary on: Social Determinants of Health: What Every Pediatric Surgeon Should Know

Invited Commentary on ChatGPT: What Every Pediatric Surgeon Should Know About Its Potential Uses and Pitfalls

Invited Commentary on ChatGPT: What Every Pediatric Surgeon Should Know About Its Potential Uses and Pitfalls

What an Endocrine Surgeon Should Know about Sample Collection and Tissue Preservation

What an Endocrine Surgeon Should Know about Sample Collection and Tissue Preservation

What Every Colorectal Surgeon Should Know About the American Medical Association/Specialty Society Relative Value Scale Update Committee.

What Every Colorectal Surgeon Should Know About the American Medical Association/Specialty Society Relative Value Scale Update Committee.

The Surgical Instrument Sterilization Process: What Every Surgeon Should Know.

» The phases of the sterilization process for surgical equipment are cleaning, disinfection, and sterilization.» Following manufacturer and regulatory guidelines will minimize contamination throughout the sterilization process.» Immediate use steam sterilization, when used appropriately, is a reasonably safe option to be used at the discretion of the operating surgeon.

Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features: What a Surgeon Should Know.

The inclusion of the less aggressive follicular form of papillary thyroid cancer (PTC) is associated with an increase in the incidence of the condition, with the follicular variant of PTC being the most common of all variants. The majority of individuals with the encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) are treated as though they have classic thyroid cancer, despite the availability of mounting evidence to contradict the aforementioned. According to numerous research, a certain type of noninvasive-EFVPTC (NI-EFVPTC) demonstrated poor histopathologic diagnostic reproducibility and has received aggressive treatment similar to that of a classical thyroid neoplasm. Therefore, to replace the term NI-EFVPC, a new nomenclature for these tumors, called "noninvasive follicular thyroid neoplasm with papillary-like nuclear characteristics" (NIFTP), was introduced in the year 2016. The present paper explores this recently introduced terminology, clinical, histologic, and molecular features, and diagnostic criteria.

Letter to Editor: “Surgical Intensive Care: Why Every General Surgeon Should Be Trained In It?”

Letter to Editor: “Surgical Intensive Care: Why Every General Surgeon Should Be Trained In It?”

Immune Checkpoint Inhibitor–Mediated Hepatobiliary Toxicity: What the Surgeon Should Know

INTRODUCTION: Immunotherapy with immune checkpoint inhibitors (ICIs) has revolutionized cancer treatment. However, immune-related adverse effects are increasingly recognized. Hepatobiliary toxicity can manifest radiographically as inflammatory and neoplastic changes that mimic surgically treated disease. The aim of this study is to investigate pitfalls of ICI-mediated hepatobiliary toxicity that require treatment with steroids, and not operation. METHODS: Patients evaluated in a hepatobiliary clinic for elevated liver function test while receiving ICI therapy for various malignancies were analyzed. Cross-sectional imaging and ultrasounds were evaluated for anatomic abnormality. RESULTS: Among 44 consecutive patients evaluated for elevated liver function test while receiving immunotherapy, 5 patients (11%) had imaging that showed anatomic abnormality. MRI and/or CT showed intra- and extrahepatic biliary ductal dilation in 3 patients, including 1 patient with imaging concerning for acute and chronic cholecystitis; hepatic pseudotumor in 1 patient, and abnormal liver enhancement in 1 patient (Figure). Among the 5 patients, 1 patient underwent operation for a presumed diagnosis of cholecystitis and choledocholithiasis. However, cholecystectomy was aborted due to findings of obscured anatomy and dense inflammation surrounding the hepatoduodenal ligament. All 5 patients received treatment with steroids with improvement in liver function test.FigureCONCLUSION: Anatomic abnormality involving the liver and biliary tree develops in a minority of patients receiving cancer treatment with ICIs. In patients who develop biliary ductal dilation and/or thickened gallbladder wall on ICI therapy, surgeons should have a heightened suspicion of an immune-related adverse event.

What Every Colorectal Surgeon Should Know About Private Practice Compensation Models.

What Every Colorectal Surgeon Should Know About Private Practice Compensation Models.

Childhood Obstructive Sleep Apnea, What a Surgeon Should Know. Part 1: Interpreting the Polysomnography Study; Part 2: Diagnosis and Management

Obstructive sleep apnea (OSA) and disordered breathing can be common in early development with certain conditions placing children at increased risk for OSA, such as micrognathia and the Pierre Robin sequence, craniosynostosis, and tonsillar hypertrophy. A Level 1 Sleep Study evaluation is recommended in all children with suspected sleep apnea. Part 1 of this review provides a discussion of the polysomnography study and interpretation. Part 2 focuses on diagnosis and management, emphasizing conditions that are amendable to surgical intervention and the impact of intervention on post-operative sleep study outcomes.

Follicular Cholecystitis: What a General Surgeon Should Know.

Follicular Cholecystitis: What a General Surgeon Should Know.

What Every Colorectal Surgeon Should Know About the No Surprises Act.

What Every Colorectal Surgeon Should Know About the No Surprises Act.

Invited Commentary: An Updated Overview of Gender Dysphoria and Gender Affirmation Surgery: What Every Plastic Surgeon Should Know.

Invited Commentary: An Updated Overview of Gender Dysphoria and Gender Affirmation Surgery: What Every Plastic Surgeon Should Know.

An Updated Overview of Gender Dysphoria and Gender Affirmation Surgery: What Every Plastic Surgeon Should Know.

Gender dysphoria refers to the medical condition experienced by individuals whose physical anatomy is not consistent with their gender identity. Surgery is a safe and effective treatment for many individuals, yet the current demand for surgery exceeds the number of trained surgeons. This article reviews gender-affirming surgical procedures and emphasizes an individualized approach within the context of a multidisciplinary team. We review pre-, intra-, and postoperative care including the preoperative requirements for surgery.

Primary Aortoenteric Fistulae: What Every Surgeon Should Know About Its Diagnosis and Treatment

Aortoenteric fistula is a rare finding that is potentially fatal and is usually seen as a fistula between the aorta or an aortic graft and the third part of the duodenum. The type without the presence of an artificial graft is considered as primary and the other type as secondary. The patients usually present with the heralding symptom of minor hematemesis, which later leads to massive and mortal GI bleeding. The most important factor in the diagnosis of an aortoenteric fistula is to have a high clinical suspicion after taking an appropriate and accurate history. In hemodynamically stable patients with clinical suspicion, performing an intravenouscontrast-CT scan of the abdomen and pelvis is of assistance in diagnosis. In general, stable hemodynamics greatly reduces the suspicion for diagnosis. Treatment is often surgical, and in regard to the severity of abdominal contamination or the level of visible infection, the extra anatomical or insitu graft repair is considered as the method of choice. This article tries to transfer our experiences in two patients, each of whom presented with hematemesis and melena without a history of underlying aortic aneurysm.

What Every Colorectal Surgeon Should Know About Advocacy and Why We Need the American College of Surgeons as our Partner.

Tsoraides, Steven S. M.D.; Bailey, H. Randolph M.D.; On behalf of the Healthcare Economics Committee of the American Society of Colon and Rectal Surgeons Author Information

Primary Bone Tumor of the Spine-An Evolving Field: What a General Spine Surgeon Should Know.

Study Design:A narrative review of the literature.Objective:This article reviews the general principles of treatment and investigation for primary bone tumors of the spine. Furthermore, it explores the emerging alternatives.Methods:A review was performed using Medline, Embase, and Cochrane databases.Results:Primary bone tumors of the spine are rare entities that general spine surgeons may encounter only a few times in their career. The treatment algorithm of these complex tumors is filled with nuances and is evolving constantly. For these reasons, patients should be referred to experienced tertiary or quaternary centers who can offer a comprehensive multidisciplinary approach. For most malignant spinal bone tumors, surgery remains the cornerstone of treatment. Respecting oncologic principles has been associated with improved survival and decreased local recurrence in multiple settings. However, even in experienced centers, these surgeries carry a significant risk of adverse events and possible long-term neurologic impairment. The associated morbidity of these procedures and the challenges of local recurrence have encouraged professionals caring for these patients to explore alternatives or adjuncts to surgical treatment.Conclusions:Over the past few years, several advances have occurred in medical oncology, radiation oncology and interventional radiology, changing the treatment paradigm for some tumors. Other advances still need to be refined before being applied in a clinical setting.

Essential Concepts for the Management of Metastatic Spine Disease: What the Surgeon Should Know and Practice.

Study Design:Literature review.Objective:To provide an overview of the recent advances in spinal oncology, emphasizing the key role of the surgeon in the treatment of patients with spinal metastatic tumors.Methods:Literature review.Results:Therapeutic advances led to longer survival times among cancer patients, placing significant emphasis on durable local control, optimization of quality of life, and daily function for patients with spinal metastatic tumors. Recent integration of modern diagnostic tools, precision oncologic treatment, and widespread use of new technologies has transformed the treatment of spinal metastases. Currently, multidisciplinary spinal oncology teams include spinal surgeons, radiation and medical oncologists, pain and rehabilitation specialists, and interventional radiologists. Consistent use of common language facilitates communication, definition of treatment indications and outcomes, alongside comparative clinical research. The main parameters used to characterize patients with spinal metastases include functional status and health-related quality of life, the spinal instability neoplastic score, the epidural spinal cord compression scale, tumor histology, and genomic profile.Conclusions:Stereotactic body radiotherapy revolutionized spinal oncology through delivery of durable local tumor control regardless of tumor histology. Currently, the major surgical indications include mechanical instability and high-grade spinal cord compression, when applicable, with surgery providing notable improvement in the quality of life and functional status for appropriately selected patients. Surgical trends include less invasive surgery with emphasis on durable local control and spinal stabilization.

What Every Colorectal Surgeon Should Know About the New American Cancer Society's Colorectal Cancer Screening Guidelines.

What Every Colorectal Surgeon Should Know About the New American Cancer Society's Colorectal Cancer Screening Guidelines.