Surgery is the cornerstone in the treatment of non-metastatic colorectal cancer, supported by selective use of systemic chemotherapy and radiotherapy to improve distant and local control respectively. Radiotherapy has already been shown to be more effective in the neoadjuvant setting, with greater compliance than in the ...
Cancer of the gastro-oesophageal junction (GOJ) is often grouped with either oesophageal or gastric cancer in trials, given its indistinct location in the distal oesophagus and proximal stomach. This retrospective study compared outcomes among 650 patients with adenocarcinoma of the GOJ treated with neoadjuvant chemoradiation and 125 who had neoadjuvant or perioperative chemotherapy. Neoadjuvant chemoradiation was not significantly associated with increased 30-day major complications or mortality, nor improved overall or disease-free survival, compared with perioperative chemotherapy.
This review examined the evidence of coaching to improve qualified surgeons’ non-technical skills. When coached in a group with other health workers, skills improved. When coached individually, surgeons perceived coaching as valuable, however, no studies assessed skill improvement. More robust studies are required to assess the impact of individual coaching.
Dear Editor The COVID-19 pandemic has had a massive impact on the organization of the Italian National Health System. To counter the pandemic, a redistribution of financial resources and a deprioritization of non-emergency medical services, including diagnostic tests and elective specialist surgery, have been implemented. ...
Based on the principles of biomedical ethics, the authors conducted a survey focusing on the ethical aspects of, didactic benefits of and possible alternatives to live surgery events. This work provides an investigation of the ethics of live surgery events in an interdisciplinary and multicentre setting. Critical ethical concerns regarding the justification of such events are highlighted through evaluation of attendees and surgeons.
Morbidity and impacts on quality of life remain significant issues following oesophagectomy for oesophageal cancer. This paper reviews and weighs the current evidence both in favour of and against the adoption of an organ-preserving approach in patients with a complete clinical response to neoadjuvant therapy.
Breast cancer is rare in men, and synthesis of real-world data is required to optimize its clinical management. This review indicated that breast-conserving therapy is safe, especially for tumours smaller than 2 cm. Postmastectomy radiation therapy to the chest wall improved survival despite total mastectomy.
Adult appendicitis is the most common emergency general surgery condition worldwide, and is normally treated with laparoscopic appendicectomy despite evidence that it can be treated safely with antibiotics. The authors followed up patients who received operative treatment and non-operative treatment with antibiotics during the first wave of the COVID-19 pandemic. Non-operative management was associated with a shorter length of hospital stay, fewer complications and a significant health cost reduction compared with operative management.
Hypothermic oxygenated machine perfusion (HOPE) reduces ischaemia–reperfusion injury of donor livers and thereby improves outcomes after transplantation. End-ischaemic normothermic machine perfusion (NMP) enables assessment of hepatobiliary viability and selection of livers that would otherwise have been declined for transplantation. We advocate the combined use of (dual) HOPE and NMP for livers that are considered high risk, but may still be transplanted safely after ex situ resuscitation and assessment of hepatobiliary viability. Combined dual HOPE–NMP has the potential to substantially decrease the high rates of deceased donor liver discard.
A survey exploring parental leave received responses from both men and women from 65 countries. The study demonstrates that a considerable proportion of surgeons had inadequate maternity/paternity leave. Gender inequity was a more significant finding than geographical and career stage differences in the experience of maternity/paternity leave and parenthood.