Surgical endoscopy
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Meta Analysis Comparative Study
Total mesorectal excision for low and middle rectal cancer: laparoscopic versus transanal approach-a meta-analysis.
Transanal total mesorectal excision (TaTME) appeared to be a challenging alternative to Laparoscopic Total Mesorectal Excision (LaTME) for low and middle rectal cancer. However, evidence remains low on the possible benefits of TaTME. The aim of this study was to perform a meta-analysis of comparative studies between TaTME and LaTME. ⋯ This meta-analysis based on nonrandomized studies suggests that TaTME seems better than LaTME in terms of overall and major morbidities, anastomotic leak, readmission rate, CRM involvement, and length of stay. These results need to be confirmed by randomized controlled trial.
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Randomized Controlled Trial
Effects of quadratus lumborum block regional anesthesia on postoperative pain after colorectal resection: a randomized controlled trial.
Postoperative pain following colorectal surgery is associated with a significant use of opioids. Recently, regional anesthesia, such as the posterior quadratus lumborum block (QL2), has been proposed to improve pain relief and reduce opioid use. However, the benefit of the QL2 on postoperative pain control remains controversial. ⋯ We did not observe a reduction in postoperative opioid administration at 24 h with a posterior quadratus lumborum block regional anesthesia in patients undergoing elective colorectal surgery.
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Speaking invitations are used by faculty promotion committees as evidence of external recognition. However, women are underrepresented as speakers at specialty society conferences despite the rise in women physicians. The purpose of this study was to estimate to what extent the gender of session conveners is associated with the gender distribution of invited speakers at SAGES meetings. ⋯ The proportion of women invited speakers at the annual SAGES meeting has significantly increased over time. All-male convener sessions were more likely to convene all-male speaker panels. Including a woman chair/co-chair increased the number of women speakers and is a successful strategy to achieve gender balance in conference planning.
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We hypothesized that practicing surgeons would successfully achieve a better and more frequent Critical View of Safety (CVS) during laparoscopic cholecystectomy (LC) after participation in a structured Safe CVS Curriculum. ⋯ A structured curriculum on achieving a quality CVS for practicing, experienced surgeons improved their confidence and frequency of obtaining the Critical View of Safety during LC. We recommend that the Safe CVS Curriculum be considered for widespread use in order to increase the quality and frequency of attaining the Critical View of Safety.
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Transanal total mesorectal excision (taTME) is a surgical approach for low rectal cancer with a learning curve estimated at 40-50 cases. The experience among taTME surgeons beyond their learning curve is limited. ⋯ Indications for taTME at experienced centers have expanded to include complex reoperative cases, local recurrences, metastatic cancer, and tumors with threatened CRM or IAS with evidence of post-treatment tumor regression. In the latter cases, taTME achieves good short-term outcomes and may facilitate R0 resection.