American journal of surgery
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Comparative Study
Colorectal complications of external beam radiation versus brachytherapy for prostate cancer.
Although radiation therapy plays a central role in the management of prostate cancer, complications remain a troubling byproduct. We sought to determine the prevalence and significance of colorectal complications after external beam radiation (EBRT) versus brachytherapy (BT) for prostate cancer. ⋯ Despite its relative safety, radiation therapy for prostate cancer has a significant incidence of colorectal complications. Overall, BT has a significantly lower incidence of acute and late toxicities than EBRT.
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Congenital midgut malrotation, a rare anatomic anomaly that can lead to duodenal or small-bowel obstruction, rarely is observed beyond the first year of life. Symptomatic patients present with either acute bowel obstruction and intestinal ischemia with a midgut or cecal volvulus or with chronic vague abdominal pain. Chronic symptoms often can make the diagnosis difficult. By using several modalities such as barium studies, computerized tomography, angiography, and emergency laparotomy, we diagnosed midgut volvulus and partial intestinal obstruction, which occur rarely in an adult with congenital midgut malrotation.
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The transformation of a trainee into a surgeon is influenced strongly by communication patterns in the operating room (OR). In the current era of limited educational opportunities, elucidation of teaching and learning strategies in this environment is critical. The aim of this study was to further understand the elements of an effective communicative instructional interaction (CII) as perceived by surgical residents. ⋯ In a unique environment such as the OR, both teacher and learner may benefit by an enhanced understanding of the elements of an effective CII.
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Comparative Study
Robotic-assisted adrenalectomy: what advantages compared to lateral transperitoneal laparoscopic adrenalectomy?
This study evaluates the perioperative outcomes of robotic-assisted adrenalectomy (RA) compared with lateral transperitoneal laparoscopic adrenalectomy (LA). ⋯ After a learning curve of 20 cases, RA has similar perioperative outcomes compared to lateral transperitoneal LA. Several criteria (previous laparoscopic expertise, first assistant's skill and tumor side) remain determinative on RA operative time.
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Case presentation and literature review for intestinal malrotation presenting in an adult. Although the number of patients with this condition that escape infancy undiagnosed is not clear, it is clear that when the rare patient presents as an adult it can be a perplexing situation for surgeons not familiar with the presenting signs and anatomy. This confusion can lead to diagnostic and intraoperative errors.