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Conference Highlights: ACS 2016

Conference Highlights: ACS 2016
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New research was presented at ACS 2016, the annual Clinical Congress of the American College of Surgeons, from October 16 to 20 in Washington, DC. The features below highlight some of the studies presented at the conference.
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Assessing Early Discontinuation of Opiates After Trauma

The inappropriate use of prescription opiates  is a significant public health issue throughout the United States, but little is known about patterns of use and factors associated with discontinuation of these drugs after major trauma. For a study, investigators sought to identify predictors of opiate discontinuation in patients who were discharged after experiencing a trauma. At 3 months, more than 90% had discontinued opiate use. Advanced age, marital status, and low socioeconomic status appeared to be significantly associated with a lower likelihood of discontinuation of opiates after a trauma whereas race, injury severity, and comorbid anxiety or depression were not. The findings may help surgeons identify high-risk patients and manage them accordingly.

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Monitoring Functional Recovery at Home

Few studied have explored the feasibility of wearable, real-time, wireless monitoring devices and their effect on functional recovery and patient-centered outcomes after surgery. For a study, researchers had major abdominal surgery patients wear wristband pedometers that tracked their steps 3 to 7 days before their operation, during their hospitalization, and for 2 weeks after they were discharged. Web-based, self-reported symptoms and quality of life (QOL) were obtained throughout the study. Adherence rates for wearing the pedometer were above 80% before and after discharge. More than 75% of symptom and QOL assessments were completed by about 63% and 74% of patients, respectively. Patient satisfaction scores were 4 out of 5.

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Predicting ICU Readmission for Surgical Patients

ICU readmission within 72 hours is an established quality measure of postoperative care, but research is lacking on predictors of these readmissions following various types of surgery. A study was conducted in which investigators evaluated more than 3,000 surgical patients admitted to an ICU. Within 72 hours, 5% of patients were readmitted after general surgery (34%), transplantation (9%), trauma (43%), and vascular surgery (14%). The study group developed a nomogram to help clinicians predict ICU readmissions. Factors in the nomogram included age, blood urea nitrogen, serum chloride, serum glucose, atrial fibrillation, renal insufficiency, and respiratory rate.

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Comparing Hepatectomy Approaches

Research comparing the effectiveness of minimally invasive surgery (MIS) with the conventional open approach for major hepatectomy or challenging resections has been limited to single-institution series. For a study, researchers collected data on more than 1,000 patients who underwent major hepatectomy at 67 hospitals in 2014. Risk of serious morbidity or mortality (SMM) was significantly lower among those who underwent MIS when compared with those who underwent open surgery. However, no significant between-group differences were observed for bile leaks, liver failure, reoperation or intervention, or 30-day readmission. Also, no significant differences were observed in SMM risk among challenging resection procedures.

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Maternal & Fetal Outcomes After Bariatric Surgery

With obesity potentially increasing pregnancy and postnatal complications and bariatric surgery becoming an increasingly common method of weight reduction in obese women, clinical investigations are needed to evaluate maternal and fetal outcomes for pregnant women who have previously undergone bariatric surgery. To address this research gap, investigators systematically reviewed studies published between 2000 and 2016 that compared maternal and fetal delivery outcomes following bariatric surgery with those among the general population of obese mothers. Women who had undergone bariatric surgery were significantly less likely to require Cesarean sections. The incidence of women who had babies that were large for gestational age, those with macrosomia, and those with assisted vaginal deliveries were significantly lower in the post-bariatric surgery group. Preterm delivery incidence rates were similar in both groups.


 

NEWS FROM ACS 2016

Clinical Congress News (Oct 16, 17)

Clinical Congress News (Oct 18)

Clinical Congress News (Oct 19)

Clinical Congress News (Oct 20)

Moonshot director calls data access the holy grail

Burnout crisis threatens medical profession

Surgeons debate when to use the scope

Resident work rules bring year-one case dip

Heparin rare before cancer operations

Neural stimulation holds promise for patients who are unresponsive to conventional treatments

ACS launches project to improve surgery in older adults

It’s ‘hard to do the right thing’ in athletic head trauma

Video: Learning a thing or two from elite athletes

3D printing’s potential comes into view

Six goals driving global access to surgery

Data suggest over-treatment in ductal carcinoma in situ

Retraining how we train

Kids can go home sooner after surgery

Emerging understanding of microbiome use

Surgeons urged to support national trauma system

Increase survival of tragedies by teaching bleeding control

Scarce data to support cholecystectomy

Anticoagulant reversal a growing issue in trauma

Endoscopy expands Barrett’s toolbox

Most kids treated for brain injuries outside the ED

Elective colectomy linked to one-year mortality in older patients

Surgeons needed in disaster relief

Posters of Exceptional Merit selected

Is the jury still out on bowel prep?

How genomics is reshaping cancer care

Primary tumor resection increases survival in stage IV colon cancer

New standards to improve geriatric surgical care

Older surgeons more apt to shun laparoscopic colectomy

Ebola enhanced surgical care in Sierra Leone

Building a bridge to resection in hepatobiliary cancers

Pediatric anesthetic risks justify precautions

Calculating risk in emergency general surgery

Dr. Canady stresses the need to attract more young neurosurgeons

Appendectomy alternatives worth considering

Cancer care needs real-world data

African-American surgical pioneers celebrated

Military-civilian partnerships keep trauma skills sharp

Surgeons share tips to beat burnout

Immunotherapy boosts cancer care options

ACS verification benefits outcomes in young and old

 

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