Information provided by the narrative operative report is subjective and often flawed. In this prospective observational cohort study of 113 surgical cases, the authors investigated the use of systematic video recording as a potential improvement in quality and safety with regard to documenting important information in colorectal cancer surgery. Compared with narrative reports alone, systematic video recording was shown to be superior.
Adhesive small-bowel obstruction is a potentially chronic, recurring illness that can require surgical care. In a population-based cohort study, Behman and colleagues compared the risk of recurrence in patients who received operative vs nonoperative management of this condition. Patients who were managed operatively had a lower risk of recurrence than those managed nonoperatively. The probability of additional recurrences increased with each nonoperatively managed episode until surgical intervention, at which point the risk of subsequent recurrence decreased by approximately 50%.
As the US population ages, older donors represent an expansion of the donor pool; however, their organs are underused. In a prospective cohort study, Haugen and colleagues examined trends in the use of liver grafts from older donors and outcomes in liver-only recipients of older donor grafts from 2003 to 2016. Their findings revealed continued decease in the use of liver grafts from older donors despite improving outcomes for recipients.
Continuing Medical Education
Emergency laparotomy has a high mortality rate in many countries. In a quality improvement collaborative project including 28 hospitals and 14鈥�809 patients in the United Kingdom, Aggarwal and colleagues assessed whether the implementation of a care bundle was associated with reductions in mortality and length of stay. The care bundle appeared to be effective, which suggests that hospitals should adopt such an approach.
Clinical Review & Education
Patient complications occur in all areas of surgery, and managing them is an important part of surgical practice. This systematic review demonstrates that the occurrence of patient complications influences surgeons鈥� psychological well-being and is associated with adverse effects on their professional and personal lives. Departments, institutions, and professional organizations should acknowledge that patient complications adversely affect surgeons鈥� health and develop strategies to educate and support surgeons in managing this part of their professional lives.
Continuing Medical Education