Pelvic Reconstruction following Abdominoperineal Resection and Pelvic Exenteration: Management Practices among Plastic and Colorectal Surgeons.

Background:  Pelvic reconstruction with a muscle flap significantly improves postoperative outcomes following abdominoperineal resection (APR). Despite it being the gold standard, significant surgeon-selection bias remains with respect to the necessity of pelvic obliteration, flap choice, and ostomy placement. The objective of the study was to characterize management practices among colorectal surgeons (CSs) and plastic surgeons (PSs).

Colectomy rates for ulcerative colitis in England 2003-2016.

Background: Temporal trends in colectomy rate for ulcerative colitis (UC) are particularly relevant in the current era of published IBD standards and changing approach to salvage of acute severe disease.

Aims: To investigate temporal trends in colectomy for UC using English population data.

Methods: The Hospital Episode Statistics (HES) were interrogated between 2003-2016 with two patient groups investigated independently.

Failure to Rescue Deteriorating Patients: A Systematic Review of Root Causes and Improvement Strategies.

Objectives: "Failure to rescue" (FTR) is the failure to prevent a death resulting from a complication of medical care or from a complication of underlying illness or surgery. There is a growing body of evidence that identifies causes and interventions that may improve institutional FTR rates. Why do patients "fail to rescue" after complications in hospital? What clinically relevant interventions have been shown to improve organizational fail to rescue rates? Can successful rescue methods be classified into a simple strategy?

Methods: A systematic review was performed and the following electronic databases searched between January 1, 2006, to February 12, 2018: MEDLINE, PsycINFO, Cochrane Library, CINAHL, and BNI databases.

Post surgical rectovaginal fistula: who really benefits from stoma diversion?

To analyze the role of stoma diversion and timing of stoma maintenance in the healing of post-surgical Recto Vaginal Fistulae (psRVF). A retrospective analysis of a prospectively maintained registry. All patients with a psRVF diagnosed at IRCCS Sacro Cuore-Don Calabria Hospital of Negrar di Valpolicella from January 2002 to December 2016 were analyzed.

LAP-VEGaS Practice Guidelines for Reporting of Educational Videos in Laparoscopic Surgery: A Joint Trainers and Trainees Consensus Statement.

Objective: Consensus statement by an international multispecialty trainers and trainees expert committee on guidelines for reporting of educational videos in laparoscopic surgery.

Summary Of Background Data: Instructive laparoscopy videos with appropriate exposition could be ideal for initial training in laparoscopic surgery, but there are no guidelines for video annotation or procedural educational and safety evaluation.

Methods: Delphi questionnaire of 45 statements prepared by a steering group and voted on over 2 rounds by committee members using an electronic survey tool.

Reducing the incidence of parastomal hernia with a simple surgical technique.

The incidence of parastomal hernia is reported at between 10% and 50%. The development of a hernia after stoma surgery can lead to both physical and psychological problems and may reduce the individual's quality of life. Many garments and appliances are aimed at managing a stoma and a peri-stomal hernia.

Surgical complications and their impact on patients' psychosocial well-being: a systematic review and meta-analysis.

Objective: Surgical complications may affect patients psychologically due to challenges such as prolonged recovery or long-lasting disability. Psychological distress could further delay patients' recovery as stress delays wound healing and compromises immunity. This review investigates whether surgical complications adversely affect patients' postoperative well-being and the duration of this impact.

A systematic review to identify the factors that affect failure to rescue and escalation of care in surgery.

Background: The relationship between the ability to recognize and respond to patient deterioration (escalate care) and its role in preventing failure to rescue (FTR; mortality after a surgical complication) has not been explored. The aim of this systematic review was to determine the incidence of, and factors contributing to, FTR and delayed escalation of care for surgical patients.

Methods: A search of MEDLINE, EMBASE PsycINFO, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials was conducted to identify articles exploring FTR, escalation of care, and interventions that influence outcomes.

National outcomes and uptake of laparoscopic gastrectomy for cancer in England.

Background: Gastrectomy remains the mainstay of curative treatment for gastric cancer, yet it is associated with significant postoperative mortality. The laparoscopic approach has been introduced in an attempt to improve surgical outcomes. This study examines the uptake of laparoscopic gastrectomy in England and quantifies postoperative mortality and morbidity following gastrectomy for cancer.

Failure to rescue patients after reintervention in gastroesophageal cancer surgery in England.

Importance: Gastroesophageal cancer resections are associated with significant reintervention and perioperative mortality rates.

Objective: To compare outcomes following operative and nonoperative reinterventions between high- and low-mortality gastroesophageal cancer surgical units in England.

Design: All elective esophageal and gastric resections for cancer between 2000 and 2010 in English public hospitals were identified from a national administrative database.

Feedback on prescribing errors to junior doctors: exploring views, problems and preferred methods.

Background: Prescribing errors are common in hospital inpatients. However, the literature suggests that doctors are often unaware of their errors as they are not always informed of them. It has been suggested that providing more feedback to prescribers may reduce subsequent error rates.

An observational study of the frequency, severity, and etiology of failures in postoperative care after major elective general surgery.

Objective: To investigate the nature of process failures in postoperative care, to assess their frequency and preventability, and to explore their relationship to adverse events.

Background: Adverse events are common and are frequently caused by failures in the process of care. These processes are often evaluated independently using clinical audit.

Measuring academic performance for healthcare researchers with the H index: which search tool should be used?

Objectives: To compare H index scores for healthcare researchers returned by Google Scholar, Web of Science and Scopus databases, and to assess whether a researcher's age, country of institutional affiliation and physician status influences calculations.

Subjects And Methods: One hundred and ninety-five Nobel laureates in Physiology and Medicine from 1901 to 2009 were considered. Year of first and last publications, total publications and citation counts, and the H index for each laureate were calculated from each database.

Poor 1-year survival in elderly patients undergoing nonelective colorectal resection.

Background: Colorectal resection in elderly patients is associated with significant morbidity and mortality, especially in an emergency setting.

Objectives: This study aims to quantify the risks associated with nonelective colorectal resection up to 1 year after surgery in elderly patients.

Design: This is a population-based observational study.

Single measures of performance do not reflect overall institutional quality in colorectal cancer surgery.

Objective: To evaluate overall performance of English colorectal cancer surgical units identified as outliers for a single quality measure--30 day inhospital mortality.

Design: 144,542 patients that underwent primary major colorectal cancer resection between 2000/2001 and 2007/2008 in 149 English National Health Service units were included from hospital episodes statistics. Casemix adjusted funnel plots were constructed for 30 day inhospital mortality, length of stay, unplanned readmission within 28 days, reoperation, failure to rescue-surgical (FTR-S) and abdominoperineal excision (APE) rates.

A framework to establish a mentoring programme in surgery.

Introduction: Mentoring programmes help to facilitate the process of continuous professional development in surgery, providing an organizational structure around a mentor-mentee relationship which helps to develop the mentee. The lack of guidelines outlining how to set up such mentoring programmes, the fragmented inter-relationships of existing schemes and the lack of a unified strategy for their implementation are obstacles to the creation of such initiatives within many surgical departments.

Methods: We draw upon previous research, the experiences of certain authors and our own reflections to identify the key features of a surgical mentoring programme.

Curriculum-based solo virtual reality training for laparoscopic intracorporeal knot tying: objective assessment of the transfer of skill from virtual reality to reality.

Background: Very few studies have addressed the transferability of skills from virtual reality (VR) to real life. The aim of this study was to assess the feasibility and effectiveness of teaching intracorporeal knot tying (ICKT) by VR simulation only.

Methods: Twenty novices underwent structured training of basic skills training on the Minimally Invasive Surgical Trainer simulator (Mentice AB, Gothenburg, Sweden) followed by knot tying training on the LapSim simulator (Surgical Science, Gothenburg, Sweden).