Evaluating a digital prehabilitation tool in patients with colorectal surgery: protocol for a multisite randomised controlled trial.

Introduction: Colorectal cancer is a leading cause of cancer mortality in the USA and occurs most frequently in older adults. These patients are at increased risk of adverse outcomes following major cancer surgery. While prehabilitation has been shown to mitigate this risk, multiple barriers to implementation remain.

Physiologic readiness and subjective workload of performing operations: A prospective observational study of attending and trainee surgeons.

Physical health and perceived workload are determinants of career satisfaction and longevity for surgeons. The aim of this prospective observational study was to determine if biometric indicators of physical recovery among surgeons are associated with perceived workload during operations. The primary outcome was whether there was an association between surgeon self-assessment and a physiologic recovery score based on heart rate variability measured with a wearable biometric sensor.

No thanks and not for me: A qualitative study of barriers to prehabilitation participation.

Background: Prehabilitation programs have been shown to improve functional status prior to surgery, postoperative recovery, and even long-term outcomes. However, these programs often lack participation, often by patients who seem to need it the most. This study aimed to identify the primary reasons for patients' declining enrollment or low adherence to a prehabilitation program.

Gastrointestinal Surgical Patient and Multidisciplinary Healthcare Provider Beliefs and Practices Around Perioperative Nutrition: A Mixed-Methods Study.

Introduction: Nutrition is critical to gastrointestinal (GI) disease prevention and treatment, including operations, yet perioperative nutrition practices vary widely. We aimed to understand GI surgical patient and health care provider's perioperative nutrition beliefs and practices.

Materials And Methods: We used a mixed-methods approach, including a patient survey (n = 19), provider survey (n = 26), and semistructured interviews with a subset of providers (n = 15).

Society for Surgery of the Alimentary Tract State-of-the-Art Session 2022: Frailty in Surgery.

Given the exponentially aging population and rising life expectancy in the United States, surgeons are facing a challenging frail population who may require surgery but may not qualify based on their general fitness. There is an urgent need for greater awareness of the importance of frailty measurement and the implementation of universal assessment of frail patients into clinical practice. Pairing risk stratification with stringent protocols for prehabilitation and minimally invasive surgery and appropriate enhanced recovery protocols could optimize and condition frail patients before, during, and immediately after surgery to mitigate postoperative complications and consequences on patient function and quality of life.

Impact of preoperative uni- or multimodal prehabilitation on postoperative morbidity: meta-analysis.

Background: Postoperative complications occur in up to 43% of patients after surgery, resulting in increased morbidity and economic burden. Prehabilitation has the potential to increase patients' preoperative health status and thereby improve postoperative outcomes. However, reported results of prehabilitation are contradictory.

Using AI and computer vision to analyze technical proficiency in robotic surgery.

Background: Intraoperative skills assessment is time-consuming and subjective; an efficient and objective computer vision-based approach for feedback is desired. In this work, we aim to design and validate an interpretable automated method to evaluate technical proficiency using colorectal robotic surgery videos with artificial intelligence.

Methods: 92 curated clips of peritoneal closure were characterized by both board-certified surgeons and a computer vision AI algorithm to compare the measures of surgical skill.

Is It Really Gone? Assessing Response to Neoadjuvant Therapy in Rectal Cancer.

Purpose: Non-operative management of rectal cancer is a feasible and appealing treatment option for patients who develop a complete response after neoadjuvant therapy. However, identifying patients who are complete responders is often a challenge. This review aims to present and discuss current evidence and recommendations regarding the assessment of treatment response in rectal cancer.

Augmented Reality Neuronavigation for En Bloc Resection of Spinal Column Lesions.

Background: Primary tumors involving the spine are relatively rare but represent surgically challenging procedures with high patient morbidity. En bloc resection of these tumors necessitates large exposures, wide tumor margins, and poses risks to functionally relevant anatomical structures. Augmented reality neuronavigation (ARNV) represents a paradigm shift in neuronavigation, allowing on-demand visualization of 3D navigation data in real-time directly in line with the operative field.

Association of Prehabilitation With Postoperative Opioid Use in Colorectal Surgery: An Observational Cohort Study.

Introduction: Preoperative optimization programs have demonstrated positive effects on perioperative physical function and surgical outcomes. In nonsurgical populations, physical activity and healthy diet may reduce pain and pain medication requirement, but this has not been studied in surgical patients. Our aim was to determine whether a preoperative diet and exercise intervention affects postoperative pain and pain medication use.

Worse outcomes and higher costs of care in fibrostenotic Crohn's disease: a real-world propensity-matched analysis in the USA.

Background: Patients with Crohn's disease (CD) may develop fibrostenotic strictures. No currently available therapies prevent or treat fibrostenotic CD (FCD), making this a critical unmet need.

Aim: To compare health outcomes and resource utilisation between CD patients with and without fibrostenotic disease.

Engagement and Adherence with a Web-Based Prehabilitation Program for Patients Awaiting Abdominal Colorectal Surgery.

Background: Understanding the drivers of patient engagement and adherence is critical to developing and implementing preoperative optimization programs. The aim of this project is to determine whether existing health beliefs are associated with engagement and adherence in a home-based online prehabilitation program.

Methods: Patients undergoing abdominal colorectal operations were enrolled in an online nutrition and exercise program.

Measuring the human immune response to surgery: multiomics for the prediction of postoperative outcomes.

Purpose Of Review: Postoperative complications including infections, cognitive impairment, and protracted recovery occur in one-third of the 300 million surgeries performed annually worldwide. Complications cause personal suffering along with a significant economic burden on our healthcare system. However, the accurate prediction of postoperative complications and patient-targeted interventions for their prevention remain as major clinical challenges.

A comparison of provider perspectives on cultural competency training: A mixed methods study.

Background: We aimed to identify differences in training among colorectal cancer physicians and advanced practice providers with high and low cultural competency METHODS: Using explanatory sequential mixed methods, we surveyed providers and dichotomized into high and low cultural competency (CC) groups, conducted qualitative interviews, and analyzed verbatim transcripts using deductive and inductive codes to compared findings across groups using a joint display.

Results: Fifty-four of 92 providers (59%) responded; 10 respondents from each group (20/36 invited) completed semi-structured interviews about previous CC trainings. Low CC providers' training included explanations of cultural differences that, in practice, improved awareness and utilization of communication tools, but they also desired decision-making tools and cultural exposure.