Influence of neoadjuvant treatment strategy on perioperative outcomes in locally advanced rectal cancer.

Aim: Neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer facilitates tumour downstaging and complete pathological response (pCR). The goal of neoadjuvant systemic chemotherapy (total neoadjuvant chemotherapy, TNT) is to further improve local and systemic control. While some patients forgo surgery, total mesorectal excision (TME) remains the standard of care.

Evaluating the oncological safety of neoadjuvant chemotherapy in locally advanced colon carcinoma: a systematic review and meta-analysis of randomised clinical trials and propensity-matched studies.

Purpose: Use of neoadjuvant chemotherapy (NAC) for locally advanced colon cancer (LACC) remains controversial. An integrated analysis of data from high-quality studies may inform the long-term safety of NAC for this cohort. Our aim was to perform a systematic review and meta-analysis of randomised clinical trials (RCTs) and propensity-matched studies to assess the oncological safety of NAC in patients with LACC.

Impact of the 12-gene recurrence score in influencing adjuvant chemotherapy prescription in mismatch repair proficient stage II/III colonic carcinoma-a systematic review and meta-analysis.

Introduction: The 12-gene recurrence score (RS) is a clinically validated assay which predicts recurrence risk in patients with stage II/III colon cancer. Decisions regarding adjuvant chemotherapy may be guided using this assay or based on the judgement of tumour board.

Aims: To assess the concordance between the RS and MDT decisions regarding adjuvant chemotherapy in colon cancer.

When pouches cannot empty: a cohort study of the symptoms this causes, the reasons it's happening, and the treatments needed.

Background: Patients with an ileal pouch have a new system of defecation. The expulsive peristalsis of the rectum is replaced by the inertia of the pouch. Defecation becomes dependent on gravity and patients are prone to inefficient pouch-emptying.

A Surgical Presentation of Churg-Strauss Syndrome.

Eosinophilic granulomatosis with polyangiitis (EGPA) or Churg-Strauss syndrome (CSS) is a rare, autoimmune vasculitis usually affecting small and medium-sized blood vessels in its later phases. It is a diffuse, systemic, multisystem disease that is reported to present with gastrointestinal manifestations but very rarely as an acute abdomen secondary to eosinophilic peritonitis. A 28-year-old relatively healthy male with a pre-existing diagnosis of inactive pulmonary sarcoidosis presented to the emergency department with an acute abdomen.

Beyond borders: A case report of small bowel obstruction secondary to undiagnosed florid endometriosis.

Introduction And Importance: Endometriosis is a gynecological condition referring to the presence of endometrial tissue outside the endometrium with the potential of progressing to malignancy. It mostly affects pelvic organs; however, it has been described beyond the pelvis. In 10% of cases it occurs in the bowel, mostly rectum and sigmoid.

Case report of the duplex vermiform appendix: A rare presentation in an elderly patient.

Introduction And Importance: Duplex appendix is a rare anatomical entity with incidence rate of 0.004 and 0.009%.

A comparison of intra-operative diagnosis to histopathological diagnosis of acute appendicitis in paediatric and adult cohorts: an analysis of over 1000 patients.

Background: Appendicitis is a common general surgical emergency. The role of removing a normal appendix is debated. However, this relies on accurate intra-operative diagnosis of a normal appendix by the operating surgeon.

Riding the waves: the ongoing impact of COVID-19 on a national surgical training cohort.

Background: The World Health Organisation declared a global pandemic on the 11 March 2020 resulting in implementation of methods to contain viral spread, including curtailment of all elective and non-emergent interventions. Many institutions have experienced changes in rostering practices and redeployment of trainees to non-surgical services. Examinations, study days, courses, and conferences have been cancelled.

Does the Length of the Prolapsed Rectum Impact Outcome of Surgical Repair?

Background: There are many surgical options for the treatment of rectal prolapse with varying recurrence rates reported. The association between rectal prolapse length and recurrence risk has not been explored previously.

Objective: The purpose of this study was to determine whether length of prolapse predicts a risk of recurrence.

Pushing the Envelope in Endoscopic Submucosal Dissection: Is It Feasible and Safe in Scarred Lesions?

Background: Endoscopic submucosal dissection is an established advanced polypectomy technique to manage large colorectal polyps.

Objective: The purpose of this study was to evaluate patients who had endoscopic submucosal dissection in the setting of significant scarring attributed to a previous intervention to determine whether this is safe and feasible.

Design: The study used a prospectively maintained database.

Impact of service delivery factors on patient outcomes in emergency general surgery.

Background: Emergency general surgery (EGS) is a high-risk process and is associated with poor outcomes and high mortality. This study aimed to evaluate the service delivery factors in a tertiary referral centre which may influence patient outcomes in emergency general surgery.

Methods: Data on consecutive patients undergoing emergency laparotomy in a tertiary referral centre were prospectively collected from July 2017-July 2018.

Use of a Novel Measure of Nontechnical Skills in Surgical Trainees: Is There an Association With Technical Skills Performance?

Objective: To investigate whether scores on a psychological measure of concentration and interpersonal characteristics, The Attentional and Interpersonal Style Inventory (TAIS), are associated with performance of surgical skills.

Design: Postgraduate surgical trainees completed an operative surgical skills assessment in the simulation laboratory and the psychological measure (TAIS). The surgical skills assessment consisted of 6 tasks (3 per trainee): laceration suturing; lipoma excision; incision and closure of a laparotomy wound; bowel anastomosis; saphenofemoral junction ligation and basic laparoscopic skills.

Visual spatial ability for surgical trainees: implications for learning endoscopic, laparoscopic surgery and other image-guided procedures.

Background: In image-guided procedures, a high level of visual spatial ability may be an advantage for surgical trainees. We assessed the visual spatial ability of surgical trainees.

Methods: Two hundred and thirty-nine surgical trainees and 61 controls were tested on visual spatial ability using 3 standardised tests, the Card Rotation, Cube Comparison and Map-Planning Tests.

A computerised test of perceptual ability for learning endoscopic and laparoscopic surgery and other image guided procedures: Score norms for PicSOr.

Background: The aptitude to infer the shape of 3-D structures, such as internal organs from 2-D monitor displays, in image guided endoscopic and laparoscopic procedures varies. We sought both to validate a computer-generated task Pictorial Surface Orientation (PicSOr), which assesses this aptitude, and to identify norm referenced scores.

Methods: 400 subjects (339 surgeons and 61 controls) completed the PicSOr test.

Basic Surgical Skill Retention: Can Patriot Motion Tracking System Provide an Objective Measurement for it?

Background: Knot tying is a fundamental skill that surgical trainees have to learn early on in their training. The aim of this study was to establish the predictive and concurrent validity of the Patriot as an assessment tool and determine the skill retention in first-year surgical trainees after 5 months of training.

Methods: First-year surgical trainees were recruited in their first month of the training program.

Experience with botulinum toxin therapy for axillary hyperhidrosis and comparison to modelled data for endoscopic thoracic sympathectomy - A quality of life and cost effectiveness analysis.

Aim: To estimate cost-effectiveness of botulinum toxin therapy for axillary hyperhidrosis compared to the standard surgical intervention of endoscopic thoracic sympathectomy (ETS).

Methods: The validated dermatology life quality index questionnaire was given to patients attending for treatment over a 4 month period, to assess their quality of life (QoL) over the preceding week (n = 44). Follow-up was performed 4-6 weeks later by telephone using the same questionnaire to validate the effectiveness of the treatment.

Zone calculation as a tool for assessing performance outcome in laparoscopic suturing.

Background: Simulator performance is measured by metrics, which are valued as an objective way of assessing trainees. Certain procedures such as laparoscopic suturing, however, may not be suitable for assessment under traditionally formulated metrics. Our aim was to assess if our new metric is a valid method of assessing laparoscopic suturing.

The impact of aptitude on the learning curve for laparoscopic suturing.

Background: Within surgery, several specialties demand advanced technical skills, specifically in the minimally invasive environment.

Methods: Two groups of 10 medical students were recruited on the basis of their aptitude (visual-spatial ability, depth perception, and psychomotor ability). All subjects were tested consecutively using the ProMIS III simulator until they reached proficiency performing laparoscopic suturing.

Factors influencing microsurgical skill acquisition during a dedicated training course.

Background: Proficient microsurgical skills are considered essential in plastic and reconstructive surgery. Specialized courses offer trainees opportunity to improve their technical skills. Trainee aptitude may play an important role in the ability of a trainee to acquire proficient skills as individuals have differing fundamental abilities.

Impact of an assistant on the technical skills of the primary operator in superficial femoral artery angioplasty.

Objective: To assess the impact of an assistant on the technical skills of the operator performing superficial femoral artery (SFA) angioplasty on the vascular intervention simulation trainer (VIST) simulator.

Methods: Eight experts performed 2 SFA angioplasties each on the VIST. Four experts had an assistant available.

Skills transfer after proficiency-based simulation training in superficial femoral artery angioplasty.

Introduction: The purpose of this study was to explore whether basic endovascular skills acquired using proficiency-based simulation training in superficial femoral artery (SFA) angioplasty translate to real-world performance.

Methods: Five international experts were invited to evaluate a preliminary 28-item rating scale for SFA angioplasty using a modified Delphi study. To test the procedural scale, 4 experts and 11 final-year medical students then performed 2 SFA angioplasties each on the vascular intervention simulation trainer simulator.

Development and evaluation of a simulator-based laparoscopic training program for surgical novices.

Background: The use of simulation to train novice surgeons in laparoscopic skills is becoming increasingly popular. To maximize benefit from simulation, training needs to be delivered and assessed in a structured manner. This study aimed to define performance goals, demonstrate construct validity of the training program, and evaluate whether novice surgeons could reach the preset performance goals.

Are residents accurate in their assessments of their own surgical skills?

Background: An appropriate level of awareness of one's own technical skill is essential to being an effective self-directed learner. The aim of this study was to analyze surgical residents' self-awareness by examining their ability to predict and assess their own performance in an objective surgical skills examination.

Methods: Surgical residents' (n = 216) pre-examination self-predicted scores and post-examination self-assessed scores were compared with objectively measured scores.