Empowering Futures: The Impact of Surgical Research Pipeline Programs on Undergraduate Career Development.

Purpose: Surgical research pipeline programs provide a unique insight into academic surgery, offering a distinctive opportunity for aspiring future surgeons and medical professionals to identify suitable mentorship. The objective of this study was to determine the impact of an academic summer research, shadowing, and mentorship program on undergraduate students with interest in the fields of medicine and surgery.

Methods: We conducted a convergent mixed methods study on undergraduate students who participated in the Surgery Undergraduate Research Experience (SURE) program from 2017 to 2022, excluding the 2020 cohort as their experience was highly impacted by COVID-19.

Molecular differentiation between complete and incomplete responders to neoadjuvant therapy in rectal cancer.

Background: Neoadjuvant chemoradiotherapy (nCRT) is the standard treatment for locally advanced rectal cancer, but only 20-40% of patients completely respond to this treatment.

Methods: To define the molecular features that are associated with response to nCRT, we generated and collected genomic and transcriptomic data from 712 cancers prior to treatment from our own data and from publicly available data.

Results: We found that patients with a complete response have decreased risk of both local recurrence and future metastasis.

High risk populations for unplanned healthcare utilization following ostomy construction.

Background: Patients with a new ostomy have high rates of unplanned healthcare utilization (UPHU). We used machine learning to assess which factors contributed the most to UPHU after ostomy construction.

Methods: We retrospectively studied new ostomy patients between 2018 and 2021 ​at a single institution.

ST6GAL1 is associated with poor response to chemoradiation in rectal cancer.

Introduction: Colorectal cancer is the third most common cause of cancer death. Rectal cancer makes up a third of all colorectal cases. Treatment for locally advanced rectal cancer includes chemoradiation followed by surgery.

Funding a general surgery residency academic development time program.

Background: To encourage progression of surgeon scientists amongst increasingly limited funding, academic interest, training institutions are supporting mid-training academic development time (ADT). We propose that supporting ADT with a full funding mechanism will improve ADT participation at minimal institutional cost.

Materials And Methods: From 2017 to 2022, our surgery department proposed a full funding mechanism for a post-graduate year three (PGY-3) resident to encourage ADT participation.

Racial Differences in Aging-Related Deficits Among Older Adults With Colorectal Cancer.

Background: Despite the known influences of both race- and aging-related factors in colorectal cancer outcomes and mortality, limited literature is available on the intersection between race and aging-related impairments.

Objective: To explore racial differences in frailty and geriatric deficit subdomains among patients with colorectal cancer.

Design: Retrospective study using data from the Cancer and Aging Resilience Evaluation registry.

Preserving the Pipeline of Surgeon Scientists: The Role of a Structured Research Curriculum.

Introduction: With shrinking National Institute of Health support, increased clinical demands, and less time for research training during residency, the future of surgeon scientists is in jeopardy. We evaluate the role of a structured research curriculum and its association with resident academic productivity.

Methods: Categorical general surgery residents who matched between 2005 and 2019 at our institution were analyzed (n = 104).

Disparities in Perioperative Use of Patient Engagement Technologies - Not All Use is Equal.

Objective: To determine the association of patient-level characteristics on the use of a patient engagement technology during the perioperative period.

Summary Of Background Data: As implementation of patient engagement technologies continues to grow, it remains unclear who uses, and not uses, these technologies. Existing literature suggests significant disparities in usage of other technologies by patient age, race, sex, and geographic location, however, have yet to characterize patient usage of patient engagement technologies.

Inhibition of DNA-PK may improve response to neoadjuvant chemoradiotherapy in rectal cancer.

Treatment of locally advanced rectal cancer includes chemoradiation and surgery, but patient response to treatment is variable. Patients who have a complete response have improved outcomes; therefore, there is a critical need to identify mechanisms of resistance to circumvent them. DNA-PK is involved in the repair of DNA double-strand breaks caused by radiation, which we found to be increased in rectal cancer after treatment.

Sialyltransferase ST6GAL-1 mediates resistance to chemoradiation in rectal cancer.

Locally advanced rectal cancer is typically treated with chemoradiotherapy followed by surgery. Most patients do not display a complete response to chemoradiotherapy, but resistance mechanisms are poorly understood. ST6GAL-1 is a sialyltransferase that adds the negatively charged sugar, sialic acid (Sia), to cell surface proteins in the Golgi, altering their function.

Multidisciplinary clinics for colorectal cancer may not provide more efficient coordination of care.

Background: This retrospective study compares a multidisciplinary clinic (MDC) to standard care for time to treatment of colorectal cancer.

Methods: We queried our institutional ACS-NSQIP database for patients undergoing surgery for colorectal cancer from 2017 to 2020. Patients were stratified by initial clinic visit (MDC vs control).

Ileostomy Patients Using Patient Engagement Technology Experience Decreased Length of Stay.

Patients who undergo colorectal surgery, particularly, construction of a new ileostomy, are known to have longer length of stay (LOS) and increased readmissions. With the increased availability of patient engagement technology (PET), we hypothesized that because PET facilitates education before and after surgery, ileostomy patients who used PET would have decreased LOS without increasing readmissions. Variables were obtained from the National Surgical Quality Improvement Program (NSQIP) database for patients undergoing ileostomy construction.

Circulating Tumor DNA Predicts Pathologic and Clinical Outcomes Following Neoadjuvant Chemoradiation and Surgery for Patients With Locally Advanced Rectal Cancer.

Purpose: This study was designed to assess the ability of perioperative circulating tumor DNA (ctDNA) to predict surgical outcome and recurrence following neoadjuvant chemoradiation for locally advanced rectal cancer (LARC).

Materials And Methods: Twenty-nine patients with newly diagnosed LARC treated between January 2014 and February 2018 were enrolled. Patients received long-course neoadjuvant chemoradiation prior to surgery.

NIH Funding of Researchers in Surgery: Decreased Career Development Awards Over Time.

Background: Over time, NIH funding has become increasingly competitive. In addition, academic surgeons' research competes with time required for patient care, operating, and administrative work. Due to these competing interests for surgeons, we hypothesize that the percentage of NIH grants awarded to researchers from departments of surgery is decreasing.

Racial disparities exist in surgical outcomes for patients with inflammatory bowel disease.

Background: Racial disparities in surgical outcomes exist for Black patients with IBD compared to White patients. However, previous studies fail to include other racial/ethnic populations. We hypothesized these disparities exist for Hispanic and Asian patients.

The impact of an enhanced recovery program (ERP) on the costs of colorectal surgery.

Background: Enhanced Recovery Programs (ERPs) benefit patients but their effects on healthcare costs remain unclear. This study aimed to investigate the costs associated with a colorectal ERP in a large academic health system.

Methods: Patients who underwent colorectal surgery from 2012 to 2014 (pre-ERP) and 2015-2017 (ERP) were propensity score matched based on patient and operative-level characteristics.

Development and characteristics of a multidisciplinary colorectal cancer clinic.

Background: Multidisciplinary cancer clinics deliver streamlined care and facilitate collaboration between specialties. We described patient volume and specialty service utilization, including surgery, of a multidisciplinary colorectal cancer clinic established at a tertiary care academic institution.

Methods: We conducted a retrospective observational cohort study of adult patients with colorectal adenocarcinoma from 2012 to 2017.

Characteristics of Patients Seeking Second Opinions at a Multidisciplinary Colorectal Cancer Clinic.

Background: Patients seeking second opinions are a challenge for the colorectal cancer provider because of complexity, failed therapeutic relationship with another provider, need for reassurance, and desire for exploration of treatment options.

Objective: The purpose of this study was to describe the patient and treatment characteristics of patients seeking initial and second opinions in colorectal cancer care at a multidisciplinary colorectal cancer clinic.

Design: This was a retrospective cohort study.

Hospital Variation in Readmissions and Visits to the Emergency Department Following Ileostomy Surgery.

Background: Ileostomy surgery is associated with a high readmission rate, and care pathways to prevent readmissions have been proposed. However, the extent to which readmission rates have improved is unknown. This study examined rates of readmission and emergency department visits ("return to hospital," or RTH) across hospitals in Michigan.

Use of Accelerated Induction Strategy of Infliximab for Ulcerative Colitis in Hospitalized Patients at a Tertiary Care Center.

Background: Infliximab can prevent colectomy in patients hospitalized with acute severe ulcerative colitis (ASUC). In cases of ASUC, fecal losses of infliximab may lead to low drug levels and reduced efficacy.

Aim: To determine 90-day colectomy risk and postoperative complications in patients receiving single-dose and accelerated induction of infliximab for ASUC.