Cadaveric Study of Colon-Lengthening Maneuvers After Sigmoidectomy.

Background: Creation of a tension-free colorectal anastomosis after left colon resection or low anterior resection is a key requirement for technical success. The relative contribution of each of a series of known lengthening maneuvers remains incompletely characterized.

Objective: The aim of this study was to compare technical procedures for lengthening of the left colon before rectal anastomosis.

Optimizing Appropriate Disposal of Unused Postoperative Opioid: What Happens to Unused Medication?

Background: Increase in opioid prescribing practices has occurred with concurrent increases in the levels of abuse, addiction, and diversion of opioid pain medication. With 82.5 opioid prescriptions prescribed for every 100 U.

Full-Thickness Laparoendoscopic Excision for Management of Complex Colon Polyps.

Background: Benign colon polyps are increasingly being detected because of improved colonoscopic screening and early detection of masses on the adenoma-to-carcinoma pathway. Full-thickness laparoendoscopic excision is a colon-preserving technique for endoscopically unresectable polyps consisting of endoscopically guided nonanatomic wedge colectomy.

Objective: This study aimed to evaluate the safety and success of full-thickness laparoendoscopic excision compared to segmental colectomy for complex polyps not amenable to endoscopic resection.

Do or doughnut: A systematic review and pooled analysis on the utility of pathological evaluation of the anastomotic doughnut in oncological colorectal operations.

Aim: End-to-end anastomosis staplers are frequently used in colorectal surgery, generating two anastomotic doughnuts. Whether pathological evaluation of the doughnut changes clinical practice remains unclear. We aim to identify any effects of pathological evaluation of anastomotic doughnuts after oncological colorectal surgery.

"Unresectable" polyp management utilizing advanced endoscopic techniques results in high rate of colon preservation.

Purpose: "Endoscopically unresectable" benign polyps identified during screening colonoscopy are often referred for segmental colectomy. Application of advanced endoscopic techniques can increase endoscopic polyp resection, sparing patients the morbidity of colectomy. This retrospective case-control study aimed to evaluate the success of colon preserving resection of "endoscopically unresectable" benign polyps using advanced endoscopic techniques including endoscopic mucosal resection, endoscopic submucosal dissection, endoluminal surgical intervention, full-thickness laparo-endoscopic excision, and combined endo-laparoscopic resection.

SSAT PG/CME Committee Symposium Highlights: Perioperative Management-Best Practice in Surgical Quality and Safety.

Perioperative management entails the multiple substeps in the performance of major abdominal surgery that are considered relevant for an optimal outcome. The PG/CME symposium of the SSAT 2018 provided a set of key talks that the authors subsequently summarized in the respective subsections of this summary article. Highlights topics included oral antibiotics and mechanical bowel prep, surgical site infections, DVT prophylaxis, enhanced recovery after surgery (ERAS), and narcotic-sparing pain management.

Outcomes of colostomy takedown following Hartmann's procedure: successful restoration of continuity comes with a high risk of morbidity.

Aim: Restoration of bowel continuity following a Hartmann's procedure is a major surgical undertaking associated with significant morbidity. The aim of this study was to review the authors' experience with Hartmann's reversal.

Method: This was a retrospective review of consecutive patients from institutional databases who were selected to undergo open or laparoscopic Hartmann's reversal at two tertiary academic referral centres and a public safety net hospital (2010-2019).

Relationship of aggressive monitoring and treatment to improved outcomes in severe traumatic brain injury.

Object: Despite being common practice for decades and being recommended by national guidelines, aggressive monitoring and treatment of patients with severe traumatic brain injury (TBI) have not been supported by convincing evidence.

Methods: The authors reviewed trials and case series reported after 1970 in which patients were treated for severe closed TBI, and mortality rates and favorable outcomes at 6 months after injury were analyzed. The patient groups were divided into those with and without intracranial pressure (ICP) monitoring and intensive therapy, and the authors performed a meta-analysis to assess the effects of treatment intensity on outcome.