Results of the Last 5 Years (2018-2022) of the Specialist Title Exam of The Brazilian College of Surgeons.

The article discusses the evolution of the Brazilian College of Surgeons (CBC) specialist title exam, highlighting the importance of evaluating not only theoretical knowledge, but also the practical skills and ethical behavior of candidates. The test was instituted in 1971, initially with only the written phase, and later included the oral practical test, starting with the 13th edition in 1988. In 2022, the assessment process was improved by including the use of simulated stations in the practical test, with the aim of assessing practical and communication skills, as well as clinical reasoning, in order to guarantee excellence in the assessment of surgeons training.

Incidental gallbladder cancer: what is the prevalence and how do we perform cholecystectomy for presumably benign biliary disease?

Objective: to determine the prevalence of incidental gallbladder cancer (IGBC) in cholecystectomies performed in a tertiary public hospital and to describe technical and epidemiological aspects of performing cholecystectomies for presumably benign disease.

Method: descriptive, retrospective observational study, based on analysis of medical records of patients undergoing cholecystectomy with preoperative hypothesis of benign disease between January 2018 and January 2022.

Results: prevalence of gallbladder adenocarcinoma in our sample was 0.

Substernal goiter and laryngopharyngeal reflux.

Objective: This study aims to compare the prevalence of laryngopharyngeal reflux signs between two groups of patients undergoing thyroidectomy for voluminous goiter: substernal goiters and voluminous cervical goiter without thoracic extension.

Subjects And Methods: A retrospective case-control study was performed with data retrieved of the charts of the patients submitted to thyroidectomies occurred at a tertiary care center (Head and Neck Surgery Department, University of São Paulo Medical School) between 2010 and 2014. The selected thyroidectomies were allocated in two groups for study: patients with substernal goiters and patients with voluminous cervical goiter without thoracic extension.

Outcomes on quality of life, weight loss, and comorbidities after Roux-en-Y gastric bypass.

Context: Bariatric surgery has become the most effective method for producing weight loss in obese patients. The evaluation of improvement of comorbidities and changes in the quality of life are important outcome factors; however, it is necessary to investigate whether they persist over the long term.

Methods: A cross-sectional study was conducted on 143 obese patients from our institution from February 2007 to February 2008.

[Spiritual surgery: an investigation].

Background: A very popular modality with the media is psychic surgery which has received little scientific evaluation though. Such phenomena always raise the issues of fakery and deceit. Research has been scarce.

[Extensive trauma of the external ear: surgical management].

Fifty nine patients with extensive traumatisms of the external ear, including 3 total amputations, 10 partial amputations with maintenance of reduced pedicle and 46 extensive lesions without further vascularization, have been attended in the Emergency Unit of Hospital das Clinicas at University of São Paulo Medical School from 1979 to 1989. Surgical behaviors performed in each case are described and explained in detail. The main purpose of the study was to show the outliving possibilities of the ear even in serious traumas and to emphasize the need of immediate repair of the ear in order to obtain a satisfactory result.

[Surgical treatment of inguinal hernias with local anesthesia].

Eighty-four cases of inguinal hernioplasty by Bassini's modified technique were performed using 1% lidocaine in regional infiltration block. The report analyzes the use of local anesthesia in the treatment of inguinal hernias. All patients had small reducible and non-recurrent inguinal hernia.

[Intolerance glucose control in the parenteral hyperalimentation].

Ten non-diabetic surgical patients, submitted to parenteral hyperalimentation, were prospectively studied, in order to determine the incidence of glucose intolerance during this treatment. Additionally three methods for the control of glucose metabolism, namely glucosuria and gtycemia, given by reagent strips, and standard blood sugar, determined at the auto-analyser, were compared, with the purpose of establishing which of these tests is best suited for routine utilization. It was concluded that: 1) The incidence of glucose intolerance, defined as one or more episodes of positive glucosuria, or of blood sugar higher than 180mg/100 ml, was 60% in the first day of intravenous nutrition, and 80% if the whole period of treatment; 2) Glucose intolerance was more often detected by urine testing than by blood determinations, either with Dextrositx or at the a auto-analyser as the glucosuria test: was performed much more frequently; 3) It is concluded that although the findings of tests for glucosuria may not adequately reflect glucose metabolism in all circumstances, they represent the choice examination for basic monitoring of patients receiving intravenous hyperalimentation, as soon as renal function is satisfactory, because of its low expense and its easy application.