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January 2018 Briefing – Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for January 2018. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Surgical Wound Monitoring App Tied to High Satisfaction

WEDNESDAY, Jan. 31, 2018 (HealthDay News) — A smartphone app for monitoring postoperative wound recovery is associated with high satisfaction among patients and providers and may help with detection of wound complications, according to a study published recently in the Journal of the American College of Surgeons.

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Mortality Impacted by Treatment Modality, Age in Early Lung CA

WEDNESDAY, Jan. 31, 2018 (HealthDay News) — For patients with early non-small-cell lung cancer, mortality rates are higher after surgery versus stereotactic body radiotherapy (SBRT), and the difference increases as a function of age, according to a study published online Jan. 18 in the Journal of Clinical Oncology.

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Survival Trends for Cancer Generally Increasing Worldwide

WEDNESDAY, Jan. 31, 2018 (HealthDay News) — Worldwide, survival trends for cancer are generally increasing, although there is considerable global variation in survival rates, according to a study published online Jan. 30 in The Lancet.

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Increased Risk of Appendicitis One Week After Colonoscopy

TUESDAY, Jan. 30, 2018 (HealthDay News) — The risk of appendicitis is increased in the week following colonoscopy, according to a research letter published in the January issue of JAMA Surgery.

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Intra-Op Decision Support System Improves Process Measures

TUESDAY, Jan. 30, 2018 (HealthDay News) — For adults undergoing surgical procedures under general anesthesia, an intraoperative decision support system with real-time visualization can improve process measures, but not clinical outcomes, according to a study published in the February issue of Anesthesiology.

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Full-Length Inferior Turbinate Reduction Best Improves Airflow

TUESDAY, Jan. 30, 2018 (HealthDay News) — The effectiveness of partial inferior turbinate reduction (ITR) for the treatment of nasal obstruction may depend on individual patient anatomy, according to a study published online Jan. 25 in JAMA Facial Plastic Surgery.

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Surgeon Case Experience Impacts Peds Cholecystectomy Morbidity

TUESDAY, Jan. 30, 2018 (HealthDay News) — High-volume general surgeons have lower morbidity rates than low-volume pediatric surgeons for laparoscopic cholecystectomy in pediatric patients, independent of pediatric volume, according to a study published online Jan. 17 in JAMA Surgery.

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Mortality, CVD, T2DM Risks Not Up for Living Kidney Donors

MONDAY, Jan. 29, 2018 (HealthDay News) — Living kidney donors have no increased risks for all-cause mortality, cardiovascular disease, hypertension, type 2 diabetes, or adverse psychological health outcomes, according to a review published online Jan. 30 in the Annals of Internal Medicine.

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Regulators Trying to Reduce Physician Burden Linked to EHR

MONDAY, Jan. 29, 2018 (HealthDay News) — The Office of the National Coordinator for Health Information Technology (ONC) is trying to address some of the issues relating to physician electronic health record (EHR) burden, partly with the appointment of Don Rucker, M.D., who is skilled in informatics and board-certified in emergency and internal medicine, according to an article published in Medical Economics.

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Pre-Op Physical Therapy May Cut Pulmonary Complications

MONDAY, Jan. 29, 2018 (HealthDay News) — A 30-minute preoperative physical therapy session focused on breathing exercises is associated with a reduced incidence of postoperative pulmonary complications (PPCs) among patients undergoing upper abdominal surgery, according to a study published online Jan. 24 in The BMJ.

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Health Care Spending Up, Mainly Due to Rising Prices

MONDAY, Jan. 29, 2018 (HealthDay News) — Americans under age 65 years who were insured through their employer spent more than ever before on health care in 2016, with faster spending growth in 2016 than in recent years, according to the Health Care Cost Institute (HCCI)’s annual Health Care Cost and Utilization Report.

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Odds of Post-Op Mortality Increase As Weekend Approaches

FRIDAY, Jan. 26, 2018 (HealthDay News) — Following elective surgery, the odds of mortality rise in a graded manner as the day of the week of surgery approaches the weekend, according to research published in the February issue of Medical Care.

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High Within-Country Economic Inequality in C-Section Rates

FRIDAY, Jan. 26, 2018 (HealthDay News) — In low- and middle-income countries, there is considerable within-country economic inequality in the rates of cesarean section, according to a study published online Jan. 24 in The BMJ.

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Care for Key Surgical Issues Up With ACA Medicaid Expansion

THURSDAY, Jan. 25, 2018 (HealthDay News) — For patients with five common surgical conditions, the Affordable Care Act (ACA)’s Medicaid expansion was associated with increased probability of early presentation and of receiving optimal management, according to a study published online Jan. 24 in JAMA Surgery.

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Pre-Op PT Education Speeds Functional Milestones Post TJA

THURSDAY, Jan. 25, 2018 (HealthDay News) — A one-time preoperative physical therapy (PT) education session coupled with a web-based microsite (preopPTed) is associated with improved readiness to discharge from PT, but does not impact length of stay (LOS) for patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA), according to a study published in the January issue of Clinical Orthopaedics and Related Research.

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Next-Generation Sequencing May Be Useful in Joint Infection

WEDNESDAY, Jan. 24, 2018 (HealthDay News) — Next-generation sequencing may be useful for identifying causative organisms in culture-negative periprosthetic joint infection, according to a study published online Jan. 17 in The Journal of Bone & Joint Surgery.

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Out-of-Pocket Expenditures Down With ACA Implementation

TUESDAY, Jan. 23, 2018 (HealthDay News) — Implementation of the Affordable Care Act (ACA) was associated with reduced out-of-pocket spending, although increases were noted in mean premium spending, according to a study published online Jan. 22 in JAMA Internal Medicine.

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Gynecologic Complications Up With Hysteroscopic Sterilization

TUESDAY, Jan. 23, 2018 (HealthDay News) — Hysteroscopic sterilization is associated with an increased risk of gynecologic complications compared with laparoscopic sterilization, according to a study published in the Jan. 23/30 issue of the Journal of the American Medical Association.

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Diabetes Tied to Higher Rates of Serious Infection

TUESDAY, Jan. 23, 2018 (HealthDay News) — Patients with diabetes, particularly type 1 diabetes mellitus (T1DM), are at increased risk of serious infection, according to a study published online Jan. 12 in Diabetes Care.

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Anticoagulation Guidance Issued for Cardiopulmonary Bypass

MONDAY, Jan. 22, 2018 (HealthDay News) — Clinical practice guidelines for anticoagulation therapy for cardiopulmonary bypass (CPB) have been developed and were published in the February issue of the Annals of Thoracic Surgery.

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In-Office Angiolytic Laser Effective for Vocal Polyps

MONDAY, Jan. 22, 2018 (HealthDay News) — In-office angiolytic laser procedures are effective for vocal fold polyps, though with occasional occurrence of minor adverse events, according to a study published online Jan. 18 in JAMA Otolaryngology-Head & Neck Surgery.

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Emotions Faced by Living Kidney Donors Can Impact Daily Life

MONDAY, Jan. 22, 2018 (HealthDay News) — Living kidney donors experience a wide range of emotions throughout the donation process that influences the lives of donors on several levels, according to a study published online Jan. 10 in the Journal of Renal Care.

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Brochure Can Improve Opioid Disposal Rates After Surgery

FRIDAY, Jan. 19, 2018 (HealthDay News) — Disseminating an educational brochure improves disposal of unused opioids after surgery, according to a study published online Jan. 10 in the Journal of the American College of Surgeons.

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Longer Duration of Post-Op Opioid Use Associated With Misuse

THURSDAY, Jan. 18, 2018 (HealthDay News) — Each refill and week of opioid prescription following surgery is associated with an increasing risk of opioid misuse among opioid naive patients, according to a study published online Jan. 17 in The BMJ.

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Increased Risk of Complications With Bariatric Surgery

THURSDAY, Jan. 18, 2018 (HealthDay News) — Bariatric surgery is associated with lower risks of obesity-related comorbidities but a clinically important increased risk for complications compared with medical treatment, according to a study published in the Jan. 16 issue of the Journal of the American Medical Association, a theme issue on obesity.

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Professionals Disagree About Asking Patients About Sexuality

THURSDAY, Jan. 18, 2018 (HealthDay News) — National Health Service (NHS) England recently recommended that professionals ask all patients their sexual orientation at every opportunity, although opinions are divided on whether this is appropriate, according to an article published online Jan. 17 in The BMJ.

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Acute Kidney Injury Ups Risk for Post-Discharge Hypoglycemia

THURSDAY, Jan. 18, 2018 (HealthDay News) — For hospitalized patients with diabetes, acute kidney injury (AKI) is a risk factor for post-discharge hypoglycemia, according to a study published online Jan. 11 in Diabetes Care.

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Adding HIPEC to Cytoreductive Surgery Beneficial in Ovarian CA

WEDNESDAY, Jan. 17, 2018 (HealthDay News) — The addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to interval cytoreductive surgery is associated with improved outcomes in patients with stage III epithelial ovarian cancer, according to a study published in the Jan. 18 issue of the New England Journal of Medicine.

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Speech Outcomes Can Be Predicted After Cochlear Implant

WEDNESDAY, Jan. 17, 2018 (HealthDay News) — Brain areas unaffected by auditory deprivation can predict speech outcomes after cochlear implant (CI) in children, according to a study published online Jan. 15 in the Proceedings of the National Academy of Sciences of the United States of America.

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Lap Sleeve Gastrectomy, RYGB Equally Effective in Weight Loss

WEDNESDAY, Jan. 17, 2018 (HealthDay News) — For patients with morbid obesity, there is no statistically significant difference in terms of weight loss at five years after laparoscopic sleeve gastrectomy versus laparoscopic Roux-en-Y gastric bypass, according to two studies published in the Jan. 16 issue of the Journal of the American Medical Association, a theme issue on obesity.

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Deep Brain Stimulation Tied to Improved Symptoms in Tourette

TUESDAY, Jan. 16, 2018 (HealthDay News) — For patients with Tourette syndrome, deep brain stimulation (DBS) is associated with symptomatic improvement but also some important adverse events, according to a study published online Jan. 16 in JAMA Neurology.

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Reduced All-Cause Mortality for Obese Patients After Bariatric Sx

TUESDAY, Jan. 16, 2018 (HealthDay News) — Obese patients who undergo bariatric surgery have reduced all-cause mortality; and obese adults with type 2 diabetes who undergo gastric bypass have improved outcomes compared with lifestyle and intensive medical management alone, according to two studies published in the Jan. 16 issue of the Journal of the American Medical Association, a theme issue on obesity.

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Color-Coded Drug Storage Trays May Cut Medication Errors

TUESDAY, Jan. 16, 2018 (HealthDay News) — Color-coded compartmentalized “rainbow trays” used for anesthetic drug preparation and storage may improve patient safety, according to a study published online Jan. 3 in Anaesthesia.

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Ceramide-Infused Skin Barrier Cuts Stoma-Related Costs

FRIDAY, Jan. 12, 2018 (HealthDay News) — Use of a ceramide-infused ostomy skin barrier is associated with reduced stoma-related cost of care, according to a study published in the January/February issue of the Journal of Wound, Ostomy and Continence Nursing.

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Non-Ventilator Hospital-Acquired Pneumonia Risk Affects All Ages

FRIDAY, Jan. 12, 2018 (HealthDay News) — Non-ventilator hospital-acquired pneumonia (NV-HAP) is a significant burden in U.S. acute care hospitals and poses a risk to nonelderly, non-intensive unit (ICU) patients, according to research published in the January issue of the American Journal of Infection Control.

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Tamper-Resistant Oxycodone Misused Less Often in Australia

FRIDAY, Jan. 12, 2018 (HealthDay News) — The tamper-resistant formulation of controlled-release oxycodone in Australia reduced tampering among high-risk populations, according to a study published online Jan. 10 in The Lancet Psychiatry.

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Serial Intralesional Steroids May Improve Tracheal Stenosis Sx

FRIDAY, Jan. 12, 2018 (HealthDay News) — For adults with subglottic and proximal tracheal stenosis (SGS/PTS), serial in-office intralesional steroid injection (ISI) after endoscopic dilation is associated with a prolonged surgery-free interval (SFI), according to a study published online Jan. 11 in JAMA Otolaryngology-Head & Neck Surgery.

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Surgery Practice Patterns Differ by Location of Residency

FRIDAY, Jan. 12, 2018 (HealthDay News) — Nonuniversity-based residency (NUBR)-trained surgeons and university-based residency (UBR)-trained surgeons have distinct practice patterns, according to a study published online Jan. 10 in JAMA Surgery.

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AMA Online Tools Address Systems-Level Physician Burnout

THURSDAY, Jan. 11, 2018 (HealthDay News) — Tools and resources have been developed to help address physician burnout at the systems level, which may affect more than half of doctors, according to a report published by the American Medical Association (AMA).

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Active Surveillance Feasible for Small, Low-Grade Bladder Cancer

THURSDAY, Jan. 11, 2018 (HealthDay News) — For patients who present with small, low-grade pTa/pT1a recurrent papillary bladder tumors, active surveillance appears to be a reasonable strategy, according to a study published in the February issue of The Journal of Urology.

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Closure of Patent Foramen Ovale Cuts Recurrent Stroke/TIA Risk

THURSDAY, Jan. 11, 2018 (HealthDay News) — Percutaneous and transcatheter patent foramen ovale (PFO) closure prevent recurrent stroke in adults with PFO and cryptogenic stroke, according to two reviews published online Jan. 9 in the Annals of Internal Medicine.

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Some Patients Would Choose Antibiotics for Appendicitis

WEDNESDAY, Jan. 10, 2018 (HealthDay News) — Although most patients would choose surgical intervention for treatment of acute uncomplicated appendicitis, some would opt for antibiotics alone, according to a study published online Jan. 10 in JAMA Surgery.

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Economic Impact of Physicians Quantified for 2015

WEDNESDAY, Jan. 10, 2018 (HealthDay News) — Physicians have a large economic impact across the nation, creating an aggregate of $2.3 trillion of economic activity and supporting employment of nearly 12.6 million Americans, according to a report published by the American Medical Association.

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Predictors of Improved CVD Risk Factors After Bariatric Sx ID’d

WEDNESDAY, Jan. 10, 2018 (HealthDay News) — Increased weight loss, female sex, and younger age predict increased probability of resolution of specific cardiovascular disease risk factors (CVD-RFs) in adolescents undergoing metabolic and bariatric surgery (MBS), according to a study published online Jan. 8 in Pediatrics.

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Complete Handover of Anesthesia Care May Up Complications

WEDNESDAY, Jan. 10, 2018 (HealthDay News) — Complete handover of intraoperative anesthesia care is associated with an increased risk of adverse postoperative outcomes among adults undergoing major surgery, according to a study published in the Jan. 9 issue of Journal of the American Medical Association.

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Black Children at Higher Risk of Death Following Surgery

WEDNESDAY, Jan. 10, 2018 (HealthDay News) — Race-specific models more accurately predict risk of death after surgery for pediatric patients, according to a study published online Jan. 10 in Pediatrics.

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Kidney Injury Common After Non-Kidney Transplants in Children

MONDAY, Jan. 8, 2018 (HealthDay News) — In children who receive a non-kidney solid organ transplant, acute kidney injury (AKI) is common in the first year after surgery and is associated with an increased risk of chronic kidney disease (CKD), according to a study published online Dec. 29 in the American Journal of Transplantation.

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Pain Self-Efficacy Questionnaire Helps to Evaluate Migraine Pain

MONDAY, Jan. 8, 2018 (HealthDay News) — The Pain Self-Efficacy Questionnaire (PSEQ) successfully demonstrates the extent of debility in migraine surgery patients and puts migraine pain in perspective within the realm of other known pain conditions, according to a study published in the January issue of Plastic and Reconstructive Surgery.

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Pediatric Sports-, Recreation-Related Eye Injuries Common

MONDAY, Jan. 8, 2018 (HealthDay News) — Pediatric sports- and recreation-related eye injuries are common, most often occurring among boys, according to a study published online Jan. 8 in Pediatrics.

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Physicians Frequently Continue to Work While Ill

FRIDAY, Jan. 5, 2018 (HealthDay News) — Many physicians continue working and caring for patients while they are sick, according to an article published in Medical Economics.

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Cancer Death Rate Continuing to Decline in United States

FRIDAY, Jan. 5, 2018 (HealthDay News) — In both men and women in the United States, the cancer death rate declined by about 1.5 percent annually from 2006 to 2015, according to a study published online Jan. 4 in CA: A Cancer Journal for Clinicians.

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KRAS Mutations Linked to Brain Arteriovenous Malformations

FRIDAY, Jan. 5, 2018 (HealthDay News) — Many patients with arteriovenous malformations of the brain have somatic activating KRAS mutations, according to a study published online Jan. 3 in the New England Journal of Medicine.

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Breast Implants Slightly Increase Risk of Breast ALCL

FRIDAY, Jan. 5, 2018 (HealthDay News) — Breast implants are associated with an increased risk of anaplastic large-cell lymphoma in the breast (breast-ALCL), though the absolute risk is small, according to a study published online Jan. 4 in JAMA Oncology.

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For Hospitals, No Benefit for Early Adoption of Financial Incentives

FRIDAY, Jan. 5, 2018 (HealthDay News) — Hospitals that volunteered to be under financial incentives for more than a decade as part of the Premier Hospital Quality Incentive Demonstration (early adopters) do not have better process scores or lower mortality than hospitals where these incentives were implemented later under the Hospital Value-Based Purchasing program (late adopters), according to a study published online Jan. 4 in The BMJ.

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CV Morbidity With Hysterectomy Despite Ovarian Conservation

THURSDAY, Jan. 4, 2018 (HealthDay News) — Hysterectomy with ovarian conservation for benign indications is associated with increased risk of cardiovascular and metabolic conditions, according to a study published online Jan. 3 in Menopause.

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Half of Gastric Cancer Patients Diagnosed From ER Visit

THURSDAY, Jan. 4, 2018 (HealthDay News) — Half of patients with gastric cancer (GC) are diagnosed as a result of an emergency department visit, which is independently associated with increased mortality, according to a study published recently in the American Journal of Surgery.

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Certain Stresses, Burnout Causing Some Women to Leave Medicine

THURSDAY, Jan. 4, 2018 (HealthDay News) — Though equal numbers of men and women are now entering medical schools, the majority of physicians are still male, and female physicians face several unique stressors, according to a report published online in Medical Economics.

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Low Rates of Major Complications After Bariatric Surgery

THURSDAY, Jan. 4, 2018 (HealthDay News) — The rates of three major complications at less than 30 days after bariatric surgery are low and vary among surgical procedures, according to research published online Dec. 20 in Obesity Reviews.

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Racial/Ethnic Disparities Up for Live Donor Kidney Transplant

THURSDAY, Jan. 4, 2018 (HealthDay News) — Racial/ethnic disparities in the receipt of live donor kidney transplantation (LDKT) among first-time kidney transplantation candidates in the United States increased from 1995-1999 to 2010-2014, according to a study published in the Jan. 2 issue of the Journal of the American Medical Association.

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Predictors of Infliximab Response in Ulcerative Colitis Identified

WEDNESDAY, Jan. 3, 2018 (HealthDay News) — For patients with acute severe ulcerative colitis (ASUC), the baseline Mayo Endoscopic Score and the C-reactive protein (CRP)/albumin ratio predict treatment response to infliximab, according to research published online Dec. 21 in the Journal of Gastroenterology and Hepatology.

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Higher Risk of Musculoskeletal Disorders in Some Physicians

WEDNESDAY, Jan. 3, 2018 (HealthDay News) — The prevalence of work-related musculoskeletal disorders (MSDs) appears to be high for at-risk physicians, according to a review published online Dec. 27 in JAMA Surgery.

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Improvement Needed in Ob-Gyn Opioid Prescribing Practices

WEDNESDAY, Jan. 3, 2018 (HealthDay News) — Improvement in obstetrician-gynecologists’ knowledge and prescribing practices regarding opioids is needed, according to a study published online Dec. 4 in Obstetrics & Gynecology.

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In Utero Exposure to Topiramate Linked to Risk of Oral Clefts

TUESDAY, Jan. 2, 2018 (HealthDay News) — Infants born to women exposed to topiramate, especially women with epilepsy taking higher doses, have an increased risk of oral clefts at birth, according to a study published online Dec. 27 in Neurology.

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10 Percent of Heart Recipients Develop De Novo Malignancy

TUESDAY, Jan. 2, 2018 (HealthDay News) — More than one in 10 adult heart transplant recipients develop de novo malignancy between one and five years after transplantation, and this is associated with increased mortality, according to a study published in the Jan. 2 issue of the Journal of the American College of Cardiology.

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Length of Surgery Predicts Bleeding After Vitrectomy

TUESDAY, Jan. 2, 2018 (HealthDay News) — Duration of vitrectomy surgery is a significant and independent predictor of postoperative bleeding among patients with diabetic retinopathy, according to a study published online Dec. 19 in the Journal of Diabetes Investigation.

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Pre-Op Accelerometry Can Assess Cardiopulmonary Fitness

TUESDAY, Jan. 2, 2018 (HealthDay News) — For patients scheduled for major surgery, preoperative accelerometry can assess cardiopulmonary fitness and act as a supplement to formal cardiopulmonary exercise tests, according to a study published online Dec. 12 in Anaesthesia.

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Same-Day, Low-Dose Bowel Prep Feasible for Colonoscopy

TUESDAY, Jan. 2, 2018 (HealthDay News) — A same-day, low-dose, 1-liter polyethylene glycol-based (1L-PEG) bowel preparation can achieve similar bowel cleansing to split-dose 4L-PEG bowel preparation in select high-risk patients before colonoscopy, according to a study published online Dec. 21 in the Journal of Digestive Diseases.

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