Essential Articles for Surgical Residents (2022-2023)

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We are excited to share a new section titled “Essential Articles for Surgical Residents.”

Keeping up with surgical literature in residency can be challenging. This list was created to serve as an easily accessible, up-to-date, and evidence-based resource for residents.

The content has been curated by faculty from each department and is intended to supplement the standard educational curriculum of each rotation with current and relevant literature.

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A generally accepted explanation for the etiology of anorectal abscess and fistula-in-ano is that the abscess results from obstruction of an anal gland and the fistula is due to chronic infection and epithelialization of the abscess drainage tract. Anorectal abscesses are defined by the anatomic space in which they develop and are more common in the perianal and ischiorectal spaces and less common in the intersphincteric, supralevator,and submucosal locations.

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Diverting ileostomy in colorectal surgery: when is it necessary?

“The role of fecal diversion using a loop ileostomy in patients undergoing rectal resection and anastomosis is controversial. There has been conflicting evidence on the perceived benefit vs. the morbidity of a defunctioning stoma. This is a review of the relevant surgical literature evaluating the risks, benefits, and costs of constructing a diverting ileostomy in current colorectal surgical practice”

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Diverting Ostomy: For Whom, When, What, Where, and Why

“Fecal diversion is an important tool in the surgical armamentarium. There is much controversy regarding which clinical scenarios warrant diversion. Some of the most common applications for the use of a diverting stoma include construction of diverting ileostomy or colostomy, ostomy for low colorectal/coloanal anastomosis, inflammatory bowel disease, diverticular disease, and obstructing colorectal cancer with the conclusion that diverting loop ileostomy is preferred to loop colostomy” (Plasencia)

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The Landmark Series: Pancreatic Neuroendocrine Tumors

“Pancreatic neuroendocrine tumors (PNETs) comprise a heterogeneous group of neoplasms arising from pancreatic islet cells that remain relatively rare but are increasing in incidence worldwide. While significant advances have been made in recent years with regard to systemic therapies for patients with advanced disease, surgical resection remains the standard of care for most patients with localized tumors. Although formal pancreatectomy with regional lymphadenectomy is the standard approach for most PNETs, pancreas-preserving approaches without formal lymphadenectomy are acceptable for smaller tumors at low risk for lymph node metastases.”

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Management of Iatrogenic Cervical Esophageal Perforations

“Esophageal perforations are difficult to diagnose and have a high mortality rate. The existing studies on esophageal perforations address treatment by anatomic location and by cause, but few focus specifically on iCEPs. The management of iCEPs is controversial. There is a need for additional prospective studies comparing treatment options for iCEPs to establish a gold standard treatment and to assess for the expanding role of endoscopic interventions.” (Chen)

(Chen)
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Essential articles: Colorectal

Emory users, open this instance of PubMed, then click the links below for full-text article access.

Anal fistulas

Sugrue J, et al. Sphincter-Sparing Anal Fistula Repair: Are We Getting Better? Dis Colon Rectum. 2017 Oct;60(10):1071-1077. doi: 10.1097/DCR.0000000000000885. 

Vogel JD, et al. Clinical Practice Guideline for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula Dis Colon Rectum. 2016 Dec;59(12):1117-1133. doi: 10.1097/DCR.0000000000000733. 

Sirany AM, et al. The ligation of the intersphincteric fistula tract procedure for anal fistula: a mixed bag of results Dis Colon Rectum. 2015 Jun;58(6):604-12. doi: 10.1097/DCR.0000000000000374. 


Diverticulitis:

Francis NK, et al. EAES and SAGES 2018 consensus conference on acute diverticulitis management: evidence-based recommendations for clinical practice Surg Endosc. 2019 Sep;33(9):2726-2741. doi: 10.1007/s00464-019-06882-z. 


Fissures

Murad-Regadas SM, et al. How much of the internal sphincter may be divided during lateral sphincterotomy for chronic anal fissure in women? Morphologic and functional evaluation after sphincterotomy Dis Colon Rectum. 2013 May;56(5):645-51. doi: 10.1097/DCR.0b013e31827a7416. 

Stewart DB Sr, et al. Clinical Practice Guideline for the Management of Anal Fissures Dis Colon Rectum. 2017 Jan;60(1):7-14. doi: 10.1097/DCR.0000000000000735. 

Thornton MJ, et al. Prospective manometric assessment of botulinum toxin and its correlation with healing of chronic anal fissure Dis Colon Rectum. 2005 Jul;48(7):1424-31. doi: 10.1007/s10350-005-0025-9. 


Hemorrhoids

Davis BR, et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Hemorrhoids Dis Colon Rectum. 2018 Mar;61(3):284-292. doi: 10.1097/DCR.0000000000001030. 

Nelson DW, et al. Prophylactic antibiotics for hemorrhoidectomy: are they really needed? Dis Colon Rectum. 2014 Mar;57(3):365-9. doi: 10.1097/DCR.0b013e3182a0e522. 

Nienhuijs S, et al. Conventional versus LigaSure hemorrhoidectomy for patients with symptomatic Hemorrhoids Cochrane Database Syst Rev. 2009 Jan 21;2009(1):CD006761. doi: 10.1002/14651858.CD006761.pub2. 


Rectal prolapse

Bordeianou L, et al. Clinical Practice Guidelines for the Treatment of Rectal Prolapse Dis Colon Rectum. 2017 Nov;60(11):1121-1131. doi: 10.1097/DCR.0000000000000889. 


Colon cancer

Allaix ME, Rebecchi F, Fichera A. The Landmark Series: Minimally Invasive (Laparoscopic and Robotic) Colorectal Cancer Surgery. Ann Surg Oncol. 2020 Oct;27(10):3704-3715.

Alonso S, Saltz L. The Landmark Series: Chemotherapy for Non-Metastatic Colon Cancer. Ann Surg Oncol. 2021 Feb;28(2):995-1001.

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Pneumatosis Intestinalis:

Sanford Z, et al Updates on the Utility of Diagnostic Laparoscopy in the Management of Pneumatosis Intestinalis: An Improvement to the Current Treatment Algorithm. Surg Innov. 2018 Dec;25(6):648-650.


Rectal Cancer

Peacock O, Chang GJ. The Landmark Series: Management of Lateral Lymph Nodes in Locally Advanced Rectal Cancer. Ann Surg Oncol. 2020 Aug;27(8):2723-2731.

Bahadoer RR, Dijkstra EA, van Etten B, et al. Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial. Lancet Oncol. 2021 Jan;22(1):29-42. doi: 10.1016/S1470-2045(20)30555-6. Epub 2020 Dec 7. Erratum in: Lancet Oncol. 2021 Feb;22(2):e42. PMID: 33301740.

Conroy T, Lamfichekh N, Etienne P, Rio E, Francois E, Mesgouez-Nebout N, et al. Total neoadjuvant therapy with mFOLFIRINOX versus preoperative chemoradiation in patients with locally advanced rectal cancer: final results of PRODIGE 23 phase III trial, a UNICANCER GI trial. J Clin Oncol 2020;38(15 Suppl.):4007.