A carefully selected group of full-text reprints from current, classic, and seminal articles is included in every issue of SRGS.
Selected Readings in General Surgery has obtained permission from journal publishers to reprint articles that appear in SRGS. Copying and distributing reprints are in violation of our agreement with the publishers.
Vol. 47, No. 6, Nutrition and Metabolic Disease
McClave SA, Lowen CC, Martindale RG. The 2016 ESPEN Arvid Wretlind lecture: The gut in stress. Clin Nutr. 2018;37(1):19-36. doi:10.1016/j.clnu.2017.07.015
McClave et al. provide a succinct overview of how microbiome alterations, particularly the rise of pathobionts, coupled with intestinal barrier breakdown and increased permeability, profoundly shape both the physiological and immunological responses in critical illness.
Wischmeyer PE, Bear DE, Berger MM, et al. Personalized nutrition therapy in critical care: 10 expert recommendations. Crit Care. 2023;27(1):261. Published 2023 Jul 4. doi:10.1186/s13054-023-04539-x
Wischmeyer and coauthors offer a comprehensive set of ten recommendations for optimizing nutritional care in the critical care environment. This article stresses the importance of prioritizing early nutritional assessment for critically ill patients, followed by rapid, protocol-driven implementation of enteral or parenteral nutrition. Focused monitoring and selective use of pharmacologic agents are advised to maximize nutritional support benefits.
Volkert D, Beck AM, Cederholm T, et al. ESPEN practical guideline: Clinical nutrition and hydration in geriatrics. Clin Nutr. 2022;41(4):958-989. doi:10.1016/j.clnu.2022.01.024
Under the auspices of ESPEN, Volkert and colleagues present a comprehensive framework for addressing the unique nutritional and hydration needs of geriatric patients. Key contributions include detailed assessment strategies, interventions specific to age-related physiological changes, and practical monitoring protocols tailored for this vulnerable population.
Marcolini EG, Putnam AT, Aydin A. History and Perspectives on Nutrition and Hydration at the End of Life. Yale J Biol Med. 2018;91(2):173-176. Published 2018 Jun 28.
Marcolini and colleagues delve into the multifaceted ethical complexities surrounding artificial nutrition and hydration (ANH) decisions for terminally ill patients. Their work emphasizes the critical need for clear communication strategies between patients, families, and healthcare providers. A focus on patient autonomy, respecting diverse cultural and religious values, and weighing the potential burdens of ANH against the possibility of comfort or increased suffering are key themes addressed in the article.
Vol. 47, No. 5, Surgical Infection
Long DR, Alverdy JC, Vavilala MS. Emerging Paradigms in the Prevention of Surgical Site Infection: The Patient Microbiome and Antimicrobial Resistance. Anesthesiology. 2022;137(2):252-262. doi:10.1097/ALN.0000000000004267
This article provided an expert commentary on the role of the patient microbiome as a contributor to surgical site infection. The authors provided valuable information regarding factors that disrupt the microbiome, events that alter the pathways for the translocation of organisms, and interventions for correcting microbiome disruptions.
Haydour Q, Hage CA, Carmona EM, et al. Diagnosis of Fungal Infections. A Systematic Review and Meta-Analysis Supporting American Thoracic Society Practice Guideline. Ann Am Thorac Soc. 2019;16(9):1179-1188. doi:10.1513/AnnalsATS.201811-766OC
The authors provided evidence supporting a recognized national clinical practice guideline. Diagnostic tests for fungal infections, guidance for the duration of anti-fungal therapy, and characteristics of various surgical infections caused by fungi are reviewed.
Bellon F, Solà I, Gimenez-Perez G, et al. Perioperative glycaemic control for people with diabetes undergoing surgery. Cochrane Database Syst Rev. 2023;8(8):CD007315. Published 2023 Aug 1. doi:10.1002/14651858.CD007315.pub3
A valuable review of evidence regarding perioperative glycemic control for patients with diabetes who must undergo an operative procedure is provided in this article.
Vol. 47, No. 4, Trauma, Part II
Tominaga G, Bernstein M. ACS TQIP Best Practices in Imaging. 2018
This publication, prepared by the ACS Committee on Trauma, provides "best practices" for obtaining high-quality medical imaging to diagnose injuries. These guidelines aim to strike a balance between ensuring accurate diagnoses, managing radiation exposure, and preventing potential adverse effects associated with medical imaging.
Malhotra A, Biffl WL, Moore EE, et al. Western Trauma Association Critical Decisions in Trauma: Diagnosis and management of duodenal injuries. J Trauma Acute Care Surg. 2015;79(6):1096-1101. doi:10.1097/TA.0000000000000870
This clinical practice algorithm promulgated by the Western Trauma Association provides guidance for successfully treating patients with rare but dangerous injuries to the duodenum. Due to these complexities, managing duodenal injuries involves complex decision-making regarding when and how to perform repairs based on the specific injury. The article discusses the diagnosis of duodenal injuries, which can occur in different scenarios, including unstable patients undergoing emergent laparotomy, stable patients diagnosed through computed tomography (CT), or delayed diagnoses after 24 hours, often with signs of sepsis.
Lucia A, Dantoni SE. Trauma Management of the Pregnant Patient. Crit Care Clin. 2016;32(1):109-117. doi:10.1016/j.ccc.2015.08.008
This article addresses the significant issue of trauma in pregnant patients, which remains a leading cause of maternal and fetal mortality globally. Lucia and Dantoni emphasize the importance of establishing a multidisciplinary team early on, comprising various medical specialists such as emergency medicine physicians, trauma surgeons, obstetricians, critical care intensivists, and neonatologists. While the well-being of the mother takes precedence in treatment decisions, the article highlights the general principle that what benefits the mother's health is usually beneficial for the fetus as well.
Vol. 47, No. 3, Trauma, Part I
Newgard CD, Fischer PE, Gestring M, et al. National guideline for the field triage of injured patients: Recommendations of the National Expert Panel on Field Triage, 2021. J Trauma Acute Care Surg. 2022;93(2):e49-e60. doi:10.1097/TA.0000000000003627
The article details the process of developing the updated field triage guideline, the supporting evidence, and the final version of the National Guidelines for the Field Triage of Injured Patients, 2021.
Coccolini F, Stahel PF, Montori G, et al. Pelvic trauma: WSES classification and guidelines. World J Emerg Surg. 2017;12:5. Published 2017 Jan 18. doi:10.1186/s13017-017-0117-6
Complex pelvic injuries are among the most dangerous and deadly trauma-related lesions. Guidelines for managing pelvic injuries and useful maneuvers for controlling pelvic fracture bleeding and achieving early fracture stabilization are reviewed in this article.
Coccolini F, Moore EE, Kluger Y, et al. Kidney and uro-trauma: WSES-AAST guidelines. World J Emerg Surg. 2019;14:54. Published 2019 Dec 2. doi:10.1186/s13017-019-0274-x
The authors reviewed the World Society of Emergency Surgery (WSES) and the American Association for the Surgery of Trauma (AAST) kidney and urogenital trauma management guidelines. Renal and urogenital injuries occur in approximately 10-20% of abdominal trauma in adults and children. Optimal management should consider the anatomic injury, the hemodynamic status, and the associated injuries.
Vol. 47, No. 2, Critical Care of Surgical Patients, Part II
Palaia I, Caruso G, Di Donato V, et al. Peri-operative blood management of Jehovah's Witnesses undergoing cytoreductive surgery for advanced ovarian cancer. Blood Transfus. 2022;20(2):112-119. doi:10.2451/2021.0416-20
This study reported outcomes from the use of a bloodless surgery protocol on patients who refused transfusion. The procedure of interest was intraperitoneal hyperthermic chemotherapy for ovarian cancer. The data showed that the protocol significantly reduced the risk of postoperative anemia.
Dugar S, Choudhary C, Duggal A. Sepsis and septic shock: Guideline-based management. Cleve Clin J Med. 2020;87(1):53-64. doi:10.3949/ccjm.87a.18143
This article provided a clear and easily readable summary of guidelines for managing the patient with sepsis and septic shock.
Vol. 47, No. 1, Critical Care of Surgical Patients, Part I
Daza JF, Bartoszko J, Van Klei W, Ladha K, McCluskey S, Wijeysundera DN. Improved Re-estimation of Perioperative Cardiac Risk Using the Surgical Apgar Score: A Retrospective Cohort Study. Ann Surg. Jul 8 2022;doi:10.1097/SLA.0000000000005509
The authors reported data from a retrospective cohort study (N=16,835) of patients undergoing noncardiac surgery at a single institution. The study aimed to determine the value of combining a preoperative risk score (Revised Cardiac Risk Index) with a score determined from intraoperative variables (Surgical APGAR Score). The outcome of interest was acute postoperative myocardial injury. The data analysis showed that combining the two scores improved risk assessment significantly.
Raimondi N, Vial MR, Calleja J, et al. Evidence-based guidelines for the use of tracheostomy in critically ill patients. J Crit Care. Apr 2017;38:304-318. doi:10.1016/j.jcrc.2016.10.009
This article reviewed the available evidence and, using an expert consensus panel developed a set of guidelines for the use of bronchoscopy and tracheostomy in patients requiring ventilator support. The guidelines provided advice but not specific recommendations for early versus late tracheostomy.
Kirkilesis G, Kakkos SK, Bicknell C, Salim S, Kakavia K. Treatment of distal deep vein thrombosis. Cochrane Database Syst Rev. 2020;4(4):CD013422. Published 2020 Apr 9. doi:10.1002/14651858.CD013422.pub2
This article provided useful data regarding the use of "deresuscitation" (treatment of fluid overload with diuretics and/or renal replacement therapy) for critically ill patients with signs of significant fluid overload. Using this approach was associated with a significant reduction in short-term mortality risk.
Vol. 46, No. 8, Vascular Surgery, Part III
Ley EJ, Brown CVR, Moore EE, et al. Updated guidelines to reduce venous thromboembolism in trauma patients: A Western Trauma Association critical decisions algorithm. J Trauma Acute Care Surg. 2020;89(5):971-981. doi:10.1097/TA.0000000000002830
This article provided important perspectives on risk factors and effective management approaches for the prevention of venous thromboembolism in injured patients. Indications for using and withholding pharmacologic prophylaxis are discussed.
Kuczmik W, Wysokinski WE, Macedo T, et al. Calf Vein Thrombosis Outcomes Comparing Anticoagulation and Serial Ultrasound Imaging Management Strategies. Mayo Clin Proc. 2021;96(5):1184-1192. doi:10.1016/j.mayocp.2021.01.024
Kuczmik and coauthors provided evidence supporting the use of systemic anticoagulation for patients with calf vein thrombosis. The recommendations do not include specific data on the potential use of ultrasound surveillance for ankle-level thrombosis.
Kirkilesis G, Kakkos SK, Bicknell C, Salim S, Kakavia K. Treatment of distal deep vein thrombosis. Cochrane Database Syst Rev. 2020;4(4):CD013422. Published 2020 Apr 9. doi:10.1002/14651858.CD013422.pub2
The authors provided a systematic review of the literature that focuses on managing distal leg vein thrombosis. They provided a thorough and clear review of pharmacologic treatments and non-pharmacologic approaches.
Vol. 46, No. 7, Vascular Surgery, Part II
Tattersall MC, Johnson HM, Mason PJ. Contemporary and Optimal Medical Management of Peripheral Arterial Disease. Surg Clin North Am. 2013;93(4):761-vii. doi:10.1016/j.suc.2013.04.009
Tattersall and coauthors reviewed the evidence supporting the use of several medical interventions to control symptoms and progression of peripheral arterial disease. Smoking cessation, diabetes control, and weight loss were some of the interventions discussed.
Beckman JA, Schneider PA, Conte MS. Advances in Revascularization for Peripheral Artery Disease: Revascularization in PAD. Circ Res. 2021;128(12):1885-1912. doi:10.1161/CIRCRESAHA.121.318261
This article provided insightful information on the value of a multidisciplinary approach to the management of patients with peripheral arterial disease. Therapeutic strategies are based on precise diagnosis, including identification and localization of atherosclerotic lesions and quantifying the severity of disease. Guidance for the use of open or endovascular approaches was provided as well.
Bala M, Catena F, Kashuk J, et al. Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery. World J Emerg Surg. 2022;17(1):54. Published 2022 Oct 19. doi:10.1186/s13017-022-00443-x
Using a careful evaluation of available evidence and expert consensus, this set of guidelines provides useful information for clinicians caring for patients with mesenteric ischemia. The guidelines stress the importance of reducing diagnostic delay, adequate resuscitation, prompt exploratory surgery with resection of infarcted bowel, and revascularization for acute mesenteric ischemia. Relevant anatomy and surgical approaches are clearly described.
Vol. 46, No. 6, Vascular Surgery, Part I
de Guerre L, Dansey K, Li C, et al. Late outcomes after endovascular and open repair of large abdominal aortic aneurysms. J Vasc Surg. Oct 2021;74(4):1152-1160. doi:10.1016/j.jvs.2021.02.024
Article summary: This article describes a large database study assessing outcomes of open and endovascular aneurysm repairs. According to their data, outcomes were better for open repairs at five years follow-up.
Beuschel B, Nayfeh T, Kunbaz A, et al. A systematic review and meta-analysis of treatment and natural history of popliteal artery aneurysms. J Vasc Surg. Jan 2022;75(1S):121S-125S e14. doi:10.1016/j.jvs.2021.05.023
Article summary: This systematic review of the literature included 36 acceptable articles. The data analysis showed that complications of popliteal aneurysms increased with time, suggesting that acceptable risk patients should undergo operative repair early in the course of the disease.
Hossack M, Patel S, Gambardella I, Neequaye S, Antoniou GA, Torella F. Endovascular vs. Medical Management for Uncomplicated Acute and Sub-acute Type B Aortic Dissection: A Meta-analysis. Eur J Vasc Endovasc Surg. May 2020;59(5):794-807. doi:10.1016/j.ejvs.2019.08.003
Article summary: Hossack and coauthors conducted a systematic review add the literature to determine the merit of medical versus endovascular management of type B thoracic aortic aneurysm dissections. Medical therapy was associated with a significantly reduced stroke risk, but endovascular management was associated with superior aorta-related complication rates.
Volume 46
- Volume 46, No. 3, 2030, Liver I
- Volume 46, No. 2, 2020, Spleen
- Volume 46, No. 1, 2020, Ethics, Patient Safety & the Business of Medicine
Volume 45
- Vol. 45, No. 3, Colon, Rectum, and Anus Part III
- Vol. 45, No. 3, Colon, Rectum, and Anus Part II
- Vol. 45, No. 2, Colon, Rectum, and Anus Part I
- Vol. 45, No. 1, Small Intestine
Volume 44
- Vol. 44, No. 7, Biliary Tract and Pancreas Part I
- Vol. 44, No. 6, Esophagus, Stomach, and Duodenum Part II
- Vol. 44, No. 5, Esophagus, Stomach, and Duodenum Part I
- Vol. 44, No. 4, Breast Diseases
- Vol. 44, No. 3, Pediatric Surgery
- Vol. 44, No. 2, General Oncology Part II
- Vol. 44, No. 1, General Oncology Part I
Volume 43
- Vol. 43, No. 8, Wound Healing & Burn Injuries
