Episode 17: Novel Form of Breast Intraoperative Radiation Therapy with CT-Guided High-Dose-Rate Brachytherapy: Interim Results of a Prospective Phase II Clinical Trial
In this episode, Dr. Jamie Coleman is joined by Shayna Showalter, MD, from the University of Virginia School of Medicine, Charlottesville, VA. They discuss Dr. Showalter’s recent evaluating precision breast intraoperative radiation therapy (PB-IORT), which uses customized CT-based treatment plans for high-dose-rate (HDR) brachytherapy. Interim results show that PB-IORT has an acceptable breast cancer recurrence rate, minimal side effects, and excellent cosmetic outcomes.Ìý
Disclosure Information: Drs. Coleman and Showalter have nothing to disclose.
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Episode 16: Comprehensive Cost Implications of Commercially Available Noninvasive Colorectal Cancer Screening Modalities
In this episode, Dr. Dante Yeh is joined by Casey Allen, MD, from the Institute of Surgery, Division of Surgical Oncology, Allegheny Health Network, Pittsburgh, Pennsylvania. They discuss Dr. Allen’s recent study, which found that widespread adoption of the fecal immunochemical test for noninvasive colorectal cancer screening could lead to substantial cost savings. This carries major value implications for a large population health system.
Episode 15: Operationalizing the Culture of Burnout and Well-Being: Multicenter Study of Value Congruence and Flourishing in General Surgery Residency
In this episode, Dr. Jamie Coleman is joined by Carter Lebares, MD, FACS, from the Department of Surgery, University of California San Francisco. They discuss Dr. Lebares’ recent at 16 academic general surgery training programs, in which residents indicated a perceived lack of value congruence with leadership regarding occupational well-being. Program directors expressed variable alignment with these perceptions. Value congruence was significantly associated with individual resident global well-being.
Epiosde 14: Leadership and Impostor Syndrome in Surgery
In this episode, Dr. Dante Yeh is joined by Lola Fayanju, MD, MA, MPHS, FACS, from the University of Pennsylvania, Philadelphia, PA. They discuss Dr Fayanju’s recent on impostor syndrome, an internalized sense of incompetence and not belonging. The study found that female physicians were more likely to experience impostor syndrome than male physicians, regardless of specialty or leadership role. While several identity-based gaps persist in leadership, impostor syndrome among racially minoritized groups may not be a significant contributor.
Episode 13: Quantifying the Prognostic Value of Preoperative Surgeon Intuition: Comparing Surgeon Intuition and Clinical Risk Prediction as Derived from the Â鶹´«Ã½ NSQIP Risk Calculator
In this episode, Dr. Dante Yeh is joined by Gabriel Brat, MD, FACS, MPH, and Jayson Marwaha, MD, MBI, from Beth Israel Deaconess Medical Center, Boston, MA. They discuss their recent , which compared the predictive utility of preoperative surgeon intuition and surgical risk calculators and found that, while preoperative surgeon intuition alone is an independent predictor of patient outcomes, traditional risk calculators are more robust predictors of postoperative complication.
Episode 12: COVID Vaccination Status and Operative Outcomes after Kidney Transplantation
In this episode, Dr. Jamie Coleman is joined by Bradley Kushner, MD, from the Washington University School of Medicine, St Louis. They discuss Dr. Kushner’s , which found that patients who are unvaccinated against COVID-19 have worse compliance and healthcare follow-up after a kidney transplant compared with those who were preoperatively vaccinated.
Episode 11: Severe Increase in Nursing Labor Cost and Effect on Surgical Department Financial Margins at an Academic, Tertiary Medical Center
In this episode, Dr. Jamie Coleman is joined by Clayton Brinster, MD, FACS, from Ochsner Health. They discuss his , which demonstrates a significant increase in surgical nursing labor cost, with a resultant decrease in department of surgery financial margins. This nationwide, precarious trend is not sustainable, and fiscal recovery will require sustained, strategic workforce allocation.
Disclosure Information: Drs Brinster and Coleman have nothing to disclose.
Episode 10: Truth of Colorectal Enhanced Recovery Programs: Process Measure Compliance in 151 Hospitals
In this episode, Dr. Dante Yeh is joined by Tejen Shah, MD, from The Ohio State University Wexner Medical Center. They discuss his , which shows that contrary to published enhanced recovery program (ERP) literature, most study hospitals had difficulty improving process compliance, with 80% not achieving substantial improvement. ERP bundles should be implemented in a more deliberate manner with better-planned, pragmatic, and informed strategies.
Disclosure Information: Dr. Shah has nothing to disclose. Dr. Yeh receives author royalties from UpToDate, advisory panel/training honoraria from Takeda Pharmaceuticals, and advisory panel honoraria from Baxter, Eli Lilly, and Fresenius Kabi.
Episode 9: Fluoroscopic Intraoperative Breast Neoplasm and Node Detection
In this episode, Dr. Jamie Coleman is joined by Roi Weiser, MD, from the University of Texas MD Anderson Cancer Center, and Suzanne Klimberg, MD, PhD, MSHCT, FACS, from the Division of Surgical Oncology at the University of Texas Medical Branch. They discuss their , which shows that fluoroscopic intraoperative neoplasm and node detection (FIND) can be used to localize the biopsy clip marking a non-palpable breast or axillary lesion, obviating the need for an additional procedure to insert a localization device. Furthermore, FIND shows promising results, with decreased margin positivity and re-excision rate compared with wire localization.
Disclosure Information: Dr. Klimberg receives book royalties from Elsevier, Springer, and Saunders. Drs Coleman and Weiser have nothing to disclose.
Episode 8: Cost-Effectiveness of Universal Screening for Blunt Cerebrovascular Injury: A Markov AnalysisÌý
In this episode, Dr. Dante Yeh is joined by Sharven Taghavi, MD, MPH, MS, FACS, from the Tulane University School of Medicine. They discuss his Ìýon blunt cerebrovascular injury (BCVI), which is a significant cause of morbidity and mortality in patients with blunt trauma. Using a Markov decision analysis, the authors found that universal screening for cerebrovascular injury using CT angiography in blunt trauma victims was the optimal strategy.
Disclosure Information: Nothing to disclose.
Disclosures outside the scope of this work: Dr. Taghavi receives funding from the CDC. Dr. Yeh receives author royalties from UpToDate, advisory panel/training honoraria from Takeda Pharmaceuticals, and advisory panel honoraria from Baxter, Eli Lilly, and Fresenius Kabi.
To earnÌý0.25 AMA PRA Category 1 Creditsâ„¢Ìýfor this episode of the JÂ鶹´«Ã½Operative Word Podcast,ÌýÌýto register for the course and complete the evaluation.
Episode 7: Disparity-Sensitive Measures in Surgical Care: A Delphi Panel Consensus
In this episode, Dr. Jamie Coleman is joined by Elzerie de Jager, MBBS(Hons), PhD, from the University of Vermont and the Center for Surgery and Public Health, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School and Harvard TH Chan School of Public Health; and LD Britt MD, MPH, FACS, from the Department of Surgery, Eastern Virginia Medical School. They discuss their study, in which a Delphi panel identified 125 potential disparity-sensitive measures which could be used to track health disparity, evaluate the impact of focused interventions, and reduce healthcare inequity.
Episode 6: Permanent vs Absorbable Mesh for Ventral Hernia Repair in Contaminated Fields
In this episode, Dr. Dante Yeh is joined by Flavio Malcher, MD, MSc, from the Department of Surgery at New York University. They discuss his study, which validates the findings of recent randomized controlled trials in a larger multicenter cohort, suggesting that permanent mesh is the ideal prosthetic to enhance ventral hernia repair even in contaminated fields, which challenges a longstanding surgical dogma.
Episode 5: Core Entrustable Professional Activities for Entering Residency: A National Survey of Graduating Medical Student Self-Assessed Skills by Specialty
In this episode, Dr. Coleman is joined by Dorothy Andriole, MD, FACS, who is a surgeon and the Senior Director of Medical Education Research at the Association of American Medical Colleges, and Jonathan Amiel, MD, who is a professor of psychiatry and Senior Associate Dean for Innovation in Health Professions Education at Columbia University. They discuss their recent study, which found that many graduating students intending to enter surgery agreed they had skills to perform some, although not all, Core Entrustable Professional Activities for Entering Residency. Continued efforts to prepare graduates more optimally for the start of residency training are warranted.Ìý
Episode 4: Analyzing Impact of Multimorbidity on Long-Term Outcomes after Emergency General Surgery: A Retrospective Observational Cohort Study
In this episode, Dr. Yeh is joined by Claire Rosen, MD, from the Hospital of the University of Pennsylvania. They discuss her recent paper, which demonstrates that past medical history, specifically multimorbidity, influences the risk of adverse outcomes after emergency general surgery, from increased mortality to limited independence and function. When surgeons understand and communicate these risks, shared decision-making is improved.
Episode 3: Long-Term Outcomes after Adolescent Bariatric Surgery
In this episode, Dr. Coleman is joined by Nestor F. De la Cruz-Muñoz Jr, MD, Professor of Surgery and Section Chief of Bariatric Surgery at the University of Miami. They discuss his , which demonstrates the lasting, positive impact of bariatric surgery even decades later, and confirms that bariatric surgery should not be denied to adolescents struggling with morbid obesity.
Episode 2: Use of Direct Oral Anticoagulant and Associated Bleeding and Thrombotic Complication after Lower Extremity Bypass
In this episode, Dr. Yeh is joined by lead author Danielle C. Sutzko, MD, MS, from the University of Alabama at Birmingham, and senior author Andrea T. Obi, MD, FACS, from the University of Michigan, both vascular surgeons. They discuss their on outcomes associated with direct oral anticoagulant and vitamin K antagonist use after lower extremity bypass.
Episode 1: Mass Shootings in America: Consensus Recommendations for Healthcare Response
In the inaugural episode, Jamie Coleman, MD, FACS, and Dante Yeh, MD, FACS, speak with Craig Goolsby, MD, MEd, FACEP, Professor and Vice Chair of Emergency Medicine at the Uniformed Services University of the Health Sciences and Science Director at the National Center for Disaster Medicine and Public Health in Bethesda, MD about his group’s , which was conducted using a Delphi process and resulted in 19 recommendations for training, public education, triage, communication, patient tracking, medical records, family reunification, and mental health. These consensus recommendations from the surgeons, physicians, and medics who cared for recent mass shooting patients will help everyone prepare for future incidents.
