https://www.gastrojournal.org/article/S0016-5085(08)00967-0/pdf

Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps.

This is the fourth updated Enhanced Recovery After Surgery (ERAS®) Society guideline presenting a consensus for optimal perioperative care in colorectal surgery and providing graded recommendations for each ERAS item within the ERAS® protocol. A wide database search on English literature publications was performed. Studies on each item within the protocol were selected with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohorts and examined, reviewed and graded according to Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. All recommendations on ERAS® protocol items are based on best available evidence; good-quality trials; meta-analyses of good-quality trials; or large cohort studies. The level of evidence for the use of each item is presented accordingly. The evidence base and recommendation for items within the multimodal perioperative care pathway are presented by the ERAS® Society in this comprehensive consensus review.

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Guidelines for perioperative care in elective colonic surgery: Enhanced recovery after surgery (ERAS®) society recommendations

Riedel DJ, Gonzalez-Cuyar LF, Zhao XF, Redfi eld RR, Gilliam BL. Plasmablastic lymphoma of the oral cavity: a rapidly progressive lymphoma associated with HIV infection. Lancet Infect Dis 2008; 8: 261–67. In this Grand Round, the references for the sentence “Occasionally, CD138-negative plasmablastic lymphoma cases (such as this case) have been reported” (page 265) should be 32, 34, and 38. Book Systematic reviews: CRD’s guidance for undertaking reviews in health care

/pdf/systematic-reviews-crd-s-guidance-for-undertaking-reviews-in-4hcrkbrbv4.pdf

Systematic reviews: CRD's guidance for undertaking reviews in health care

Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis.

American College of Gastroenterology Guidelines for Colorectal Cancer Screening 2008

Background:  Because of specific methodological difficulties in conducting randomized trials, surgical research remains dependent predominantly on observational or non-randomized studies. Few validated instruments are available to determine the methodological quality of such studies either from the reader's perspective or for the purpose of meta-analysis. The aim of the present study was to develop and validate such an instrument.

Methods:  After an initial conceptualization phase of a methodological index for non-randomized studies (MINORS), a list of 12 potential items was sent to 100 experts from different surgical specialities for evaluation and was also assessed by 10 clinical methodologists. Subsequent testing involved the assessment of inter-reviewer agreement, test-retest reliability at 2 months, internal consistency reliability and external validity.

Results:  The final version of MINORS contained 12 items, the first eight being specifically for non-comparative studies. Reliability was established on the basis of good inter-reviewer agreement, high test-retest reliability by the κ-coefficient and good internal consistency by a high Cronbach's α-coefficient. External validity was established in terms of the ability of MINORS to identify excellent trials.

Conclusions:  MINORS is a valid instrument designed to assess the methodological quality of non-randomized surgical studies, whether comparative or non-comparative. The next step will be to determine its external validity when used in a large number of studies and to compare it with other existing instruments.

Methodological index for non-randomized studies (minors): development and validation of a new instrument.

Hypothesis Better knowledge of independent risk factors might decrease mortality and morbidity rates following colorectal surgery. Design Prospective multicenter study. Interventions From June to September 2002, consecutive patients undergoing open or laparoscopic surgery (electively or on an emergent basis) for colorectal cancers or diverticular disease were prospectively included. Exclusion criteria were colectomy for other causes (eg, inflammatory bowel diseases, benign polyps). The structured sheet of data collection included more than 200 items on all perioperative data concerning the patient, the disease, and the operating surgeons. Postoperative mortality and morbidity were defined as in-hospital death and complications. Results Among 1421 patients, the in-hospital death rate was 3.4% and the overall morbidity rate was 35%. Four independent preoperative risk factors of mortality were found: emergency surgery, loss of more than 10% of weight, neurological comorbidity, and age older than 70 years. Six independent risk factors of morbidity were found: age older than 70 years, neurologic comorbidity, hypoalbuminemia, cardiorespiratory comorbidity, long duration of operation, and peritoneal contamination. Conclusion Colorectal resection in France is associated with a 3.4% mortality rate and a 35% morbidity rate. Knowledge of the risk factors could help surgeons manage cases.

https://jamanetwork.com/journals/jamasurgery/articlepdf/508425/soa4112_278_283.pdf

Postoperative mortality and morbidity in French patients undergoing colorectal surgery: results of a prospective multicenter study.

Background
Surgical management of left colonic cancer presenting as an acute obstruction remains controversial and still is associated with high mortality and morbidity rates. Recently, self-expandable metallic stents (SEMS) have been used as a bridge to surgery in an attempt to decompress the colon and then allow elective one-stage surgical resection without stoma placement. This study aimed to compare the outcomes of emergency surgery alone with emergency placement of colonic SEMS as a bridge to surgery in terms of efficiency and reduction of the stoma placement rate.

Emergency preoperative stenting versus surgery for acute left-sided malignant colonic obstruction: a multicenter randomized controlled trial

Background: Morbid obesity predisposes patients to lung collapse and hypoxemia during induction of anesthesia. The aim of this prospective study was to determine whether noninvasive positive pressure ventilation (NPPV) improves arterial oxygenation and end-expiratory lung volume (EELV) compared with conventional preoxygenation, and whether NPPV followed by early recruitment maneuver (RM) after endotracheal intubation (ETI) further improves oxygenation and respiratory function compared with NPPV alone. Methods: Sixty-six consecutive patients (body mass index, 46 6 kg/m 2 ) were randomized to receive 5 min of either

/pdf/noninvasive-ventilation-and-alveolar-recruitment-maneuver-1zk7pwy5j5.pdf

Noninvasive ventilation and alveolar recruitment maneuver improve respiratory function during and after intubation of morbidly obese patients: a randomized controlled study.

Objectif, - L 'index de qualite de vie pour les maladies digestives (GIQLI) est un questionnaire developpe en Allemagne. Le but de cette etude etait d'en valider la version francaise. Methodes. - Le questionnaire comporte 36 items explorant les symptomes, la condition physique, les emotions, l'integration sociale, et l'effet du traitement medical, Il a ete propose a 615 personnes. 335 sujets sains et 280 malades. L'acceptabilite du questionnaire et les scores absolu et relatif etaient calcules dans les 2 groupes. La validation psychometrique etait faite par l'etude de la pertinence du regroupement des items (validites convergente et discriminante) et la fiabilite du questionnaire (coherence interne). Resultats. - L'acceptabilite etait de 93 %. Le score absolu moven etait de 126 (sur 144) pour les sujets sains et 96 pour les malades (P < 0.00001). La pertinence du regroupement des items, la fiabilite etaient demontrees et la validite clinique suggeree dans ce groupe de malades. Conclusion. - Cette etude a permis la validation psychometrique de la version francaise du GIQLI, Ce questionnaire pourrait etre utilise en France comme un moyen de mesure fiable de la qualite de vie en pathologie digestive.

Fabrice Kwiatkowski

Papers

Methodological index for non-randomized studies (minors): development and validation of a new instrument.

Postoperative mortality and morbidity in French patients undergoing colorectal surgery: results of a prospective multicenter study.

Emergency preoperative stenting versus surgery for acute left-sided malignant colonic obstruction: a multicenter randomized controlled trial

Noninvasive ventilation and alveolar recruitment maneuver improve respiratory function during and after intubation of morbidly obese patients: a randomized controlled study.

First validation of the French version of the Gastrointestinal Quality of Life Index (GIQLI)