BY NEIL OSTERWEIL
Frontline Medical News
BOSTON – The operation was a success, but the patient
It’s an old chestnut for sure, but there is a painful kernel
of truth in it, say investigators who found that patients who
undergo complex cancer surgery and have serious complications are at significantly increased risk for death for at least 6
months after surgery, compared with patients who undergo
the same procedure with few or no complications.
“Our work has important implications for quality assessment. I think in cancer surgery in particular we have to get
away from the short-term metrics of survival, and we have
to think about the implications of complications for long-term survival, even if at a very high-quality hospital we’re
good at salvaging those patients who do experience those
complications,” said Dr. Hari Nathan of the University of
Michigan, Ann Arbor.
In a retrospective study, results of which were presented
at the annual Society of Surgical Oncology Cancer Symposium, Dr. Nathan and colleagues showed that patients
who underwent surgery for cancers of the esophagus and
lung who had serious complications but survived at least
Longer-term metrics tell the full story.
Operating with pain: Surgeon
workplace injury underrecognized
VOL. 12 • NO. 4
See Survival Ü page 10
3 l Commentary
Dr. Patrick V. Bailey offers
expert advice on how to
connect with legislators.
17 l Practice Management
New carpal tunnel syndrome guidelines
from the AAOS highlight treatments with
21 l General Surgery
Dr. Mark Savarise gives his view
on a study linking colonoscopy
anesthesia with complications.
Online & In-Depth
Dr. Anees Chagpar spoke at the Miami
Breast Cancer Conference 2016 about the
factors to be considered when assessing
costs of prophylactic mastectomy. Watch the
interview at http://goo.gl/Ye2JfJ.
BY DEEPAK CHITNIS
Frontline Medical News
BOSTON – For many surgeons, hours in the
OR can translate into serious or chronic neck,
back, and hand pain.
Studies of occupational injury related to
performing surgery took off in the 1990s when
laparoscopic surgery became widespread
and put new physical demands on surgeons
(Surg Endosc 1999:13:466-468; Arch Surg
1999;134:1011-1016). Findings from a study
presented at the Society for Surgical Oncology
suggest that the problem remains widespread.
Dr. Rachael K. Voss, a research resident at
the University of Texas MD Anderson Cancer
Center, Houston, and her colleagues conduct-
ed a survey among oncologic surgeons at the
Center to explore the extent, sources and risk
factors of workplace injuries.
“[Workplace injury] is a serious issue for
surgeons, but it is something we don’t talk
about and there is very little training and information as we are going through training.
But these occupational hazards are something
we need to acknowledge. We need to do
more work in the future with ergonomics
experts and occupational hygiene experts
See Pain Ü page 9
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FROM THE EDITOR
LAYTON F. RIKKERS, M.D., FACS
The Power of Quiet
Surgeons who find themselves in leadership positions need
input from both extroverts and introverts on their teams.
Dr. Rikkers offers some advice on how to encourage the quiet
ones to make a contribution to the team.
Ü Page 2