RAYMOND M. BLEDAY, DPM, MD

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This study looked at how the number of lymph nodes removed during surgery affects survival in patients with advanced appendiceal cancer. Among nearly 9,743 patients, those with 12 to 23 lymph nodes removed had a 27% lower risk of dying compared to those with fewer than 12 lymph nodes. Importantly, having cancer that had spread to lymph nodes was linked to a doubled risk of mortality, and while chemotherapy didn't help most patients without node involvement, it seemed beneficial for a small group with certain tumor characteristics when fewer lymph nodes were removed. Who this helps: This research benefits patients with appendiceal cancer and their doctors by informing treatment decisions.

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This study examined how race/ethnicity and socioeconomic status (SES) affect patient care and recovery after elective colorectal surgeries. Researchers looked at data from 1,519 patients between 2018 and 2021 and found that patients with low SES had worse outcomes: they were less likely to follow important pre-surgery steps, had longer hospital stays (4 days compared to 3 days for those with high SES), and faced higher risks of infections (2.5 times more likely) and complications (50% more likely). There were also notable issues for Black patients, who had longer hospital stays and higher chances of respiratory complications (4 times more likely). Who this helps: This research assists doctors and healthcare providers in understanding and addressing disparities in surgical care for patients, especially those from low-income and minority backgrounds.

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This study looked at how implementing a standardized protocol called Enhanced Recovery after Surgery (ERAS) across four hospitals affected recovery outcomes for patients undergoing elective colorectal surgery. Researchers found that after ERAS was implemented, infections and other complications decreased significantly — for example, superficial infections dropped from 7.5% to 2.5%, and the average hospital stay reduced from 5 days to 4 days. These improvements are important because they lead to better patient recovery and lower healthcare costs. Who this helps: This helps patients undergoing elective colorectal surgery.

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This study looked at a rare type of tumor in the rectum called gastrointestinal stromal tumors (GISTs), which happen in about 5% of cases. Researchers reported on a woman in her 70s who had a GIST found near her lower back, treated first with a drug called imatinib before surgery. After a successful operation using an innovative technique, she recovered well and continued taking the drug for further treatment, showing this surgical method as a safe and effective option for similar tumors. Who this helps: This helps patients with rectal GISTs, doctors treating them, and caregivers involved in their treatment.

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This study looked at whether using non-opioid medications during recovery from colorectal surgery can reduce the likelihood that patients will continue to use opioids in the long term. The research followed 1,363 patients who had never used opioids before their surgery. It found that the percentage of patients still using opioids at 12 months decreased from 11% in 2017-2018 to just 4% in 2019-2020 after implementing new surgery recovery strategies, showing that better planning can significantly reduce long-term opioid use. Who this helps: This helps patients who undergo colorectal surgery and aim to avoid long-term opioid dependency.

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This study looked at how age and fragility affect how patients respond to health surveys about their outcomes after surgery. Researchers found that older adults aged 66 to 84 and those classified as "prefrail" were more likely to fill out these surveys compared to younger patients and those who are healthier. This is important because understanding who responds to these surveys can help improve healthcare evaluations for different patient groups. Who this helps: This benefits healthcare providers and older patients by improving the understanding of patient feedback.

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This study looked at how well MRI scans for rectal cancer matched up with actual tissue tests after surgery. Out of 105 patients, 28 had mismatched results—27%—where some were inaccurately staged as having less or more advanced cancer than they actually did. This is important because accurate staging ensures patients get the right treatment, which can lead to better outcomes. Who this helps: This helps patients with rectal cancer by ensuring they receive appropriate treatments based on accurate staging.

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This study examined how a protein called VentX affects immune responses within tumors, particularly in non-small cell lung cancer (NSCLC). Researchers found that increasing VentX levels in certain immune cells (macrophages) improved their ability to fight tumors and enhanced the effectiveness of a cancer treatment called PD-1 antibody, showing a 25% increase in T-cell activation without harming healthy cells. This discovery is important because it offers a new strategy to boost cancer treatment effectiveness while protecting normal tissue. Who this helps: This helps cancer patients, especially those with non-small cell lung cancer, by potentially improving their treatment outcomes.

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This study looked at how effective a specific type of surgery (gracilis flap reconstruction) is for patients who had their pelvic area surgically treated for cancer. Out of 101 patients, 8 had serious complications soon after surgery, and 13 experienced serious problems later on. However, most patients (91.1%) did not have issues at the site where the tissue was taken from, and most wound problems were minor and easily treated. This research is important because it shows that gracilis flaps can be a safe and effective option for pelvic reconstruction, especially for cancer patients. Who this helps: This helps patients recovering from pelvic cancer surgeries.

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Researchers studied how well healthcare teams are using a special care plan for older patients undergoing elective surgeries, focusing on those having colorectal or neurosurgery. They found that 32 doctors felt strongly that this new approach, which includes screening for frailty, works better than standard care, but for it to be successful long-term, hospitals need to invest more in resources and training. This research is important because it highlights the need to improve surgical care for older patients, making it safer and more effective. Who this helps: Older surgery patients and their medical teams.

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This study looked at how patients with malignant peritoneal mesothelioma, a rare and difficult-to-treat cancer, fare at academic hospitals compared to community hospitals. Researchers found that 29.7% of patients treated at academic centers survived for at least five years, compared to only 18.3% of those treated at community centers. Patients at academic hospitals also received more aggressive treatment options, such as surgery and same-day chemotherapy, which likely contributed to their better survival rates. Who this helps: This information benefits patients with malignant peritoneal mesothelioma, as it highlights the importance of seeking treatment at specialized academic hospitals.

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This study looked at how the number of rectal cancer surgeries performed at a hospital each year affects patient survival after surgery. It found that patients treated at hospitals performing 50 surgeries a year had a 72% chance of surviving five years after surgery, compared to 69% for those at hospitals doing only 10 surgeries a year. This is important because it shows that getting treated at a higher-volume facility can lead to better chances of survival for rectal cancer patients. Who this helps: This helps patients with rectal cancer and their families.

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This study looked at complications that can happen during elective surgery for diverticulitis, analyzing data from 1,225 patients across multiple international hospitals. They found that patients with chronic obstructive pulmonary disease (COPD) had a 3.2 times higher risk of minor complications, while those with factors like dyspnea or preoperative sepsis had a significantly increased risk of major complications. Understanding these risks helps hospitals improve patient care and reduce surgery-related problems. Who this helps: This benefits patients undergoing diverticulitis surgery and their healthcare providers.

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This study looked at how a cancer drug called doxorubicin affects tumor cells and the immune environment around them. Researchers found that low doses of doxorubicin, which don’t kill tumor cells, help enhance the immune response against tumors by increasing a protein called VentX in certain immune cells. This process can make tumors more sensitive to treatment by over 10 times without harming normal cells, making chemotherapy safer and more effective. Who this helps: This benefits cancer patients by potentially improving treatment outcomes while minimizing side effects.

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This study looked at how often early-stage rectal cancer spreads to nearby lymph nodes, which is important for deciding on treatment. They found that 12.2% of patients with T1 tumors and 18.0% of those with T2 tumors had positive lymph nodes. The study also showed that factors like poor tumor quality and the presence of certain signs of spread significantly increase the chances of lymph node positivity, making it crucial to consider these factors before surgery. Who this helps: This helps doctors make better treatment decisions for patients with early-stage rectal cancer.

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This research studied patients with a rare type of cancer called primary small bowel lymphoma, which accounts for 2% of small intestine cancers. Researchers looked at data from 2,283 patients who had surgery between 2004 and 2015, finding that those who received chemotherapy alongside surgery had a better five-year survival rate—70% compared to 55% for those who only had surgery. This matters because it shows that chemotherapy can significantly improve survival rates for patients with this type of lymphoma, highlighting the need for better treatment strategies. Who this helps: This helps patients with small bowel lymphoma and their doctors by guiding treatment decisions.

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This study looked at how often doctors talk to patients about their resuscitation wishes before surgery, specifically focusing on those who do not want to be revived (DNR) or intubated (DNI). Out of 158 patient cases, these important discussions were documented only 70% of the time, showing that many conversations may not be happening. This matters because clear communication about resuscitation wishes can lead to better care and ensure that patients' preferences are respected during surgery. Who this helps: This helps patients and their families by ensuring their wishes are understood and honored.

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This study looked at anal squamous cell carcinoma (SCC) survival rates in men and women from 2004 to 2016. Researchers found that women had better survival rates than men, with 1-year survival at 90.2% for women versus 85.8% for men, and 5-year survival at 67.7% for women compared to 55.9% for men. Understanding these differences is important because it can help doctors identify which patient groups may need more targeted treatments and screenings. Who this helps: This helps patients and doctors by guiding screening and treatment strategies based on sex differences.

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In this study, researchers looked at how immune responses to colorectal cancer vary between different types of tumors. They analyzed over 371,000 cells from the tumors of 28 people with tumors that have normal DNA repair and 34 people with tumors that have faulty DNA repair. They found that the tumors with faulty DNA repair had more active immune responses and identified specific areas where immune and cancer cells interact, which helps to understand how these interactions can influence cancer progression. Who this helps: This research benefits doctors and researchers working to improve cancer treatments and immune therapies for patients.

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This study looked at a young woman with a genetic condition called familial adenomatous polyposis (FAP), who developed a specific type of colon cancer known as microsatellite instability-high (MSI-high), despite FAP usually being associated with a different cancer pathway. The woman responded well to an advanced immunotherapy treatment, allowing doctors to surgically remove her colon cancer, and she has remained cancer-free for over 10 months. This case is important because it shows that cancer pathways may not always follow expected patterns, which could lead to better treatment options in similar cases. Who this helps: Patients with rare cancer types and their doctors.

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This study looked at how a special care program called Enhanced Recovery After Surgery (ERAS) affects heart rhythm problems after colorectal surgeries. Researchers found that only 1.8% of patients in the ERAS group experienced cardiac arrhythmias, compared to 5.3% in the standard care group, showing that ERAS significantly reduces these complications. This matters because fewer heart issues can lead to quicker recoveries and better overall health for patients after surgery. Who this helps: This helps patients undergoing colorectal surgery.

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This study looked at how having Crohn's disease affects survival rates for people with small bowel adenocarcinoma, a type of cancer. Researchers analyzed data from 2,668 patients and found that while those with Crohn's disease were generally younger and had more aggressive tumors, their overall survival rates were similar to those of patients with sporadic cases of the cancer. This matters because it shows that having Crohn's disease doesn’t significantly increase the risk of dying from small bowel adenocarcinoma, suggesting that treatment approaches can focus on the cancer rather than the underlying condition. Who this helps: This helps patients with Crohn's disease and their doctors by providing clearer survival expectations and treatment guidelines.

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This study looked at how using an Enhanced Recovery After Surgery (ERAS) program affects patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Researchers found that the average hospital stay decreased from 9 days to 6 days after implementing the ERAS guidelines, while no patients experienced kidney complications, and there were no changes in readmission rates or overall complications. This matters because it shows that ERAS programs can lead to a faster recovery for patients without increasing risks. Who this helps: This helps patients undergoing CRS/HIPEC and their doctors by improving recovery times and potentially enhancing patient care.

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This study looked at how using a specific pain relief method called liposomal bupivacaine transversus abdominis plane (TAP) blocks affects opioid use in colorectal surgery patients. It found that patients who received this treatment used about 15.9 mg less opioid medication within 72 hours after surgery and had shorter hospital stays by about 0.8 days compared to those who received standard pain relief. This matters because reducing opioid use can help prevent addiction and improve recovery times after surgery. Who this helps: This benefits patients undergoing colorectal surgery who want to manage pain more effectively and recover faster.

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This study looked at two different surgical options for patients with early-stage distal rectal cancer: local excision (LE) and a more extensive surgery called abdominoperineal resection (APR). It found that for patients with T1 tumors, survival rates were about the same whether they had LE or APR, and similarly, T2 patients saw no significant survival benefit from one method over the other. This matters because it shows that less invasive surgery might be a good choice for treating early rectal cancer without sacrificing survival chances. Who this helps: This helps patients with early distal rectal cancer and their doctors in choosing treatment options.

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This study examined patients with diverticulitis who were scheduled for elective surgery to determine which factors made their condition more complex. Out of 1,502 patients, 559 (37%) had a complicated form of diverticulitis marked by issues such as abscesses or strictures. The research found that these patients tended to be older, less healthy, and had more other health issues, but they did not have more previous diverticulitis episodes compared to those with uncomplicated cases. Who this helps: This research helps doctors provide better care for patients with complex diverticulitis.

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This study examined why some patients with stage I-III rectal cancer choose not to have surgery, which is a common treatment. Out of over 80,000 patients, only 509 with stage I and 2,082 with stage II/III opted out of surgery, making refusal rates 2.6% and 3.5%, respectively. Those who were older, Black, uninsured, or lived in rural areas were more likely to refuse surgery, and refusing surgery was linked to lower survival rates. Who this helps: This information benefits patients and healthcare providers by highlighting the factors influencing surgical treatment decisions.

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The study looked at where colorectal surgeons are located in the United States and how their distribution relates to the characteristics of the local population. They found that areas with more nonwhite and college-educated residents had more colorectal surgeons, while areas with higher rates of uninsured individuals had fewer. This is important because it highlights access issues; some communities may struggle to get specialized care for colorectal cancer due to fewer available surgeons. Who this helps: Patients, especially those in underserved areas.

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This study looked at the financial effects of implementing an Enhanced Recovery After Surgery (ERAS) program for patients undergoing colon surgery in a single hospital. Researchers found that the median cost for surgeries with complications dropped from $24,111 to $21,896 after ERAS was introduced, while costs for surgeries without complications decreased slightly from $19,268 to $18,444, although these changes weren't statistically significant at the lower-cost category. This matters because the ERAS program led to significant savings in nursing costs, which likely balanced out the increased expenses in other areas like operating room supplies and anesthesia. Who this helps: This benefits hospitals and patients undergoing colorectal surgeries.

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This research looked at why some patients with stage I-III colon cancer choose not to have surgery, which is important for their chance of recovery. Among over 150,000 patients studied, 1,071 (about 0.71%) refused surgery, with factors like older age, being Black, and having limited insurance playing a role in this decision. The study found that those who refused surgery had significantly lower 5-year survival rates compared to those who chose surgery. Who this helps: This information is valuable for doctors and healthcare providers aiming to support patients in making informed treatment decisions.

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This study looked at whether training general surgery residents on how to prescribe opioids properly can lead to less opioid use after surgery. Researchers found that residents who didn’t receive formal education prescribed many more opioids compared to those who did. For instance, after thyroid surgery, 24% of untrained residents prescribed at least 20 pills, while none of the trained residents did. This is important because it shows that better education for doctors could help reduce the number of patients who become long-term opioid users after surgery. Who this helps: This helps patients who are undergoing surgery and are at risk of becoming reliant on opioids.

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This research looked at how a special recovery plan called the Enhanced Recovery After Surgery (ERAS) program affects patients having surgery for soft tissue sarcoma. The study found that patients in the ERAS program had significantly fewer complications, such as wound issues (only 0.9% compared to 13.1% for those not in the program) and shorter hospital stays (5 days compared to 6 days). This matters because improving recovery outcomes can lead to better patient experiences and lower healthcare costs. Who this helps: This benefits patients undergoing surgery for soft tissue sarcoma.

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This study looked at patients who had colorectal surgery to understand who uses more opioids while in the hospital and how that relates to ongoing opioid use afterward. Researchers analyzed data from 1,646 patients and found that those in the highest group for opioid use (more than 250 morphine milligram equivalents) were almost twice as likely to continue using opioids 90-180 days after surgery compared to those with lower usage (19.8% vs. 9.7%). Identifying factors like being under 65, having emergency surgery, or existing bowel issues can help doctors find patients who might need strategies to use fewer opioids. Who this helps: This information benefits patients and doctors by promoting safer pain management after surgery.

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This study looked at the survival rates of patients with a rare cancer called small bowel leiomyosarcoma (SB LMS) who had surgery to remove the tumor. Out of 288 patients, 77% were alive one year after surgery, and 43% were alive five years later. The findings indicate that complete surgical removal of the tumor significantly increases survival, highlighting the importance of early diagnosis and treatment. Who this helps: This benefits patients with small bowel leiomyosarcoma and their doctors.

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This study looked at how certain immune cells called tumor-associated macrophages (TAMs) behave in pancreatic cancer. The researchers found that these TAMs had reduced ability to clear cancer cells compared to normal immune cells. By increasing the levels of a protein called VentX in these TAMs, they were able to enhance their ability to fight the cancer, which could lead to better outcomes for patients. Who this helps: This research benefits pancreatic cancer patients by providing insights into potential new treatment strategies.

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This study looked at patients with rectal cancer who had a specific surgery called abdominoperineal resection (APR) to see if using a technique called an omental flap could reduce wound complications. Out of over 3,000 patients, those who had an omental flap were actually more likely to develop a serious infection inside the body (10.4% compared to 6.5% for those without the flap). This matters because it highlights that, instead of helping, the omental flap might increase the risk of certain complications after surgery. Who this helps: This information helps doctors make better decisions about surgical options for rectal cancer patients.

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This study examined where colorectal cancer is found in patients under 50 years old. Researchers found that 74.4% of these young patients had left-sided tumors, compared to 56.1% of older patients. Understanding this pattern is important for improving screening methods and patient care for young people diagnosed with this disease. Who this helps: This helps younger patients and healthcare providers by guiding screening strategies.

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This study looked at how systemic chemotherapy affects survival in patients with a rare type of appendiceal cancer called low-grade mucinous adenocarcinoma. Researchers analyzed data from 639 patients and found that those who received chemotherapy had a five-year survival rate of 61.3%, compared to 52.9% for those who did not receive chemotherapy; however, chemotherapy did not significantly improve overall survival when other factors were considered. The findings highlight the need for clearer treatment guidelines, since surgery and being female were linked to better survival outcomes. Who this helps: This helps patients with appendiceal cancer and doctors treating them.

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This study looked at the risk of discovering appendiceal cancer in patients who had surgery for appendicitis between 2016 and 2017. Researchers found that older patients face a significantly higher risk of having cancer diagnosed after surgery, with those over 80 being more than five times as likely to have cancer compared to younger patients. This is important because it highlights the need for doctors to carefully consider age and other factors when deciding between surgery and non-surgery treatments for appendicitis, as missing a diagnosis could lead to worse outcomes. Who this helps: This benefits older patients and their doctors making treatment decisions.

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This study focused on understanding how many patients used opioids for a long time after undergoing colectomy, a type of bowel surgery. Researchers found that 10.6% of the 1,243 patients studied continued to use opioids between 90 to 180 days after their surgery. Key factors increasing the risk of prolonged use included previous opioid prescriptions and receiving a high quantity of opioids at discharge, which can lead to complications and hospital readmissions. Who this helps: This information helps doctors better manage pain treatment for surgery patients, aiming to reduce long-term opioid dependence.

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This study looked at how chemotherapy affects the survival of patients with stage II and III mucinous colon cancer. It found that patients with stage II mucinous colon cancer who received chemotherapy had a 21% better chance of surviving than those who did not, while patients with stage III mucinous colon cancer had a 44% better chance of survival. These results matter because they highlight the importance of chemotherapy in improving outcomes for patients with these specific types of colon cancer. Who this helps: This benefits patients with stage II and III mucinous colon cancer.

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This study looked at how race affects survival rates for patients with anal squamous cell carcinoma (SCC). Researchers found that Black patients had lower chances of surviving five years after diagnosis compared to White patients, with survival rates of 71.2% versus 80.6% for stage I, 64.6% versus 69.3% for stage II, and 50.9% versus 58.1% for stage III cancer. These differences in survival are significant and point to underlying issues that need to be addressed to improve outcomes for all patients. Who this helps: This helps patients and healthcare providers who are working to improve cancer treatment and health equity.

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This study looked at goblet cell carcinoid tumors (GCC) of the appendix, a rare type of cancer, to find out how well patients survive based on the stage of their disease and the treatments they received. Out of 2,552 patients, those diagnosed with early-stage (Stage I and II) tumors had high 5-year survival rates of around 91% and 90%, while those with advanced tumors (Stage III and IV) had much lower survival rates of 57% and 19%, respectively. The findings highlight that factors such as older age and cancer spread to lymph nodes are linked to worse survival outcomes. Who this helps: This research benefits patients and doctors by providing important insights into survival rates and treatment effectiveness for those diagnosed with GCC tumors.