WALTER E. LONGO, MD

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The study looked at how colorectal surgeons understand and handle low anterior resection syndrome (LARS), a condition that can affect patients after rectal cancer surgery. Out of 378 surveyed surgeons, 76.7% always warned their patients about the risk of LARS before surgery, but only 42.4% regularly checked for it afterward. Most surgeons (32.7%) commonly treated LARS with lifestyle changes and medications, but a significant number didn’t provide any treatment at all. Who this helps: This benefits patients recovering from rectal cancer by improving their chances of receiving appropriate follow-up care and effective treatments for LARS.

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Researchers examined patients with celiac artery compression (CAC) to better understand median arcuate ligament syndrome (MALS), a condition that causes abdominal pain after eating. Out of 293 patients studied, 69 (about 24%) were diagnosed with MALS, who tended to be younger (average age of 55.7 compared to 68.1 years) and had fewer issues like diabetes and high blood pressure compared to those without MALS. This matters because recognizing these patterns can help doctors diagnose and treat MALS more effectively in patients suffering from abdominal symptoms. Who this helps: This helps patients experiencing unexplained abdominal pain after meals.

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This study looked at sexual harassment experienced by surgical trainees and found that almost half (48.9%) reported being harassed, with the operating room being the primary location for this behavior (74% of those harassed). The main harassers included senior doctors and nurses, and typical harassment included being called disrespectful names. This research highlights the urgent need to change the culture in operating rooms to protect trainees from such harmful experiences. Who this helps: This helps surgical trainees and contributes to creating a safer work environment for future doctors.

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Surgical residents face significant financial stress from educational debt and low salaries during long training periods. This follow-up survey of New England general surgery residents found ongoing financial strain, with debt levels and financial literacy gaps persisting over time. Residency programs should incorporate financial wellness support to reduce a known driver of burnout.

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Surgical culture has begun prioritizing resident well-being, but longitudinal data tracking how well-being changes over training are scarce. This five-year multi-institutional survey of New England surgery residents found persistent rates of burnout and poor health maintenance, with limited improvement over the study period. Structural changes—not just wellness programs—are needed to durably improve surgical resident health.

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This paper discusses how the US Department of Veterans Affairs (VA) has significantly advanced medical care over the past century, particularly through its surgical innovations. Key accomplishments include pioneering techniques in colon surgery and vascular disease treatments, as well as leading the way in cardiac surgery and liver transplants. These advancements have improved healthcare not just for veterans, but for patients worldwide, while also providing excellent training for doctors. Who this helps: Patients and healthcare providers globally benefit from these innovations and training.

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This study looked at sexual harassment in surgical training, finding that nearly half (48.9%) of all trainees experienced harassment, and this number rose to 70.8% for female trainees. Shockingly, only 7.6% of those who faced harassment reported it, mainly because they felt the behavior was harmless or thought reporting wouldn't change anything. Addressing these issues is critical to create a safer environment for surgical trainees and encourage reporting. Who this helps: Patients and surgical trainees.

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This study looked at how to improve the way surgery residents receive feedback in the operating room by using simple reminders placed at scrub sinks. After putting up these reminders, residency feedback satisfaction jumped significantly, with residents reporting considerably more talks about learning goals before surgery and better discussions afterward (an improvement so notable it had a statistical significance of p < 0.01). This is important because better feedback can help residents learn more effectively and become better surgeons. Who this helps: This benefits surgery residents who need constructive feedback to develop their skills.

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This research looked at how surgical residents prescribe opioids for pain relief after surgery. It found that while 100% of residents prescribe opioids for some procedures, they often prescribe more than what they believe patients actually need—averaging 166.3 morphine milligram equivalents instead of the 113.9 they think is necessary. This is significant because better training for residents on pain management could help reduce the risk of opioid overprescribing, which contributes to the opioid crisis. Who this helps: This helps patients by promoting safer pain management practices post-surgery.

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This study looked at how to increase the number of surgeries performed by junior surgical residents, particularly to meet a requirement of at least 250 surgeries by their second year. The researchers made several changes to the training program, and as a result, the average number of surgeries done by these residents jumped from 176 to 330. This is significant because it ensures that residents get enough hands-on experience, which is crucial for their training and future practice. Who this helps: This helps junior surgical residents in their training.

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This study looked at how taking time for research during surgical training affects doctors' future earnings. It found that dedicating time to research can significantly reduce career earnings; for example, those aiming for cardiothoracic surgery could lose about $1.4 million over their careers. Most residents did not realize how much this research time could impact their pay. Who this helps: This information benefits medical residents and training programs, helping them make informed decisions about research during their training.

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This study looked at whether watching an instructional video helps surgery residents notice mistakes when inserting central lines, which are tubes used to deliver medications or fluids. Researchers found that residents who watched the video were 72.6% better at identifying errors compared to those who didn't, indicating that simply watching a demonstration can greatly enhance skill in spotting mistakes. This matters because training programs can use videos to make sure residents are safer and more effective as they learn these critical procedures. Who this helps: Patients and healthcare providers benefit from improved training methods for surgical residents.

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This study looked at the personal and professional well-being of surgical trainees in New England, focusing on their health maintenance, finances, work environment, and ability to manage stress. Among the 166 residents surveyed, 54% reported missing basic health check-ups, 44% experienced unwanted weight gain, and 92% felt moderate to extreme work-related stress, which affected their overall well-being. These findings highlight the need for residency programs to make small changes that help trainees take care of their health and manage stress, as their well-being directly impacts patient care. Who this helps: This helps surgical residents and their patients.

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In this study, researchers investigated how confident senior general surgery residents feel about performing flexible endoscopy procedures like upper endoscopy and colonoscopy. They found that while 66.7% of residents felt confident with upper endoscopy, only 52.7% felt the same about colonoscopy. The study highlights a significant gap in confidence among surgical residents, emphasizing the need for enhanced training methods, such as more simulation training and dedicated practice opportunities. Who this helps: This benefits surgical residents and ultimately enhances patient care.

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This study looked at how general surgery residency programs in the U.S. handle pregnancy and parenthood for their residents. Out of 66 program directors surveyed, 67% had maternity leave policies, but only 48% had policies for paternity leave. The research found that many believe having children negatively impacts female residents more than male residents, with 61% saying it affects their work negatively. Who this helps: This helps surgery residents, particularly those who are expecting or planning to start a family.

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This paper reviews treatment guidelines for diverticulitis, a condition often linked to a lack of dietary fiber that causes pouches (diverticula) to form in the colon. It emphasizes that these guidelines, primarily used at Yale New Haven hospitals, are based on insights from the last 20 years and detail management strategies for different stages of the disease. Following these updated guidelines can lead to better patient outcomes and reduced complications. Who this helps: This helps patients suffering from diverticulitis and the doctors treating them.

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This study examined how confident graduating surgical residents feel about performing open vascular surgery, specifically looking at their ability to carry out key procedures. They found that while 70% of residents felt confident doing a vascular anastomosis (a type of connection between blood vessels), fewer than 25% felt confident with four other important vascular techniques. This is important because it highlights a significant gap in surgical training, affecting how well new surgeons can handle vascular issues in their future practices. Who this helps: This helps graduating surgical residents and their future patients.

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This study looked at how the merger of a community surgery program with an academic program affected the experiences and attitudes of surgery residents. Out of 35 residents surveyed, those from the community program felt they had better opportunities for research and networking with faculty after the merger, while experiences among the academic program residents were less positively impacted. This matters because it shows that combining different residency programs can provide benefits, especially in research and networking, without harming the training quality. Who this helps: This helps residents in surgical training programs, particularly those from community programs.

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This study looks at the life and contributions of Dr. Ashley W. Oughterson, a prominent surgeon from Yale University and a military leader during World War II. He pioneered important surgical techniques for pancreatic surgery and played a crucial role in wartime medical care, documenting his experiences in a detailed diary, which is a key resource on surgical practices at that time. His work shaped cancer research leadership after the war, influencing future studies and practices in oncology. Who this helps: This benefits patients and doctors by improving cancer treatment and surgical practices.

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This study looked at how confident graduating surgery residents in the Northeast feel about performing open surgeries. Out of 232 residents surveyed, only 52% felt confident enough to practice independently after finishing their training. The study found that their confidence differed based on factors like sex, the type of training program, and their experience in performing surgeries, and highlights a significant lack of confidence in various surgical procedures. Who this helps: This information can help improve training programs for surgery residents to better prepare them for their careers.

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This study looked at how confident graduating general surgery residents feel about performing open surgeries. Researchers surveyed 653 residents and found that while many expected to feel confident (72%), over 25% of them lacked confidence in doing eight out of thirteen surgeries they were asked about. Factors like the size and type of their training program influenced their confidence levels, with more experience leading to more confidence. Who this helps: This benefits surgical residents and their future patients by highlighting areas where training may need improvement.

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This study looked at sexually transmitted infections (STIs) affecting the anus and rectum, which are becoming more common, especially in the context of the HIV/AIDS epidemic. The researchers highlighted that certain anal lesions need special treatment, and they provided updated information on how to diagnose and manage these infections effectively. This is important because it helps improve health outcomes for those affected and addresses a growing public health issue. Who this helps: This helps patients with STIs and healthcare providers treating them.

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This study looked at human papillomavirus (HPV) infections in the anal area and found that behaviors related to sexual activity and rising HIV rates are increasing infection rates. Certain types of HPV, like 6 and 11, can cause harmless warts, while others like 16 and 18 can lead to serious issues like anal cancer. Early detection and treatment of harmful lesions are vital for preventing complications, and the research also shows that vaccines can help protect against HPV in some groups. Who this helps: This information benefits patients at risk for HPV-related anal conditions, healthcare providers, and public health officials.

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This study looked at diverticular disease, a condition affecting around 2.5 million people in the U.S., and its impact on patients' health and healthcare systems. It found that patients often suffer from bothersome symptoms like abdominal pain and experience serious complications like diverticulitis, leading to a reduced quality of life and higher mortality rates compared to healthy individuals. In 2002 alone, there were over 254,000 hospitalizations and nearly 1.5 million outpatient visits related to this disease, costing between $9,742 and $11,729 per hospital stay. Improving treatment options will help both patients and healthcare systems manage this burden better. Who this helps: This helps patients with diverticular disease and their healthcare providers.

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This study looked at a case involving a 47-year-old man who developed a serious and often deadly fungal infection called invasive aspergillosis, even though he didn't have the usual risk factors for this disease. Despite his critical condition and lack of traditional vulnerabilities, he faced severe complications in the hospital, and he was diagnosed with this infection after his death. This finding is important because it shows that even patients who seem healthy or have no significant immune issues can still develop deadly infections, highlighting the need for awareness and careful monitoring in critically ill patients. Who this helps: This helps doctors in hospitals better recognize and treat fungal infections in seriously ill patients.

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This study looked at a new way to fix perineal hernias, which can occur after surgery for rectal cancer. Researchers treated a 69-year-old man using a modified technique involving skin and muscle from his thigh, leading to successful repair with no recurrence of the hernia for 18 months. This approach is important because it avoids some complications of traditional methods and offers a stronger, more reliable solution for patients who can't use their abdomen for repair. Who this helps: This helps patients recovering from surgeries related to rectal cancer.

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This study looked at how bleeding disorders can increase risks during surgery. It found that understanding a patient's medical history, including their medications and supplements, is crucial for managing these risks effectively. Proper screening can help prevent complications related to bleeding, which is particularly important for patient safety during and after surgery. Who this helps: This benefits patients undergoing surgery and their doctors.

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This study looked at a protein called NHE4 in the colon of rats and humans to see how it helps regulate pH levels, which are important for maintaining a balance of fluids and ions. The researchers found that NHE4 is active in both species and that its activity increases when exposed to a hormone called aldosterone. This is significant because it shows that NHE4 can help control the acidity inside cells, which is essential for healthy colon function. Who this helps: This research benefits patients with digestive issues and doctors who treat them.

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This study compared two methods of removing the appendix: a new approach using only the vagina (called pure transvaginal appendectomy or TVA) and the standard method that uses three small cuts in the abdomen (traditional laparoscopic appendectomy or LA). Among the 40 patients, those who had the TVA experienced significantly less pain after surgery, using an average of 8.7 mg of morphine compared to 23 mg for those who had the LA. Additionally, patients who had the TVA returned to their normal activities in about 3.3 days, while those with the LA took about 9.7 days, showing that the TVA allows for faster recovery. Who this helps: This benefits patients undergoing appendectomy by providing a less painful and quicker recovery option.

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This study looked at patients who had bowel obstructions and previously been treated for gynecologic cancers. It found that 69.8% of the 189 patients had malignant bowel obstructions, with those suffering from advanced-stage cancer and ovarian cancer being at the highest risk. Survival rates were significantly different, averaging 9 months for those with malignant obstructions compared to 49 months for those with benign ones. Who this helps: This information helps doctors provide better care and focus on palliative options for patients with advanced gynecologic cancers.

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This study looked at how older patients with acute cholecystitis (inflammation of the gallbladder) were treated, comparing surgery to non-surgical options. Out of 290 patients who had surgery, 20% needed a more complicated open procedure and faced significant complications like respiratory issues and heart attacks. In contrast, of the 185 patients who received non-surgical treatment, only 4% had a return of their condition within 15 months, and no major complications occurred in those who did. Who this helps: This research benefits elderly patients with acute cholecystitis and their doctors by offering safer treatment options.

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This study looked at how structured training programs can help surgical residents communicate better with patients, especially those receiving cancer diagnoses. Out of 44 residents, those who went through the training showed a significant improvement in their case-specific communication scores, going from an average of 65% to 84% after the program. This is important because strong communication skills are essential in healthcare, particularly when discussing sensitive issues like cancer diagnoses. Who this helps: This helps patients by ensuring they receive clearer and more compassionate communication from their doctors.

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This study looked at the airborne chemicals released when using spray sealants for tiles and fabrics in two settings: a bathroom and a recreational vehicle. It found that while the amount of fluoride released was very low (less than 2.0 micrograms per cubic meter), the levels of volatile organic compounds (VOCs) were quite high, ranging from 400 to 2,300 milligrams per cubic meter during use. This is important because high levels of VOCs can have negative health effects, making it crucial for users to understand the risks involved when using these products. Who this helps: This helps patients and consumers who use spray sealants, as well as health professionals concerned about indoor air quality.

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This study looked at how effectively two imaging methods, ultrasound (US) and computed tomography (CT), diagnose acute cholecystitis (inflammation of the gallbladder) in older patients. Out of 475 elderly patients, 35.7% had inflammation detected by both imaging tests, while only 20.2% showed it on US alone and 19% on CT alone. It found that CT is more commonly used for urgent cases, but using both methods together led to a lower rate of surgery and higher complications. Who this helps: This research helps doctors treating elderly patients with gallbladder issues.

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This research looked at the presence of asbestos in Zonolite attic insulation when it is cleaned, moved, or removed in homes. The studies found that when the insulation is left undisturbed, asbestos levels in the air are normal, but disturbing it can release harmful airborne asbestos particles. Specifically, significant amounts of asbestos were found during cleaning and remodeling activities. Who this helps: This helps homeowners and construction workers who might be exposed to asbestos while working in attics with Zonolite insulation.

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This study looked at how much diacetyl, a chemical linked to serious lung disease, is released from different types of butter and artificial butter flavorings when heated. The results showed that artificial butter flavoring products, like powders and pastes, can emit high levels of diacetyl; for example, wetted powders released up to 54.7 parts per million (ppm) of diacetyl, while natural butter had only trace amounts. This matters because being exposed to these levels of diacetyl can harm people’s lungs, especially in workplaces like popcorn factories. Who this helps: This helps workers exposed to butter flavoring products, including those in food manufacturing.

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This study looked at a patient with Crohn's disease who developed a rare connection between the colon and stomach due to eating a foreign object, which medicine couldn't fix. The patient had surgery to remove the affected part of the colon and the connection to the stomach, during which the foreign object was found. This is important because it shows that certain complications in Crohn's disease, like fistulas, may be caused by foreign bodies, and surgery might be necessary when medication fails. Who this helps: This helps patients with Crohn's disease and their doctors.

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This study looked at patients with ischemic colitis, a condition where blood flow to the intestines is reduced, to determine which factors might indicate a need for surgery. Out of 253 patients, 48 required surgery at some point, with 12 needing it right away and 36 later. Key factors that suggested surgery might be necessary included having fluid in the abdomen seen on scans and not having active rectal bleeding, which could help doctors decide who needs urgent surgical intervention to prevent further health issues.

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This study looked at the reasons why general surgery residents at a university program in Connecticut left their training between 1986 and 2006. Out of 99 residents, 30 (30%) did not complete the program, with 21 (70%) choosing to leave for other specialties, primarily primary care or non-surgical fields. While the school's attrition rate of 6.7% over 20 years is slightly above the national average of 5.8%, most students tend to leave before their third year, and it's important to understand why they are leaving to improve the training experience. Who this helps: This benefits medical educators and program directors who want to improve residency training and retention.

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This study looked at the career paths of doctors who started their training in non-designated preliminary general surgery positions between 1997 and 2007. Out of 110 initial participants, 39% successfully moved on to become categorical general surgery residents, while 47% chose to pursue non-surgical specialties, and only 14% left medical education altogether. This matters because it shows that non-designated positions provide a significant opportunity for many aspiring doctors to advance their careers in surgery or other fields. Who this helps: This helps medical students seeking residency positions and surgical training programs.

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This study looked at older patients (ages 65 and up) undergoing emergency surgeries for colorectal issues to see what factors predict complications and death after surgery. Out of 292 patients, 15% died in the hospital, and 35% experienced complications such as pneumonia or heart issues. The findings highlight that quicker access to surgery and better screening for colorectal cancer could lead to better outcomes for these patients. Who this helps: This benefits elderly patients facing colorectal emergencies and the doctors who care for them.

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This research paper examined conditions where the blood supply to the intestines is insufficient, leading to various types of intestinal disorders. It found that common causes include hardening of the arteries and blood clots, and the severity of injury can range from minor to life-threatening. Understanding these causes and how they affect the intestines is important because diagnosing and treating these conditions remains difficult despite medical advancements.