The American College of Surgeons, Oct. 22-26

The 103rd Annual American College of Surgeons Clinical Congress

The annual meeting of the American College of Surgeons was held from October 22 to 26 in San Diego and attracted approximately 14,000 participants from around the world, including surgeons, allied health professionals, and administrators. The conference included hundreds of general and specialty sessions, postgraduate courses, scientific paper presentations, video-based education presentations, and posters focused on the latest advances in surgical care.

In one study, Amir A. Ghaferi, M.D., of the University of Michigan in Ann Arbor, and colleagues found that patients who underwent bariatric surgery had a more than 45 percent increased risk of developing new persistent opioid use after surgery compared with general surgery patients.

"Nearly one in 10 patients may develop new persistent opioid use after bariatric surgery," said Ghaferi. "We are increasing our focus on Enhanced Recovery After Surgery (ERAS) protocols that can minimize early opioid use. There are even some who believe and are already able to make bariatric surgery an opioid-free operation. That would be an excellent goal but does not diminish the importance of paying attention to the current risks."

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In another study, Raul J. Rosenthal, M.D., of the Cleveland Clinic in Weston, Florida, and colleagues found that rapid weight loss associated with bariatric surgery can result in normalization of the heart architecture and functionality.

"Obesity affects the structure and functionality of the heart. It is imperative that physicians recommend early surgical intervention in obese subjects so that obesity-related structural changes of the heart can be reversed," said Rosenthal.

However, more than half of the patients in the study did not achieve normalization of the heart architecture and functionality with rapid weight loss.

"We are looking at the reasons why the remaining number of patients in this cohort did not achieve reversal of structural changes and functionality," said Rosenthal. "Our hypothesis is that if surgical intervention is not indicated early in obese subjects, the structural changes might become irreversible."

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Asad J. Choudhry, M.B.B.S., of the Mayo Clinic in Rochester, Minnesota, and colleagues found that fewer patients followed up with additional questions after they were discharged from the hospital when the clinical team revised discharge instructions to make them easier to read.

"We felt that if patients were able to understand what information they were being sent home with, they'd have more autonomy in their own care, which would allow them to understand how to care for themselves in a post-hospital setting," Choudhry said in a statement. "This does show that improvement in the information that patients are given, and their ability to understand that information, can go a long way to decrease questions that they may ask, as they have greater comprehension of information."

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