Sahil Sharma

Colorectal Surgery Fellow @McGColorectal @McGillDeptSurg

[Sahil Sharma @SharmaS_14]

Thank you for sharing our work @SWexner looking at the role of warmed‐humidified carbon dioxide insufflation in colorectal surgery. @McMasterSurgery @tylermckechnie @ColorectalDis

[Steven D Wexner MD, PhD @SWexner]

The role of warmed‐humidified carbon dioxide insufflation in colorectal surgery: A systematic review and meta‐analysis OPEN ACCESS @ColorectalDis https://t.co/yakvmFnjiR @ACPGBI @escp_tweets @coloproctoaec

[Sahil Sharma @SharmaS_14]

Our review on intraoperative dexmedetomidine highlights its effectiveness in enhancing postoperative gastrointestinal function in colorectal surgery @SAGES_Updates @SurgEndosc #ColorectalSurgery #Dexmedetomidine #PostOpRecovery https://t.co/ScP6SNoQ6x
📷

[Sahil Sharma @SharmaS_14]

Congratulations to my wife and superstar scientist Gayatri Nair on this important paper!

[Alexander Hynes @APHage_]

A picture is worth 1536 plaque assays. While we used a robot, we also tried a dirt-cheap 3D-printed alternative which works wonders at 384-density. I really believe this pre-print has the potentially to be the largest impact I will make on my field.
https://t.co/49LaoV1fMD

[Sahil Sharma @SharmaS_14]

@McMasterSurgery ready for another exciting day of #GSRP2024 #RoyalCottage @CAGS_Residents @CAGS_ACCG @macgensurg

[Sahil Sharma @SharmaS_14]

Day 2 of #GSRP2024 has us on the edge of our seats. #RoyalCottage @macgensurg @YungLeeMDMPH @ECHodgson

[Sahil Sharma @SharmaS_14]

@McMasterSurgery is ready for #gsrp2024 #RoyalCottage @YungLeeMDMPH @ECHodgson

[neuroccm @neuroccm]

Massive congratulations to Dr. @ArjBalachandar , who has been awarded the DOM 2024 Outstanding Resident Researcher Award @UofT @uoftmedicine @UofT_DoM @UofTNeurologyPD @uoftneurons - Arjun's work on #AI #Stroke #MovementDisorders has been impactful and innovative - tremendous recognition, and all done during (soon to be done) Residency training! Congrats Arjun! @AANmember

[Sahil Sharma @SharmaS_14]

@JohnAgzarianMD @macgensurg @AATSHQ Congrats @JanhaviPatel16

[Sahil Sharma @SharmaS_14]

Thank you Dr.@BoutrosMarylise for your support! #SAGES2024 @macgensurg

[Marylise Boutros @BoutrosMarylise]

Beautifully presented important work #SAGES2024 Congratulations @SharmaS_14 @macgensurg @SAGES_Updates

[Marylise Boutros @BoutrosMarylise]

@SAGES_Updates #Colorectal Taskforce getting lots of high impact work done 💩amazing colleagues, great ideas and phenomenal leadership #SAGES2024

[Sahil Sharma @SharmaS_14]

Our work on frailty in IBD now available. @tylermckechnie @YungLeeMDMPH @ColorectalDis @McMasterSurgery

Frailty in inflammatory bowel disease: analysis of the National Inpatient Sample 2015–2019 - Sharma - Colorectal Disease - Wiley Online Library https://t.co/Rb9w4BHxG6

[Sahil Sharma @SharmaS_14]

Recurrence following perineal proctosigmoidectomy (Altemeier) with levatorplasty. @tylermckechnie @JigishKhamar05

https://t.co/E1Za90Psg0

[DCRjournal @DCRjournal]

Fragility of statistically significant outcomes in colonic diverticular disease randomized trials. How robust are they? #DCRJournal: https://t.co/7jSL6mR72B

Accompanying editorial: https://t.co/VgSyNt9Mrd

@tylermckechnie @YungLeeMD @Doctor_Doum @Drbariatricsx @McMasterSurgery

[Sahil Sharma @SharmaS_14]

Postoperative Gastrointestinal Dysfunction After Neuromuscular Blockade Reversal With Sugammadex Versus Cholinesterase Inhibitors in Patients Undergoing Gastrointestinal Surgery: A Systematic Review and Meta-Analysis - Sahil Sharma https://t.co/uvD7mQoxno

[Sean Langenfeld @SeanLangenfeld]

Important secondary analysis of the OPRA trial with a median f/u of 4 years.

This provides important details from a landmark study, and can help guide patient counseling. Of note, it's not broken down to compare induction TNT to consolidation TNT.

My analysis is long-winded, and the target audience is surgeons who offer organ preservation to patients with rectal cancer:

Patients with a cCR at restaging: 98% offered organ preservation/watch-and-wait (WW), of which 22% experienced local regrowth. Patients with a sustained cCR had a 5% rate of distant metastases.

Of the local regrowths, 93% underwent salvage TME and 7% underwent salvage local excision. For these patients, 33% developed recurrence (4% local, 22% distant, and 7% local+distant).
_______________________________________

Patients with a near-complete CR at restaging: 20 (17.5%) went straight to surgery, of which only 3 (16%) had a pathologic CR (pCR). Recurrence after upfront TME for near-cCR was 30% (15% local, 10% distant, 5% local+distant). These numbers were small (n=3 for local recurrence) and should be interpreted with caution.

Of the remaining 94 patients (82.5%) who underwent WW, 48 (51%) developed local regrowth. Salvage TME was performed in 34 patients (71% compared to 93% for cCRs). 2 of 34 TMEs (6%) had a pCR.

For patients with a near-cCR who developed regrowth after WW, 33% developed recurrence (4% local, 21% distant, 8% local+distant).

Of the 46 patients (40%) with a near-cCR who remained in the WW program, 13% developed distant metastases (compared to 5% for cCRs).
______________________________________
Patients with an incomplete response at restaging:
88% were offered upfront TME, of which 4/51 (8%) had a pCR. For ICR and upfront TME, recurrence rate was 35% (3.5% local, 21% distant, 10.5% local+distant).

8 patients with incomplete response were still enrolled in WW for different reasons, of which 5/8 (63%) developed local regrowth. All 5 underwent TME, and the local recurrence was 20% (1/5). Of the 3/8 that remained in WW without regrowth, 2/3 (66%) developed lung metastases.
_______________________________________
Overall, the 3-year organ preservation rate was 77% for cCRs and 40% for near-cCRs. The median time to TME for near-cCRs was 1 year.

3-year DFS was 88% for cCR, 69% for near-cCR, and 56% for incomplete response.
_____________________________
For patient counseling purposes:

Of the 123 patients with a cCR who were offered WW, the local recurrence rate was 22% (0f which 93% underwent salvage TME) and the rate of distant metastasis was 10.5%.

Of the 94 patients with a near-cCR who were offered WW, local recurrence rate was 51% (of which 71% underwent salvage TME) and the rate of distant metastasis was 15%.

Of the 57 patients with incomplete response who were offered upfront TME, local recurrence was 14% and the rate of distant metastasis was 32%.

@JohnRTMonsonMD @R_Perez_MD @ianmpaquette @JonVogel7 @jendavidsmd @KyleCologne @debby_keller @juliomayol @Neil_J_Smart @FergaljFleming @ScottRSteeleMD @JISBMD

[Sahil Sharma @SharmaS_14]

@StanfordSurgery @TGrantcharovMD @StanfordGenSurg @StanfordHealth Congratulations Dr. @TGrantcharovMD great news!

[Ambarish Satwik @AmbarishSatwik]

“Now, you’ve got an aneurysm in there as big as a grapefruit, and it’s about ready to burst. But you’re a strong boy, and I’m the best surgeon in the world, so if this had to happen, we’ve got the best possible odds.”

[Sahil Sharma @SharmaS_14]

@colecystitis @hockeynight @MapleLeafs @KevinWeekes @HLundqvist @aavoros @colecystitis is the biggest @MapleLeafs fan I know!

[WindsorVax Finders @WindsorVax]

MILESTONE REACHED:

70% of Windsor-Essex adults have now had at least one dose of the Covid-19 vaccine🎉

This is a significant milestone and we want to thank all of the frontline healthcare workers who made this possible!

Let’s keep going!