Natalia Rivera

[Natalia Rivera @NaticasRivera]

@waitmaya 31

[Journal of Trauma and Acute Care Surgery @JTraumAcuteSurg]

Appendectomy is one of the most common on-call general surgery emergencies which is usually managed with expedited surgery. Our data shows that slight delays to operation (6-24 hours) may allow for similar outcomes as expedited surgery in both children and adults.

@UAlberta; @UAlbertaSurgery; @sukhdeepjatana_

https://t.co/terlyn3Xiu

[Journal of Trauma and Acute Care Surgery @JTraumAcuteSurg]

Proficiency in REBOA can be achieved after approximately 5 cases for surgeons and 10 for institutions. The short learning curve supports broader adoption to improve trauma care outcomes.

https://t.co/J9btsBfeso

[Dr Rishabh Jain @DrRishabhOnco]

🧵 Rectal cancer is not one disease. Tumor location should shape treatment.

A new JCO review argues that low- and mid-rectal cancers need different neoadjuvant strategies, with major implications for organ preservation, RT use, and QoL.

📍 Low-rectal cancers
Goal: maximize cCR and preserve organ/sphincter whenever safely possible

Relevant trials:
RAPIDO, STELLAR, PRODIGE 23, OPRA, CAO/ARO/AIO-12

💡 Takeaway:
TNT is often the preferred platform when the priority is watch-and-wait / organ preservation.

📍 Mid-rectal cancers
Goal: avoid overtreatment, especially unnecessary pelvic RT in selected patients

Relevant trials:
PROSPECT, CONVERT, FOWARC, GRECCAR4

💡 Takeaway:
In MRI-favorable, selected mid-rectal tumors, chemo-first or chemo-alone strategies may reduce long-term bowel, urinary, and sexual toxicity without compromising outcomes.

🎯 Organ preservation evidence base
OPRA supports consolidation-based TNT for better TME-free survival.
GRECCAR2, ACOSOG Z6041, OPERA reinforce that selected good responders may avoid radical surgery.

Bottom line:
Low rectum = intensify for cCR
Mid rectum = de-escalate when safe

That is the real shift toward precision rectal cancer care. 🔖

📖 Full paper in comment ⬇️

#OncoTwitter #MedTwitter #RectalCancer #ColorectalCancer
@OncoAlert @ASCO @myESMO

[Dr. Foxpaws Fauxpas @foxpaws_onco]

Let's review #TNT Total Neoadjuvant Treatment and Organ Preservation in #Rectal #Cancers.

1. PRODIGE23 - Induction CT + CRT
2. PROSPECT - No RT & Mid/upper only
3. OPRA - Induction CRT CT Ph2
4. OPERA - Contact Brachy Boost
5. MORPHEUS - HDR BT boost

#crcsm
#Oncology

[Josh Trebach, MD @jtrebach]

An 18-year-old female presents to the emergency department with abdominal pain and shortness of breath after drinking a fancy cocktail. Her x-ray is below.

What do you think is going on?

[JAMA Surgery @JAMASurgery]

Personalized prehabilitation improved physical and cognitive function, altered immune signaling, and reduced postoperative complications compared to standard programs in elective surgery patients. https://t.co/uqPV7PPcaM

[JAMA Surgery @JAMASurgery]

A surgical infection prevention program improved compliance with infection prevention and control standards and reduced surgical site infections in 5 hospitals outside of Ethiopia. https://t.co/v9INrJO5dQ @nicholestarr5, drdrconstance

[BehindTheKnife @BehindTheKnife]

Check out the FULL 📹 from our Trauma Surgery Video Atlas: https://t.co/XJIBSx6tFa

via @Kniery_Bird @clarkninam @georgoff @mcclellanjm

[JAMA Surgery @JAMASurgery]

Although mortality after major emergency abdominal surgery decreased from 2002 to 2022, readmissions increased and postoperative complications remained frequent. https://t.co/ZanjRi0R2t

[Annals of Surgery @AnnalsofSurgery]

Robotic surgery shouldn’t replace laparoscopy—it should complement it. Training must emphasize versatility and prioritize safety, especially for new adopters.
https://t.co/mfJaxTY2MG

[JAMA Surgery @JAMASurgery]

In older, multimorbid patients hospitalized with acute cholecystitis operative treatment is associated with lower 30 and 90-day mortality. https://t.co/baAeQb3X4E

[Journal of Trauma and Acute Care Surgery @JTraumAcuteSurg]

This study externally validates the PECARN rule for blunt abdominal trauma requiring intervention. While PECARN has excellent NPV, the rule missed 13% of clinically significant abdominal injuries in our cohort.

https://t.co/TFIY5NoWNT

[Journal of Trauma and Acute Care Surgery @JTraumAcuteSurg]

Early laparoscopic cholecystectomy for gallbladder perforation does not result in increased post-operative complications, post-operative length of stay, the rate of re-operation, or re-admission. #cholecystitis #cholecystectomy #acutecaresurgery

https://t.co/jsVzpAjtgH

[Burjeel Hospital @burjeelhospital]

Burjeel Hospital Abu Dhabi hosted a General Surgery CME on Anal Incontinence After Childbirth, covering causes, diagnosis & latest treatments. Experts discussed obstetric trauma’s impact & advanced management to improve postpartum care & quality of life.

#WomensHealth #CME

[Journal of Trauma and Acute Care Surgery @JTraumAcuteSurg]

Ten years ago, authors examined the effect of SB-1108, which allowed concealed carry without permit or training, concluding that liberalization of gun access is associated with increased fatalities from guns. Do you agree? #TraumaSurg https://t.co/o13G5pgYgI

[Adi Kumar @adi_kumar1]

Summary of surgical confidence:

- Be you
- Lower the bar
- Raise the floor
- Quiet your ego
- Trust your training

[Adi Kumar @adi_kumar1]

The over-confident surgeon causes harm by doing too much.

The under-confident surgeon causes harm by doing too little.

5 steps to building surgical confidence 🧵

[Natalia Rivera @NaticasRivera]

@jgholguinh De acuerdo!💪🏼

[Javo® @javoac]

El cáncer ganó una batalla más. Y ayer presencié una de las escenas más desgarradoras y que me ha roto más el corazón, mi hermano despidiéndose del amor de su vida, nadie te prepara para eso, nadie está listo para dejar ir a la persona con la que juraste envejecer, nadie está listo para ver cómo la vida se le apaga.
Y les digo esto porque yo veía ajeno esto, cuando alguien aconsejaba gozar la vida y disfrutar a tus amados por qué algún día se irían, lo veía ajeno y lejano. Pero después de la esto les digo de verdad: disfruten a su ser amado, amenlo sin medida, disfruten cada segundo.