American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Videos from Tuesday's First Edition

Primary tumor resection linked to longer survival in patients with distant thyroid cancer metastasis

Mahsa Sedaghati, MD
Stanford, CA

Dr. Mahsa Sedaghati discusses hers and colleagues’ finding of a significantly longer median survival (54 months vs. 3 months) in patients who underwent primary thyroid tumor resection after presenting with thyroid cancer and distant metastases, vs. patients who did not have primary tumor resection. Data came from a retrospective analysis of Surveillance, Epidemiology and End Results database (1973-2015), including 193,831 cases of thyroid cancer. Of these, 8,178 presented with distant metastases. In turn 5,950 of these had primary tumor resection and 2,228 did not. The survival gap stood despite significant differences in demographics and clinical conditions such as lymph node involvement.

View the study's abstract.



Current hospital credentialing requirements for robotic surgery show minimal follow-up

Elizabeth Huffman, MD
Philadelphia, PA

A review of robotic surgery credentialing and privileging policies at 41 geographically dispersed U.S. hospitals found significant variability. Most require completion of a training course and a small number of proctored cases, but few policies include specific requirements for maintenance of privileges and fewer require ongoing objective performance assessments and patient outcomes monitoring. Less than 25% define “proctor.” Dr. Elizabeth Huffman discusses the study’s conclusion that policies are often inadequate to ensure surgeon competence and to encourage creation of robust credentialing and privileging guidelines.

View the study's abstract.



Helicopter trauma transport falls nearly 40% from 2010-216; Comparative mortality varies by scene and Transport from Scene or Hospital Matters

Areg Grigorian
Orange, CA

Review of data from 723,483 patients found the rate of helicopter transport decreased overall from 22.8% in 2010 to 14.1% in 2016 – a decline of nearly 40%. Helicopter transport was associated with decreased risk of mortality compared with ground ambulance, after controlling for known predictors of mortality and for pre-hospital transport time. Closer analysis shows patients transferred by helicopter from scenes have decreased risk of mortality while those transferred from hospitals have higher risk. Dr. Areg Grigorian discusses the study and its conclusion that scene transport data is encouraging, with inter-hospital transfer rates likely driven by selection bias.

View the study's abstract.