Seminars in Colon and Rectal Surgery最新文献

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Thriving through career challenges: Building and maintaining resilience

IF 0.4 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2025-03-01 DOI: 10.1016/j.scrs.2025.101082

Najjia N. Mahmoud MD

The focus on interventions to prevent burnout has shifted over the past five years from those exclusively aimed at the personal circumstances and personalities of surgeons and other healthcare workers, to approaches that affect the systems we work within. Systemic factors that create psychological stress, anxiety, feelings of helplessness, and moral injury have proven to be serious instigators and compounders of burnout. Additionally, strategies that contribute to enhancing engagement and building resiliency are widely recognized as essential to creating an environment where a physician may not only thrive, but survive the inevitable personal and professional challenges that arise. This chapter explores how resilience is best supported to survive not only the serious systemic issues that create moral injury and burnout, but personal issues that arise that can negatively impact a wonderful career. Interventions aimed at increasing engagement and promoting resiliency include those that contemplate strategies for individuals, healthcare institutions, and national organizations. Reviewing information supporting a range of interventions is important to understanding how to implement change meaningfully. Prevention of burnout and identification of factors boosting resilience should start early in training with modeling and messaging from mentors, and should incorporate individualized stress management strategies. Critically, however, the most compelling data for building resilience requires structural re-organization of institutions to align their values and processes with those of physicians and allied providers. Advocating for changes at the institutional and national level that preserve our relationships with our patients and colleagues, provide time for reflection and for outside interests that recharge and restore, should be a common goal and imperative for healthcare reform.

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引用次数: 0

Uncomfortably numb. The hidden pain of burnout and a failure to recognize it. What could I have done differently?

IF 0.4 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2025-03-01 DOI: 10.1016/j.scrs.2025.101081

Dan Wood PhD MB.BS FRCS Urol

引用次数: 0

Ergonomics and body wellness during surgery: A review and practical guide 手术期间的人体工程学和身体健康：回顾与实用指南

IF 0.4 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2025-03-01 DOI: 10.1016/j.scrs.2025.101085

Basil Karam MD, Ian Soriano MD

Work-related musculoskeletal disorders (WRMSDs) are highly prevalent among surgeons, contributing to chronic pain, reduced operative efficiency, and premature career attrition. The increasing adoption of minimally invasive and robotic-assisted surgical techniques has introduced distinct ergonomic challenges that necessitate targeted interventions. This review examines the impact of surgical ergonomics on surgeon well-being, outlining key risk factors, prevalence data, and preventive strategies. A structured approach to optimizing posture, instrument handling, operating room configuration, and intraoperative microbreaks is presented.. The integration of ergonomic principles into surgical practice is essential for enhancing surgeon longevity, optimizing performance, and ensuring sustainable career progression.

引用次数: 0

Returning to the operating room 返回手术室

IF 0.4 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2025-03-01 DOI: 10.1016/j.scrs.2025.101084

Alexis D. Desir MD, Emina H. Huang MD

Returning to the operating room after birth-related leave presents significant challenges for female surgeons, who are often navigating the demands of parenthood alongside rigorous work schedules. This manuscript explores the multifaceted hurdles faced by these surgeons, including physical, mental, financial, and professional impacts. The physically demanding nature of surgery, coupled with hormonal changes, breastfeeding challenges, and sleep deprivation, exacerbates the difficulties of postpartum recovery. Additionally, female surgeons are at higher risk for postpartum depression and anxiety, which can hinder their performance in the operating room. Professionally, trainees may face changes in relationships with co-residents, potential delays in graduation, and evolving career priorities as they balance surgical training with family responsibilities. The manuscript emphasizes the need for flexible, supportive environments in surgical programs to better accommodate new mothers. By recognizing these challenges and adopting policies that prioritize wellness, the surgical community can help ensure that female surgeons successfully reintegrate into their careers without compromising their health or professional development.

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引用次数: 0

The joys of a surgical career and beyond

IF 0.4 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2025-03-01 DOI: 10.1016/j.scrs.2025.101087

Patricia Roberts MD, FACS, FASCRS

In 2017, my Presidential address to the American Society of Colon and Rectal Surgeons was titled “the joys of a surgical career.” The address examined the continuum of a long surgical career, and particularly the four stages including the initial education and training to become a colon and rectal surgeon, early career, mid career and late career. This paper builds on that address and specifically looks at ways to continue to thrive and to find joy in the clinical practice of surgery and beyond.

引用次数: 0

A wellness resource guide for residents and fellows 住院医师和研究员健康资源指南

IF 0.4 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2025-03-01 DOI: 10.1016/j.scrs.2025.101083

Vanessa A. Hortian DO, MS, LAc

Surgical training requires resilience and grit, as well as sacrifice. Each stage of training presents a set of unique challenges. Studies have shown that training is associated with burnout, attrition, and even cases of suicide. This article describes training-associated challenges that can lead to burnout and attrition and provides a resource guide to aid in maintaining well-being and humanity while navigating the journey of surgical training.

引用次数: 0

What it takes to be a surgeon today 今天的外科医生

IF 0.4 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2025-03-01 DOI: 10.1016/j.scrs.2025.101080

Celine Soriano MD., Terrah Paul Olson MD

A long career in surgery requires prioritizing surgeon well-being. Burnout is prevalent in surgery, and is tied to job dissatisfaction, mental illness, and adverse patient outcomes. Individual and institutional factors, such as protection of identity, boundary setting, supportive workplace culture and communities, and creative re-structuring of work models can alleviate burnout and optimize surgeon wellness. This can allow surgeons today to thrive in the profession and enjoy life outside of it.

引用次数: 0

Coaching as a resource for the modern surgeon 教练是现代外科医生的资源

IF 0.4 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2025-03-01 DOI: 10.1016/j.scrs.2025.101086

Sharon L. Stein MD

Surgical coaching is becoming more prevalent over the last ten years. The practice of surgical coaching is widely variant, from technical coaching to developmental and remedial coaching. However, the premise behind coaching remains the same, to continue to foster the growth and development of news skills for the surgeon. This chapter reviews some of the data on coaching, as well as information on types of coaching. It also reviews some of the cultural biases that limit the acceptance of coaching by surgeons.

近十年来，手术指导越来越普遍。手术指导的做法多种多样，有技术指导，也有发展和补救指导。然而，指导背后的前提始终不变，即继续促进外科医生新闻技能的增长和发展。本章回顾了一些有关教练的数据以及教练类型的信息。本章还回顾了限制外科医生接受辅导的一些文化偏见。

引用次数: 0

Identifying and optimizing psychosocial frailty in surgical practice 在外科实践中识别和优化社会心理脆弱性

IF 0.4 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2024-11-06 DOI: 10.1016/j.scrs.2024.101061

Kurt S. Schultz MD, Caroline E. Richburg MD, Emily Y. Park MD, Ira L. Leeds MD MBA ScM

Psychosocial frailty is under-screened for and under-treated in patients undergoing surgery, even though patients with psychosocial frailty are at increased risk for postoperative complications. Numerous approaches exist to identifying psychosocial frailty in the preoperative period, ranging from neighborhood-level indices to patient-level, patient-reported data. Presurgical optimization of psychosocial frailty has returned mixed results, focusing primarily on psychological well-being with limited attention paid to addressing a patient's social risk profile. Mediators and moderators of psychosocial frailty in surgical outcomes must be further elucidated before investigators can appropriately trial psychosocial optimization programs that benefit patients. In recent years, new policies and system-level changes have incentivized screening for psychosocial frailty, and additional reimbursement strategies should be formulated to address frailty in the preoperative period in a feasible, sustainable, and cost-effective manner.

尽管心理社会功能虚弱的患者术后出现并发症的风险会增加，但对手术患者的心理社会功能虚弱筛查和治疗却不足。目前有许多方法可用于识别术前的心理社会脆弱性，从邻里层面的指数到患者层面的患者报告数据，不一而足。手术前优化心理社会脆弱性的结果不一，主要集中在心理健康方面，而对患者的社会风险概况关注有限。必须进一步阐明社会心理脆弱对手术结果的中介和调节因素，研究人员才能适当地试用有益于患者的社会心理优化方案。近年来，新政策和系统层面的变化激励了社会心理虚弱的筛查，应制定更多的报销策略，以可行、可持续和具有成本效益的方式解决术前阶段的虚弱问题。

引用次数: 0

Improving surgical outcomes for older adults with adoption of technological advances in comprehensive geriatric assessment 采用先进技术进行老年综合评估，改善老年人的手术效果

IF 0.4 Q4 SURGERY

Seminars in Colon and Rectal Surgery

Pub Date : 2024-11-06 DOI: 10.1016/j.scrs.2024.101060

Sydney F Tan MD, Benjamin Cher MD, Julia R Berian MD, MS

Frailty is a well-recognized predictor of poor surgical outcomes for older adults, yet effective measurements and interventions remain limited. Technological advances offer an opportunity to address this gap and improve surgical care for older adults. This paper reviews the background of frailty and comprehensive geriatric assessments in surgery, and how technological innovations can advance frailty measurement and intervention in surgical settings. We review two broad areas of technological advancement as applied to frailty in surgery: (1) Innovation in the use of electronic health records (EHR) using Artificial Intelligence (AI) and Machine Learning (ML), and (2) Novel uses for wearable sensors and mobile health (mHealth) applications. We explore the integration of AI and ML with EHR systems, which can surpass traditional comorbidity indices by providing comprehensive health assessments and enhancing prediction models. Innovations like the electronic Frailty Index (eFI) show promise in expanding the reach of frailty assessments and facilitating real-time screening. Additionally, wearable devices and mobile health (mHealth) applications offer new ways to monitor and improve physical activity, nutrition, and psychological well-being, supporting perioperative rehabilitation. While these technologies present challenges, such as the need for infrastructure, training, and data interoperability, they offer promising strategies to facilitate the assessment and management of frailty among surgical patients. Continued research and tailored implementation strategies will be essential to fully realize the potential of these advancements in improving surgical outcomes for frail older adults.

衰弱是公认的老年人手术效果不佳的预测因素，但有效的测量和干预措施仍然有限。技术进步为弥补这一不足、改善老年人外科护理提供了机会。本文回顾了虚弱的背景和外科手术中的老年综合评估，以及技术创新如何推进外科手术中的虚弱测量和干预。我们回顾了应用于外科虚弱的两大技术进步领域：(1) 使用人工智能（AI）和机器学习（ML）的电子健康记录（EHR）的使用创新，以及 (2) 可穿戴传感器和移动医疗（mHealth）应用的新用途。我们探索将人工智能和 ML 与电子病历系统集成，通过提供全面的健康评估和增强预测模型，超越传统的合并症指数。电子虚弱指数（eFI）等创新技术有望扩大虚弱评估的覆盖范围并促进实时筛查。此外，可穿戴设备和移动医疗（mHealth）应用为监测和改善体力活动、营养和心理健康提供了新的方法，为围术期康复提供了支持。虽然这些技术存在一些挑战，如需要基础设施、培训和数据互操作性，但它们为促进手术患者体弱状况的评估和管理提供了前景广阔的策略。要想充分发挥这些先进技术在改善体弱老年人手术效果方面的潜力，就必须继续开展研究并制定有针对性的实施策略。

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