Behind The Knife: The Surgery Podcast

Behind The Knife: The Surgery Podcast
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Aug 12, 2025 • 15min

Behind the Knife General Surgery Oral Board Review – Sample Episode 9 - Axillary Management of Breast Cancer

Behind the Knife's General Surgery Oral Board Review Course includes 123 Audio Scenarios + 10 Interactive Video Scenarios + 97 Operative Descriptions that cover all SCORE topic. Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. All of our premium courses are available via our website and apps (iOS and Android).  Users can take notes, pin chapters and download content for offline viewing.  Learn more about the General Surgery Oral Board Review Course at https://app.behindtheknife.org/premium/general-surgery-oral-board-review **Institutional Discounts Available - Please email hello@behindtheknife.org to learn more.** Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  
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Aug 11, 2025 • 17min

Behind the Knife General Surgery Oral Board Review – Sample Episode 8 - Trauma Resuscitation and ED Thoracotomy

Behind the Knife's General Surgery Oral Board Review Course includes 123 Audio Scenarios + 10 Interactive Video Scenarios + 97 Operative Descriptions that cover all SCORE topic. Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. All of our premium courses are available via our website and apps (iOS and Android).  Users can take notes, pin chapters and download content for offline viewing.   Learn more about the General Surgery Oral Board Review Course at https://app.behindtheknife.org/premium/general-surgery-oral-board-review **Institutional Discounts Available - Please email hello@behindtheknife.org to learn more.** Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  
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Aug 7, 2025 • 34min

Clinical Challenges in Emergency General Surgery: Open Cholecystectomy - “A Lost Art”

When the gallbladder turns hostile, sometimes you must do more than just pause—you have to call in a senior partner for help. Join the Behind the Knife EGS team at Mizzou as we dive into the art and grit of open cholecystectomy. From fundus-first dissection to navigating the “barrier to happiness,” this episode is packed with surgical pearls, tough love, and the kind of wisdom only scars can teach. Participants: Dr. Rushabh Dev FACS (Moderator, Surgical Attending) – Assistant Professor of Surgery, Associate PD ACS & SCCM Fellowship, SICU Medical Director, Lieutenant Commander United States Navy Reserve  Dr. Jeffery Coughenour FACS (Surgical Attending) – Professor of Surgery and Emergency Medicine, Trauma Medical Director at the University of Missouri SOM Dr. Christopher Nelson FACS (Surgical Attending) – Associate Professor of Surgery, Medical Director of Emergency General Surgery at the University of Missouri SOM Dr. Micah Ancheta (ACS Fellow) – Major, United States Airforce  Dr. Desra Fletcher (3rd year general surgery resident) Learning Objectives:  ·      Recognize Indications for Conversion Identify clinical and intraoperative factors that necessitate conversion from laparoscopic to open cholecystectomy. ·      Apply Risk Stratification Tools Utilize grading systems (e.g., Parkland, Tokyo, AAST) to assess cholecystitis severity and predict surgical difficulty. ·      Implement Safe Cholecystectomy Techniques Describe the six steps of the SAGES Safe Cholecystectomy Program to minimize bile duct injury. ·      Understand Bailout Strategies Differentiate between fenestrating and reconstituting subtotal cholecystectomy techniques and their respective risks. ·      Master Key Operative Steps Outline the essential components of open cholecystectomy: positioning, incision, exposure, and dissection. ·      Navigate High-Risk Anatomy Recognize “zones of danger” and use the B-SAFE mnemonic to reorient and ensure safe progression. ·      Develop Intraoperative Judgment Demonstrate when to proceed with subtotal techniques, convert to open, or call for assistance. ·      Perform Technical Nuances Safely Identify proper dissection planes, manage gallbladder bed inflammation, and secure cystic structures with confidence. ·      Prevent and Manage Complications Understand the risks of bile leaks, bilomas, and subcostal hernias—and how to mitigate them through technique and closure. ·      Foster Surgical Maturity Emphasize humility, collaboration, and mentorship in difficult operations—knowing when to ask for help is a skill. References: 1.     Dhanasekara, C. S., Shrestha, K., Grossman, H., Garcia, L. M., Maqbool, B., Luppens, C., ... & Dissanaike, S. (2024). A comparison of outcomes including bile duct injury of subtotal cholecystectomy versus open total cholecystectomy as bailout procedures for severe cholecystitis: A multicenter real-world study. Surgery, 176(5), 605–613. https://doi.org/10.1016/j.surg.2024.03.057 2.     Motter, S. B., de Figueiredo, S. M. P., Marcolin, P., Trindade, B. O., Brandao, G. R., & Moffett, J. M. (2024). Fenestrating vs reconstituting laparoscopic subtotal cholecystectomy: A systematic review and meta-analysis. Surgical Endoscopy, 38, 7475–7485. https://doi.org/10.1007/s00464-024-11225-8 3.     Brunt, L. M., Deziel, D. J., Telem, D. A., Strasberg, S. M., Aggarwal, R., Asbun, H., ... & Stefanidis, D. (2020). Safe cholecystectomy multi-society practice guideline and state of the art consensus conference on prevention of bile duct injury during cholecystectomy. Surgical Endoscopy.https://www.sages.org/publications/guidelines/safe-cholecystectomy-multi-society-practice-guideline/ 4.     Elshaer, M., Gravante, G., Thomas, K., Sorge, R., Al-Hamali, S., & Ebdewi, H. (2015). Subtotal cholecystectomy for “difficult gallbladders”: Systematic review and meta-analysis. JAMA Surgery, 150(2), 159–168. https://doi.org/10.1001/jamasurg.2014.1219 5.     Koo, S. S. J., Krishnan, R. J., Ishikawa, K., Matsunaga, M., Ahn, H. J., Murayama, K. M., & Kitamura, R. K. (2024). Subtotal vs total cholecystectomy for difficult gallbladders: A systematic review and meta-analysis. The American Journal of Surgery, 229(1), 145–150. https://doi.org/10.1016/j.amjsurg.2023.12.022 6.     Strasberg, S. M., Pucci, M. J., Brunt, L. M., & Deziel, D. J. (2016). Subtotal cholecystectomy—“Fenestrating” vs “reconstituting” subtypes and the prevention of bile duct injury: Definition of the optimal procedure in difficult operative conditions. Journal of the American College of Surgeons, 222(1), 89–96. https://doi.org/10.1016/j.jamcollsurg.2015.09.019 7.     Ahmed, O., & Walsh, T. N. (2020). Surgical trainee experience with open cholecystectomy and the Dunning-Kruger effect. Journal of Surgical Education.https://doi.org/10.1016/j.jsurg.2020.03.025 8.     Seshadri, A., & Peitzman, A. B. (2024). The difficult cholecystectomy: What you need to know. The Journal of Trauma and Acute Care Surgery, 97(3), 325–336. https://doi.org/10.1097/TA.0000000000004156 9.     Invited commentary on “A comparison of outcomes including bile duct injury of subtotal cholecystectomy versus open total cholecystectomy as bailout procedures for severe cholecystitis: A multicenter real-world study”. (2024). Surgery, 176(5), 614–615. https://doi.org/10.1016/j.surg.2024.05.003 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
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Aug 4, 2025 • 23min

Journal Review in Burn Surgery: Fluid Resuscitation

You’re on call at a level I trauma center and you get called that you’re receiving a large TBSA burn patient – you’re not working at a burn center! You remember hearing about some controversy surrounding burn resuscitation – was it the parkland formula? Consensus formula? ABSITE asked about the Modified Brooke Formula?!? Join Dr. Kathleen Romanowski, Dr. Laura Johnson, Dr. Victoria Miles, and Dr. Lauren Nosanov to discuss modern burn fluid resuscitation! Hosts:  ·      Kathleen Romanowski – University of California Davis Hospital, Shriners Hospital Sacramento ·      Laura Johnson – Grady Memorial Hospital ·      Lauren Nosanov – Grady Memorial Hospital ·      Victoria Miles – Louisiana State University Health Science Center, University Medical Center New Orleans Learning Objectives: ·      Review the basics of initial burn fluid resuscitation ·      Evaluate the literature informing national burn fluid resuscitation guidelines ·      Consider the causes of failed burn resuscitation and strategies for identifying these complications References: ·      Pham TN, Cancio LC, Gibran NS. American Burn Association Practice Guidelines Burn Shock Resuscitation. J Burn Care Res. 2008: 257-266. doi:10.1097/jbcr.0b013e31815f3876. https://pubmed.ncbi.nlm.nih.gov/18182930/ ·      Rizzo JA, Coates EC, Serio-Melvin ML, et al. Higher Initial Formula for Resuscitation After Severe Burn Injury Means Higher 24-Hour Volumes. J Burn Care Res. 2023:1017-1022. doi:10.1093/jbcr/irad065. https://pubmed.ncbi.nlm.nih.gov/37339255/  Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
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Jul 31, 2025 • 20min

Journal Review in Minimally Invasive Surgery: Achalasia

Today, we’re diving into a condition that’s as fascinating as it is complex: Achalasia—where the esophagus stops playing nice, and swallowing becomes a daily challenge. We’re breaking down the latest evidence, comparing POEM, pneumatic dilation, and Heller myotomy, and digging into what actually matters when deciding how to treat each achalasia subtype. Join show hosts Drs. Jake Greenberg, Dana Portenier, Zach Weitzner, and Joey Lew as they discuss the past, present, and future of Achalasia management. Whether you're a medical student or a seasoned attending, this episode will arm you with the tools to think critically about diagnosis, tailor your treatment strategy, and stay ahead of the curve on the future of achalasia care. Hosts:  ·      Jacob Greenberg, MD, EdM, MIS Division Chief and Vice Chair for Education, Duke University ·      Dana Portenier, MD, MIS Fellowship Director, Duke University ·      Zachary Weitzner, MD, Minimally Invasive and Bariatric Surgery Fellow, Duke University, @ZachWeitznerMD ·      Joey Lew, MD, MFA, Surgical resident PGY-3, Duke University, @lew__actually Learning Goals:  By the end of this episode, listeners will be able to: ·      Describe the pathophysiology and key diagnostic criteria for achalasia, including the role of manometry, EGD, and esophagram. ·      Differentiate between the three subtypes of achalasia based on the Chicago Classification and understand the clinical significance of each. ·      Compare treatment options for achalasia—pneumatic dilation, Lap Heller myotomy, and POEM—including indications, efficacy, and long-term outcomes. ·      Interpret landmark studies (e.g., European Achalasia Trial, JAMA POEM trial) and their impact on treatment decision-making. ·      Recognize patient-specific factors (age, comorbidities, achalasia subtype) that influence the choice of therapy. ·      Discuss evolving technologies and future directions in achalasia management, including endoluminal robotics, ARMS, and combined anti-reflux strategies. ·      Outline a basic treatment algorithm for newly diagnosed achalasia, incorporating diagnostic steps and tailored interventions. ·      Appreciate the multidisciplinary approach to achalasia care, including the roles of MIS surgeons, gastroenterologists, and emerging procedural skillsets. References: ·      Boeckxstaens G, Elsen S, Belmans A, Annese V, Bredenoord AJ, Busch OR, Costantini M, Fumagalli U, Smout AJPM, Tack J, Vanuytsel T, Zaninotto G, Salvador R; European Achalasia Trial Investigators. 10‑year follow-up results of the European Achalasia Trial: a multicentre randomised controlled trial comparing pneumatic dilation with laparoscopic Heller myotomy. Gut. 2024 Mar;73(4):582‑589. doi: 10.1136/gutjnl‑2023‑331374. PMID: 38050085 https://pubmed.ncbi.nlm.nih.gov/38050085/ ·      He J, Yin Y, Tang W, Jiang J, Gu L, Yi J, Yan L, Chen S, Wu Y, Liu X. Objective Outcomes of an Extended Anti‑reflux Mucosectomy in the Treatment of PPI‑Dependent Gastroesophageal Reflux Disease (with Video). J Gastrointest Surg. 2022 Aug;26(8):1566–1574. doi:10.1007/s11605‑022‑05396‑9. PMID: 35776296 https://pubmed.ncbi.nlm.nih.gov/35776296/ ·      Modayil RJ, Zhang X, Rothberg B, et al. Peroral endoscopic myotomy: 10-year outcomes from a large, single-center U.S. series with high follow-up completion and comprehensive analysis of long-term efficacy, safety, objective GERD, and endoscopic functional luminal assessment. Gastrointest Endosc. 2021;94(5):930-942. doi:10.1016/j.gie.2021.05.014. PMID: 33989646. https://pubmed.ncbi.nlm.nih.gov/33989646/ ·      Ponds FA, Fockens P, Lei A, Neuhaus H, Beyna T, Kandler J, Frieling T, Chiu PWY, Wu JCY, Wong VWY, Costamagna G, Familiari P, Kahrilas PJ, Pandolfino JE, Smout AJPM, Bredenoord AJ. Effect of peroral endoscopic myotomy vs pneumatic dilation on symptom severity and treatment outcomes among treatment-naive patients with achalasia: a randomized clinical trial. JAMA. 2019 Jul 9;322(2):134–144. doi:10.1001/jama.2019.8859. PMID: 31287522. https://pubmed.ncbi.nlm.nih.gov/31287522/ ·      Vaezi MF, Pandolfino JE, Yadlapati RH, Greer KB, Kavitt RT; ACG Clinical Guidelines Committee. ACG clinical guidelines: Diagnosis and management of achalasia. Am J Gastroenterol. 2020 Sep;115(9):1393–1411. doi:10.14309/ajg.0000000000000731. PMID: 32773454; PMCID: PMC9896940 https://pubmed.ncbi.nlm.nih.gov/32773454/ ·      West RL, Hirsch DP, Bartelsman JF, de Borst J, Ferwerda G, Tytgat GN, Boeckxstaens GE. Long term results of pneumatic dilation in achalasia followed for more than 5 years. Am J Gastroenterol. 2002;97(6):1346-1351. doi:10.1111/j.1572-0241.2002.05771.x. PMID:12094848. https://pubmed.ncbi.nlm.nih.gov/12094848/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
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Jul 28, 2025 • 30min

Mattox Conference Pro-Con Debate 2025: Direct to OR Resuscitation

Every spring for over 50 years, the Trauma, Critical Care, and Acute Care Surgery conference, best known simply as the MATTOX conference, is held in Las Vegas (https://www.trauma-criticalcare.com/).  The conference is unique in that it is entirely focused on practice-changing clinical education. It’s a damn good time too!  A favorite feature is the annual debates.  Today, we are featuring a showdown between Drs. Teddy Puzo and Joseph Dubois as they battle it out over the use of a DIRECT TO OR TRAUMA RESUSCITATION STRATEGY.  You can listen on the podcast or watch the debate with accompanying slides on our website or app.  Let's get ready to RUMMMBLLLEEEE! Video Link: https://www.youtube.com/watch?v=-DTTGBaLcHo TRAUMA SURGERY VIDEO ATLAS: https://app.behindtheknife.org/course-details/trauma-surgery-video-atlas Preparing for the deadliest injuries is challenging, and currently available resources are limited. That is why we created the Behind the Knife Trauma Surgery Video Atlas. Be ready for the most complex injuries, like penetrating trauma to the neck, audible bleeding from the IVC, and pelvic hemorrhage, with 24 scenarios.  Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
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Jul 25, 2025 • 31min

Mattox Conference Pro-Con Debate 2025: Trauma Video Review

Every spring for over 50 years, the Trauma, Critical Care, and Acute Care Surgery conference, best known simply as the MATTOX conference, is held in Las Vegas (https://www.trauma-criticalcare.com/).  The conference is unique in that it is entirely focused on practice-changing clinical education. It’s a damn good time too!  A favorite feature is the annual debates.  Today, we are featuring a showdown between Drs. Ryan Dumas and Bellal Joseph (@TopKniFe_B) as they battle it out over the use of TRAUMA VIDEO REVIEW.  You can listen on the podcast or watch the debate with accompanying slides on our website or app.  Let's get ready to RUMMMBLLLEEEE! Video Link: https://app.behindtheknife.org/video/mattox-conference-pro-con-debate-2025-trauma-video-review TRAUMA SURGERY VIDEO ATLAS: https://app.behindtheknife.org/course-details/trauma-surgery-video-atlas Preparing for the deadliest injuries is challenging, and currently available resources are limited. That is why we created the Behind the Knife Trauma Surgery Video Atlas. Be ready for the most complex injuries, like penetrating trauma to the neck, audible bleeding from the IVC, and pelvic hemorrhage, with 24 scenarios.  Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
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Jul 24, 2025 • 40min

BIG T Trauma Ep. 24 - Trauma Video Review

In this episode of the Big T Trauma Series, Dr. Patrick Georgoff (@georgoff) and Dr. Jason Brill dive into the evolving world of Trauma Video Review (TVR) with special guests Dr. Michael Vella and Dr. Ryan Dumas. Together, they explore how TVR is transforming trauma care by offering unprecedented insight into both technical and non-technical performance in the trauma bay. The conversation covers everything from implementation logistics and HIPAA concerns to cultural shifts and emerging AI applications. Whether you're curious about getting started or wondering if TVR should be part of trauma verification, this episode delivers essential insights from two national leaders in the space. Don’t miss it! Dr. Ryan Dumas is an associate professor of surgery at Baylor College of Medicine in Houston Texas where he serves as the Section Chief of Acute Care Surgery.  Dr. Dumas conducts and publishes research in trauma surgery and artificial intelligence, with a specific emphasis on video technology to capture and review trauma resuscitations. He has helped develop and run several Trauma Video Review programs across the country and utilizes video review as a tool for quality improvement, education, and research. Dr. Dumas is a consultant for Teleflex and Surgical Safety Technologies. Dr. Michael Vella is an associate professor of surgery, division of acute care surgery and trauma, at the university of Rochester medical center in Rochester, NY and the trauma medical director of the Kessler Level I trauma center.  He currently serves as chair of the New York State Committee on Trauma.  He has a clinical and research interest in trauma video review, particularly as it relates to trauma team dynamics and initial resuscitation.  Dr. Dumas is a consultant for Teleflex. This episode of Big T Trauma was sponsored by Teleflex, a global provider of medical devices. Learn more at teleflex.com and at the Teleflex Trauma and Emergency Medicine LinkedIn page. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
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Jul 21, 2025 • 39min

Clinical Challenges in Colorectal Surgery: Early Onset Colorectal Cancer

The incidence of early onset colorectal cancer (EOCRC) has been rising prompting the change in change in screening guidelines to 45 years of age for average risk patients. Join us for an in-depth discussion with guest speakers Dr. Andrea Cercek and Dr. Nancy You, where we provide a comprehensive look at the growing challenge of EOCRC. Hosts: - Dr. Janet Alvarez - General Surgery Resident at New York Medical College/Metropolitan Hospital Center - Dr. Wini Zambare – General Surgery Resident at Weill Cornell Medical Center/New York Presbyterian - Dr. Phil Bauer, Graduating Colorectal Surgical Oncology Fellow at Memorial Sloan Kettering Cancer Center  - Dr. J. Joshua Smith MD, PhD, Chair, Department of Colon and Rectal Surgery at MD Anderson Cancer Center - Dr. Andrea Cercek - Gastrointestinal Medical Oncologist at Memorial Sloan Kettering Cancer Center - Dr. Y. Nancy You, MD MHSc - Professor, Department of Colon and Rectal Surgery at MD Anderson Cancer Center Learning objectives:  - Describe trends in incidence of colorectal cancer, with emphasis on the rise of EOCRC. - Identify age groups and demographics most affected by EOCRC. - Summarize USPSTF recommendations for colorectal cancer screening. - Distinguish between screening methods (e.g., colonoscopy, FIT-DNA) and their sensitivity. - Understand treatment approaches for colon and rectal cancer (CRC) - Understand the role of mismatch repair (MMR) status in guiding treatment. - Outline the importance of genetic counseling and testing in young patients. - Discuss racial, ethnic, and socioeconomic disparities in CRC incidence and outcomes. - Describe the impact of cancer treatment on fertility and sexual health. -  Review fertility preservation options. - Identify the value of integrated care teams for young CRC patients. References: 1.         Siegel, R. L. et al. Colorectal Cancer Incidence Patterns in the United States, 1974–2013. JNCI J. Natl. Cancer Inst. 109, djw322 (2017). https://pubmed.ncbi.nlm.nih.gov/28376186/ 2.         Abboud, Y. et al. Rising Incidence and Mortality of Early-Onset Colorectal Cancer in Young Cohorts Associated with Delayed Diagnosis. Cancers 17, 1500 (2025). https://pubmed.ncbi.nlm.nih.gov/40361427/ 3.         Phang, R. et al. Is the Incidence of Early-Onset Adenocarcinomas in Aotearoa New Zealand Increasing? Asia Pac. J. Clin. Oncol.https://pubmed.ncbi.nlm.nih.gov/40384533/ 4.         Vitaloni, M. et al. Clinical challenges and patient experiences in early-onset colorectal cancer: insights from seven European countries. BMC Gastroenterol. 25, 378 (2025). https://pubmed.ncbi.nlm.nih.gov/40375142/ 5.         Siegel, R. L. et al. Global patterns and trends in colorectal cancer incidence in young adults. (2019) doi:10.1136/gutjnl-2019-319511. https://pubmed.ncbi.nlm.nih.gov/31488504/ 6.         Cercek, A. et al. A Comprehensive Comparison of Early-Onset and Average-Onset Colorectal Cancers. J. Natl. Cancer Inst. 113, 1683–1692 (2021). https://pubmed.ncbi.nlm.nih.gov/34405229/ 7.         Zheng, X. et al. Comprehensive Assessment of Diet Quality and Risk of Precursors of Early-Onset Colorectal Cancer. JNCI J. Natl. Cancer Inst. 113, 543–552 (2021). https://pubmed.ncbi.nlm.nih.gov/33136160/ 8.         Standl, E. & Schnell, O. Increased Risk of Cancer—An Integral Component of the Cardio–Renal–Metabolic Disease Cluster and Its Management. Cells 14, 564 (2025). https://pubmed.ncbi.nlm.nih.gov/40277890/ 9.         Muller, C., Ihionkhan, E., Stoffel, E. M. & Kupfer, S. S. Disparities in Early-Onset Colorectal Cancer. Cells 10, 1018 (2021). https://pubmed.ncbi.nlm.nih.gov/33925893/ 10.       US Preventive Services Task Force. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA 325, 1965–1977 (2021). https://pubmed.ncbi.nlm.nih.gov/34003218/ 11.       Fwelo, P. et al. Differential Colorectal Cancer Mortality Across Racial and Ethnic Groups: Impact of Socioeconomic Status, Clinicopathology, and Treatment-Related Factors. Cancer Med. 14, e70612 (2025). https://pubmed.ncbi.nlm.nih.gov/40040375/ 12.       Lansdorp-Vogelaar, I. et al. Contribution of Screening and Survival Differences to Racial Disparities in Colorectal Cancer Rates. Cancer Epidemiol. Biomarkers Prev. 21, 728–736 (2012). https://pubmed.ncbi.nlm.nih.gov/22514249/ 13.       Ko, T. M. et al. Low neighborhood socioeconomic status is associated with poor outcomes in young adults with colorectal cancer. Surgery 176, 626–632 (2024). https://pubmed.ncbi.nlm.nih.gov/38972769/ 14.       Siegel, R. L., Wagle, N. S., Cercek, A., Smith, R. A. & Jemal, A. Colorectal cancer statistics, 2023. CA. Cancer J. Clin. 73, 233–254 (2023). https://pubmed.ncbi.nlm.nih.gov/36856579/ 15.       Jain, S., Maque, J., Galoosian, A., Osuna-Garcia, A. & May, F. P. Optimal Strategies for Colorectal Cancer Screening. Curr. Treat. Options Oncol. 23, 474–493 (2022). https://pubmed.ncbi.nlm.nih.gov/35316477/ 16.       Zauber, A. G. The Impact of Screening on Colorectal Cancer Mortality and Incidence: Has It Really Made a Difference? Dig. Dis. Sci. 60, 681–691 (2015). https://pubmed.ncbi.nlm.nih.gov/25740556/ 17.       Edwards, B. K. et al. Annual report to the nation on the status of cancer, 1975-2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer 116, 544–573 (2010). https://pubmed.ncbi.nlm.nih.gov/19998273/ 18.       Cercek, A. et al. Nonoperative Management of Mismatch Repair–Deficient Tumors. New England Journal of Medicine 392, 2297–2308 (2025). https://pubmed.ncbi.nlm.nih.gov/40293177/ 19.       Monge, C., Waldrup, B., Carranza, F. G. & Velazquez-Villarreal, E. Molecular Heterogeneity in Early-Onset Colorectal Cancer: Pathway-Specific Insights in High-Risk Populations. Cancers 17, 1325 (2025). https://pubmed.ncbi.nlm.nih.gov/40282501/ 20.       Monge, C., Waldrup, B., Carranza, F. G. & Velazquez-Villarreal, E. Ethnicity-Specific Molecular Alterations in MAPK and JAK/STAT Pathways in Early-Onset Colorectal Cancer. Cancers 17, 1093 (2025). https://pubmed.ncbi.nlm.nih.gov/40227607/ 21.       Benson, A. B. et al. Colon Cancer, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology. J. Natl. Compr. Cancer Netw. JNCCN 19, 329–359 (2021). https://pubmed.ncbi.nlm.nih.gov/33724754/ 22.       Christenson, E. S. et al. Nivolumab and Relatlimab for the treatment of patients with unresectable or metastatic mismatch repair proficient colorectal cancer. https://pubmed.ncbi.nlm.nih.gov/40388545/ 23.       Dasari, A. et al. Fruquintinib versus placebo in patients with refractory metastatic colorectal cancer (FRESCO-2): an international, multicentre, randomised, double-blind, phase 3 study. The Lancet 402, 41–53 (2023). https://pubmed.ncbi.nlm.nih.gov/37331369/ 24.       Strickler, J. H. et al. Tucatinib plus trastuzumab for chemotherapy-refractory, HER2-positive, RAS wild-type unresectable or metastatic colorectal cancer (MOUNTAINEER): a multicentre, open-label, phase 2 study. Lancet Oncol. 24, 496–508 (2023). https://pubmed.ncbi.nlm.nih.gov/37142372/ 25.       Sauer, R. et al. Preoperative versus Postoperative Chemoradiotherapy for Rectal Cancer. N. Engl. J. Med. 351, 1731–1740 (2004). https://pubmed.ncbi.nlm.nih.gov/15496622/ 26.       Cercek, A. et al. Adoption of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer. JAMA Oncol. 4, e180071 (2018). https://pubmed.ncbi.nlm.nih.gov/29566109/ 27.       Garcia-Aguilar, J. et al. Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy. J. Clin. Oncol. 40, 2546–2556 (2022). https://pubmed.ncbi.nlm.nih.gov/35483010/ 28.       Schrag, D. et al. Preoperative Treatment of Locally Advanced Rectal Cancer. N. Engl. J. Med. 389, 322–334 (2023). https://pubmed.ncbi.nlm.nih.gov/37272534/ 29.       Kunkler, I. H., Williams, L. J., Jack, W. J. L., Cameron, D. A. & Dixon, J. M. Breast-Conserving Surgery with or without Irradiation in Early Breast Cancer. N. Engl. J. Med. 388, 585–594 (2023). https://pubmed.ncbi.nlm.nih.gov/36791159/ 30.       Jacobsen, R. L., Macpherson, C. F., Pflugeisen, B. M. & Johnson, R. H. Care Experience, by Site of Care, for Adolescents and Young Adults With Cancer. JCO Oncol. Pract. (2021) doi:10.1200/OP.20.00840. https://pubmed.ncbi.nlm.nih.gov/33566700/ 31.       Ruddy, K. J. et al. Prospective Study of Fertility Concerns and Preservation Strategies in Young Women With Breast Cancer. J. Clin. Oncol. (2014) doi:10.1200/JCO.2013.52.8877. https://pubmed.ncbi.nlm.nih.gov/24567428/ 32.       Su, H. I. et al. Fertility Preservation in People With Cancer: ASCO Guideline Update. J. Clin. Oncol. 43, 1488–1515 (2025). https://pubmed.ncbi.nlm.nih.gov/40106739/ 33.       Smith, K. L., Gracia, C., Sokalska, A. & Moore, H. Advances in Fertility Preservation for Young Women With Cancer. Am. Soc. Clin. Oncol. Educ. Book 27–37 (2018) doi:10.1200/EDBK_208301. https://pubmed.ncbi.nlm.nih.gov/30231357/ 34.       Blumenfeld, Z. How to Preserve Fertility in Young Women Exposed to Chemotherapy? The Role of GnRH Agonist Cotreatment in Addition to Cryopreservation of Embrya, Oocytes, or Ovaries. The Oncologist 12, 1044–1054 (2007). 35.       Bhagavath, B. The current and future state of surgery in reproductive endocrinology. Curr. Opin. Obstet. Gynecol. 34, 164 (2022). 36.       Ribeiro, R. et al. Uterine transposition: technique and a case report. Fertil. Steril. 108, 320-324.e1 (2017). 37.       Yazdani, A., Sweterlitsch, K. M., Kim, H., Flyckt, R. L. & Christianson, M. S. Surgical Innovations to Protect Fertility from Oncologic Pelvic Radiation Therapy: Ovarian Transposition and Uterine Fixation. J. Clin. Med. 13, 5577 (2024). 38.       Holowatyj, A. N., Eng, C. & Lewis, M. A. Incorporating Reproductive Health in the Clinical Management of Early-Onset Colorectal Cancer. JCO Oncol. Pract. 18, 169–172 (2022). ***Behind the Knife Colorectal Surgery Oral Board Audio Review: https://app.behindtheknife.org/course-details/colorectal-surgery-oral-board-audio-review Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
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Jul 17, 2025 • 23min

Journal Review in Artificial Intelligence: Four Times Better Than Us

You have probably seen recent headlines that Microsoft has developed an AI model that is 4x more accurate than humans at difficult diagnoses. It’s been published everywhere, AI is 80% accurate compared to a measly 20% human rate, and AI was cheaper too! Does this signal the end of the human physician? Is the title nothing more than clickbait? Or is the truth somewhere in-between? Join Behind the Knife fellow Ayman Ali and Dr. Adam Rodman from Beth Israel Deaconess/Harvard Medical School to discuss what this study means for our future.       Studies: Sequential Diagnosis with Large Language Models: https://arxiv.org/abs/2506.22405v1 METR study: https://metr.org/blog/2025-07-10-early-2025-ai-experienced-os-dev-study/ Hosts: Ayman Ali, MD Ayman Ali is a Behind the Knife fellow and general surgery PGY-4 at Duke Hospital in his academic development time where he focuses on applications of data science and artificial intelligence to surgery.  Adam Rodman, MD, MPH, FACP, @AdamRodmanMD Dr. Rodman is an Assistant Professor and a practicing hospitalist at Beth Israel Deaconess Medical Center. He’s the Beth Israel Deaconess Medical Center Director of AI Programs. In addition, he’s the co-director of the Beth Israel Deaconess Medical Center iMED Initiative. Podcast Link: http://bedside-rounds.org/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

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