Faculty Bibliography

Endovascular stent grafting (EVAR) is now the preferred approach to repair of abdominal aortic aneurysms for many patients. One of the most common complications associated with EVAR is the development of an endoleak, or continued flow of blood into the aneurysm sac outside the graft. Type II endoleaks, those due to retrograde flow through a branch vessel such as the inferior mesenteric artery (IMA) or a lumbar artery, are the most common. Options for treatment include transarterial embolization, translumbar embolization, and laparoscopic ligation. Embolization techniques require reintervention in approximately 20%, with less than half free from aneurysm sac growth at five years, though current evidence is insufficient to determine a clear threshold for intervention or optimal technique.[1,2]

Caustic injury of the gastrointestinal tract (GI) has remained a costly and devastating problem to the bi-modal population affected, however it has seen encouraging evolutions in its care. Caustic injury is defined as an ingested acid or base that results in a wide range of pathology in theupper GI tract, mainly the upper airway, esophagus and stomach. To yield an update on caustic injuries with succinct recent innovations in care, previously published articles, with an emphasis on more recent articles were searched for using Pubmed and MEDLINE. Major advancements in technology have improved the treatment of the acute phase of injury leading to a more uniform methodology in diagnosis, less morbid acute temporizing measures and improved staging of acute injury with the help of advancements in computed tomography and endoscopic interventions. With the advancement of endoscopy and laparoscopy, acute treatment and chronic complications of caustic injury have been reassuringly improved. Endoscopy and laparoscopy have also aided in therapeutic advancements with the implementation of endoscopic dilation of strictures and minimally invasive techniques for gastro esophageal bypasses and resections. Emerging are biochemical platforms such as bioscaffolds to promote esophageal healing and topical anti-cytotoxic agents to treat esophageal strictures. Treating caustic injury has seen recent advancements with the aid of minimally invasive diagnostic and therapeutic modalities to help in the acute and chronic phases of care as improvements in clinical outcomes with novel biocellular techniques emerging

INTRODUCTION: The relationship between the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and its industry partners has been longstanding, productive technologically, and beneficial to patient care and education. In order to both maintain this important relationship to honor its responsibility to society for increasing transparency, SAGES established a Conflict of Interest Task Force (CITF) and charged it with identifying and managing potential conflicts of interest (COI) and limiting bias at the SAGES Annual Scientific Meetings. The CITF developed and implemented a comprehensive process for reporting, evaluating, and managing COI in accordance with (and exceeding) Accreditation Council for Continuing Medical Education guidelines. METHODS: From 2011 to 2013, all presenters, moderators, and session chairs received proactive and progressively increasing levels of education regarding the CITF rationale and processes and were required to disclose all relationships with commercial interests. Disclosures were reviewed and discussed by multiple layers of reviewers, including moderators, chairs, and CITF committee members with tiered, prescribed actions in a standardized, uniform fashion. Meeting attendees were surveyed anonymously after the annual meeting regarding perceived bias. The CITF database was then analyzed and compared to the reports of perceived bias to determine whether the implementation of this comprehensive process had been effective. RESULTS: In 2011, 68 of 484 presenters (14 %) disclosed relationships with commercial interests. In 2012, 173 of 523 presenters (33.5 %) disclosed relationships, with 49 having prior review (9.4 %), and eight required alteration. In 2013, 190 of 454 presenters disclosed relationships (41.9 %), with 93 presentations receiving prior review (20.4 %), and 20 presentations were altered. From 2008 to 2010, the perceived bias among attendees surveyed was 4.7, 6.2, and 4.4 %; and in 2011-2013, was 2.2, 1.2, and 1.5 %. CONCLUSION: It is possible to have a surgical meeting that includes participation of speakers that have industry relationships, and minimize perceived bias.