Long-term outcomes after complete mesocolic excision for colon cancer at a tertiary care center in Saudi Arabia

Assessing the Knowledge and Prescription Practice of Gastroenterologists and Pharmacists Toward Probiotics in Saudi Arabia: An Electronic Survey-Based Study

Background

Probiotics are live microorganisms that provide many benefits to the human body when supplemented with a diet. In Saudi Arabia, there are limited studies on the use of probiotic supplements for some gastrointestinal inflammatory and infectious conditions. Many health professionals who provide health care for patients with gastrointestinal conditions may recommend probiotics at different degrees based on their knowledge and experience. This study aimed to explore the knowledge and practice of gastroenterologists and pharmacists in Saudi Arabia regarding probiotics.

Methods

We measured the practice of recommending, prescribing, and using probiotics by analyzing the responses of the healthcare specialists (gastroenterologists and pharmacists) using an anonymous online survey. The survey was constructed to explore the knowledge, use, and manner of prescribing probiotics by healthcare practitioners in the Saudi community to discuss health benefits with patients with gastrointestinal conditions.

Results

Most gastroenterologists (61.5%) partially disagreed that probiotics could benefit the treatment of digestive symptoms. However, a third of the pharmacists agreed that probiotic products could relieve digestive symptoms. The attitude toward and practice of prescribing probiotics depend on many factors, including professionals' beliefs in the benefits of probiotics, insufficient evidence from previous studies and clinical trials about the beneficial use of probiotics, cost, and manufacturing brands.

Conclusion

Gastroenterologists' and pharmacists' knowledge of probiotics was up to date as evident by their ability to identify specific digestive disorders for which probiotics may be beneficial, as well as their rejection of the notion that probiotics are universally effective in all gastrointestinal disorders, which is a commonly held belief in the community. The cost of probiotics as supplements to dairy products or as brands alone may also affect the prescription of probiotics by health professionals, as shown in the current study.

Definition and reporting of lymphadenectomy and complete mesocolic excision for radical right colectomy: a systematic review

BACKGROUND

Several procedures have been proposed to reduce the rates of recurrence in patients with right-sided colon cancer. Different procedures for a radical right colectomy (RRC), including extended D3 lymphadenectomy, complete mesocolic excision and central vascular ligation have been associated with survival benefits by some authors, but results are inconsistent. The aim of this study was to assess the variability in definition and reporting of RRC, which might be responsible for significant differences in outcome evaluation.

METHODS

PRISMA-compliant systematic literature review to identify the definitions of RRC. Primary aims were to identify surgical steps and different nomenclature for RRC. Secondary aims were description of heterogeneity and overlap among different RRC techniques.

RESULTS

Ninety-nine articles satisfied inclusion criteria. Eight surgical steps were identified and recorded as specific to RRC: Central arterial ligation was described in 100% of the included studies; preservation of mesocolic integrity in 73% and dissection along the SMV plane in 67%. Other surgical steps were inconstantly reported. Six differently named techniques for RRC have been identified. There were 35 definitions for the 6 techniques and 40% of these were used to identify more than one technique.

CONCLUSIONS

The only universally adopted surgical step for RRC is central arterial ligation. There is great heterogeneity and consistent overlap among definitions of all RRC techniques. This is likely to jeopardise the interpretation of the outcomes of studies on the topic. Consistent use of definitions and reporting of procedures are needed to obtain reliable conclusions in future trials. PROSPERO CRD42021241650.