Jorge, Irving A

Background This study aimed to evaluate outcomes of different antibiotic durations in patients with severe diverticulitis. Methods Initial electronic medical record review identified 2437 adult patients who underwent sigmoid colectomy. Manual chart review identified 133 patients who underwent sigmoid resection and proximal diversion for Hinchey stage 3 or 4 diverticulitis. Patients who received a short antibiotic course (SAC, ≤5 days) were compared with those who received a long antibiotic course (LAC, >5 days). The primary composite outcome included superficial, incisional, organ-space infections or death within 30 days post procedure. Results A total of 53 SAC patients and 55 LAC patients were identified. The composite outcome occurred more frequently in LAC patients than in SAC patients (40% vs 15%; P = .005). Organ-space infection occurred more frequently in LAC patients than in SAC patients (31% vs 13%; P = .04). Conclusions Extended duration of antibiotics after adequate source control does not improve outcomes even in the setting of extensive intra-abdominal contamination.

Global surgical collaboration presents opportunities for knowledge exchange, but it also highlights the inequities that influence how surgery is practiced across different contexts. As a Latino surgeon trained in a high-income country, I reflect on my experience at a multidisciplinary, Spanish-language conference in Mexico City that brought together over 600 participants from Mexico and six Latin American countries. The program spanned cholecystectomy, bariatric surgery, hepatology, anesthesia, and interventional radiology, with survey results showing that 87% of attendees reported increased knowledge and 98% intended to apply new practices. Yet, financial constraints, limited time, and lack of institutional support remained significant barriers. For me, the experience was both professional and deeply personal. Teaching exclusively in Spanish affirmed cultural belonging and highlighted language as a tool of equity. At the same time, it underscored the systemic nature of barriers in low- and middle-income countries, where adopting new techniques depends not only on interest or skill but on resources, infrastructure, and institutional support. Standing at the intersection of privilege and solidarity, I felt both pride in contributing and discomfort at the inequities that persist. This reflection suggests that global surgical engagement must move beyond episodic exchanges toward sustained, equitable partnerships that are linguistically accessible, culturally grounded, and structurally supported. Surgery itself exists in two worlds, the technical and the systemic. Embracing that duality can strengthen our collaborations and shift the measure of surgical impact from the number of cases completed to the number of bridges built.