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Cardiovascular disease risk scores in patients with optimal vs suboptimal weight loss after bariatric surgery: Translating improvements into clinical practice Am. J. Surg. (IF 3.0) Pub Date : 2024-03-11 Rajaa Mohamed Salih, Juan S. Barajas-Gamboa, Gabriel Diaz Del Gobbo, Mohammed Abdallah, Helen Sun, Terrence Lee-St John, Oshin Kanwar, Carlos Abril, Juan Pablo Pantoja, Javed Raza, Hani Sabbour, John Rodriguez, Matthew Kroh, Ricard Corcelles
The aim of this study was to evaluate cardiovascular disease (CVD) risk modification in patients with optimal weight loss (OWL) versus suboptimal weight loss SWL following MBS. This was a retrospective analysis. The 10-year risk CVD was estimated before and after one year of surgery using the “Framingham Score”. 191 patients were included in our study. Mean baseline Framingham score was 7.2 ± 6.9%
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Survival disparities in rural versus urban patients with pancreatic neuroendocrine tumor: A multi-institutional study from the US neuroendocrine tumor study group Am. J. Surg. (IF 3.0) Pub Date : 2024-03-11 Muhammad Bilal Mirza, Jordan J. Baechle, Paula Marincola Smith, Mary Dillhoff, George Poultsides, Flavio G. Rocha, Clifford S. Cho, Emily R. Winslow, Ryan C. Fields, Shishir K. Maithel, Kamran Idrees
Pancreatic Neuroendocrine Tumors (PNETs) are indolent malignancies that often have a prolonged clinical course. This study assesses disparities in outcomes between PNET patients who live in urban (UA) and rural areas (RA). A retrospective cohort study was performed using the US Neuroendocrine Tumor Study Group database. PNET patients with a home zip code recorded were included and categorized as RA
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Surgical journal clubs: Navigating the post-pandemic landscape Am. J. Surg. (IF 3.0) Pub Date : 2024-03-11 Taylor A. Brown, Maeve Alterio, Erik C. Stiles, Michael Vu, Blair B. Washington, Theodore R. Chauvin, Anjali S. Kumar
Pandemic-related distancing regulations gave medical educators at our college an opportunity to reimagine and expand our evidenced-based medicine curriculum to an asynchronous, virtual format. We share the experience of course directors, faculty, and students with our new surgical journal club format. Our goal was to support learners’ critical appraisal skills of the surgical literature through active
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Teaching cultural dexterity in surgical care: As essential to a surgeon's skill set as tying a knot Am. J. Surg. (IF 3.0) Pub Date : 2024-03-11 Gezzer Ortega, Brittany M. Dacier, Jorge Zárate Rodriguez, Maria B.J. Chun, N. Rhea Udyavar, Benjamin G. Allar, Alexander R. Green, Adil H. Haider, Douglas S. Smink, the PACTS Trial Group, Benjamin G. Allar, Rachel B. Atkinson, Jeenn Barreiro-Rosado, L.D. Britt, Molly A. Brittain, Katharine Caldwell, Annie Chen, Maria B.J. Chun, Brittany M. Dacier, Caroline Demko, Alexander R. Green, Adil H. Haider
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Cultivating emotional intelligence in general surgery residents through a patient-centered experience Am. J. Surg. (IF 3.0) Pub Date : 2024-03-11 Hayley Standage, Katherine Kelley, Heather Buxton, Cate Wetzel, Karen Brasel, Heather Hoops
Emotional intelligence (EI) can decrease physician burnout. EI and burnout were assessed in surgical residents through participation in Patient-Centric Resident Conferences (PCRCs), which incorporated patients in resident education. We hypothesized PCRCs would improve EI and reduce burnout. This was a single institution study of General Surgery residents from 2018 to 2019. Residents participated in
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Optimization of a standardized letter of recommendation for faculty who wish to support candidates applying to surgical training programs Am. J. Surg. (IF 3.0) Pub Date : 2024-03-09 Clare Zipf-Sigler, Alisha L. Nguyen, Amber Huang, Ryan De Leon, Shannon Helbling, Eliza B. Littleton, Anjali S. Kumar
Letters of recommendation (LORs) play an important role in applicant selection for graduate medical education programs. LORs may be of increasing importance in the evaluation of applicants given the recent change of the USMLE Step 1 to pass/fail scoring and the relative lack of other objective measures by which to differentiate and stratify applicants. Narrative letters of recommendation (NLORs), although
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Axillary ultrasonography for early-stage invasive breast cancer Am. J. Surg. (IF 3.0) Pub Date : 2024-03-08 Karen Jiang, Crystal Ma, Yuwei Yang, Elaine McKevitt, Jin-Si Pao, Rebecca Warburton, Carol Dingee, Jieun Newman- Bremang, Melina Deban, Amy Bazzarelli
Among women with early invasive breast cancer and 1–2 positive sentinel nodes, sentinel lymph node biopsy (SLNB) is non-inferior to axillary lymph node dissection (ALND). However, preoperative axillary ultrasonography (AxUS) may not be sensitive enough to discriminate burden of nodal metastasis in these patients, potentially leading to overtreatment. This study compares axillary operation rates in
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Clinical factors and outcomes of spleen-conserving surgery versus total splenectomy in splenic injuries: A nationwide database study Am. J. Surg. (IF 3.0) Pub Date : 2024-03-08 Angela Tang-Tan, Chih Ying Chien, Stephen Park, Morgan Schellenberg, Lydia Lam, Matthew Martin, Kenji Inaba, Kazuhide Matsushima
The objective of this study was to identify factors associated with the use of spleen-conserving surgeries, as well as patient outcomes, on a national scale. This retrospective cohort study (2010–2015) included patients (age≥16 years) with splenic injury in the National Trauma Data Bank. Patients who received a total splenectomy or a spleen-conserving surgery were compared for demographics and clinical
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Multiple positive imaging tests in diagnosing acute appendicitis: An analysis of more than 27,000 cases Am. J. Surg. (IF 3.0) Pub Date : 2024-03-08 Akie Watanabe, Michael Guo, Christina Schweitzer, Sam M. Wiseman
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The association of hernia-specific and procedural risk factors with early complications in ventral hernia repair: ACHQC analysis Am. J. Surg. (IF 3.0) Pub Date : 2024-03-08 Mazen R. Al-Mansour, Delaney D. Ding, Celeste G. Yergin, Robert Tamer, Li-Ching Huang
Many surgical risk assessment tools emphasize patient-specific risk factors. Our objective was to use a hernia-specific database to assess risk factors of complications in ventral hernia repair (VHR) focusing on hernia-specific and procedural factors. The ACHQC database was queried for elective VHR in adults from 2012-2023. Primary outcome was overall 30-day complications. Multivariable logistic regression
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Subtotal cholecystectomy: Are we describing thoroughly our approaches? Am. J. Surg. (IF 3.0) Pub Date : 2024-03-06 Luis Adrian Alvarez-Lozada, Ethel Valeria Orta-Guerra, María Fernanda Gutiérrez-Alvarez, Alejandro Quiroga-Garza, Rodrigo E. Elizondo-Omaña
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Risk factors for post-operative VTE following colorectal surgery: Is caprini score enough? Am. J. Surg. (IF 3.0) Pub Date : 2024-03-06 Anyelin Almanzar, Sophia L. Dahmani, Sami Shoucair, Zhifei Sun, Jennifer Ayscue, Brian Bello, Sara Berkey
Post-operative colorectal venous thromboembolism (VTE) rates range between 1 and 3%. Often, surgeons utilize risk assessment models, like the modified Caprini, to determine need for prophylaxis. However, studies reveal additional unaccounted risk factors like preoperative serum albumin level, perioperative blood transfusion, emergency surgery, and preoperative steroid use. This was a multicenter, retrospective
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Screening for asymptomatic nephrolithiasis in primary hyperparathyroidism patients is warranted Am. J. Surg. (IF 3.0) Pub Date : 2024-03-05 Taryn Zabolotniuk, Michael Guo, Michelle Kwon, Akie Watanabe, Joel M.H. Teichman, Sam M. Wiseman
We aimed to investigate the prevalence, characteristics, and management of nephrolithiasis in primary hyperparathyroidism (PHPT) patients. Medical records of patients who underwent parathyroidectomy at a tertiary care hospital in British Columbia from January 2016 to April 2023 were retrospectively reviewed. Demographic data, laboratory results, imaging reports, and urologic consultations were examined
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Surgical tactics of parathyroidectomy: Should we abandon the use of ioPTH? Am. J. Surg. (IF 3.0) Pub Date : 2024-03-05 Joaquín Gómez-Ramírez, Raquel Arranz Jiménez
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The overtreatment of papillary thyroid microcarcinoma in the community Am. J. Surg. (IF 3.0) Pub Date : 2024-03-04 Peter J. Abraham, Christopher Wu, Rongzhi Wang, Brendon Herring, Polina Zmijewski, Andrea Gillis, Jessica Fazendin, Brenessa Lindeman, Herbert Chen
Total thyroidectomy is the traditional primary approach for papillary thyroid cancer. However, recent evidence supports conservative management for low-risk tumors like papillary thyroid microcarcinomas (PTMCs). This study explores the adoption of these practices in our community, using a cancer database to analyze treatment strategies. A retrospective review of a 1433-patient institutional database
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Invited commentary – Parental leave policies in general surgery residencies Am. J. Surg. (IF 3.0) Pub Date : 2024-03-04 Kimberly M. Ramonell
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Fraudulent feelings: Imposter syndrome in surgery Am. J. Surg. (IF 3.0) Pub Date : 2024-03-03 J, e, s, s, i, c, a, , L, ., , W, e, a, v, e, r
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Beyond the headlines: The impact of the affordable care act on equitable access to bariatric surgery Am. J. Surg. (IF 3.0) Pub Date : 2024-03-02 Marcus P. Sirianno, Margaux N. Mustian
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Should breast surgery be considered for patients with de novo metastatic inflammatory breast cancer? Am. J. Surg. (IF 3.0) Pub Date : 2024-03-02 Lauren M. Drapalik, Robert Shenk, Lisa Rock, Ashley Simpson, Amanda L. Amin, Megan E. Miller
We aimed to identify factors predicting surgery for de novo stage IV inflammatory breast cancer (IBC) and determine the association of surgery with overall survival (OS). Female patients with unilateral AJCC clinical stage IV IBC treated 2010–2018 in the NCDB were identified. Logistic regression and multivariable proportional Cox hazards regressions determined factors associated with treatment and
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Patient adherence to an oral rehydration solution intervention to prevent dehydration following ileostomy creation: A qualitative study Am. J. Surg. (IF 3.0) Pub Date : 2024-03-01 Sarah E. Bradley, C. Ann Vitous, Maedeh Marzoughi, Shukri H.A. Dualeh, Samantha J. Rivard, Ashley Duby, Samantha Hendren, Pasithorn A. Suwanabol
Patients undergoing surgery for ileostomy creation frequently experience postoperative dehydration and subsequent renal injury. The use of oral rehydration solutions (ORS) has been shown to prevent dehydration, but compliance may be variable. Semi-structured qualitative interviews were conducted with 17 patients who received a postoperative hydration kit and dehydration education to assess barriers
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From the Editor – In – Chief: Top papers from the Midwest Surgical Association Am. J. Surg. (IF 3.0) Pub Date : 2024-02-29 Herbert Chen
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Understanding current ergonomics setup for urologists conducting anatomical endoscopic enucleation of the prostate surgeries: Survey analysis from the endourological society Am. J. Surg. (IF 3.0) Pub Date : 2024-02-29 Ahmad AlShammari, Tarek Benzouak, Abdulghani Khogeer, Rakan AlHaidey, Adel Arezki, Nader Fahmy, Sero Andonian, Serge Carrier, Mélanie Aubé-Peterkin, Fadl Hamouche
Ensuring ergonomic posture and safety for surgeons is key to preventing work-related injuries and promoting sustained practice. We evaluated ergonomic aspects of Anatomic Endoscopic Enucleation of the Prostate (AEEP) and its relation to musculoskeletal injuries. A two-month online survey involving 119 Endourological Society members provided an in-depth analysis of AEEP practices and their musculoskeletal
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Innovations in surgery for gallbladder cancer: A review of robotic surgery as a feasible and safe option Am. J. Surg. (IF 3.0) Pub Date : 2024-02-27 Sebastian Mellado, Ariana M. Chirban, Emanuel Shapera, Belen Rivera, Elena Panettieri, Marcelo Vivanco, Claudius Conrad, Iswanto Sucandy, Eduardo A. Vega
This study evaluates the efficacy and safety of robotic-assisted surgical techniques in the treatment of gallbladder cancer, comparing it with traditional open and laparoscopic methods. A systematic review of the literature searched for comparative analyses of patient outcomes following robotic, open, and laparoscopic surgeries, focusing on oncological results and perioperative benefits. Five total
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Genetic and biologic risk factors associated with hernia formation: A review Am. J. Surg. (IF 3.0) Pub Date : 2024-02-27 Chris Amro, Ellen F. Niu, Ellie Deianni, Laurie Smith, Maylene Qiu, Jared Torkington, Robyn B. Broach, Lillias H. Maguire, Scott M. Damrauer, Kamal Itani, John P. Fischer
This systematic review aims to identify genetic and biologic markers associated with abdominal hernia formation. Following PRIMSA-guidelines, we searched PubMed, MEDLINE, Embase, Scopus, and COCHRANE databases. Of 5946 studies, 65 were selected, excluding parastomal hernias due to insufficient data. For inguinal hernias, five studies unveiled 92 susceptible loci across 66 genes, predominantly linked
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Clinical outcomes of outpatient thyroidectomy: A systematic review and single-arm meta-analysis Am. J. Surg. (IF 3.0) Pub Date : 2024-02-27 Hayato Nakanishi, Rongzhi Wang, Shahid Miangul, Grace E. Kim, Omotayo A. Segun-Omosehin, Natalie E. Bourdakos, Christian A. Than, Benjamin E. Johnson, Herbert Chen, Andrea Gillis
The aim of this meta-analysis is to investigate the safety of outpatient thyroidectomy based on 24-h and same-day discharge criteria. CENTRAL, Embase, PubMed, and Scopus were searched. A meta-analysis of selected studies was performed. The review was registered prospectively with PROSPERO (CRD42022361134). Thirty-one studies met the eligibility criteria, with a total of 74328 patients undergoing thyroidectomy
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Long-term outcomes after amputation and sentinel node biopsy for subungual melanoma: A single-institution series Am. J. Surg. (IF 3.0) Pub Date : 2024-02-24 Cristian D. Valenzuela, Graham Fowler, Kaiya Kozuma, Sonny Kusaka, John T. Vetto
Subungual melanoma (SUM) is a rare tumor with historically poor outcomes. Thus, the benefit of proximal versus distal amputation in SUM remains unclear. We performed a retrospective review of our prospectively-maintained institutional melanoma database, including SUM and non-subungual acral melanoma (AM) patients who underwent sentinel lymph node biopsy (SLNB) between 1999 and 2022. All SUMs had distal
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Modified 2-stage IPAA has similar postoperative complication rates and functional outcomes compared to 3-stage IPAA Am. J. Surg. (IF 3.0) Pub Date : 2024-02-24 E. Clement, W. Lin, D. Shojaei, P. Au-Yeung, A. Motamedi, P.T. Phang
Reconstructive ileal-pouch anal anastomosis (IPAA) for ulcerative colitis (UC) is often created in 3-stages: colectomy + ileostomy, proctectomy + pouch creation with diverting loop ileostomy, then subsequent ileostomy closure. Modified 2-stage IPAA is without pouch diversion, thus avoiding a third operation. This study compares perioperative complications, quality of life (QOL) and functional outcomes
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Advancing geriatric surgical outcomes in elective ventral and incisional hernia repair surgeries: An American college of surgeons national surgical quality improvement program study Am. J. Surg. (IF 3.0) Pub Date : 2024-02-23 Alyssa K. Greenwood Francis, Natalie N. Merchant, Katherine Aguirre, Alonso Andrade
Increasing age is known to be associated with increased risk for postoperative morbidity and mortality, however, the goal of this study was to determine if an increase in age correlates to differences in surgical outcomes for elective ventral hernia repair. Retrospective cohort study using American College of Surgeons NSQIP database from 2016 to 2020. Included diagnosis codes were laparoscopic or open
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Gender differences in ergonomics during simulated ureteroscopy Am. J. Surg. (IF 3.0) Pub Date : 2024-02-22 Erin Kim, Alec Sun, Juan Sebastian Rodriguez-Alvarez, Louisa Ho, Kyle O'Laughlin, Smita De
Female urologists report higher rates of work-related physical discomfort compared to male urologists. We compared ergonomics during simulated ureteroscopy, the most common surgery for kidney stones, between male and female urologists. Surface electromyography was used to measure muscle activation during common ureteroscopic tasks in urology trainees and staff with different surgeon positions and ureteroscopes
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Mortality in hypotensive combat casualties who require emergent laparotomy in the forward deployed environment Am. J. Surg. (IF 3.0) Pub Date : 2024-02-20 Luke Pumiglia, James M. Williams, Marissa Beiling, Andrew D. Francis, Beau J. Prey, Daniel T. Lammers, John M. McClellan, Jason R. Bingham, Jennifer Gurney, Martin Schreiber
Mortality rates among hypotensive civilian patients requiring emergent laparotomy exceed 40%. Damage control (DCR) principles were incorporated into the military's Clinical Practice Guidelines (CPG) in 2008. We examined combat casualties requiring emergent laparotomy to characterize how mortality rates compare to hypotensive civilian trauma patients. The DoD Trauma Registry (2004–2020) was queried
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“Blunt adrenal injury does not affect outcomes in the pediatric population with isolated abdominal injury- a National Trauma Data Bank Review®.” Am. J. Surg. (IF 3.0) Pub Date : 2024-02-19 Anthony J. Duncan, Ikttesh K. Chahal, Dustin J. Nowotny, Hilla I. Sang, Mentor Ahmeti
The incidence of blunt abdominal injury (BAI) in the adult population has been estimated to be between 0.03% and 4.95%. However, the impact of BAI on the pediatric population remains unknown. We conducted a retrospective review of National Trauma Data Bank datasets for the years 2017–2019. We included patients under the age of 18 who experienced blunt trauma and had suffered a blunt abdominal injury
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Collating evidence to support the validation of a simulated laparotomy incision and closure-training model Am. J. Surg. (IF 3.0) Pub Date : 2024-02-17 Adam F. Roche, Dara Kavanagh, Niamh McCawley, J.M. O'Riordan, Caitriona Cahir, Conor Toale, Dara O'Keeffe, Tim Lawler, Claire M. Condron
It is essential to evaluate the functionality of surgical simulation models, in order to determine whether they perform as intended. In this study, we assessed the use of a simulated laparotomy incision and closure-training model by collating validity evidence to determine its utility as well as pre and post-test interval data. This was a quantitative study design, informed by Messick's unified validity
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Should surgeons reconsider the role of intraoperative sentinel lymph node evaluation for premenopausal breast cancer patients in the era of RxPONDER? Am. J. Surg. (IF 3.0) Pub Date : 2024-02-17 Chandler S. Cortina, Amanda L. Kong
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“Do No harm” - How Medicare Advantage policies are harming cancer patients Am. J. Surg. (IF 3.0) Pub Date : 2024-02-16 James Waters, Young Hong
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Can screen-time help? An analysis of usage of patient engagement technology following colorectal surgery Am. J. Surg. (IF 3.0) Pub Date : 2024-02-16 Ahmer Irfan, Burke Smith, Lauren Wood, Robert H. Hollis, Eric Wallace, Michael Rubyan, Sushanth Reddy, Daniel I. Chu
Patient engagement technologies (PETs) guide patients through the perioperative period. We aimed to investigate the levels of patient engagement with PETs through the peri-operative period and its impact on clinical outcomes. Retrospective cohort study of patients undergoing elective colorectal surgery from 2018 to 2022. Outcomes were length of stay, readmissions, and complications within 30 days of
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Intraoperative hypotension and postoperative acute kidney injury: A systematic review Am. J. Surg. (IF 3.0) Pub Date : 2024-02-16 Yordan Penev, Matthew M. Ruppert, Ahmet Bilgili, Youlei Li, Raiya Habib, Abdul-Vehab Dozic, Coulter Small, Esra Adiyeke, Tezcan Ozrazgat-Baslanti, Tyler J. Loftus, Chris Giordano, Azra Bihorac
There is no consensus regarding safe intraoperative blood pressure thresholds that protect against postoperative acute kidney injury (AKI). This review aims to examine the existing literature to delineate safe intraoperative hypotension (IOH) parameters to prevent postoperative AKI. PubMed, Cochrane Central, and Web of Science were systematically searched for articles published between 2015 and 2022
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Outcomes and quality of life of frail patients following elective ventral hernia repair: Retrospective review of a national hernia collaborative Am. J. Surg. (IF 3.0) Pub Date : 2024-02-15 Alison Whalen, Sahana Holla, Savannah Renshaw, Molly Olson, Kavya Sreevalsan, Benjamin K. Poulose, Courtney E. Collins
Ventral hernia repair (VHR) is one of the most common general surgery procedures among older adults but is often deferred due to a higher risk of complications. This study compares postoperative quality of life (QOL) and complications between frail and non-frail patients undergoing elective VHR. We hypothesized that frail patients would have higher complication rates and smaller gains in quality of
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Determinants of long-term physical and mental health outcomes after intensive care admission for trauma survivors Am. J. Surg. (IF 3.0) Pub Date : 2024-02-14 Juan P. Herrera-Escobar, Taylor Lamarre, Jordan Rosen, Saba Ilkhani, Ashley N. Haynes, Kaman Hau, Kendall Jenkins, Jack Ruske, Joyce Y. Wang, Jessica Serventi-Gleeson, Sabrina E. Sanchez, Haytham MA. Kaafarani, George Velmahos, Ali Salim, Nomi C. Levy-Carrick, Geoffrey A. Anderson
Collectively, studies from medical and surgical intensive care units (ICU) suggest that long-term outcomes are poor for patients who have spent significant time in an ICU. We sought to identify determinants of post-intensive care physical and mental health outcomes 6–12 months after injury. Adult trauma patients [ISS ≥9] admitted to one of three Level-1 trauma centers were interviewed 6–12 months post-injury
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A stakeholder model for prioritization and distribution of elective surgery for population health Am. J. Surg. (IF 3.0) Pub Date : 2024-02-14 Victor Agbafe, Jennifer F. Waljee, Nicholas L. Berlin
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Traumatic lower extremity amputation as a risk factor for venous thromboembolism Am. J. Surg. (IF 3.0) Pub Date : 2024-02-13 Dias Argandykov, Emanuele Lagazzi, Jefferson A. Proaño-Zamudio, Wardah Rafaqat, May Abiad, Michael DeWane, Charudutt N. Paranjape, Haytham M.A. Kaafarani, George C. Velmahos, John O. Hwabejire
This study aimed to evaluate whether lower extremity (LE) amputation among civilian casualties is a risk factor for venous thromboembolism. All patients with severe LE injuries (AIS ≥3) derived from the ACS-TQIP (2013–2020) were divided into those who underwent trauma-associated amputation and those with limb salvage. Propensity score matching was used to mitigate selection bias and confounding and
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We don't really know our residents as well as we think. Trait characteristic recognition by faculty in autonomy needs more attention. But does it matter? Am. J. Surg. (IF 3.0) Pub Date : 2024-02-13 James N. Lau
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The incidence and risk factors of marginal ulcers in the short and medium term in symptomatic post-pancreaticoduodenectomy patients ---- single-center experience Am. J. Surg. (IF 3.0) Pub Date : 2024-02-13 Shaoqin Fan, Guosheng Chen, Kai Zhang, Li Zhao, Hao Yuan, Junli Wu, Wentao Gao, Jishu Wei, Chunhua Xi, Feng Guo, Jianmin Chen, Zipeng Lu, Kuirong Jiang, Yi Miao, Bin Xiao
Marginal ulcer (MU) is one of the postoperative complications of pancreaticoduodenectomy (PD), which needs particular attention in postoperative treatments. The data of 190 patients who underwent PD and follow-up gastroscopic review due to upper GI symptoms within two years were retrospectively analyzed. The incidence of MU and risk factors were analyzed based on personal history, surgical procedure
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My thoughts: The rise of social media as a reporting source for firearm violence Am. J. Surg. (IF 3.0) Pub Date : 2024-02-13 Shaelyn Choi, Jason Liang, Megan R. Donnelly, Mallory Jebbia, Catherine M. Kuza, Lourdes Swentek, Areg Grigorian, Jeffry Nahmias
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Some thoughts on surgery for primary hyperparathyroidism Am. J. Surg. (IF 3.0) Pub Date : 2024-02-11 Antonio Sitges-Serra
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Patient reported outcomes of emergency general surgery procedures Am. J. Surg. (IF 3.0) Pub Date : 2024-02-10 Pawan J. Mathew, Yasmin M. Ali, Rick O'Connor, Rachel Levinson, Ahmed Khan, Kevin M. Schuster
Emergency general surgery (EGS) involves care of a patient's often previously unknown disease in the setting of an unplanned interaction with the healthcare system. This leads to challenges collecting and interpreting patient reported outcome measures (PROMs). We performed a qualitative and mixed methods study using semi-structured interviews during the index hospitalization and at 6–12 months to capture
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Beyond grit and resilience: An association of Women Surgeon's series on surgical culture change Am. J. Surg. (IF 3.0) Pub Date : 2024-02-10 Jenny M. Shao, Morgan Hopp, Lauren Nosanov, Chantal Reyna, Lisa K. Cannada
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Standardizing the standards Am. J. Surg. (IF 3.0) Pub Date : 2024-02-10 Lindsey Loss, Luis Tinoco Garcia, Martin Schreiber
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Are we measuring what matters most? ACP completion among patients undergoing gastrostomy tube placement Am. J. Surg. (IF 3.0) Pub Date : 2024-02-10 R.I. Ekaireb, K.E. Kopecky
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Bilateral exploration in primary hyperparathyroidism: Double adenoma distribution and biochemical patterns over two decades Am. J. Surg. (IF 3.0) Pub Date : 2024-02-09 Tim N. Beck, Gustavo Romero-Velez, Salem I. Noureldine, Gilman Plitt, Sarah Wang, Judy Jin
We investigated if anatomic patterns of abnormal parathyroid glands have ch anged for primary hyperparathyroidism (pHPT) as atypical biochemical presentation (normohormonal and normocalcemic) has increased. Retrospective review of patients with pHPT who underwent routine bilateral neck exploration. 2762 patients were included. The “late” cohort (2014–2020) exhibited lower preoperative calcium (10.8
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Hazards of surgical smoke from electrocautery: A critical review of the data Am. J. Surg. (IF 3.0) Pub Date : 2024-02-09 Roger D. Hurst, Camille L. Stewart
Concerns have been voiced regarding the possibility of health risks to the operating room personnel from exposure to surgical smoke generated from electrocautery. Ovid Medline was queried using search terms “surgical smoke”, “electrosurgery,” “smoke evacuator”. The NIOSH Health Hazard Evaluations Database was searched using terms, “hospital”, “operating room”, “Ames”, “mutagen”, and “salmonella". Levels
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The Operating and Anesthetic Reference Assistant (OARA): A fine-tuned large language model for resident teaching Am. J. Surg. (IF 3.0) Pub Date : 2024-02-09 Estefania Guthrie, Dominique Levy, Gabriel del Carmen
This study aimed to fine-tune a large language model (LLM) for domain-specific text generation in surgical and anesthesia residency education. With growing interest in artificial intelligence (AI) for medical training, the potential of LLMs to transform residency education is explored. The 7-billion parameter base model “Vicuna v1.5" was trained on 266,342 lines of text from 821 peer-reviewed documents
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An examination of rectal prolapse surgery patients’ quality of life and symptoms using patient-reported outcome instruments: A prospective cohort study Am. J. Surg. (IF 3.0) Pub Date : 2024-02-08 Rajan Bola, Michael Guo, Ahmer Karimuddin, Guiping Liu, P. Terry Phang, Trafford Crump, Jason M. Sutherland
We measured changes in self-reported health and symptoms attributable to rectal prolapse surgery using patient-reported outcome (PRO) measures. A prospectively recruited cohort of patients scheduled for rectal prolapse repair in Vancouver, Canada between 2013 and 2021 were surveyed before and 6-months after surgery using seven PROs: the EuroQol Five-Dimension Instrument (EQ-5D-5L), Generalized Anxiety
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Preoperative depression and anxiety associated with younger age and receipt of immediate breast reconstruction Am. J. Surg. (IF 3.0) Pub Date : 2024-02-08 Katelynn Tang, Jason M. Sutherland, Guiping Liu, Trafford Crump, Amy Bazzarelli, Carol Dingee, Jin-Si Pao, Rebecca Warburton, Elaine McKevitt
As survivorship for breast cancer continues to improve, emphasis of care falls upon improving patients’ quality of life. Understanding physical and mental health in the preoperative period is needed to aid surgical decision making and improve patient experience. Consecutive patients awaiting total mastectomy (TM), TM with immediate breast reconstruction (IBR) and breast conserving surgery (BCS) were
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From the Editor – In – Chief: Featured papers in the March 2024 issue Am. J. Surg. (IF 3.0) Pub Date : 2024-02-07 Herbert Chen
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Pain and opioid use after colorectal resection for benign versus malignant disease: A single institution analysis Am. J. Surg. (IF 3.0) Pub Date : 2024-02-07 Sarah Diaz, Kara K. Brockhaus, Matthew C. Bobel, Sara M. Colom, Carole Ramm, Robert K. Cleary
Studies comparing opioid needs between benign and malignant colorectal diseases are inconclusive. Single institution analysis of prospectively maintained colorectal surgery database. Multiple regression analyses done on perioperative numeric pain scores (NPS) and opioids prescribed at discharge. 641 patients in Benign and 276 patients in the Malignant group. Unadjusted comparison revealed significantly
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Sex differences and racial/ethnic disparities in the presentation and treatment of medullary thyroid cancer Am. J. Surg. (IF 3.0) Pub Date : 2024-02-07 Saiesh Kalva, Sara P. Ginzberg, Jesse E. Passman, Jacqueline M. Soegaard Ballester, Caitlin B. Finn, Douglas L. Fraker, Rachel R. Kelz, Heather Wachtel
This study assessed for disparities in the presentation and management of medullary thyroid cancer (MTC). Patients with MTC (2010–2020) were identified from the National Cancer Database. Differences in disease presentation and likelihood of guideline-concordant surgical management (total thyroidectomy and resection of ≥1 lymph node) were assessed by sex and race/ethnicity. Of 6154 patients, 68.2% underwent
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Outcomes following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal malignancies: 10 Year experience Am. J. Surg. (IF 3.0) Pub Date : 2024-02-06 Isabella Graham, Anna Boston, Richard Hayward, Richard Berri
The treatment of peritoneal malignancies has evolved and select patients can undergo effective surgical therapies. Access to innovative oncology procedures can be improved if programs are developed within and outside of academic cancer centers. We report the creation of a high volume, comprehensive peritoneal malignancy program developed in a community center. A retrospective single-site study was
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Axillary nodal disease burden is not associated with an elevated 21-gene recurrence score in post-menopausal women presenting with a clinically negative axilla Am. J. Surg. (IF 3.0) Pub Date : 2024-02-06 Astrid Botty van den Bruele, Morgan A. Paul, Samantha M. Thomas, Sarah L. Sammons, Maggie L. DiNome, Jennifer K. Plichta, Sydney M. Record, Hannah Woriax, Akiko Chiba, Laura H. Rosenberger, E Shelley Hwang
The predictive and prognostic value of the recurrence score (RS) has emphasized the importance of tumor biology and has reduced the prognostic implications of limited nodal burden in post-menopausal women with HR+/HER2-invasive breast cancer (IBC). It is unclear whether routine axillary staging has a continued role in the management of small, clinically node negative (cN0) HR+/HER2- IBC. We sought
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From the Editor – in – Chief: Featured papers in the February 2024 issue Am. J. Surg. (IF 3.0) Pub Date : 2024-02-03 Herbert Chen
Abstract not available
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Impact of extra-nodal extension and AJCC lymph node staging in predicting recurrence following lymphadenectomy in patients with melanoma Am. J. Surg. (IF 3.0) Pub Date : 2024-02-02 Julia Downey, Jeremy Hamm, Christopher Baliski
Regional lymphadenectomy (RL) has traditionally been recommended in patients with melanoma found to have clinical lymphadenopathy or a positive sentinel lymph node biopsy (SLNB). Regional control of disease is still a relevant issue for patients, even after undergoing lymphadenectomy. The goal of this study was to identify the clinicopathologic characteristics that predict locoregional recurrence in