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Better Operating Room Ventilation as Determined by a Novel Ventilation Index is Associated with Lower Rates of Surgical Site Infections Ann. Surg. (IF 13.787) Pub Date : 2022-08-10 Bernard Surial, Andrew Atkinson, Rüdiger Külpmann, Arnold Brunner, Kurt Hildebrand, Benoît Sicre, Nicolas Troillet, Andreas Widmer, Eveline Rolli, Judith Maag, Jonas Marschall
Objective: To assess the impact of operating room (OR) ventilation quality on surgical site infections (SSI) using a novel ventilation index. Summary Background Data: Previous studies compared laminar air flow with conventional ventilation, thereby ignoring many parameters that influence air flow properties. Methods: In this cohort study, we surveyed hospitals participating in the Swiss SSI surveillance
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Errors in Surgery: A Case Control Study Ann. Surg. (IF 13.787) Pub Date : 2022-08-10 Katherine M. Marsh, Florence E. Turrentine, Worthington G. Schenk, John B. Hanks, Bruce D. Schirmer, John P. Davis, Timothy L. McMurry, Sarah J. Ratcliffe, Victor M. Zaydfudim, R. Scott Jones
Objective: While errors can harm patients they remain poorly studied. This study characterized errors in the care of surgical patients and examined the association of errors with morbidity and mortality. Summary Background Data: Errors have been reported to cause less than 10% or greater than 60% of adverse events. Such discordant results underscore the need for further exploration of the relationship
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An International Expert Delphi Consensus on Defining Textbook Outcome in Liver Surgery (TOLS) Ann. Surg. (IF 13.787) Pub Date : 2022-08-10 Burak Görgec, Andrea Benedetti Cacciaguerra, Timothy M. Pawlik, Luca A. Aldrighetti, Adnan A. Alseidi, Umberto Cillo, Norihiro Kokudo, David A. Geller, Go Wakabayashi, Horacio J. Asbun, Marc G. Besselink, Daniel Cherqui, Tan To Cheung, Pierre-Alain Clavien, Claudius Conrad, Mathieu D’Hondt, Ibrahim Dagher, Christos Dervenis, John Devar, Elijah Dixon, Bjørn Edwin, Mikhail Efanov, Giuseppe M. Ettore
Objective: To reach global expert consensus on the definition of TOLS in minimally invasive and open liver resection among renowned international expert liver surgeons using a modified Delphi method. Summary Background Data: Textbook outcome is a novel composite measure combining the most desirable postoperative outcomes into one single measure and representing the ideal postoperative course. Despite
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Change in Body Mass Index and Attributable Risk of New Onset Hypertension among Obese Living Kidney Donors Ann. Surg. (IF 13.787) Pub Date : 2022-08-10 Rhiannon D. Reed, M. Chandler McLeod, Paul A. MacLennan, Vineeta Kumar, Sydney E. Pittman, Andrew G. Maynor, Luke A. Stanford, Gavin A. Baker, Carrie A. Schinstock, John R. Silkensen, Garrett R. Roll, Dorry L. Segev, Babak J. Orandi, Cora E. Lewis, Jayme E. Locke
Objective: To examine whether body mass index (BMI) changes modify the association between kidney donation and incident hypertension. Summary Background Data: Obesity increases hypertension risk in both general and living kidney donor (LKD) populations. Donation-attributable risk in the context of obesity, and whether weight change modifies that risk, is unknown. Methods: Nested case-control study
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Impact of Axillary Lymph Node Dissection and Sentinel Lymph Node Biopsy on Upper Limb Morbidity in Breast Cancer Patients: A Systematic Review and Meta-Analysis Ann. Surg. (IF 13.787) Pub Date : 2022-08-10 Nur Amalina Che Bakri, Richard M. Kwasnicki, Naairah Khan, Omar Ghandour, Alice Lee, Yasmin Grant, Aleksander Dawidziuk, Ara Darzi, Hutan Ashrafian, Daniel R. Leff
Objective: To evaluate the impact of ALND and SLNB on upper limb (UL) morbidity in breast cancer patients. Summary Background: Axillary de-escalation is motivated by a desire to reduce harm of ALND. Understanding the impact of axillary surgery and disparities in operative procedures on post-operative arm morbidity would better direct resources to the point of need and cement the need for de-escalation
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Early Recurrence After Resection of Locally Advanced Pancreatic Cancer Following Induction Therapy: An International Multicenter Study. Ann. Surg. (IF 13.787) Pub Date : 2022-08-11 Leonard W F Seelen, A Floortje van Oosten, Lilly J H Brada, Vincent P Groot, Lois A Daamen, Marieke S Walma, Bastiaan F van der Lek, Mike S L Liem, Gijs A Patijn, Martijn W J Stommel, Ronald M van Dam, Bas Groot Koerkamp, Olivier R Busch, Ignace H J T de Hingh, Casper H J van Eijck, Marc G Besselink, Richard A Burkhart, Inne H M Borel Rinkes, Christopher L Wolfgang, I Quintus Molenaar, Jin He, Hjalmar
To establish an evidence-based cut-off and predictors for early recurrence in patients with resected locally advanced pancreatic cancer (LAPC).
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Racial and Ethnic Differences in Elective vs. Emergency Surgery for Colorectal Cancer. Ann. Surg. (IF 13.787) Pub Date : 2022-08-11 Ryan Howard, Samantha Hendren, Minal Patel, Vidhya Gunaseelan, Matthew Wixson, Jennifer Waljee, Michael Englesbe, Mark C Bicket
To evaluate differences in presentation and outcomes of surgery for colorectal cancer.
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Segmental vs. Diffuse Main Duct Intraductal Papillary Mucinous Neoplasm: Examination of Main Pancreatic Duct Morphology and Implications for Malignancy Risk and Extent of Surgical Resection. Ann. Surg. (IF 13.787) Pub Date : 2022-08-11 Brett L Ecker, Shannan M Dickinson, Lily V Saadat, Alice J Tao, Alessandra Puliverenti, Vinod P Balachandran, Michael I D'Angelica, Jeffrey A Drebin, T Peter Kingham, William R Jarnagin, Alice C Wei, Mithat Gonen, Kevin C Soares
To determine whether the morphologic features of the main pancreatic duct (MPD) of main-duct-involved-IPMN (i.e., Main duct or mixed main duct/side branch) have implications for risk of malignancy and extent of resection.
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How's the Water? Assessing the Culture of Academic Medicine. Ann. Surg. (IF 13.787) Pub Date : 2022-08-10 Defne Altan,Gregory A Leya,Keith D Lillemoe,Thoralf M Sundt,David C Chang
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If Aristotle were a Surgeon Phronetic Knowledge in Surgery. Ann. Surg. (IF 13.787) Pub Date : 2022-08-09 Jonathan D D'Angelo,David A Cook,Anne-Lise D D'Angelo
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To Wait or Not to Wait? Covid-19 Vaccination Mitigates Adverse Surgical Outcomes. Ann. Surg. (IF 13.787) Pub Date : 2022-08-09 Ioana Baiu,Mary Hawn
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Re-Aiming Equity Evaluation in Clinical Decision Support: A Scoping Review of Equity Assessments in Surgical Decision Support Systems. Ann. Surg. (IF 13.787) Pub Date : 2022-08-09 Nicholas E Ingraham, Emma K Jones, Samantha King, James Dries, Michael Phillips, Tyler Loftus, Heather L Evans, Genevieve B Melton, Christopher J Tignanelli
Clinical decision support (CDS) systems are increasingly used to facilitate surgical care delivery. Despite formal recommendations to do so, equity evaluations are not routinely performed on CDS systems and underrepresented populations are at risk of harm and further health disparities. We explored surgical literature to determine frequency and rigor of CDS equity assessments and offer recommendations
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Incidence and Relative Burden of Surgical Site Infections in Children Undergoing Non-Emergent Surgery: Implications for Performance Benchmarking and Prioritization of Prevention Efforts. Ann. Surg. (IF 13.787) Pub Date : 2022-08-09 Katherine He, Marie Iwaniuk, Michael J Goretsky, Robert A Cina, Jacqueline M Saito, Bruce Hall, Catherine Grant, Mark E Cohen, Jason Newland, Matthew Hall, Clifford Y Ko, Shawn J Rangel
To establish surgical site infection (SSI) performance benchmarks in pediatric surgery and to develop a prioritization framework for SSI prevention based on procedure-level SSI burden.
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Variation in Complications and Mortality According to Infant Diagnosis. Ann. Surg. (IF 13.787) Pub Date : 2022-08-09 Steven C Mehl, Jorge I Portuondo, Sara C Fallon, Sohail R Shah, David E Wesson, Adam M Vogel, Alice King, Monica E Lopez, Nader N Massarweh
Investigate patterns of infant perioperative mortality, describe the infant diagnoses with the highest mortality burden, and evaluate the association between types of postoperative complications and mortality in infants.
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Poorly Cohesive Gastric Cancers Showing the Transcriptomic Hallmarks of Epithelial-Mesenchymal Transition Behave Aggressively Ann. Surg. (IF 13.787) Pub Date : 2022-08-05 Maria Bencivenga, Michele Simbolo, Chiara Ciaparrone, Caterina Vicentini, Lorena Torroni, Maria Liliana Piredda, Michele Sacco, Mariella Alloggio, Claudia Castelli, Anna Tomezzoli, Aldo Scarpa, Giovanni De Manzoni
Hypothesis: Poorly cohesive (PC) gastric cancer (GC) exhibits variable clinical behaviour, being extremely aggressive in most cases but more indolent at times. We hypothesized that the integrative genomic and gene expression characterization of a PC GC series could help identifying molecular subtypes with potential clinical implications. Methods: 64 PC GCs were assessed for alterations in 409 genes
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Long-term Oncological Outcomes after Colorectal Anastomotic Leakage; A Retrospective Dutch Population Based Study Ann. Surg. (IF 13.787) Pub Date : 2022-08-05 Melissa N.N. Arron, Nynke G. Greijdanus, Sarah Bastiaans, Pauline A.J. Vissers, Rob H.A. Verhoeven, Richard P.G. ten Broek, Henk M.W. Verheul, Pieter J. Tanis, Harry van Goor, Johannes H.W. de Wilt
Objective: To evaluate the impact of anastomotic leak (AL) after colon cancer (CC) and rectal cancer (RC) surgery on 5-year relative survival, disease-free survival and disease recurrence. Background: AL after CC and RC resection is a severe postoperative complication with conflicting evidence whether it deteriorates long-term outcomes. Methods: Patients with stage I-IV CC and RC who underwent resection
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A Single-Center Prospective Observational Study Investigating the Accuracy of Preoperative Diagnostic Procedures in the Assessment of Lymph Node Metastases in Nonfunctioning Pancreatic Neuroendocrine Tumors Ann. Surg. (IF 13.787) Pub Date : 2022-08-05 Stefano Partelli, Francesca Muffatti, Valentina Andreasi, Fabio Giannone, Gemma Rossi, Diego Palumbo, Paola Mapelli, Marco Schiavo Lena, Paolo Giorgio Arcidiacono, Francesco De Cobelli, Maria Picchio, Claudio Doglioni, Massimo Falconi
Objective: To determine the accuracy of preoperative imaging, including contrast-enhanced computed tomography (CE-CT), endoscopic ultrasound (EUS) and 68Gallium-DOTATOC positron emission tomography (68Ga-DOTATOC PET), in identifying nodal metastases (N+) in sporadic nonfunctioning pancreatic neuroendocrine tumors (NF-PanNETs). Summary Background Data: An accurate preoperative identification of N+
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Multicenter Study to Evaluate Endovascular Repair of Extent I-III Thoracoabdominal Aneurysms Without Prophylactic Cerebrospinal Fluid Drainage Ann. Surg. (IF 13.787) Pub Date : 2022-08-04 Giulianna B. Marcondes, Nolan C. Cirillo-Penn, Emanuel R. Tenorio, Donald J. Adam, Carlos Timaran, Martin J. Austermann, Luca Bertoglio, Tomasz Jakimowicz, Michele Piazza, Maciej T. Juszczak, Carla K. Scott, Bärbel Berekoven, Roberto Chiesa, Guilherme B.B. Lima, Katarzyna Jama, Francesco Squizzato, Martin Claridge, Bernardo C. Mendes, Gustavo S. Oderich, the Trans-Atlantic Aortic Research Consortium
Objective: To assess outcomes of fenestrated-branched endovascular aortic repair (FB-EVAR) of Extent I-III thoracoabdominal aortic aneurysms (TAAAs) without prophylactic cerebrospinal fluid drainage (CSFD). Background: Prophylactic CSFD has been routinely used during endovascular TAAA repair, but concerns about major drain-related complications gave led to revising this paradigm. Methods: We reviewed
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The Diagnostic Efficacy of an App-based Diagnostic Health Care Application in the Emergency Room: eRadaR-Trial. A prospective, Double-blinded, Observational Study Ann. Surg. (IF 13.787) Pub Date : 2022-08-04 Sara F. Faqar-Uz-Zaman, Luxia Anantharajah, Philipp Baumartz, Paula Sobotta, Natalie Filmann, Dora Zmuc, Michael von Wagner, Charlotte Detemble, Svenja Sliwinski, Ursula Marschall, Wolf O. Bechstein, Andreas A. Schnitzbauer
Objective: To evaluate the diagnostic accuracy of the app-based diagnostic tool Ada and the impact on patient outcome in the emergency room (ER). Background: Artificial intelligence (AI)-based diagnostic tools can improve targeted processes in healthcare delivery by integrating patient information with a medical knowledge base and a machine learning system, providing clinicians with differential
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Ex Vivo Liver Resection and Autotransplantation – Should It be Used more Frequently? Ann. Surg. (IF 13.787) Pub Date : 2022-08-03 Joshua Weiner, Alan Hemming, David Levi, Thiago Beduschi, Rei Matsumoto, Abhishek Mathur, Peter Liou, Adam Griesemer, Benjamin Samstein, Daniel Cherqui, Jean Emond, Tomoaki Kato
Objective: We herein advocate for more extensive utilization of ex vivo resection techniques for otherwise unresectable liver tumors by presenting the largest collective American experience. Summary Background Data: Advanced in situ resection and vascular reconstruction techniques have made R0 resection possible for otherwise unresectable liver tumors. Ex vivo liver resection may further expand the
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Proteomic Profiling of Hypoplastic Lungs Suggests an Underlying Inflammatory Response in the Pathogenesis of Abnormal Lung Development in Congenital Diaphragmatic Hernia Ann. Surg. (IF 13.787) Pub Date : 2022-08-03 Richard Wagner, Paula Lieckfeldt, Hadeesha Piyadasa, Moritz Markel, Jan Riedel, Camelia Stefanovici, Nicole Peukert, Daywin Patel, Gabrielle Derraugh, Suyin Lum Min, Jan-Hendrik Gosemann, Jan Deprest, Christopher D. Pascoe, Andrew Tse, Martin Lacher, Neeloffer Mookherjee, Richard Keijzer
The pathogenesis of lung hypoplasia in congenital diaphragmatic hernia (CDH), a common birth defect, is poorly understood. The diaphragmatic defect can be repaired surgically, but the abnormal lung development contributes to a high mortality in these patients. To understand the underlying pathobiology, we compared the proteomic profiles of fetal rat lungs at the alveolar stage (E21) that were either
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Trends in Surgical Technique and Outcomes of Ventral Hernia Repair in the United States Ann. Surg. (IF 13.787) Pub Date : 2022-08-03 Ryan Howard, Jyothi Thumma, Anne Ehlers, Michael Englesbe, Justin Dimick, Dana Telem
Objective: To describe national trends in surgical technique and rates of reoperation for recurrence for patients undergoing ventral hernia repair (VHR) in the United States. Summary Background Data: Surgical options for VHR, including minimally invasive approaches, mesh implantation, and myofascial release, have expanded considerably over the past two decades. Their dissemination and impact on population-level
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Explainable Machine Learning to Bring Database to the Bedside: Development and Validation of the TROUT (Trauma fRailty OUTcomes) Index, a Point-of-Care Tool to Prognosticate Outcomes after Traumatic Injury based on Frailty Ann. Surg. (IF 13.787) Pub Date : 2022-08-03 Jeff Choi, Taylor Anderson, Lakshika Tennakoon, David A. Spain, Joseph D. Forrester
Objective: Exemplify an explainable machine learning framework to bring database to the bedside; develop and validate a point-of-care frailty assessment tool to prognosticate outcomes after injury. Summary Background Data: A geriatric trauma frailty index that captures only baseline conditions, is readily-implementable, and validated nationwide remains underexplored. We hypothesized Trauma fRailty
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“Failure to Rescue” following Colorectal Cancer Resection: Variation and Improvements in a National Study of Postoperative Mortality: Reducing Mortality after Colorectal Surgery Ann. Surg. (IF 13.787) Pub Date : 2022-08-03 Cameron I. Wells, Chris Varghese, Luke J. Boyle, Matthew J. McGuinness, Celia Keane, Greg O’Grady, Jason Gurney, Jonathan Koea, Chris Harmston, Ian P. Bissett
Objective: To examine variation in “failure to rescue” (FTR) as a driver of differences in mortality between centres and over time for patients undergoing colorectal cancer surgery. Background: Wide variation exists in postoperative mortality following colorectal cancer surgery. FTR has been identified as an important determinant of variation in postoperative outcomes. We hypothesized that differences
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Transanal vs Laparoscopic TME--all that Glitters is not Gold. Ann. Surg. (IF 13.787) Pub Date : 2022-08-02 Montserrat Guraieb-Trueba,George J Chang
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A Breakthrough Improvement Collaborative Significantly Reduces Hospital Stay after Elective Colectomy for Cancer Across a Healthcare System Ann. Surg. (IF 13.787) Pub Date : 2022-08-02 Ellen Coeckelberghs, Kris Vanhaecht, Deborah Seys, Bianca Cox, Gabriele Bislenghi, Albert M. Wolthuis, André D’Hoore, On behalf of BIC4CRC research group
Objective: This multicenter study aimed to assess (1) the effect of an improvement collaborative on enhanced recovery after surgery (ERAS) protocol adherence after elective colectomy and (2) the association between adherence and patient outcomes. Summary Background Data: ERAS pathways provide a framework to standardize care processes and improve postoperative outcomes in patients after colon surgery
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A Gene Expression Signature to Select Hepatocellular Carcinoma Patients for Liver Transplantation Ann. Surg. (IF 13.787) Pub Date : 2022-08-01 Hugo Pinto-Marques, Joana Cardoso, Sílvia Silva, João L. Neto, Maria Gonçalves-Reis, Daniela Proença, Marta Mesquita, André Manso, Sara Carapeta, Mafalda Sobral, Antonio Figueiredo, Clara Rodrigues, Adelaide Milheiro, Ana Carvalho, Rui Perdigoto, Eduardo Barroso, José B. Pereira-Leal
Objective: To propose a new decision algorithm combining biomarkers measured in a tumor biopsy with clinical variables, to predict recurrence after liver transplantation (LT). Summary Background Data: Liver cancer is one of the most frequent causes of cancer-related mortality. LT is the best treatment for hepatocellular carcinoma (HCC) patients but the scarcity of organs makes patient selection a
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Preoperative Cognitive Impairment and Postoperative Delirium in Elderly Surgical Patients – a Retrospective Large Cohort Study Ann. Surg. (IF 13.787) Pub Date : 2022-08-01 Yotam Weiss, Lilach Zac, Einat Refaeli, Shimon Ben-Yishai, Alexander Zegerman, Barak Cohen, Idit Matot
Objective: To test the hypothesis that in surgical patients ≥70 years, preoperative cognitive impairment is independently associated with postoperative delirium. Background: Postoperative delirium is common among elderly surgical patients and is associated with longer hospitalization and significant morbidity. Some evidence suggest that baseline cognitive impairment is an important risk factor. Routine
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Surgeons’ Leadership Style and Team Behavior in the Hybrid Operating Room: Prospective Cohort Study Ann. Surg. (IF 13.787) Pub Date : 2022-07-29 Gilles Soenens, Benoit Marchand, Bart Doyen, Teodor Grantcharov, Isabelle Van Herzeele, Peter Vlerick
Objective: This study aimed to assess the relationship between surgeons’ leadership style and team behavior in the hybrid operating room through video coding. Secondly, possible fluctuations in leadership styles and team behavior during operative phases were studied. Summary/Background-Data: Leadership is recognized as a key component to successful team functioning in high-risk industries. The ‘full
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The Role of Pelvic Floor Muscle Training on Low Anterior Resection Syndrome A Multicenter Randomized Controlled Trial. Ann. Surg. (IF 13.787) Pub Date : 2022-07-27 Anne Asnong, André D'Hoore, Marijke Van Kampen, Albert Wolthuis, Yves Van Molhem, Bart Van Geluwe, Nele Devoogdt, An De Groef, Ipek Guler Caamano Fajardo, Inge Geraerts
Total mesorectal excision (TME) for rectal cancer (RC) often results in significant bowel symptoms, commonly known as Low Anterior Resection Syndrome (LARS). Although pelvic floor muscle training (PFMT) is recommended in non-cancer populations for treating bowel symptoms, this has been scarcely investigated in RC-patients. The objective was to investigate PFMT-effectiveness on LARS in patients after
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Sex Disparities in Outcomes following Major Liver Surgery - New Powers of Estrogen? Ann. Surg. (IF 13.787) Pub Date : 2022-07-27 Dominique L Birrer, Michael Linecker, Víctor López-López, Roberto Brusadin, Álvaro Navarro-Barrios, Tim Reese, Sahar Arbabzadah, Deniz Balci, Massimo Malago, Marcel A Machado, Victoria Ardiles, Olivier Soubrane, Roberto Hernandez-Alejandro, Eduardo de Santibañes, Karl Oldhafer, Irinel Popescu, Bostjan Humar, Pierre-Alain Clavien, Ricardo Robles-Campos
To explore potential sex differences in outcomes and regenerative parameters post major hepatectomies.
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Living Donor Liver Transplantation with Augmented Venous Outflow and Splenectomy: A Promised Land for Small Left Lobe Grafts. Ann. Surg. (IF 13.787) Pub Date : 2022-07-27 Masato Fujiki, Koji Hashimoto, Cristiano Quintini, Federico Aucejo, Choon Hyuck David Kwon, Hajime Matsushima, Kazunari Sasaki, Luis Campos, Bijan Eghtesad, Teresa Diago, Giuseppe Iuppa, Giuseppe D'amico, Siva Kumar, Peter Liu, Charles Miller, Antonio Pinna
Living donor liver transplantation (LDLT) using small grafts, especially left-lobe grafts (LLG), continues to be a challenge due to small-for-size syndrome (SFSS). We herein demonstrate that with surgical modifications, outcomes with small grafts can be improved.
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Sentinel Lymph Node Mapping in Breast Cancer Patients through Fluorescent Imaging using Indocyanine Green - the INFLUENCE trial. Ann. Surg. (IF 13.787) Pub Date : 2022-07-27 Claudia A Bargon, Anne Huibers, Danny A Young-Afat, Britt A M Jansen, Jules Lavalaye, Henk-Jan van Slooten, Helena M Verkooijen, Christiaan F P van Swol, Annemiek Doeksen
To compare the (sentinel) lymph node detection rate of ICG-fluorescent imaging versus standard-of-care 99mTc-nanocoilloid for sentinel lymph node (SLN)-mapping.
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Liver Transplantation as a New Standard of Care in Patients with Perihilar Cholangiocarcinoma? Results from an International Benchmark Study. Ann. Surg. (IF 13.787) Pub Date : 2022-07-27 Eva Breuer, Matteo Mueller, Majella B Doyle, Liu Yang, Sarwa Darwish Murad, Imran J Anwar, Shaheed Merani, Ashley Limkemann, Heithem Jeddou, Steven C Kim, Victor López-López, Ahmed Nassar, Frederik J H Hoogwater, Eric Vibert, Michelle L De Oliveira, Daniel Cherqui, Robert J Porte, Joseph F Magliocca, Lutz Fischer, Constantino Fondevila, Krzysztof Zieniewicz, Pablo Ramírez, David P Foley, Karim Boudjema
To define benchmark values for liver transplantation (LT) in patients with perihilar cholangiocarcinoma (PHC) enabling unbiased comparisons.
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Novel Benchmark Values for Redo Liver Transplantation. Does the Outcome Justify the Effort? Ann. Surg. (IF 13.787) Pub Date : 2022-07-27 Fariba Abbassi, Daniel Gero, Xavier Muller, Alba Bueno, Wojciech Figiel, Fabien Robin, Sophie Laroche, Benjamin Picard, Sadhana Shankar, Tommy Ivanics, Marjolein van Reeven, Otto B van Leeuwen, Hillary J Braun, Diethard Monbaliu, Antoine Breton, Neeta Vachharajani, Eliano Bonaccorsi Riani, Greg Nowak, Robert R McMillan, Samir Abu-Gazala, Amit Nair, Rocio Bruballa, Flavio Paterno, Deborah Weppler Sears
To define benchmark cutoffs for redo liver transplantation (redo-LT).
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Assessing Outcomes after Adrenalectomy for Primary Aldosteronism - Early is Accurate: Retrospective Cohort Study. Ann. Surg. (IF 13.787) Pub Date : 2022-07-27 Diederik P D Suurd, Wessel M C M Vorselaars, Dirk-Jan Van Beek, Inne H M Borel Rinkes, Wilko Spiering, Gerlof D Valk, Menno R Vriens
We aimed to investigate the postoperative trend in blood pressure-related outcomes (blood pressure and antihypertensive drug use) during the year following adrenalectomy for primary aldosteronism (PA) to determine the optimal timing for outcome assessment and to determine the necessary follow-up length.
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Identification of an EMT-related Gene Signature Predicting Recurrence in Stage II/III Colorectal Cancer - A Retrospective Study in 1780 Patients. Ann. Surg. (IF 13.787) Pub Date : 2022-07-26 Florian Bösch, Haoyu Ren, Elise Pretzsch, Sven Jacob, C Benedikt Westphalen, Julian Holch, Jens Werner, Martin K Angele
To identify a prognostic significant gene signature for predicting colorectal cancer (CRC) recurrence.
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Recurrent Disease after Esophageal Cancer Surgery: A Substudy of The Dutch Nationwide Ivory Study. Ann. Surg. (IF 13.787) Pub Date : 2022-07-26 Marianne C Kalff, Sofie P G Henckens, Daan M Voeten, David J Heineman, Maarten C C M Hulshof, Hanneke W M van Laarhoven, Wietse J Eshuis, Peter C Baas, Renu R Bahadoer, Eric J T Belt, Baukje Brattinga, Linda Claassen, Admira Ćosović, David Crull, Freek Daams, Annette D van Dalsen, Jan Willem T Dekker, Marc J van Det, Manon Drost, Peter van Duijvendijk, Stijn van Esser, Marcia P Gaspersz, Burak Görgec
This study investigated the patterns, predictors and survival of recurrent disease following esophageal cancer surgery.
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Gastric Bypass Resolves Metabolic Dysfunction-associated Fatty Liver Disease (MAFLD) in low-BMI Patients: A Prospective Cohort Study. Ann. Surg. (IF 13.787) Pub Date : 2022-07-26 Adrian T Billeter, Katharina M Scheurlen, Barbara Israel, Beate B Straub, Peter Schirmacher, Stefan Kopf, Peter P Nawroth, Beat P Müller-Stich
Metabolic dysfunction-associated fatty liver disease (MAFLD) reflects the multifactorial pathogenesis of fatty liver disease in metabolically sick patients. The effects of metabolic surgery on MAFLD have not been investigated. This study assesses the impact of Roux-en-Y gastric bypass (RYGB) on MAFLD in a prototypical cohort outside the guidelines for obesity surgery.
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Polygenic Risk Prediction in Diverticulitis. Ann. Surg. (IF 13.787) Pub Date : 2022-07-25 Ana C De Roo, Yanhua Chen, Xiaomeng Du, Samuel Handelman, Mary Byrnes, Scott E Regenbogen, Elizabeth K Speliotes, Lillias H Maguire
To derive and validate a polygenic risk score (PRS) to predict the occurrence and severity of diverticulitis and to understand the potential for incorporation of a PRS in current decision-making.
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Evaluating the Role of Circulating MicroRNAs to Aid Therapeutic Decision Making for Neoadjuvant Chemotherapy in Breast Cancer - A Prospective, Multicenter Clinical Trial. Ann. Surg. (IF 13.787) Pub Date : 2022-07-25 Matthew G Davey, Maire Caitlin Casey, Andrew McGuire, Ronan M Waldron, Maxwell Paganga, Emma Holian, John Newell, Helen M Heneghan, Ailbhe M McDermott, Maccon M Keane, Aoife J Lowery, Nicola Miller, Michael J Kerin
To evaluate whether circulating miRNAs predict response to neoadjuvant chemotherapy (NAC) and inform decision-making in breast cancer patients.
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Postoperative Serum Hyperamylasemia (POH) Adds Sequential Value to the Fistula Risk Score (FRS) in Predicting Pancreatic Fistula after Pancreatoduodenectomy. Ann. Surg. (IF 13.787) Pub Date : 2022-07-25 Elisa Bannone, Giovanni Marchegiani, Charles Vollmer, Giampaolo Perri, Giuseppa Procida, Gaetano Corvino, Sara Peressotti, Pier Giuseppe Vacca, Roberto Salvia, Claudio Bassi
To evaluate whether postoperative serum hyperamylasemia (POH), with drain fluid amylase (DFA) and C-reactive protein (CRP), improves the Fistula Risk Score (FRS) accuracy in assessing the risk of a postoperative pancreatic fistula (POPF).
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CROSS Versus FLOT Regimens in Esophageal and Esophagogastric Junction Adenocarcinoma: A Propensity-matched Comparison. Ann. Surg. (IF 13.787) Pub Date : 2022-07-25 Noel E Donlon, Brendan Moran, Anitha Kamilli, Maria Davern, Andrew Sheppard, Sinead King, Claire L Donohoe, Maeve Lowery, Moya Cunningham, Narayanasamy Ravi, Carmen Mueller, Jonathan Cools-Lartigue, Lorenzo Ferri, John V Reynolds
The FLOT protocol and the CROSS tri-modality regimen represent current standards in the management of locally advanced esophageal adenocarcinoma (EAC). In the absence of published RCT data, this propensity-matched comparison evaluated tolerance, toxicity, impact on sarcopenia and pulmonary physiology, operative complications, and oncologic metrics.
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A Novel Tumor Staging System Incorporating Tumor Regression Grade (TRG) with Lymph Node Status (ypN-category) Results in Better Prognostication than ypTNM Stage Groups after Neoadjuvant Therapy for Esophageal Squamous Cell Carcinoma. Ann. Surg. (IF 13.787) Pub Date : 2022-07-25 Ian Y H Wong, Jason C Y Chung, Rui Qi Zhang, X Gao, K O Lam, Dora L W Kwong, Y K Chao, Simon Y K Law
This study aims at constructing a staging system incorporating tumor regression grade and ypN-category (TRG-N) in patients with neoadjuvant therapy before esophagectomy. It is hypothesized that this would prognosticate better than the current AJCC post neoadjuvant therapy (ypTNM) stage groups.
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Effect of the Use of Reinforced Stapling on the Occurrence of Pancreatic Fistula after Distal Pancreatectomy: Results of the REPLAY Multicenter Randomized clinical trial REPLAY: REinforcement of the Pancreas in distaL pAncreatectomY. Ann. Surg. (IF 13.787) Pub Date : 2022-07-25 Aude Merdrignac, Jonathan Garnier, Safi Dokmak, Nicolas Regenet, Mickaël Lesurtel, Jean Yves Mabrut, Antonio Sa Cunha, David Fuks, Damien Bergeat, Fabien Robin, Estelle Le Pabic, Karim Boudjema, Olivier Turrini, Bruno Laviolle, Laurent Sulpice
The aim of the study was to evaluate the impact of the use of a reinforced stapler (RS) during distal pancreatectomy on postoperative outcomes.
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Outcome of Pancreatic Surgery During the First Six Years of a Mandatory Audit within the Dutch Pancreatic Cancer Group. Ann. Surg. (IF 13.787) Pub Date : 2022-07-22 J Annelie Suurmeijer, Anne Claire Henry, Bert A Bonsing, Koop Bosscha, Ronald M van Dam, Casper H van Eijck, Michael F Gerhards, Erwin van der Harst, Ignace H de Hingh, Martijn P Intven, Geert Kazemier, Johanna W Wilmink, Daan J Lips, Fennie Wit, Vincent E de Meijer, I Quintus Molenaar, Gijs A Patijn, George P van der Schelling, Martijn W J Stommel, Olivier R Busch, Bas Groot Koerkamp, Hjalmar C van
To describe outcome after pancreatic surgery in the first six years of a mandatory nationwide audit.
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Perforation and Fistula of the Gastrointestinal Tract in Patients with Necrotizing Pancreatitis: a Nationwide Prospective Cohort. Ann. Surg. (IF 13.787) Pub Date : 2022-07-22 Hester C Timmerhuis, Sven M van Dijk, Robert A Hollemans, Devica S Umans, Christina J Sperna Weiland, Marc G Besselink, Stefan A W Bouwense, Marco J Bruno, Peter van Duijvendijk, Casper H J van Eijck, Yama Issa, Sven Mieog, I Quintus Molenaar, Martijn W J Stommel, Thomas L Bollen, Rogier P Voermans, Robert C Verdonk, Hjalmar C van Santvoort
The aim of this study was to explore the incidence, risk factors, clinical course and treatment of perforation and fistula of the gastrointestinal tract in a large unselected cohort of patients with necrotizing pancreatitis.
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Retrospective Analysis of Retroperitoneal-Abdominal-Pelvic Ganglioneuromas: An International Study by the Transatlantic Australasian Retroperitoneal Sarcoma Working Group. Ann. Surg. (IF 13.787) Pub Date : 2022-07-22 Sangkyu Noh, Carolyn Nessim, Emily Z Keung, Christina L Roland, Dirk Strauss, Gausihi Sivarajah, Marco Fiore, Davide Biasoni, Stefano Piero Bernardo Cioffi, Winta Mehtsun, Ferdinando Carlo Maria Cananzi, Federico Sicoli, Vittorio Quagliuolo, Jun Chen, Chenghua Luo, Rebecca A Gladdy, Carol Swallow, Wendy Johnston, Samuel J Ford, Caroline Evenden, Fabio Tirotta, Max Almond, Laura Nguyen, Piotr Rutkowski
The Transatlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG) conducted a retrospective study on the disease course and clinical management of ganglioneuromas.
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Alternative Randomized Trial Designs in Surgery: Systematic Review. Ann. Surg. (IF 13.787) Pub Date : 2022-07-22 Simone Augustinus, Iris W J M van Goor, Johannes Berkhof, Lois A Daamen, Bas Groot Koerkamp, Tara M Mackay, I Quintus Molenaar, Hjalmar C van Santvoort, Helena M Verkooijen, Peter M van de Ven, Marc G Besselink
Randomized controlled trials (RCTs) yield the highest level of evidence but are notoriously difficult to perform in surgery. Surgical RCTs may be hampered by slow accrual, the surgical learning curve, and lack of financial support. Alternative RCT designs such as stepped-wedge RCTs (SW-RCTs), registry-based RCTs (RB-RCTs), and trials-within-cohorts (TwiCs) may overcome several of these difficulties
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Follow-up Schedule for Patients with Sentinel Node Negative Cutaneous Melanoma: an International Phase III Randomised Clinical Trial. Ann. Surg. (IF 13.787) Pub Date : 2022-07-22 Marc D Moncrieff, Esther Bastiaannet, Beverly Underwood, Anne Brecht Francken, Jennifer Garioch, Samantha Damude, Martin Heaton, Eric Deckers, Nakul Patel, Josette Hoekstra-Weebers, Harald Hoekstra
The MELFO (MELanoma FOllow-up) study is an international phase III RCT comparing an experimental low-intensity schedule against current national guidelines.
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Ten-year Survival and Recurrence Patterns after Three-field Lymph Node Dissection for Squamous Cell and Adenocarcinoma of the Esophagus. Ann. Surg. (IF 13.787) Pub Date : 2022-07-22 Nasser Altorki, Nathan Mynard, Abu Nasar, Cathy Spinelli, Jonathan Villena-Vargas, Oliver Chow, Benjamin Lee, Sebron Harrison, Jeffrey Port
To determine the prevalence of metastases to the cervical and recurrent laryngeal cervicothoracic (CT) nodes as well as survival and recurrence patterns after esophagectomy with three-field lymph node dissection (TFD) in patients with predominately adenocarcinoma (AC) of the esophagus.
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Machine Learning Risk Prediction Model of 90-day Mortality after Gastrectomy for Cancer. Ann. Surg. (IF 13.787) Pub Date : 2022-07-22 Manuel Pera, Joan Gibert, Marta Gimeno, Elisenda Garsot, Emma Eizaguirre, Mónica Miró, Sandra Castro, Coro Miranda, Lorena Reka, Saioa Leturio, Marta González-Duaigües, Clara Codony, Yanina Gobbini, Alexis Luna, Sonia Fernández, Aingeru Sarriugarte, Carles Olona, Joaquín Rodríguez-Santiago, Javier Osorio, Luis Grande
To develop and validate a risk prediction model of 90-day mortality (90DM) using machine learning in a large multicenter cohort of patients undergoing gastric cancer resection with curative intent.
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So, you want to be a Surgeon? 2022 ESA Presidential Lecture. Ann. Surg. (IF 13.787) Pub Date : 2022-07-21 P Ronan O'Connell
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Robotic Distal Pancreatectomy, a Novel Standard of Care? Benchmark Values for Surgical Outcomes from 16 International Expert Centers. Ann. Surg. (IF 13.787) Pub Date : 2022-07-21 Philip C Müller, Eva Breuer, Felix Nickel, Sabino Zani, Emanuele Kauffmann, Lorenzo De Franco, Christoph Tschuor, Paul Suno Krohn, Stefan K Burgdorf, Jan Philipp Jonas, Christian E Oberkofler, Henrik Petrowsky, Olivier Saint-Marc, Leonard Seelen, Izaak Quintus Molenaar, Ulrich Wellner, Tobias Keck, Andrea Coratti, Coen van Dam, Roeland de Wilde, Bas Groot Koerkamp, Valentina Valle, Pier Giulianotti
Robotic distal pancreatectomy (DP) is an emerging attractive approach, but its role compared to laparoscopic or open surgery remains unclear. Benchmark values are novel and objective tools for such comparisons. The aim of this study was to identify benchmark cutoffs for many outcome parameters for DP with or without splenectomy beyond the learning curve.
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High Dimensional Multi-omics Reveals Unique Characteristics of Early Plasma Administration in Polytrauma Patients with TBI. Ann. Surg. (IF 13.787) Pub Date : 2022-07-21 Junru Wu, Hamed Moheimani, Shimena Li, Upendra K Kar, Jillian Bonaroti, Richard S Miller, Brian J Daley, Brian G Harbrecht, Jeffrey A Claridge, Danielle S Gruen, Herbert A Phelan, Francis X Guyette, Matthew D Neal, Jishnu Das, Jason L Sperry, Timothy R Billiar
We sought to identify causal factors that explain the selective benefit of pre-hospital administration of thawed plasma (TP) in traumatic brain injury (TBI) patients using mediation analysis of a multi-omic database.
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Do Individual Surgeon Preferences Affect Procedural Outcomes? Ann. Surg. (IF 13.787) Pub Date : 2022-07-21 Hossein Mohamadipanah, Calvin A Perumalla, LaDonna E Kearse, Su Yang, Brett J Wise, Cassidi K Goll, Anna K Witt, James R Korndorffer, Carla M Pugh
Surgeon preferences such as instrument and suture selection and idiosyncratic approaches to individual procedure steps have been largely viewed as minor differences in the surgical workflow. We hypothesized that idiosyncratic approaches could be quantified and shown to have measurable effects on procedural outcomes.
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Salvage of Declined Extended Criteria DCD Livers Using in-situ Normothermic Regional Perfusion. Ann. Surg. (IF 13.787) Pub Date : 2022-07-21 Ivo J Schurink, Femke H C de Goeij, Lex J M Habets, Fenna E M van de Leemkolk, Christian A A van Dun, Gabriel C Oniscu, Ian P J Alwayn, Wojciech G Polak, Volkert A L Huurman, Jeroen de Jonge
This study investigates whether liver grafts donated after circulatory death (DCD) that are declined by the entire Euro-transplant region can be salvaged with abdominal normothermic regional perfusion (aNRP).
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Towards a Virtual «Global Academia of Surgeons». Ann. Surg. (IF 13.787) Pub Date : 2022-07-21 Karoline Horisberger, Samuela Di Natale, Christian A Gutschow, Pierre-Alain Clavien
To explore the prospects of academic e-learning by evaluating our long-standing internet-based surgical learning program and to assess the impact of training on the presentation skills of our residents. The eventual goal is to search whether such models could be further developed by the ESA.
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Should Cell Salvage be Used in Liver Resection and Transplantation? A Systematic Review and Meta-analysis. Ann. Surg. (IF 13.787) Pub Date : 2022-07-21 Luckshi Rajendran, Tori Lenet, Risa Shorr, Jad Abou Khalil, Kimberly A Bertens, Fady K Balaa, Guillaume Martel
To evaluate the effect of intraoperative blood salvage and autotransfusion (IBSA) use on red blood cell (RBC) transfusion and postoperative outcomes in liver surgery.
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An International Cohort Study of Prognosis Associated with Pathologically Complete Response Following Neoadjuvant Chemotherapy versus Chemoradiotherapy of Surgical Treated Esophageal Adenocarcinoma. Ann. Surg. (IF 13.787) Pub Date : 2022-07-21 Jonathan Cools-Lartigue, Sheraz Markar, Carmen Mueller, Wayne Hofstetter, Magnus Nilsson, Ilkka Ilonen, Henna Soderstrom, Jari Rasanen, Suzanne Gisbertz, George B Hanna, Jessie Elliott, John Reynolds, Aaron Kisiel, Ewen Griffiths, Mark Van Berge Henegouwen, Lorenzo Ferri
To compare overall (OS) and recurrence-free survival (RFS) in esophageal adenocarcinoma patients with a complete pathological response (pCR) following neoadjuvant chemotherapy (nCT) or neoadjuvant chemoradiotherapy (nCRT).