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An Ethical Framework for Cost-Conscious Surgical Practice. Ann. Surg. (IF 7.5) Pub Date : 2025-02-13 Hannah M Phelps,Sean C Wightman,Baddr A Shakhsheer
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MEsh FIxation STudy in Laparoendoscopic Repair of M3 Inguinal Hernias: multicenter, double-blind, randomized controlled trial - MEFISTO Trial. Ann. Surg. (IF 7.5) Pub Date : 2025-02-13 Mateusz Zamkowski,Śmietański Maciej,Franczak Paula,Górski Dominik,Grabias Jacek,Janik Michał,Król Aleksander,Mitura Kryspin,Mędraś Olaf,Nawacki Łukasz,Romańczuk Michał,Rymkiewicz Przemysław,Saluk Sławomir,Sroczyński Przemysław,Sułkowski Leszek,Wieczorek Dominik,Włodarczyk Marcin
OBJECTIVE To evaluate the efficacy of non-fixation versus fixation of meshes in laparoendoscopic repair of M3 inguinal hernias in terms of recurrence, postoperative pain, and surgical complications. SUMMARY BACKGROUND DATA International guidelines recommend mesh fixation for large M3 inguinal hernias during laparoendoscopic repairs due to high recurrence rates. However, emerging experimental and registry
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Influence of the Surgeon's First Operation of the Day on Patient Outcomes. Ann. Surg. (IF 7.5) Pub Date : 2025-02-13 Filippo Dagnino,Tephanie Polazzi,Jean-Christophe Lifante,Tanujit Dey,Antoine Duclos,
OBJECTIVE To investigate whether the cumulative operative time spent by a surgeon operating on patients on the same day prior to starting a new procedure was associated with surgical outcomes. BACKGROUND The impact of daily operating room workload on a surgeon's performance and patient outcomes is uncertain. METHODS All elective patients, operated by attending surgeons across seven specialties in four
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The Role of High-Resolution Manometry Before and Following Antireflux Surgery: The Padova Consensus: Erratum. Ann. Surg. (IF 7.5) Pub Date : 2025-02-12
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The Relevance of Optimal Preoperative Glycemic Control for Outcomes of Patients with Diabetes Undergoing Surgery. Ann. Surg. (IF 7.5) Pub Date : 2025-02-12 Adriana C Panayi,Samuel Knoedler,Michael Alfertshofer,Dany Y Matar,Sarah Friedrich,Jasmin Rühl,Valentin Haug,Emre Gazyakan,Amir Khosrow Bigdeli,Ulrich Kneser,Dennis P Orgill,Gabriel Hundeshagen
OBJECTIVE To investigate the association between glycemic control, measured by glycated hemoglobin (HbA1c) levels, and post-operative complications across various procedures, identify the prevalence of patients with undiagnosed prediabetes or diabetes undergoing surgery, and explore whether better glycemic management is associated with reduced short-term postoperative complications. BACKGROUND The
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Evolving Epidemiology of Increasing Trauma Deaths in the UNITED STATES (2000-2020). Ann. Surg. (IF 7.5) Pub Date : 2025-02-11 Peter Rhee,John B Holcomb,Bardiya Zangbar
BACKGROUND Over the past two decades, the epidemiology of trauma has shifted significantly, driven primarily by demographic changes. Aim of our study was to illustrate the changing landscape of trauma mortality rates and compare them with other leading causes of death. METHODS We performed a cross-sectional study from 2000-2020, using data from the CDC and WISQARS™. Trauma deaths were defined according
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Cost-analysis of Implementing robot-assisted Versus Open Pancreatoduodenectomy. Ann. Surg. (IF 7.5) Pub Date : 2025-02-10 Julia E Menso,Michiel F G Francken,Nine de Graaf,Alessandro M Bonomi,Riccardo Guastella,Dylan Balaban,Mahsoem Ali,H Jaap Bonjer,Susan van Dieren,Marcel G W Dijkgraaf,Jony van Hilst,Gabriela Pilz da Cunha,Joris Erdmann,Geert Kazemier,Rutger-Jan Swijnenburg,Barbara M Zonderhuis,Freek Daams,Sebastiaan Festen,Olivier R Busch,Marc G Besselink,
OBJECTIVE To perform a cost-analysis during the implementation of robot-assisted pancreatoduodenectomy (RPD) in a high-volume center. BACKGROUND Many high-volume centers are implementing RPD as alternative to open pancreatoduodenectomy (OPD) but the persevering concerns about increased costs of RPD versus OPD have not been addressed by large studies. METHODS Post-hoc cost-analysis of consecutive RPD
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Recurrence Following Operative vs. Non-Operative Management of Adhesive Small Bowel Obstruction in Children: A Multi-center Prospective Observational Study. Ann. Surg. (IF 7.5) Pub Date : 2025-02-10 Utsav M Patwardhan,Romeo C Ignacio,Kaci Pickett-Nairne,Katie W Russell,Justin Lee,Ben Padilla,Caroline Melhado,Lorraine I Kelley-Quon,David H Rothstein,Hariharan Thangarajah,Ana Ibarra-Meraz,Rabab M Barq,Kezlyn E Larsen,Kathryn L Fowler,Zebediah Hunteman,Maria Valencia-Bradd,Katrine Lofberg,Aaron Jensen,Samir Pandya,Shannon N Acker,
OBJECTIVE Data on the incidence of recurrent adhesive small bowel obstruction (ASBO) following index admission for ASBO in children are limited. We sought to determine if operative management was associated with a lower rate of recurrence compared to non-operative management (NOM). METHODS We conducted a prospective observational study of children with ASBO admitted to nine hospitals from 10/2020 to
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Predictors of Neurodevelopmental Impairment After Intestinal Resection for Necrotizing Enterocolitis: A Multicenter Retrospective Study. Ann. Surg. (IF 7.5) Pub Date : 2025-02-10 Utsav M Patwardhan,Alex Gonzalez,Insiyah Campwala,Erin E West,Madeline Goldfarb,Daniel B Gehle,Lauren Camp,Krishna Manohar,Brooke E Allen,Mary E Moya-Mendez,Isabel DeLaura,Kathryn Maselli,Grant Gershner,Alena Golubkova,Georgi Mladenov,Amanda Witte,Gabriella Grisotti,Troy A Markel,Rebeccah L Brown,Henry E Rice,Jose H Salazar,Catherine J Hunter,Tim Jancelewicz,Samir Gadepalli,Andrei Radulescu,Paul Waltz
OBJECTIVE The aim of this study was to evaluate pre-resection risk factors for neurodevelopmental impairment (NDI) in infants with necrotizing enterocolitis (NEC) that might better inform the timing of intestinal resection. SUMMARY BACKGROUND DATA Surgical NEC is associated with a 57% risk for NDI. METHODS A retrospective study of patients with NEC who underwent intestinal resection within 10 days
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The Association Between Surgical Margin Status, Recurrence Patterns, and Oncologic Outcomes in Patients with Colorectal Liver Metastases. Ann. Surg. (IF 7.5) Pub Date : 2025-02-10 Thomas Perrin,Sarah M McIntyre,Fiona Ehrich,Jon Heiselman,Eric P van der Stok,Megan Fiasconaro,Mithat Gönen,Jinru Shia,T Peter Kingham,Vinod P Balachandran,Jeffrey A Drebin,Alice C Wei,William R Jarnagin,Michael I D'Angelica
OBJECTIVE To enhance understanding of the relationships between margin width, recurrence patterns, recurrence-free survival, and salvage therapy following initial hepatectomy for colorectal liver metastases (CRLM). BACKGROUND The prognostic implications of the technical aspects of CRLM have not been well-characterized. METHODS A prospective database of 1776 patients who underwent complete resection
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Temporary Portal Vein Bypass for Resection of Pancreatic Neoplasms. Ann. Surg. (IF 7.5) Pub Date : 2025-02-10 Max Heckler,Souhaylah Abdallah,Benedict Kinny-Köster,Christoph Berchtold,Mohammed Al-Saeedi,Arianeb Mehrabi,Thilo Hackert,Ulf Hinz,Thomas Hank,Christoph W Michalski,Markus W Büchler,Martin Loos
OBJECTIVE We analyzed perioperative outcomes of patients undergoing pancreatectomy with portal vein resection for pancreatic cancer using temporary intraoperative mesoportal or mesocaval bypass. SUMMARY BACKGROUND DATA Pancreatectomy for advanced pancreatic cancer with long-segment involvement or complete occlusion of the mesoportal venous axis and cavernous transformation represents a major technical
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Implications of Neoadjuvant Therapy on Prognostic Factors in Pancreatic Ductal Adenocarcinoma: A Path Towards Personalized Prognostication. Ann. Surg. (IF 7.5) Pub Date : 2025-02-07 Ammar A Javed,Joseph R Habib,Paul C M Andel,Brady A Campbell,Ingmar F Rompen,Omar Mahmud,Asad Fatimi,Iris W J M van Goor,Thijs J Schouten,Thomas F Stoop,Camila Hidalgo Salinas,Hjalmar C van Santvoort,Bas Groot Koerkam,I Quintus Molenaar,Christopher L Wolfgang,Marc G Besselink,Jin He,Lois A Daamen,
OBJECTIVE The aim of the study was to investigate prognostic factors in context of neoadjuvant therapy (NAT) and develop tools that can allow for accurate and personalized patient prognostication. SUMMARY OF BACKGROUND DATA NAT might impact the prognostic ability of well-established clinicopathological factors in resected pancreatic ductal adenocarcinoma (PDAC). METHODS Patients after resection for
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ACS NSQIP Surgical Risk Calculator Accuracy When Operative Risk is Represented by the Principal CPT® code Versus Many Codes. Ann. Surg. (IF 7.5) Pub Date : 2025-02-07 Mark E Cohen,Yaoming Liu,Bruce L Hall,Clifford Y Ko
OBJECTIVE To determine whether ACS NSQIP risk calculator (RC) accuracy can be improved by incorporating CPT codes beyond the principal code. BACKGROUND Because of technical limitations, past and current RC algorithms have relied only on the principal CPT code, represented as a logit score, to adjust for procedure-related risk. RC performance was evaluated when using a new machine learning (ML) algorithm
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Effects of Peripheral Nerve Block on Perioperative Recovery Following Major Thoracic and Abdominal Surgery: A Retrospective Cohort Study With Propensity-score Matching. Ann. Surg. (IF 7.5) Pub Date : 2025-02-05 Zhen Zhang,Chen Li,Zhen-Zhen Xu,Jia-Hui Ma,Dong-Xin Wang
OBJECTIVE To test the hypothesis that peripheral nerve block (PNB) use might be associated with improved perioperative outcomes following major surgery. SUMMARY BACKGROUND DATA PNB has been used to improve postoperative analgesia. METHODS This was a retrospective cohort study with propensity score matching. We included patients aged ≥65 years who underwent major (≥2 h) non-cardiac thoracic and abdominal
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Reconsidering Abdominal Drainage After Left Pancreatectomy - The Randomized Controlled PANDRA II Trial. Ann. Surg. (IF 7.5) Pub Date : 2025-02-05 Joerg Kaiser,Willem Niesen,Ulf Hinz,Markus K Diener,Frank Pianka,Rosa Klotz,Oliver Strobel,Arianeb Mehrabi,Christoph Berchtold,Beat Müller,Martin Schneider,Martin Loos,Christoph Michalski,Markus W Büchler,Thilo Hackert,Pascal Probst
OBJECTIVE Intraabdominal drainage following left pancreatectomy (LP) has been a longstanding practice to mitigate postoperative complications, particularly postoperative pancreatic fistulas (POPF). SUMMARY BACKGROUND DATA Recent studies challenge the necessity of routine drainage, suggesting potential benefits in omitting drains. METHODS The PANDRA II trial was a randomized controlled non-inferiority
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Multimodality Therapy Including Pleurectomy/Decortication in Pleural Mesothelioma: Long-Term Outcomes in 152 Consecutive Patients A Retrospective Cohort Study. Ann. Surg. (IF 7.5) Pub Date : 2025-02-05 Loïc Lang-Lazdunski,Yu Zhi Zhang,Andrew G Nicholson
OBJECTIVE Evaluate the long-term outcomes of pleurectomy decortication, systemic chemotherapy and prophylactic radiotherapy in pleural mesothelioma (PM). SUMMARY BACKGROUND DATA There is no known cure for PM and cytoreductive surgery remains controversial. METHODS Retrospective analysis of a cohort of patients treated consecutively between October 2004 and October 2019. Patients with PM were referred
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Volume Matters: Examining The Management Of Necrotizing Pancreatitis In The United States. Ann. Surg. (IF 7.5) Pub Date : 2025-02-04 Ikemsinachi C Nzenwa,Vahe S Panossian,Michael P DeWane,Katherine H Albutt,Yasmin G Hernandez-Barco,Carlos F Fernandez-Del Castillo,Keith D Lillemoe,Andrew L Warshaw,Peter J Fagenholz,Casey M Luckhurst
OBJECTIVE To examine the impact of hospital volume on mortality and healthcare utilization in patients admitted with necrotizing pancreatitis (NP). BACKGROUND Over 20% of patients with acute pancreatitis develop NP, which has been associated with higher rates of procedural intervention, morbidity, and mortality. METHODS Adult patients admitted with NP were identified in the 2016-2019 Nationwide Readmissions
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KRAS Mutations in Duodenal Lavage Fluid after Secretin Stimulation for Detection of Pancreatic Cancer. Ann. Surg. (IF 7.5) Pub Date : 2025-02-04 Shinichi Yachida,Shigetaka Yoshinaga,Satoshi Shiba,Makiko Urabe,Hidenori Tanaka,Yohei Takeda,Akinori Shimizu,Yuri Sakamoto,Susumu Hijioka,Shin Haba,Reiko Ashida,Yoshinori Kushiyama,Kento Asano,Makiko Kobayashi,Yoshiyuki Murawaki,Kouji Onishi,Taro Yamashita,Hirokazu Kimura,Yasushi Totoki,Hideki Kamada,Hajime Isomoto,Satoshi Hattori,Chigusa Morizane,Kazuyoshi Ohkawa,Masayuki Kitano,Kazuo Hara,Kenji Ikezawa
OBJECTIVE Although pancreatic ductal adenocarcinoma (PDAC) is still a devastating disease, the survival rate for surgically removed PDACs has significantly improved in recent years. Early detection is essential in managing PDAC. SUMMARY BACKGROUND DATA The presence of KRAS mutations in PDAC leads to the initial genetic abnormality and offers a significant timeframe for identifying resectable PDACs
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The Diabetes Remission Index (DRI): A Novel Prognostic Calculator Model Predicting Diabetes Remission Before and After Metabolic Procedures. Ann. Surg. (IF 7.5) Pub Date : 2025-02-04 Wissam Ghusn,Pearl Ma,Robert A Vierkant,Manpreet Mundi,Matyas Fehervari,Kayla Ikemiya,Karl Hage,Andres Acosta,Michael Camilleri,Barham Abu Dayyeh,Kelvin Higa,Omar M Ghanem
OBJECTIVE To develop and validate two predictive models, the Diabetes Remission Index (DRI) and the Weight Loss-Adjusted Diabetes Remission Index (W-DRI), for assessing type 2 diabetes (T2D) remission following metabolic and bariatric surgery (MBS). SUMMARY BACKGROUND DATA Metabolic and bariatric surgery, including Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), is highly effective in
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Validation of the PANAMA-Score for Survival and Benefit of Adjuvant Therapy in Patients with Resected Pancreatic Cancer After Neoadjuvant FOLFIRINOX. Ann. Surg. (IF 7.5) Pub Date : 2025-01-31 Ingmar F Rompen,Thomas F Stoop,Stijn van Roessel,Eran van Veldhuisen,Quisette P Janssen,Adnan Alseidi,Alberto Balduzzi,Gianpaolo Balzano,Frederik Berrevoet,Morgan Bonds,Olivier R Busch,Giovanni Butturini,Ammar A Javed,Marco Del Chiaro,Kevin C Conlon,Massimo Falconi,Isabella Frigerio,Giuseppe K Fusai,Johan Gagnière,Oonagh Griffin,Thilo Hackert,Ernesto Sparrelid,Asif Halimi,Knut J Labori,Giuseppe Malleo
AIM To validate the prognostic value of the PAncreatic NeoAdjuvant MAssachusetts (PANAMA)-score and to determine its predictive ability for survival benefit derived from adjuvant treatment in patients after resection of pancreatic ductal adenocarcinoma (PDAC) following neoadjuvant FOLFIRINOX. BACKGROUND The PANAMA-score was developed to guide prognostication in patients after neoadjuvant therapy and
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International Medical Graduates in Academic Cardiothoracic Surgery. Ann. Surg. (IF 7.5) Pub Date : 2025-01-31 Simar S Bajaj,Hanjay Wang,Kiah M Williams,Jack H Boyd
OBJECTIVE To assess the research productivity, career advancement, grant funding, and scholarly impact of international medical graduates (IMGs) in academic cardiothoracic surgery. SUMMARY BACKGROUND DATA Physician shortages undermine patient care and risk exacerbating inequities, especially in cardiothoracic surgery, which may lose a quarter of its workforce by 2050-the most substantial reduction
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Defer, Share, or Drive the Decision: Empowering Patients with Varied Preferences to Engage in Decision-making (an Analysis from Alliance A231701CD). Ann. Surg. (IF 7.5) Pub Date : 2025-01-31 Megan C Saucke,Nora Jacobson,Selina Chow,Grace McKinney,Heather B Neuman
OBJECTIVE To understand how breast cancer patients experience the surgical decision process and identify strategies surgeons can employ to empower patients to engage in decision-making. BACKGROUND Patient engagement in decision-making is associated with improved patient outcomes. Although, some patients prefer that their healthcare provider drive the decision, the benefits of engaging in decision-making
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Prevalence and Incidence of Oral Benzodiazepine Use in Hospitalized Surgical Patients: A Retrospective Cohort Study. Ann. Surg. (IF 7.5) Pub Date : 2025-01-30 Roos Geensen,Jorrit G Verhoeven,Johanna M Hendriks,Wim J R Rietdijk,Johannes Jeekel,Nicole G M Hunfeld,Markus Klimek
OBJECTIVE To determine the prevalence of intrahospital oral benzodiazepine use in the surgical population of a tertiary care centre. SUMMARY OF BACKGROUND DATA Oral benzodiazepines used for treating sleep disturbances and anxiety are widely used in the general population. Information regarding benzodiazepine use during hospitalization is scarce. METHODS A retrospective cohort study was conducted using
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Seeing the Forest and the Trees: The Future of Robotic Surgery and the Path Forward. Ann. Surg. (IF 7.5) Pub Date : 2025-01-29 Jenny M Shao,Justin B Dimick,Hope T Jackson
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Preventing and Treating Delayed Gastric Emptying (DGE) after Pancreatic Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Ann. Surg. (IF 7.5) Pub Date : 2025-01-29 Roberto M Montorsi,Bo T M Strijbos,Martijn W J Stommel,Kees van Laarhoven,Freek Daams,Olivier R Busch,Pascal Probst,Umberto Cillo,Giovanni Marchegiani,Marc G Besselink
OBJECTIVE To identify strategies to prevent and treat delayed gastric emptying (DGE) after pancreatic surgery. BACKGROUND Among all complications of pancreatic surgery, DGE has the largest impact on prolonged hospital stay. Several randomized controlled trials (RCTs) have addressed DGE after pancreatic surgery, either as primary or as secondary outcome. METHODS RCTs involving pancreatic surgery with
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Serial Transverse Enteroplasty and The Re-establishment of Enteral Autonomy Among The Adult Population: New Insights with Advanced Clinical Practice and Novel Outcome Predictive Model. Ann. Surg. (IF 7.5) Pub Date : 2025-01-28 Masato Fujiki,Sherif R Armanyous,Ayat ElSherif,Neha Parekh,Guilherme Costa,Amanda Hawthorne,Mohammed Osman,Kareem M Abu-Elmagd
OBJECTIVES To define the evolving role of serial transverse enteroplasty(STEP) in the surgical management of intestinal failure(IF) in patients with short bowel syndrome(SBS) especially among the adult population. BACKGROUND The current literature is lacking the rationale and long-term efficacy of STEP as a part of the multidisciplinary management of SBS-IF adult population. METHODS The study included
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Still not There yet: Persistence of Racial and Ethnic Disparities in Declining Cancer Surgery. Ann. Surg. (IF 7.5) Pub Date : 2025-01-27 George Molina
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Differential Risk Profiles of Incident Abdominal Aortic Aneurysms in Specific Subgroups: A Large Cohort-based Study. Ann. Surg. (IF 7.5) Pub Date : 2025-01-23 Yudiyang Ma,Jianing Wang,Linxi Tang,Feipeng Cui,Yaohua Tian,Jing Zhang,Jian Yang
OBJECTIVE The aim of this study is to explore the risk profiles associated with Abdominal aortic aneurysm (AAA) incidence in both the general population and diverse subpopulations. SUMMARY BACKGROUND DATA AAA is a life-threatening arterial disease, and there is limited understanding of its etiological spectrum across the age, sex, and genetic risk subgroups, making early prevention efforts more complicated
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Tangential Versus Segmental Portomesenteric Venous Resection During Pancreatoduodenectomy for Pancreatic Cancer: An International Multicenter Cohort Study on Surgical and Oncological Outcome. Ann. Surg. (IF 7.5) Pub Date : 2025-01-22 Thomas F Stoop,Adrienne Molnár,Leonard W F Seelen,Toshitaka Sugawara,Jacobien C M Scheepens,Mahsoem Ali,Ammar A Javed,Asif Halimi,Atsushi Oba,Bas Groot Koerkamp,Bodil Andersson,Caroline Williamsson,Christopher L Wolfgang,Daisuke Ban,Ernesto Sparrelid,Freek Daams,Geert Kazemier,Hjalmar C van Santvoort,Ingmar F Rompen,I Quintus Molenaar,Joseph R Habib,Lysanne P M Beuk,Niek J Geerdink,Roeland F de Wilde
OBJECTIVE To investigate whether tangential versus segmental portomesenteric venous resection (PVR) impacts surgical and oncological outcome in patients undergoing pancreatoduodenectomy for pancreatic cancer with portomesenteric vein (PMV) involvement. SUMMARY BACKGROUND DATA Current comparative studies on tangential versus segmental PVR as part of pancreatoduodenectomy for pancreatic cancer include
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Early Cold Stored Platelet Transfusion Following Traumatic Brain Injury: A Randomized Clinical Trial. Ann. Surg. (IF 7.5) Pub Date : 2025-01-22 Matthew D Neal,David O Okonkwo,Francis X Guyette,James F Luther,Laura E Vincent,Ava M Puccio,Ashley M Harner,Allison G Agnone,Donovan P Brubaker,Emily T Love,Christine M Leeper,Joshua B Brown,Raquel Forsythe,Philip C Spinella,Mark H Yazer,Stephen R Wisniewski,Jason L Sperry,
OBJECTIVE To determine the feasibility, efficacy, and safety of cold stored compared to room temperature platelet transfusion in patients with traumatic brain injury. SUMMARY BACKGROUND DATA Data demonstrating the safety and efficacy of cold stored platelet transfusion are lacking following traumatic brain injury. METHODS A phase 2, randomized, open label, clinical trial was performed at a single U
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Pancreatic Fistula and Intraabdominal Fluid Collections after Distal Pancreatectomy: Incidence, Implications, and Natural History. Ann. Surg. (IF 7.5) Pub Date : 2025-01-20 Thakerng Pitakteerabundit,Peter J Fagenholz,Casey M Luckhurst,Shravya Srinivas Rao,Avinash Kambadakone,Andrew L Warshaw,Keith D Lillemoe,Motaz Qadan,Carlos Fernandez-Del Castillo
OBJECTIVE To investigate the incidence and management of pancreatic fistula and fluid collections (FC) after distal pancreatectomy (DP). SUMMARY BACKGROUND DATA Pancreatic fistula and FC are common after DP. The relationship between pancreatic fistula, FC, and surgical drain placement remains unclear. METHODS We retrospectively reviewed patients who underwent DP at a single institution between June
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Normothermic Liver Machine Perfusion At a Large European Center -Real World Outcomes Following 238 Applications. Ann. Surg. (IF 7.5) Pub Date : 2025-01-20 Felix J Krendl,Benno Cardini,Margot Fodor,Jessica Singh,Florian Ponholzer,Franka Messner,Annemarie Weissenbacher,Thomas Resch,Manuel Maglione,Christian Margreiter,Stephan Eschertzhuber,Christian Irsara,Andrea Griesmacher,Harald Schennach,Robert Breitkopf,Lisa Schlosser,Heinz Zoller,Herbert Tilg,Rupert Oberhuber,Stefan Schneeberger
OBJECTIVE To report outcomes from routine clinical practice of liver transplantation (LT) following normothermic liver machine perfusion (NLMP) and compare to LT after static cold storage (SCS). BACKGROUND NLMP is emerging as a clinical routine in LT as has recently received renewed attention, however outcomes outside of clinical trials are lacking. METHODS All adult LT between February 2018 and January
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Feasibility of Pure Laparoscopic Donor Right Hepatectomy Compared to Open Donor Right Hepatectomy: A Large Single-Center Cohort Study. Ann. Surg. (IF 7.5) Pub Date : 2025-01-20 Sang-Hoon Kim,Ki-Hun Kim,Young-In Yoon,Woo-Hyoung Kang,Sang-Kyung Lee,Shin Hwang,Chul-Soo Ahn,Deok-Bog Moon,Tae-Yong Ha,Gi-Won Song,Dong-Hwan Jung,Gil-Chun Park,Ji Hoon Kim,Eun-Kyoung Jwa,Byeong-Gon Na,Sung Min Kim,Rak-Kyun Oh,I-Ji Jeong,Hyo Jung Ko,Minha Choi,Dae Hyeon Won,Ji Hoon Kang,Sung-Gyu Lee
OBJECTIVE This study aimed to compare morbidity of living donors and recipients after pure laparoscopic donor right hepatectomy (PLDRH) and open donor right hepatectomy (ODRH). BACKGROUND Donor and recipient morbidity have not been sufficiently reported in large-scale comparisons of PLDRH and ODRH. METHODS This retrospective study reviewed 3348 donors who underwent PLDRH (n=329) and ODRH (n=3019) and
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Prolonged Preservation of up to 24h at 10°C does not Impact Outcomes after Lung Transplantation. Ann. Surg. (IF 7.5) Pub Date : 2025-01-16 Konrad Hoetzenecker,Aadil Ali,Jose Campo-Cañaveral de la Cruz,Stefan Schwarz,Silvana Crowley Carrasco,Alexandra Romero Roman,Mohammed Aladaileh,Alberto Benazzo,Peter Jaksch,Elliott Wakeam,Meghan Aversa,Shaf Keshavjee,Marcelo Cypel
OBJECTIVE To determine the impact of prolonged storage of donor lungs at 10°C of up to 24h on outcome after lung transplantation. BACKGROUND An increasing body of evidence suggests 10°C as the optimal storage temperature for donor lungs. A recent study showed that cold ischemic times can be safely expanded to >12h when lungs are stored at 10°C. However, it is currently unknown how long donor lungs
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Recurrence Patterns and Management after Pleurectomy Decortication for Pleural Mesothelioma. Ann. Surg. (IF 7.5) Pub Date : 2025-01-15 Juuso Paajanen,William G Richards,Yue Xie,Emanuele Mazzola,Kristina Sidopoulos,John Kuckelman,Ritu R Gill,Raphael Bueno
OBJECTIVE We hypothesize that recurrence following pleurectomy decortication (PD) is primarily local. We explored factors associated with tumor recurrence patterns, disease-free interval (DFI), and post-recurrence survival (PRS). SUMMARY BACKGROUND DATA Tumor recurrence is a major barrier for long-term survival after pleural mesothelioma (PM) surgery. METHODS All patients who underwent PD between 1998
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Does Parathyroid Autotransplantation Prevent Hypoparathyroidism after Thyroid Surgery? Ann. Surg. (IF 7.5) Pub Date : 2025-01-15 Julia Adriana Kasmirski,Ashba Allahwasaya,Christopher Wu,Zhixing Song,Ramsha Akhund,Sanjana Balachandra,M Chandler McLeod,Andrea Gillis,Jessica Fazendin,Brenessa Lindeman,Herbert Chen
OBJECTIVE To assess the impact of parathyroid gland autotransplantation on the restoration of parathyroid function in patients who are hypoparathyroid after thyroidectomy. BACKGROUND DATA Hypoparathyroidism post-thyroidectomy arises when all parathyroid glands are devascularized or injured. Autotransplantation of compromised parathyroids aims to preserve their function and prevent permanent hypoparathyroidism
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Perspectives, Experiences, and Opportunities of Academic Surgeons in the Era of Healthcare Corporatization. Ann. Surg. (IF 7.5) Pub Date : 2025-01-15 Sara Sakowitz,Syed Shahyan Bakhtiyar,Nicholas S Sienna,Saad Mallick,Konmal Ali,Peyman Benharash,Richard Jolly,Timothy R Donahue
OBJECTIVE To characterize contemporary surgeons' viewpoints and perspectives on the academic mission during healthcare corporatization. SUMMARY BACKGROUND DATA Academic surgery, traditionally driven by the tripartite missions of excellence in clinical care, scientific research, and education, faces increasing challenges from a corporatized healthcare environment. While previous studies have addressed
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Performance of an Algorithm Grading Surgery-Related Adverse Events According to the Clavien-Dindo Classification. Ann. Surg. (IF 7.5) Pub Date : 2025-01-15 Lisen Båverud Olsson,Dennis Parkan,Annika Sjövall,Pontus Nauclér,Suzanne D van der Werff,Christian Buchli
OBJECTIVE To assess performance of an algorithm for automated grading of surgery-related adverse events (AEs) according to Clavien-Dindo (C-D) classification. SUMMARY BACKGROUND DATA Surgery-related AEs are common, lead to increased morbidity for patients, and raise healthcare costs. Resource-intensive manual chart review is still standard and to our knowledge algorithms using electronic health record
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Association between Deficient MSH2/MSH6 vs MLH1/PMS2 Status and Survival Rates in Localized Colorectal Cancer: A Nationwide Cohort Study. Ann. Surg. (IF 7.5) Pub Date : 2025-01-14 Tobias Freyberg Justesen,Adile Orhan,Andreas Weinberger Rosen,Mikail Gögenur,Peter-Martin Krarup,Camilla Qvortrup,Ismail Gögenur
OBJECTIVE This study investigated the association between loss of MSH2/MSH6 versus loss of MLH1/PMS2 expression and overall survival and disease-free survival in patients with localized colorectal cancer. BACKGROUND The risk of developing colorectal cancer varies depending on the expression of mismatch repair proteins. However, it is unknown if the prognosis differs accordingly. METHODS In this retrospective
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Optimal Timing and Approaches for First Tangential Excision in Patients with ≥70% TBSA Burns: Insights from a Retrospective Cohort of a Mass Casualty Incident. Ann. Surg. (IF 7.5) Pub Date : 2025-01-13 Runzhi Huang,Yuntao Yao,Sujie Xie,Junqiang Li,Wei Zhang,Yifan Liu,Shuyuan Xian,Hanlin Sun,Guosheng Wu,Heng He,Linhui Li,Xinru Wu,Yuanan Li,Haoyu Zhang,Bingnan Lu,Jiajie Zhou,Yibin Zhou,Dayuan Xu,Zhaofan Xia,Shizhao Ji
OBJECTIVE We aim to determine the optimal timing and approaches for first tangential excision of severely burned patients ≥70% total body surface area (TBSA). BACKGROUND Early tangential excision is the gold-standard surgical therapy for full-thickness burns. However, there are debates about its optimal timing and approaches for severely burned patients ≥70%TBSA. MATERIALS AND METHODS This study included
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Life after Pelvic Exenteration for Rectal Cancer: The Patient and Carer Perspective on Long Term Consequences and Survivorship. Ann. Surg. (IF 7.5) Pub Date : 2025-01-09 Kilian G M Brown,Kate White,Michael J Solomon,Paul Sutton,Kheng-Seong Ng,Daniel Steffens
OBJECTIVE To explore the perspectives and experiences of patients and carers living with the long-term consequences of pelvic exenteration. SUMMARY BACKGROUND DATA Pelvic exenteration is accepted as the standard of care for selected patients with locally advanced or recurrent rectal cancer. With contemporary 5-year survival reported at 40-60%, the number of long-term survivors is expected to increase
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Enhanced Recovery After Surgery Protocol Compliance and Early Outcomes for Elective Colorectal Procedures by Race/Ethnicity and Socioeconomic Status. Ann. Surg. (IF 7.5) Pub Date : 2025-01-09 Marta Antoniv,Luisa Jane Maldonado,Andrei Nikiforchin,Esteban Fabian Gershanik,Ronald Bleday
OBJECTIVE To explore the association of socioeconomic status (SES) and race/ethnicity with perioperative metrics within the Enhanced Recovery After Surgery (ERAS) framework to identify gaps for equity-informed improvements. SUMMARY BACKGROUND DATA Although ERAS pathways improve perioperative outcomes through standardized care, disparities in protocol adherence and postoperative outcomes persist, particularly
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Research Agenda for Entrustable Professional Activities Among US Surgical Specialties. Ann. Surg. (IF 7.5) Pub Date : 2025-01-09 Gurjit Sandhu,Andrew Jones,Carol L Barry,Jo Buyske,John D Mellinger,Brenessa Lindeman
The magnitude of advances in surgical care inspires awe consistent with the impact of these developments on patients' lives. With this comes greater knowledge, new practices, and novel technologies for integration into residency training, making the skillset required of today's residents quite different from those in the past. Competency-based medical education and learner-centered approaches offer
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Clinicopathological Characteristics and Long-Term Outcomes of Cystic vs. Solid Pancreatic Neuroendocrine Tumors: A Multi-Institutional Experience with 1727 Patients. Ann. Surg. (IF 7.5) Pub Date : 2025-01-09 Marco Ventin,Shahrzad Arya,Giulia Cattaneo,Carlos Fernandez-Del Castillo,Alice C Wei,Amer H Zureikat,Jurgis Alvikas,Ammar A Javed,Brady A Campbell,Yurie Sekigami,Jian Zheng,Motaz Qadan,Keith D Lillemoe,Jin He,Cristina R Ferrone,
OBJECTIVE To investigate the clinicopathological features and long-term outcomes of cystic and solid pancreatic neuroendocrine tumors (PanNETs). SUMMARY BACKGROUND DATA PanNETs uncommonly present as cystic lesions. Whether cystic PanNETs represent a distinct clinical entity compared to solid PanNETs is controversial. METHODS Clinicopathologic data of patients with resected PanNETs were collected from
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"Gender-Affirming Vaginoplasty Using Robotic Peritoneal Flap Method: Long Term Outcomes of 500 Cases". Ann. Surg. (IF 7.5) Pub Date : 2025-01-09 Gaines Blasdel,Kshipra Hemal,Charlie Dubach-Reinhold,Augustus Parker,Chris Amro,Lee C Zhao,Rachel Bluebond-Langner
OBJECTIVE The objective of this study was to determine the outcomes of robotic peritoneal flap vaginoplasty. BACKGROUND There is a lack of long-term outcomes data for gender-affirming vaginoplasty to inform patient decision-making. METHODS A retrospective cohort of 500 consecutive patients undergoing robotic peritoneal flap vaginoplasty from 2017-2023 were reviewed. Complications requiring procedural
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Remote Symptom Monitoring in Thoracic Surgery Patients After Discharge. Ann. Surg. (IF 7.5) Pub Date : 2025-01-08 Marisa Sewell,Thomas Boerner,Caitlin Harrington,Meier Hsu,Kay See Tan,Rebecca A Carr,Susan Jones,Daniel Zocco,Prasad S Adusumilli,Manjit S Bains,Matthew J Bott,Robert J Downey,James Huang,James M Isbell,Bernard J Park,Gaetano Rocco,Valerie W Rusch,Smita Sihag,David R Jones,Jennifer Cracchiolo,Daniela Molena
OBJECTIVE Evaluate an electronic platform for remote symptom monitoring to enhance postdischarge care in thoracic surgery using patient reporting of symptoms. SUMMARY BACKGROUND DATA Owing to the increased use of enhanced recovery after surgery protocols, patients are spending a larger portion of their postoperative course at home. For patients undergoing complex operations, this represents an opportunity
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Homelessness Research Has a Data Problem. Ann. Surg. (IF 7.5) Pub Date : 2025-01-08 Hannah Decker,Elizabeth Wick
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Long-term Changes in Pain, Depression, Function and Informal Caregiving after Major Elective Surgeries Among Seriously Ill Older Adults. Ann. Surg. (IF 7.5) Pub Date : 2024-12-25 Jolene Wong Si Min,Yihan Wang,Evan Bollens-Lund,Amanda J Reich,Hiba Dhanani,Claire K Ankuda,Stuart Lipsitz,Tamryn F Gray,Dae Hyun Kim,Christine S Ritchie,Amy S Kelley,Zara Cooper
OBJECTIVE To compare differences in pain, depression, function, and informal caregiving pre-and-post major elective surgery among older adults with and without serious illness; and determine if serious illness was independently associated with increasing pain, depression, assistance in activities of daily living (ADLs) and informal caregiving post-surgery. BACKGROUND The American College of Surgeons
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Musculoskeletal Disorders Among Surgeons and Attitudes Towards Wearable Devices for Ergonomic Optimization. Ann. Surg. (IF 7.5) Pub Date : 2024-12-24 Lauren C LaMonica,Mark W Farha,Connor R Mullen,Tasha M Hughes,Jeffrey H Kozlow,Kristin L Chrouser
OBJECTIVE To assess the burden of ergonomic strain and to examine factors influencing intention to use wearable technology that may improve ergonomics during surgery. BACKGROUND Surgical ergonomic strain leads to high rates of work-related musculoskeletal disorders (MSDs) and pain, contributing to early surgeon retirement and an epidemic of burnout. METHODS A cross-sectional survey of surgeons at a
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Fertility and Sexual Function in Males with Hirschsprung's Disease: A Nordic Cross-Sectional Study. Ann. Surg. (IF 7.5) Pub Date : 2024-12-23 Linnea Söderström,Gustav Axelsson,Annika Mutanen,Pernilla Stenström,Johan Danielsson,Helena Borg,Anders Telle Hoel,Signe Olsbø,Mikko Pakarinen,Niels Qvist,Kristin Bjørnland,Tomas Wester,Anna Löf Granström
OBJECTIVE The aim was to assess fertility, sexual function and sexual quality of life in males with Hirschsprung's disease (HSCR) in the Nordic countries with a cross-sectional study using self-reported validated questionnaires. SUMMARY BACKGROUND DATA Data on fertility and sexual function in males with HSCR are limited. METHODS This multi-center study targeted all males born between 1970-2003 who
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Enhancing Surgeons' Mindfulness, Well-being and Performance: Insights from a Scoping Review. Ann. Surg. (IF 7.5) Pub Date : 2024-12-23 Beth Frates
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Association of Perioperative Glucagon-like Peptide-1 Receptor Agonist Use and Postoperative Outcomes. Ann. Surg. (IF 7.5) Pub Date : 2024-12-20 Seth Z Aschen,Ashley Zhang,Gillian M O'Connell,Sophia Salingaros,Caroline Andy,Christine H Rohde,Jason A Spector
OBJECTIVE To assess rates of surgical complications and postoperative readmission in diabetic patients with and without active perioperative prescriptions for GLP-1 RA medications. BACKGROUND With the rapid growth of glucagon-like peptide-1 receptor agonist (GLP-1 RA) use in the United States, it is important to understand the potential effect of these drugs on surgical outcomes broadly. METHODS In
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External Validation of the ISGPS Complexity Grading System for Minimally Invasive Pancreatoduodenectomy: Insights from the IGOMIPS registry. Ann. Surg. (IF 7.5) Pub Date : 2024-12-18 Niccolò Napoli,Greta Donisi,Emanuele F Kauffmann,Michael Ginesini,Mohammad Abu Hilal,Gianluca Baiocchi,Umberto Bracale,Alberto Brolese,Giovanni Butturini,Roberto Coppola,Andrea Coratti,Raffaele Dalla Valle,Fabrizio Di Benedetto,Giorgio Ercolani,Giovanni Ferrari,Gianluca Garulli,Elio Jovine,Michele Mazzola,Riccardo Memeo,Carlo Molino,Luca Moraldi,Luca Morelli,Roberto Salvia,Giovanni D Tebala,Vincenzo
OBJECTIVE To validate the ISGPS complexity grading system for minimally invasive pancreaticoduodenectomy (MIPD). BACKGROUND Although concerns about patient safety persist, MIPD is gaining popularity. The ISGPS recently introduced a difficulty grading system to improve patient selection by aligning procedural complexity with surgeon and center expertise. METHODS Data from MIPD cases reported in the
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From Moral Injury Vulnerability to Protective Equity: The Voyage Every Surgeon Must Take. Ann. Surg. (IF 7.5) Pub Date : 2024-12-18 Praveen Vimalathas,Elisa J Gordon,Jason A Nieuwsma,Keith Meador,Sunil K Geevarghese
OBJECTIVE To examine the relationship between moral injury and surgical practice, further explore the concept of protective equity, and understand its role in mitigating the impact of morally injurious events throughout a surgical career. BACKGROUND Moral injury in healthcare settings has evolved from Jonathan Shay's original definition, modified by Brett Litz and others, to encompass the psychological
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Patient-reported outcomes of Children with an Anorectal Malformation. Ann. Surg. (IF 7.5) Pub Date : 2024-12-18 Richard J Wood,Shruthi Srinivas,Misel Trajanovska,Brennan J Collis,Reuben Lim,Molly Fuchs,Daniel Dajusta,Chris Westgarth-Taylor,Ihab Halaweish,Alessandra A Gasior,Marc A Levitt,John M Hutson,Sebastian K King
OBJECTIVE We aimed to study the impact of anorectal malformation (ARM) type and sacral ratio on continence outcomes in children. We secondarily aimed to compare continence outcomes by age group and determine quality of life (QoL) with different bowel regimens. SUMMARY BACKGROUND DATA Children with ARM experience dysfunctional stooling into adulthood. Little is known about how ARM type, sacral ratio
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Neoadjuvant Pembrolizumab in Stage I-III Deficient Mismatch Repair Colon Cancer: A Clinical Trial. Ann. Surg. (IF 7.5) Pub Date : 2024-12-18 Ismail Gögenur,Tobias Freyberg Justesen,Line Schmidt Tarpgaard,Mustafa Bulut,Torben Frøstrup Hansen,Lars Henrik Jensen,Hans Bjarke Rahr,Tove Kirkegaard,Lukas Balsevicius,Hans Raskov,Peter Clausager Petersen,Jens Ravn Eriksen,Søren Salomon,Anne-Marie Kanstrup Fiehn,Søren Brandsborg,Kåre Andersson Gotschalck,Katrine J Emmertsen,Pernille Wolder Born,Ole Thorlacius-Ussing,Michael Bødker Lauritzen,René
OBJECTIVE This clinical trial investigated the safety and efficacy of single-cycle pembrolizumab in patients with localized deficient mismatch repair (dMMR) colon cancer. BACKGROUND Neoadjuvant immunotherapy has induced remarkable rates of pathological complete response in patients with dMMR colon cancer. However, the optimal length and type of treatment are yet to be determined. METHODS This was an
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Portomesenteric Venous Thrombosis after Pancreatic Cancer Surgery with Venous Resection and Reconstruction: Timing, Incidence, and Risk Factors. Ann. Surg. (IF 7.5) Pub Date : 2024-12-16 Hiroyuki Ishida,Shuichi Watanabe,Salvador Rodriguez Franco,Oskar Franklin,Thomas F Stoop,Michael J Kirsch,Richard D Schulick,Marco Del Chiaro
OBJECTIVE To investigate the incidence and risk factors of portomesenteric venous thrombosis (PVT) after pancreatic cancer surgery with portomesenteric venous resection (PVR). SUMMARY BACKGROUND DATA Pancreatic cancer surgery with PVR can be complicated by PVT, but the long-term associations, risk factors, and consequences of PVT have not been clearly elucidated. METHODS This study included pancreatic
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Development and Validation of the Predictive and Prognostic ChemoResist Signature in Resected Pancreatic Ductal Adenocarcinoma: Multicenter Study. Ann. Surg. (IF 7.5) Pub Date : 2024-12-16 Lei Huang,Quanli Han,Liangchao Zhao,Zhikuan Wang,Guanghai Dai,Yan Shi
OBJECTIVE To develop and validate a signature to precisely predict prognosis in pancreatic ductal adenocarcinoma (PDAC) undergoing resection and adjuvant chemotherapy. SUMMARY BACKGROUND DATA PDAC is largely heterogeneous, and responds discrepantly to treatment. METHODS 551 consecutive patients with PDAC from 3 tertiary centers were initially enrolled. Genetic events of the four most commonly mutated
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Trends in the Management and Outcomes of Neuroendocrine Liver Metastases: A Three-decade, Multi-centre Observational Cohort Study. Ann. Surg. (IF 7.5) Pub Date : 2024-12-16 Andrea Frilling,Ashley K Clift,Daniel Kaemmerer,Kira C Steinkraus,Joerg Schrader,Stefan Wolter,Panagiotis Drymousis,Marc-Olaf Liedke,Merten Hommann,Nagy Habib,Richard P Baum,Harpreet Wasan,Irvin M Modlin,Jakob R Izbicki
OBJECTIVE To describe the evolution of management strategies for neuroendocrine liver metastases (NE LM) and trends in patient outcomes over the preceding 3 decades. SUMMARY BACKGROUND DATA Liver metastases are common in neuroendocrine neoplasms and impair prognosis. A broad therapeutic armamentarium has evolved over recent decades but there remains uncertainty regarding optimal treatment selection
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Biochemical, Radiographic, or Pathologic Response to Neoadjuvant Chemotherapy in Resected Pancreatic Cancer: Which is Best? Ann. Surg. (IF 7.5) Pub Date : 2024-12-16 M Usman Ahmad,Christopher S Javadi,Julia D Chang,Erna Forgó,Daniel J Delitto,Monica M Dua,George A Fisher,Gregory M Heestand,Daniel T Chang,Erqi Pollom,Lucas K Vitzthum,Amanda Kirane,Byrne Lee,Brendan C Visser,Jeffrey A Norton,George A Poultsides
OBJECTIVE To examine the optimal method of assessing response to neoadjuvant therapy (NAT) in operable pancreatic ductal adenocarcinoma (PDAC) patients. SUMMARY OF BACKGROUND DATA PDAC response to NAT is measured with biochemical, radiographic and pathologic parameters, which can often be discordant with each other. METHODS PDAC patients undergoing resection after NAT at a single institution were retrospectively