OBJECTIVE To explore surgeons' perspectives on and priorities for communicating about non-curative operations for patients with advanced cancers, which aim to improve longevity or quality of life without possibility of cure. SUMMARY BACKGROUND DATA Describing the potential benefits of non-curative surgery is important so that treatment decisions are based on an accurate understanding of what surgery

OBJECTIVE To assess the efficacy and safety of hypovolemic phlebotomy (HP) versus conventional management (control group) in achieving low central venous pressure (CVP) to reduce blood loss during open liver resections. BACKGROUND Excessive blood loss increases perioperative complications and worsen patient outcomes. HP is used to reduce blood loss and the need for allogenic transfusions. This study

OBJECTIVE To assess the feasibility of integrating environmental sustainability into clinical guidelines for operating rooms (ORs) and provide evidence-based recommendations. SUMMARY BACKGROUND DATA Surgical practices contribute significantly to healthcare's environmental impact. Incorporating sustainability into evidence-based clinical guidelines can support environmentally responsible decision-making

OBJECTIVE This study aimed to investigate whether microRNAs (miRNAs) quantified from primary pancreatic ductal adenocarcinoma (PDAC) samples could serve as potential biomarkers for identifying PDAC with occult liver metastasis. SUMMARY BACKGROUND DATA Undetectable occult liver metastasis impair the survival of PDAC. Novel biomarkers are immediately required to detect occult liver metastasis in PDAC

OBJECTIVE Use a new patient registry to characterize and predict progression of lower-extremity chronic wounds to amputation and/or death, while considering infection history. BACKGROUND Chronic wounds are a common health issue causing amputation and death. The Regenstrief Chronic Wound Registry, created from one of the U.S.'s largest health information exchanges, can give insights into their epidemiology

OBJECTIVE Our objective was to assess outcomes for newborns with congenital diaphragmatic hernia (CDH) and congenital heart disease (CHD). SUMMARY BACKGROUND DATA CDH is a complex malformation often associated with CHD, yet limited data exist on outcomes for infants with both conditions. This study highlights factors associated with survival and how specific cardiac diagnoses shape patient outcomes

OBJECTIVE To establish benchmark cutoffs for robotic liver resection (R-LR), encompassing both major and minor resections, and to determine the impact of patient selection on outcomes. BACKGROUND R-LR is a key advancement in minimally invasive liver surgery but lacks standardized benchmarks, especially for minor resections. While guidelines endorse R-LR, its role in optimizing outcomes remains unclear

OBJECTIVE The purpose of this study is to estimate differences in the supply of general surgeons by age group and rurality and model potential impending shortages, with an emphasis on surgeons reaching and above the traditional retirement age. SUMMARY BACKGROUND DATA The healthcare workforce at large is experiencing shortages and impending retirements, which are especially prominent in rural communities

OBJECTIVE To longitudinally compare trends in quality of care for common surgical conditions at CAHs compared to non-CAHs. SUMMARY BACKGROUND DATA Critical access hospitals (CAH) simultaneously face challenges of preserving access and ensuring quality. Data have identified concerns of quality over time for medical conditions, but less is understood about surgical care. DESIGN, SETTING, PARTICIPANTS

OBJECTIVE To assess the accuracy of the ACS NSQIP Risk Calculator (RC) when applied to subsets of high-risk patients. BACKGROUND The RC plays an especially important role in surgical decision making in situations where probabilities for adverse events are high. However, the performance of the RC in these situations has not been studied in detail. Furthermore, past criticisms of the RC have evaluated

OBJECTIVE This study assessed the association of histopathological features in the resection specimen of CD patients with (severe) endoscopic postoperative recurrence (ePOR) in a large prospective, multicenter cohort study. SUMMARY BACKGROUND DATA The predictive value of histopathologic features of the intestinal resection specimen for the risk of Crohn's disease (CD) recurrence after ileocolic (re-)resection

OBJECTIVE To investigate weight loss outcomes of semaglutide in a real-world setting, specifically in patients who have undergone metabolic/bariatric surgery (MBS). SUMMARY BACKGROUND DATA Despite excellent weight loss for semaglutide in clinical trials, actual results may be limited due to factors such as costs, drug availability, insurance coverage, and adverse events. METHODS A retrospective series

OBJECTIVE We sought to define potential census-tract level differences between areas designated as clinical trial (CT) deserts versus non-CT deserts, and assess the association of area deprivation and digital divide with CT access. SUMMARY BACKGROUND DATA CTs serve as the foundation of evidence-based medicine, influencing multiple aspects of patient care; therefore, ensuring equitable access is important

OBJECTIVE Minimally invasive subtotal cholecystectomy is safe alternative to minimally invasive cholecystectomy that prevents bile duct injury. Nonetheless, it is associated with higher rates of other complications, namely post-operative bile leak and symptomatic remnant cholelithiasis. SUMMARY BACKGROUND DATA Bile leak presents as biloma requiring drainage and subsequently high bilious drain output

OBJECTIVE To determine the 10-year outcomes regarding weight loss and remission of obesity-related diseases after primary Roux-en-Y gastric bypass (RYGB), when performed in routine clinical care. SUMMARY OF BACKGROUND DATA Long-term results of metabolic bariatric surgery (MBS) are important, as the number of patients needing help with this chronic condition is increasing globally. However, results

OBJECTIVE Compare outcomes, stratified by frailty, of patients with eight common conditions with plausible operative and nonoperative management strategies. SUMMARY BACKGROUND DATA A surgical pause, evaluating potential adverse outcomes among frail patients, improves postoperative outcomes; however, the outcomes among patients opting for nonoperative management are unknown. METHODS In an observational

OBJECTIVE To assess the outcomes of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in patients with prior fundoplication. SUMMARY BACKGROUND DATA Obesity and gastroesophageal reflux disease (GERD) often coexist, posing clinical challenges. Fundoplication is the standard treatment for GERD refractory to medical therapy. Managing obesity after fundoplication is complex and while RYGB is

OBJECTIVE Review the current literature for available treatments for acute cholecystitis (AC) in non-surgical candidates and provide guidelines for the management of these patients. BACKGROUND Cholecystectomy is the gold standard treatment modality for AC. A considerable number of patients who are not eligible for surgery are managed by percutaneous and endoscopic techniques. There is recent data regarding

SIGNIFICANCE We evaluated the impact of OOS on organ utilization and also what factors impact the decision to employ OOS. BACKGROUND Deceased donor liver allocation typically follows a ranked match-run of potential recipients. Organ procurement organizations (OPOs) may deviate from liver transplant standardized allocation using "out-of-sequence" (OOS) matches. METHODS All eligible donors from the Scientific

OBJECTIVE To compare statistical models applied to electronic health record (EHR) data to predict and identify non-infectious postoperative complications. The models have been published and are part of the Automated Surveillance of Postoperative Infections (ASPIN) project, which has expanded to include non-infectious complications. SUMMARY OF BACKGROUND DATA Postoperative complications occur in 15%

OBJECTIVE To assess the safety and efficacy of intermittent inflow occlusion (IIO) during robotic right donor hepatectomy (RDH) for adult living donor liver transplantation. SUMMARY BACKGROUND DATA Although evidence supports minimally invasive donor hepatectomy, its adoption by surgeons remains limited. Key challenges include bleeding during parenchymal transection and prolonged warm ischemia during

OBJECTIVE This randomized phase II/III study evaluated the superiority of neoadjuvant therapy with gemcitabine plus S-1 over upfront surgery for patients with resectable pancreatic ductal adenocarcinoma (PDAC). SUMMARY BACKGROUND DATA Pancreatic ductal adenocarcinoma is a leading cause of cancer mortality that urgently requires better treatment. METHODS Patients with resectable PDAC (without arterial

OBJECTIVE This study explains successful implementation of hospital enhanced recovery programs (ERPs) through unique configurations of contextual and implementation conditions. SUMMARY BACKGROUND DATA Despite proven benefits in improving surgical outcomes, ERPs are often ineffectively implemented in hospitals, possibly due to the complex ways in which the interventions, local environment contexts,

OBJECTIVE To establish a novel method for evaluating carbohydrate antigen 19-9 (CA19-9) during neoadjuvant therapy (NAT) and assess its role in predicting overall (OS) and disease-free (DFS) survival in borderline resectable pancreatic adenocarcinoma (BR-PC). SUMMARY BACKGROUND DATA Static CA19-9 values or percentage changes often fail to capture therapeutic responses in patients with BR-PC undergoing

OBJECTIVE Understand challenges faced by older adults who undergo elective major surgery. BACKGROUND Preparation for and recovery from elective major surgery is often described from clinician perspectives, limiting insights into older patients' experiences. METHODS We conducted a qualitative study with adults age 65+ years, 30-90 days post colectomy, using interviews and surveys at a Northeastern U

OBJECTIVE To evaluate the impact of preoperative analgesic education on postoperative opioid consumption, pain scores, and patient satisfaction with analgesia. BACKGROUND Effective postoperative pain management is crucial for patient recovery and satisfaction, yet opioid use poses risks of tolerance and addiction. Preoperative patient education offers a potential avenue to mitigate opioid reliance

OBJECTIVE We sought to identify which absent firearm laws would have prevented the most firearm suicides (FS) in each state of the US. SUMMARY BACKGROUND DATA Prior studies suggested efficacy for FS prevention varies greatly between different firearm laws. However, this body of work did not probe how this efficacy may differ by state. METHODS This state-level, retrospective cohort study of firearm

OBJECTIVE The clinical aim of this work is to predict intraoperative LRC from preoperative CT scans only. SUMMARY OF BACKGROUND DATA Liver resection (LR) is the most prevalent curative treatment for primary liver cancer, yet overall mortality/morbidity rates remain elevated. The conventional definition and classification of LR complexity (LRC) lack inclusion of the disease-induced 3D anatomical surgery

OBJECTIVE Given the outsized contribution of surgical care to the carbon footprint of the health sector, we aim to understand attitudes towards sustainability among academic surgeons in the United States (U.S.). SUMMARY BACKGROUND DATA The healthcare sector accounts for 8.5% of United States (U.S.) greenhouse gas emissions-of which one third come from surgical care. Though prior studies suggested that

OBJECTIVE To determine whether perioperative monitoring with nursing triage intervention is feasible and improves surgical outcomes and recovery. BACKGROUND There are increased demands for outpatient recovery after complex gastrointestinal oncologic surgery with simultaneous expectations of improving quality of life and expedited functional recovery. Telemonitoring is a proposed mechanism to achieve

OBJECTIVE To evaluate age, TNW, or tumor diameter (TD) as continuous prognostic variables for outcomes in early stage FHWT after accounting for biology and treatment. SUMMARY OF BACKGROUND DATA Patient age (< 2 vs. ≥ 2 years) and tumor nephrectomy weight (TNW; < 550g vs. ≥ 550 grams) have been used to risk stratify children with stage I favorable histology Wilms tumor (FHWT) on Children's Oncology

OBJECTIVE Evaluate the effectiveness of an intraoperative exoskeleton that supports surgeons' heads, necks, and backs to reduce neck discomfort. SUMMARY BACKGROUND DATA Surgeons are at a considerable risk of developing neck pain and related injuries. Passive exoskeletons are a potential intervention to support surgeons' body parts and alleviate strain and discomfort. METHODS The NekSpine TM (a passive

OBJECTIVE To evaluate the 1-year clinical outcomes of patients enrolled in the #HOPE4LIVER trial of hepatic histotripsy. SUMMARY BACKGROUND DATA Histotripsy is a novel non-invasive, non-thermal focused ultrasound therapy that liquefies tissue at the focal point of the transducer. Following diagnostic ultrasound targeting, an automated treatment is performed via a robotic arm to treat a user-defined

OBJECTIVE This study evaluated the effect of neoadjuvant therapy (NAT) and the prognostic significance of carcinoembryonic antigen (CEA) levels in patients with non-elevated serum carbohydrate antigen (CA) 19-9 levels. SUMMARY BACKGROUND DATA The impact of NAT followed by surgical resection on oncologic outcomes in patients with localized pancreatic ductal adenocarcinoma (PDAC) remains unclear. METHODS

OBJECTIVE To compare perioperative outcomes in patients undergoing minimally invasive liver surgery (MILR) with or without central venous pressure (CVP) reduction (≤5 mmHg). BACKGROUND Reduction CVP during parenchymal transection is widely accepted in open hepatectomy to reduce intraoperative blood loss, as a major predictor of postoperative outcomes. However, the effect of CVP reduction on blood loss

OBJECTIVE To assess the prevalence of chronic pain and sexual dysfunction after groin hernia repair in adolescents. SUMMARY BACKGROUND DATA Adolescents present unique challenges in groin hernia management due to their evolving anatomy, yet data on patient-reported outcomes remain limited. METHODS A nationwide survey was conducted in Denmark, linking patient-reported outcomes to the Danish National

OBJECTIVES This study aims to provide a comprehensive update on the representation of women in academic surgery by specialty, measuring progress and opportunity with regard to women "breaking" the glass ceiling at the trainee, faculty, and department chair levels. BACKGROUND Over the past two decades, initiatives have contributed to educational awareness, culture shifts, and a focus on inclusive excellence

OBJECTIVE To evaluate the outcomes of a multidisciplinary effort involving surgical and gastroenterological departments in managing bowel dysfunction, specifically low anterior resection syndrome (LARS), following rectal cancer treatment. SUMMARY BACKGROUND DATA An increasing number of rectal cancer survivors experience LARS, heightening the need for specialized treatment. METHODS Patients referred

OBJECTIVE The DELORES trial investigated whether laparoscopic resection rectopexy (LRR) is superior to Delorme's procedure (DP) in full-thickness rectal prolapse. SUMMARY OF BACKGROUND DATA Multiple perineal and transabdominal procedures are current practice for rectal prolapse surgery. Evidence from adequately designed randomized studies addressing the question of which of these procedures are superior

OBJECTIVE To evaluate the prognostic impact of resection margin in distal cholangiocarcinoma (dCC). BACKGROUND Due to the relatively low prevalence of dCC in Western countries and the use of various definitions of resection margin status, the prognostic impact of bile duct resection margin status remains unclear. METHODS This study included consecutive patients who underwent curative surgery and were

OBJECTIVE How does distance to care affect time to surgery (TTS) and overall survival (OS) among rural patients with breast cancer? SUMMARY BACKGROUND DATA TTS>60 days is associated with known sociodemographic characteristics and worse OS after breast cancer diagnosis, but the relationship between rurality, proximity to care, TTS, and OS remains unknown. METHODS We identified females≥18 years with

OBJECTIVE To characterize the relationship between surgeon-staff familiarity and the time required to perform an operation. SUMMARY BACKGROUND DATA The clinical and operational efficiency of operating rooms (ORs) is a driver of hospital finances and patient outcomes. Surgeon-staff familiarity is an important focus for quality improvement and process optimization. METHODS A retrospective cohort study

OBJECTIVE To determine the prevalence of ductal cancerization at the pancreatic neck margin and to investigate its prognostic significance. SUMMARY BACKGROUND DATA Ductal cancerization (cancerization of ducts; COD) describes the growth of invasive cancer in pre-existing ducts, and is frequently seen in pancreatic cancer resection specimens. Although COD is a well-defined histological diagnosis, it

OBJECTIVE To compare the outcomes of fully robotic versus open left lobe donor hepatectomies, focusing on donor safety. SUMMARY BACKGROUND DATA Right lobe hepatectomies are traditionally preferred for adult liver transplants due to their larger graft size but may involve increased risks for donors. Left lobe hepatectomies are considered safer for donors but are less commonly used due to concerns about

OBJECTIVE To determine the relationship between intraoperative lowest measured temperature (LMT) during cardiac surgery using cardiopulmonary bypass (CPB) and the risk for postoperative stroke. Secondarily, to determine the association between LMT and risk for 30-day mortality and other adverse outcomes. BACKGROUND The effectiveness of deliberate hypothermia during CPB for the prevention of cardiac

OBJECTIVE To apply interpretable machine learning methodology to electronic health record (EHR) data to develop models for preoperative risk estimation and postoperative detection of non-infectious postoperative complications. SUMMARY BACKGROUND DATA We previously developed preoperative risk and postoperative detection models for surveillance of postoperative infections. The purpose of the present

OBJECTIVE To assess postoperative readmission for patients with non-English primary language (NEPL) at Language Serving Hospitals (LSH) versus non-LSH. SUMMARY BACKGROUND DATA Patients with NEPL have worse surgical outcomes compared to patients with an English primary language. Hospital-level language access resources vary, potentially leading to disparate health outcomes. METHODS We performed a retrospective

OBJECTIVE To evaluate perioperative morbidity and mortality outcomes in a large, contemporary series of patients undergoing pancreas head resection for chronic pancreatitis. SUMMARY BACKGROUND DATA Select chronic pancreatitis (CP) patients benefit from pancreatic head resection, but contemporary data are sparse. Anatomy dictates selection of duodenum-preserving pancreatic head resection (DPPHR) or

OBJECTIVE This review evaluated whether broad-spectrum penicillin-based antibiotic prophylaxis (BS-AB) such as piperacillin-tazobactam might lead to better outcomes in pancreatoduodenectomy compared to standard care antibiotics, mainly cephalosporins (CE-AB). BACKGROUND Pancreatoduodenectomy is commonly associated with high postoperative infectious complications contributing to increased morbidity

OBJECTIVE To investigate the association between perioperative ctDNA status and prognosis in patients with esophageal squamous cell carcinoma (ESCC). BACKGROUND Circulating tumor DNA (ctDNA) has emerged as a promising biomarker for assessing molecular residual disease (MRD) in various malignancies. However, there are limited studies evaluating the utility of ctDNA for predicting recurrence risk in

OBJECTIVE The aim was to build a calculator for personalized surveillance of BD-IPMNs. SUMMARY BACKGROUND DATA The interval time for surveillance of low-risk branch duct intraductal papillary mucinous neoplasms (BD-IPMNs) has not been established yet. METHODS The study included an international cohort of BD-IPMNs without worrisome features (WFs) or high-risk stigmata (HRS). IPMN evolution was defined