ImportanceBecause mentorship is critical for professional development and career advancement, it is essential to examine the status of mentorship and identify challenges that junior surgical faculty (assistant and associate professors) face obtaining effective mentorship.ObjectiveTo evaluate the mentorship experience for junior surgical faculty and highlight areas for improvement.Design, Setting, and

ImportanceWomen on the liver transplant waiting list are less likely to undergo a transplant than men. Recent approaches to resolving this disparity have involved adjustments to Model for End-Stage Liver Disease (MELD) scoring, but this will not affect candidates who rely on exception scores rather than calculated MELD score, the majority of whom have hepatocellular carcinoma (HCC).ObjectiveTo evaluate

ImportancePrimary hyperparathyroidism (PHPT) is a common endocrine disorder associated with neuropsychiatric symptoms. Although parathyroidectomy has been associated with improvement of preexisting depression among adults with PHPT, the effect of parathyroidectomy on the development of new depression is unknown.ObjectiveTo determine the effect of early parathyroidectomy on the incidence of new depression

ImportanceProphylactic placement of a mesh has been suggested to prevent parastomal hernia. Evidence to support this practice is contradictory.ObjectiveTo determine whether funnel-shaped permanent synthetic parastomal mesh is effective and safe in parastomal hernia prevention.Design, Setting, and ParticipantsThe Chimney Trial was a randomized single-blinded multicenter trial conducted in 4 hospitals

ImportanceWide variations exist in traumatic brain injury (TBI) management strategies and transfer guidelines across the country.ObjectiveTo assess the outcomes of patients with TBI transferred to the American College of Surgeons (ACS) level I (LI) or level II (LII) trauma centers (TCs) on a nationwide scale.Design, Setting, and ParticipantsIn this secondary analysis of the ACS Trauma Quality Improvement

This cohort study examines the association between blood transfusion and major adverse cardiovascular events and mortality among people undergoing elective open vascular operations.

Importance It is unclear whether counseling to promote walking reduces the risk of major adverse cardiovascular events (MACE) in people with peripheral artery disease (PAD). Objective To test whether a counseling intervention designed to increase walking reduced the risk of MACE in patients with PAD. Design, Setting, and Participants The BIP trial was a randomized clinical trial, with recruitment performed

This study assesses nationwide trends in the use of observation for pancreatic neuroendocrine tumors 2 cm or smaller and to evaluate factors associated with resection.

ImportanceThe 1-year results of the SECURE trial, a randomized trial comparing a restrictive strategy vs usual care for select patients with symptomatic cholelithiasis for cholecystectomy, resulted in a significantly lower operation rate after restrictive strategy. However, a restrictive strategy did not result in more pain-free patients at 1 year.ObjectiveTo gauge pain level and determine the proportion

ImportanceCurrent trauma-care protocols advocate early administration of fresh frozen plasma (FFP) in a ratio close to 1:1 with red blood cells (RBCs) to manage trauma-induced coagulopathy in patients with severe blunt trauma. However, the benefits of a higher FFP to RBC ratio have not yet been established.ObjectiveTo investigate the effectiveness of a high FFP to RBC transfusion ratio in the treatment

Importance While nipple-sparing mastectomy (NSM) for breast cancer was only performed using the open method in the past, its frequency using endoscopic and robotic surgical instruments has been increasing rapidly. However, there are limited studies regarding postoperative complications and the benefits and drawbacks of minimal access NSM (M-NSM) compared with conventional NSM (C-NSM). Objective To

This Viewpoint proposes several ways to innovate electronic health record (EHR) systems to address surgeon-specific needs and to improve clinicians’ experience and health care quality.

ImportanceIdentifying disparities in health outcomes related to modifiable patient factors can improve patient care.ObjectiveTo compare likelihood of withdrawal of life-supporting treatment (WLST) and mortality in patients with complete cervical spinal cord injury (SCI) with different types of insurance.Design, Setting, and ParticipantsThis retrospective cohort study collected data between 2013 and

ImportanceChildbearing has been a particular barrier to successful recruitment and retention of women in surgery. Pregnant surgeons are more likely to have major pregnancy complications, such as preterm delivery, intrauterine growth restriction, infertility, and miscarriage, compared with nonsurgeons. The average obstetric complication rate for surgeons ranges between 25% and 82% in the literature

This cohort study examines an increase in motor vehicle fatality rates for Black individuals in the US beginning in 2014 compared with White individuals.

Importance Liberal oxygen (hyperoxia) is commonly administered to patients during surgery, and oxygenation is known to impact mechanisms of perioperative organ injury. Objective To evaluate the effect of intraoperative hyperoxia compared to maintaining normoxia on oxidative stress, kidney injury, and other organ dysfunctions after cardiac surgery. Design, Setting, and Participants This was a participant-

ImportanceMultimorbidity and postoperative clinical decompensation are common among older surgical patients with cancer, highlighting the importance of primary care to optimize survival. Little is known about the association between primary care use and survivorship among older adults (aged ≥65 years) undergoing cancer surgery.ObjectiveTo examine primary care use among older surgical patients with

ImportanceExtensive bowel surgery is often necessary to achieve complete cytoreduction in patients with epithelial ovarian cancer. Regardless of who performs the surgery, it has been well documented that bowel resections are a high-risk procedure and an anastomotic leak is a severe complication that can occur. There are few studies addressing whether surgeon type impacts surgical outcomes in this patient

This case series evaluates changes in numeric pain scores, opioid use, and other measures before, during, and 30 days after computed tomography–guided percutaneous cryoneurolysis in patients with rib injury.

This article discusses the ACGME requirement that sponsoring institutions of postgraduate medical training provide trainees with at least 6 weeks of paid parental leave throughout their training period.

ImportanceThe indications, safety, and efficacy of chemical venous thromboembolism prophylaxis (cVTE) in pediatric trauma patients remain unclear. A set of high-risk criteria to guide cVTE use was recently recommended; however, these criteria have not been evaluated prospectively.ObjectiveTo examine high-risk criteria and cVTE use in a prospective multi-institutional study of pediatric trauma patients

ImportanceNeonates requiring surgery are often cared for in neonatal intensive care units (NICUs). Despite a breadth of surgical pathology, neonates share many perioperative priorities that allow for the development of unit-wide evidence-based Enhanced Recovery After Surgery (ERAS) recommendations.ObservationsThe guideline development committee included pediatric surgeons, anesthesiologists, neonatal

ImportanceEvaluating how social determinants of health (SDOH) influence veteran outcomes is crucial, particularly for quality improvement.ObjectiveTo measure associations between SDOH, care fragmentation, and surgical outcomes using a Desirability of Outcome Ranking (DOOR).Design, Setting, And ParticipantsThis was a cohort study of US veterans using data from the Veterans Affairs (VA) Surgical Quality

This cohort study compares survival outcomes between patients with unresectable colorectal liver metastasis who received chemotherapy-based multimodal therapy and patients who underwent liver transplant.

ImportanceThere are currently no clinically relevant criteria to predict a futile up-front pancreatectomy in patients with anatomically resectable pancreatic ductal adenocarcinoma.ObjectivesTo develop a futility risk model using a multi-institutional database and provide unified criteria associated with a futility likelihood below a safety threshold of 20%.Design, Setting, and ParticipantsThis retrospective

ImportanceGender inequities and limited representation are an obstacle to surgical workforce diversification. There has been limited examination of gender-based disparities in billing practices among surgeons.ObjectiveTo evaluate variations in practice metrics and billing practices among female and male surgeons and identify factors associated with gender disparities in Medicare reimbursements.Design