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Safety of Same-Day Discharge after Bariatric Operation: A Retrospective 6-Year North American Analysis J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-20 Tina Bharani, Ali Tavakkoli, Thomas C Tsai, Malcolm K Robinson, Eric G Sheu
Background: With increasing implementation of Enhanced Recovery After Surgery protocols and rising demand for inpatient hospital beds accentuated by COVID, there has been interest in same day discharge (SDD) for bariatric operation. The aim of this study was to determine the national trends, safety profile, and risk factors for complications of SDD for minimally invasive bariatric operation. Study
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Women Surgeons: Forged by the Sea J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-20 Margaret Shield, Tamara J Worlton
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Timing of Surgery or Time for Surgery? J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-20 Kariem El-Boghdadly
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“Tension-Free”: A Fundamental Surgical Principle in Need of Supporting Evidence J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-20 Mazen Al-Mansour
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Examining the Gastric Bypass Long-Term Metabolic Benefit J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-19 Ann M Rogers
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Acute Intraoperative Conversion from Endovascular to Open vs Planned Open Operation for Abdominal Aortic Aneurysm: A Propensity-Score Matched Study from the American College of Surgeons NSQIP Targeted Database J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-19 Renxi Li, Anton Sidawy, Bao-Ngoc Nguyen
Background Evaluating outcomes for acute intraoperative conversion to open surgery during endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) was difficult due to low incidence. This study aimed to compare 30-day outcomes between patients with acute intraoperative conversion during EVAR and planned open surgery, and to identify risk factors associated with acute conversion. Methods
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Abdominal Wall Tension and Early Outcomes after Posterior Component Separation with Transversus Abdominis Release: Does a “Tension-Free” Closure Really Matter? J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-19 Benjamin T Miller, Ryan Ellis, Sara M Maskal, Clayton C Petro, David M Krpata, Ajita S Prabhu, Lucas RA Beffa, Chao Tu, Michael J Rosen
Background: Ventral hernias result in fibrosis of the lateral abdominal wall muscles, increasing tension on fascial closure. Little is known about the effect of abdominal wall tension on outcomes after abdominal wall reconstruction. We aimed to identify an association between abdominal wall tension and early postoperative outcomes in patients who underwent posterior components separation (PCS) with
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Remission of Obesity-Related Sleep Apnea and Its Effect on Mortality and Cardiovascular Events After Metabolic and Bariatric Surgery: A Propensity Matched Cohort Study J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-19 Erik Stenberg, Johan Ottosson, Erik Näslund
Background: While obstructive sleep apnea (OSA) is common among patients with obesity and linked to cardiovascular disease, there is a lack of studies evaluating the effects of reaching remission from OSA after metabolic and bariatric surgery (MBS). Study Design: A registry-based nationwide study including patients operated with sleeve gastrectomy or Roux-en-Y gastric bypass from 2007 until 2019 in
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Refractory and Recurrent Idiopathic Granulomatous Mastitis Treatment: Adaptive, Randomized Clinical Trial J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-19 Fatemeh Shojaeian, Shahpar Haghighat, Fereshteh Abbasvandi, Alireza Houshdar Tehrani, Niki Najar Najafi, Ashkan Zandi, Asiie Olfatbakhsh, Maryam Sharifi, Esmat Hashemi, Nahid Nafissi, Safa Najafi
Background: Idiopathic Granulomatous Mastitis (IGM) is mostly described as an autoimmune disease with high prevalence among Middle Eastern childbearing-age women. The current study aimed to evaluate the best treatment of choice in patients with resistant or recurrent IGM. Study Design: Patients with established recurrent or resistant IGM who were referred to the breast cancer research center from 2017
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Evaluating Outcomes of Non-Accidental Trauma in Military Children J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-19 Katie Joskowitz, Utsav M Patwardhan, Gretchen M Floan, Megan Heflinger, Sheena Cruz, Maya David, Priyanka Jadhav, Shalon Nienow, Hari Thangarajah, Romeo C Ignacio
Background: Non-accidental trauma (NAT), or child abuse, is a leading cause of childhood injury and death in the United States. Studies demonstrate that military-affiliated individuals are at greater risk of mental health complications and family violence, including child maltreatment. There is limited information about the outcomes of military children who experience NAT. This study compares the outcomes
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When It’s Not Worth the Wait: Early Elective Repair for Paraesophageal Hernias J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-15 Marcelo Cerullo, Kunal Patel
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In Search of the Truth: Choice of Ground-Truth for Predictive Modeling of Trauma Team Activation in Pediatric Trauma J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-15 Miranda Chacon, Catherine W Liu, Loralai Crawford, Hadassah Polydore, Tiffany Ting, Derek Wakeman, Nicole A Wilson
Background: Assigning trauma team activation levels for trauma patients is a classification task that machine learning models can help optimize. However, performance is dependent upon the “ground-truth” labels used for training. Our purpose was to investigate two ground-truths, the Cribari matrix and the Need for Trauma Intervention (NFTI), for labeling training data. Study Design: Data was retrospectively
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Updated Markov Model to Determine the Optimal Management Strategy for Patients with Paraesophageal Hernia with Symptoms, Cameron Ulcer, or Comorbid Conditions J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-15 Steven R DeMeester, Lisa Bernard, Sebastian F Schoppmann, Sarah C McKay, J Scott Roth
Background: The current paradigm of watchful waiting (WW) in people 65 years or older with an asymptomatic paraesophageal hernia (PEH) is based on a now 20-year old Markov analysis. Recently we have shown that elective laparoscopic PEH repair (ELHR) provides an increase in life-years compared to watchful waiting (WW) in most healthy patients aged 40-90. However, elderly patients often have comorbid
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Continued Diabetes Remission Despite Weight Recurrence: Gastric Bypass Long-Term Metabolic Benefit J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-13 Omar M Ghanem, Kamal Abi Mosleh, Anthony Kerbage, Lauren Lu, Karl Hage, Barham K Abu Dayyeh
Background: Roux-en-Y gastric bypass (RYGB) demonstrates high rates of type-2 diabetes mellitus (T2DM) remission, a phenomenon hypothesized to be mediated mainly by weight loss. Compared to procedures that do not bypass the proximal small-intestines, such as sleeve gastrectomy (SG), RYGB exhibits weight-loss independent intestinal mechanisms conducive to T2DM remission. We investigated continued diabetes
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Risk of Early Postoperative Cardiovascular and Cerebrovascular Complication in Patients with Preoperative COVID-19 Undergoing Cancer Surgery J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-13 Gopika SenthilKumar, Nathaniel B Verhagen, Kaitlyn Nimmer, Xin Yang, Carlos E Figueroa Castro, Aniko Szabo, Bradley W Taylor, Njeri Wainaina, Jon C Gould, Anai N Kothari
Background: As the COVID-19 pandemic shifts to an endemic phase, an increasing proportion of cancer patients with a preoperative history of COVID-19 will require surgery. This study aimed to assess the influence of preoperative COVID-19 on postoperative risk for major adverse cardiovascular and cerebrovascular events (MACE) among those undergoing surgical cancer resection. Secondary objectives included
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Reduction of Urinary Tract Infection in Pediatric Surgical Patients Using NSQIP-P and Quality Improvement Methodology J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-12 Kyla A Clasie, Aniruddh V Deshpande, Andrew JA Holland, Ashish V Jiwane, Vanessa G Da Silva, Fiona A Filtness, Margaret M Allen, Grahame HH Smith
Background: Hospital acquired urinary tract infections (UTIs) have a detrimental effect on patients, families and hospital resources. The Sydney Children’s Hospital Network (SCHN) participates in the National Surgical Quality Improvement Program - Pediatric (NSQIP-P) to monitor post operative complications. NSQIP-P data revealed that the median UTI rate at SCHN was 1.75% in 2019, 3.5 times higher than
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Impact of Preoperative Weight Loss on 30-Day Complication Rate after Bariatric Surgery J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-12 Omnia S Saleh, Youssef MK Farag, Pourya Medhati, Ali Tavakkoli
Background: The aim of this study is to evaluate the impact of pre-operative weight loss on surgical outcomes and OR times after primary bariatric procedures, including Laparoscopic Sleeve Gastrectomy (LSG) and Laparoscopic Roux-en-Y Gastric Bypass (RYGB). Study Design: A retrospective cohort study utilizing the 2021 MBSAQIP dataset. Pre-operative total weight loss (TWL)% was calculated. Patients were
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Anchors Aweigh! The History of Women Surgeons at Sea J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-09 Amy A Hernandez, André B Sobocinski, Matthew D Tadlock
Throughout history, the maritime nations of the world have employed surgeons in seagoing service. The history of women in surgery and the military is well described, but no prior report exists describing the gender breakdown of past and current sea-going U.S. Navy general surgeons. Using literature review, primary sources, personal interviews, and correspondence with Navy Medicine administrative leaders
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Resection of the Primary Tumor and Survival in Patients with Single-Site Synchronous Oligometastatic Non-Small Cell Lung Cancer: Propensity-Matched Analysis of the National Cancer Database J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-09 Jorge Humberto Rodriguez-Quintero, Rajika Jindani, Mohamed K Kamel, Roger Zhu, Marc Vimolratana, Neel P Chudgar, Brendon M Stiles
Background: Local therapy for the primary tumor is postulated to remove resistant cancer cells as well as immunosuppressive cells from the tumor microenvironment, potentially improving response to systemic therapy. We sought to determine whether resection of the primary tumor was associated with overall survival in a multicentric cohort of patients with single-site synchronous oligometastatic NSCLC
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The Implications of Social Policy for Injury J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-08 Diane N Haddad, Elinore J Kaufman
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State-Level Analysis of Intimate Partner Violence, Abortion Access, and Peripartum Homicide: Call for Screening and Violence Interventions for Pregnant Patients J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-08 Grace Keegan, Mark Hoofnagle, Julie Chor, David Hampton, Jennifer Cone, Abid Khan, Susan Rowell, Timothy Plackett, Andrew Benjamin, Neha Bhardwaj, Selwyn O Rogers, Tanya L Zakrison, Justin M Cirone
Background: Despite representing 4% of the global population, the United States has the 5th highest number of intentional homicides in the world. Peripartum people represent a unique and vulnerable subset of homicide victims. This study aims to understand the risk factors for peripartum homicide. Study Design: We used data from the 2018-2020 National Violent Death Reporting System to compare homicide
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Recent Changes in the Management of High-Grade Blunt Pancreatic Injury in Children: A Nationwide Trend Analysis J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-07 Morihiro Katsura, Tatsuyoshi Ikenoue, Makoto Aoki, Akira Kuriyama, Kyosuke Takahashi, Morgan Schellenberg, Matthew J Martin, Kenji Inaba, Kazuhide Matsushima
Background: The optimal management of pediatric patients with high-grade blunt pancreatic injury (BPI) involving the main pancreatic duct remains controversial. This study aimed to assess the nationwide trends in the management of pediatric high-grade BPI at pediatric (PTC), mixed (MTC), and adult trauma centers (ATC). Methods: This is a retrospective observational study of the National Trauma Data
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2023 Edward D Churchill Lecture: Service, Synergy, and Surgical Mythology J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-07 M Margaret Knudson
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Proposal for Prognosis-Oriented Definition of Borderline Resectable Hepatocellular Carcinoma J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-07 Koichiro Haruki, Norifumi Harimoto, Kenei Furukawa, Tomohiko Taniai, Mitsuru Yanagaki, Yosuke Igarashi, Masashi Tsunematsu, Yoshihiro Shirai, Ken Shirabe, Toru Ikegami
Background: Owing to advances in the multidisciplinary treatment of hepatocellular carcinoma (HCC), a conceptualization and definition for borderline resectable (BR) HCC, which carries a high risk of recurrence, is warranted. In this study, we aimed to define BR-HCC using a prognosis-oriented approach. Methods: The study included an original cohort of 221 patients and an independent validation cohort
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Revisiting Pearls that Epitomize the Principles of Surgery J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-06 Alan Meinke, Walter Longo
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Differentiating Pathologic from Physiologic Fibrinolysis: Not as Simple as Conventional Thrombelastography J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-01 Hunter B Moore, Christopher D Barrett, Ernest E Moore, Fredric M Pieracci, Angela Sauaia
Background: Conventional rapid-thrombelastography (rTEG) cannot differentiate fibrinolysis shutdown from hypofibrinolysis, as both of these patient populations have low fibrinolytic activity. Tissue plasminogen activator (tPA) TEG can identify depletion of fibrinolytic inhibitors, and its use in combination with rTEG has the potential to differentiate all three pathologic fibrinolytic phenotypes following
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Utility of Circulating Tumor DNA Assessment in Characterizing Recurrence Sites after Optimal Resection for Metastatic Colorectal Cancer J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-02-01 Varun V Bansal, Erika Belmont, Frederick Godley IV, Ankit Dhiman, Hunter D D Witmer, Shen Li, Andy Liao, Oliver S Eng, Kiran K Turaga, Ardaman Shergill
Introduction: Plasma ctDNA is a promising biomarker for metastatic colorectal cancer (mCRC); however, its role in characterizing recurrence sites after mCRC resection remains poorly understood. This single-institution study investigated the timing of ctDNA detection and its levels in the context of recurrence at different sites following mCRC resection. Methods: Patients who underwent optimal resection
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Gender-Affirming Mastectomy: Psychosocial and Surgical Outcomes in Transgender Adults J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-31 AA Bertrand, Michael R DeLong, Sean P McCleary, Edward H Nahabet, Ginger C Slack, Andrew L DaLio, Amy K Weimer, Lorna Kwan, Jessica Bernacki, George H Rudkin
Background: Limited literature exists examining the effects of gender-affirming mastectomy on transmasculine and nonbinary patients that is prospective and uses validated survey instruments. Study Design: The psychosocial functioning of transmasculine and nonbinary patients was compared between patients who underwent gender-affirming mastectomy and those who had not yet undergone surgery. Participants
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Mentor, Coach, Sponsor: Who, Why, How J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-31 Kenneth W Sharp
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Proteomic Analysis and Sex-Specific Changes in Chronically Ischemic Swine Myocardium Treated with Sodium-Glucose Cotransporter-2 Inhibitor Canagliflozin J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-30 Dwight D Harris, Sharif A Sabe, Mark Broadwin, Christopher Stone, Akshay Malhotra, Cynthia M Xu, Mohamed Sabra, M Ruhul Abid, Frank W Sellke
Background: Although sodium-glucose cotransporter-2 (SGLT-2) inhibitors have been shown to improve cardiovascular outcomes in general, little is presently known about any sex-specific changes that may result from this therapy. We sought to investigate and quantify potential sex-specific changes seen with the SGLT-2 inhibitor canagliflozin (CAN) in a swine model of chronic myocardial ischemia. Study
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Discussion of The Kidney Not Taken: Single Kidney Use in Deceased Donors J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-30
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Discussion of Socioeconomic Determinants of Outcomes Disparity among Pediatric Sarcoma Patients J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-30
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Artificial Intelligence to the Rescue: The Unending Search for Retained Surgical Items J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-30 Emma Burke, Todd K Rosengart
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Discussion of Incidental but Not Insignificant: Thyroid Cancer in Patients with Graves Disease J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-25
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A Deeper Analysis of the Therapeutic Effect of Upper Mediastinal Lymphadenectomy (In Reply to Ke) J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-25 Taro Oshikiri
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The Clinical Efficacy of Resected Lymph Nodes Should Depend on Lymph Nodes Stations and the Primary Location of the Tumor J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-25 Kexun Li, Simiao Lu, Tengfei Ke
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Discussion of Artificial Intelligence to Predict Quality of Life Outcomes for Vascular Intervention of the Leg J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-25
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Clinical Validation of Computer-Aided Diagnosis Software for Preventing Retained Surgical Sponges J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-23 Ken Kurisaki, Akihiko Soyama, Shin Hamauzu, Masahiko Yamada, Shun Yamaguchi, Kunihito Matsuguma, Enzo Kerkhof, Toru Fukuda, Ryo Toya, Susumu Eguchi
Background: We previously reported the successful development of a computer-aided diagnosis (CAD) system for preventing retained surgical sponges with deep learning using training data, including composite and simulated radiographs. In this study, we evaluated the efficacy of the CAD system in a clinical setting. Study design: 1,053 postoperative radiographs obtained from patients aged 20 years or
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Judgment Errors in Surgical Care J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-23 Katherine M Marsh, Florence E Turrentine, Ruyun Jin, Bruce D Schirmer, John B Hanks, John P Davis, Worthington G Schenk, R Scott Jones
Background: Human error is impossible to eliminate, particularly in systems as complex as health care. The extent to which judgment errors in particular impact surgical patient care or lead to harm is unclear. Study Design: American College of Surgeons National Surgery Quality Improvement Program (2018) procedures from a single institution with 30-day morbidity or mortality were examined. Medical records
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Social Determinants of Outcomes Disparity among Pediatric Solid Tumor Patients J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-23 Elizabeth D Cochran, Jillian C Jacobson, Mithin Nehrubabu, Jingbo Qiao, Sullivan McCreery, Dai H Chung
Background: Socioeconomic factors have a significant impact on healthcare outcomes. Metrics such as the Area Deprivation Index (ADI) are used to quantify the anticipated influence of these factors. Here, we sought to assess the impact of socioeconomic factors on clinical outcomes among pediatric solid tumor patients in our region. Study Design: We identified 3863 pediatric patients who were diagnosed
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Race and Ethnic Group Enrollment and Outcomes for Wilms Tumor: Analysis of the Current Era Children’s Oncology Group Study AREN03B2 J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-22 Harold N Lovvorn III, Lindsay A Renfro, Daniel J Benedetti, Meera Kotagal, Hannah M Phelps, Peter F Ehrlich, Andrea C Lo, Jesse K Sandberg, Amanda L Treece, Kenneth W Gow, Richard D Glick, Andrew M Davidoff, Nicholas G Cost, David B Dix, Conrad V Fernandez, Jeffrey S Dome, James I Geller, Elizabeth A Mullen
Introduction: To review race and ethnic group enrollment and outcomes for Wilms tumor (WT) across all four risk-assigned therapeutic trials from the current era Children’s Oncology Group Renal Tumor Biology and Risk Stratification Protocol, AREN03B2. Methods: For WT patients enrolled on AREN03B2 (2006-2019), disease and biologic features, therapeutic study-specific enrollment, and event-free (EFS)
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Airway, Breathing, Circulation vs Circulation, Airway, Breathing J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-22 Charles E Lucas
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Improving Long-term Care of Chronic Pancreatitis Patients J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-22 Kevin M Turner, Gregory C Wilson
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Total Pancreatectomy Is a Questionable Choice for Treatment of Chronic Pancreatitis J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-22 Jan Bardenhagen, Jakob R Izbicki
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The First Woman Medical Doctor in Venezuela J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-22 Luis Morales Ojeda
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Discussion of Increasing Injury Intensity Among 6500 Violent Deaths in the State of Maryland J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-19
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Discussion of Use of Preoperative Endoscopic Capsule-Based pH Testing Before Bariatric Surgery J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-18
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Home Is Not Always Where the Sleep Is: The Effect of Home Call on Sleep, Burnout, and Surgeon Well-Being J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-18 Jamie J Coleman, Caitlin K Robinson, William von Hippel, Ryan A Lawless, Kelly M McMasters, Mitchell J Cohen
Background: In-house calls contribute to loss of sleep and surgeon burnout. While acknowledged to have an opportunity cost, home call is often considered less onerous, with minimal effects on sleep and burnout. We hypothesized home call would result in impaired sleep and increased burnout in acute care surgeons (ACS). Study Design: Data from 224 ACS were collected over six months. Participants wore
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Discussion of Impact of Neoadjuvant Therapy for Pancreatic Cancer: A Transatlantic Trend and Outcomes Analysis J. Am. Coll. Surg. (IF 5.2) Pub Date : 2024-01-18