American Journal of Surgery

Michael A Edwards, Michael Mazzei, Huaqing Zhao, Satyajit Reddy, Riyaz Bashir
BACKGROUND: Prophylactic inferior vena cava (IVC) filter use in bariatric surgery patients is a physician- and patient-dependent practice pattern with unclear safety and efficacy. Factors that mediate physicians' decisions for IVC filter placement preoperatively remain unclear. The role of race in decision-making also remains unclear. METHODS: From the 2015-2016 MBASQIP database, patient characteristics leading to IVC filter use and outcomes after IVC filter placement were compared between Black and White primary bariatric surgery patients...
March 19, 2020: American Journal of Surgery
Jennifer Schendel, Evan Jost, Matt Mah, Lloyd Mack, Michael McCall, Ningzhi Gu, Shiying Kong, Yuan Xu, Antoine Bouchard-Fortier
BACKGROUND: As Canada's population ages, incidence of gastric cancer in elderly patients is increasing. There is little data on treatment and outcomes of gastric cancer in patients older than age 75. This study aimed to assess treatment patterns and outcomes of non-metastatic elderly gastric cancer patients in Alberta, Canada. METHODS: Records of elderly patients (age 75 or older) diagnosed with localized gastric or gastroesophageal junction cancer between 2007 and 2012 who received curative intent surgery were retrospectively collected from the Alberta Cancer Registry...
March 19, 2020: American Journal of Surgery
Patrick T Dolan, Matthew M Symer, Jialin I Mao, Julie A Sosa, Heather L Yeo
BACKGROUND: Attrition from general surgery residency is high with a national rate of 20%. We evaluated potential associations between financial considerations and attrition. METHODS: National prospective cohort study of categorical general surgery trainees. RESULTS: Of the 1048 interns who started training in 2007, 681 (65%) had complete survey and follow-up data. In logistic regression, those with higher starting attending salary expectations (>$300K) were more likely to leave training (OR 2...
March 17, 2020: American Journal of Surgery
Quinton Hatch, Christopher Marenco, Daniel Lammers, Kaitlin Morte, Andrew Schlussel, Shane McNevin
INTRODUCTION: Limited data exists regarding outcomes for the Bascom cleft lift procedure for pilonidal disease. METHODS: Single-center retrospective review of patients who underwent a Bascom cleft lift from 2013 to 2018. Univariate analysis was performed to determine associations between patient-specific characteristics and post-operative complications. Postoperative complications were categorized as major or minor. Multivariate analysis was performed to identify predictors of postoperative complications...
March 14, 2020: American Journal of Surgery
Elettra Merola, Massimo Falconi, Anja Rinke, Stefan Staettner, Felix Krendl, Stefano Partelli, Valentina Andreasi, Thomas M Gress, Andreas Pascher, Ruza Arsenic, Claudio Doglioni, Daniel Kaemmerer, Bertram Wiedenmann, Marianne E Pavel
BACKGROUND: Stage IV gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) G3 are the NENs with the worst prognosis. According to ENETS guidelines, platinum-based chemotherapy is the standard treatment for this population. Surgery is only considered in highly selected "resectable" NENs with usually lower Ki67. However, the role of surgery with curative intent has been poorly investigated. OBJECTIVE: To describe, in a retrospective series of stage IV GEP-NENs G3, overall survival (OS) and recurrence-free survival (RFS) rates after curatively intended surgery...
March 14, 2020: American Journal of Surgery
Sandra MacDonald, Jodi Siever, Christopher Baliski
BACKGROUND: Among melanoma patients with a tumor-positive sentinel node biopsy (SNB), approximately 20% harbor disease in non-sentinel nodes (nSN), as determined by a completion lymph node dissection (CLND). CLND lacks a survival benefit and has high morbidity. This study assesses predictive factors for nSN metastasis and validates five models predicting nSN metastasis. METHODS: Patients with invasive melanoma were identified from the BC Cancer Agency (2005-2015)...
March 13, 2020: American Journal of Surgery
Eric B Rosero, J Gregory Modrall, Girish P Joshi
BACKGROUND: We aimed to examine whether safety-net burden is a significant predictor of failure-to-rescue (FTR) after major abdominal surgery controlling for patient and hospital characteristics, including surgical volume. METHODS: Data were extracted from the 2007-2011 Nationwide Inpatient Sample. FTR was defined as mortality among patients experiencing major postoperative complications. Differences in rates of complications, mortality, and FTR across quartiles of safety-net burden were assessed with univariate analyses...
March 12, 2020: American Journal of Surgery
Ekene Onwuka, Justin Huntington, Amanda Onwuka, Vinay Prasad, Benedict Nwomeh
BACKGROUND: The aim of this study was to determine whether acute histologic inflammatory activity at the rectal margin predicts postoperative complications in children with ulcerative colitis following ileal pouch-anal anastomoses (IPAA). METHODS: Patients who underwent IPAA following previous total abdominal colectomy for ulcerative colitis between 2006 and 2014 were included. Data collected included demographics, operative and postoperative data, histologic grading of the rectal margin at time of IPAA, and stooling outcomes at one, six and 12 months following ileostomy closure...
March 11, 2020: American Journal of Surgery
Jay Zhu, Kathryn M Stadeli, Kavita Pandit, Jennifer Zech, Andrew Ludwig, Kathryn Harris, Hannah Naughton, Jonathan Yi, Giana H Davidson, Patricia A Kritek
BACKGROUND: Clear and effective communication supports interdisciplinary teamwork and prevents adverse patient events. At our academic teaching hospital, poor communication between surgical residents and nurses was identified as a recurring problem, particularly on the inpatient general surgery night float rotation. METHODS: A standardized nightly huddle with surgical residents and nurses was developed and implemented as a resident-led quality improvement initiative on two acute care units...
March 10, 2020: American Journal of Surgery
Kathryn M Stadeli, Dirir Abdullahi, Abdifatah Ali, Kelsey M Conrick, Maria Paulsen, Eileen M Bulger, Monica S Vavilala, Farah Bille Mohamed, Ahmed Ali, Anisa Ibrahim
BACKGROUND: We developed a culturally-adapted program (WE Stop the Bleed) to increase bleeding control knowledge and self-efficacy among Somali individuals, and to build trust between Somali individuals and first responders. METHODS: WE Stop the Bleed was piloted in the Seattle Somali community with first responders as skills coaches. The program included: 1) adapted ACS Stop the Bleed program; 2) cultural exchange. We evaluated knowledge, self-efficacy, and trust between Somali participants and first responders using a pre/post survey...
March 10, 2020: American Journal of Surgery
Thomas L Sutton, Nathalie Johnson, Alexander Schlitt, Stuart K Gardiner, Jennifer R Garreau
BACKGROUND: Neoadjuvant chemotherapy (NAC) is increasingly used in the treatment of breast cancer. The time interval from last dose of cytotoxic chemotherapy to surgery (TTS) can vary widely. We aimed to evaluate the effect of TTS on postoperative complications. METHODS: A retrospective review for women treated with NAC at our institution between January 2011 through December 2016 was performed. Charts were reviewed for postoperative wound complications, and multivariate analysis was performed...
March 10, 2020: American Journal of Surgery
Christopher Baliski, Jeremy Hamm
BACKGROUND: Patients with early breast cancer have multiple surgical options, with their choice being based on personal values, and ultimately being preference sensitive. Most patients will choose breast conserving surgery (BCS) as their preferred management, with some ultimately requiring mastectomy. These patients may have lower satisfaction with this approach than others choosing mastectomy as their preferred option. METHODS: The BREAST-Q patient reported outcomes (PRO) measurement tool was retrospectively administered to patients undergoing mastectomy...
March 10, 2020: American Journal of Surgery
Stephanie Radu, Dale Han, Graham Fowler, Gang Han, Jeanine Fortino, John T Vetto
INTRODUCTION: Patient age has been intermittently associated with demographics and outcomes in cutaneous melanoma. We looked at the association of age and patient demographics, tumor features, and melanoma-related outcomes in patients undergoing sentinel lymph node (SLN) biopsy for melanoma. METHODS: We reviewed demographics (age, gender), tumor features (mean Breslow thickness, ulceration, SLN positivity rates), and outcomes (all-site relapse, progression to stage IV, death from melanoma, complications) from a university-based prospective database of 1633 patients...
March 10, 2020: American Journal of Surgery
Melissa Wong, Assaf P Oron, Anna Faino, Susan Stanford, Jennifer Stevens, Claudia S Crowell, Patrick J Javid
BACKGROUND: In newborns with gastroschisis, both primary repair and delayed fascial closure with initial silo placement are considered safe with similar outcomes although cost differences have not been explored. METHODS: A retrospective review was performed of newborns admitted with gastroschisis at a single center from 2011 to 2016. Demographic, clinical, and cost data during the initial hospitalization were collected. Differences between procedure costs and clinical endpoints were analyzed using multivariable linear regression adjusting for prematurity, complicated gastroschisis, and performance of additional operations...
March 9, 2020: American Journal of Surgery
Xiuling Cui, Cuinv Zhu, Peng Chen, Min Qu, Bowei Zhang, Hongtao Li
BACKGROUND: To investigate whether the use of Pecs II block benefit patients with the respect to the immune functions. METHODS: Totally 196 patients were included in this study. These patients were randomized to two groups, general anesthesia alone group (G group) and Pectoral nerve (Pecs) II block under general anesthesia group (PG group). RESULTS: It was found that remifentanil consumption was less in PG group than it in G group. PG group showed a higher proportion of NK cells in peripheral blood mononuclear cell (PBMC) and an improved killing activity than G groups after surgery...
March 8, 2020: American Journal of Surgery
Nikolaos Kokoroskos, Thomas Peponis, Jae Moo Lee, Majed El Hechi, Leon Naar, Joana Abed Elahad, Charlie Nederpelt, Alexander Bonde, Karien Meier, April Mendoza, David King, Peter Fagenholz, Haytham Kaafarani, George Velmahos, Noelle Saillant
BACKGROUND: Laparoscopic cholecystectomy (LC) has a wide range of technical difficulty. Preoperative risk stratification is essential for adequate planning and patient counseling. We hypothesized that gallbladder wall thickness (GWT) is more objective marker than symptom duration in predicting complexity, as determined by operative time (OT), intraoperative events (IE), and postoperative complications. METHODS: All adult patients who underwent LC during 2010-2018 were included...
March 8, 2020: American Journal of Surgery
Allen H Hayashi
No abstract text is available yet for this article.
March 6, 2020: American Journal of Surgery
Yam Po Chu Patricia, Wong Ka Fai Kevin, Lam Fong Yee, Fung Kiu Jing, Szeto Kylie, Leung Siu Kee
BACKGROUND: Duodenal stump leakage is a challenging condition causing significant morbidity and mortality. The aim of this study is to identify the risk factors associated with duodenal leak and advocate modification to prevent the incident. METHODS: A retrospective cohort study was performed to include patients who had gastrectomy with excluded duodenum in a single surgical centre in the period of Jan 2003-March 2017. Analysis of associated factors was performed...
March 2, 2020: American Journal of Surgery
Patrick D Melmer, Ryan Taylor, Keely Muertos, Jason D Sciarretta
Fatal lower level falls commonly result from ladder fall injuries (LFIs), an often-avoidable injury. We hypothesized that older patients' injury severity differs from younger patients falling from the same mechanism with fall height determining overall morbidity. A retrospective review was completed of all traumatic LFIs during a 6-year period resulting in 178 patients. The mean LFI height was 10.9 ± 6.0 feet, the majority being male (87%), with a mean age of 50.7 ± 16.6 years. The mean ISS was 7.7 ± 7...
February 29, 2020: American Journal of Surgery
John Kuckelman, Varinia Vigueras, Dom Forte, Jason Bingham, James Sebesta, Matthew Eckert
BACKGROUND: Currently, no evidence compares outcomes for techniques utilizing surgical specimen extractions bags versus unprotected extraction. METHODS: Evaluation of sleeve gastrectomies performed at two high-volume centers. Cases where an extraction bag was used (+EB) were compared to bag-less extraction (-EB). Outcomes included operative contamination, surgical site infections and extraction-site hernias. RESULTS: 674 patients were evaluated (417 in the +EB group and 257 in the -EB group)...
February 29, 2020: American Journal of Surgery
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