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Annals of Surgery

Min Seo Kim, Won Jun Kim, Woo Jin Hyung, Hyoung-Il Kim, Sang-Uk Han, Young-Woo Kim, Keun Won Ryu, Sungsoo Park
OBJECTIVE: To evaluate the complication-based learning curve and identify learning-associated complications of robotic gastrectomy. SUMMARY BACKGROUND DATA: With the increased popularity of robotic surgery, a sound understanding of the learning curve in the surgical outcome of robotic surgery has taken on great importance. However, a multicenter prospective study analyzing learning-associated morbidity has never been conducted in robotic gastrectomy. METHODS: Data on 502 robotic gastrectomy cases were prospectively collected from 5 surgeons...
September 9, 2019: Annals of Surgery
Eleonora G Karthaus, Thaïs M L Tong, Anco Vahl, Jaap F Hamming
OBJECTIVE: The aim of this was to analyze differences between saccular-shaped abdominal aortic aneurysms (SaAAAs) and fusiform abdominal aortic aneurysms (FuAAAs) regarding patient characteristics, treatment, and outcome, to advise a threshold for intervention for SaAAAs. BACKGROUND: Based on the assumption that SaAAAs are more prone to rupture, guidelines suggest early elective treatment. However, little is known about the natural history of SaAAAs and the threshold for intervention is not substantiated...
September 5, 2019: Annals of Surgery
Mehdi El Amrani, Xavier Lenne, Guillaume Clement, Jean-Robert Delpero, Didier Theis, François-René Pruvot, Amelie Bruandet, Stephanie Truant
OBJECTIVES: We aimed to examine whether the improved outcome of a digestive cancer procedure in high-volume hospitals is specific or correlates with that of other digestive cancer procedures, and determine if the discriminant cut-off of hospital volume may influence postoperative mortality (POM) regardless of the procedure. BACKGROUND: Performing complex surgeries in tertiary centers is associated with improved outcome. However, the association between POM and hospital volume of nonspecific procedures is unknown...
September 5, 2019: Annals of Surgery
Luis Sabater, Esteban Cugat, Alejandro Serrablo, Gonzalo Suarez-Artacho, Luis Diez-Valladares, Julio Santoyo-Santoyo, Elena Martín-Pérez, Fabio Ausania, Santiago Lopez-Ben, Jose Maria Jover-Navalon, Marina Garcés-Albir, Maria Isabel Garcia-Domingo, Mario Serradilla, Elia Pérez-Aguirre, Belinda Sánchez-Pérez, Marcello Di Martino, Paula Senra-Del-Rio, Laia Falgueras-Verdaguer, Alberto Carabias, Mari Carmen Gómez-Mateo, Antonio Ferrandez, Dimitri Dorcaratto, Elena Muñoz-Forner, Constantino Fondevila, Javier Padillo
OBJECTIVE: To compare the rates of R0 resection in pancreatoduodenectomy (PD) for pancreatic and periampullary malignant tumors by means of standard (ST-PD) versus artery-first approach (AFA-PD). BACKGROUND: Standardized histological examination of PD specimens has shown that most pancreatic resections thought to be R0 resections are R1. "Artery-first approach" is a surgical technique characterized by meticulous dissection of arterial planes and clearing of retropancreatic tissue in an attempt to achieve a higher rate of R0...
September 5, 2019: Annals of Surgery
Marialuisa Lugaresi, Benedetta Mattioli, Niccolò Daddi, Francesco Bassi, Vladimiro Pilotti, Luca Ferruzzi, Sandro Mattioli
MINI: In cases of true short esophagus diagnosed intraoperatively with an endoscopic-laparoscopic method, Collis-Nissen and stomach around stomach fundoplication procedures achieved similar results. The notion that the gastric fundus must be wrapped around a conveniently long segment of the tubular esophagus to obtain an efficient fundoplication should be revised. OBJECTIVE: To explore the true short esophagus (TSE) frequency and long-term results of patients undergoing gastro-esophageal reflux disease (GERD) or hiatus hernia (HH) surgery...
September 3, 2019: Annals of Surgery
Panos Kougias, Sherene Sharath, Zhibao Mi, Kousick Biswas, Joseph L Mills
OBJECTIVES: To determine the effect of postoperative permissive anemia and high cardiovascular risk on postoperative outcomes. METHODS: The Veterans Affairs Surgical Quality Improvement Program and Corporate Data Warehouse databases were queried for patients who underwent major vascular or general surgery operations. The status of cardiovascular risk was assessed by calculating the Revised Cardiac Risk Index. Primary endpoint was a composite of mortality, myocardial infarction, acute renal failure, coronary revascularization, or stroke within 90 days postoperatively...
August 30, 2019: Annals of Surgery
Rui Mao, Kan Li, Jian-Qiang Cai, Sheng Luo, Megan Turner, Dan Blazer, Hong Zhao
OBJECTIVE: The aim of this study was to determine whether adjuvant chemotherapy (AC) provides a survival benefit in patients with nonmetastatic poorly differentiated colorectal neuroendocrine carcinomas (CRNECs) following resection. BACKGROUND: There is little evidence to support the association between use of AC and improved overall survival (OS) in patients with CRNECs. METHODS: Patients with resected non-metastatic CRNECs were identified in the National Cancer Database (2004-2014)...
August 30, 2019: Annals of Surgery
Ryan Howard, Joceline Vu, Jay Lee, Chad Brummett, Michael Englesbe, Jennifer Waljee
OBJECTIVE: Opioid prescriptions after surgery are effective for pain management but have been a significant contributor to the current opioid epidemic. Our objective is to review pragmatic approaches to develop and implement evidence-based guidelines based on a learning health system model. SUMMARY BACKGROUND DATA: During the last 2 years there has been a preponderance of data demonstrating that opioids are overprescribed after surgery. This contributes to a number of adverse outcomes, including diversion of leftover pills in the community and rising rates of opioid use disorder...
August 30, 2019: Annals of Surgery
Joel Ward, Zahir Soonawalla, Michael Silva
No abstract text is available yet for this article.
August 29, 2019: Annals of Surgery
Timothy E Newhook, Timothy J Vreeland, Whitney L Dewhurst, Elsa M Arvide, Morgan L Bruno, Kristen A Robinson, Nikita Rajkot, Thomas A Aloia, Matthew H G Katz, Jean-Nicolas Vauthey, Jeffrey E Lee, Ching-Wei D Tzeng
No abstract text is available yet for this article.
August 29, 2019: Annals of Surgery
Xupeng Zhao, Chengcheng Wang, Zhen Li
No abstract text is available yet for this article.
August 29, 2019: Annals of Surgery
Sam M Wiseman, Jennifer Li, Masoud Pourrahmat, Elizaveta Vasilyeva, Peter T Kim, Jill Osborn
No abstract text is available yet for this article.
August 29, 2019: Annals of Surgery
Mustafa Raoof, Sidra Haye, Philip H G Ituarte, Yuman Fong
OBJECTIVE: The aim of this study was to estimate population-level causal effects of liver resection on survival of patients with colorectal cancer liver metastases (CRC-LM). BACKGROUND: A randomized trial to prove that liver resection improves survival in patients with CRC-LM is neither feasible nor ethical. Here, we test this assertion using instrumental variable (IV) analysis that allows for causal-inference by controlling for observed and unobserved confounding effects...
August 29, 2019: Annals of Surgery
Siobhan Deshauer, Sydney McQueen, Melanie Hammond Mobilio, Dorotea Mutabdzic, Carol-Anne E Moulton
OBJECTIVE: The present study investigated the role of mental skills in surgery through the unique lens of current surgeons who had previously served as Olympic athletes, elite musicians, or expert military personnel. BACKGROUND: Recent work has demonstrated great potential for mental skills training in surgery. However, as a field, we lag far behind other high-performance domains that explicitly train and practice mental skills to promote optimal performance. Surgery stands to benefit from this work...
August 28, 2019: Annals of Surgery
Nathanial Miletta, Katherine Siwy, Chad Hivnor, Jason Clark, Joshua Shofner, David Zurakowski, R Rox Anderson, Kachiu Lee, Matthias Donelan
OBJECTIVE: The aim of this study is to determine objective and subjective changes in mature hypertrophic burn scars treated with a fractional ablative carbon dioxide (CO2) laser. BACKGROUND: Fractional CO2 laser treatment has been reported to improve burn scars, with increasing clinical use despite a paucity of controlled, prospective clinical studies using objective measures of improvement. METHODS: A multicenter, site-controlled, prospective open-label study was conducted from 2013 to 2016...
August 28, 2019: Annals of Surgery
Abeed H Chowdhury, Alfred Adiamah, Anisa Kushairi, Krishna K Varadhan, Zeljko Krznaric, Anil D Kulkarni, Keith R Neal, Dileep N Lobo
OBJECTIVE: To define the impact of perioperative treatment with probiotics or synbiotics on postoperative outcome in patients undergoing abdominal surgery. BACKGROUND: Postoperative surgical infection accounts for a third of all cases of sepsis, and is a leading cause of morbidity and mortality. Probiotics, prebiotics, and synbiotics (preparations that combine probiotics and prebiotics) are nutritional adjuncts that are emerging as novel therapeutic modalities for preventing surgical infections...
August 28, 2019: Annals of Surgery
Katherine B Santosa, Ji Qi, Hyungjin M Kim, Jennifer B Hamill, Andrea L Pusic, Yoon Sun Chun, Edwin G Wilkins, Jeffrey H Kozlow
OBJECTIVE: The primary aim of this study was to compare patient-reported outcomes (PROs) of women who underwent immediate implant-based breast reconstruction (IBBR) after receiving either: (1) nipple-sparing mastectomy (NSM) or (2) simple mastectomy with subsequent nipple reconstruction (SNR). BACKGROUND: The goal of post-mastectomy breast reconstruction is to restore body image and quality-of-life after mastectomy, but removal of the nipple-areolar complex may have its own negative psychosocial consequences...
August 28, 2019: Annals of Surgery
Cheryl K Zogg, Jyothi R Thumma, Andrew M Ryan, Justin B Dimick
OBJECTIVE: To assess whether a hospital's percentage of Black patients associates with variations in FY2017 overall/domain-specific Hospital Acquired-Condition Reduction Program (HACRP) scores and penalty receipt. Differences in socioeconomic status and receipt of disproportionate share hospital payments (a marker of safety-net status) were also assessed. SUMMARY OF BACKGROUND DATA: In FY2015, Medicare began reducing payments to hospitals with high adverse event rates...
August 28, 2019: Annals of Surgery
Lisa M Brown, Dylan P Thibault, Andrzej S Kosinski, David T Cooke, Mark W Onaitis, Henning A Gaissert, Patrick S Romano
OBJECTIVE: The aim of this study was to identify independent predictors of hospital readmission for patients undergoing lobectomy for lung cancer. SUMMARY BACKGROUND DATA: Hospital readmission after lobectomy is associated with increased mortality. Greater than 80% of the variability associated with readmission after surgery is at the patient level. This underscores the importance of using a data source that includes detailed clinical information. METHODS: Using the Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTSD), we conducted a retrospective cohort study of patients undergoing elective lobectomy for lung cancer...
August 28, 2019: Annals of Surgery
Jules H Eustache, Samer Tohme, Simon Milette, Roni F Rayes, Allan Tsung, Jonathan D Spicer
: Since their discovery, neutrophil extracellular traps (NETs) have been implicated in a broad array of functions, both beneficial and detrimental to the host. Indeed, NETs have roles in infection, sepsis, wound healing, thrombotic disease, and cancer propagation, all of which are directly implicated in the care of surgical patients. Here we provide an updated review on the role of NETs in the perioperative period with specific emphasis on perioperative infections, wound healing, vascular complications, cancer propagation, as well as discussing ongoing, and future therapeutic targets...
August 27, 2019: Annals of Surgery
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