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Annals of Surgery

J Madison Hyer, Aslam Ejaz, Adrian Diaz, Diamantis I Tsilimigras, Faiz Gani, Susan White, Timothy M Pawlik
OBJECTIVE: The aim of this study was to characterize preoperative super-utilizers and examine the effect of surgery on service utilization among patients undergoing major elective surgery. SUMMARY BACKGROUND DATA: Rising healthcare costs are becoming increasingly burdensome for Medicare. Super-utilizers have been increasingly identified and studied as this subset of patients consume a disproportionate amount of healthcare services compared with the majority of the population...
July 10, 2019: Annals of Surgery
Christine M Leeper, Stephen J Strotmeyer, Matthew D Neal, Barbara A Gaines
OBJECTIVE: The aim of this study was to delineate the kinetics of coagulation dysregulation after injury in children. SUMMARY BACKGROUND DATA: Trauma-induced coagulopathy is common and portends poor outcomes in severely-injured children. Transfer to pediatric trauma centers is common; time from injury to laboratory testing is therefore highly variable. METHODS: Records of severely injured children age <18 years with rapid thromboelastography (TEG) on arrival and documented time of injury were queried...
July 10, 2019: Annals of Surgery
Albert Chan, Wei Yi Zhang, Kenneth Chok, Jeff Dai, Ren Ji, Crystal Kwan, Nancy Man, Ronnie Poon, Chung Mau Lo
OBJECTIVE: The aim of this study was to evaluate the short- and long-term outcome of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) for hepatitis-related hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA: ALPPS has been advocated for future liver remnant (FLR) augmentation in liver metastasis or noncirrhotic liver tumors in recent years. Data on the effect of ALPPS in chronic hepatitis or cirrhosis-related HCC remained scarce...
July 10, 2019: Annals of Surgery
Abhinav Humar, Swaytha Ganesh, Dana Jorgensen, Amit Tevar, Armando Ganoza, Michele Molinari, Christopher Hughes
OBJECTIVE: The aim of this study was to compare outcomes between living donor liver transplant (LDLT) and deceased donor liver transplant (DDLT) at a single center to demonstrate the advantages of LDLT and provide justification for the increased utilization and application of this procedure. SUMMARY OF BACKGROUND DATA: LDLT comprises a very small percentage of all liver transplants performed in the United States, this despite its advantages and a shortage of the availability of deceased donor organs...
July 10, 2019: Annals of Surgery
Mary C Politi, Clara N Lee, Sydney E Philpott-Streiff, Randi E Foraker, Margaret A Olsen, Corinne Merrill, Yu Tao, Terence M Myckatyn
OBJECTIVE: To evaluate a web-based breast reconstruction decision aid, BREASTChoice. SUMMARY AND BACKGROUND DATA: Although postmastectomy breast reconstruction can restore quality of life and body image, its morbidity remains substantial. Many patients lack adequate knowledge to make informed choices. Decisions are often discordant with patients' preferences. METHODS: Adult women with stages 0-III breast cancer considering postmastectomy breast reconstruction with no previous reconstruction were randomized to BREASTChoice or enhanced usual care (EUC)...
July 10, 2019: Annals of Surgery
David Romero Funes, David Gutierrez Blanco, Camila Ortiz Gómez, Joel S Frieder, Emanuele Lo Menzo, Samuel Szomstein, Kevin P White, Raul J Rosenthal
INTRODUCTION: According to the Chronic Kidney Disease Prognosis Consortium (CKD-PC), 1 in 4 patients age ≥ 65 in North America has some form of chronic kidney disease (CKD), while 3 in 100 will progress to kidney failure. The aim of this study was to evaluate whether bariatric surgery alters the progression of CKD to kidney failure in patients who are severely obese. METHODS: We conducted a retrospective review of all patients who underwent bariatric surgery at our institution over the last 16 years...
July 8, 2019: Annals of Surgery
Ronan J Kelly, Amir M Ansari, Tomoharu Miyashita, Marianna Zahurak, Frank Lay, A Karim Ahmed, Louis J Born, Maryam K Pezhouh, Kevan J Salimian, Christopher Ng, Aerielle E Matsangos, Anne-Heloise Stricker-Krongrad, Ken-Ichi Mukaisho, Guy P Marti, Christine H Chung, Marcia I Canto, Michelle A Rudek, Stephen J Meltzer, John W Harmon
OBJECTIVE: The aim of the study was to investigate whether inhibition of Sonic Hedgehog (SHH) pathway would prevent progression of Barrett's Esophagus (BE) to esophageal adenocarcinoma. BACKGROUND: The hedgehog signaling pathway is a leading candidate as a molecular mediator of BE and esophageal adenocarcinoma (EAC). Repurposed use of existing off-patent, safe and tolerable drugs that can inhibit hedgehog, such as itraconazole, could prevent progression of BE to EAC...
July 8, 2019: Annals of Surgery
Jesse A Columbo, Pablo Martinez-Camblor, Alistair James O'Malley, Bjoern D Suckow, Andrew W Hoel, David H Stone, Andres Schanzer, Marc L Schermerhorn, Art Sedrakyan, Philip P Goodney
OBJECTIVE: To describe the long-term reintervention rate after endovascular abdominal aortic aneurysm repair (EVR), and identify factors predicting reintervention. SUMMARY OF BACKGROUND DATA: EVR is the most common method of aneurysm repair in America, and reintervention after EVR is common. Clinical factors predicting reintervention have not been described in large datasets with long-term follow-up. METHODS: We studied patients who underwent EVR using the Vascular Quality Initiative registry linked to Medicare claims...
July 8, 2019: Annals of Surgery
Elisabeth Dupont, Theodore Tsangaris, Carlos Garcia-Cantu, Marissa Howard-McNatt, Akiko Chiba, Adam C Berger, Edward A Levine, Jennifer S Gass, Kristalyn Gallagher, Sharon S Lum, Ricardo D Martinez, Alliric I Willis, Sonali V Pandya, Eric A Brown, Andrew Fenton, Amanda Mendiola, Mary Murray, Naveenraj L Solomon, Maheswari Senthil, David W Ollila, David Edmonson, Melissa Lazar, Jukes P Namm, Fangyong Li, Meghan Butler, Noreen E McGowan, Maria E Herrera, Yoana P Avitan, Brian Yoder, Laura L Walters, Tara McPartland, Anees B Chagpar
OBJECTIVE: Single-center studies have demonstrated that resection of cavity shave margins (CSM) halves the rate of positive margins and re-excision in breast cancer patients undergoing partial mastectomy (PM). We sought to determine if these findings were externally generalizable across practice settings. METHODS: In this multicenter randomized controlled trial occurring in 9 centers across the United States, stage 0-III breast cancer patients undergoing PM were randomly assigned to either have resection of CSM ("shave" group) or not ("no shave" group)...
July 8, 2019: Annals of Surgery
Ajita S Prabhu, Benjamin K Poulose, Michael J Rosen
No abstract text is available yet for this article.
July 8, 2019: Annals of Surgery
Julien Hasselmann, Jonas Björk, Robert Svensson-Björk, Stefan Acosta
OBJECTIVE: A randomized controlled trial (RCT) was undertaken to determine the effect of negative pressure wound therapy (NPWT) on closed incisions after inguinal vascular surgery regarding surgical site infections (SSIs) and other wound complications. BACKGROUND: SSIs are a major concern in open vascular procedures involving the inguinal region. Prophylactic NPWT on closed incisions has shown promising results, but the quality of evidence can be debated. This study aims to objectively evaluate whether NPWT on sutured inguinal incisions after elective vascular surgery can decrease the incidence of surgical site complications...
July 5, 2019: Annals of Surgery
Edwin Christopher Ellison
No abstract text is available yet for this article.
July 5, 2019: Annals of Surgery
Francis I Macedo, Emily Ryon, Shishir K Maithel, Rachel M Lee, David A Kooby, Ryan C Fields, William G Hawkins, Greg Williams, Ugwuji Maduekwe, Hong J Kim, Syed A Ahmad, Sameer H Patel, Daniel E Abbott, Patrick Schwartz, Sharon M Weber, Charles R Scoggins, Robert C G Martin, Vikas Dudeja, Dido Franceschi, Alan S Livingstone, Nipun B Merchant
OBJECTIVE: To compare the survival outcomes associated with clinical and pathological response in pancreatic ductal adenocarcinoma (PDAC) patients receiving neoadjuvant chemotherapy (NAC) with FOLFIRINOX (FLX) or gemcitabine/nab-paclitaxel (GNP) followed by curative-intent pancreatectomy. BACKGROUND: Newer multiagent NAC regimens have resulted in improved clinical and pathological responses in PDAC; however, the effects of these responses on survival outcomes remain unknown...
July 5, 2019: Annals of Surgery
Mohammad Y Zaidi, Alexandra G Lopez-Aguiar, Jeffrey M Switchenko, Joseph Lipscomb, Valentina Andreasi, Stefano Partelli, Adriana C Gamboa, Rachel M Lee, George A Poultsides, Mary Dillhoff, Flavio G Rocha, Kamran Idrees, Clifford S Cho, Sharon M Weber, Ryan C Fields, Charles A Staley, Massimo Falconi, Shishir K Maithel
OBJECTIVE: Despite heterogeneous biology, similar surveillance schemas are utilized after resection of all pancreatic neuroendocrine tumors (PanNETs). Given concerns regarding excess radiation exposure and financial burden, our aim was to develop a prognostic score for disease recurrence to guide individually tailored surveillance strategies. METHODS: All patients with primary nonfunctioning, nonmetastatic well/moderately differentiated PanNETs who underwent curative-intent resection at 9-institutions from 2000 to 2016 were included (n = 1006)...
July 5, 2019: Annals of Surgery
Valentina Bellini, Alberto Petroni, Monica Mordonini, Paolo Del Rio, Franco Marinangeli, Elena Bignami
No abstract text is available yet for this article.
July 5, 2019: Annals of Surgery
Edmund K Bartlett, Christina E Curtin, Kenneth Seier, Li-Xuan Qin, Meera Hameed, Sam S Yoon, Aimee M Crago, Murray F Brennan, Samuel Singer
OBJECTIVE: We sought to define the prognostic significance of histologic subtype for extremity/truncal liposarcoma (LPS). BACKGROUND: LPS, the most common sarcoma, is comprised of 5 histologic subtypes. Despite their distinct behaviors, LPS outcomes are frequently reported as a single entity. METHODS: We analyzed data on all patients from a single-institution prospective database treated from July 1982 to September 2017 for primary, nonmetastatic, extremity or truncal LPS of known subtype...
July 5, 2019: Annals of Surgery
Nathan J Curtis, Godwin Dennison, Chris S B Brown, Peter J Hewett, George B Hanna, Andrew R L Stevenson, Nader K Francis
OBJECTIVE: To investigate the frequency, nature, and severity of intraoperative adverse near miss events within advanced laparoscopic surgery and report any associated clinical impact. BACKGROUND: Despite implementation of surgical safety initiatives, the intraoperative period is poorly documented with evidence of underreporting. Near miss analyses are undertaken in high-risk industries but not in surgical practice. METHODS: Case video and data from 2 laparoscopic total mesorectal excision randomized controlled trials were analyzed (ALaCaRT ACTRN12609000663257, 2D3D ISRCTN59485808)...
July 3, 2019: Annals of Surgery
Shinya Urakawa, Tomoki Makino, Makoto Yamasaki, Koji Tanaka, Yasuhiro Miyazaki, Tsuyoshi Takahashi, Yukinori Kurokawa, Masaki Motoori, Yutaka Kimura, Kiyokazu Nakajima, Masaki Mori, Yuichiro Doki
OBJECTIVE: The aim of this study was to evaluate primary tumor (PT) and lymph node (LN) responses to neoadjuvant chemotherapy (NACT) for predicting long-term survival in patients with metastatic esophageal cancer (EC). BACKGROUND: In evaluating NACT responses in patients with EC, imaging modalities typically target the PT in the esophagus, which is unmeasurable. Targeting measurable organs, like positive LNs, might provide more accurate assessments. METHODS: We enrolled 251 patients with EC and clinically positive LNs that underwent curative resections, after triplet NACT...
July 3, 2019: Annals of Surgery
Giampaolo Perri, Laura Prakash, Huamin Wang, Priya Bhosale, Gauri R Varadhachary, Robert Wolff, David Fogelman, Michael Overman, Shubham Pant, Milind Javle, Eugene Koay, Joseph Herman, Michael Kim, Naruhiko Ikoma, Ching-Wei Tzeng, Jeffrey E Lee, Matthew H G Katz
OBJECTIVE: We sought to identify potential radiologic and serologic markers of pancreatic tumor response to therapy, using pathologic major response (pMR) as the objective endpoint. BACKGROUND: We previously demonstrated that a pMR to preoperative therapy, defined as detection of <5% viable cancer cells in the surgical specimen on histopathological analysis, is an important prognostic factor for patients with pancreatic ductal adenocarcinoma (PDAC). METHODS: Pretreatment and posttreatment computed tomography scans of consecutive patients who received preoperative chemotherapy and/or (chemo)radiation before pancreatectomy for PDAC between January 2010 and December 2018 were rereviewed...
July 3, 2019: Annals of Surgery
Edwin Christopher Ellison, Jeffrey L Ponsky, Michael R Harrison, Mary H McGrath, Peter Angelos, Thomas M Krummel
No abstract text is available yet for this article.
July 3, 2019: Annals of Surgery
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