Journal of the American College of Surgeons

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BACKGROUND: This retrospective multicenter study aimed to evaluate the risk of postpancreatectomy hemorrhage (PPH) in patients receiving antithrombotic agents (ATAs). PPH is the most severe complication after pancreatectomy. However, there is little known about the strength of the association between ATA use, PPH, and other clinical outcomes. STUDY DESIGN: Between 2007 and 2016, 1297 patients underwent pancreatectomy at two surgical centers. ATA use included aspirin, clopidogrel, ticlopidine, warfarin, direct oral anticoagulants, and intravenous unfractionated heparin...

BACKGROUND: Global assessments of technical skill have been associated with surgical outcomes. More detailed understanding of which specific aspects of technique combine to make the "optimal" sleeve gastrectomy are necessary to help surgeons improve their practice. STUDY DESIGN: Practicing bariatric surgeons (n=30) voluntarily submitted a de-identified video of a typical sleeve gastrectomy (SG) that was reviewed by a minimum of 10 peer surgeons on the technical quality of 9 operative maneuvers (i...

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No abstract text is available yet for this article.

BACKGROUND: Acute kidney injury (AKI) is a significant cause of morbidity and mortality for critically injured trauma patients. The Kidney Disease: Improving Global Outcomes (KDIGO) practice guideline is the most up-to-date classification for AKI. The aims of this study were to determine the incidence and risk factors for AKI in critically injured trauma patients using the current KDIGO definitions. STUDY DESIGN: A prospective cohort study was performed at our academic, Level 1 trauma center from September 2017 to August 2018...

BACKGROUND: After pylorus-preserving pancreaticoduodenectomy (PPPD), incision and suture of the abdominal muscles cause inflammatory changes and elicit somatic pain that deteriorates the quality of life. There have been no previous reports on needle electrical twitch obtaining intramuscular stimulation (NETOIMS) in abdominal open surgery; thus, this study aimed to apply NETOIMS for postoperative somatic pain in patients undergoing PPPD as a new treatment modality for pain control. METHODS: Between June 2018 and January 2019, 44 patients who underwent PPPD were randomly assigned to the control group and NETOIMS group...

Our objective was to assess the safety of foregoing surgery in patients without abdominopelvic surgery history presenting with small bowel obstruction (SBO). Classic dogma has counseled early surgical intervention for small bowel obstruction (SBO) in the virgin abdomen - patients without abdominopelvic surgery history - given their presumed higher risk of malignant or potentially catastrophic etiologies compared to those who underwent prior abdominal operations. The term virgin abdomen was coined before widespread use of computed tomography, which now elucidates many SBO etiologies...

BACKGROUND: Current risk-adjusted models used to predict donor heart utilization and cardiac graft survival from organ donors after brain death (DBDs) do not include bedside critical care data. We sought to identify novel independent predictors of heart utilization and graft survival to better understand the relationship between donor management and transplant outcomes. STUDY DESIGN: Prospective observational study of DBDs managed from 2008 to 2013 by 10 organ procurement organizations...

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INTRODUCTION: Traumatic brain injury (TBI) is the leading cause of elderly trauma admissions. Previous research identified that each minute delay to TBI diagnosis was associated with a 2% mortality increase, delaying treatment to older patients (age ≥70 years) who do not meet trauma activation criteria. A TBI protocol and clinical decision support intervention (CDS-I) were developed to reduce time to imaging in older patients with head trauma not meeting trauma activation criteria. METHODS: An emergency department (ED) head CT protocol and CDS-I were developed and implemented to facilitate rapid imaging of older patients...

BACKGROUND: Washington State experienced the first major outbreak of COVID-19 in the United States and despite a significant number of cases, has seen a relatively low death rate per million population compared to other states with major outbreaks and has seen a substantial decrease in the projections for healthcare utilization, i.e. "flattening the curve". This consensus report seeks to identify the key factors contributing to the effective health system disaster response in western WA...

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No abstract text is available yet for this article.

BACKGROUND: The COVD-19 global pandemic has placed a large demand on personal protective equipment for healthcare workers. N-95 respirators, required to perform aerosolizing procedures, are in short supply and have increased significantly in cost. The lack of a clear end to the pandemic requires that hospitals need to create a long-term, cost effective solution to the N95 shortage. We initially used previously described methods to reuse and resterilize N95 masks however we found they did not solve the issues related to just in time fit-testing and cost...

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BACKGROUND: Optimal postoperative pain therapy for patients undergoing minimally invasive surgery remains controversial. The aim of this meta-analysis was to compare the efficacy and safety of the novel laparoscopic-guided transversus abdominis plane block (L-TAP) to other analgesic alternatives in adults undergoing minimally invasive surgery. STUDY DESIGN: A systematic literature search of several databases was conducted according to the PRISMA guidelines through March 9, 2020, to identify randomized controlled trials (RCTs) reporting on L-TAP...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.