journal
https://read.qxmd.com/read/38770924/national-analysis-of-clinical-outcomes-associated-with-cirrhotic-blunt-trauma-patients-undergoing-emergency-laparotomy-versus-non-operative-management-a-propensity-case-matched-analysis
#1
JOURNAL ARTICLE
Adel Elkbuli, Nikita Bundschu, Hazem Nasef, Brian Chin, David L McClure, Heather X Rhodes-Lyons
INTRODUCTION: This study aims to evaluate clinical outcomes among severely injured trauma patients presenting with isolated blunt abdominal solid organ injuries with a pre-diagnosis of liver cirrhosis (LC) undergoing emergency laparotomy vs nonoperative management (NOM). METHODS: This retrospective cohort study utilized the American College of Surgeons Trauma Quality Program Participant Use File (ACS-TQIP-PUF) dataset from 2017 to 2021. Adults (≥18 years) with a pre-existing diagnosis of LC who presented with severe blunt (ISS ≥ 16) isolated solid organ abdominal injuries and underwent laparotomy or NOM were included...
May 21, 2024: American Surgeon
https://read.qxmd.com/read/38770756/pathologic-outcomes-of-short-course-and-long-course-radiotherapy-for-locally-advanced-rectal-cancers-treated-with-total-neoadjuvant-therapy
#2
JOURNAL ARTICLE
Brian Williams, Abhinav Gupta, Priyanka Iype, Sabrina Woll, Sarah E Koller, Joongho Shin, Kyle G Cologne, Sang W Lee, Marjun P Duldulao
INTRODUCTION: Total neoadjuvant therapy (TNT) for patients with locally advanced rectal cancer (LARC) is now the standard of care. Randomized trials suggest the use of short-course radiotherapy (SCRT) and long-course radiotherapy (LCRT) are oncologically equivalent. OBJECTIVE: To describe pathologic outcomes after surgical resections of patients receiving SCRT versus LCRT as part of TNT for LARC. PARTICIPANTS: All patients with LARC treated at a single tertiary hospital who underwent proctectomy after completing TNT were included...
May 21, 2024: American Surgeon
https://read.qxmd.com/read/38770753/the-great-debate-mesh-or-no-mesh-in-contaminated-hernia-repairs
#3
JOURNAL ARTICLE
Yuchen You, So Un Kim, Jeremy Schweitzer, Tommy H Lee
Abdominal hernia surgeries are commonly performed with many different approaches, and mesh utilization has become a cornerstone in hernia repair, ensuring durable outcomes with minimal recurrence risk. However, managing contaminated hernia repairs presents unique challenges due to the heightened risks of mesh infection. Recent advancements in lightweight macroporous polypropylene meshes offer promising solutions. Studies have highlighted the superiority of macroporous polypropylene meshes compared to primary suture repair and other mesh types in terms of reduced surgical site infection rates and lower hernia recurrence rates...
May 21, 2024: American Surgeon
https://read.qxmd.com/read/38770751/calculation-and-feedback-of-risk-adjusted-antibiotic-days-as-a-process-measure-in-a-statewide-trauma-collaborative
#4
JOURNAL ARTICLE
Naveen F Sangji, Jacob M Dougherty, Christopher J Tignanelli, Hannan A Maqsood, Anne H Cain-Nielsen, Bryant W Oliphant, Mark R Hemmila
BACKGROUND: Optimization of antibiotic stewardship requires determining appropriate antibiotic treatment and duration of use. Our current method of identifying infectious complications alone does not attempt to measure the resources actually utilized to treat infections in patients. We sought to develop a method accounting for treatment of infections and length of antibiotic administration to allow benchmarking of trauma hospitals with regard to days of antibiotic use. METHODS: Using trauma quality collaborative data from 35 American College of Surgeons (ACS)-verified level I and level II trauma centers between November 1, 2020, and January 31, 2023, a two-part model was created to account for (1) the odds of any antibiotic use, using logistic regression; and (2) the duration of usage, using negative binomial distribution...
May 21, 2024: American Surgeon
https://read.qxmd.com/read/38770550/did-implementation-of-michigan-surgical-quality-collaborative-initiative-reduce-the-post-operative-infection-rate-elective-colorectal-surgery-a-community-hospital-experience
#5
JOURNAL ARTICLE
Tarik Wasfie, Adriana Sharp, Cindy Chu, Griffin Fox, Anthony Lewis, Sara Lynch, Sahiba Singh, Lori Wiskur
No abstract text is available yet for this article.
May 21, 2024: American Surgeon
https://read.qxmd.com/read/38769853/compliance-among-pediatric-patients-with-closed-head-injuries-treated-at-a-community-hospital
#6
JOURNAL ARTICLE
Stephanie Massimilian, Lisa Ngo, Jennifer Hernandez, Maymun Mohiuddin, Rachele Solomon, Shenae Samuels, Brenda Shaver, Roberta Kopolovits, Tamar Levene
No abstract text is available yet for this article.
May 20, 2024: American Surgeon
https://read.qxmd.com/read/38769751/nationwide-trends-in-utilization-of-minimally-invasive-techniques-for-blunt-abdominal-trauma
#7
JOURNAL ARTICLE
Nikhil L Chervu, Jaron Butterfield, Sara Sakowitz, Nguyen Le, Saad Mallick, Nam Y Cho, Peyman Benharash
BACKGROUND: Despite increasing use of minimally invasive surgical (MIS) techniques for trauma, limited large-scale studies have evaluated trends, outcomes, and resource utilization at centers that utilize MIS modalities for blunt abdominal trauma. METHODS: Operative adult admissions after blunt assault, falls, or vehicular collisions were tabulated from the 2016-2020 National Inpatient Sample. Patients who received diagnostic laparoscopy or other laparoscopic and robotic intervention were classified as MIS...
May 20, 2024: American Surgeon
https://read.qxmd.com/read/38769499/impact-of-concomitant-traumatic-pancreatic-and-colon-injuries-on-outcomes
#8
JOURNAL ARTICLE
Richard H Lewis, Tomas Jacome, Danielle Dooley, Brian Carr, Louis J Magnotti
BACKGROUND: Colon and pancreatic injuries have both long been independently associated with intraabdominal infectious complications in trauma patients. The goal of this study was to evaluate the impact of concomitant pancreatic injury on outcomes in patients with traumatic colon injuries. METHODS: Consecutive patients over a 3-year period who underwent operative management of colon injuries were identified. Patient characteristics, severity of injury and shock, presence and grade of pancreatic injury, and intraoperative packed red blood cell (PRBC) transfusions were recorded...
May 20, 2024: American Surgeon
https://read.qxmd.com/read/38768947/resilience-and-value-pediatric-trauma-care-in-safety-net-hospitals
#9
JOURNAL ARTICLE
Monique Motta, Azalia Avila, Hayley M Carroll, Deep Vakil, Jennifer Hernandez, Tamar Levene, Joshua P Parreco
Background: In the setting of limited funding and high expectations for quality care, safety net hospitals play a crucial role in treating pediatric trauma patients. This study aimed to compare outcomes and hospitalization costs of pediatric trauma patients in safety net hospitals across the United States. Methods: The Nationwide Readmissions Database for 2016-2020 was queried for all patients under the age of 18 years hospitalized for traumatic injury. Patients admitted to safety net hospitals were propensity matched 1:1 to all other patients...
May 20, 2024: American Surgeon
https://read.qxmd.com/read/38767188/colorectal-sarcomatoid-carcinoma-30-year-experience
#10
JOURNAL ARTICLE
Dante L S Souza, Scott R Kelley
Background: Primary colorectal sarcomatoid carcinoma is a rare and aggressive malignant neoplasm that displays mixed epithelial and mesenchymal differentiation, with uncertain histogenesis. First described in 1986, there is a paucity of literature related to this condition and there are no evidence-based treatment guidelines. The aim of our study is to present our 30-year experience with primary colorectal sarcomatoid carcinoma. Methods: Retrospective single-center analysis of all patients treated for primary colorectal sarcomatoid carcinoma from 1992 to 2022...
May 20, 2024: American Surgeon
https://read.qxmd.com/read/38767044/diffuse-dermal-angiomatosis-of-the-breast-clinically-mimicking-cellulitis-and-inflammatory-breast-cancer
#11
JOURNAL ARTICLE
Lauren R Moore, Robin A Skrine
A 40-year-old woman admitted for hyponatremia and anasarca due to decompensated cirrhosis after a recent steroid taper developed extremely painful cutaneous breast lesions clinically mimicking cellulitis and inflammatory breast cancer and was biopsy-diagnosed instead with diffuse dermal angiomatosis (DDA) of the breasts, a rare and painful disease that can be a diagnostic chameleon. This case highlights the importance of early surgical consultation and tissue biopsy to correctly diagnose the etiology of severely painful mastitis and prevent prolonged symptomology and repeated administrations of ineffective treatments...
May 20, 2024: American Surgeon
https://read.qxmd.com/read/38756087/epiploic-appendagitis-systematic-review-of-a-distinctive-pathology
#12
REVIEW
Carlos D Acevedo-Castillo, Hannia M Macias-Cruz, Arantxa Ramirez-Cisneros, Uriel A Bautista-Coronado, Jose A Moran-Guerrero, Eduardo Alberto Guzman
Introduction: Epiploic appendagitis (EA) is an essential cause of abdominal pain that can be confused with more typical causes such as acute diverticulitis and appendicitis. Epiploic appendagitis accounts for 1% of all cases of abdominal pain in adults. The scarcity of information has limited its recognition as an essential nonsurgical cause of acute abdominal pain. Methods: We performed a systematic review of all EA cases published. We searched Scopus, Medline, Web of Science, and Google Scholar to retrieve all available studies from January 2000 to November 2023...
May 17, 2024: American Surgeon
https://read.qxmd.com/read/38752529/machine-learning-differentiates-extracorporeal-membrane-oxygenation-mortality-risk-profiles-among-trauma-patients
#13
JOURNAL ARTICLE
Bryan R Campbell, Alexandra S Rooney, Andrea Krzyzaniak, Richard Y Calvo, Kyle D Checchi, Alyssa N Carroll, Michael J Sise, Vishal Bansal, Michael J Krzyzaniak
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is resource intensive with high mortality. Identifying trauma patients most likely to derive a survival benefit remains elusive despite current ECMO guidelines. Our objective was to identify unique patient risk profiles using the largest database of trauma patients available. METHODS: ECMO patients ≥16 years were identified using Trauma Quality Improvement Program data (2010-2019). Machine learning K-median clustering (ML) utilized 101 variables including injury severity, demographics, comorbidities, and hospital stay information to generate unique patient risk profiles...
May 16, 2024: American Surgeon
https://read.qxmd.com/read/38722066/pediatric-injuries-sustained-on-the-united-states-mexico-border-fence-in-el-paso
#14
JOURNAL ARTICLE
Soroush Farsi, Alyssa Greenwood Francis, Kaitlynn Trinh, Byron Meshram, Katherine Aguirre, Grace Ng, John Lawrence
No abstract text is available yet for this article.
May 9, 2024: American Surgeon
https://read.qxmd.com/read/38716696/factors-associated-with-additional-axillary-disease-in-patients-with-positive-sentinel-lymph-nodes-after-neoadjuvant-chemotherapy-for-breast-cancer
#15
JOURNAL ARTICLE
Natalie C Johnson, Hannah Kornfeld, Lorena Gonzalez, Hannah Mora, Nikita Shah, Veronica C Jones, Katharine Schulz-Costello
Background: In previous studies, breast cancer patients with positive sentinel lymph node(s) (SLN) after neoadjuvant chemotherapy (NAC) frequently had additional nonSLN involvement. Per guidelines, residual SLN disease warrants completion axillary lymph node dissection (cALND), which has increased morbidity. Given recent improvements in NAC, we hypothesized that nonSLN positivity may be lower than previously reported for certain subgroups. Methods: We retrospectively reviewed breast cancer patients who received NAC and had positive lymph nodes on SLN biopsy or targeted axillary dissection and underwent cALND at one institution in 1/2018-8/2023...
May 8, 2024: American Surgeon
https://read.qxmd.com/read/38712351/development-and-validation-of-a-prognostic-nomogram-for-breast-cancer-patients-with-multi-organ-metastases-an-analysis-of-the-surveillance-epidemiology-and-end-results-program-database
#16
JOURNAL ARTICLE
Xiao Huang, An Xu, Xiangnan Xu, Zhou Luo, Chunlian Li, Xueying Wang, Deyuan Fu
BACKGROUND: Multi-organ metastases represent a substantial life-threatening risk for breast cancer (BC) patients. Nonetheless, the current dearth of assessment tools for patients with multi-organ metastatic BC adversely impacts their evaluation. METHODS: We conducted a retrospective analysis of BC patients with multi-organ metastases using data from the SEER database from 2010 to 2019. The patients were randomly allocated into a training cohort and a validation cohort in a 7:3 ratio...
May 7, 2024: American Surgeon
https://read.qxmd.com/read/38709236/enhancing-lymph-node-yield-in-gastric-cancer-resection-impact-of-back-table-dissection-on-number-of-lymph-node-examined
#17
JOURNAL ARTICLE
Harry J Wong, Rushil Rawal, Joshua Tseng, Edward Phillips, Alexandra Gangi, Miguel Burch
INTRODUCTION: During gastric cancer resection, back table dissection (BTD) involves examination and separation of lymph node (LN) packets from the surgical specimen based on LN stations, which are sent to pathology as separately labeled specimens. With potential impact on clinical outcomes, we aimed to explore how BTD affects number of LNs examined. METHODS: A retrospective review of a gastric cancer database was performed, including all cases of gastrectomy with D2 lymphadenectomy from January 2009 to March 2022...
May 6, 2024: American Surgeon
https://read.qxmd.com/read/38708574/identification-of-chronic-pancreatitis-associated-micrornas-and-genes-for-the-diagnosis-of-pancreatic-cancer
#18
JOURNAL ARTICLE
Jing Gong, Qinghua Zhang, Qimin Peng, Dongling Shi
OBJECTIVE: The timely identification of both malignant and nonmalignant pancreatic lesions has the potential to significantly enhance prognosis and implement risk management strategies across various levels. microRNAs (miRs) and their corresponding targets play a crucial role in the development of pancreatic lesions and can serve as valuable diagnostic and therapeutic targets. The objective of our study was to investigate potential diagnostic markers that can effectively differentiate between malignant and nonmalignant pancreatic lesions...
May 6, 2024: American Surgeon
https://read.qxmd.com/read/38703074/a-comparative-analysis-of-surgery-first-vs-endoscopy-first-for-pediatric-choledocholithiasis-presenting-at-the-end-of-the-week
#19
JOURNAL ARTICLE
Garrett R Reid, Jessica L Rauh, Bonnie E Laingen, Elizabeth A Azar, Elizabeth C Wood, Gloria D Sanin, Gabriel E Cambronero, Maggie E Bosley, Aravindh S Ganapathy, James W Patterson, Lucas P Neff
BACKGROUND: Choledocholithiasis in children is commonly managed with an "endoscopy first" (EF) strategy (endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy (LC) under a separate anesthetic). Endoscopic Retrograde Cholangiopancreatography is limited at the end of the week (EoW). We hypothesize that a "surgery first" (SF) approach with LC, intraoperative cholangiogram (IOC), and possible laparoscopic common bile duct exploration (LCBDE) can decrease length of stay (LOS) and time to definitive intervention (TTDI)...
May 4, 2024: American Surgeon
https://read.qxmd.com/read/38703056/-you-have-to-be-a-doctor-first-trauma-surgeons-perspectives-on-police-interactions-in-the-hospital
#20
JOURNAL ARTICLE
Emily V Jones, Philippe Bourgois, Ji Seon Song, Vincent E Chong
BACKGROUND: Police activity in emergency medical settings has been shown to complicate the care of patients and impact patient-provider relationships. Recent scholarship has called for clear hospital policy outlining the terms of police access to patients and the role of clinicians. Despite regular contact between trauma surgeons and police, research on the impact of police activity on trauma care has been limited. METHODS: Semi-structured interviews were conducted with attending trauma surgeons and general surgery residents (N = 13) at 3 urban hospitals about their interactions with police in clinical settings...
May 4, 2024: American Surgeon
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