17,429 results match your criteria American Surgeon[Journal]

Thyroid Lymphoma: Case Series Review.

Am Surg 2022 Jun 27:31348221111512. Epub 2022 Jun 27.

General Surgery Department, James Cook University Hospital, England.

Background: Primary thyroid lymphoma (PTL) is a rare malignancy accounting for about 5% of all thyroid malignancies and less than 2% of extra-nodal lymphomas. Diffuse B-cell lymphoma is the most common pathological subtype of PTL.

Patients And Methods: This is a retrospective review of all patients diagnosed with thyroid lymphoma in our hospital during the period from 2011 to 2021. Read More

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Bracketed Localization in Breast-Conserving Surgery: Indications and Success Rates From a Single, High Volume, Academic Breast Cancer Center.

Am Surg 2022 Jun 27:31348221111516. Epub 2022 Jun 27.

Department of General Surgery, 6529Thomas Jefferson University Hospital, Philadelphia, PA, USA.

Background: Bracketed localization is a technique used to help localize lesions for breast-conserving surgery (BCS). To date, there are no guidelines for when bracketed localization should be used in clinical practice. Based on our experience, we aim to provide criteria that should prompt surgeons to consider bracketing. Read More

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Racial Disparities in Colorectal Cancer Care for Black Patients: Barriers and Solutions.

Am Surg 2022 Jun 26:31348221111513. Epub 2022 Jun 26.

Department of Surgery, 21640Harbor-UCLA Medical Center, Torrance, CA, USA.

Racial disparities in colorectal cancer for Black patients have led to a significant mortality difference when compared to White patients, a gap which has remained to this day. These differences have been linked to poorer quality insurance and socioeconomic status in addition to lower access to high-quality health care resources, which are emblematic of systemic racial inequities. Disparities impact nearly every point along the colorectal cancer care continuum and include barriers to screening, surgical care, oncologic care, and surveillance. Read More

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Examining the Domestic Violence Crisis in Ventura County in the Wake of the COVID-19 Pandemic.

Am Surg 2022 Jun 26:31348221111509. Epub 2022 Jun 26.

Department of Surgery, 25352Ventura County Medical Center, Ventura, CA, USA.

Background: Domestic violence (DV) worsened during COVID-19 and Family Justice Centers (FJCs) were, even more so than before, a critical part of providing services to DV victims. This study characterizes the clinical and sociodemographic features of the clients that come to the Ventura County FJC (VCFJC) and examines the effect of COVID-19, thus informing awareness of services available to victims of DV.

Methods: This was a retrospective cohort study utilizing the VCFJC database from 2019 to 2021. Read More

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Smartphone Use for Patient Photography by Plastic Surgery Trainees.

Am Surg 2022 Jun 24:31348221091943. Epub 2022 Jun 24.

Division of Plastic Surgery, 14434University of Utah School of Medicine, Salt Lake City, UT, USA.

Medical photography has become essential to patient care, trainee education, and research in highly visual specialties such as plastic surgery. As smartphone technology advances, plastic surgeons and trainees are using their personal smartphones to take medical photographs prompting ethical and legal concerns about patient consent and privacy. This study aims to determine the prevalence of personal smartphone use for patient photography among plastic surgery trainees, evaluate encryption practices, and establish understanding of current guidelines. Read More

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Can Customized YouTube Videos Improve ABSITE Performance?

Am Surg 2022 Jun 22:31348221109492. Epub 2022 Jun 22.

536923Community Memorial Health System, Ventura, CA, USA.

Introduction: The COVID-19 pandemic decreased in-person didactic sessions in our general surgery residency. We piloted a program to develop online tutorials posted to a YouTube channel designed to prepare our residents for the ABSITE examination.

Methods: Study participants were General Surgery residents in our five-year ACGME accredited general surgery residency program who took the ABSITE in-service exam between 2019 and 2021. Read More

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Impact of Mental Health on General Surgery Patients and Strategies to Improve Outcomes.

Am Surg 2022 Jun 22:31348221109469. Epub 2022 Jun 22.

Department of Surgery, 12239Emory University School of Medicine, Atlanta, GA, USA.

Mental Health Disorders (MHD) are a growing concern nationwide. The significant impact MHD have on surgical outcomes has only recently started to be understood. This literature review investigated how mental health impacts the outcomes of general surgery patients and what can be done to make improvements. Read More

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High-Grade Colonic Stricture After a Severe Case of COVID-19 Pneumonia.

Am Surg 2022 Jun 21:31348221109811. Epub 2022 Jun 21.

Division of Colon and Rectal Surgery, Department of Surgery, 23387Mayo Clinic, Phoenix, AZ, USA.

Extrapulmonary involvement of coronavirus-19 disease (COVID-19) is being documented and studied at an increasing frequency. Specifically, gastrointestinal involvement is hypothesized to occur due to cellular entry via the ACE2 receptor found in gastrointestinal epithelial cells, causing inflammation and symptoms such as abdominal pain, nausea/vomiting, and diarrhea. We present the case of a 45-year-old female with recent severe COVID-19 infection and early gastrointestinal symptoms who later presented with worsening abdominal pain, nausea, vomiting, and constipation after initial discharge. Read More

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Adherence Patterns and Acceptability of a Perioperative, App-Based Mindfulness Meditation Among Surgical Patients With Chronic Pain.

Am Surg 2022 Jun 21:31348221109815. Epub 2022 Jun 21.

189275Winship Cancer Institute of Emory University, Atlanta, GA, USA.

Identifying barriers to compliance with mindfulness-based interventions (MBIs) during the perioperative period is paramount to the design and implementation of non-pharmacologic, opiate-sparing pain regimens. We prospectively investigated the acceptability and adherence patterns of an app-based MBI amongst surgical patients with chronic pain. Patients were provided a subscription code to a meditation app and encouraged to use the app an average of 10 minutes/day over a 6-week study period. Read More

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The University of Alabama at Birmingham Surgery Community Network: Tackling the Challenges of Rural Surgery.

Am Surg 2022 Jun 21:31348221109471. Epub 2022 Jun 21.

Department of Surgery, 155569University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.

Over the past 5 years, The University of Alabama at Birmingham (UAB) Department of Surgery has taken a keen interest in the practice of surgery in rural Alabama and has established the UAB surgery community network. Our goal is to improve the delivery of surgical care in rural areas through active recruitment of rural surgeons, the development of research around rural surgery practice, and the expansion of a surgery network throughout the state. Here, we will present the challenges faced by rural surgery, our early work to address these challenges, and offer a plan for moving forward. Read More

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Molecular Testing for Indeterminate Thyroid Nodules: Association of Negative Predictive Value With Nodule Size.

Am Surg 2022 Jun 19:31348221109489. Epub 2022 Jun 19.

Department of Surgery, 528756Wake Forest Baptist Health, Winston-Salem, NC, USA.

Background: Molecular testing helps stratify risk of malignancy in indeterminate thyroid nodules, but it may be limited in its ability to rule out malignancy in large nodules.

Methods: We compared small thyroid nodules (<4 cm) to large thyroid nodules (4 cm or greater) in a retrospective, single center, cohort study of indeterminate thyroid nodules analyzed with ThyroSeq from 10/2015 through 4/2020. Our primary outcome was negative predictive value. Read More

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Not All Patients With Locally Advanced Rectal Cancer Benefit From Neoadjuvant Therapy.

Am Surg 2022 Jun 18:31348221109476. Epub 2022 Jun 18.

24575University Hospitals Research in Surgical Outcomes and Effectiveness (UH RISES), Cleveland, OH, USA.

Background: While neoadjuvant combined modality therapy (NA-CMT) is beneficial for most patients with locally advanced rectal cancer some patients may experience disease progression during treatment. The purpose of this study is to identify characteristics associated with progression during NA-CMT.

Methods: A single institution retrospective review of patients with stage II-III rectal cancer receiving NA-CMT was conducted from 2008-2019. Read More

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Declining Military Surgical Cases and the Impact on Military Surgical Graduate Medical Education.

Am Surg 2022 Jun 19:31348221109451. Epub 2022 Jun 19.

Naval Medical Research Unit San Antonio, San Antonio, TX, USA.

Background: Several studies have indicated a decline in the number, types, and complexity of surgical procedures within military treatment facilities (MTFs). This study aims to determine what effect, if any, these downward trends have had on the relationship between the military health system (MHS) and surgical graduate medical education.

Methods: Graduating chief resident final ACGME case logs from 4 of thirteen military general surgery programs were evaluated from 2015 to 2020. Read More

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Telemedicine and Vascular Surgery: Expanding Access and Providing Care Through the COVID-19 Pandemic.

Am Surg 2022 Jun 19:31348221109464. Epub 2022 Jun 19.

Surgical & Perioperative Careline, Department of Surgery, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA.

Introduction: Access to surgical service is limited by provider availability and geographic barriers. Telemedicine ensures that patients can access medical care.

Objective: The objective is to describe our use of telemedicine in delivering vascular surgery services to remote locations before and during the COVID-19 pandemic. Read More

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Gastric Neuroendocrine Tumor Treatment and Survival Outcome Depends on Facility Type.

Am Surg 2022 Jun 19:31348221109460. Epub 2022 Jun 19.

Department of Surgery, 2202Cooper University Hospital, Camden, NJ, USA.

Background: Gastric neuroendocrine tumors (gNETs) are rare cancers for which surgery may improve survival. We aim to determine if facility type affects treatment and survival outcomes.

Methods: The NCDB was queried for patients with gNET from 2004-2016 and stratified into Academic/Research Program (ARP), Community Cancer Program (CCP), Comprehensive Community Cancer Program (CCCP), or Integrated Network Cancer Program (INCP). Read More

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Complete Versus Partial Excision of an Infected Mesh Following Abdominal Wall Hernia Repair: A Systematic Review and Meta-analysis.

Am Surg 2022 Jun 20:31348221109816. Epub 2022 Jun 20.

Department of General Surgery, Hereford County Hospital, 8947Wye Valley NHS Trust, Hereford, UK.

Background: To evaluate comparative outcomes of complete and partial excision of infected mesh following abdominal wall hernia repair.

Methods: A systematic search of electronic databases, including MEDLINE, EMBASE, CINAHL, and CENTRAL, and bibliographic reference lists with application of a combination of free text and controlled vocabulary search adapted to thesaurus headings, search operators and limits was conducted. Surgical site infection chronic sinus formation, recurrent hernia, and need for reoperation were the evaluated outcome measures. Read More

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Prior Antibiotic Exposure Is Associated With Reoperation After Elective Non-colorectal Surgery.

Am Surg 2022 Jun 18:31348221109812. Epub 2022 Jun 18.

Division of Trauma, Emergency General Surgery, and Surgical Critical Care; Department of Surgery, Section of Surgical Sciences, 12328Vanderbilt University Medical Center, Nashville, TN, USA.

Background: Recent antibiotic exposure has previously been associated with poor outcomes following elective surgery. The purpose of this study is to evaluate the impact of prior recent antibiotic exposure in a multicenter cohort of Veterans Affairs patients undergoing elective non-colorectal surgery.

Methods: This is a retrospective cohort study of the Veterans Affairs Surgical Quality Improvement Program, including elective, non-cardiovascular, non-colorectal surgery from 2013 to 2017. Read More

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Predicting Patient-Reported Outcomes Following Surgery Using Machine Learning.

Am Surg 2022 Jun 18:31348221109478. Epub 2022 Jun 18.

Department of Plastic and Reconstructive Surgery, 571198The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Patient-reported outcomes (PROs) enable providers to identify differences in treatment effectiveness, postoperative recovery, quality of life, and patient satisfaction. By allowing a shift from disease-specific factors to the patient perspective, PROs provide a tailored patient-centric approach to shared decision-making. Artificial intelligence (AI) and machine learning (ML) techniques can facilitate such shared decision-making and improve patient outcomes by accurate prediction of PROs. Read More

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The Sepsis Bundle Effect: An Evaluation of Culture Results and Utilization in Pediatric Appendicitis.

Am Surg 2022 Jun 17:31348221109495. Epub 2022 Jun 17.

Department of Pediatric Surgery, 14423Arkansas Children's Hospital, Little Rock, AR, USA.

Introduction: Sepsis prevention pathways, which often include blood and urine cultures, are common in children's hospitals. Fever and tachycardia, signs often seen in patients with appendicitis, frequently trigger these pathways. We hypothesized that cultures were frequently obtained in children with appendicitis. Read More

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A Synopsis of Artificial Intelligence and its Applications in Surgery.

Am Surg 2022 Jun 17:31348221109450. Epub 2022 Jun 17.

Department of Plastic & Reconstructive Surgery, 571198The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Artificial intelligence (AI) has made steady in-roads into the healthcare scenario over the last decade. While widespread adoption into clinical practice remains elusive, the outreach of this discipline has progressed beyond the physician scientist, and different facets of this technology have been incorporated into the care of surgical patients. New AI applications are developing at rapid pace, and it is imperative that the general surgeon be aware of the broad utility of AI as applicable in his or her day-to-day practice, so that healthcare continues to remain up-to-date and evidence based. Read More

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Peroral Endoscopic Myotomy; Novice Surgeon Learning Curve.

Am Surg 2022 Jun 16:31348221109457. Epub 2022 Jun 16.

Division of Gastrointestinal Surgery, Department of Surgery, 33697University of South Florida Morsani College of Medicine, Tampa, FL, USA.

Introduction: Peroral endoscopic myotomy (POEM) is a novel endoscopic procedure used to treat achalasia and other spastic esophageal disorders that is an alternative to Heller myotomy. We seek to define the learning curve of POEM for a foregut surgeon with no formal endoscopic or POEM training by analyzing different intraoperative factors in a single series.

Methods And Procedures: The first 38 consecutive patients undergoing POEM by a single foregut surgeon were included in this retrospective study. Read More

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Should We Perform Incidental Appendectomy in Trauma Patients Undergoing Laparotomy?

Am Surg 2022 Jun 15:31348221109458. Epub 2022 Jun 15.

Department of Surgery, 12343Texas Tech University Health Science Center, Lubbock, TX, USA.

Incidental appendectomy (IA) is sometimes performed in patients undergoing abdominal operations to prevent subsequent development of appendicitis. Patients who undergo laparotomy for major abdominal trauma are at high risk of developing dense adhesions, increasing the risk of future operations. Therefore, there is a potential benefit to IA for patients undergoing trauma laparotomy. Read More

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Standardized Medical Coding Curriculum in Surgical Graduate Medical Education.

Am Surg 2022 Jun 15:31348221109470. Epub 2022 Jun 15.

Department of Surgery, 25105Orlando Regional Medical Center, Orlando, FL, USA.

Introduction: Despite the increasing importance of coding and billing in healthcare as a whole and calls from the Accreditation Council for Graduate Medical Education (ACGME) to emphasize systems-based practice, many surgical training programs have not prioritized coding and billing within their curricula. We aim to evaluate the performance of surgical residents and early career surgeons in coding and billing and to appraise interventions to improve coding and billing abilities within this group.

Methods: A literature search from conception to March 15th, 2022 utilizing PubMed, Google Scholar, and EMBASE was conducted to search for studies that evaluate surgical resident coding practices and interventions to improve practice management and financial competency. Read More

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Bilateral Lower Extremity Compartment Syndrome Secondary to COVID-19 Myositis in a Young Vaccinated Woman.

Am Surg 2022 Jun 15:31348221083951. Epub 2022 Jun 15.

Department of Surgery, Division of Trauma Acute Care Surgery, and Surgical Critical Care, Reading Hospital, 419713Tower Health.

Coronavirus disease 2019 (COVID-19) typically manifests with respiratory symptoms and can ultimately progress to severe multiorgan failure. Viral myositis, systemic capillary leak syndrome, and arteriovenous thrombosis are atypical manifestations of COVID-19. We present a case of a 33-year-old woman, fully vaccinated against COVID-19, who developed myositis and shock. Read More

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The Impact of Primary Care Physicians on the Surgical Presentation and Outcomes of Colorectal Cancer in Vulnerable Populations.

Am Surg 2022 Jun 15:31348221109474. Epub 2022 Jun 15.

Department of Surgery, 21640Harbor-UCLA Medical Center, Torrance, CA, USA.

Background: Multiple socioeconomic and clinical factors have been implicated in the health disparities that exist amongst vulnerable populations with colorectal cancer. Efforts have been directed toward addressing these factors to improve outcomes. We evaluate the impact of primary care physicians (PCP) on the surgical presentation and outcomes of colorectal cancer at a safety-net hospital. Read More

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Perforated Appendicitis With Migrated Inguinal Mesh Involvement.

Am Surg 2022 Jun 13:31348221084957. Epub 2022 Jun 13.

Department of General Surgery, 440172AdventHealth Orlando University, Orlando, FL, USA.

Mesh-plug hernioplasty has been recognized as a safe and effective surgical repair for primary inguinal hernias and is a common procedure in the United States. Critics of the mesh-plug system describe erosion, migration, and chronic pain as reasons not to employ mesh plugs in primary hernia repair. To our knowledge, mesh graft infection associated with perforated acute appendicitis has been documented only once before in the surgical literature, highlighting an exceedingly rare but possible complication. Read More

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The Hernia Coding Conundrum: A Potential Benefit of the International Hernia Collaboration Online Social Media Platform.

Am Surg 2022 Jun 11:31348221084968. Epub 2022 Jun 11.

Department of Surgery, 24520New Hanover Regional Medical Center, Wilmington, NC, USA.

Background: Despite various resources on the subject, there remain questions regarding billing and coding hernia surgery. Recently, social media has been used to disseminate information in about surgery. The purpose of this project is to evaluate posts relating to coding through one online social media platform. Read More

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Situations That Preclude Routine Intraoperative Cholangiography.

Am Surg 2022 Jun 12:31348221091950. Epub 2022 Jun 12.

Department of Surgery, 24520Novant Health New Hanover Regional Medical Center, Wilmington, NC, USA.

Intraoperative cholangiogram (IOC) is a useful tool for surgeons to assess anatomy of the biliary tree and diagnose biliary pathology. Many surgeons utilize cholangiography in most cases in hopes of preventing ductal injuries and are deemed routine cholangiographers. There is little data on the success rate and reasons why IOC is not performed. Read More

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Treatment of Radiation Enteritis With Fecal Transplantation.

Am Surg 2022 Jun 12:31348221091954. Epub 2022 Jun 12.

Research Center of Intestinal Barrier and Fecal Microbiota Transplantation, 26468The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Radiation enteritis (RE) is a frequent complication in patients who undergo pelvic irradiation, and this condition has been increasingly diagnosed. Fecal microbiota transplantation (FMT) is being developed in recent years, and it has remarkable curative effect for the clostridium and inflammatory bowel disease. Herein, we present a case of recurrent RE in a 59-year-old woman with RE 18 years after radiotherapy for cervical carcinoma. Read More

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A Novel Hidden Stitching Method for Preventing Complications in Laparoscopic Hernia Repair.

Am Surg 2022 Jun 11:31348221101593. Epub 2022 Jun 11.

Department of Surgery, 26385Sapporo Higashi Tokushukai Hospital, Sapporo, Japan.

Purpose: Barbed suture provides a rapid and effective method for closure in minimally invasive surgery. However, postoperative complications involving barbed suture have been reported in recent years. The aim of this study is to introduce a novel hidden stitching technique for peritoneal closure in laparoscopic hernia repair. Read More

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