24,104 results match your criteria American journal of surgery[Journal]


Young donors with severe acute kidney injury offer an opportunity to expand the donor pool.

Am J Surg 2019 Apr 12. Epub 2019 Apr 12.

Albert Einstein College of Medicine, Bronx, NY, USA; Montefiore-Einstein Center for Transplantation, Montefiore Medical Center, Bronx, NY, USA.

Background: This study assessed our experience transplanting kidneys from young donors with severe acute kidney injury.

Methods: We performed a single center retrospective analysis of 315 kidney transplants between 1/1/2014-12/31/2016. Donor kidneys were classified according to the Acute Kidney Injury Network (AKIN) criteria. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.04.005DOI Listing
April 2019
2 Reads

Surgical outcome in patients with biliary colic and atypical workup findings.

Am J Surg 2019 May 27;217(5):986-989. Epub 2019 Mar 27.

Meridian Surgery Center, Puyallup, WA, USA.

Background: Surgical response of patients with symptomatic biliary colic but atypical findings of gallbladder polyps, hyper-dynamic gallbladder and otherwise negative biliary workup are underrepresented in the literature from community practice.

Methods: A clinical outcome study with a retrospective design compared the short term and long term symptomatic improvement reported by patients with pre-operatively diagnosed biliary dyskinesia to all other biliary colic patients with atypical pre-operative diagnoses. All patients underwent surgery at Meridian Surgery Center from the years 2010-2017. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.03.017DOI Listing

Clinical characteristics and outcomes of benign, atypical, and malignant breast adenomyoepithelioma: a single institution's experience.

Am J Surg 2019 Apr 1. Epub 2019 Apr 1.

Division of Endocrine and Oncologic Surgery, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Rena Rowan Breast Center, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. Electronic address:

Background: Breast adenomyoepithelioma (AME) is rare. We sought to evaluate clinical characteristics, treatment, and outcomes of a contemporary patient cohort stratified by histology.

Methods: We queried health records containing "adenomyoepithelioma" between 2000 and 2018. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.03.026DOI Listing

The volume-time index (VTI) is prognostic in patients with colorectal cancer peritoneal metastases undergoing cytoreductive surgery and intraperitoneal chemotherapy.

Am J Surg 2019 Apr 1. Epub 2019 Apr 1.

Hepatobiliary and Surgical Oncology Unit, Department of Surgery, St George Hospital, Kogarah, NSW, Australia; St George Hospital Clinical School, University of New South Wales, Sydney, NSW, Australia. Electronic address:

Background: Peritoneal cancer index (PCI) is an important prognostic factor in colorectal cancer peritoneal metastases (CRPM), however it fails to consider the time period over which disease burden develops. The volume-time index (VTI) is the ratio between PCI and time from primary tumour resection.

Methods: A retrospective cohort study of 182 patients managed from 1996 to 2017 was performed. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00029610193015
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http://dx.doi.org/10.1016/j.amjsurg.2019.03.023DOI Listing
April 2019
2 Reads

The effect of preoperative nutritional status on postoperative complications and overall survival in patients undergoing pelvic exenteration: A multi-disciplinary, multi-institutional cohort study.

Am J Surg 2019 Apr 4. Epub 2019 Apr 4.

Department of Gastrointestinal, Tumor and Endocrine Surgery, University of Colorado, Aurora, CO, USA.

Introduction: Optimization of preoperative nutritional status has been recommended and associated with improved outcomes for other oncologic procedures, but has not been studied in patients undergoing pelvic exenteration.

Methods: A retrospective chart review of 199 patients was conducted. Overall survival (OS) was calculated using the Kaplan-Meier method and multivariate analysis was performed with Cox proportional hazards. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00029610183161
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http://dx.doi.org/10.1016/j.amjsurg.2019.03.021DOI Listing
April 2019
2 Reads

Quality of life assessment for patients undergoing irreversible electroporation (IRE) for treatment of locally advanced pancreatic cancer (LAPC).

Am J Surg 2019 Apr 1. Epub 2019 Apr 1.

Department of Surgery, Division of Surgical Oncology, University of Louisville, Louisville, KY, USA. Electronic address:

Background: IRE is a non-thermal ablative modality that has been shown to be safe and efficacious in LAPC and liver tumors, but few studies have shown its effects on patients' (QOL). The goal of this study is to evaluate quality-of-life (QOL) before and after irreversible electroporation (IRE) therapy for treatment of locally advanced pancreatic carcinoma (LAPC).

Methods: Between 11/2014 and 12/2016, patients scheduled for IRE therapy for LAPC were offered QOL questionnaires (EORTC QLQ-C30 V2. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00029610183140
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http://dx.doi.org/10.1016/j.amjsurg.2019.03.020DOI Listing
April 2019
3 Reads

It still hurts! Persistent pain and use of pain medication one year after injury.

Am J Surg 2019 Apr 1. Epub 2019 Apr 1.

Department of Surgery, Division of Trauma, Burn and Surgical Critical Care, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA.

Background: Given the scarce literature data on chronic post-traumatic pain, we aim to identify early predictors of long-term pain and pain medication use after major trauma.

Methods: Major trauma patients (Injury Severity Score ≥ 9) from three Level I Trauma Centers at 12 months after injury were interviewed for daily pain using the Trauma Quality of Life questionnaire. Multivariate logistic regression models identified patient- and injury-related independent predictors of pain and use of pain medication. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.03.022DOI Listing

Racial disparities in post-discharge healthcare utilization after trauma.

Am J Surg 2019 Apr 1. Epub 2019 Apr 1.

Department of Surgery, Division of Trauma, Burn and Surgical Critical Care, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address:

Background: Racial disparities in trauma outcomes have been documented, but little is known about racial differences in post-discharge healthcare utilization. This study compares the utilization of post-discharge healthcare services by African-American and Caucasian trauma patients.

Methods: Trauma patients with an Injury Severity Score (ISS)≥9 from three Level-I trauma centers were contacted between 6 and 12 months post-injury. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.03.024DOI Listing

A multi-center, prospective clinical trial of a hepatic derived porcine surgical mesh for the laparoscopic repair of symptomatic paraesophageal hernias.

Am J Surg 2019 Apr 1. Epub 2019 Apr 1.

Carolinas Surgical Specialty Center, Charlotte, NC, USA.

Introduction: We report the results of a multicenter trial evaluating a unique, biological mesh (MIROMESH) derived from decellularized porcine liver for hiatal cruralplasty during laparoscopic PEHR.

Methods: 41 subjects underwent a laparoscopic PEHR which included primary crural closure, and MIROMESH onlay. Subjects were assessed at 2-weeks and 6, 12, 18 and 24 months using the SF-36, GERD-HRQL questionnaire, and VAS GERD related symptoms, and UGI. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.03.025DOI Listing
April 2019
1 Read
2.291 Impact Factor

The feasibility of laparoscopic subtotal colectomy with cecorectal anastomosis in community practice for slow transit constipation.

Authors:
Matthew R Macha

Am J Surg 2019 May 26;217(5):974-978. Epub 2019 Mar 26.

Idaho Surgical Partners, PC, 323 E. Riverside Drive, Suite 220, Eagle, Idaho, 83616, USA. Electronic address:

Background: The objective of this paper is to demonstrate if slow transit constipation (STC) can be accurately diagnosed, selecting patients appropriate for surgery, and safely perform laparoscopic subtotal colectomy with cecorectal anastomosis (CRA) with acceptable short and long-term outcomes in the setting of medically complex patients in a community practice.

Methods: A retrospective study was performed at a private community surgical practice. Cohort involved 10 patients with up to 10 years in follow-up care with a diverse range of ages, body mass index (BMI) and medical conditions. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.03.018DOI Listing
May 2019
2 Reads

10 years of laparoscopic common bile duct exploration: A single tertiary institution experience.

Am J Surg 2019 May 26;217(5):970-973. Epub 2019 Mar 26.

Oregon Health and Science University, Portland, OR.

Introduction: Laparoscopic common bile duct exploration (LCBDE-LC) or ERCP plus laparoscopic cholecystectomy (ERCP-LC) represent minimally invasive choledocholithiasis treatments. We hypothesized that LCBDE-LC has a shorter length of stay (LOS) and lower charges than ERCP-LC.

Methods: Charts were reviewed for all LCBDE-LC or ERCP-LC for choledocholithiasis from 2007 to 2017. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.03.006DOI Listing
May 2019
6 Reads

Factors influencing amount of guidance in the operating room during laparoscopic cases.

Am J Surg 2019 May 22;217(5):979-985. Epub 2019 Mar 22.

Department of Surgery, Oregon Health and Sciences University, Portland, OR, USA.

Background: Identifying factors associated with resident autonomy may help improve training efficiency. This study evaluates resident and procedural factors associated with level of guidance needed in the operating room.

Methods: Intraoperative performance and yearly performance on Fundamentals of Laparoscopic Surgery (FLS) tasks from 74 general surgery residents were retrospectively reviewed. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.03.019DOI Listing

An effective multi-modality model for single-session cricothyroidotomy training for trainees.

Am J Surg 2019 Jan 30. Epub 2019 Jan 30.

Beth Israel Deaconess Medical Center, Boston, MA, USA. Electronic address:

Background: We piloted a curriculum combining a flipped classroom with two-stage narration, role-play, and partial task trainer simulation to teach this critical skill to trainees.

Methods: This "flipped classroom" module (2012-2018) for open and percutaneous cricothyroidotomy (OC and PC) required participants to watch two 4 min training videos for OC and PC. The simulation session consisted of a 45-min hands-on simulation of OC and PC in which participants rotated between the roles of operator, narrator, and critiquer. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2018.12.059DOI Listing
January 2019
1 Read

The effects of tranexamic acid on blood loss and transfusion rate in colorectal surgery.

Am J Surg 2019 Mar 15. Epub 2019 Mar 15.

Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA. Electronic address:

Background: The present study aimed to evaluate safety of tranexamic acid (TA) administration and to assess bleeding risk in colorectal surgery (CRS).

Methods: Retrospective cohort study including consecutive patients undergoing elective CRS by a single surgeon between August 2014 and May 2015. All patients received 1 g of TA intravenously at induction and at closure. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.03.013DOI Listing
March 2019
1 Read

Pheochromocytoma: 20 years of improving surgical care.

Am J Surg 2019 May 19;217(5):967-969. Epub 2019 Mar 19.

Department of Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mail Code L223A, Portland, OR, 97239, USA. Electronic address:

Background: Laparoscopic adrenalectomy is now the standard for pheochromocytoma. We report two decades of institutional experience with pheochromocytoma adrenalectomy.

Methods: A retrospective review was undertaken of pheochromocytoma adrenalectomy patients between 1997 and 2017. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.03.016DOI Listing
May 2019
1 Read

Short term outcomes and unintended benefits of establishing a HPB program at a university-affiliated community hospital.

Am J Surg 2019 Mar 15. Epub 2019 Mar 15.

Western Michigan University Homer Stryker M.D. School of Medicine, Department of General Surgery, 1000 Oakland Dr, Kalamazoo, MI, 49008, USA; Western Michigan Cancer Center, 200 N Park St, Kalamazoo, MI, 49007, USA. Electronic address:

Background: In hepato-pancreato-biliary (HPB) surgery higher volumes are associated with improved outcomes; however, there are limitations to regionalization. Here we report our experience establishing multidisciplinary HPB program at a university-affiliated community hospital.

Methods: This is a retrospective review of patients who underwent HPB surgery between 2015 and 2017. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00029610183050
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http://dx.doi.org/10.1016/j.amjsurg.2019.03.015DOI Listing
March 2019
2 Reads
2.291 Impact Factor

Academic inertia: Examining changes of scholarly output over time among academic minimally invasive surgeons.

Am J Surg 2019 Mar 15. Epub 2019 Mar 15.

Division of General and GI Surgery, Emory University Hospital, Atlanta, GA, USA.

Introduction: The purpose of this study is to assess how the Hirsch Index (h-index) and other academic metrics change over time for academic minimally invasive surgeons (MIS).

Methods: Through the Fellowship Council's website, MIS program-directors and associate program-directors were identified in 2017 and again in 2018. Using the Scopus database, the number of publications, citations, self-citations, and h-indices were calculated. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.03.014DOI Listing

Obstruction reduction: Use of water-soluble contrast challenge to differentiate between partial and complete small bowel obstruction.

Am J Surg 2019 Feb 28. Epub 2019 Feb 28.

Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.

Differentiating SBO that will resolve conservatively from those requiring surgery remains challenging. Water-soluble contrast administration may be diagnostic and therapeutic. Our study evaluated use of a WSC challenge protocol. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.034DOI Listing
February 2019
2 Reads

External validation of the Japanese difficulty scoring system for minimally-invasive distal pancreatectomies.

Am J Surg 2019 Mar 15. Epub 2019 Mar 15.

Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, 20 College Road, Level 5 Academia, 169856, Singapore; Duke NUS Medical School, Singapore.

Introduction: Preoperative prediction of the difficulty of surgery would be useful for surgeons embarking on MIDP. A novel difficulty scoring system(DSS) was recently developed in Japan but has not been externally validated. This study aims to externally validate the DSS determine its association with important clinical outcome parameters. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.03.012DOI Listing
March 2019
6 Reads
2.291 Impact Factor

Total abdominal colectomy is cost-effective in treating colorectal cancer in patients with genetically diagnosed Lynch Syndrome.

Am J Surg 2019 Mar 16. Epub 2019 Mar 16.

Department of Surgery, University Hospital Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA. Electronic address:

Background: Lynch syndrome (LS) has a 80% lifetime risk of developing colorectal cancer and metachronous cancer. No studies have examined the quality adjusted life expectancy after SEG or TAC for LS patients, which this study was aiming for. If TAC offers a higher quality adjusted life year (QALY) to SEG in LS patients, preoperative diagnosis of LS is critical as it alters the recommended surgical procedure. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.03.011DOI Listing

Skeletal muscle mass predicts the prognosis of patients with intrahepatic cholangiocarcinoma.

Am J Surg 2019 Mar 14. Epub 2019 Mar 14.

Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.

Background: We studied the prognostic impact of sarcopenia after hepatic resection for intrahepatic cholangiocarcinoma (ICC).

Methods: Sixty-one patients who underwent surgery for ICC during 2000-2017 were analyzed retrospectively. Psoas muscle areas were measured on CT scans at the third lumbar vertebra. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00029610183165
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http://dx.doi.org/10.1016/j.amjsurg.2019.03.010DOI Listing
March 2019
4 Reads

Assessing quality and resources during campus-wide simulation integration.

Am J Surg 2019 Mar 13. Epub 2019 Mar 13.

UT Southwestern Simulation Center, UT Southwestern Medical Center, Dallas, TX, USA.

Introduction: Our simulation center, supported by four departments (Surgery, OB/GYN, Urology, and Anesthesiology), is accredited as a comprehensive Accredited Educational Institute (AEI) and is now expanding to accommodate all departments on campus.

Methods: A 61-point questionnaire was administered to 44 stakeholders, representing all of UME and GME. Data were compared for AEI vs. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00029610193003
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http://dx.doi.org/10.1016/j.amjsurg.2019.03.008DOI Listing
March 2019
3 Reads

Billroth II reconstruction in gastric cancer surgery: A good option for Western patients.

Am J Surg 2019 Mar 13. Epub 2019 Mar 13.

Department of Digestive Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.

Purpose: The aim of this study is to report the short and long-term results of a cohort of patients who underwent Billroth II (BII) Distal Gastrectomy (DG) for gastric cancer (GC), in a tertiary referral Western center.

Methods: From January 2005 to December 2015, a prospective observational study was conducted in candidate patients to elective gastrectomy for cancer.

Results: Among 514 patients observed with GC, a series of 258 patients underwent BII DG for middle/lower third GC. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.03.009DOI Listing

How important is the 4-ICG score for a thyroid surgeon?

Am J Surg 2019 Mar 11. Epub 2019 Mar 11.

Department of General Surgery, AIIMS, Patna, 801507, India. Electronic address:

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http://dx.doi.org/10.1016/j.amjsurg.2019.03.004DOI Listing
March 2019
1 Read

Expedited discharge in uncomplicated acute appendicitis: Decreasing the length of stay while maintaining quality.

Am J Surg 2019 May 13;217(5):830-833. Epub 2019 Mar 13.

Cumming School of Medicine, University of Calgary, Department of Surgery, North Tower, Foothills Medical Centre, 1403 29 St NW, Calgary, Alberta, T2N 2T9, Canada.

Background: An expedited discharge protocol for uncomplicated appendicitis was developed at a Canadian academic hospital to determine if patients could be safely discharged home early without negatively impacting care and patient satisfaction.

Methods: A non-randomized prospective quality improvement project was completed between February 01, 2017 and January 31, 2018. The project included patients between 16 and 65 years with uncomplicated appendicitis managed with laparoscopic appendectomy. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.03.007DOI Listing
May 2019
3 Reads

Decreasing failed extubations with the implementation of an extubation checklist.

Am J Surg 2019 Mar 5. Epub 2019 Mar 5.

University of Texas at Austin Dell Medical School, USA; Dell Seton Medical Center at the University of Texas, Department of Trauma Services, USA. Electronic address:

Background: Failed extubation has been shown to increase ICU stay, transfers to rehabilitation facilities, and mortality. The purpose of this study was to assess the differences in rates of failed extubation before and after implementation of an extubation checklist.

Methods: We performed a retrospective study from January 2013-April 2017 on adult trauma patients (age 18-89) who were admitted to the ICU and required mechanical ventilation. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.028DOI Listing
March 2019
2 Reads

Assessment of general surgery resident study habits and use of the TrueLearn question bank for American Board of Surgery In-Training exam preparation.

Am J Surg 2019 Feb 28. Epub 2019 Feb 28.

University of Texas, Southwestern Medical Center Department of Surgery, Dallas, TX, USA. Electronic address:

Background: Little information exists on the value of online question banks in preparing residents for the American Board of Surgery In-Training Examination (ABSITE).

Methods: We reviewed surgical residents' use of an online question bank (TrueLearn) and compared it to their ABSITE performance.

Results: The 2016-2017 records of 44 PGY 2-5 general surgery residents were examined. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.031DOI Listing
February 2019
1 Read

Small bowel obstruction in a virgin abdomen.

Am J Surg 2019 Feb 12. Epub 2019 Feb 12.

Department of Surgery, Mayo Clinic, Rochester, MN, USA.

Introduction: Surgical exploration is still considered mandatory in the setting of small bowel obstruction (SBO) and a virgin abdomen by some large centers. The aim of this study is to determine the etiology of SBO in patients without prior abdominal operation.

Methods: Retrospective review of the patients treated for SBO and virgin abdomen at the Mayo Clinic between 2006 and 2016 was performed. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.011DOI Listing
February 2019
3 Reads

Simulation training results in improvement of the management of operating room fires-A single-blinded randomized controlled trial.

Am J Surg 2019 Mar 4. Epub 2019 Mar 4.

Department of Surgery, Section of Minimally Invasive Surgery, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL, 60201, USA. Electronic address:

Background: Operating room (OR) fires are a preventable danger. Our aim is to examine the effectiveness of OR fire simulation scenarios as a supplement to classroom-based training for managing OR fires.

Methods: Eighty-two participants were randomly divided into 14 groups. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.035DOI Listing

Risk factors for infection and evaluation of Sepsis-3 in patients with trauma.

Am J Surg 2019 Mar 8. Epub 2019 Mar 8.

Division of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL, USA.

Background: We aim to examine the risk factors associated with infection in trauma patients and the Sepsis-3 definition.

Methods: This was a retrospective cohort study of adult trauma patients admitted to a Level I trauma center between January 2014 and January 2016.

Results: A total of 1499 trauma patients met inclusion criteria and 15% (n = 232) had an infection. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00029610193003
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http://dx.doi.org/10.1016/j.amjsurg.2019.03.005DOI Listing
March 2019
5 Reads

Letter to the Editor: "Prediction of hypocalcemia after total thyroidectomy using indocyanine green angiography of parathyroid glands: A simple quantitative scoring system".

Am J Surg 2019 Mar 11. Epub 2019 Mar 11.

Department of Endocrine Surgery, SGPGI, Lucknow, India. Electronic address:

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http://dx.doi.org/10.1016/j.amjsurg.2019.03.003DOI Listing
March 2019
1 Read
2.291 Impact Factor

Implementation of a medical coding curriculum for surgery residents.

Am J Surg 2019 May 4;217(5):834-838. Epub 2019 Mar 4.

Department of Surgery, Oregon Health and Sciences University, Portland, OR, USA. Electronic address:

Background: Medical coding knowledge is important for practice. We hypothesized that general surgery residents lack confidence in medical coding (MC) and that implementation of focused didactics would increase resident confidence and knowledge.

Methods: A MC curriculum was delivered to general surgery residents covering domains of the global procedural period (GPP), evaluation and management (E/M) coding, and hospital payment and quality metrics (HPQM). Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.027DOI Listing

Preoperative opioid use and postoperative pain associated with surgical readmissions.

Am J Surg 2019 Feb 28. Epub 2019 Feb 28.

Birmingham VA Medical Center, Birmingham, AL, USA; Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.

Background: The extent of preoperative opioid utilization and the relationship with pain-related readmissions are not well understood.

Methods: VA Surgical Quality Improvement Program data on general, vascular, and orthopedic surgeries (2007-2014) were merged with pharmacy data to evaluate preoperative opioid use and pain-related readmissions. Opioid use in the 6-month preoperative period was categorized as none, infrequent, frequent, and daily. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.033DOI Listing
February 2019
1 Read

Predictive factors of upstaging DCIS to invasive carcinoma in BCT vs mastectomy.

Am J Surg 2019 Feb 23. Epub 2019 Feb 23.

Department of General Surgery, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA. Electronic address:

Background: Upstaging from DCIS to invasive ductal carcinoma varies widely from 0 to 59%. We aim to identify risk factors associated with upstaging in all DCIS patients and based on specific surgical intervention.

Methods: Patients with a pre-operative diagnosis of DCIS undergoing BCT or mastectomy were reviewed. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2018.12.069DOI Listing
February 2019

Prevalence of posttraumatic stress disorder (PTSD) in patients with an incisional hernia.

Am J Surg 2019 Mar 7. Epub 2019 Mar 7.

Comprehensive Hernia Center, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.

Background: We investigate the prevalence of PTSD in patients with an incisional hernia presenting for evaluation at our institution.

Methods: Study patients were screened for PTSD using the PCL-5 checklist for DSM-5. Patient-reported quality of life and pain scores were assessed using validated tools (HerQLes and PROMIS Pain Intensity 3a survey). Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.03.002DOI Listing
March 2019
3 Reads

Groin anatomy, preoperative pain, and compression neuropathy in primary inguinal hernia: What really matters.

Am J Surg 2019 May 27;217(5):873-877. Epub 2019 Feb 27.

Cascade Hernia Institute, USA.

Introduction: Enlargement of the ilioinguinal nerve distal to the inguinal ring is common in primary open inguinal herniorrhaphy and is histologically consistent with compression neuropathy. However, the origin of this neuropathy has not been thoroughly studied in primary inguinal hernia.

Methods: In this prospective study, 143 primary inguinal herniorrhaphies were performed. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.017DOI Listing

Disparities in elective surgery for diverticulitis: Identifying the gap in care.

Am J Surg 2019 Mar 5. Epub 2019 Mar 5.

Division of Colon and Rectal Surgery, Mayo Clinic, Jacksonville, FL, USA. Electronic address:

Background: Minimally invasive surgery (MIS) in patients with diverticulitis is advantageous relative to open surgery. We aimed to determine disparities associated with MIS access for diverticulitis and post-operative complications.

Methods: The Florida Inpatient Discharge Dataset was retrospectively queried for patients with diverticulitis undergoing elective surgery between 2013 and 2015. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00029610193003
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http://dx.doi.org/10.1016/j.amjsurg.2019.03.001DOI Listing
March 2019
8 Reads

Donor age is the most important predictor of long term graft function in donation after cardiac death simultaneous pancreas-kidney transplantation: A retrospective study.

Am J Surg 2019 Mar 5. Epub 2019 Mar 5.

Schulich School of Medicine and Dentistry, Western University, London, ON, Canada; Department of Surgery, Western University, London, ON, Canada; Matthew Mailing Center for Translational Transplant Studies, Western University, London, ON, Canada; Department of Microbiology and Immunology, Western University, London, ON, Canada. Electronic address:

Background: Allografts donated after cardiac death (DCD) are the fastest growing organ source worldwide. Unfortunately, information is lacking on how to judge these organs' viability. Here, we analyzed the effects of donor characteristics, including age and BMI, on outcomes of DCD simultaneous-pancreas-kidney transplantation (SPK). Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.024DOI Listing
March 2019
1 Read

Predictors of adjuvant treatment and survival in patients with intrahepatic cholangiocarcinoma who undergo resection.

Am J Surg 2019 Mar 4. Epub 2019 Mar 4.

Department of Surgery, Massachusetts General Hospital, Boston, MA, 02114, USA; Newton Wellesley Hospital, Newton, MA 02462, USA. Electronic address:

Background: Administration of adjuvant therapy (AT) in patients with intrahepatic cholangiocarcinoma (ICC) remains inconsistent despite recent trial data. This study investigates predictors of receipt of AT and survival.

Methods: Patients with ICC who underwent resection were identified using the NCDB (2004-2014). Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.036DOI Listing
March 2019
4 Reads

Emergency general surgery procedures in hematopoietic stem cell transplant recipients.

Am J Surg 2019 Feb 28. Epub 2019 Feb 28.

Brigham and Women's Hospital, Division of Trauma, Burn, and Surgical Critical Care, Boston, MA, USA.

Background: Outcomes of emergency general surgery (EGS) procedures on hematopoietic stem cell transplant (HST) recipients have not been defined in a large, national database. Whether EGS during HST engraftment admission, or in HST patients with graft versus host disease (GVHD) results in worse outcomes is unknown.

Methods: The National Inpatient Sample (NIS) was examined for patients with a history of BMT between 2001 and 2014. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.030DOI Listing
February 2019
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Clinical trial enrollment in patients with endocrine neoplasm: Parity achievable, but cancer.

Am J Surg 2019 Feb 14. Epub 2019 Feb 14.

Endocrine Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States; Department of Surgery, The George Washington University, School of Medicine and Health Sciences, Washington, DC, United States.

Background: We sought to assess participation of underrepresented minorities with endocrine neoplasms in clinical trials conducted in the National Cancer Institute's (NCI) Intramural Research Program.

Methods: We performed a retrospective analysis of patients enrolled in Endocrine Oncology Branch (EOB) clinical trials, comparing demographics to regional and national demographics. We compared specific endocrine cancer patient data to data from NCI's Surveillance, Epidemiology, and End Results (SEER) program. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.019DOI Listing
February 2019
2 Reads

Salvage of rib stabilization hardware with antibiotic beads.

Am J Surg 2019 Feb 28. Epub 2019 Feb 28.

Division of Trauma, Critical Care, and General Surgery, Mayo Clinic Rochester, Rochester, MN, United States. Electronic address:

Background: Surgical stabilization of rib fractures (SSRF) can be used to improve pulmonary mechanics; however, hardware infection is a morbid complication. Antibiotic impregnated beads have been used to suppress infection in orthopedic practices. We aimed to determine the efficacy of antibiotic beads for infected and at-risk SSRF hardware. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.032DOI Listing
February 2019
2 Reads

Hospital and surgeon variation in positive circumferential resection margin among rectal cancer patients.

Am J Surg 2019 Feb 28. Epub 2019 Feb 28.

Surgical Health Outcomes and Research Enterprise, Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA; Department of Public Health Sciences, Division of Epidemiology, University of Rochester Medical Center, Rochester, NY, USA. Electronic address:

Background: The objective of this study was to evaluate variation in positive CRM at the surgeon and hospital levels and assess impact on disease-specific survival.

Methods: Patients with stage I-III rectal cancer were identified in New York State. Bayesian hierarchical regressions estimated observed-to-expected (O/E) ratios for each surgeon/hospital. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.029DOI Listing
February 2019
1 Read

Too fast, or not fast enough? The FAST exam in patients with non-compressible torso hemorrhage.

Am J Surg 2019 May 13;217(5):882-886. Epub 2019 Feb 13.

Department of Surgery, Madigan Army Medical Center, Tacoma, WA, USA; Trauma and Emergency Surgery Service, Legacy Emanuel Medical Center, Portland, OR, USA. Electronic address:

Background: Focused assessment with sonography for trauma (FAST) performance metrics are unknown in patients with non-compressible torso hemorrhage (NCTH).

Methods: Retrospective review of a dedicated NCTH database from four level 1 trauma centers (2008-2012). NCTH was defined as (1) named axial torso vessel disruption; (2) AIS chest or abdomen >2 with shock (base deficit < -4) or truncal operation in ≤ 90 min; or (3) pelvic fracture with ring disruption. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.012DOI Listing

Outcomes of Hartmann's procedure and subsequent intestinal restoration. Which patients are most likely to undergo reversal?

Am J Surg 2019 Feb 21. Epub 2019 Feb 21.

Department of Surgery, University of Valencia, Valencia, Spain.

Background: Aim of the study was to describe characteristics and outcomes of Hartmann's procedure (HP) and subsequent intestinal restoration.

Methods: Retrospective study including all patients who underwent HP over a period of 16 consecutive years. We propose a classification and regression tree for a more accurate view of the relationship between the variables related to intestinal restoration and their weighting in the decision to reverse HP. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.025DOI Listing
February 2019
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Poor compliance despite equal access: Military experience with screening breast MRI in high risk women.

Am J Surg 2019 May 20;217(5):843-847. Epub 2019 Feb 20.

Department of Surgery, Madigan Army Medical Center, Tacoma, WA, USA. Electronic address:

Background: Using the military as a model for an equal-access, no-cost healthcare system, we sought to (1) describe screening breast MRI compliance rates and (2) identify patient-perceived barriers to screening.

Methods: In this retrospective cohort study of a prospectively maintained database at a tertiary level center, we compared compliance among women at ≥20% risk of developing breast cancer (Tyrer-Cuzick) and conducted structured phone interviews with women at ≥30% risk.

Results: From 2015 to 2016, 1,052 women met criteria for screening MRI. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.021DOI Listing
May 2019
2 Reads

Frailty as a prognostic factor for the critically ill older adult trauma patients.

Am J Surg 2019 Feb 22. Epub 2019 Feb 22.

Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, United States. Electronic address:

Background: Frailty is highly prevalent in the elderly and confers high risk for adverse outcomes. We aimed to assess the impact of frailty on critically ill older adult trauma patients.

Methods: We analyzed the ACS-TQIP(2010-2014) including all critically-ill trauma patients ≥65y. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.035DOI Listing
February 2019
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The effects of propranolol and clonidine on bone marrow expression of hematopoietic cytokines following trauma and chronic stress.

Am J Surg 2019 Feb 21. Epub 2019 Feb 21.

University of Florida, Department of Surgery and Sepsis and Critical Illness Research Center, Gainesville, FL, USA. Electronic address:

Background: Attenuating post-injury neuroendocrine stress abrogates persistent injury-associated anemia. Our objective was to examine the mechanisms by which propranolol and clonidine modulate this process. We hypothesized that propranolol and clonidine would decrease bone marrow expression of high-mobility group box-1 (HMGB1) and increase expression of stem cell factor (SCF) and B-cell lymphoma-extra large (Bcl-xL). Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.023DOI Listing
February 2019
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Risk factors and outcome of acute kidney injury in elderly trauma patients.

Am J Surg 2019 Feb 12. Epub 2019 Feb 12.

Department of Surgery, University of Louisville, Louisville, KY, 40202, USA.

Background: Acute Kidney Injury (AKI) is associated with significant morbidity. The risk factors for AKI in elderly trauma patients have not been defined.

Methods: Injured patients 75 years old or older from 2014 to 2016 were evaluated. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.007DOI Listing
February 2019
5 Reads

Sage wisdom or anecdotal dictum? Equivalent opioid use after open, laparoscopic, and robotic inguinal hernia repair.

Am J Surg 2019 May 22;217(5):839-842. Epub 2019 Feb 22.

Madigan Army Medical Center, Tacoma, WA, USA. Electronic address:

Background: Purported benefits of minimally-invasive inguinal hernia repair techniques include less postoperative pain, but objective data is lacking. We analyzed prescribing habits and opiate requirements to provide an objective comparison.

Methodology: Inguinal hernia repairs performed on patients aged 18-65 from October 2016 through February 2018 were examined. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.022DOI Listing
May 2019
3 Reads