24,036 results match your criteria American journal of surgery[Journal]


Regional therapies for the treatment of primary and metastatic hepatic tumors: A disease-based review of techniques and critical appraisal of current evidence.

Am J Surg 2019 Mar 16;217(3):541-545. Epub 2018 Oct 16.

Spectrum Health General Surgery Residency Program, Grand Rapids, MI, USA; Michigan State University College of Human Medicine, Department of Surgery, Grand Rapids, MI, USA; Spectrum Health Medical Group, Division of Surgical Oncology, Grand Rapids, MI, USA. Electronic address:

The practice of hepatic surgery has become increasingly complex as additional therapeutic options emerge to treat both primary and metastatic tumors of the liver. Liver-directed therapy options include selective internal radiation therapy (SIRT), stereotactic body radiation therapy, chemoembolization, bland embolization, hepatic artery infusion chemotherapy (HAIC), and ablative techniques such as microwave or radiofrequency ablation. Hepatocellular carcinoma has been treated with many of these therapies for palliation of symptoms, definitive treatment, and as a bridge to transplantation. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2018.10.018DOI Listing

Pathology results of architectural distortion on detected with digital breast tomosynthesis without definite sonographic correlate.

Am J Surg 2019 Jan 31. Epub 2019 Jan 31.

Diagnostic Imaging Northwest PC, Legacy Good Samaritan Hospital, 1015 N.W. 22nd Ave, Portland, OR, 97210, USA.

Background: Digital breast tomosynthesis (DBT) is a mammographic technique which improves the detection of breast cancer. Architectural distortion of malignancy may be occult on 2D mammography and ultrasound but detected by DBT.

Methods: 110 patients who underwent 116 DBT-guided needle biopsies for architectural distortion were identified between June 2014 and August 2017 and underwent review of medical records. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.029DOI Listing
January 2019

A decade of experience with laparoscopic ventral hernia repairs.

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Am J Surg 2019 Mar;217(3):550-551

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http://dx.doi.org/10.1016/j.amjsurg.2018.12.048DOI Listing

Quality that you cannot believe.

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Am J Surg 2019 Mar;217(3):452-453

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http://dx.doi.org/10.1016/j.amjsurg.2018.12.034DOI Listing

Antibiotic use in prevention of anal fistulas following incision and drainage of anorectal abscesses: A systematic review and meta-analysis.

Am J Surg 2019 Jan 31. Epub 2019 Jan 31.

Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alberta, Canada. Electronic address:

Background: Treatment of anorectal abscesses continues to revolve around early surgical drainage and control of perianal sepsis. Yet even with prompt drainage, abscess recurrence and postoperative fistula formation rates are as high as 40% within 12 months. These complications are thought to be associated with inadequate drainage, elevated bacterial load, or a noncryptoglandular etiology of disease. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.015DOI Listing
January 2019

Extreme oncoplasty: Expanding indications for breast conservation.

Am J Surg 2019 Jan 24. Epub 2019 Jan 24.

John Wayne Cancer Institute, Providence Saint John's Health Center, Santa Monica, CA, USA. Electronic address:

Introduction: Presence of multiple lesions and/or tumor span ≥5 cm are traditional indications for mastectomy. Patient desire for breast conservation has increased the interest in extreme oncoplastic breast conserving surgery (EOBCS) to avoid mastectomy; however, perioperative outcomes in this population have not been well described.

Methods: This is an observational cohort of breast cancer patients with multiple lesions and disease span ≥5 cm who underwent EOBCS. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.004DOI Listing
January 2019

Financial burden amongst cancer patients treated with curative intent surgery alone.

Am J Surg 2019 Jan 31. Epub 2019 Jan 31.

Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address:

Background: The costs of cancer care in the US continue to increase and may have serious consequences for patients. We hypothesize that even cancer patients treated with curative-intent surgery alone experience substantial financial burden.

Methods: A questionnaire was administered to adult cancer patients who were treated with curative-intent surgery. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.033DOI Listing
January 2019

Limited clinical utility of intraoperative frozen section during parathyroidectomy for treatment of primary hyperparathyroidism.

Am J Surg 2019 Feb 5. Epub 2019 Feb 5.

Department of Surgery, University of British Columbia & St Paul's Hospital, C303-1081, Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. Electronic address:

Background: This study's objective was to evaluate the utility of intraoperative frozen section (IFS) performed during parathyroidectomy for treatment of primary hyperparathyroidism (PHP), and to identify patients for whom it is most helpful.

Methods: A retrospective chart review was carried out for all patients who underwent parathyroidectomy for treatment of PHP between January 2013 and June 2018.

Results: 262 patients made up the final study population. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.032DOI Listing
February 2019

Is bigger better? Twenty-year institutional experience of atypical ductal hyperplasia discovered by core needle biopsy.

Am J Surg 2019 Feb 2. Epub 2019 Feb 2.

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

Objectives: The increasing accuracy of large-bore (11- or 8-gauge) vacuum-assisted core needle biopsies (VACNB) has challenged the commonly-accepted practice that surgery is needed for definitive diagnosis when atypical ductal hyperplasia (ADH) is found on VACNB. This study seeks to demonstrate the impact of increased VACNB caliber on the pathologic upgrade rate of ADH.

Methods: Patients diagnosed with isolated ADH by VACNB who subsequently underwent surgical excision at our tertiary medical center were retrospectively studied. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.028DOI Listing
February 2019

Advanced laparoscopic skills: Understanding the relationship between simulation-based practice and clinical performance.

Am J Surg 2019 Jan 31. Epub 2019 Jan 31.

Department of Surgery, Indiana University, Indianapolis, IN, USA.

Introduction: The advanced laparoscopic skills (ALS) curriculum was created to address the need for improved laparoscopic training for senior surgical trainees. It focuses on the domain of laparoscopic suturing and consists of 6 tasks with established proficiency benchmarks. Tasks are performed using a standard laparoscopic box trainer. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.024DOI Listing
January 2019

Corrigendum to "Methocarbamol use is associated with decreased hospital length of stay in trauma patients with closed rib fractures" [Am J Surg 214/4 (2018) 738-742].

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

Department of Pharmacy Practice & Science, College of Pharmacy, The University of Arizona, Tucson, AZ, USA.

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http://dx.doi.org/10.1016/j.amjsurg.2019.02.001DOI Listing
February 2019

Cytoreductive surgery and heated intraperitoneal chemotherapy for peritoneal carcinomatosis from rare etiologies.

Am J Surg 2019 Jan 25. Epub 2019 Jan 25.

Department of Surgery and Oncology, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada. Electronic address:

Background: Cytoreductive surgery and heated intraperitoneal chemotherapy (CRS/HIPEC) are commonly used in the treatment of peritoneal carcinomatosis (PC) originating from colorectal, appendiceal and ovarian cancers. It is unclear what benefit CRS/HIPEC might have for PC from uncommon etiologies, therefore we sought to describe local practice patterns and evaluate overall survival (OS).

Methods: All patients who had CRS/HIPEC between 2000 and 2016 were identified using our institutional cancer database. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.011DOI Listing
January 2019
1 Read

Human leukocyte antigens class I and II in patients with idiopathic granulomatous mastitis.

Authors:
Hande Koksal

Am J Surg 2019 Jan 31. Epub 2019 Jan 31.

Saglik Bilimleri University, Faculty of Medicine, Konya Education and Research Hospital, Department of General Surgery, Yeni Meram Cad, Number: 97, Konya, Turkey. Electronic address:

Background: To determine the distribution of human leukocyte antigens (HLA) in patients with idiopathic granulomatous mastitis (IGM).

Methods: The study included 48 patients diagnosed with IGM and 50 controls consisting of healthy donor candidates.

Results: The frequencies of HLA-A*10, HLA-A*2403, HLA-B*18 and HLA-DR*17 antigens were significantly higher in the patient group than control group (p = 0. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.038DOI Listing
January 2019

Perioperative risk factors of acute kidney injury after non-cardiac surgery: A multicenter, prospective, observational study in patients with low grade American Society of Anesthesiologists physical status.

Am J Surg 2019 Jan 31. Epub 2019 Jan 31.

Department of Anesthesiology and Reanimation, School of Medicine, Acibadem Mehmet Ali Aydınlar University, Istanbul, Turkey. Electronic address:

Background: The aim of this study was to determine the incidence and the perioperative risk factors of acute kidney injury (AKI) using "Kidney Disease: Improving Global Outcomes" (KDIGO) guidelines, in patients with low grade American Society of Anesthesiologists physical status (ASA-PS) undergoing non-cardiac surgery.

Methods: In this multicenter, prospective, observational study, 870 surgical patients older than 40 years with ASA-PS I-II who underwent noncardiac surgery, were included. The primary outcome of this study was perioperative AKI defined by the KDIGO criteria. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.031DOI Listing
January 2019
3 Reads

Incision & drainage of perianal sepsis in the immunocompromised: A need for heightened postoperative awareness.

Am J Surg 2019 Jan 31. Epub 2019 Jan 31.

Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA.

Background: Incision and drainage of perianal sepsis has appreciable success in the immunocompetent population, but outcomes after incision and drainage in the immunosuppressed population are unknown.

Methods: 13,666 patients (n = 930 immunosuppressed) undergoing incision and drainage of perianal sepsis between 2011 and 2015 in the American College of Surgeons National Surgical Quality Improvement Program were identified. The main outcomes were major morbidity, return to the operating room, and mortality. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.036DOI Listing
January 2019

A cost-utility analysis comparing large volume displacement oncoplastic surgery to mastectomy with free flap reconstruction in the treatment of breast cancer.

Am J Surg 2019 Jan 31. Epub 2019 Jan 31.

Department of Surgery, Indiana Medical Center, Indianapolis, IN, USA.

Purpose: Breast cancer surgical treatment may include large volume displacement oncoplastic surgery (LVOS) or mastectomy with free flap reconstruction (MFFR). We investigated the cost-utility between LVOS versus MFFR to determine which approach was most cost-effective.

Methods: A literature review was performed to calculate probabilities for clinical outcomes for each surgical option (LVOS versus MFFR), and to obtain utility scores that were converted into quality adjusted life years (QALYs) as measures for clinical effectiveness. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.037DOI Listing
January 2019

Redefining the sensitivity of screening mammography: A review.

Am J Surg 2019 Feb 2. Epub 2019 Feb 2.

Department of Surgery, Mercy Hospital, 4401 W. McAuley Blvd., Suite #1100, Mercy Hospital Coletta Building, Oklahoma City, OK, USA. Electronic address:

From its inception, screening mammography has enjoyed a perceived level of sensitivity that is inconsistent with available evidence. The original data that imparted erroneous beliefs about sensitivity were based on a variety of misleading definitions and approaches, such as the inclusion of palpable tumors, using the inverse of interval cancer rates (often tied to an arbitrary 12 month interval), and quoting prevalence screen sensitivity wherein tumors are larger than those found on incidence screens. This review addresses the background for the overestimation of mammographic sensitivity, and how a major adjustment in our thinking is overdue now that multi-modality imaging allows us to determine real time mammographic sensitivity. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.039DOI Listing
February 2019

All work and no play: Addressing medical students' concerns about duty hours on the surgical clerkship.

Am J Surg 2018 Dec 11. Epub 2018 Dec 11.

Department of Surgery, Northwestern University Feinberg School of Medicine, 251 E. Huron St., Suite 3-150, Chicago, IL, USA; Center for Healthcare Studies, Institute for Public Health and Medicine, 633 N. St. Clair St., 20th Floor, Chicago, IL, USA. Electronic address:

Background: Given the option of preferencing rotations for a 3rd year core surgery clerkship, we observed students often requested services perceived as less time-intensive. We compare self-reported duty hours with academic outcomes.

Methods: We examined duty hours from 165 third-year medical students on a surgery clerkship at a single institution for academic year 2016-2017. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2018.12.012DOI Listing
December 2018

Impact of SSO-ASTRO margin guidelines on reoperation rates following breast-conserving surgery.

Am J Surg 2019 Jan 17. Epub 2019 Jan 17.

Department of Surgical Oncology, Sindi Ahluwalia Hawkins Centre for the Southern Interior, BC Cancer Agency, Kelowna, BC, Canada; Department of Surgery, University of British Columbia, Vancouver, BC, Canada; Department of Surgery, Kelowna General Hospital, Kelowna, BC, Canada. Electronic address:

Background: Re-operation rates following breast-conserving surgery (BCS) for early invasive breast cancer are highly variable, largely due to uncertainty regarding adequate margins. The 2014 SSO-ASTRO guidelines recommended "no ink on tumor" as adequate margins. We evaluated the effect of guideline implementation on re-operation following BCS at our regional cancer center. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.007DOI Listing
January 2019

Medical students' perceptions and motivations prior to their surgery clerkship.

Am J Surg 2019 Jan 21. Epub 2019 Jan 21.

Department of Surgery, Massachusetts General Hospital, 55 Fruit Street GRB 425, Boston, MA, 02114, United States. Electronic address:

Background: This study aims to determine the effect of a pre-clerkship workshop on medical students' perceptions of surgery and surgeons and to describe their concerns and learning goals.

Methods: Thirty-nine medical students completed surveys before and after a workshop preceding their surgery clerkship. Quantitative data and free responses that were inductively coded were used to assess effectiveness. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.010DOI Listing
January 2019
2 Reads

Assessment of clinical outcome of cholecystectomy according to age in preparation for the "Silver Tsunami".

Am J Surg 2019 Jan 25. Epub 2019 Jan 25.

Department of Surgery, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan.

Background: Recent rapid increases in the aging population have created an impending "Silver Tsunami" in advanced countries. The overall prevalence of gallstone disease and its related complications will soon increase, and there will be a larger demand for gallbladder surgery.

Methods: We examined the outcomes of cholecystectomy according to age among patients with cholelithiasis to determine how a patient's age influences the outcome of cholecystectomy. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.021DOI Listing
January 2019
1 Read

Prolonged ICU stay and its association with 1-year trauma mortality: An analysis of 19,000 American patients.

Am J Surg 2019 Jan 29. Epub 2019 Jan 29.

Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Harvard Medical School, USA.

Introduction: Prior research on patients with traumatic injury suggests high in-hospital survivability. However, little is known about their long-term outcomes, especially in the context of a prolonged ICU length-of-stay (LOS). We sought to determine the association between prolonged ICU-LOS and 1-year survival in trauma patients. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.025DOI Listing
January 2019

The effect of increasing body mass index on wound complications in open ventral hernia repair with mesh.

Am J Surg 2019 Jan 25. Epub 2019 Jan 25.

Comprehensive Hernia Center Department of Surgery, University of Wisconsin School of Medicine and Public Health, 4602 Eastpark Boulevard, Madison, WI, 53718, USA.

Background: There is a paucity of data delineating the relationship between body mass index (BMI) and wound complications. We investigated the association between BMI and wound morbidity following open ventral hernia repair with mesh (OVHR).

Design: Patients undergoing elective OVHR were identified within the Americas Hernia Society Quality Collaborative. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.022DOI Listing
January 2019

Fellow-led SICU morbidity and mortality conferences address patient safety, quality improvement, interprofessional cooperation and ACGME milestones.

Am J Surg 2019 Jan 28. Epub 2019 Jan 28.

Northwestern University Feinberg School of Medicine, Department of Surgery, Division of Trauma and Surgical Critical Care, 676 N. Saint Clair Street, Suite 650, Chicago, Illinois 60611, USA.

Background: Morbidity and mortality conferences (MMCs) promote patient safety, spur quality improvement (QI) projects, and enhance interprofessional cooperation. The use of MMCs to address the Accreditation Council for Graduate Medical Education's (ACGME's) six core competencies and specialty-specific milestones for surgical critical care (SCC) fellows has yet to be explored.

Methods: We developed a monthly, interprofessional, case-based MMC program managed by SCC fellows. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.026DOI Listing
January 2019

Significance of Glisson's capsule invasion in patients with colorectal liver metastases undergoing resection.

Am J Surg 2019 Jan 25. Epub 2019 Jan 25.

Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Electronic address:

Background: Significance of Glisson's capsule invasion in colorectal liver metastases (CLM) patients undergoing resection has been little investigated.

Methods: CLM patients (244) with curative resection (2011-2016) were divided into two groups: patients with (Group 1; n = 49 [20%]) and without (Group 2; n = 195 [80%]) histologically-proven Glisson invasion. Eight (16%) Group 1 patients were identified by pre- or intra-operative findings. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.023DOI Listing
January 2019
2.291 Impact Factor

Long-term oncological outcomes in laparoscopic versus open gastrectomy for advanced gastric cancer: A meta-analysis of high-quality nonrandomized studies.

Am J Surg 2019 Jan 26. Epub 2019 Jan 26.

Department of Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, No. 127 Changle West Road, Xi'an, 710032, China. Electronic address:

Background: Multicenter randomized controlled trials (RCTs) and several meta-analyses have confirmed that laparoscopic gastrectomy (LG) is a safe and feasible procedure for patients with locally advanced gastric cancer (AGC) in terms of short-term outcomes. However, the long-term oncological outcomes of LG for AGC are still needed for further evaluation. This study aimed to compare the long-term oncological outcomes of LG with open gastrectomy (OG) for patients with AGC. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.020DOI Listing
January 2019

Do outcomes in emergency general surgery vary for minority patients based on surgeons' racial/ethnic case mix?

Am J Surg 2019 Jan 9. Epub 2019 Jan 9.

Center for Surgery and Public Health, Brigham & Women's Hospital, 1620 Tremont Street, 4-020, Boston, MA, 02120, USA; Department of Surgery, Brigham & Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.

Background: We hypothesized that Black and Hispanic patients undergoing Emergency General Surgery (EGS) with surgeons who treat higher proportions of minority patients will experience better outcomes.

Methods: Using the Florida State Inpatient Database (2010-2014), we performed multivariable regression to assess complications in patients undergoing EGS as a function of patient race and the proportion of Black, Hispanic, or White patients treated by the surgeon during the study period. Analyses were clustered by hospital and adjusted for patient age, comorbidities, sex, insurance, and hospital-level variables. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.01.001DOI Listing
January 2019