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    23273 results match your criteria American journal of surgery[Journal]

    1 OF 466

    Are we catching women in the safety net? Colorectal cancer outcomes by gender at a safety net hospital.
    Am J Surg 2017 Oct 19;214(4):715-720. Epub 2017 Jul 19.
    Department of Surgery, Division of Colorectal Surgery, MetroHealth Medical Center, Cleveland, OH, USA. Electronic address:
    Background: Our goal was to evaluate presentation and outcomes for colorectal cancer across gender in a safety net hospital (SNH).

    Methods: An institutional Tumor Registry was reviewed for colorectal cancer resections 12/2009-2/2016. Patients were stratified into male and female cohorts. Read More

    A multi-institutional analysis of intraoperative radiotherapy for early breast cancer: Does age matter?
    Am J Surg 2017 Oct 23;214(4):629-633. Epub 2017 Jun 23.
    Moffitt Cancer Center, Tampa, USA. Electronic address:
    Background: Single-session intraoperative radiation therapy (IORT) minimizes treatment demands associated with traditional whole breast radiation therapy (WBRT) but outcomes on local disease control and morbidity among the elderly is limited.

    Methods: A multi-institutional retrospective registry was established from 19 centers utilizing IORT from 2007 to 2013. Patient, tumor, and treatment variables were analyzed for ages <70 and ≥70. Read More

    Resected irradiated rectal cancers: Are twelve lymph nodes really necessary in the era of neoadjuvant therapy?
    Am J Surg 2017 Aug 26. Epub 2017 Aug 26.
    Department of General Surgery, Duke University Medical Center, Durham, NC, United States.
    Background: Our study aims to identify the minimum number of lymph nodes (LN) associated with improved survival in patients who underwent NRT for stage II-III rectal cancer.

    Methods: Adults with clinical stage II and III rectal adenocarcinoma in the National Cancer Data Base were stratified by NRT. Multivariable Cox regression modeling with restricted cubic splines was used to determine the minimum number of LNs associated with improved survival. Read More

    Predicting and evaluation the severity in acute pancreatitis using a new modeling built on body mass index and intra-abdominal pressure.
    Am J Surg 2017 Jun 3. Epub 2017 Jun 3.
    Surgical Intensive Care Unit (SICU), Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 Zhongshan East Road, Nanjing, 210002, China. Electronic address:
    Object: Acute pancreatitis (AP) keeps as severe medical diagnosis and treatment problem. Early evaluation for severity and risk stratification in patients with AP is very important. Some scoring system such as acute physiology and chronic health evaluation-II (APACHE-II), the computed tomography severity index (CTSI), Ranson's score and the bedside index of severity of AP (BISAP) have been used, nevertheless, there're a few shortcomings in these methods. Read More

    Local parastomal hernia repair with biological mesh is safe and effective.
    Am J Surg 2017 Aug 5. Epub 2017 Aug 5.
    Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, Park Ridge, IL, USA.
    Purpose: The goal of this study was to evaluate the efficacy, morbidity and safety of local parastomal hernia repair using biological mesh.

    Patients And Methods: A retrospective analysis of a prospectively maintained database was performed for parastomal hernia repairs. All patients who underwent local parastomal hernia repair with biological mesh between July 2006 and July 2015 were included in the study. Read More

    Integrating technical and non-technical skills coaching in an acute trauma surgery team training: Is it too much?
    Am J Surg 2017 Aug 25. Epub 2017 Aug 25.
    Department of Surgery, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
    Objective: Research on effective integration of technical and non-technical skills in surgery team training is sparse. In a previous study we found that surgical teachers predominantly coached on technical and hardly on non-technical skills during the Definitive Surgical and Anesthetic Trauma Care (DSATC) integrated acute trauma surgery team training. This study aims to investigate whether the priming of teachers could increase the amount of non-technical skills coaching during such a training. Read More

    Impact of screening for metabolic syndrome on the evaluation of obese living kidney donors.
    Am J Surg 2017 Sep 1. Epub 2017 Sep 1.
    Department of Surgery, University of Michigan, Ann Arbor, MI, USA. Electronic address:
    Background: We report our experience with metabolic syndrome screening for obese living kidney donor candidates to mitigate the long-term risk of CKD.

    Methods: We retrospectively reviewed 814 obese (BMI≥30) and 993 nonobese living kidney donor evaluations over 12 years. Using logistic regression, we explored interactions between social/clinical variables and candidate acceptance before and after policy implementation. Read More

    Evaluation of negative pressure wound therapy to closed laparotomy incisions in acute care surgery.
    Am J Surg 2017 Aug 23. Epub 2017 Aug 23.
    Sanford Medical Center, 801 Broadway Avenue, Fargo, ND, 58122, USA.
    Background: Surgical site complications in the form of wound infections are a major burden to the healthcare system. Negative pressure wound therapy (NPWT) as delivered by a surgical incision management system (SIMS) is a novel approach to improve wound healing when applied to closed incisions. However, data is limited in its application to laparotomy incisions in the acute care surgery setting. Read More

    Temporal artery biopsy in the diagnosis of giant cell arteritis: Bigger is not always better.
    Am J Surg 2017 Sep 1. Epub 2017 Sep 1.
    Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, Helios Clinic, University Hospital Witten-Herdecke, Wuppertal, Germany.
    Objective: Accurate early giant cell arteritis (GCA) diagnosis can be established through temporal artery biopsy (TAB). We herein investigate the relationship between specimen length and positive TAB result in a tertiary-care hospital in Germany during a 8-year period. Secondarily, we studied the relationships of specific epidemiological and laboratory parameters with positive TABs. Read More

    Management of colonoscopic perforations: A systematic review.
    Am J Surg 2017 Aug 26. Epub 2017 Aug 26.
    Vanderbilt University, Department of Surgery, Nashville, TN, USA.
    Background: Perforation during colonoscopy is a rare but well recognized complication with significant morbidity and mortality. We aim to systematically review the currently available literature concerning care and outcomes of colonic perforation. An algorithm is created to guide the practitioner in management of this challenging clinical scenario. Read More

    Quality of life, functional status and adhesiolysis during elective abdominal surgery.
    Am J Surg 2017 Aug 10. Epub 2017 Aug 10.
    Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
    Background: Adhesiolysis during abdominal surgery can cause iatrogenic organ injury, increased operative time and a more complicated convalescence. We assessed the impact of adhesiolysis and adhesiolysis-related complications on quality of life and functional status following elective abdominal surgery.

    Methods: Prospective cohort study, comparing patients requiring and not requiring adhesiolysis during an elective laparotomy or laparoscopy using the SF-36 and DASI questionnaire scores. Read More

    The role of multiorgan procurement for abdominal transplant in general surgery resident education.
    Am J Surg 2017 Aug 25. Epub 2017 Aug 25.
    Baylor University Medical Center, Dallas, TX, United States. Electronic address:
    Background: To assess the impact of participation of multiorgan procurement (MP) by general surgery (GS) residents on surgical knowledge and skills, a prospective cohort study of GS residents during transplant surgery rotation was performed.

    Methods: Before and after participation in MPs, assessment of knowledge was performed by written pre and post tests and surgical skills by modified Objective Structured Assessment of Technical Skill (OSATS) score. Thirty-nine residents performed 84 MPs. Read More

    Greater hypertrophy can be achieved with associating liver partition with portal vein ligation for staged hepatectomy compared to conventional staged hepatectomy, but with a higher price to pay?
    Am J Surg 2017 Aug 26. Epub 2017 Aug 26.
    Division of Hepatopancreaticobiliary Surgery and Liver Transplantation, Department of Surgery, National University Health System, Singapore. Electronic address:
    Background: Associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) and conventional staged hepatectomy (CSH) are options for patients with unresectable liver tumors due to insufficient future liver remnant (FLR).

    Methods: A retrospective comparison of clinical data, liver volumetry and surgical outcomes between 10 ALPPS and 29 CSH patients was performed.

    Results: Patient demographics and disease characteristics were similar between both groups. Read More

    Sponsoring surgeons; an investigation on the influence of the da Vinci robot.
    Am J Surg 2017 Aug 26. Epub 2017 Aug 26.
    Section of Pediatric Surgery, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA; Department of General Surgery, Michigan Medicine, Ann Arbor, MI, USA.
    Introduction: The integrity of the medical literature about robotic surgery remains unclear despite wide-spread adoption. We sought to determine if payment from Intuitive Surgical Incorporated (ISI) affected quality of the research produced by surgeons.

    Methods: Publicly available financial data from the CMS website regarding the top-20 earners from ISI for 2015 was gathered. Read More

    Nationwide analysis of adrenocortical carcinoma reveals higher perioperative morbidity in functional tumors.
    Am J Surg 2017 Aug 25. Epub 2017 Aug 25.
    Division of Endocrine Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, United States.
    Background: Current adrenalectomy outcomes for functional adrenocortical carcinoma (ACC) remain unclear. This study examines nationwide in-hospital post-adrenalectomy outcomes for ACC.

    Methods: A retrospective analysis of the Nationwide Inpatient Sample database (2006-2011) to identify unilateral adrenalectomy patients for functional or nonfunctional ACC was performed. Read More

    Vital sign based shock scores are poor at triaging South African trauma patients.
    Am J Surg 2017 Aug 28. Epub 2017 Aug 28.
    Greys Hospital, Pietermaritzburg, Kwazulu-Natal, South Africa; Edendale Hospital, Pietermaritzburg, Kwazulu-Natal, South Africa. Electronic address:
    Background: Traumatic shock cannot be diagnosed by a single physiological measurement and a number of vital sign based combined shock scores (CSS) have been proposed to identify and triage trauma patients with shock. This audit uses data from a prospectively entered electronic trauma registry to compare the ability of these CSS to predict in-hospital mortality, need for surgery, need for blood transfusion and ICU admission.

    Materials And Methods: The data used in the study was obtained from the Hybrid Electronic Medical Record (HEMR) in Pietermaritzburg from January 2012-September 2015. Read More

    Clinical usefulness of postoperative C-reactive protein/albumin ratio in pancreatic ductal adenocarcinoma.
    Am J Surg 2017 Aug 26. Epub 2017 Aug 26.
    Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan. Electronic address:
    Background: Patients' prognoses have been predicted by the preoperative inflammation-based score, but predicting a patient's risk for operative load remains challenging. This study investigates the usefulness of the postoperative C-reactive protein/albumin (CRP/Alb) ratio in patients with pancreatic ductal adenocarcinoma (PDAC).

    Methods: This study retrospectively assessed 142 patients who underwent pancreatic resection for PDAC between 2004 and 2014. Read More

    Geriatric rescue after surgery (GRAS) score to predict failure-to-rescue in geriatric emergency general surgery patients.
    Am J Surg 2017 Aug 15. Epub 2017 Aug 15.
    Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address:
    Background: Geriatric-patients(GP) undergoing emergency-general-surgery(EGS) are vulnerable to develop adverse-outcomes. Impact of patient-level-factors on Failure-to-Rescue(FTR) in EGS-GP remains unclear. Aim of our study was to determine factors associated with FTR(death from major-complication) and devise simple-bedside-score that predicts FTR in EGS-GP. Read More

    Colorectal cancer screening in rural and poor-resourced communities.
    Am J Surg 2017 Aug 12. Epub 2017 Aug 12.
    University of Arkansas for Medical Sciences, Department of Surgery, Health Initiatives and Disparities Research, 4301 West Markham Street #827, Little Rock, AR, 72205-7199, USA. Electronic address:
    To test the efficacy of a community-based intervention, Empowering Communities for Life (EC4L), designed to increase colorectal cancer (CRC) screening through fecal occult blood test (FOBT) in rural underserved communities in a randomized controlled trial. Participants were randomized into 3 groups (2 interventions and 1 control). Interventions were delivered by community lay health workers or by academic health professionals. Read More

    Cancer-promoting mechanisms of tumor-associated neutrophils.
    Am J Surg 2017 Aug 10. Epub 2017 Aug 10.
    University of Colorado, School of Medicine, Department of Surgery, USA. Electronic address:
    Importance: Neutrophils have classically been considered to mount a defensive response against tumor cells, yet recent evidence suggests tumors modulate neutrophil function to support tumor growth and progression.

    Observations: Tumor-associated neutrophils (TANs) are phenotypically distinct from circulating neutrophils in terms of their surface protein composition and cyto/chemokine activity and response. Although TANs have been shown to both promote and inhibit tumor advancement, the preponderant activity augments tumor progression. Read More

    Mesh cruroplasty in laparoscopic repair of paraesophageal hernias is not associated with better long-term outcomes compared to primary repair.
    Am J Surg 2017 Oct 24;214(4):651-656. Epub 2017 Jun 24.
    Department of Cardiothoracic Surgery, Division of Thoracic and Foregut Surgery, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address:
    Background: Equipoise still exists regarding routine mesh cruroplasty during laparoscopic paraesophageal hernia (PEH). We aimed to determine whether selective mesh cruroplasty is associated with differences in recurrence and patient-reported outcomes.

    Methods: We compared symptom outcomes (n = 688) and radiographic recurrences (n = 101; at least 10% [or 2 cm] of stomach above hiatus) for 795 non-emergent PEH repair with fundoplication (n = 106 with mesh). Read More

    Implementation of a standardized handoff protocol for post-operative admissions to the surgical intensive care unit.
    Am J Surg 2017 Aug 10. Epub 2017 Aug 10.
    University of Mississippi Medical Center, 2500 N State Street, Jackson, MS, 39216, USA.
    Background: The transfer of critically ill patients from the operating room (OR) to the surgical intensive care unit (SICU) involves handoffs between multiple providers. Incomplete handoffs lead to poor communication, a major contributor to sentinel events. Our aim was to determine whether handoff standardization led to improvements in caregiver involvement and communication. Read More

    Dementia as a predictor of mortality in adult trauma patients.
    Am J Surg 2017 Jul 19. Epub 2017 Jul 19.
    Department of Surgery, The University of Kansas School of Medicine - Wichita, 929 N. Saint Francis St., Room 3082, Wichita, KS, 67214, USA; Department of Trauma Services, Via Christi Hospital Saint Francis, 929 N. Saint Francis St., Room 3082, Wichita, KS, 67214, USA. Electronic address:
    Background: The specific contribution of dementia towards mortality in trauma patients is not well defined. The purpose of the study was to evaluate dementia as a predictor of mortality in trauma patients when compared to case-matched controls.

    Methods: A 5-year retrospective review was conducted of adult trauma patients with a diagnosis of dementia at an American College of Surgeons-verified level I trauma center. Read More

    Rothman Index variability predicts clinical deterioration and rapid response activation.
    Am J Surg 2017 Aug 10. Epub 2017 Aug 10.
    Yale School of Medicine, Department of Surgery, New Haven, CT, USA.
    Background: The overall utility of the Rothman Index (RI), a global measure of inpatient acuity, for surgical patients is unclear. We evaluate whether RI variability can predict rapid response team (RRT) activation in surgical patients.

    Methods: Surgical patients who underwent RRT activation from 2013 to 2015 were matched to four control cases. Read More

    Understanding readmissions following operations of the thyroid and parathyroid glands.
    Am J Surg 2017 Sep 10;214(3):501-508. Epub 2017 Jan 10.
    Hospital of the University of Pennsylvania, Center for Surgery and Health Economics, Department of Surgery, Philadelphia, PA, USA.
    Background: In anticipation of bundled-payment models for thyroid and parathyroid disease, a better understanding of resource utilization following surgery is required. We sought to characterize the use of hospital services following such operations using an analysis of readmissions.

    Methods: Patients age 18+years who underwent a thyroid or parathyroid operation in CA or NY (2008-2011) were classified by procedure type. Read More

    The obesity paradox in patients with severe soft tissue infections.
    Am J Surg 2017 Sep 9;214(3):385-389. Epub 2016 Jul 9.
    Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School and Harvard T. H. Chan School of Public Heath, Boston, MA, USA; Trauma, Burn and Surgical Critical Care Division, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address:
    Background: The "obesity paradox" has been demonstrated in chronic diseases but not in acute surgery. We sought to determine whether obesity is associated with improved outcomes in patients with severe soft tissue infections (SSTIs).

    Methods: The 2006 to 2010 Nationwide Inpatient Sample was used to identify adult patients with SSTIs. Read More

    Component separation technique for giant incisional hernia: A systematic review.
    Am J Surg 2017 Aug 10. Epub 2017 Aug 10.
    Department of General, Hepatobiliary Surgery and Liver Transplantation, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
    The component separation technique (CST) has gained popularity among general surgeons in the management of giant abdominal hernia. A systematic review of the MedLine and EMBASE databases was performed. 36 observational cohort studies were included for data-analysis and divided in 4 main groups: Open Anterior Approach (OAA), Transversus Abdominis Release (TAR), Laparoscopic Anterior Approach (LAA) and Perforator Preserving Approach (PPA). Read More

    A model for a career in a specialty of general surgery: One surgeon's opinion.
    Am J Surg 2017 Aug 10. Epub 2017 Aug 10.
    Department of Surgery, Northwestern Medicine, 251 E. Huron, Chicago, IL, 60611, USA; Department of Surgery, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH, 44109-1998, USA. Electronic address:
    Background: The integration of general and endocrine surgery was studied as a potential career model for fellowship trained general surgeons.

    Methods: Case logs collected from 1991-2016 and academic milestones were examined for a single general surgeon with a focused interest in endocrine surgery. Operations were categorized using CPT codes and the 2017 ACGME "Major Case Categories" and there frequencies were determined. Read More

    Predictors of pathologic upstaging in early esophageal adenocarcinoma: Results from the national cancer database.
    Am J Surg 2017 Jul 18. Epub 2017 Jul 18.
    Department of Surgery, University of Chicago, Chicago, IL, USA; NorthShore University Health System, Evanston, IL, USA. Electronic address:
    Background: Upstaging in early esophageal adenocarcinoma (EAC) patients happens at a high rate and has implications for treatment. We sought to identify risk factors predicting upstaging.

    Study Design: The National Cancer Database (2010-2013) was queried for all patients with clinical T1/T2 and N0 EAC who underwent esophagectomy without neoadjuvant therapy. Read More

    Groin hernia repair in women - A nationwide register study.
    Am J Surg 2017 Jul 25. Epub 2017 Jul 25.
    Department of Surgical and Perioperative Science, Umeå University, 901 85, Umeå, Sweden.
    Introduction: The aim of this study was to investigate reoperation for recurrence in men and women with respect to method of repair, hernia anatomy and year of operation.

    Method: Since 1992, groin hernia repairs performed in Sweden are prospectively registered in the Swedish Hernia Register, (SHR). Reoperations are noted, regardless of where the reoperation is performed. Read More

    Operative outcomes of conventional specimen radiography versus in-operating room specimen radiography in radioactive seed-localized segmental mastectomies.
    Am J Surg 2017 Jul 19. Epub 2017 Jul 19.
    Department of General Surgery, Mayo Clinic Hospital, 5777 E Mayo Blvd, Phoenix, AZ 85054, USA. Electronic address:
    Introduction: In-operating room specimen radiography (ORSR) has not been studied among women undergoing radioactive seed localization (RSL) for breast cancer surgery and had the potential to decrease operative time and perhaps improve intraoperative margin management.

    Methods: One hundred consecutive RSL segmental mastectomies among 98 patients using ORSR were compared to 100 consecutive segmental mastectomies among 98 patients utilizing conventional radiography (CSR) prior to the initiation of ORSR from December 2013 to January 2015 after radioactive seed localization. Final pathologic margins were considered to be 10 mm for all cases of no residual disease after biopsy or neoadjuvant therapy, but such patients were excluded from analyses involving tumor size. Read More

    Objective scoring of an electronic surgical logbook: Analysis of impact and observations within a surgical training body.
    Am J Surg 2017 Jul 21. Epub 2017 Jul 21.
    Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland.
    Background: Historically, evaluating operative-volumes has proven difficult due to mass-variability in operative-complexities and participation. This study aimed to introduce a national scoring interface for residents' operative-logs while forming meaningful observations on specialities, training-institutes and technical competency.

    Methods: A weighted-scoring algorithm was applied prospectively to residents' operative volumes since July 8th(,) 2013 with daily web-based quantitative feedback. Read More

    Surgical management of epiphrenic diverticulum: A single-center experience and brief review of literature.
    Am J Surg 2017 Jul 19. Epub 2017 Jul 19.
    Creighton University School of Medicine, Omaha, NE, 68131, USA; Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, 85013, USA. Electronic address:
    Background: We present single-center experience of surgery for primary epiphrenic diverticulum (PED) over a 12-year period.

    Methods: Prospectively maintained database was queried to identify patients who underwent PED surgery. Preoperative and postoperative symptoms, operative data, perioperative complications, and follow-up were reviewed. Read More

    Surgical registrars' perceptions of surgical training and capacity in Zambia: Results from three COSECSA affiliated training hospitals.
    Am J Surg 2017 Jul 21. Epub 2017 Jul 21.
    Department of Surgery, NYU Langone Medical Center, New York, NY, United States. Electronic address:
    Background: Surgery is a vital component of a comprehensive health system, but there are often personnel limitations in resource constrained areas. Zambia provides post graduate surgical training through two systems to help address this shortage. However, no studies have analyzed surgical trainees' perceptions of these programs. Read More

    Regional differences for pancreaticoduodenectomy in Florida: Location matters.
    Am J Surg 2017 Jul 19. Epub 2017 Jul 19.
    Southeastern Center for Digestive Disorders and Pancreatic Cancer, Advanced Minimally Invasive & Robotic Surgery, Florida Hospital Tampa, USA.
    Introduction: Regionalization of care raises potential for differences in cost of care and outcome. This study was undertaken to determine if costs and outcome after pancreaticoduodenectomy vary by region in Florida, and whether costs and outcome are related.

    Methods: Inpatient data for pancreaticoduodenectomy in Florida during 2010-2012 were obtained from the Florida Agency for Health Care Administration. Read More

    Unplanned readmission and outpatient examination 90-days after acute appendectomy in adults.
    Am J Surg 2017 Jul 21. Epub 2017 Jul 21.
    Department of Gastrointestinal Surgery, Diakonhjemmet Hospital, Oslo, Norway; Department of Gastrointestinal and Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway. Electronic address:
    Background: The aim of this study was to determine the frequency and indications for unplanned readmission and outpatient examination after acute appendectomy.

    Methods: Adults who underwent acute appendectomy from 2008-2013 were included in the study and events occurring within 90-days from discharge recorded.

    Results: A total of 710 patients underwent surgery. Read More

    Decreasing readmissions by focusing on complications and underlying reasons.
    Am J Surg 2017 Jul 21. Epub 2017 Jul 21.
    Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address:
    Background: To analyze demographics and outcomes of patients focusing on 30-day readmission status and identify procedure-specific risk factors.

    Methods: Patients undergoing abdominal colorectal surgery (2011-2013) were identified Demographics and outcomes including in-hospital complications were compared based on readmission status.

    Results: A total of 6637 patients were identified with a mean age of 51. Read More

    The impact of positive and negative intraoperative surgeons' leadership behaviors on surgical team performance.
    Am J Surg 2017 Jul 18. Epub 2017 Jul 18.
    Department of Urology, Queen's University, Kingston, Ontario, Canada. Electronic address:
    Background: The effects of surgeons' leadership on team performance are not well understood. The purpose of this study was to examine the simultaneous effects of transformational, passive, abusive supervision and over-controlling leadership behaviors by surgeons on surgical team performance.

    Methods: Trained observers attended 150 randomly selected operations at a tertiary care teaching hospital. Read More

    Stapled Transabdominal Ostomy Reinforcement with retromuscular mesh (STORRM): Technical details and early outcomes of a novel approach for retromuscular repair of parastomal hernias.
    Am J Surg 2017 Jul 21. Epub 2017 Jul 21.
    Cleveland Comprehensive Hernia Center, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. Electronic address:
    Background: Parastomal hernia repair (PHR) remains a challenge with no optimal repair technique. During retromuscular hernia repair, traversing the stomal conduit through the abdominal wall can result in angulation and compression. Widening of traditional cruciate incisions in mesh and/or fascia likely contributes to recurrences. Read More

    Health-related quality of life during trans-arterial chemoembolization with drug-eluting beads loaded with doxorubicin (DEBDOX) for unresectable hepatic metastases from ocular melanoma.
    Am J Surg 2017 Jul 21. Epub 2017 Jul 21.
    University of Louisville, Department of General Surgery, Division of Surgical Oncology, Louisville, KY, USA. Electronic address:
    Background: We have previously reported favorable response and survival rates using drug-eluting beads loaded with doxorubicin (DEBDOX) for unresectable hepatic metastases. This study investigates the quality of life (QoL) impact of DEBDOX for the treatment of unresectable hepatic metastases from melanoma.

    Methods: A multi-center, prospective, non-controlled clinical trial was reviewed. Read More

    A prospective randomized study comparing laparoscopic transabdominal preperitoneal (TAPP) versus Lichtenstein repair for bilateral inguinal hernias.
    Am J Surg 2017 Jul 19. Epub 2017 Jul 19.
    General Surgery Department, Sanchinarro Hospital, San Pablo University of Madrid, Spain.
    Background: In literature, only a few studies have prospectively compared the results of laparoscopic with open inguinal hernia repair yet none have compared bilateral inguinal hernia repair. The aim of this study is to compare the open Lichtenstein repair (OLR) with laparoscopic trans-abdominal preperitoneal (TAPP) repair in patients undergoing surgery for bilateral inguinal hernia.

    Methods: Patients were prospectively randomized between March 2013 and March 2015. Read More

    Model for prioritization of Graduate Medical Education funding at a university setting - Engagement of GME committee with the Clinical Enterprise.
    Am J Surg 2017 Jul 19. Epub 2017 Jul 19.
    Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
    Background: Funding for graduate medical education (GME) is becoming scarce and is likely to worsen. There is a higher degree of accountability and return on investment demanded from public funds dedicated to GME. Academic centers (AC) partnered with clinical enterprises (CE) are finding it increasingly difficult to retain sustainable funding streams for GME activities. Read More

    Parental leave policies in graduate medical education: A systematic review.
    Am J Surg 2017 Oct 30;214(4):634-639. Epub 2017 Jun 30.
    Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Chicago, Chicago, IL, United States. Electronic address:
    Background: A thorough understanding of attitudes toward and program policies for parenthood in graduate medical education (GME) is essential for establishing fair and achievable parental leave policies and fostering a culture of support for trainees during GME.

    Methods: A systematic review of the literature was completed. Non-cohort studies, studies completed or published outside of the United States, and studies not published in English were excluded. Read More

    Should classification as an ACS-NSQIP high outlier be used to direct hospital quality improvement efforts?
    Am J Surg 2017 Jul 21. Epub 2017 Jul 21.
    Department of Colon and Rectal Surgery, Lahey Hospital & Medical Center, 41 Burlington Mall Road, Burlington, MA, 01805, USA. Electronic address:
    Background: ACS-NSQIP classifies hospitals as "high outliers" if their performance is significantly worse than expected. We determined how often hospitals return to as-expected performance after being newly identified as outliers.

    Methods: Outlier status was identified in ACS-NSQIP semi-annual reports (SARs) 2008-2011 for 13 postoperative adverse events. Read More

    Analysis of the tractive force pattern on a knot by force measurement during laparoscopic knot tying.
    Am J Surg 2017 Jul 19. Epub 2017 Jul 19.
    Department of Urology and Andrology, Graduate School of Medicine, Kansai Medical University, Osaka, Japan. Electronic address:
    Background: Quantifying surgical skills assists novice surgeons when learning operative techniques. We measured the interaction force at a ligation point and clarified the features of the force pattern among surgeons with different skill levels during laparoscopic knot tying.

    Methods: Forty-four surgeons were divided into three groups based on experience: 13 novice (0-5 years), 16 intermediate (6-15 years), and 15 expert (16-30 years). Read More

    A novel systematic inflammation related index is prognostic in curatively resected non-metastatic colorectal cancer.
    Am J Surg 2017 Jul 19. Epub 2017 Jul 19.
    Department of Medical Oncology, Affiliated Hospital of Jiangnan University and Fourth People's Hospital of Wuxi, 200 Huihe Road, Wuxi, China. Electronic address:
    Backgroud: To better identify patients with high mortality risk, we developed a systematic inflammation index (IPI) based on neutrophil to lymphocyte ratio (NLR) and albumin.

    Methods: The performance of pretreatment IPI was evaluated in patients with surgically resected non-metastatic colorectal cancer. IPI was predefined and compared with Glasgow Prognostic Score (GPS)/modified GPS in terms of discrimination and calibration abilities. Read More

    Effects of modifiable, non-modifiable and clinical process factors in ventral hernia repair surgical site infections: A retrospective study.
    Am J Surg 2017 Jul 19. Epub 2017 Jul 19.
    Division of General Surgery, University of South Florida, Tampa, FL, USA. Electronic address:
    Background: The hypothesis of this study is that non-modifiable factors are more important in ventral hernia repair (VHR) surgical site infection (SSI) than care process factors.

    Methods: All VHR's which were reviewed retrospectively for both NSQIP-recorded data, and also: preoperative hospitalization, existing mesh, enterocutaneous fistula, open wound, case month, case day, case length, prophylactic antibiotics, skin preparation, other procedure performed, re-do operation, estimate blood loss, hernia size, repair approach, repair type, mesh used, skin closure, suture type, use of drains, and dressing.

    Results: 7% of 223 VHR's had an SSI. Read More

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