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American Journal of Surgery

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https://www.readbyqxmd.com/read/28939252/does-lymph-node-status-influence-adjuvant-therapy-decision-making-in-women-70-years-of-age-or-older-with-clinically-node-negative-hormone-receptor-positive-breast-cancer
#1
Anees B Chagpar, Nina Horowitz, Tara Sanft, Lynn D Wilson, Andrea Silber, Brigid Killelea, Meena S Moran, Michael P DiGiovanna, Erin Hofstatter, Gina Chung, Lajos Pusztai, Donald R Lannin
BACKGROUND: Women ≥70 years old with clinically (c) lymph node (LN) negative (-), hormone receptor (HR) positive (+) breast cancer are recommended not to be routinely staged with a sentinel LN biopsy. We sought to determine how this affects adjuvant decision-making. METHODS: Statistical analyses were performed to determine the association of LN evaluation with adjuvant chemotherapy and radiation therapy in cLN-, HR + breast cancer patients in the National Cancer Database...
September 19, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28939251/laparoscopic-common-bile-duct-exploration-versus-endoscopic-retrograde-cholangiopancreatography-for-choledocholithiasis-found-at-time-of-laparoscopic-cholecystectomy-analysis-of-a-large-integrated-health-care-system-database
#2
Mohammed H Al-Temimi, Edwin G Kim, Bindupriya Chandrasekaran, Vanessa Franz, Charles N Trujillo, Asrai Mousa, Deron J Tessier, Samir D Johna, David A Santos
BACKGROUND: We compared endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic common bile duct exploration (LCBDE) for managing choledocholithiasis found at time of cholecystectomy. METHODS: One hundred and five LCBDE (2005-2015) were compared to 195 LC/ERCP (2014-2015) from the Southern California Kaiser Permanente database. RESULTS: LC/ERCP was more effective at clearing the CBD (98% vs. 88.6%, p = 0.01); but required more procedures per patient (mean ± standard deviation, 1...
September 18, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28939250/not-every-trauma-patient-with-a-radiographic-head-injury-requires-transfer-for-neurosurgical-evaluation-application-of-the-brain-injury-guidelines-to-patients-transferred-to-a-level-1-trauma-center
#3
Gweniviere Kayla Capron, Mary Beth Voights, Henry R Moore, Derek B Wall
BACKGROUND: Patients with radiographically-identified traumatic brain injury are often transferred to our regional trauma center for neurosurgical evaluation, yet few injuries require neurosurgical intervention. Transfer is costly, inconvenient, and potentially risky in inclement weather. We propose that previously-published brain injury guidelines (BIG)(1) can help to determine which patients could avoid mandatory transfer. METHODS: Retrospective chart review of patients transferred between January 2012 and December 2013 was performed...
September 18, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28882358/impact-of-screening-for-metabolic-syndrome-on-the-evaluation-of-obese-living-kidney-donors
#4
Daniel P Marcusa, Douglas E Schaubel, Kenneth J Woodside, Randall S Sung
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. RESULTS: Obese donor candidate acceptance decreased after metabolic syndrome screening began (56...
September 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28877848/temporal-artery-biopsy-in-the-diagnosis-of-giant-cell-arteritis-bigger-is-not-always-better
#5
Marios Papadakis, Sarantos Kaptanis, Aikaterini Kokkori-Steinbrecher, Nikolaos Floros, Frauke Schuster, Gunnar Hübner
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. METHOD: We retrospectively reviewed the medical records of all patients with suspected GCA, who underwent TAB in our institution...
September 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28859918/vital-sign-based-shock-scores-are-poor-at-triaging-south-african-trauma-patients
#6
Robert Barnes, Damian Clarke, Zane Farina, Benn Sartorius, Petra Brysiewicz, Grant Laing, John Bruce, Victor Kong
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...
August 28, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28890055/resected-irradiated-rectal-cancers-are-twelve-lymph-nodes-really-necessary-in-the-era-of-neoadjuvant-therapy
#7
Morgan L Cox, Mohamed A Adam, Mithun M Shenoi, Megan C Turner, Zhifei Sun, Christopher R Mantyh, John Migaly
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. RESULTS: Of 38,363 patients, 76% received NRT...
August 26, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28865668/management-of-colonoscopic-perforations-a-systematic-review
#8
REVIEW
Alexander T Hawkins, Kenneth W Sharp, Molly M Ford, Roberta L Muldoon, M Benjamin Hopkins, Timothy M Geiger
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. DATA SOURCES: A systematic review of the literature based on PRISMA-P guidelines was performed. We evaluate 31 articles focusing on findings over the past 10 years...
August 26, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28859921/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
#9
Daryl K A Chia, Zachery Yeo, Stanley E K Loh, Shridhar Ganpathi Iyer, Glenn Kunnath Bonney, Krishnakumar Madhavan, Alfred W C Kow
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...
August 26, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28859920/sponsoring-surgeons-an-investigation-on-the-influence-of-the-da-vinci-robot
#10
Cory N Criss, Samir K Gadepalli
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. Studies conducted by these surgeons were identified using PubMed. Inclusion criteria consisted of publications about the da Vinci(®) robot on patient outcomes...
August 26, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28859917/clinical-usefulness-of-postoperative-c-reactive-protein-albumin-ratio-in-pancreatic-ductal-adenocarcinoma
#11
Kota Arima, Yo-Ichi Yamashita, Daisuke Hashimoto, Shigeki Nakagawa, Naoki Umezaki, Takanobu Yamao, Masayo Tsukamoto, Yuki Kitano, Kensuke Yamamura, Tatsunori Miyata, Hirohisa Okabe, Takatsugu Ishimoto, Katsunori Imai, Akira Chikamoto, Hideo Baba
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. The time at which perioperative CRP/Alb ratio most influences the prognosis was identified, and the correlations among the perioperative CRP/Alb ratio, clinicopathological factors, and patient outcomes were investigated...
August 26, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28882359/integrating-technical-and-non-technical-skills-coaching-in-an-acute-trauma-surgery-team-training-is-it-too-much
#12
Alexander Alken, Jan-Maarten Luursema, Mariska Weenk, Simon Yauw, Cornelia Fluit, Harry van Goor
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...
August 25, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28859922/the-role-of-multiorgan-procurement-for-abdominal-transplant-in-general-surgery-resident-education
#13
Johanna Bayer, Carol-Anne Moulton, Kimberley Monden, Robert M Goldstein, Gregory J McKenna, Giuliano Testa, Richard M Ruiz, Tiffany L Anthony, Nicholas Onaca, Goran B Klintmalm, Peter T W Kim
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...
August 25, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28859919/nationwide-analysis-of-adrenocortical-carcinoma-reveals-higher-perioperative-morbidity-in-functional-tumors
#14
Punam P Parikh, Gustavo A Rubio, Josefina C Farra, John I Lew
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. Patient demographics, comorbidities and postoperative outcomes were evaluated by t-test, Chi-square and multivariate regression...
August 25, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28851487/improving-prediction-for-postoperative-morbidity-and-mortality
#15
LETTER
Hui-Xian Li, Fu-Shan Xue, Ya-Yang Liu, Gui-Zhen Yang
No abstract text is available yet for this article.
August 24, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28882357/evaluation-of-negative-pressure-wound-therapy-to-closed-laparotomy-incisions-in-acute-care-surgery
#16
Elleson Schurtz, Jerome Differding, Eric Jacobson, Christopher Maki, Mentor Ahmeti
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. METHODS: A retrospective case-control study was performed to evaluate the outcomes of SIMS with regard to surgical site infections in a series of 48 consecutive patients in which SIMS was applied to closed laparotomy incisions in the acute care surgery setting...
August 23, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28864358/granulomatous-mastitis-we-need-a-useful-classification-system
#17
LETTER
Oktay Irkorucu
No abstract text is available yet for this article.
August 21, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28847410/assessing-acute-kidney-injury-following-pancreatic-surgery
#18
LETTER
Shi-Yu Wang, Fu-Shan Xue, Ya-Yang Liu, Gui-Zhen Yang
No abstract text is available yet for this article.
August 21, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28851486/geriatric-rescue-after-surgery-gras-score-to-predict-failure-to-rescue-in-geriatric-emergency-general-surgery-patients
#19
Muhammad Khan, Asad Azim, Terence O'Keeffe, Faisal Jehan, Narong Kulvatunyou, Chelsey Santino, Andrew Tang, Gary Vercruysse, Lynn Gries, Bellal Joseph
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. METHODS: 3-year(2013-15) analysis of patients, age≥65y on acute-care-surgery-service and underwent EGS. Regression analysis used to analyze factors associated with FTR and natural-logarithm of significant odds-ratio used to calculate estimated-weights for each factor...
August 15, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28842164/colorectal-cancer-screening-in-rural-and-poor-resourced-communities
#20
Michael A Preston, Katherine Glover-Collins, Levi Ross, Austin Porter, Zoran Bursac, Delores Woods, Jacqueline Burton, Karen Crowell, Jonathan Laryea, Ronda S Henry-Tillman
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. The main outcome of interest was return rate of FOBT screening kit within 60 days...
August 12, 2017: American Journal of Surgery
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