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American Journal of Surgery

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https://www.readbyqxmd.com/read/27908501/prospective-evaluation-of-surgical-palliative-care-immersion-training-for-general-surgery-residents
#1
Mustafa Raoof, Lisa O'Neill, Leigh Neumayer, Mindy Fain, Robert Krouse
BACKGROUND: Palliative care competencies in surgical training are recognized to improve the care of surgical patients with advanced or life-threatening illnesses. Formal programs to teach these competencies are lacking. The study aims to assess the feasibility and utility of a unique surgical palliative care immersion training program. STUDY DESIGN: A half-day Surgical Palliative Care Immersion Training (SPCIT) was developed using the American College of Surgeon's manual titled "Surgical Palliative Care: A Resident's Guide" as a framework...
November 27, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27916197/peak-creatinine-kinase-level-is-a-key-adjunct-in-the-evaluation-of-critically-ill-trauma-patients
#2
Saskya Byerly, Elizabeth Benjamin, Subarna Biswas, Jayun Cho, Eugene Wang, Monica D Wong, Kenji Inaba, Demetrios Demetriades
BACKGROUND: Elevated creatinine kinase (CK) can indicate rhabdomyolysis, a risk factor for acute kidney injury (AKI). We investigated risk factors and clinical significance of peak CK levels. METHODS: Retrospective analysis, adult trauma patients. Logistic regression was used to identify risk factors for elevated CK and AKI. RESULTS: 3240 trauma patients were analyzed; median time to peak CK was 17 h and 347 patients had peak CK > 5000...
November 24, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27932088/grit-as-a-predictor-of-risk-of-attrition-in-surgical-residency
#3
Arghavan Salles, Dana Lin, Cara Liebert, Micaela Esquivel, James N Lau, Ralph S Greco, Claudia Mueller
BACKGROUND: Grit, a measure of perseverance, has been shown to predict resident well-being. In this study we assess the relationship between grit and attrition. METHODS: We collected survey data from residents in a single institution over two consecutive years. All residents in general surgery were invited to participate (N = 115). Grit and psychological well-being were assessed using validated measures. Risk of attrition was measured using survey items. RESULTS: 73 residents participated (63% response rate)...
November 23, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27894508/intrapancreatic-accessory-spleen-ipas-a-single-institution-experience-and-review-of-the-literature
#4
Neal Bhutiani, Michael E Egger, Catherine A Doughtie, Elizabeth S Burkardt, Charles R Scoggins, Robert C G Martin, Kelly M McMasters
INTRODUCTION: Accessory spleens located within the pancreatic parenchyma (intrapancreatic accessory spleen, IPAS) pose a unique clinical challenge. In many cases, despite imaging and other diagnostic studies, malignancy cannot be excluded and patients are subjected to pancreatic resection. We review our experience with the presentation, diagnosis, and treatment of patients with IPAS to provide insight into improving pre-operative evaluation of these patients METHODS: A retrospective chart review identified seven patients who underwent surgical resection of an intrapancreatic spleen at University of Louisville Hospital between 2004 and 2015...
November 23, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27908502/centralized-capacity-building-training-of-lichtenstein-hernioplasty-in-brazil
#5
Alexandra M Moore, Néha Datta, Justin P Wagner, Alexander D Schroeder, Wolfgang Reinpold, Maurice Y Franciss, Rodrigo A Silva, David C Chen, Charles J Filipi, Sergio Roll
BACKGROUND: In Brazil, access to healthcare varies widely by community. Options for repair of surgically correctable conditions, such as inguinal hernias, are limited. A training program was instituted to expand access to Lichtenstein hernioplasty. METHODS: Between September, 2014 and September, 2015, 3 orders of training series took place in São Paulo, Brazil. Participating surgeons received training and assessments from expert trainers using the Operative Performance Rating Scale (OPRS)...
November 22, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27908500/effectiveness-of-a-comprehensive-mental-skills-curriculum-in-enhancing-surgical-performance-results-of-a-randomized-controlled-trial
#6
Dimitrios Stefanidis, Nicholas E Anton, Lisa D Howley, Eric Bean, Ashley Yurco, Manuel E Pimentel, Cameron K Davis
INTRODUCTION: We hypothesized that the implementation of a novel mental skills curriculum (MSC) during laparoscopic simulator training would improve mental skills and performance, and decrease stress. METHODS: Sixty volunteer novices were randomized into intervention and control groups. All participants received FLS training while the intervention group also participated in the MSC. Skill transfer and retention were assessed on a live porcine model after training and 2 months later, respectively...
November 22, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27894507/do-simple-beside-lung-function-tests-predict-morbidity-after-rib-fractures
#7
Christopher A Butts, John J Brady, Sara Wilhelm, Laura Castor, Alicia Sherwood, Abby McCall, John Patch, Pamela Jones, Vicente Cortes, Adrian W Ong
BACKGROUND: We evaluated if incentive spirometry volume (ISV) and peak expiratory flow rate (PEFR) could predict acute respiratory failure (ARF) in patients with rib fractures. METHODS: Normotensive, co-operative patients were enrolled prospectively. ISV and PEFR were measured on admission, at 24 h and at 48 h by taking the best of three readings each time. The primary outcome, ARF, was defined as requiring invasive or noninvasive positive pressure ventilation...
November 19, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27890330/assessing-surgical-residents-imaging-interpretation-skills
#8
Joseph J Eid, Francisco Igor B Macedo, Edsa Negussie, Vijay K Mittal
PURPOSE: During general surgery (GS) training, residents are expected to accurately interpret radiologic images. Objective evidence evaluating residents' ability to provide accurate interpretation of imaging studies is currently lacking. METHODS: A 30-item web-based test was developed using images from different radiologic modalities. Residents from 6 ACGME accredited GS programs participated. Residents from 1 radiology program served as a control group. RESULTS: 74 GS residents (GSR) enrolled in the online test...
November 19, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27887677/outcome-disparities-between-african-americans-and-caucasians-in-contemporary-kidney-transplant-recipients
#9
David J Taber, Leonard E Egede, Prabhakar K Baliga
BACKGROUND: Racial disparities in African-American (AA) kidney transplant have persisted for nearly 40 years, with limited data available on the scope of this issue in the contemporary era of transplantation. METHODS: Descriptive retrospective cohort study of US registry data including adult solitary kidney transplants between Jan 1, 2005 to Dec 31, 2009. RESULTS: 60,695 recipients were included; 41,426 Caucasians (68%) and 19,269 AAs (32%)...
November 18, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27932087/racial-disparities-in-the-use-of-laparoscopic-surgery-to-treat-colonic-diverticulitis-are-not-fully-explained-by-socioeconomics-or-disease-complexity
#10
Randi L Lassiter, Asif Talukder, Meryl M Abrams, Bao-Ling Adam, Daniel Albo, Cassandra Q White
BACKGROUND: Several studies have demonstrated favorable outcomes for laparoscopic surgery over open surgery for the treatment of diverticular disease. This study was designed to analyze the relationship between race, socioeconomic status and the use of laparoscopy to address diverticulitis. METHODS: A retrospective analysis of 53,054 diverticulitis admissions was performed using data from the 2009-2013 National Inpatient Sample (NIS). The primary outcome was the use of laparoscopic versus open colectomy...
November 17, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27890333/diagnostic-evaluation-of-ovarian-torsion-an-analysis-of-pediatric-patients-using-the-nationwide-emergency-department-sample
#11
Kristy L Rialon, Steven Wolf, Jonathan C Routh, Obinna O Adibe
BACKGROUND: Ultrasonography (US) is the diagnostic modality of choice during work-up for ovarian torsion, although computed tomography (CT) may be used. We examined the utilization of CT in girls with ovarian torsion, and determined which patients are most likely to undergo this study. METHODS: The Nationwide Emergency Department Sample dataset was searched for patients <18 years who presented with ovarian torsion from 2006 to 2012. Hospitals were categorized by the volume of pediatric patients seen...
November 17, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27889271/assessment-of-perioperative-nutrition-practices-and-attitudes-a-national-survey-of-colorectal-and-gi-surgical-oncology-programs
#12
J D Williams, Paul E Wischmeyer
BACKGROUND: Implementation of evidence-based peri-operative nutrition in the U.S. is poorly described and hypothesized to be suboptimal. This study broadly describes practices and attitudes regarding nutrition screening/intervention in U.S. gastrointestinal and oncologic surgeons. METHODS: Nationwide nutritional practice survey of GI/Oncologic surgical faculty. RESULTS: Program response rates were 57% and 81% for colorectal and oncology fellowships, respectively...
November 17, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27881243/early-stage-papillary-thyroid-carcinoma-in-developing-country-scenario-a-different-perspective
#13
LETTER
Kushagra Gaurav, Saroj Kanta Mishra
No abstract text is available yet for this article.
November 16, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27876380/laparoscopic-complete-mesocolic-excision-with-central-vascular-ligation-in-600-right-total-mesocolectomies-safety-prognostic-factors-and-oncologic-outcome
#14
Luca Maria Siani, Andrea Lucchi, Pierluigi Berti, Gianluca Garulli
BACKGROUND: To analyze our experience with laparoscopic right Mesocolectomy in right colonic cancers. METHODS: 600 consecutive patients were studied. RESULTS: Mortality was 0.5%; morbidity was 35.5%. Mean mesocolic area was 15339 ± 1639 mm3, specimen length 24.3 ± 3.3 cm, distance from the tumor to high tie was 103 ± 6 mm and mean lymph nodes harvested was 27 ± 3; mesocolic plane was achieved in 81% of cases. Survival was 83%; stratified survival in patients with stage II, IIIA/B and in the subgroup of stage IIIC patients with negative apical nodes was 88...
November 16, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27871680/clinical-significance-of-circumportal-pancreas-a-rare-congenital-anomaly-in-pancreatectomy
#15
Takao Ohtsuka, Yasuhisa Mori, Kousei Ishigami, Takaaki Fujimoto, Yoshihiro Miyasaka, Kohei Nakata, Kenoki Ohuchida, Eishi Nagai, Yoshinao Oda, Shuji Shimizu, Masafumi Nakamura
BACKGROUND: Circumportal pancreas is a rare congenital pancreatic anomaly. The aim of this study was to clarify the clinical characteristics of patients with circumportal pancreases undergoing pancreatectomy. METHODS: The medical records of 508 patients who underwent pancreatectomy were retrospectively reviewed. The prevalence of circumportal pancreas and related anatomical variations were assessed. Surgical procedures and postoperative outcomes were compared in patients with and without circumportal pancreas...
November 15, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27914583/injuries-from-all-terrain-vehicles-an-opportunity-for-injury-prevention
#16
Emily C Benham, Samuel W Ross, Mariana Mavilia, Peter E Fischer, A Britton Christmas, Ronald F Sing
BACKGROUND: Patient demographics, behavior, and injury patterns were assessed to inform preventative efforts for reduced incidence of all-terrain vehicle (ATV) trauma. METHODS: ATV-related injuries treated at a Level I trauma center from 2008 to 2012 were retrospectively reviewed. Patient outcomes and incidence of traumatic brain injury (TBI) were compared by helmet use and alcohol intoxication. RESULTS: Helmet data were available for 304 patients of 404 patients included; of these, 75 (24...
November 14, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27889270/does-implementing-a-general-surgery-residency-program-and-resident-involvement-affect-patient-outcomes-and-increase-care-associated-charges
#17
Trevor Wexner, Armando Rosales-Velderrain, Steven D Wexner, Raul J Rosenthal
BACKGROUND: Variable results regarding general surgery residency program (GSRP) impact on patient outcomes and charges are reported. The aim of this study was to determine any significant differences in patient outcomes and cost with a new GSRP. METHODS: We analyzed all laparoscopic appendectomies (lap-ap), cholecystectomies (lap-chole), and inguinal hernia repairs (IHR) performed before and after implementing a GRSP. RESULTS: Operative time significantly increased for lap-ap (p < 0...
November 14, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27889268/evaluating-surgical-management-and-outcomes-of-colovaginal-fistulas
#18
Yuxiang Wen, Alison R Althans, Justin T Brady, Eslam M G Dosokey, Dongjin Choi, Madhuri Nishtala, Conor P Delaney, Scott R Steele
BACKGROUND: Colovaginal fistula is a rare condition associated with significant morbidity. The literature characterizing colovaginal fistula repair is sparse. We present our institution's experience treating colovaginal fistulas. METHODS: A retrospective review of all patients surgically treated for colovaginal fistula between 2005 and 2015 was performed. Patient demographics, intra-operative details, and post-operative outcomes were reviewed. RESULTS: We identified 27 patients with a mean age of 71 (±13) and BMI of 30 (±9)...
November 14, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27890332/impact-of-hospital-transfer-on-surgical-outcomes-of-intestinal-atresia
#19
T Erickson, P G Vana, B A Blanco, S A Brownlee, H N Paddock, P C Kuo, A N Kothari
BACKGROUND: Examine effects of hospital transfer into a quaternary care center on surgical outcomes of intestinal atresia. METHODS: Children <1 yo principally diagnosed with intestinal atresia were identified using the Kids' Inpatient Database (2012). Exposure variable was patient transfer status. Outcomes measured were inpatient mortality, hospital length of stay (LOS) and discharge status. Linearized standard errors, design-based F tests, and multivariable logistic regression were performed...
November 12, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27890331/the-safety-of-same-day-breast-reconstructive-surgery-an-analysis-of-short-term-outcomes
#20
Erin Cordeiro, Toni Zhong, Timothy Jackson, Tulin Cil
BACKGROUND: We sought to examine the safety of same-day breast reconstructive (BR) surgery. METHODS: An analysis of the American College of Surgeons, National Surgical Quality Improvement Program (ACS-NSQIP) files was performed. Patients undergoing BR for breast cancer were examined, excluding those with high-risk co-morbidities or concurrent surgery. A propensity score was calculated and a multivariable logistic regression analysis was used to calculate the difference in 30-day complications between those undergoing SDS versus longer hospital stay...
November 12, 2016: American Journal of Surgery
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