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American Journal of Surgery

Courtney J Balentine, Kelly Kenzik, Daniel I Chu, Melanie S Morris, Sara J Knight, Cynthia J Brown, Smita Bhatia
BACKGROUND: We compared short-term recovery for patients discharged to inpatient rehabilitation versus skilled nursing facilities after gastrointestinal surgery. MATERIALS & METHODS: We conducted a propensity-matched cohort study of 12,939 adults discharged to inpatient rehabilitation or skilled nursing facilities after colectomy, pancreatectomy or hepatectomy at hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program from 2011 to 2014...
May 16, 2018: American Journal of Surgery
Tenglong Tang, Weihui Peng, Leiyi Zhang, Zhongkun Zuo, Ding Cao, Jiangsheng Huang, Lunxi Duan
AIM: To compare the results of total laparoscopic distal gastrectomy (TLDG) and laparoscopy-assisted distal gastrectomy (LADG) and explore the safety and feasibility of TLDG. METHODS: Data were collected and analyzed from patients underwent TLDG and LADG from January 2009 to December 2011 at our institution. RESULTS: 127 LADG cases and 104 TLDG cases were included and balanced for age, sex, BMI, ASA scores, and CEA level in this study...
May 16, 2018: American Journal of Surgery
Omar Nunez Lopez, Byron D Hughes, Deepak Adhikari, Kari Williams, Ravi S Radhakrishnan, Kanika A Bowen-Jallow
BACKGROUND: Traumatic injuries account for 18% of child abuse cases and 1680 children die from abuse annually. We set out to determine the impact of sociodemographic characteristics on resource utilization and outcomes in nonaccidental trauma (NAT). METHODS: We used the Kid's Inpatient Database to identify children with two main subgroups of child abuse diagnoses: NAT and other forms of child abuse. Income was represented by quartiles. Statistical analysis included descriptive statistics and regression analyses...
May 12, 2018: American Journal of Surgery
Erin G Andrade, Olubode A Olufajo, Eleanor L Drew, Grant V Bochicchio, Laurie J Punch
BACKGROUND: Post colonoscopy blunt splenic injury (PCBSI) is a rarely reported and poorly recognized event. We analyzed cases of PCBSI managed at our hospital and compared them to existing literature. METHODS: We identified 5 patients admitted with PCBSI through chart review. RESULTS: There were 5 cases of PCBSI identified from April 2016-July 2017. Four of the patients were older than 65 years, three had prior surgeries, and all were women...
May 12, 2018: American Journal of Surgery
Roberto E Kusminsky
No abstract text is available yet for this article.
May 3, 2018: American Journal of Surgery
Jon S Thompson, David F Mercer, Luciano M Vargas, Wendy J Grant, Fedja A Rochling, Alan N Langnas
INTRODUCTION: Cholelithiasis is common in patients with short bowel syndrome (SBS). Prophylactic cholecystectomy (PC) of the non-diseased gallbladder has been recommended in SBS patients when laparotomy is being undertaken for other reasons. Our aim was to determine if PC is being utilized. METHODS: 500 adults with SBS were seen over a 25 year period. 215 undergoing cholecystectomy prior to SBS were excluded, leaving 285 patients for evaluation. RESULTS: 151 (53%) SBS patients underwent a subsequent laparotomy...
April 27, 2018: American Journal of Surgery
Tatsuhiko Abe, Shigehiko Uchino, Yusuke Sasabuchi, Masanori Takinami
BACKGROUND: Although hyperlactatemia is often developed in critically ill patients, it is unclear whether hyperlactatemia is associated with poor prognosis for surgical ICU (SICU) patients. METHODS: We performed a retrospective analysis in an academic hospital in Tokyo. The maximum lactate was defined as the highest value within the SICU stay. The primary outcome was the composite outcome of in-hospital mortality, re-admission to the SICU or admission to the general ICU and emergency reoperation...
April 23, 2018: American Journal of Surgery
Zeyad T Sahli, Sheng Zhou, Omar Najjar, Oluwadamilola Onasanya, Dorry Segev, Allan Massie, Martha A Zeiger, Aarti Mathur
BACKGROUND: The rising proportion of older adults in the US population coupled with an increased prevalence of nodular thyroid disease will result in more thyroidectomies being performed. The aim of this study is to evaluate the clinical outcomes among older adults (age ≥65) undergoing thyroidectomy compared to younger adults (18-64). METHODS: This was a population-based study of adult thyroidectomy patients using the Premier Healthcare Database, 2005-2014. Discharge status, hospital length of stay (LOS), morbidity, and total patient charge were compared between younger adults and older adults in three different age groups: ≥65, ≥70, and ≥80 years old...
April 22, 2018: American Journal of Surgery
Xavier Serra-Aracil, Raquel Gràcia, Laura Mora-López, Sheila Serra-Pla, Anna Pallisera-Lloveras, Maritxell Labró, Salvador Navarro-Soto
BACKGROUND: The aim of this study is to assess postoperative morbidity and mortality in tumors with a proximal margin 15 cm or more from the anal verge operated with transanal endoscopic microsurgery (TEM). METHODS: This observational study of consecutive rectal tumor patients undergoing TEM was carried out from July 2004 to June 2017. We compared the results of rectal tumors at distances of ≥15 cm (group A) and <15 cm (group B) from the anal verge. RESULTS: During the study period 667 patients were included: 118 in group A and 549 in group B...
April 22, 2018: American Journal of Surgery
Irfan A Rhemtulla, Jaclyn T Mauch, Robyn B Broach, Charles A Messa, John P Fischer
BACKGROUND: Incisional hernias (IH) following abdominal surgery are frequent and morbid. Prophylactic mesh augmentation (PMA) has emerged as a technique to reduce IH formation. We aim to report patient selection, techniques and early outcomes after PMA. METHODS: Retrospective chart review identified descriptive characteristics, risk factors, operative technique, and early post-operative outcomes for PMA patients and matched non-PMA patients between January 1, 2016 and October 31, 2017...
April 22, 2018: American Journal of Surgery
Vivian Youngjean Park, Eun-Kyung Kim, Hee Jung Moon, Jung Hyun Yoon, Min Jung Kim
BACKGROUND: This article aims to assess the diagnostic performance of ultrasound-guided fine needle aspiration (US-FNA) in diagnosing axillary lymph node (ALN) recurrence in patients with a history of breast cancer. METHODS: From January 2005 to June 2015, 231 US-FNA examinations performed for suspicious axillary lesions in 218 patients with a history of breast cancer were included. Diagnostic performance of US-FNA for ALN recurrence were evaluated. RESULTS: Of the 231 US-FNA examinations, 172 (74...
April 21, 2018: American Journal of Surgery
Matthew M Symer, Jonathan S Abelson, Art Sedrakyan, Heather L Yeo
BACKGROUND: There is no consensus on the ideal management of complicated appendicitis. METHODS: The New York State Planning and Research Cooperative database was used to identify all patients admitted with complicated appendicitis and undergoing appendectomy within 1-year. Primary outcome was any complication. Secondary outcomes included length of stay (LOS), hospital charges, and laparoscopy use. Outcomes were compared in appendectomy before or after 48h from admission...
April 19, 2018: American Journal of Surgery
Apostolos Gaitanidis, Michail Alevizakos, Alexandra Tsaroucha, Constantinos Simopoulos, Michail Pitiakoudis
BACKGROUND: The liver is the most common metastatic site in patients with gastrointestinal stromal tumors (GISTs). The purpose of this study is to identify the incidence and predictive factors associated with synchronous liver metastases among patients with GISTs. METHODS: A retrospective review of the Surveillance Epidemiology and End Results (SEER) database was performed. RESULTS: Overall, 2757 patients were identified, of which 276 (10%) had synchronous liver metastases...
April 19, 2018: American Journal of Surgery
Gilgamesh Eamer, Mohamed J H Al-Amoodi, Jayna Holroyd-Leduc, Darryl B Rolfson, Lindsey M Warkentin, Rachel G Khadaroo
BACKGROUND: Informed surgical consent requires accurate estimation of risks and benefits. Multiple risk assessment tools are available; however, most are not widely used or are specific to certain interventions. Assessing surgical risk is especially challenging in elderly patients because of their range of comorbidities, level of frailty, or severity of illness and a number of available surgical interventions. DATA SOURCES: We searched MEDLINE from January 2014 to July 2017 for studies that used risk assessment tools in studies on elderly surgical patients...
April 18, 2018: American Journal of Surgery
Susan E Smith, Susan E Hamblin, Oscar D Guillamondegui, Oliver L Gunter, Bradley M Dennis
BACKGROUND: Neuromuscular blocking agents (NMBA) have been associated with decreased time to fascial closure following damage control laparotomy (DCL). Changes in resuscitation over the last decade bring this practice into question. METHODS: A retrospective cohort study of adults who underwent DCL between 2009 and 2015 was conducted at an ACS-verified level 1 trauma center. The study group (NMBA+) received continuous NMBA within 24 h of DCL. Data collected included demographics, resuscitative fluids, mortality, and complications...
April 18, 2018: American Journal of Surgery
J M Jones, N Bhutiani, D Wei, L Goldstein, C M Jones, R M Cannon
INTRODUCTION: This study sought to approximate the cost-effectiveness of tPA utilization for prevention of biliary strictures (PTBS) in donation after circulatory death liver transplantation (DCD-LT). METHODS: Previously-reported PTBS rates in DCD-LT with and without tPA were used to calculate the number needed to treat (NNT) for prevention of one PTBS. The incremental cost of PTBS was then used to determine the cost effectiveness of tPA for prevention of PTBS. RESULTS: The incidence of PTBS in the setting of tPA administration was 20%, while incidence in patients without tPA use was 43% (p < 0...
April 17, 2018: American Journal of Surgery
Mohamed O Abdelhamid, Cornelius A Thiels, Juliane Bingener
INTRODUCTION: Reports from US administrative databases showed an increase in cholecystectomy rate for functional gallbladder disorder (FGBD), a disease is not well recognized elsewhere. We aimed to identify the incidence and cholecystectomy rate for FGBD in an epidemiologically well-defined and prospectively studied population and compare results to published data. METHODS: After IRB approval, we extracted data from the NIH funded Rochester Epidemiology Project...
April 17, 2018: American Journal of Surgery
Ricardo J Bello, Meredith L Meyer, Damon S Cooney, Gedge D Rosson, Scott D Lifchez, Carisa M Cooney
BACKGROUND: Operative rating tools can enhance performance assessment in surgical training. However, assessments completed late may have questionable reliability. We evaluated the reliability of assessments according to evaluation time-to-completion. METHODS: We stratified assessments from MileMarker's™ Operative Entrustability Assessment by evaluation time-to-completion, using concordance correlation coefficient (CCC) between self-assessment and evaluator scores as a measure of reliability...
April 17, 2018: American Journal of Surgery
F Dumont, P Dartigues, B Delga, E Thibaudeau, L Benhaim, L Campion, J F Mosnier, J Raimbourg, O Kerdraon, D Goéré
BACKGROUND: The purpose of this study was to identify the predictive factors for ypN0 status in tumors with good pathologic response to chemoradiotherapy (CRT). METHODS: A retrospective chart review was conducted on patients at two tertiary cancer center who underwent rectal resection after good response to CRT between 2000 and 2013. RESULTS: No preoperative treatment (oxaliplatin use, radiotherapy boost of 5,4 Gy, delay CRT-surgery) impacted on the ypN status...
March 31, 2018: American Journal of Surgery
Mitsuyoshi Tei, Masahisa Otsuka, Yozo Suzuki, Kentaro Kishi, Masahiro Tanemura, Hiroki Akamatsu
BACKGROUND: Single-port surgery for rectal cancer is challenging and controversial. The aim of this study was to compare the short-term outcomes of single-port laparoscopic low anterior resection (S-LAR) to multi-port laparoscopic low anterior resection (M-LAR) for upper rectal cancer. METHODS: From January 2011 to December 2015, a total of 93 patients who underwent S-LAR (n = 44) or M-LAR (n = 49) without protective diverting ileostomy for upper rectal cancer were identified...
March 26, 2018: American Journal of Surgery
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