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American Journal of Surgery

Jeffrey D Howard, Mickey S Ising, Megan E Delisle, Robert C G Martin
BACKGROUND: Appropriate postoperative readmission rates and modifiable risk factors for readmission have yet to be defined for many operations. This systematic review and meta-analysis attempt to define these parameters for pancreaticoduodenectomy. MATERIALS AND METHODS: The main outcomes were readmission rate, risk factors, and reasons for readmission. Meta-analyses were performed when data was homogeneous, otherwise, a qualitative review was performed. RESULTS: The 30-day, 90-day, and overall readmission rates were 17...
July 13, 2018: American Journal of Surgery
Kenta Takayasu, Kenji Yoshida, Takao Mishima, Masato Watanabe, Tadashi Matsuda, Hidefumi Kinoshita
BACKGROUND: This study aimed to analyze the posture patterns of surgeons with two different skill levels during laparoscopic surgery using an optical motion capture system. METHODS: Twenty participants were divided into novice and expert groups. Their upper body motions during suturing tasks were captured, including average angle and angle variability (shoulder, elbow, wrist), joint fixation, head movement, and thoracolumbar flexion angle. RESULTS: Our analysis showed that (1) the arms of the expert surgeons were more loosely held at their sides by about 7°; (2) their elbows were more bent by about 10°; (3) they had a greater change in shoulder angle by about 1...
July 12, 2018: American Journal of Surgery
Christopher P Michetti, Margaret M Griffen, Erik J Teicher, Jennifer L Rodriguez, Hani Seoudi, Chang Liu, Elena Lita, Anna Newcomb
BACKGROUND: A Form for Re-Intubation Evaluation by Nurses and Doctors (FRIEND) was used to prospectively collect pre-extubation data, to determine failure of extubation (FOE) risk. METHODS: FRIENDs, including airway, breathing, and neurologic variables, were completed before extubation on trauma & surgical patients in one ICU from 1/1/16 to 5/31/17. Those with failed vs. successful extubation were compared. We excluded those with tracheostomy, comfort measures, or death before extubation...
July 10, 2018: American Journal of Surgery
Reema Mallick, Ammar Asban, Sebastian Chung, Jinwoo Hur, Brenessa Lindeman, Herbert Chen
BACKGROUND: Outpatient thyroidectomy is increasingly performed. Thyroidectomy for Graves' disease, however, has greater risk of periprocedural complications, limiting use of same-day procedures. We sought to demonstrate that these patients may be managed with ambulatory surgery. METHODS: The experience of one endocrine surgeon with thyroidectomy for Graves' was examined from January 2016-November 2017. Forty-one patients met criteria. Patient demographics, perioperative parameters, and postoperative outcomes including emergency department utilization and readmission were recorded...
July 10, 2018: American Journal of Surgery
Kensuke Kudou, Hiroshi Saeki, Yuichiro Nakashima, Shun Sasaki, Tomoko Jogo, Kosuke Hirose, Qingjiang Hu, Yasuo Tsuda, Koichi Kimura, Ryota Nakanishi, Nobuhide Kubo, Koji Ando, Eiji Oki, Tetsuo Ikeda, Yoshihiko Maehara
BACKGROUND: There were few studies assessed the postoperative sarcopenia in patients with cancers. The objective of present study was to assess whether postoperative development of sarcopenia could predict a poor prognosis in patients with adenocarcinoma of esophagogastric junction, (AEG) and upper gastric cancer (UGC). METHODS: Patients with AEG and UGC who were judged as non-sarcopenic before surgery were reassessed the presence of postoperative development of sarcopenia 6 months after surgery...
July 10, 2018: American Journal of Surgery
Sook C Hoang, Adam A Klipfel, Leslie A Roth, Mathew Vrees, Steven Schechter, Nishit Shah
BACKGROUND: Despite the introduction of the Surgical Care Improvement Project, surgical site infections remain a source of morbidity. The aim of this study was to determine the value of implementing a colorectal bundle on SSI rates. METHODS: Between 2011 and 2016 a total of 1351 patients underwent colorectal operations. Patients were grouped into pre-implementation (Group A, January 1, 2011-December 31, 2012), implementation (Group B, January 1, 2013-December 31, 2014) and post-implementation (Group C, January 1, 2015-December 31, 2016)...
July 9, 2018: American Journal of Surgery
Viraj Pandit, Muhammad Khan, Carolina Martinez, Faisal Jehan, Muhammad Zeeshan, Jenna Koblinski, Mohammad Hamidi, Pamela Omesieta, Obiyo Osuchukwu, Valentine Nfonsam
INTRODUCTION: Assessing outcomes in patients with colon cancer (CC) undergoing surgical intervention is challenging. Frailty has been as established tool for assessing patient outcomes. The aim was of this study was to assess role of frailty in patients with CC. METHODS: National estimates for patients with CC were abstracted from the National Inpatient Sample (NIS) database (2011). Frailty was calculated using a 11 variable CCFI. Patient was stratified as frail (FL) (mFI≥0...
July 9, 2018: American Journal of Surgery
Elena Parvez, Sylvie D Cornacchi, Erin Fu, Nicole Hodgson, Forough Farrokhyar, Susan Reid, Peter J Lovrics
INTRODUCTION: Radioguided seed localization (RSL) is an alternative technique to wire-guided localization (WL) for localizing non-palpable breast lesions for breast conserving surgery. The purpose of this study was to assess adoption and outcomes of RSL at 3 academic hospitals in our city. METHODS: Data for consecutive invasive and in-situ breast cancer cases localized with RSL or WL at 3 hospitals between January 2012 and February 2016 were abstracted. Data analysis was conducted using the Student's t-test, ANOVA with Tukey's HSD test for post-hoc multiple comparisons, and chi-squared test...
July 9, 2018: American Journal of Surgery
Ann M Borzecki, Qi Chen, William O'Brien, Michael Shwartz, Peter A Najjar, Kamal M F Itani, Amy K Rosen
BACKGROUND: Studies disagree whether surveillance bias is associated with perioperative venous thromboembolism (VTE) performance measures. A prior VA study used a chart-based outcome; no studies have used the fully specified administrative data-based AHRQ Patient Safety Indicator, PSI-12, as their primary outcome. If surveillance bias were present, we hypothesized that inpatient surveillance rates would be associated with higher PSI-12 rates, but with lower post-discharge VTE rates. METHODS: Using VA data, we examined Pearson correlations between hospital-level VTE imaging rates and risk-adjusted PSI-12 rates and post-discharge VTE rates...
July 4, 2018: American Journal of Surgery
Vijaya T Daniel, Didem Ayturk, Doyle V Ward, Beth A McCormick, Heena P Santry
BACKGROUND: An association between lack of insurance and inferior outcomes has been well described for a number of surgical emergencies, yet little is known about the relationship of payor status and outcomes of patients undergoing emergent surgical repair for upper gastrointestinal (UGI) perforations. We evaluated the association of payor status and in-hospital mortality for patients undergoing emergency surgery for UGI perforations in the United States. METHODS: Nationwide Inpatient Sample (NIS) was queried to identify patients between 18 and 64 years of age who underwent emergent (open or laparoscopic) repair for UGI perforations secondary to peptic ulcer disease (2010-2014)...
July 2, 2018: American Journal of Surgery
Guy Sheahan, Richard Reznick, Don Klinger, Leslie Flynn, Boris Zevin
PURPOSE: Video feedback and faculty feedback has been shown to improve surgical performance; however, consistent access to faculty is challenging. We studied the utility of structured peer-feedback (PF) compared to faculty-feedback (FF) during acquisition of basic and intermediate surgical skills. METHODOLOGY: Two randomized non-inferiority trials were conducted with 1st (n = 30) and 2nd year (n = 29) medical students learning skin-lesion excision and closure (S), and single-layer hand-sewn bowel anastomosis (B), respectively...
June 30, 2018: American Journal of Surgery
Pauline Asseeva, Nunzia Cinzia Paladino, Carole Guerin, Frédéric Castinetti, Josiane Vaillant-Lombard, Ahmad Esmaeel Abdullah, Bardia Farman-Ara, Anderson Loundou, Frédéric Sebag, David Taïeb
BACKGROUND: Primary hyperparathyroidism/(PHPT) is one of the most common endocrinological conditions. Surgery remains the only curative option. We have evaluated the performance of double isotope 123 I/99m Tc-sestamibi parathyroid scintigraphy/(PS) with subtraction SPECT/CT in PHP for identifying uniglandular disease. METHODS: Ninety PHPT patients undergoing parathyroidectomy (December 2015-August 2016) were included. All patients were evaluated with neck ultrasound/(US), PS and SPECT/CT with a new protocol...
June 30, 2018: American Journal of Surgery
Stavros A Antoniou, Nadine van Veenendaal, Hendrik Jaap Bonjer
No abstract text is available yet for this article.
June 25, 2018: American Journal of Surgery
Solomon Azouz, Piper Boyll, Marco Swanson, Nikki Castel, Terry Maffi, Alanna M Rebecca
BACKGROUND: Among hospital staff, little is known concerning barriers to recycling and perception of waste in the operating room (OR), despite continued improvement in recycling programs. This study sought to identify barriers to OR recycling and implement a recycling improvement educational program. METHODS: A survey was administered within Mayo Clinic at four campuses. Based on survey results, a recycling improvement program was devised and implemented at a surgery center in Paradise Valley, Arizona...
June 23, 2018: American Journal of Surgery
Muhammed Ashraf Memon, Aiman Awaiz, Rossita Mohamad Yunus, Breda Memon, Shahjahan Khan
BACKGROUND: We conducted a meta-analysis of the randomized evidence to determine the relative merits of histopathological outcomes of laparoscopic assisted (LARR) versus open rectal resection (ORR) for rectal cancer. DATA SOURCES: A search of PubMed and other electronic databases comparing LARR and ORR between Jan 2000 and June 2016 was performed. Histopathological variables analyzed included; location of rectal tumors; complete and incomplete TME; positive and negative circumferential resection margins (+/-CRM); positive distal resected margins (+DRM); distance of tumor from DRM; number of lymph nodes harvested; resected specimen length; tumor size and perforated rectum...
June 19, 2018: American Journal of Surgery
Shanley B Deal, Michael I D'Angelica, William G Hawkins, Michael Pucci, Michael Ujiki, L Michael Brunt, Steven Wexner, Adnan A Alseidi
BACKGROUND: Synoptic operative reports (SOR) are more accurate than dictated operative reports (DOR) in a few single institution experiences. We sought to examine the completeness of SOR for laparoscopic cholecystectomy (LC) and pancreaticoduodenectomy (PD) in a multi institutional pilot study. METHODS: Six institutions participated in SOR submission via a web-based survey. One institution collected DOR and case matched historical dictated operative reports (HOR) for subset analysis...
June 19, 2018: American Journal of Surgery
Warqaa M Akram, Riad H Al-Natour, Jeremy Albright, Juan Wu, Jane Ferraro, Beth-Ann Shanker, Amanda M McClure, Robert K Cleary
INTRODUCTION: There may be short-term outcomes advantages for the intracorporeal approach to minimally invasive right colectomy. METHODS: This is a retrospective propensity score-matched comparison of intracorporeal and extracorporeal techniques for robotic-assisted right colectomy in an Enhanced Recovery colorectal surgery service. RESULTS: 55 intracorporeal and 55 extracorporeal cases were compared. Operative time was significantly longer (p < 0...
June 19, 2018: American Journal of Surgery
Edin Mujagic, Jasmin Zeindler, Michael Coslovsky, Henry Hoffmann, Savas D Soysal, Robert Mechera, Marco von Strauss, Tarik Delko, Franziska Saxer, Richard Glaab, Rebecca Kraus, Alexandra Mueller, Gaudenz Curti, Lorenz Gurke, Marcel Jakob, Walter R Marti, Walter P Weber
BACKGROUND: Surgical drains are widely used despite limited evidence in their favor. This study describes the associations between drains and surgical site infections (SSI). METHODS: This prospective observational double center study was performed in Switzerland between February 2013 and August 2015. RESULTS: The odds of SSI in the presence of drains were increased in general (OR 2.41, 95%CI 1.32-4.30, p = 0.004), but less in vascular and not in orthopedic trauma surgery...
June 19, 2018: American Journal of Surgery
Madeline Lemke, Yvonne DeWit, Sulaiman Nanji, Christopher M Booth, Jennifer A Flemming
BACKGROUND: Differences in outcomes between males and females with biliary tract cancer (BTC) has been previously reported but not studied. METHODS: This was a population-based retrospective cohort study of patients undergoing BTC resection in Ontario between 2002 and 2012. Descriptive statistics on patient, disease, and treatment-related factors in each BTC subtype were reported. Kaplan Meier Curves and Cox Proportional Hazards analysis were used to examine the univariate relationship between sex and overall survival...
June 19, 2018: American Journal of Surgery
Dustin Baker, Shruti Sevak, Rose E Callahan, Peter F Czako, Larry R Lloyd, Sapna Nagar
BACKGROUND: Cinacalcet is an effective treatment for renal hyperthyroidism when traditional medical therapy has failed. We studied the impact of pre-operative cinacalcet administration on post-surgical outcomes. METHODS: A retrospective analysis was performed of patients from 2002 to 2017 diagnosed with renal hyperparathyroidism requiring parathyroidectomy to evaluate the need for post-operative supplementation and outcomes. RESULTS: 102 patients were identified; 34 patients were treated with cinacalcet prior to undergoing parathyroidectomy...
June 19, 2018: American Journal of Surgery
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