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American Journal of Surgery

Kei Hosoda, Keishi Yamashita, Shinichi Sakuramoto, Natsuya Katada, Hiromitsu Moriya, Hiroaki Mieno, Masahiko Watanabe
BACKGROUND: Little is known about postgastrectomy syndrome and quality of life (QOL after laparoscopy-assisted pylorus-preserving gastrectomy (LAPPG). The aim of this study was to assess postgastrectomy syndrome and QOL after LAPPG as compared with laparoscopy-assisted distal gastrectomy with Billroth-I reconstruction (LADGBI). METHODS: Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45) questionnaires were sent by mail to 167 patients. To balance the characteristics of the groups, propensity score matching was performed...
October 8, 2016: American Journal of Surgery
Terence C Chua, Anubhav Mittal, Jenny Arena, Amy Sheen, Anthony J Gill, Jaswinder S Samra
INTRODUCTION: Distal cholangiocarcinoma remains a rare cancer associated with a dismal outcome. There is a lack of effective treatment options and where disease is amendable to resection, surgery affords the best potential for long-term survival. The aim of this study was to examine the survival outcomes and prognostic factors of patients undergoing pancreatoduodenectomy for distal cholangiocarcinoma. METHODS: Between January 2004 to May 2016, patients who had undergone pancreatoduodenectomy with histologically proven distal cholangiocarcinoma were identified...
October 8, 2016: American Journal of Surgery
Mary E Klingensmith
No abstract text is available yet for this article.
October 8, 2016: American Journal of Surgery
Andrea E Geddes, Clay Cothren Burlew, Amy E Wagenaar, Walter L Biffl, Jeffrey L Johnson, Fredric M Pieracci, Eric M Campion, Ernest E Moore
BACKGROUND: We implemented expanded screening criteria for blunt cerebrovascular injuries (BCVIs) in an attempt to capture the remaining 20% of patients not historically identified with earlier protocols. We hypothesized that these expanded criteria would capture the additional 20% of BCVI patients not previously identified. METHODS: Screening criteria for BCVI were expanded in 2011 after identifying new injury patterns. The study population included 4 years prior (2007 to 2010; classic) and following (2011 to 2014; expanded) implementation of expanded criteria...
September 29, 2016: American Journal of Surgery
Marten N Basta, Liza C Wu, Suhail K Kanchwala, Joseph M Serletti, Julia C Tchou, Stephen J Kovach, Joshua Fosnot, John P Fischer
BACKGROUND: Breast cancer-related lymphedema remains a significant complication post mastectomy. Identifying patients at highest risk may better inform targeted healthcare resource allocation and improve outcomes. This study aims to identify lymphedema predictors after mastectomy to develop a simple, accurate risk assessment tool. METHODS: An institutional retrospective review identified all women with breast cancer undergoing mastectomy between January 2000 and July 2013 with postmastectomy lymphedema as the primary outcome...
September 7, 2016: American Journal of Surgery
Sulaiman Nanji, Melanie E Tsang, Xuejiao Wei, Christopher M Booth
BACKGROUND: More than half of the patients undergoing resection for colorectal cancer liver metastases develop recurrent hepatic disease. We report management and outcomes of patients undergoing repeat hepatectomy in routine practice. METHODS: All cases of repeat hepatectomy for colorectal cancer liver metastases from 2002 to 2009 in the Canadian Province of Ontario were identified using the population-based Ontario Cancer Registry and linked treatment records. RESULTS: Of 1,310 patients who underwent resection of CRLM, 78 (6...
September 6, 2016: American Journal of Surgery
Olubode A Olufajo, Gally Reznor, Stuart R Lipsitz, Zara R Cooper, Adil H Haider, Ali Salim, Erika L Rangel
BACKGROUND: The risk of mortality after emergency general surgery (EGS) in elderly patients is prolonged beyond initial hospitalization. Our objective was to develop a preoperative scoring tool to quantify risk of 1-year mortality. METHODS: Three hundred ninety EGS patients aged 70 years or more were analyzed. Risk factors for 1-year mortality were identified using stepwise-forward logistic multivariate regression and weights assigned using natural logarithm of odds ratios...
September 3, 2016: American Journal of Surgery
Brittany L Murphy, Tanya L Hoskin, Judy C Boughey, Amy C Degnim, James W Jakub, Adam C Krajewski, Steven R Jacobson, Tina J Hieken
BACKGROUND: While nipple-sparing mastectomy (NSM) is gaining acceptance for risk reduction and for treatment of early stage breast cancer, node-positive disease remains a relative contraindication. Our aim was to evaluate the use and outcomes of NSM in node-positive breast cancer patients. METHODS: We identified 240 cancers in 226 patients (14 bilateral) scheduled for NSM and operated on between 1/2009 and 6/2014. We compared outcomes for 58 node-positive vs 182 node-negative patients...
September 3, 2016: American Journal of Surgery
Chaya Shwaartz, Adam C Fields, Jake G Prigoff, Jeffrey J Aalberg, Celia M Divino
BACKGROUND: Up to 20% of patients with colorectal cancer present with obstruction. The goal of this study was to compare the short-term outcomes of patients with obstructing colon cancer who underwent resection and primary anastomosis with or without proximal diversion. METHODS: The American College of Surgeons' National Surgical Quality Improvement Program Procedure Targeted Colectomy databases from 2012 to 2014 were reviewed. Patients undergoing colorectal resection with or without diverting ostomy for obstructing colorectal cancer were analyzed...
September 2, 2016: American Journal of Surgery
Alexandra Thomas, Ronald J Weigel, Charles F Lynch, Philip M Spanheimer, Elizabeth K Breitbach, Mary C Schroeder
BACKGROUND: Recent incidence, treatment patterns, and outcomes for node negative microscopically invasive breast cancer (MIBC) have not been reported. METHODS: State Health Registry of Iowa data identified women with ductal carcinoma in situ (DCIS), MIBC, and stage I breast cancer excluding MIBC (stage 1BC). RESULTS: From 2000 to 2013, 1,706, 193, and 4,514 women were diagnosed with DCIS, MIBC, and stage 1BC, respectively. MIBC increased at an annual percentage change of 2...
September 2, 2016: American Journal of Surgery
Christopher J Pannucci, Ann Marie Prazak, Melody Scheefer
BACKGROUND: Between 2% and 10% of the highest risk surgery, patients have a "breakthrough" venous thromboembolism (VTE) event despite receipt of chemoprophylaxis. The goals of this review are to summarize how patient-level factors may predict enoxaparin metabolism and how alterations in enoxaparin dose magnitude and frequency affect both anti-factor Xa (aFXa) levels and downstream VTE events. DATA SOURCES: Relevant articles were identified on PubMed. Fixed-dose prophylaxis provides inadequate enoxaparin prophylaxis for most surgical patients based on anti-factor Xa levels...
September 2, 2016: American Journal of Surgery
M Justin Coffey
No abstract text is available yet for this article.
August 31, 2016: American Journal of Surgery
Andrew R Doben, Fredric M Pieracci
No abstract text is available yet for this article.
August 28, 2016: American Journal of Surgery
Jack W Rostas, Timothy B Lively, Sidney B Brevard, Jon D Simmons, Mohammad A Frotan, Richard P Gonzalez
BACKGROUND: The purpose of this study was to identify patients with rib injuries who were at risk for solid organ injury. METHODS: A retrospective chart review was performed of all blunt trauma patients with rib fractures during the period from July 2007 to July 2012. Data were analyzed for association of rib fractures and solid organ injury. RESULTS: In all, 1,103 rib fracture patients were identified; 142 patients had liver injuries with 109 (77%) associated right rib fractures...
August 28, 2016: American Journal of Surgery
Jon S Thompson
No abstract text is available yet for this article.
August 25, 2016: American Journal of Surgery
Dimitrios Stefanidis, Nicholas E Anton, Graham McRary, Lisa D Howley, Manuel Pimentel, Cameron Davis, Ashley M Yurco, Nick Sevdalis, Charles Brown
BACKGROUND: Mental skills training refers to the implementation of cognitive performance-enhancing strategies to promote optimal performance. We aimed to develop a surgery-specific mental skills curriculum (MSC) and obtain initial evidence of efficacy. METHODS: The developed MSC consisted of 8 proven performance-enhancing modules. Its efficacy was assessed during laparoscopic simulator-based practice by novices using validated instruments of mental skills, workload, and stress, in addition to a skill transfer test to a porcine model...
August 22, 2016: American Journal of Surgery
Cianna Pender, Vladimir Kiselov, Qingzhao Yu, Jennifer Mooney, Patrick Greiffenstein, John T Paige
BACKGROUND: We evaluated the effectiveness of implementing a proficiency-driven, simulation-based knot tying and suturing curriculum for medical students during their 3rd-year surgery clerkship. METHODS: Medical students on the 3rd-year surgical clerkship completed a proficiency-driven, simulation-based knot tying and suturing curriculum consisting of 6 tasks. The effectiveness was evaluated by comparing the initial presession scores to the final postsession scores on an 8-item self-efficacy scale and evaluating pass rates on end of clerkship skills testing...
August 22, 2016: American Journal of Surgery
Robert H Hollis, Carla N Holcomb, Javier A Valle, Burke P Smith, Aerin J DeRussy, Laura A Graham, Joshua S Richman, Kamal M F Itani, Thomas M Maddox, Mary T Hawn
BACKGROUND: We evaluated coronary angiography use among patients with coronary stents suffering postoperative myocardial infarction (MI) and the association with mortality. METHODS: Patients with prior coronary stenting who underwent inpatient noncardiac surgery in Veterans Affairs hospitals between 2000 and 2012 and experienced postoperative MI were identified. Predictors of 30-day post-MI mortality were evaluated. RESULTS: Following 12,096 operations, 353 (2...
August 20, 2016: American Journal of Surgery
Jessica A Rotman, George I Getrajdman, Majid Maybody, Joseph P Erinjeri, Hooman Yarmohammadi, Constantinos T Sofocleous, Stephen B Solomon, F Edward Boas
BACKGROUND: The purpose of this study is to determine whether larger abdominopelvic abscess drains reduce the time required for abscess resolution or the probability of tube occlusion. METHODS: 144 consecutive patients who underwent abscess drainage at a single institution were reviewed retrospectively. RESULTS: Larger initial drain size did not reduce drainage time, drain occlusion, or drain exchanges (P > .05). Subgroup analysis did not find any type of collection that benefitted from larger drains...
August 17, 2016: American Journal of Surgery
John Mayberry
No abstract text is available yet for this article.
August 17, 2016: American Journal of Surgery
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