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American Journal of Surgery

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https://www.readbyqxmd.com/read/28233540/overseas-organ-donation-during-wartime-operations-benchmarking-military-performance-against-civilian-practice
#1
John S Oh, Darren Malinoski, Kathleen D Martin, J Salvador De La Cruz, David Zonies
BACKGROUND: Over the past 15 years of war, eligible U.S. military members donated organs overseas in Germany. Our hypothesis was that outcomes at a military treatment facility were comparable to a civilian cohort. METHODS: Military donors were matched 1:3 with a donor cohort from the U.S. United Network for Organ Sharing. Data were compared using univariate and multivariate analysis. Significance set at p < 0.05. RESULTS: Forty military organ donors were compared with 116 civilian matched donors...
February 14, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28233538/comparing-definitions-of-outpatient-surgery-implications-for-quality-measurement
#2
Hillary J Mull, Peter E Rivard, Aaron Legler, Steven D Pizer, Mary T Hawn, Kamal M F Itani, Amy K Rosen
BACKGROUND: Adverse event (AE) rates in outpatient surgery are inconsistently reported, partly because of the lack of a standard definition of outpatient surgery. We compared the types and rates of surgical procedures defined by two national healthcare agencies: Health Care Cost Institute (HCCI) and the Healthcare Cost and Utilization Project (HCUP) and considered implications for quality measurement. METHODS: We used HCCI and HCUP definitions to identify FY2012-14 VA outpatient surgeries...
February 14, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28228249/a-computerised-test-of-perceptual-ability-for-learning-endoscopic-and-laparoscopic-surgery-and-other-image-guided-procedures-score-norms-for-picsor
#3
Patrick Henn, Anthony G Gallagher, Emmeline Nugent, Roddy Cowie, Neal E Seymour, Randy S Haluck, Hazem Hseino, Oscar Traynor, Paul C Neary
BACKGROUND: The aptitude to infer the shape of 3-D structures, such as internal organs from 2-D monitor displays, in image guided endoscopic and laparoscopic procedures varies. We sought both to validate a computer-generated task Pictorial Surface Orientation (PicSOr), which assesses this aptitude, and to identify norm referenced scores. METHODS: 400 subjects (339 surgeons and 61 controls) completed the PicSOr test. 50 subjects completed it again one year afterwards...
February 14, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28219624/the-effects-of-body-mass-index-on-complications-and-mortality-after-emergency-abdominal-operations-the-obesity-paradox
#4
Elizabeth R Benjamin, Evren Dilektasli, Tobias Haltmeier, Elizabeth Beale, Kenji Inaba, Demetrios Demetriades
BACKGROUND: Recent literature suggests that obesity is protective in critically illness. This study addresses the effect of BMI on outcomes after emergency abdominal surgery (EAS). METHODS: Retrospective, ACS-NSQIP analysis. All patients that underwent EAS were included. The study population was divided into five groups based on BMI; regression models were used to evaluate the role of obesity in morbidity and mortality. RESULTS: 101,078 patients underwent EAS; morbidity and mortality were 19...
February 13, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28214477/hospital-wide-porcine-mesh-conversion-results-in-cost-savings-with-equivalent-clinical-outcomes
#5
Nickolas Byrge, Mary C Mone, Daniel Vargo
BACKGROUND: A variety of biologic mesh is available for ventral hernia repair. Despite widely variable costs, there is no data comparing cost of material to clinical outcome. METHODS: Biologic mesh product change was examined. A prospective survey was done to determine appropriate biologic mesh utilization, followed by a retrospective chart review of those treated from Sept. 2012 to Aug. 2013 with Strattice™ and from Sept. 2013 to Aug. 2014 with Permacol™. Outcome variables included complications associated with each material, repair success, and cost difference over the two periods...
February 12, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28233537/predictors-of-curative-resection-and-long-term-survival-of-gallbladder-cancer-a-retrospective-analysis
#6
Pramod Kumar Mishra, Sundeep Singh Saluja, Nabi Prithiviraj, Vaibhav Varshney, Neeraj Goel, Nilesh Patil
BACKGROUND: Gallbladder cancer (GBC) is an aggressive malignancy. We analysed factors predicting resectability and survival of patients with GBC and the impact of surgical obstructive jaundice (SOJ). METHODS: Four hundred and thirty-seven patients with suspected GBC were analysed (52 excluded: benign pathology n = 35, missed GBC n = 17). The remaining 385 patients were divided into non-SOJ (n = 234) and SOJ (n = 151) groups. Predictors of resectability and long term survival were analysed and compared with their subgroups...
February 9, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28215963/racial-and-ethnic-variations-in-one-year-clinical-and-patient-reported-outcomes-following-breast-reconstruction
#7
Nicholas L Berlin, Adeyiza O Momoh, Ji Qi, Jennifer B Hamill, Hyungjin M Kim, Andrea L Pusic, Edwin G Wilkins
BACKGROUND: Existing studies evaluating racial and ethnic disparities focus on describing differences in procedure type and the proportion of women who undergo reconstruction following mastectomy. This study seeks to examine racial and ethnic variations in clinical and patient-reported outcomes (PROs) following breast reconstruction. METHODS: The Mastectomy Reconstruction Outcomes Consortium is an 11 center, prospective cohort study collecting clinical and PROs following autologous and implant-based breast reconstruction...
February 9, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28213998/portal-inflow-modulation-by-somatostatin-after-major-hepatectomy-is-it-reliable
#8
LETTER
Antonios Athanasiou, Eleftherios Spartalis, Christos Damaskos, Emmanouil Pikoulis
No abstract text is available yet for this article.
February 9, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28213997/echocardiographic-correlates-are-associated-with-in-hospital-mortality-in-trauma-and-burn-patients
#9
Duraid Younan, Russell Griffin, Donald Reiff, Jeffrey Richey, Eric Schinnerer, Jean-Francois Pittet, Ahmed Zaky
BACKGROUND: The role of echocardiographic indices of preload and contractility in predicting outcomes is unknown. We report the association of end diastolic area (EDA) and fractional area of change (FAC) with mortality in a cohort of trauma and burn patients. METHODS: Data on 86 patients admitted to a tertiary care center between July 2013 and July 2015 were reviewed. The association between abnormal EDA and FAC and adverse clinical outcomes was tested using exact logistic regression analysis...
February 9, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28202161/complication-profile-failure-to-rescue-and-mortality-following-elective-endovascular-aortic-aneurysm-repair
#10
David S Kauvar, Eric D Martin, Todd E Simon, Matthew D Givens
INTRODUCTION: Understanding the relationship between patient risk factors, postoperative complications, and morbidity and mortality is important when considering elective endovascular aortic aneurysm repair (E-EVAR) performed to prevent aneurysm rupture mortality. We aimed to stratify complications in E-EVAR and explore their relationship with postoperative death. METHODS: E-EVAR cases from 2012 NSQIP were identified. 30-day complications were categorized as major (MAJCX) or minor (MINCX) using the Clavien-Dindo classification...
February 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28202160/should-post-neoadjuvant-chemotherapy-patients-with-and-without-clinically-palpable-nodes-be-clubbed-together-while-analysing-identification-rates-and-false-negative-rates-in-sentinel-lymph-node-biopsy
#11
LETTER
C Sonthineni, S Mayilvaganan, G Agarwal
No abstract text is available yet for this article.
February 7, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28187858/impact-of-the-c-reactive-protein-to-albumin-ratio-on-long-term-outcomes-after-hepatic-resection-for-colorectal-liver-metastases
#12
Koichiro Haruki, Hiroaki Shiba, Takashi Horiuchi, Taro Sakamoto, Takeshi Gocho, Yuki Fujiwara, Kenei Furukawa, Takeyuki Misawa, Katsuhiko Yanaga
BACKGROUND: The aim of this study is to investigate the association C-reactive protein to albumin (CRP/Alb) ratio, a novel inflammation based prognostic score, and long-term outcomes among patients with colorectal liver metastases (CRLM) after hepatic resection. METHODS: We retrospectively investigated 106 patients who underwent hepatic resection for CRLM and explored the relationship between CRP/Alb ratio and long-term outcomes. RESULTS: In multivariate analysis, more than 4 lymph node metastases (p = 0...
February 6, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28173938/spinal-versus-general-anesthesia-for-transabdominal-preperitoneal-tapp-repair-of-inguinal-hernia-interim-analysis-of-a-controlled-randomized-trial
#13
Chamaidi Sarakatsianou, Stavroula Georgopoulou, Ioannis Baloyiannis, Maria Chatzimichail, George Vretzakis, Dimitris Zacharoulis, George Tzovaras
BACKGROUND: General anesthesia has been used as standard for laparoscopic hernia repair by the transabdominal preperitoneal (TAPP) approach. Regional anesthesia has been occasionally applied in high risk patients where general anesthesia is contraindicated. This randomized clinical trial compares spinal anesthesia with general anesthesia for TAPP inguinal hernia repair in non-high risk patients. METHODS: Seventy adult American Society of Anesthesiologists I, II and III patients undergoing elective TAPP inguinal hernia repair were randomized to either general or spinal anesthesia...
February 2, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28233539/preoperative-adrenal-biopsy-does-not-affect-overall-survival-in%C3%A2-adrenocortical-carcinoma
#14
Paritosh Suman, Natalie Calcatera, Chi-Hsiung Wang, Tricia A Moo-Young, David J Winchester, Richard A Prinz
BACKGROUND: The impact of preoperative biopsy on overall survival (OS) in adrenocortical carcinoma (ACC) is unclear. We analyzed the National Cancer Data Base (NCDB) for factors associated with preoperative adrenal biopsy and its effect on OS in ACC. METHODS: The NCDB was queried from 2003 to 2012 for M0 ACC. Patients with or without preoperative biopsy were compared for factors associated with an increased rate of biopsy. Survival analysis was performed after adjusting for patient and tumor-related variables...
February 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28173936/left-sided-early-onset-colorectal-carcinomas-a-sporadic-neoplasm-with-aggressive-behavior
#15
Emanuela Pilozzi, Laura Lorenzon, Simone Lo Baido, Mario Ferri, Enrico Duranti, Flavio Fochetti, Paolo Mercantini, Giovanni Ramacciato, Genoveffa Balducci, Luigi Ruco
BACKGROUND: Early onset (≤50y) colorectal carcinomas (EO-CRCs) are increasing in incidence according to epidemiological data. We investigated clinical-pathological, molecular features and outcomes of 62 left sided EO-CRCs (EOLS-CRCs) and compared them to a group of late onset (≥65) LS-CRCs (LOLS-CRCs). MATERIALS AND METHODS: Samples were evaluated for pathological features and microsatellite instability (MSI). Overall survival (OS), disease free survival (DFS) and disease specific survival were evaluated in both groups...
January 31, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28223046/acute-kidney-injury-in-pancreatic-surgery-association-with-urine-output-and-intraoperative-fluid-administration
#16
Or Goren, Amalia Levy, Anat Cattan, Guy Lahat, Idit Matot
BACKGROUND: Acute kidney injury (AKI) is a devastating postoperative complication. Intraoperative urine output is assumed to reflect patient's intravascular volume and kidney function. We thus evaluated the incidence of postoperative AKI and its association with intraoperative urine output and the volume of fluid administered. METHODS: A retrospective study on 153 consecutive patients admitted to Tel Aviv Medical Center for pancreatic surgery. RESULTS: The incidence of AKI in patients undergoing pancreatic surgery was 9...
January 30, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28173939/outcome-and-management-of-endoscopic-retrograde-cholangiopancreatography-perforations-a-community-perspective
#17
Mallory S Bray, Andrew J Borgert, Milan E Folkers, Shanu N Kothari
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) carries a small but significant risk of perforation. Recent data suggest that select patients can be managed non-operatively. We sought to evaluate the management of ERCP perforations at our community medical center. METHODS: ERCPs performed from 2004 to 2015 were reviewed. RESULTS: Twenty-one of 2423 patients who underwent ERCP had a perforation (0.9%). ERCP procedures included balloon sweep with/without sphincterotomy and pancreatic duct stent (71%), common bile duct brushing (10%), and pancreatic duct stenting (5%)...
January 30, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28173937/student-use-and-perceptions-of-mobile-technology-in-clinical-clerkships-guidance-for-curriculum-design
#18
Joanna K Law, Parker A Thome, Brenessa Lindeman, Daren C Jackson, Anne O Lidor
BACKGROUND: We examined the types of technology used by medical students in clinical clerkships, and the perception of technology implementation into the curriculum. METHODS: An online survey about technology use was completed prior to general surgery clinical clerkship. Types of devices and frequency/comfort of use were recorded. Perceptions of the benefits and barriers to technology use in clerkship learning were elicited. RESULTS: 125/131 (95...
January 30, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28173934/laparoscopic-hepatectomy-significantly-shortens-the-time-to-postoperative-chemotherapy-in-patients-undergoing-major-hepatectomies
#19
Nsehniitooh Mbah, Steven C Agle, Prejesh Philips, Michael E Egger, Charles R Scoggins, Kelly M McMasters, Robert C G Martin
BACKGROUND: The benefit of adjuvant chemotherapy occurs with early initiation, but is commonly delayed due to postoperative complications. Minimally invasive surgery is proven to significantly reduce complications and hospital length of stay. This study compares open versus laparoscopic liver resection in patients requiring adjuvant chemotherapy. METHODS: 120 consecutive patients with metastatic colorectal liver cancer who underwent liver resection between 2007 through 2012 were reviewed from an IRB prospective database...
January 30, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28173933/comment-on-article-entitled-open-preperitoneal-groin-hernia-repair-with-mesh-a-qualitative-systematic-review
#20
E P Pelissier, G G Koning, P Ngo
No abstract text is available yet for this article.
January 30, 2017: American Journal of Surgery
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