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Annals of Surgery

Cheryl K Zogg, Kevin M Schuster, Adrian A Maung, Kimberly A Davis
OBJECTIVE: To identify the association between insurance status and the probability of emergency department admission versus transfer for patients with major injuries (Injury Severity Score >15) and other complex trauma likely to require higher-level trauma center (TC) care across the spectrum of TC care. BACKGROUND: Trauma systems were developed to facilitate direct transport and transfer of patients with major/complex traumatic injuries to designated TCs. Emerging literature suggests that uninsured patients are more likely to be transferred...
July 12, 2018: Annals of Surgery
Emanuel Eguia, Adrienne N Cobb, Anai N Kothari, Ayrin Molefe, Majid Afshar, Gerard V Aranha, Paul C Kuo
OBJECTIVE: This study aims to evaluate the trends in cancer (CA) admissions and surgeries after the Affordable Care Act (ACA) Medicaid expansion. METHODS: This is a retrospective study using HCUP-SID analyzing inpatient CA (pancreas, esophagus, lung, bladder, breast, colorectal, prostate, and gastric) admissions and surgeries pre- (2010-2013) and post- (2014) Medicaid expansion. Surgery was defined as observed resection rate per 100 cancer admissions. Nonexpansion (FL) and expansion states (IA, MD, and NY) were compared...
July 12, 2018: Annals of Surgery
Ming-Huei Cheng, Marco Pappalardo, Chieh Lin, Chang-Fu Kuo, Chia-Yu Lin, Kevin C Chung
OBJECTIVE: The aim was to validate the new Taiwan Lymphoscintigraphy Staging, correlate it with Cheng Lymphedema Grading (CLG) and evaluate the treatment outcomes of unilateral extremity lymphedema. BACKGROUND: No consensus has been reached for diagnosis and staging for patients with lymphedema among medical specialties. METHODS: We included 285 patients with unilateral extremity lymphedema using lymphoscintigraphy. Lymphoscintigraphy was correlated to clinical symptoms and signs, and classified into normal lymphatic drainage, partial obstruction, and total obstruction...
July 12, 2018: Annals of Surgery
Ammar Asban, Sebastian K Chung, Margaret A Tresler, Priyanka Huilgol, Rongbing Xie, James K Kirklin, Courtney J Balentine, Brenessa M Lindeman, Herbert Chen
OBJECTIVE: The aim of this study was to determine the prevalence of undiagnosed and untreated hyperthyroidism among patients with suppressed thyroid-stimulating hormone (TSH). BACKGROUND: Hyperthyroidism can significantly diminish patient quality of life and increase the financial burden on patients and health systems. We hypothesized that many patients with hyperthyroidism remain undiagnosed because physicians fail to recognize and evaluate suppressed TSH as the first indication of disease...
July 12, 2018: Annals of Surgery
Scott A LeMaire, Barbara W Trautner, Uma Ramamurthy, Susan Y Green, Qianzi Zhang, William E Fisher, Todd K Rosengart
OBJECTIVE: The objective of this study was to evaluate a new academic relative-value unit (aRVU) scoring system linked to faculty compensation and analyze its association with overall departmental academic productivity. SUMMARY BACKGROUND DATA: Faculty are often not incentivized or financially compensated for educational and research activities crucial to the academic mission. METHODS: We launched an online, self-reporting aRVU system in 2015 to document and incentivize the academic productivity of our faculty...
July 12, 2018: Annals of Surgery
Cornelius A Thiels, Daniel S Ubl, Kathleen J Yost, Sean C Dowdy, Tad M Mabry, Halena M Gazelka, Robert R Cima, Elizabeth B Habermann
OBJECTIVE: The aim of this study was to conduct a prospective, multicenter survey of patients regarding postoperative opioid use to inform development of standardized, evidence-based, procedure-specific opioid prescribing guidelines. SUMMARY OF BACKGROUND DATA: Previous work has shown significant variation in the amount of opioids prescribed after elective procedures, calling for optimization of prescribing. METHODS: Adults (n = 3412) undergoing 25 elective procedures were identified prospectively from 3 academic centers (March 2017 to January 2018) to complete a 29-question telephone interview survey 21 to 35 days post-discharge (n = 688 not contacted, n = 107 refused)...
July 12, 2018: Annals of Surgery
Michaela A West, Shelley Hwang, Ronald V Maier, Nita Ahuja, Peter Angelos, Barbara L Bass, Karen J Brasel, Herbert Chen, Kimberly A Davis, Timothy J Eberlein, Yuman Fong, Caprice C Greenberg, Keith D Lillemoe, Mary C McCarthy, Fabrizio Michelassi, Patricia J Numann, Sareh Parangi, Jorge D Reyes, Hilary A Sanfey, Steven C Stain, Ronald J Weigel, Sherry M Wren
OBJECTIVE: The leadership of the American Surgical Association (ASA) appointed a Task Force to objectively address issues related to equity, diversity, and inclusion with the discipline of academic surgery. SUMMARY OF BACKGROUND DATA: Surgeons and the discipline of surgery, particularly academic surgery, have a tradition of leadership both in medicine and society. Currently, we are being challenged to harness our innate curiosity, hard work, and perseverance to address the historically significant deficiencies within our field in the areas of diversity, equity, and inclusion...
July 12, 2018: Annals of Surgery
Adam Tanious, Alexander B Pothof, Laura T Boitano, Alaska A Pendleton, Linda J Wang, Gert J de Borst, David W Rattner, Marc L Schermerhorn, Mohammad H Eslami, Mahmoud B Malas, Matthew J Eagleton, William Darrin Clouse, Mark F Conrad
OBJECTIVE: Our objective was to identify the postoperative risk associated with different timing intervals of repair. BACKGROUND: Timing of carotid intervention in poststroke patients is widely debated with the scales balanced between increased periprocedural risk and recurrent neurologic event. National database reviews show increased risk to patients treated within the first 2 days of a neurologic event compared to those treated after 6 days. METHODS: Utilizing Vascular Quality Initiative data, all carotid interventions performed on stroke patients between the years 2012 and 2017 were queried...
July 12, 2018: Annals of Surgery
Charles Mock, Haile Debas, Charles M Balch, Murray Brennan, Jo Buyske, James Cusack, Steven DeMeester, David Herndon, Ai-Xuan Le Holterman, Bernard Jaffe, Emad Kandil, Gordon Kauffman, George Mazariegos, Nipun Merchant, Patricia Numann, Dmitry Oleynikov, Oluyinka Olutoye, James O'Neill, Steven Shackford, Peter Stock, John L Tarpley, Todd Tuttle, Steven Wolf, Sherry M Wren, George P Yang
: There is an unacceptably high burden of death and disability from conditions that are treatable by surgery, worldwide and especially in low- and middle-income countries (LMICs). The major actions to improve this situation need to be taken by the surgical communities, institutions, and governments of the LMICs. The US surgical community, including the US academic surgical community, has, however, important roles to play in addressing this problem. The American Surgical Association convened a Working Group to address how US academic surgery can most effectively decrease the burden from surgically treatable conditions in LMICs...
July 12, 2018: Annals of Surgery
John Rodriguez, Andrew T Strong, Ivy N Haskins, Joshua P Landreneau, Matthew T Allemang, Kevin El-Hayek, James Villamere, Chao Tu, Michael S Cline, Matthew Kroh, Jeffrey L Ponsky
OBJECTIVE: For patients with gastroparesis, temporary pyloric disruption has been shown to improve symptoms and gastric emptying. Per-oral pyloromyotomy (POP) is an innovative endoscopic procedure to divide the pylorus from within a submucosal tunnel, as a corollary to surgical pyloromyotomy. Here we evaluate subjective and objective outcomes 12-weeks after POP at a high volume center. METHODS: The first 100 consecutive patients undergoing POP were included, with procedure dates between January 2016 and October 2017...
July 12, 2018: Annals of Surgery
Timothy L McMurry, George J Stukenborg, Larry G Kessler, Graham A Colditz, Melisa L Wong, Amanda B Francescatti, David R Jones, Jessica R Schumacher, Caprice C Greenberg, George J Chang, David P Winchester, Daniel P McKellar, Benjamin D Kozower
OBJECTIVE: To evaluate whether an association exists between the intensity of surveillance following surgical resection for non-small cell lung cancer (NSCLC) and survival. BACKGROUND: Surveillance guidelines following surgical resection of NSCLC vary widely and are based on expert opinion and limited evidence. METHODS: A Special Study of the National Cancer Database randomly selected stage I to III NSCLC patients for data reabstraction. For patients diagnosed between 2006 and 2007 and followed for 5 years through 2012, registrars documented all postsurgical imaging with indication (routine surveillance, new symptoms), recurrence, new primary cancers, and survival, with 5-year follow-up...
July 12, 2018: Annals of Surgery
Bonnie E Lonze, Vasishta S Tatapudi, Elaina P Weldon, Elijah S Min, Nicole M Ali, Cecilia L Deterville, Bruce E Gelb, Judith A Benstein, Nabil N Dagher, Ming Wu, Robert A Montgomery
OBJECTIVES: The presence of a donor-specific positive crossmatch has been considered to be a contraindication to kidney transplantation because of the risk of hyperacute rejection. Desensitization is the process of removing hazardous preformed donor-specific antibody (DSA) in order to safely proceed with transplant. Traditionally, this involves plasmapheresis and intravenous immune globulin treatments that occur over days to weeks, and has been feasible when there is a living donor and the date of the transplant is known, allowing time for pre-emptive treatments...
July 12, 2018: Annals of Surgery
Elisa Bannone, Stefano Andrianello, Giovanni Marchegiani, Gaia Masini, Giuseppe Malleo, Claudio Bassi, Roberto Salvia
OBJECTIVE: The aim of the study is to characterize postoperative acute pancreatitis (POAP). SUMMARY BACKGROUND DATA: A standardized definition of POAP after pancreaticoduodenectomy (PD) has been recently proposed, but specific studies are lacking. METHODS: The patients were extracted from the prospective database of The Pancreas Institute of Verona. POAP was defined as an elevation of the serum pancreatic amylase levels above the upper limit of normal (52 U/L) on postoperative day (POD) 0 or 1...
July 12, 2018: Annals of Surgery
Jan H N Lindeman, Jaap Jan Zwaginga, Graziella Kallenberg-Lantrua, Rob C van Wissen, Abbey Schepers, Hajo J van Bockel, Willem E Fibbe, Jaap F Hamming
BACKGROUND AND AIMS: Prospects for no-option, end-stage peripheral artery disease (PAD) patients remain poor. Although results from open and semiblinded studies fuel hope for cell-based strategies in no-option patients, so far conclusions from the available placebo-controlled studies are not supportive. With the intention to end the remaining controversy with regard to cell therapy for PAD we conducted a confirmatory, double-blinded randomized placebo-controlled phase 3 trial. STUDY DESIGN: This randomized controlled trial was registered (NCT00539266)...
July 12, 2018: Annals of Surgery
Linda M O'Neill, Emer Guinan, Suzanne L Doyle, Annemarie E Bennett, Conor Murphy, Jessie A Elliott, Jacintha OʼSullivan, John V Reynolds, Juliette Hussey
OBJECTIVE: The Rehabilitation Strategies in Esophagogastric cancer (RESTORE) randomized controlled trial evaluated the efficacy of a 12-week multidisciplinary program to increase the cardiorespiratory fitness and health-related quality of life (HRQOL) of esophagogastric cancer survivors. BACKGROUND: Patients following treatment for esophagogastric cancer are at risk of physical deconditioning, nutritional compromise, and sarcopenia. Accordingly, compelling rationale exists to target these impairments in recovery...
July 12, 2018: Annals of Surgery
Geertrui Dewinter, Steve Coppens, Marc Van de Velde, André D'Hoore, Albert Wolthuis, Eva Cuypers, Steffen Rex
OBJECTIVE: To investigate the comparative analgesic efficacy of systemic lidocaine and quadratus lumborum (QL) block in laparoscopic colorectal surgery. BACKGROUND: Although epidural analgesia is the standard to control pain in patients undergoing open colorectal surgery, optimal analgesic management in laparoscopic surgery is less well-defined. There is need for effective and efficient alternatives to epidural analgesia for pain management in patients undergoing laparoscopic colorectal surgery...
July 12, 2018: Annals of Surgery
Joonas H Kauppila, Asif Johar, Pernilla Lagergren
OBJECTIVE: To evaluate the impact of postoperative complications on health-related quality of life (HRQOL) up to 10 years after surgery for esophageal cancer. BACKGROUND: The impact of postoperative complications on HRQOL past 5 years is unknown. METHODS: Some 616 patients undergoing open esophageal cancer surgery between April 2, 2001 and December 31, 2005 in Sweden were enrolled in this population-based, nationwide, and prospective cohort study...
July 10, 2018: Annals of Surgery
Naoya Yoshida, Keisuke Kosumi, Ryuma Tokunaga, Yoshifumi Baba, Yohei Nagai, Yuji Miyamoto, Shiro Iwagami, Masaaki Iwatsuki, Yukiharu Hiyoshi, Takatsugu Ishimoto, Kojiro Eto, Yu Imamura, Masayuki Watanabe, Hideo Baba
OBJECTIVE: To elucidate the clinical value of mean corpuscular volume (MCV) for prognostic prediction in patients with esophageal cancer who underwent radical esophagectomy. BACKGROUND: High MCV is suggested to be relevant to the incidence and prognosis of several malignancies. However, few studies investigating the correlation between MCV and survival outcome of esophageal cancer have been conducted. METHODS: This study included 570 patients with esophageal cancer who underwent radical esophagectomy between April, 2005 and December, 2017...
July 10, 2018: Annals of Surgery
Johan Gagnière, Aurélien Dupré, Sepideh S Gholami, Denis Pezet, Thomas Boerner, Mithat Gönen, Thomas P Kingham, Peter J Allen, Vinod P Balachandran, Ronald P De Matteo, Jeffrey A Drebin, Rona Yaeger, Nancy E Kemeny, William R Jarnagin, Michael I D'Angelica
OBJECTIVE: To analyze clinical outcomes and prognostic variables of patients undergoing hepatic resection for BRAF mutant (BRAF-mut) colorectal liver metastases (CRLM). BACKGROUND: Outcomes following hepatectomy for BRAF-mut CRLM have not been well studied. METHODS: All patients who underwent hepatectomy for CRLM with complete resection and known BRAF status during 2001 to 2016 at 3 high-volume centers were analyzed. RESULTS: Of 4124 patients who underwent hepatectomy for CRLM, 1497 had complete resection and known BRAF status...
July 10, 2018: Annals of Surgery
Daniel A Hashimoto, Guy Rosman, Daniela L Rus, Ozanan R Meireles
No abstract text is available yet for this article.
July 10, 2018: Annals of Surgery
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