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Journal of the American College of Surgeons

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https://www.readbyqxmd.com/read/29778821/evaluating-mastectomy-skin-flap-necrosis-in-the-extended-breast-reconstruction-risk-assessment-score-for-one-year-prediction-of-prosthetic-reconstruction-outcomes
#1
Nora Hansen, Sasa Espino, Jordan T Blough, Michael M Vu, Neil A Fine, John Ys Kim
BACKGROUND: Rates of mastectomy for breast cancer treatment and immediate reconstruction continue to rise. With increasing scrutiny on outcomes and patient satisfaction, there is an impetus for providers to be more deliberate in deciding appropriate patient selection for breast reconstruction. The Breast Reconstruction Risk Assessment (BRA) Score was developed for prediction of complications after primary prosthetic breast reconstruction, focusing on calculating risk estimations for a variety of complications based on individual patient demographics and perioperative characteristics...
May 17, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29753982/does-urinary-bisphenol-a-change-after-bariatric-surgery
#2
Carl L Dambkowski, Luis Garcia, Natalia Leva, John M Morton
BACKGROUND: One of the world's highest volume chemicals is bisphenol-A (BPA), an organic compound with a high solubility in fat. An emerging body of literature has suggested a link between BPA and obesity and insulin resistance. The study aim is to determine if surgical weight loss is associated with changes in BPA levels. METHODS: Demographic, preoperative, and 3, 6, and 12 month postoperative urine and laboratory data were prospectively collected on 22 bariatric surgery patients at a single academic institution...
May 10, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29752997/indications-and-perioperative-outcomes-for-pancreatectomy-with-arterial-resection
#3
May C Tee, Adam C Krajewski, Ryan T Groeschl, Michael B Farnell, David M Nagorney, Michael L Kendrick, Sean P Cleary, Rory L Smoot, Kristopher P Croome, Mark J Truty
BACKGROUND: Pancreatectomy with AR is infrequently performed. As indications evolve, we evaluated indications, outcomes and predictors of mortality, morbidity, and survival after AR. STUDY DESIGN: Single-institution review of elective pancreatectomies with AR (7/1990-7/2017). Univariate/multivariate analyses performed for predictors of outcomes and survival. RESULTS: Total of 111 patients underwent pancreatectomy with AR including any hepatic (54%), any celiac (44%), any superior mesenteric (14%), or multiple ARs (14%) with revascularization in 55%...
May 9, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29746919/opioid-medication-use-in-the-surgical-patient-an-assessment-of-prescribing-patterns-and-utilization
#4
Wen Hui Tan, Jennifer Yu, Sara Feaman, Jared M McAllister, Lindsey G Kahan, Mary A Quasebarth, Jeffrey A Blatnik, J Christopher Eagon, Michael M Awad, L Michael Brunt
BACKGROUND: With the epidemic of prescription opioid abuse in the United States, rates of opioid-related unintentional deaths have risen dramatically. However, little data exists comparing postoperative opioid prescriptions with patient use. We sought to better elucidate this relationship in surgical patients. STUDY DESIGN: A prospective cohort study was conducted of narcotic-naïve patients undergoing open and laparoscopic abdominal procedures on a minimally invasive surgery service...
May 7, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29746918/circulating-tumor-cells-in-stage-iv-melanoma-patients
#5
Carolyn S Hall, Merrick Ross, Jessica B Bowman Bauldry, Joshua Upshaw, Mandar G Karhade, Richard Royal, Sapna Patel, Anthony Lucci
BACKGROUND: Management of stage IV melanoma patients remains a challenge. In spite of promising new therapies, many patients develop resistance and progression. The aim of this pilot study was to determine if CTCs are associated with shortened (180-day) progression-free survival (PFS) following a baseline CTC assessment in stage IV melanoma patients. METHODS: A baseline CTC assessment was performed in 93 stage IV melanoma patients using a commercially available immunomagnetic system...
May 7, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29733906/cadaver-based-trauma-procedural-skills-training-skills-retention-30-months-after-training-among-practicing-surgeons-in-comparison-to-experts-or-more-recently-trained-residents
#6
Colin F Mackenzie, Mark W Bowyer, Sharon Henry, Samuel A Tisherman, Adam Puche, Hegang Chen, Valerie Shalin, Kristy Pugh, Evan Garofalo, Stacy A Shackelford
BACKGROUND: Long-term retention of trauma procedural core-competency skills and need for re-training after a one-day cadaver-based course remains unknown. We measured and compared technical skills for trauma core competencies mean 14 months (38 residents), 30 months (35 practicing surgeons) and 46 months (10 experts) after training to determine if skill degradation occurs with time. Technical performance during extremity vascular exposures and lower-extremity fasciotomy in fresh cadavers measured by validated individual procedure score (IPS) was primary outcome...
May 4, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29733905/bouffant-vs-skull-cap-and-impact-on-surgical-site-infection-does-operating-room-headgear-really-matter
#7
Shanu N Kothari, Madeline J Anderson, Andrew J Borgert, Kara J Kallies, Todd J Kowalski
BACKGROUND: The American College of Surgeons (ACS) guidelines indicate that skullcaps are acceptable, while the Association of periOperative Registered Nurses (AORN) recommends bouffant caps. However, no scientific evidence has shown a significant advantage in surgical site infection (SSI) reduction with either cap. The objective of this study was to determine the influence of surgical cap choice on SSIs. STUDY DESIGN: Data from a previously published prospective randomized trial on the impact of hair clipping on SSI were analyzed...
May 4, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29782913/statewide-collaborative-to-reduce-surgical-site-infection-results-of-the-hawaii-surgical-unit-based-safety-program
#8
Della M Lin, Kathryn A Carson, Lisa H Lubomski, Elizabeth C Wick, Julius Cuong Pham
BACKGROUND: Surgical Site Infections (SSI) after colorectal surgery are common, lead to patient harm, and are costly to the healthcare system. This study's purpose was to evaluate the effectiveness of the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Surgery in Hawaii. STUDY DESIGN: This pre-post cohort study involved 100% of 15 hospitals in Hawaii from January 2013-June 2015. The intervention was a statewide implementation of the Comprehensive-Unit-based-Safety-Program (CUSP) and individualized bundles of interventions to reduce SSI...
May 3, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29729926/fast-track-two-stage-hepatectomy-using-a-hybrid-interventional-radiology-operating-suite-as-alternative-option-to-alpps-procedure
#9
Bruno C Odisio, Eve Simoneau, Alex A Holmes, Claudius H Conrad, Jean-Nicolas Vauthey
No abstract text is available yet for this article.
May 3, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29723579/perineal-closure-after-abdominoperineal-resection-using-a-pedicled-deep-inferior-epigastric-perforator-flap-a-safe-alternative-to-rectus-abdominis-myocutaneous-flap
#10
Zaher Lakkis, Maxime Laydi, Brice Paquette, Célia Turco, Nicolas Bouviez, Simone Manfredelli, Alexandre Doussot, Julien Pauchot
No abstract text is available yet for this article.
April 30, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29723578/conventional-epidural-vs-transversus-abdominis-plane-block-with-liposomal-bupivacaine-a-randomized-trial-in-colorectal-surgery
#11
Matthew Torgeson, Joel Kileny, Christopher Pfeifer, Lawrence Narkiewicz, Shawn Obi
BACKGROUND: Colorectal surgery is a focus of enhanced recovery protocols (ERP). The utility of Transversus Abdominis Plane block (TAP) for abdominal surgery has demonstrated effectiveness in ERP, however no direct comparison of epidural versus TAP for non-analgesic clinical factors have been published to date. The primary aim of this study was to compare epidural to TAP for length of stay (LOS) in colorectal surgery. STUDY DESIGN: Patients undergoing open and laparoscopic colorectal surgery were prospectively randomized into epidural (n=39) or TAP (n=44) groups preoperatively...
April 30, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29680415/home-antibiotics-at-discharge-for-pediatric-complicated-appendicitis-friend-or-foe
#12
Kathryn Tinsley Anderson, Marisa A Bartz-Kurycki, Akemi L Kawaguchi, Mary T Austin, Galit Holzmann-Pazgal, Lillian S Kao, Kevin P Lally, Kuojen Tsao
BACKGROUND: The role of home discharge antibiotics in children after perforated appendicitis is unclear. This study evaluates the outcomes of complicated appendicitis patients being discharged with or without home antibiotics after initial surgery and in-patient treatment. STUDY DESIGN: The 2015 and 2016 National Surgical Quality Improvement-Pediatric (NSQIP-P) database was queried for patients <18 years of age with complicated appendicitis. Home antibiotics (HA) were prescribed or not (No Home Antibiotics- NHA)...
April 19, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29680414/financial-stability-of-level-i-trauma-centers-within-safety-net-hospitals
#13
Lisa M Knowlton, Arden M Morris, Lakshika Tennakoon, David A Spain, Kristan L Staudenmayer
BACKGROUND: Level I trauma centers often exist within Safety-Net Hospitals (SNHs), facilities servicing high proportions of low-income and uninsured patients. Given the current healthcare funding environment, trauma centers within SNHs may be at particular risk. Using California as a model, we hypothesized that SNHs with trauma centers vary in terms of financial stability. STUDY DESIGN: A retrospective cohort study using data from publically-available financial disclosure reports from California's Office of Statewide Health Planning and Development...
April 19, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29680412/variation-in-medicare-payments-and-reimbursement-rates-for-hepatopancreatic-surgery-based-on-quality-is-there-a-financial-incentive-for-high-quality-hospitals
#14
Jay J Idrees, Brad F Rosinski, Qinyu Chen, Fabio Bagante, Katiuscha Merath, Susan White, Timothy M Pawlik
BACKGROUND: To better define the financial impact of high-quality care for payers and hospitals, we compared outcomes and Medicare payments between high-quality (HQ) and low-quality (LQ) hospitals after hepatopancreatic surgery. STUDY DESIGN: Between 2013 through 2015 15,874 Medicare beneficiaries underwent hepatopancreatic surgery. Using the entire cohort, multivariable logistic regression was performed to categorize hospitals into quintiles based on the probability of experiencing a major complication; HQ (bottom 20%) and LQ (top 20%) hospitals were identified...
April 19, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29680413/freedom-with-responsibility-a-consensus-strategy-for-preventing-injury-death-and-disability-from-firearm-violence
#15
Ronald M Stewart, Deborah A Kuhls, Michael F Rotondo, Eileen M Bulger
Reducing violence-related, intentional injury (including intentional firearm-related injury) requires a multifaceted, integrated public health approach. This requires engagement, responsibility and partnership across disciplines, geographic regions, and philosophic differences. A commitment to the values of civility, professionalism, humility and mutual respect are required.
April 18, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29655618/concurrent-surgery-and-the-role-of-the-pediatric-attending-surgeon-comparing-parents-and-surgeons-expectations
#16
Jennie K Choe, Christopher Ibarra, Richard S Feinn, Manuel I Rodriguez-Davalos, Cordelia W Carter
BACKGROUND: The common practice of performing concurrent or overlapping surgeries has been intensely scrutinized by lay media and academic press to investigate its safety and cost-effectiveness. However, there is little information about its use within the pediatric population. Even less is known about parents' expectations regarding the surgeon's role on the day of surgery and how they align with those of pediatric surgeons and surgical trainees, despite the potential for significant discrepancies in expectations to erode trust and damage the physician-family relationship...
April 12, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29709584/resuscitative-endovascular-balloon-occlusion-of-the-aorta-implementation-and-preliminary-results-at-an-academic-level-i-trauma-center
#17
Marcus D Darrabie, Chasen A Croft, Scott C Brakenridge, Alicia M Mohr, Martin A Rosenthal, Frederick A Moore, R Stephen Smith
BACKGROUND: REBOA is a novel method of controlling subdiaphragmatic hemorrhage while improving hemodynamic stability. This procedure achieves many of the goals of resuscitative thoracotomy (RT), but is less invasive. Herein, we present the initial experience with REBOA at a level 1 academic trauma center. STUDY DESIGN: A retrospective review was performed. Orientation of surgeons and residents to REBOA was accomplished by an educational program including a hands-on simulation session (1...
April 11, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29653881/battlefield-to-bedside-bringing-precision-medicine-to-surgical-care
#18
Arnaud Belard, Seth Schobel, Matthew Bradley, Benjamin Kyle Potter, Christopher Dente, Timothy Buchman, Allan Kirk, Eric Elster
No abstract text is available yet for this article.
April 10, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29627334/preoperative-risk-score-to-predict-occult-metastatic-or-locally-advanced-disease-in-patients-with-resectable-perihilar-cholangiocarcinoma-on-imaging
#19
Jimme K Wiggers, Bas Groot Koerkamp, David van Klaveren, Robert J Coelen, C Yung Nio, Peter J Allen, Marc G Besselink, Olivier R Busch, Michael I D'Angelica, Ronald P DeMatteo, T Peter Kingham, Thomas M van Gulik, William R Jarnagin
BACKGROUND: Many patients with resectable perihilar cholangiocarcinoma (PHC) on imaging are intra-operatively diagnosed with occult metastatic or locally advanced disease precluding a curative-intent resection. This study aimed to develop and validate a preoperative risk score. STUDY DESIGN: Patients with resectable PHC on imaging who underwent surgery in two high-volume centers (USA and Europe) between 2000 and 2015 were included. Multivariable logistic regression analysis was used to develop the risk score...
April 5, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29609024/short-interval-between-preoperative-short-course-radiotherapy-and-operation-for-rectal-cancer-increases-anastomotic-leakage
#20
Cloë L Sparreboom, Zhouqiao Wu, Hester F Lingsma, Anand G Menon, Gert-Jan Kleinrensink, Joost J Nuyttens, Michel Wjm Wouters, Johan F Lange
BACKGROUND: Short-course preoperative radiotherapy is indicated in patients with resectable rectal cancer to control local recurrence. Although no clear evidence is available, short-course radiotherapy with surgery within a week is common practice. The aim of this study was to investigate the impact of timing of surgery for rectal cancer after short-course radiotherapy on anastomotic leakage. STUDY DESIGN: Data from the Dutch ColoRectal Audit (DCRA) were used. All patients who received short-course preoperative radiotherapy and underwent elective surgery within 14 days for rectal cancer between January 1st, 2011 and December 31th, 2016 were included...
March 30, 2018: Journal of the American College of Surgeons
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