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Journal of the American College of Surgeons

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https://www.readbyqxmd.com/read/28529137/medicaid-participation-among-liver-transplant-candidates-after-the-affordable-care-act-medicaid-expansion
#1
Dmitry Tumin, Eliza W Beal, Khalid Mumtaz, Don Hayes, Joseph D Tobias, Timothy M Pawlik, W Kenneth Washburn, Sylvester M Black
BACKGROUND: The 2014 Medicaid expansion in participating states increased insurance coverage among people with chronic health conditions, but its implications for access to surgical care remain unclear. We investigated how Medicaid expansion influenced the insurance status of candidates for liver transplantation (LT) and transplant center payor mix. STUDY DESIGN: Data on LT candidates age 18-64 years in 2012-2013 (pre-expansion) and 2014-2015 (post-expansion) were obtained from the United Network for Organ Sharing registry...
May 18, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28529136/preparing-the-bowel-for-surgery-learning-from-the-past-and-planning-for-the-future
#2
REVIEW
John C Alverdy, Neil Hyman, Jack Gilbert, James N Luo, Monika Krezalek
No abstract text is available yet for this article.
May 18, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28522168/is-pre-hospital-cpr-a-risk-factor-for-early-death-in-patients-transferred-to-an-adult-burn-center
#3
Kanika Trehan, Stacey Rotta, Shea C Gregg, Kristen Glasgow, Roselle E Crombie, Walter M Cholewczynski, Nabil Atweh, Alisa Savetamal
BACKGROUND: Burn patients who require cardiopulmonary resuscitation (CPR) prior to admission to a Burn Center are anecdotally known to suffer higher mortality than those who do not require pre-hospital CPR. STUDY DESIGN: A retrospective chart review identified adult patients admitted to our burn center between 2013 and 2015. Included patients met one or both of the following criteria: (1) 20 percent or more total body surface area (%TBSA) burned and (2) need for intubation prior to admission to our facility...
May 15, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28483605/intramural-surgery-a-new-vista-in-minimally-invasive-therapy
#4
Andrew T Strong, John Rodriguez, Matthew Kroh, Jeffrey L Ponsky
Endoscopic therapy for lesions of the gastrointestinal tract has become commonplace. Endoscopic excision of polyps was introduced over four decades ago. Today, removal of large, sessile lesions by means of endoscopic mucosal resection or endoscopic submucosal dissection is increasingly employed throughout the gastrointestinal tract. A decade ago, the concept of trans-lumenal endoscopic surgery was introduced. Although not widely practiced, it ushered in development of new concepts and technology which have contributed extensively to the growth of endoscopic and laparoscopic surgical practice...
May 5, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28483604/selective-approach-for-patients-with-advanced-malignancy-and-gastrointestinal-obstruction
#5
Deep Pujara, Yi-Ju Chiang, Janice N Cormier, Eduardo Bruera, Brian Badgwell
BACKGROUND: The purpose of this study was to determine the frequency of tumor-related gastrointestinal obstruction and identify variables associated with functional outcome and survival in patients with advanced malignancy and gastrointestinal obstruction. STUDY DESIGN: We reviewed the medical records of 490 patients with advanced cancer who underwent surgical consultation for gastrointestinal obstruction between January 2000 and May 2014. We used chi-square and logistic regression analyses to identify variables associated with survival and eating at discharge...
May 5, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28455251/triphasic-dynamic-contrast-enhanced-computed-tomography-in-the-differentiation-of-benign-and-malignant-gallbladder-polypoid-lesions
#6
Wei Zhou, Guichen Li, Ling Ren
OBJECTIVE: With triphasic dynamic contrast-enhanced CT scan to identify benign and malignant gallbladder polypoid lesions, we hope to find out an accurate diagnosis before surgery. MATERIALS AND METHODS: Ninety patients with gallbladder polypoid lesions were treated surgically in Department of Hepatobiliary Surgery, the First Affiliated Hospital of China Medical University (Shenyang, China) from July 2013 to July 2016, and divided into malignant group with 44 patients, and benign group with 46, according to postoperative pathological results...
April 25, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28450062/laparoscopic-vs-robotic-intraperitoneal-mesh-repair-for-incisional-hernia-an-americas-hernia-society-quality-collaborative-analysis
#7
Ajita S Prabhu, Eugene O Dickens, Chad M Copper, John W Mann, Jonathan P Yunis, Sharon Phillips, Li-Ching Huang, Benjamin K Poulose, Michael J Rosen
BACKGROUND: Robotic intraperitoneal mesh placement (rIPOM) has recently emerged as an alternative to laparoscopic intraperitoneal mesh placement (LapIPOM) for minimally invasive incisional hernia repair. We aimed to compare LapIPOM to rIPOM in terms of hospital length of stay (LOS) and 30-day postoperative complications in patients undergoing incisional hernia repair within the Americas Hernia Society Quality Collaborative (AHSQC) STUDY DESIGN: Propensity score analysis was used to compare matched groups of patients within the AHSQC undergoing LapIPOM versus rIPOM...
April 24, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28445797/development-of-a-clinically-actionable-incisional-hernia-risk-model-after-colectomy-using-the-healthcare-cost-and-utilization-project
#8
Jason M Weissler, Michael A Lanni, Jesse Y Hsu, Michael G Tecce, Martin J Carney, Rachel R Kelz, Justin P Fox, John P Fischer
BACKGROUND: Incisional hernia (IH) remains a persistent and burdensome complication following colectomy. Through individualized risk-assessment and prediction models, we aim to: 1) improve preoperative risk counseling for patients undergoing colectomy; 2) identify modifiable preoperative risk factors; and 3) encourage the utilization of evidence-based risk prediction instruments in the clinical setting. STUDY DESIGN: A retrospective review of the Healthcare Cost and Utilization Project (HCUP) data was conducted for all patients undergoing either open or laparoscopic colectomy as identified through the state inpatient databases (SID) of California, Florida and New York in 2009...
April 23, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28445796/decreasing-the-use-of-damage-control-laparotomy-in-trauma-a-quality-improvement-project
#9
John A Harvin, Lillian S Kao, Mike K Liang, Sasha D Adams, Michelle K McNutt, Joseph D Love, Laura J Moore, Charles E Wade, Bryan A Cotton, John B Holcomb
BACKGROUND: Our institution has published damage control laparotomy (DCL) rates of 30% and documented the substantial morbidity associated with the open abdomen. The purpose of this quality improvement (QI) project was to decrease the rate of DCL at a busy, Level I trauma center in the US. STUDY DESIGN: A prospective cohort of all emergent trauma laparotomies from November 2013 to October 2015 (QI group) was followed. The QI intervention was multifaceted and included audit and feedback for every DCL case...
April 23, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28445795/a-novel-approach-to-calculating-small-intestine-length-based-on-magnetic-resonance-enterography
#10
Nicole A Wilson, Hyung-Soon Park, Kyoung Soub Lee, Lauren K Barron, Brad W Warner
BACKGROUND: Bowel length is an important factor in the management of patients with intestinal failure and short bowel syndrome (SBS). However, it is difficult to accurately measure the length of the small intestine. Our purpose was to demonstrate the feasibility of a dedicated software algorithm for calculating small intestine length based on magnetic resonance enterography (MRE) images. STUDY DESIGN: A custom algorithm for image thresholding, wall-identification, segmentation, and path extraction was designed and implemented...
April 23, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28445794/post-transplant-malignancy-after-pediatric-kidney-transplantation-retrospective-analysis-of-incidence-and-risk-factors-in-884-patients-transplanted-between-1963-and-2015-at-the-university-of-minnesota
#11
Oscar K Serrano, Ananta S Bangdiwala, David M Vock, Srinath Chinnakotla, Ty B Dunn, Erik B Finger, Raja Kandaswamy, Timothy L Pruett, John S Najarian, Arthur J Matas, Blanche M Chavers
BACKGROUND: Post-transplant malignancy (PTM) remains a concern among pediatric kidney transplant (PKT) recipients. STUDY DESIGN: Between 1963 and 2015, 884 pediatric (age: 0-17 years old) recipients received 1055 PKTs at our institution. Cox proportional hazards models were constructed to identify risk factors for PTM after PKT with time-to-first-PTM as a primary outcome. Secondly, the hazard of death or graft loss was calculated in patients who developed PTM. RESULTS: Median patient survival was 33 years (interquartile range [IQR]: 18...
April 23, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28445793/predictors-of-30-day-pulmonary-complications-after-outpatient-surgery-relative-importance-of-body-mass-index-weight-classifications-in-risk-assessment
#12
Gildasio S De Oliveira, Robert J McCarthy, Kristopher Davignon, Herb Chen, Heather Panaro, William G Cioffi
BACKGROUND: The current literature is controversial regarding the importance of obese body mass index (BMI) classifications as a risk factor for pulmonary complications following outpatient surgery. The objective of the current investigation was to evaluate predictors of pulmonary outcomes following outpatient surgery and to assess the importance of BMI weight classifications in risk assessment. STUDY DESIGN: Patients with "outpatient" recorded as their inpatient/outpatient status in the 2012-2013 NSQIP database were included...
April 23, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28522144/viscoelastic-tissue-plasminogen-activator-challenge-predicts-massive-transfusion-in-15-minutes
#13
Hunter B Moore, Ernest E Moore, Michael P Chapman, Benjamin R Huebner, Peter M Einersen, Solimon Oushy, Christopher C Silliman, Anirban Banerjee, Angela Sauaia
BACKGROUND: Coagulopathy is associated with massive transfusion in trauma, yet most clinical scores to predict this end point do not incorporate coagulation assays. Previous work has identified that shock increases circulating tissue plasminogen activator (tPA). When tPA levels saturate endogenous inhibitors, systemic hyperfibrinolysis can occur. Therefore, the addition of tPA to a patient's blood sample could stratify a patients underlying degree of shock and early coagulation changes to predict progression to massive transfusion...
April 17, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28414115/cost-analysis-of-a-surgical-consensus-guideline-in-breast-conserving-surgery
#14
Jennifer Yu, Leisha C Elmore, Amy E Cyr, Rebecca L Aft, William E Gillanders, Julie A Margenthaler
BACKGROUND: The Society of Surgical Oncology and American Society of Radiation Oncology consensus statement was the first professional guideline in breast oncology to declare "no ink on tumor" as a negative margin in patients with stages I/II breast cancer undergoing breast-conservation therapy. We sought to analyze the financial impact of this guideline at our institution using a historic cohort. STUDY DESIGN: We identified women undergoing re-excision after breast-conserving surgery for invasive breast cancer from 2010 through 2013 using a prospectively maintained institutional database...
April 14, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28414114/why-do-long-distance-travelers-have-improved-pancreatectomy-outcomes
#15
Manila Jindal, Chaoyi Zheng, Humair S Quadri, Chukwuemeka U Ihemelandu, Young K Hong, Andrew K Smith, Vikas Dudeja, Nawar M Shara, Lynt B Johnson, Waddah B Al-Refaie
BACKGROUND: Centralization of complex surgical care has led patients to travel longer distances. Emerging evidence suggested a negative association between increased travel distance and mortality after pancreatectomy. However, the reason for this association remains largely unknown. We sought to unravel the relationships among travel distance, receiving pancreatectomy at high-volume hospitals, delayed surgery, and operative outcomes. STUDY DESIGN: We identified 44,476 patients who underwent pancreatectomy for neoplasms between 2004 and 2013 at the reporting facility from the National Cancer Database...
April 14, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28414117/global-surgery-lifeline-for-the-us-military-surgeon
#16
Dallas G Hansen
No abstract text is available yet for this article.
April 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28414116/the-largest-european-single-center-experience-300-laparoscopic-pancreatic-resections
#17
Safi Dokmak, Fadhel Samir Ftériche, Béatrice Aussilhou, Philippe Lévy, Philippe Ruszniewski, Jérome Cros, Marie Pierre Vullierme, Linda Khoy Ear, Jacques Belghiti, Alain Sauvanet
BACKGROUND: Although laparoscopic pancreatic resection (LPR) has become routine, large single-center series are still lacking. Our aim was to analyze the results of a large European single-center series of LPR. STUDY DESIGN: Between January 2008 and September 2015, 300 LPRs were performed and studied prospectively, including 165 (55%) distal pancreatectomies, 68 (23%) pancreaticoduodenectomies (PDs), 30 (10%) enucleations, 35 (11%) central pancreatectomies, and 2 (1%) total pancreatectomies...
April 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28412539/laparoscopic-reoperative-antireflux-surgery-is-more-cost-effective-than-open-approach
#18
Farzaneh Banki, Matthew Weaver, David Roife, Chandni Kaushik, Anshu Khanna, Kelly Ochoa, Charles C Miller
BACKGROUND: We previously reported on the outcomes of laparoscopic and open reoperative antireflux surgery. The aim of this study was to compare the costs of these procedures. STUDY DESIGN: We performed a retrospective review. Financial and procedure coding data were obtained using a cost accounting system. There were 49 procedures in 46 patients (36 female and 10 male). There were 38 laparoscopic (including 4 conversions) and 11 open procedures (7 transabdominal repairs and 4 gastric-preserving Roux-en-Y esophagojejunostomy)...
April 12, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28408311/validation-of-a-difficulty-scoring-system-for-laparoscopic-liver-resection-a-multicenter-analysis-by-the-endoscopic-liver-surgery-study-group-in-japan
#19
Shogo Tanaka, Shoji Kubo, Akishige Kanazawa, Yutaka Takeda, Fumitoshi Hirokawa, Hiroyuki Nitta, Takayoshi Nakajima, Takashi Kaizu, Hironori Kaneko, Go Wakabayashi
BACKGROUND: Laparoscopic liver resection (LLR) is widely used for hepatic disease treatment. Preoperative prediction of operative difficulty can be beneficial as a roadmap for surgeons advancing from simple to highly technical LLR. We performed a multicenter analysis to investigate a "difficulty scoring system" for predicting the difficulty of LLR. STUDY DESIGN: The proposed "difficulty scoring system" includes 3 difficulty levels based on 5 factors. The system was validated in a cohort of 2,199 patients who underwent LLR at 74 Japanese centers between 2010 and 2014; the difficulty level was rated as low (n = 965), intermediate (n = 891), and high (n = 343)...
April 10, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28400300/neoadjuvant-locoregional-therapy-and-recurrent-hepatocellular-carcinoma-after-liver-transplantation
#20
Min Xu, Mb Majella Doyle, Babak Banan, Neeta Vachharajani, Xuanchuan Wang, Nael Saad, Kathryn Fowler, Elizabeth M Brunt, Yiing Lin, William C Chapman
BACKGROUND: Neoadjuvant locoregional therapies (LRTs) have been widely used to reduce tumor burden or to downstage hepatocellular carcinoma (HCC) before orthotopic liver transplantation (OLT). We examined the impact of LRT response on HCC recurrence after OLT. STUDY DESIGN: We performed a retrospective study of 384 patients with HCC treated by OLT. Tumor necrosis was determined by pathologic evaluation. The vascular and lymphatic vessels were localized by immunofluorescence staining in formalin-fixed, paraffin-embedded tissue; expressions of vascular endothelial growth factor receptor (VEGFR)-2 and VEGFR-3 were analyzed by Western blot...
April 9, 2017: Journal of the American College of Surgeons
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