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Journal of the American College of Surgeons

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https://www.readbyqxmd.com/read/28690207/hypophosphatemia-after-hepatectomy-or-pancreatectomy-role-of-the-nicotinamide-phosphoribosyltransferase
#1
Jian Zheng, Ilya G Glezerman, Eran Sadot, Anjuli McNeil, Cristina Zarama, Mithat Gönen, John Creasy, Linda M Pak, Vinod P Balachandran, Michael I D'Angelica, Peter J Allen, Ronald P DeMatteo, T Peter Kingham, William R Jarnagin, Edgar A Jaimes
BACKGROUND: Postoperative hypophosphatemia is common and is associated with a lower risk of liver failure after hepatectomy but higher morbidity after pancreatectomy. Whether different physiologic mechanisms underlie the hypophosphatemia associated with these very different clinical outcomes is unclear. This study aims to evaluate the underlying mechanism in postoperative hypophosphatemia. STUDY DESIGNS: We prospectively enrolled 120 patients who underwent major hepatectomy (n=30), minor hepatectomy (n=30), pancreatectomy (n=30), and laparotomy without resection (control group, n=30)...
July 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28690206/combination-of-oral-antibiotics-and-mechanical-bowel-preparation-reduces-surgical-site-infection-in-colorectal-surgery
#2
Kerri A Ohman, Leping Wan, Tracey Guthrie, Bonnie Johnston, Jennifer A Leinicke, Sean C Glasgow, Steven R Hunt, Matthew G Mutch, Paul E Wise, Matthew L Silviera
BACKGROUND: Surgical site infections (SSI) are a common complication after colorectal surgery. An infection prevention bundle (IPB) was implemented to improve outcomes. STUDY DESIGN: A standardized IPB that included the administration of oral antibiotics with a mechanical bowel preparation, preoperative shower with chlorhexidine, hair removal and skin preparation in holding, antibiotic wound irrigation, and a "clean-closure" protocol was implemented in January 2013...
July 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28690205/bronchoalveolar-lavage-microvesicles-protect-burn-injured-mice-from-pulmonary-infection
#3
Teresa C Rice, Amanda M Pugh, Brent T Xia, Aaron P Seitz, Brynne E Whitacre, Erich Gulbins, Charles C Caldwell
BACKGROUND: Pseudomonas aeruginosa (PA) is a major cause of morbidity and mortality among burn patients, despite antibiotic therapy. There is a need to identify innate immune defenses that prevent PA infection in injured adults in an effort to find therapeutic alternatives to antibiotics. Here, we tested our hypothesis that Microvesicles (MVs) in bronchoalveolar (BAL) fluid have a role in the immunity of the lung in response to pathogens. STUDY DESIGN: MVs were isolated from murine BAL fluid, quantified using nanoparticle tracking analysis, and injected into burn injured mice prior to PA infection...
July 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28728962/oncologic-safety-of-nipple-sparing-mastectomy-in-women-with-breast-cancer
#4
Barbara L Smith, Rong Tang, Upahvan Rai, Jennifer K Plichta, Amy S Colwell, Michele A Gadd, Michelle C Specht, William G Austen, Suzanne B Coopey
BACKGROUND: Nipple sparing mastectomy (NSM) has gained popularity for breast cancer treatment and prevention. There is limited data about long-term oncologic safety of this procedure. STUDY DESIGN: Review of oncologic outcomes of consecutive therapeutic NSM at a single institution. Nipple sparing mastectomy was offered to patients with no radiologic or clinical evidence of nipple involvement. RESULTS: 2182 NSM were performed from 2007-2016...
July 5, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28687511/first-lieutenant-william-t-fitzsimons-md
#5
Ricardo F Gonzalez-Fisher
No abstract text is available yet for this article.
July 4, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28687510/flange-gastroenterostomy-results-in-reduction-in-delayed-gastric-emptying-after-standard-pancreatoduodenectomy-a-prospective-cohort-study
#6
Adeel S Khan, Greg Williams, Cheryl Woolsey, Jingxia Liu, Ryan C Fields, Majella Mb Doyle, William G Hawkins, Steven M Strasberg
INTRODUCTION: Delayed gastric emptying (DGE) is a common serious problem after pancreatoduodenectomy (PD). Flange gastrojejunostomy (FL-GE) is a previously described technique that creates an internal flange in a hand sewn gastroenterostomy. Results of FL-GE on incidence and severity of DGE after PD are presented. METHODS: Data were extracted from a prospective database of PD. Standard PD with antrectomy were performed -with Flange Gastroenterostomy (FL-GE) or other techniques (NonFL-GE) at a single institution...
July 4, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28687509/postoperative-liver-failure-risk-score-identifying-patients-with-resectable-perihilar-cholangiocarcinoma-who-may-benefit-from-portal-vein-embolization
#7
Pim B Olthof, Jimme K Wiggers, Bas Groot Koerkamp, Robert J Coelen, Peter J Allen, Marc G Besselink, Olivier R Busch, Michael I D'Angelica, Ronald P DeMatteo, T Peter Kingham, Krijn P van Lienden, William R Jarnagin, Thomas M van Gulik
BACKGROUND: Major liver resection for perihilar cholangiocarcinoma (PHC) is associated with a 22-33% postoperative liver failure (LF) incidence. The aim of this study was analyze the predictive value of future liver remnant (FLR) volume for postoperative LF after resection for PHC and to develop a risk score in order to improve patient selection for portal vein embolization (PVE) STUDY DESIGN: A consecutive series of 217 patients underwent major liver resection for PHC between 1997 and 2014 at two Western centers; FLR volumes were calculated with CT volumetry and other variables included jaundice at presentation, immediate preoperative bilirubin, and preoperative cholangitis...
July 4, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28669886/correlation-between-lymphedema-disease-severity-and-lymphoscintigraphic-findings-a-clinical-radiological-study
#8
Reid A Maclellan, David Zurakowski, Stephan Voss, Arin K Greene
BACKGROUND: Lymphoscintigraphy is used to confirm the diagnosis of lymphedema; pathological findings are abnormal transit time to regional nodes and dermal backflow. A universal protocol for the test does not exist. The purpose of this study was to determine if the clinical severity of lymphedema correlates with lymphoscintigraphy findings. METHODS: Patients treated in our Lymphedema Program between 2009 and 2017 were reviewed. Diagnosis of lymphedema was determined by history, physical examination, and lymphoscintigraphy...
June 29, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28669885/evaluation-of-gastric-microcirculation-by-laser-speckle-contrast-imaging-during-esophagectomy
#9
Rikard Ambrus, Michael P Achiam, Niels H Secher, Morten Bs Svendsen, Kim Rünitz, Mette Siemsen, Lars B Svendsen
BACKGROUND: Thoracic epidural anesthesia (TEA) may provoke hypotension, and that, as well as the use of vasopressors and the surgical technique, could affect splanchnic microcirculation, of which the surgical target organ is of particular interest. This study used laser speckle contrast imaging (LSCI) to monitor gastric microcirculation during esophagectomy. STUDY DESIGN: Forty-five patients undergoing open esophagectomy were randomized to primary activation (EA; 25 patients) or no intraoperative activation (LA; 20 patients) of TEA...
June 29, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28652144/extended-segmentectomy-ii-to-left-hepatic-vein-importance-of-preserving-umbilical-fissure-vein-to-avoid-congestion-of-segment-iii
#10
Kosuke Kobayashi, Kiyoshi Hasegawa, Takashi Kokudo, Nobuhisa Akamatsu, Junichi Arita, Junichi Kaneko, Yoshihiro Sakamoto, Norihiro Kokudo
No abstract text is available yet for this article.
June 23, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28668274/impact-of-time-between-diagnosis-and-slnb-on-outcomes-in-cutaneous-melanoma
#11
Daniel W Nelson, Stacey Stern, David E Elashoff, Robert Elashoff, John F Thompson, Nicola Mozzillo, Omgo E Nieweg, Harald J Hoekstra, Alistair J Cochran, Mark B Faries
BACKGROUND: Hypothetically, delay between melanoma diagnosis and SLNB could affect outcomes, either adversely by allowing growth and dissemination of metastases, or beneficially by allowing development of an anti-melanoma immune response. Available data are conflicting about the effect of SLNB delay on patient survival. Our objective was to determine whether delay between initial diagnosis and SLNB affects outcomes in patients with cutaneous melanoma. STUDY DESIGN: We performed query and analysis of a large prospectively maintained database of patients with primary cutaneous melanomas undergoing SLNB...
June 16, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28627411/impact-of-procedural-training-on-pregnancy-outcomes-and-career-satisfaction-in-female-postgraduate-medical-trainees-in-the-united-states
#12
Jennifer S Davids, Rebecca E Scully, Nelya Melnitchouk
BACKGROUND: Compared with nonprocedural fields, procedural specialization requires longer training, less flexible schedules, and greater physical demands. The impact of these factors on pregnancy, maternity outcomes, and career satisfaction has not been well described. STUDY DESIGN: Data were gathered from 738 US postgraduate medical trainee mothers via an anonymous, IRB-approved online survey. Univariate analysis was performed using chi-square tests. A logistic regression model was used to investigate the impact of procedural training on odds of assisted reproduction use and pregnancy complications, adjusting for age at first pregnancy...
June 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28610880/comparison-of-analgesic-efficacy-of-laparoscope-assisted-and-ultrasound-guided-transversus-abdominis-plane-block-after-laparoscopic-colorectal-operation-a-randomized-single-blind-non-inferiority-trial
#13
Soo Yeun Park, Jun Seok Park, Gyu-Seog Choi, Hye Jin Kim, Suyoung Moon, Jinseok Yeo
BACKGROUND: Transversus abdominis plane (TAP) block has been used as a component of multimodal analgesia after abdominal operation. We introduced a new laparoscope-assisted TAP (LTAP) block technique using intraperitoneal injection and compared its analgesic effect with that of an ultrasound-guided TAP (UTAP) block in terms of postoperative pain control. STUDY DESIGN: A prospective, randomized, single-blinded non-inferiority clinical trial was conducted with patients undergoing elective laparoscopic colectomy for colon cancer...
June 10, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28606484/short-and-long-term-outcomes-after-a-reconstituting-and-fenestrating-subtotal-cholecystectomy
#14
Aafke H van Dijk, Sandra C Donkervoort, Wytze Lameris, Eefje de Vries, Quirijn Aj Eijsbouts, Bart C Vrouenraets, Olivier R Busch, Marja A Boermeester, Philip R de Reuver
BACKGROUND: Multiple surgical techniques are advised to safely perform cholecystectomy in difficult cases, such as conversion to open surgery or subtotal cholecystectomy (STC). A reconstituting and a fenestrating STC are techniques for STC. The aim of this study was to investigate short and long-term morbidity and quality of life associated with STC and to compare the outcomes after fenestrating and reconstituting STC. STUDY DESIGN: Patients who underwent STC were identified...
June 9, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28606483/a-novel-approach-to-mesh-fixation-in-retrorectus-ventral-hernia-repair-using-fibrin-sealant
#15
Ashkan Moazzez, Emily D Dubina
No abstract text is available yet for this article.
June 9, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28602724/achalasia-treatment-outcomes-utilization-and-costs-a-population-based-study-from-the-united-states
#16
Anne P Ehlers, Brant K Oelschlager, Carlos A Pellegrini, Andrew S Wright, Michael D Saunders, David R Flum, Hao He, Farhood Farjah
OBJECTIVE: Randomized trials show that pneumatic dilatation ≥30mm (PD) and laparoscopic myotomy (LM) provide equivalent symptom relief and disease-related quality of life for patients with achalasia. However, there remain questions about the safety, burden, and costs of treatment options. METHODS: We performed a retrospective cohort study of achalasia patients initially treated with PD or LM (2009-2014) using the Truven Health MarketScan® Research Databases. All patients had one year of follow-up after initial treatment...
June 7, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28579548/syndecan-1-a-quantitative-marker-for-the-endotheliopathy-of-trauma
#17
Erika Gonzalez Rodriguez, Sisse R Ostrowski, Jessica C Cardenas, Lisa A Baer, Jeffrey S Tomasek, Hanne H Henriksen, Jakob Stensballe, Bryan A Cotton, John B Holcomb, Pär I Johansson, Charles E Wade
BACKGROUND: Endothelial glycocalyx breakdown elicits syndecan-1 shedding, and traumatic endotheliopathy (EoT). We hypothesized that a cutoff syndecan-1 level can identify patients with endothelial dysfunction who would have poorer outcomes. STUDY DESIGN: Prospective observational study; trauma patients with the highest level of activation admitted during July 2011-September 2013 were eligible. We recorded demographics, injury type/severity (ISS), physiology and outcome data, and quantified syndecan-1 and soluble thrombomodulin from plasma with ELISAs...
June 1, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28554782/external-validation-of-the-herniascore-an%C3%A2-observational-study
#18
Deepa V Cherla, Maya L Moses, Krislynn M Mueck, Craig Hannon, Tien C Ko, Lillian S Kao, Mike K Liang
BACKGROUND: The HERNIAscore is a ventral incisional hernia (VIH) risk assessment tool that uses only preoperative variables and predictable intraoperative variables. The aim of this study was to validate and modify, if needed, the HERNIAscore in an external dataset. STUDY DESIGN: This was a retrospective observational study of all patients undergoing resection for gastrointestinal malignancy from 2011 through 2015 at a safety-net hospital. The primary end point was clinical postoperative VIH...
May 26, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28633941/pancreatic-cyst-fluid-vascular-endothelial-growth-factor-a-and-carcinoembryonic-antigen-a-highly-accurate-test-for-the-diagnosis-of-serous-cystic-neoplasm
#19
Rosalie A Carr, Michele T Yip-Schneider, Scott Dolejs, Bradley A Hancock, Huangbing Wu, Milan Radovich, C Max Schmidt
BACKGROUND: Accurate differentiation of pancreatic cystic lesions is important for pancreatic cancer early detection and prevention as well as avoidance of unnecessary surgical intervention. Serous cystic neoplasms (SCN) have no malignant potential, but may mimic premalignant mucinous cystic lesions: mucinous cystic neoplasm (MCN) and intraductal papillary mucinous neoplasm (IPMN). We recently identified vascular endothelial growth factor (VEGF)-A as a novel pancreatic fluid biomarker for SCN...
May 18, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28599966/effect-of-american-college-of-surgeons-trauma-center-designation-on-outcomes-measurable-benefit-at-the-extremes-of-age-and-injury
#20
Michael D Grossman, Jay A Yelon, Lisa Szydiak
BACKGROUND: ACS verification is believed to provide benefits for trauma patients but is associated with direct costs. STUDY DESIGN: One-year retrospective review of the NTDB for 2012. Patients separated into three age groups; Pediatric (PEDS) 0-14, Adult 15-65, and elderly (ELD), >65. We analyzed 2 injury severity cohorts, ISS 9-74 (ALL) and ISS 25-74 (MAJ). Multiple logistic regression to determine significance of ACS verification on mortality and major complications, controlling for age, ISS, shock, GCS, gender, age, co-morbidities and mechanism...
May 18, 2017: Journal of the American College of Surgeons
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