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Journal of the American College of Surgeons

Danielle Berglund, Varvara Kirchner, Timothy Pruett, Saumya Mangalick, Raja Kandaswamy, Oscar K Serrano, Bradley Benson, Steven Mongin, John Lake, Srinath Chinnakotla
BACKGROUND: Living liver donation is one of the most selfless and humane acts a person can perform. Few single-center reports have been published specifically evaluating complications and quality of life postdonation. STUDY DESIGN: A retrospective analysis of outcomes of 176 living liver donors at our center to determine the incidence, type, and Clavien grade of complications, as well as long-term quality of life RESULTS: Of 176 living donors, 154 underwent right hepatectomy; 4, left-hepatectomy lobectomy; and 18, left lateral segmentectomy...
March 16, 2018: Journal of the American College of Surgeons
Colette S Inaba, Christina Y Koh, Sarath Sujatha-Bhaskar, Jack P Silva, Yanjun Chen, Danh V Nguyen, Ninh T Nguyen
BACKGROUND: Contemporary mortality after bariatric surgery is low and has been decreasing over the past two decades. Most studies have reported inpatient or 30-day mortality, which may not represent the true risk of bariatric surgery. The objective of this study was to examine 1-year mortality and factors predictive of 1-year mortality after contemporary laparoscopic bariatric surgery. STUDY DESIGN: Using the 2008-2012 Bariatric Outcomes Longitudinal Database (BOLD), data from 158,606 operations were analyzed, including 128,349 (80...
March 15, 2018: Journal of the American College of Surgeons
Cheryl I Anderson, Marc D Basson, Muhammad Ali, Alan T Davis, Robert L Osmer, Michael K McLeod, Pam S Haan, Robert G Molnar, Andi N Peshkepija, John C Hardaway, Karen A Chojnacki, Christopher C Pfeifer, Jeffrey M Gauvin, Mark W Jones, M Ashraf Mansour
BACKGROUND: It is increasingly important for faculty to teach deliberately and provide timely, detailed and formative feedback on surgical trainee performance. We initiated a multicenter study to improve resident evaluative processes and enhance teaching and learning behaviors while engaging residents in their education. METHODS: Faculty from seven U.S. postgraduate training programs rated resident operative performances using the perioperative briefing, intraoperative teaching, debriefing model (BID) and rated patient visits/academic performances using the entrustable professional activities (EPAs) model via a web-based platform...
March 15, 2018: Journal of the American College of Surgeons
Leticia L Lauricella, Priscila B Costa, Michele Salati, Paulo M Pego-Fernandes, Ricardo M Terra
INTRODUCTION: Database quality measurement should be considered a mandatory step to ensure an adequate level of confidence in data used for research and quality improvement. Several metrics have been described in the literature, but no standardized approach has been established. We aimed to describe a methodological approach applied to measure the quality and inter-rater reliability of a regional multicentric thoracic surgical database (Paulista Lung Cancer Registry, PLCR). METHODS: Data from the first 3 years of the PLCR underwent an audit process with 3 metrics: completeness, consistency, and inter-rater reliability (IRR)...
March 15, 2018: Journal of the American College of Surgeons
John R Potts
No abstract text is available yet for this article.
March 9, 2018: Journal of the American College of Surgeons
Anees B Chagpar, Theodore N Tsangaris, Donald R Lannin
BACKGROUND: Positive margins have been reported in 20-40% of patients undergoing a partial mastectomy (PM), often resulting in re-excision. How often the re-excision yields further cancer and whether there are predictors of residual disease remains unknown. STUDY DESIGN: Patients who had a positive margin (defined as tumor at ink for patients with invasive disease or within 1 mm for patients with DCIS) in the SHAVE trial prior to randomization were evaluated to determine the rate of additional disease either in cavity shave margins (CSM) or at re-excision...
March 7, 2018: Journal of the American College of Surgeons
Nabil Wasif, David Etzioni, Elizabeth B Habermann, Amit Mathur, Barbara A Pockaj, Richard J Gray, Yu-Hui Chang
BACKGROUND: Regionalization of complex visceral surgery across the United States has followed identification of a volume-outcome association. However, a simultaneous trend towards improved surgical outcomes may have attenuated this relationship. We hypothesize that the difference in adjusted postoperative mortality between low, medium and high volume hospitals has decreased over time. STUDY DESIGN: The National Inpatient Sample (NIS) was used to identify patients undergoing bladder, esophageal, pancreatic, liver, lung, and rectal surgery from 2003-2011...
March 7, 2018: Journal of the American College of Surgeons
Abigail Schirmer, Courtney Swan, Steven J Hughes, Terrie Vasilopoulos, Monika Oli, Sana Chaudhry, Nikolaus Gravenstein, Chris Giordano
BACKGROUND: The American College of Surgeons reports that 60% of the hundreds of thousands of surgical site infections occurring annually are preventable. The practice of surgeons taking phone calls while remaining sterile in the operating field is often accomplished by interposing a sterile disposable towel between the phone and their glove. After completing the call, surgeons resume operating. The purpose of our study is to test the conceptual idea of whether bacteria transmit from an inanimate object, such as a telephone, to the gloves of a surgeon through a sterile disposable towel...
March 7, 2018: Journal of the American College of Surgeons
Mary J Edwards, Christopher E White, Kyle N Remick, Kurt D Edwards, Kirby R Gross
No abstract text is available yet for this article.
March 7, 2018: Journal of the American College of Surgeons
Hirofumi Kawanaka, Shoji Hiroshige, Nobuhide Kubo, Teijiro Hirashita, Takeshi Masuda, Yushi Kaisyakuji, Tadahiro Tajiri, Akinori Egashira, Toshifumi Matsumoto, Tokujiro Yano
BACKGROUND: Obturator hernia (OH) is a rare but serious disease associated with high morbidity and mortality because of patients' advanced age and comorbidities. This study evaluated the feasibility of a laparoscopic approach for OH. STUDY DESIGN: We retrospectively reviewed the records of 32 patients (median age: 84 years; 31 women) with OH treated between 2003 and 2016. RESULTS: Five patients with incidental OH underwent totally extraperitoneal (TEP) repair...
March 6, 2018: Journal of the American College of Surgeons
Daniel Gilsdorf, Jake Henrichsen, Katie Liljestrand, Allison Staheli, Griffin Olsen, Prem Narayanan, Mark Ott, David S Morris, Raymond Price
BACKGROUND: The ideal management of common bile duct (CBD) stones remains controversial, whether with single-stage management using laparoscopic CBD exploration (LCBDE) during laparoscopic cholecystectomy, or with two-stage management using preoperative or postoperative endoscopic retrograde cholangiopancreatography (ERCP). We wished to elucidate the practice patterns within our health system, which includes both large urban referral centers and small rural critical access hospitals. STUDY DESIGN: Retrospective data analysis from our 22-hospital, not-for-profit, integrated healthcare system...
March 5, 2018: Journal of the American College of Surgeons
Matthew M Symer, Jonathan S Abelson, Heather L Yeo, Julie A Sosa, M Zachary Rosenthal
BACKGROUND: There is limited understanding of the wide variation in attrition rates among general surgery residencies. We used the validated BIS/BAS (Behavior Inhibitory System/Behavior Approach System) instrument to compare motivational traits among residents who did/not complete surgical training. STUDY DESIGN: All US general surgery categorical interns in the class of 2007-2008 were surveyed with a validated motivational trait assessment tool. American Board of Surgery records from 2008-2016 were used to determine who completed training...
March 3, 2018: Journal of the American College of Surgeons
Jessica Lindemann, Leigh Anne Dageforde, Neeta Vachharajani, Emily Stahlschmidt, Diane Brockmeier, Jason R Wellen, Adeel Khan, William C Chapman, Majella Doyle
BACKGROUND: Donation after cardiac death (DCD) is one method of organ donation. Nationally, more than half of evaluated DCD donors do not yield transplantable organs. There is no algorithm for predicting which DCD donors will be appropriate for organ procurement. DCD program costs from an organ procurement organization (OPO) accounting for all evaluated donors have not been reported. STUDY DESIGN: Hospital, transportation, and supply costs of potential DCD donors evaluated at a single OPO from January 2009 to June 2016 were collected...
March 2, 2018: Journal of the American College of Surgeons
Haley DesJardins, Lindsay Duy, Christopher Scheirey, Thomas Schnelldorfer
BACKGROUND: Management of gallbladder wall calcifications has been controversial for many decades. While the traditionally perceived strong association with gallbladder cancer mandated prophylactic cholecystectomy, newer evidence suggests a much lesser association and may indicate an observational approach. STUDY DESIGN: A retrospective cohort study of 113 patients with gallbladder wall calcifications diagnosed between 2004 and 2016 at a single institution was conducted...
March 2, 2018: Journal of the American College of Surgeons
John C Alverdy
No abstract text is available yet for this article.
March 2, 2018: Journal of the American College of Surgeons
Chetana Lim, Michael Osseis, Eylon Lahat, Daniel Azoulay, Chady Salloum
No abstract text is available yet for this article.
March 1, 2018: Journal of the American College of Surgeons
Thomas Peponis, Trine G Eskesen, Tomaz Mesar, Noelle Saillant, Haytham Ma Kaafarani, D Dante Yeh, Peter J Fagenholz, Marc A de Moya, David R King, George C Velmahos
BACKGROUND: Bile spillage (BS) occurs frequently during laparoscopic cholecystectomy, yet its impact on postoperative outcomes remains unknown. We hypothesized that BS increases the risk of surgical site infections (SSI) after laparoscopic cholecystectomy. STUDY DESIGN: Patients older than 18, who were admitted to an academic hospital for a laparoscopic (or laparoscopic converted to open) cholecystectomy from 05/2010 to 03/2017, were prospectively included. Open cholecystectomies were excluded...
March 1, 2018: Journal of the American College of Surgeons
Mayo H Fujii, Ashley C Hodges, Ruby L Russell, Kristin Roensch, Bruce Beynnon, Thomas P Ahern, Peter Holoch, Jesse S Moore, S Elizabeth Ames, Charles D MacLean
BACKGROUND: The number of deaths from prescription opioids in the United States continues to increase and remains a major public health concern. Opioid-related deaths parallel prescribing trends and post-operative opioids are a significant source of opioids in the community. Our objective was to identify opioid prescribing and use patterns after surgery to inform evidenced-based practices. STUDY DESIGN: Data from a 340-bed academic medical institution and its affiliated outpatient surgical facility included: 1) retrospective medical record data, 2) prospective telephone questionnaire and medical record data...
February 27, 2018: Journal of the American College of Surgeons
Karel D Capek, Linda E Sousse, Gabriel Hundeshagen, Charles D Voigt, Oscar E Suman, Celeste C Finnerty, Kristofer Jennings, David N Herndon
BACKGROUND: The standard of burn treatment today reflects major advances. We sought to quantitate the impact of these advances on burn survival via age-stratified mortality ratios compared with other reported mortality analyses in burns. STUDY DESIGN: Age, percent of the total body surface area (TBSA) burned, presence of inhalation injury, length of stay, and survival status were recorded at admission and at discharge for all new burn admissions between 1989 and 2017...
February 23, 2018: Journal of the American College of Surgeons
Adishesh K Narahari, J Hunter Mehaffey, Robert B Hawkins, Eric J Charles, Pranav K Baderdinni, Anirudha S Chandrabhatla, Joseph W Kocan, R Scott Jones, Gilbert R Upchurch, Irving L Kron, John A Kern, Gorav Ailawadi
BACKGROUND: Obtaining National Institutes of Health (NIH) funding over the last 10 years has become increasingly difficult due to a decrease in the number of research grants funded and an increase in the number of NIH applications. STUDY DESIGN: National Institutes of Health funding amounts and success rates were compared for all disciplines using data from NIH, Federation of American Societies for Experimental Biology (FASEB), and Blue Ridge Medical Institute. Next, all NIH grants (2006 to 2016) with surgeons as principal investigators were identified using the National Institutes of Health Research Portfolio Online Reporting Tools Expenditures and Results (NIH RePORTER), and a grant impact score was calculated for each grant based on the publication's impact factor per funding amount...
February 23, 2018: Journal of the American College of Surgeons
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