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Journal of the American College of Surgeons

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https://www.readbyqxmd.com/read/28216422/systemic-chemotherapy-combined-with-resection-for-locally-advanced-gallbladder-carcinoma-surgical-and-survival-outcomes
#1
John M Creasy, Debra A Goldman, Vikas Dudeja, Maeve A Lowery, Andrea Cercek, Vinod P Balachandran, Peter J Allen, Ronald P DeMatteo, T Peter Kingham, Michael I D'Angelica, William R Jarnagin
BACKGROUND: Preoperative chemotherapy is a strategy for conversion to resection and/or assessing disease biology prior to operation. The utility of such an approach in gallbladder carcinoma (GBCA) is unknown. This study evaluates outcomes of GBCA patients treated with chemotherapy for locally advanced or lymph node involved tumors. STUDY DESIGN: Patients that received systemic chemotherapy for locally advanced or lymph node positive GBCA were identified from a departmental database...
February 12, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28196693/public-perceptions-of-overlapping-surgery
#2
Michael Kent, Richard Whyte, Aaron Fleishman, David Tomich, Lachlan Forrow, James Rodrigue
BACKGROUND: Overlapping surgery is highly contentious, both in regards to the safety of the practice and the degree to which patients should be informed. However, no study has surveyed attitudes of the general public in regards to overlapping surgery, and willingness to consent to such a procedure. STUDY DESIGN: A survey regarding overlapping surgery was completed by participants using Amazon Mechanical Turk (mTurk), an online crowd-sourcing worksite. Responders completed a 51-question survey regarding their knowledge of overlapping surgery, expectations regarding disclosure during the informed consent process, and their willingness to participate in such a procedure...
February 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28189662/operating-room-fires-and-surgical-skin-preparation
#3
Edward L Jones, Douglas M Overbey, Brandon C Chapman, Teresa S Jones, Sarah A Hilton, John T Moore, Thomas N Robinson
BACKGROUND: Operating room fires are "never" events that remain an under-reported source of devastating complications. One common set-up which promotes fires is the use of surgical skin preparations combined with electrosurgery and oxygen. Limited data exist examining the incidence of fires and surgical skin preps. STUDY DESIGN: A standardized, ex-vivo model was created with a 15x15cm section of clipped, porcine skin. An electrosurgical "Bovie" pencil was activated for 2 seconds on 30Watts coagulation mode in 21% oxygen (room air) both immediately and 3 minutes following skin prep application...
February 8, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28188839/if-charles-l-scudder-could-see-us-now
#4
J Wayne Meredith
No abstract text is available yet for this article.
February 7, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28188838/lymph-node-positivity-in-appendiceal-adenocarcinoma-should-size-matter
#5
John V Gahagan, Matthew D Whealon, Michael J Phelan, Steven Mills, Alessio Pigazzi, Michael J Stamos, Ninh T Nguyen, Joseph C Carmichael
BACKGROUND: The management algorithm for appendiceal adenocarcinoma is not well defined. This study sought to determine whether tumor size or depth of invasion better correlates with the presence of lymph node metastases in appendiceal adenocarcinoma, and to compare these rates to colon adenocarcinoma. STUDY DESIGN: A retrospective review of the National Cancer Database was performed to identify patients with appendiceal or colonic adenocarcinoma from 2004 to 2013 who underwent surgical resection...
February 7, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28167228/comparison-of-conflict-of-interest-among-published-hernia-researchers-self-reported-to-the-centers-of-medicare-and-medicaid-services-open-payments-database
#6
Oscar A Olavarria, Julie L Holihan, Deepa Cherla, Cristina A Perez, Lillian S Kao, Tien C Ko, Mike K Liang
INTRODUCTION: Many healthcare providers have financial interests and relationships with healthcare companies. In order to maintain transparency, investigators are expected to disclose their conflicts of interest (COI). Recently, the Centers of Medicare and Medicaid Services (CMS) developed an open payment database of COI reported by industry. We hypothesize there is discordance between industry-reported and physician self-reported COI among ventral hernia publications. METHODS: PubMed was searched for ventral hernia studies accepted for publication between June 2013 and October 2015 and published by authors from the United States...
February 3, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28167227/public-private-partnership-model-to-provide-humanitarian-services-in-developing-countries
#7
Rahul M Jindal, Thakor G Patel, Stephen G Waller
No abstract text is available yet for this article.
February 3, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28167226/outcomes-icu-utilization-and-length-of-stay-in-chronically-ill-black-and-white-children-on-medicaid-hospitalized-for-surgery
#8
Jeffrey H Silber, Paul R Rosenbaum, Shawna Calhoun, Joseph G Reiter, Alexander S Hill, Orit Even-Shoshan, William J Greeley
BACKGROUND: With increasing Medicaid coverage, it has become especially important to determine if racial differences exist within the Medicaid system. We asked if disparities exist in hospital practice and patient outcomes between matched black and white Medicaid children with chronic conditions undergoing surgery. STUDY DESIGN: A matched cohort study, matching 6,398 pairs within states on detailed patient characteristics, using data from 25 states contributing adequate Medicaid Analytic eXtract (MAX) claims for dmissions of children with chronic conditions undergoing the same surgical procedures between January 1, 2009 and November 30, 2010 for ages 1-18 years...
February 3, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28167225/no-child-left-behind-liver-transplantation-in-critically-ill-children
#9
Abbas Rana, Michael Kueht, Moreshwar Desai, Fong Lam, Tamir Miloh, Jennifer Moffett, N Thao N Galvan, Ronald Cotton, Christine O'Mahony, John Goss
BACKGROUND: Advances in critical care prolong survival in children with liver failure, allowing more critically ill children to undergo orthotopic liver transplantation (OLT). In order to justify the use of a scarce donor resource and avoid futile transplants, we sought to determine survival in children who undergo OLT while receiving pre-OLT critical care. STUDY DESIGN: We analyzed 13,723 pediatric OLTs using the United Network for Organ Sharing (UNOS) database from 1987 to 2015, including 6,746 recipients in the Model for End-Stage Liver Disease/Pediatric End-Stage Liver Disease (MELD/PELD) era (2002 to 2015)...
February 3, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28163089/comparative-effectiveness-of-minimally-invasive-surgery-and-conventional-approaches-to-major-or-challenging-hepatectomy
#10
Lucas W Thornblade, Xu Shi, Alex Ruiz, David R Flum, James O Park
BACKGROUND: The benefits of minimally invasive surgery (MIS) for low-risk or minor liver resection are well established. There is growing interest in MIS for major hepatectomy (MH) and other challenging resections, but there remain unanswered questions of safety that prevent broad adoption of this technique. STUDY DESIGN: Retrospective cohort study of patients undergoing hepatectomy at 65 hospitals participating in the NSQIP Hepatopancreatobiliary Collaborative in 2014...
February 2, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28161484/twenty-year-experience-with-aorto-enteric-fistula-repair-gastrointestinal-complications-predict-mortality
#11
Atish Chopra, Lucyna Cieciura, J Gregory Modrall, R James Valentine, Jayer Chung
BACKGROUND: Aorto-enteric fistulae (AEF) represent a lethal subset of aortic graft infections. The optimal management of AEF remains unclear. We aimed to identify predictors of morbidity and mortality. STUDY DESIGN: We performed a single-center retrospective review of consecutive AEF repairs. Demographics, co-morbidities, and peri-operative variables were obtained. Descriptive statistics, Chi-squared, Kruskall-Wallis, and Cox proportional-hazards modeling were utilized where appropriate...
February 1, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28161483/onlay-with-adhesive-use-compared-to-sublay-mesh-placement-in-ventral-hernia-repair-was-chevrel-right-an-americas-hernia-society-quality-collaborative-analysis
#12
Ivy N Haskins, Guy R Voeller, Nathaniel F Stoikes, David L Webb, Robert G Chandler, Sharon Phillips, Benjamin K Poulose, Michael J Rosen
BACKGROUND: The use of mesh during ventral hernia repair (VHR) is a well-accepted concept. However, the ideal location of mesh placement remains heavily debated. While VHR with onlay mesh placement has been historically associated with a high rate of wound events, this surgical approach is technically less challenging than VHR with sublay mesh placement. The purpose of this study is to compare onlay mesh placement with adhesive fixation to sublay mesh placement 30-day wound events using the Americas Hernia Society Quality Collaborative (AHSQC) database...
February 1, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28161482/evaluation-of-a-standardized-risk-based-venous-thromboembolism-prophylaxis-protocol-in-the-setting-of-thyroid-and-parathyroid-surgery
#13
Ryan Macht, Ivy Gardner, Stephanie Talutis, Pamela Rosenkranz, Gerard Doherty, David McAneny
BACKGROUND: An elevated odds ratio for venous thromboembolism (VTE) prompted the development of a Caprini risk assessment and risk-based prophylaxis protocol for all General Surgery patients. This system includes pre- and post-operative prophylactic heparin as well as extended courses of low molecular weight heparin for high-risk patients. This study evaluates the safety of this chemoprophylaxis program in thyroid and parathyroid surgery. STUDY DESIGN: A retrospective review was conducted of all General Surgery patients undergoing thyroid or parathyroid operations after the implementation of the Caprini prophylaxis protocol...
February 1, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28159650/impact-of-the-new-kidney-allocation-system-on-perioperative-outcomes-and-costs-in-kidney-transplantation
#14
David J Taber, Derek DuBay, John W McGillicuddy, Satish Nadig, Charles F Bratton, Kenneth D Chavin, Prabhakar K Baliga
BACKGROUND: In December 2014, a new kidney allocation system (KAS) was implemented nationwide with the goal of improving longevity matching, increasing access to sensitized patients, and improving racial/ethnic disparities. STUDY DESIGN: National cohort study of US kidney transplantation programs, analyzing hospital-level outcomes (October 2012 to June 2016) using University HealthSystem Consortium data. In-hospital outcomes and costs were analyzed for trends over time using interrupted time series analysis with segmented regression...
January 31, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28153601/quantitative-assessment-of-tension-reduction-at-the-midline-closure-during-abdominal-components-separation
#15
Ahmed M Afifi, Emily Hartman, Ahmed Talaat, Ashraf Abo Alfotooh, Omar S Omar, Sayed Mareei, Ruston Sanchez, Steve J Kempton
BACKGROUND: Abdominal component separation is commonly utilized for the closure of midline abdominal wounds. The value of each step in reducing tension has not been studied. Our aim is to test if component separation decreases tension in the midline closure and quantify the value of each procedural step. STUDY DESIGN: Tension required to bring the rectus muscle to midline was measured using tensiometry after subcutaneous dissection (Step 1), external oblique muscle release (Step 2), separation of the internal and external oblique muscles (Step 3), and internal oblique muscle release (Step 4)...
January 31, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28147253/minimally-invasive-vs-open-congenital-diaphragmatic-hernia-repair-is-there-a-superior-approach
#16
Luke R Putnam, Kuojen Tsao, Kevin P Lally, Martin L Blakely, Tim Jancelewicz, Pamela A Lally, Matthew T Harting
BACKGROUND: The minimally-invasive (MIS) approach for congenital diaphragmatic hernia (CDH) repair remains controversial. Our objective was to compare outcomes and complications of the MIS and open approaches, with risk-stratification of patients based on defect size and key patient characteristics. STUDY DESIGN: The multi-national CDH Study Group (CDHSG) registry was queried for the period from 2007-2015. Patient demographics and operative details including the CDHSG Staging System defect size (A-D) were reviewed...
January 29, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28147252/novel-calculator-to-estimate-overall-survival-benefit-from-neoadjuvant-chemoradiation-in-patients-with-esophageal-adenocarcinoma
#17
Emmanuel Gabriel, Kristopher Attwood, Rupen Shah, Steven Nurkin, Steven Hochwald, Moshim Kukar
BACKGROUND: Our group published that patients with clinically node negative (cN-) esophageal adenocarcinoma do not derive overall survival (OS) benefit from neoadjuvant chemoradiation (nCRT) compared to clinically node positive (cN+) patients. The aim of this study was to develop a calculator that could more easily identify which patients derive OS benefit from nCRT. STUDY DESIGN: Using the National Cancer Data Base (NCDB), 2006-2012, patients with clinical status T1b-T4a, N-/+, M0 adenocarcinoma of the esophagus who underwent resection were selected...
January 29, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28147251/incidence-and-adverse-prognostic-implications-of-histopathologic-organ-invasion-in-primary-retroperitoneal-sarcoma
#18
Mark Fairweather, Jiping Wang, Vickie Y Jo, Elizabeth H Baldini, Monica M Bertagnolli, Chandrajit P Raut
BACKGROUND: The incidence of histopathologic organ invasion (HOI) in retroperitoneal sarcoma (RPS) is not well described. We reviewed our experience to investigate the rate and prognostic implications of HOI. STUDY DESIGN: Patients with primary RPS who underwent surgery at our institution were reviewed. HOI was defined as microscopic organ invasion confirmed by re-review of pathology slides by an expert sarcoma pathologist. Impact of HOI on the crude cumulative incidence (CCI) of locoregional recurrence (LRR), distant recurrence (DR) and overall survival (OS) rates was analyzed...
January 29, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28143718/comparative-efficacy-of-bilateral-thoracoscopic-splanchnicectomy-for-intractable-pain-secondary-to-pancreatic-cancer-vs-chronic-pancreatitis
#19
Neal Bhutiani, Gerald A Cheadle, Michael H Bahr, Gary C Vitale
BACKGROUND: Splanchnicectomy has been evaluated for treatment of chronic pain in both pancreatic cancer and chronic pancreatitis patients, though its efficacy has not been compared in these two patient populations. This study aims to compare bilateral thoracoscopic splanchnicectomy (BTS) in treatment of abdominal pain secondary to pancreatic cancer (PC) and chronic pancreatitis (CP). METHODS: A University of Louisville database was evaluated from July 1998 to March 2016 for patients undergoing BTS for intractable pain secondary to PC (n=48) or CP (n=75)...
January 28, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28137538/oliver-wendell-holmes-physician-writer-poet-teacher-lecturer-and-more
#20
André Hebra, H Biemann Othersen
No abstract text is available yet for this article.
January 27, 2017: Journal of the American College of Surgeons
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