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Journal of the American College of Surgeons

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https://www.readbyqxmd.com/read/28818700/vascularized-jejunal-mesenteric-lymph-node-transfer-a-novel-surgical-treatment-for-extremity-lymphedema
#1
Michelle Coriddi, Corrine Wee, Joseph Meyerson, Daniel Eiferman, Roman Skoracki
BACKGROUND: Vascularized lymph node transfer (VLNT) is a surgical treatment for lymphedema. Multiple donor sites have been described and each has significant disadvantages. We propose the jejunal mesentery as a novel donor site for VLNT. METHODS: Cadaveric anatomic study analyzing jejunal lymph nodes (LNs) and description of outcomes from the first patients who received jejunal mesenteric VLNT for treatment of lymphedema. RESULTS: In 5 cadavers, the average number of total LNs and peripheral LNs were identified in the proximal, middle and distal segments of jejunum...
August 14, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28807881/taking-the-initiative-risk-reduction-strategies-and-decreased-malpractice-costs
#2
Steven E Raper, Deborah Rose, Mary Ellen Nepps, Jeffrey A Drebin
BACKGROUND: To heighten awareness of attending and resident surgeons regarding strategies for defense against malpractice claims, a series of Risk Reduction Initiatives (Initiatives) have been carried out in our Department of Surgery (Surgery). We hypothesized that emphasis on certain aspects of risk might be associated with decreased malpractice costs. The relative impact of Surgery Initiatives was assessed when compared to malpractice experience for the rest of the Clinical Practices of the University of Pennsylvania (CPUP)...
August 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28782603/randomized-clinical-trial-of-epidural-compared-to-conventional-analgesia-after-minimally-invasive-colorectal-surgery
#3
Mark H Hanna, Mehraneh D Jafari, Fariba Jafari, Michael J Phelan, Joseph Rinehart, Coral Sun, Joseph C Carmichael, Steven D Mills, Michael J Stamos, Alessio Pigazzi
OBJECTIVE: The effectiveness of thoracic epidural analgesia (EA) versus conventional intravenous analgesia (IV) after minimally invasive surgery (MIS) is still unproven. We designed a randomized controlled trial comparing EA versus IV after MIS colorectal surgery. METHODS: A total of 87 patients who underwent MIS colorectal procedures at a single institution between 2011 and 2014 were enrolled. 8 patients were excluded and 38 were randomized to EA and 41 to IV. Pain was assessed with the visual analogue scale (VAS) and quality of life with the Overall Benefit of Analgesia Score (OBAS) daily until discharge...
August 3, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28797562/surgical-technical-evidence-review-for-colorectal-surgery-conducted-for-the-ahrq-safety-program-for-improving-surgical-care-and-recovery
#4
REVIEW
Kristen A Ban, Melinda M Gibbons, Clifford Y Ko, Elizabeth C Wick
No abstract text is available yet for this article.
July 27, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28754410/laparoscopic-adjustable-gastric-band-explantation-and-implantation-at-academic-centers
#5
Christina Y Koh, Colette S Inaba, Sarath Sujatha-Bhaskar, Samuel Hohmann, Jaime Ponce, Ninh T Nguyen
BACKGROUND: The laparoscopic adjustable gastric band (LAGB) was approved for use in the US in 2001 and has been found to be a safe and effective surgical treatment for morbid obesity. However, there is a recent trend toward reduced use of LAGB nationwide. The objective of this study was to examine the prevalence and outcomes of primary LAGB implantation compared with revision and explantation at academic centers. STUDY DESIGN: Data were obtained from the Vizient database from 2007 through 2015...
July 25, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28739154/prostaglandin-e2-a-pancreatic-fluid-biomarker-of-intraductal-papillary-mucinous-neoplasm-dysplasia
#6
Michele T Yip-Schneider, Rosalie A Carr, Huangbing Wu, C Max Schmidt
BACKGROUND: With the increased frequency of diagnostic imaging, pancreatic cysts are now detected in >3% of American adults. Most of these are intraductal papillary mucinous neoplasm (IPMN) with well-established but variable malignant potential. A biomarker that predicts malignant potential or dysplastic grade would help determine which IPMN require removal or can be safely observed. We previously reported that pancreatic fluid prostaglandin E2 (PGE2) levels may have promise as a predictor of IPMN dysplasia and seek to validate these results in the current study...
July 21, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28739153/active-donor-management-during-the-hospital-phase-of-care-is-associated-with-more-organs-transplanted-per-donor
#7
Madhukar S Patel, Salvador De La Cruz, Mitchell B Sally, Tahnee Groat, Darren J Malinoski
BACKGROUND: Meeting donor management goals (DMGs) while caring for potential organ donors has been associated with more organs transplanted per donor (OTPD). Concern persists, however, as to whether this reflects that younger/healthier donors are more likely to meet DMGs or whether active management affects outcomes. STUDY DESIGN: A prospective observational study of all standard criteria donors (SCDs) was conducted by 10 organ procurement organizations across UNOS Regions 4, 5, and 6...
July 21, 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
#8
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 are limited data about long-term oncologic safety of this procedure. STUDY DESIGN: We reviewed 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: There were 2,182 NSM performed from 2007 to 2016...
July 17, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28818425/the-hartford-consensus-survey-of-the-public-and-healthcare-professionals-on-active-shooter-events-in-hospitals
#9
Lenworth M Jacobs, Karyl J Burns
No abstract text is available yet for this article.
July 15, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28690207/hypophosphatemia-after-hepatectomy-or-pancreatectomy-role-of-the-nicotinamide-phosphoribosyltransferase
#10
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
#11
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
#12
Teresa C Rice, Amanda M Pugh, Brent T Xia, Aaron P Seitz, Brynne E Whitacre, Erich Gulbins, Charles C Caldwell
BACKGROUND: Pseudomonas aeruginosa 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 P aeruginosa 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: Microvesicles were isolated from murine BAL fluid, quantified using Nanoparticle Tracking Analysis, and injected into burn-injured mice before P aeruginosa infection...
July 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28687511/first-lieutenant-william-t-fitzsimons-md
#13
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
#14
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
#15
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
#16
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
#17
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/28774550/association-between-burn-injury-and-mental-illness-among-burn-survivors-a-population-based-self-matched-longitudinal-cohort-study
#18
Stephanie A Mason, Avery B Nathens, James P Byrne, Janet Ellis, Robert A Fowler, Alejandro Gonzalez, Paul J Karanicolas, Rahim Moineddin, Marc G Jeschke
BACKGROUND: Mental health disorders are prevalent before and after burn injury. However, the impact of burn injury on risk of subsequent mental health disorders is unknown. STUDY DESIGN: We conducted a population-based, self-matched longitudinal cohort study using administrative data in Ontario, Canada between 2003 and 2011. All adults who survived to discharge following major burn injury were included, and all mental health-related emergency department visits were identified...
June 28, 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
#19
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/28627411/impact-of-procedural-training-on-pregnancy-outcomes-and-career-satisfaction-in-female-postgraduate-medical-trainees-in-the-united-states
#20
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
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