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Journal of the American College of Surgeons

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https://www.readbyqxmd.com/read/28627411/impact-of-procedural-training-on-pregnancy-outcomes-and-career-satisfaction-in-female-post-graduate-medical-trainees-in-the-united-states
#1
Jennifer S Davids, Rebecca E Scully, Nelya Melnitchouk
BACKGROUND: Compared to non-procedural 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 United States postgraduate medical trainee mothers via an anonymous, IRB-approved online survey. Univariate analysis was performed using Chi-squared tests...
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-surgery-a-randomized-single-blind-non-inferiority-trial
#2
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 following abdominal surgery. We introduced a new laparoscope-assisted TAP (LTAP) block technique using intraperitoneal injection, and compared its analgesic effect to that of an ultrasound-guided AP (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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28549765/improving-patient-centered-transitional-care-after-complex-abdominal-surgery
#10
Alexandra W Acher, Stephanie A Campbell-Flohr, Maria Brenny-Fitzpatrick, Kristine M Leahy-Gross, Sara Fernandes-Taylor, Alexander V Fisher, Suresh Agarwal, Amy J Kind, Caprice C Greenberg, Pascale Carayon, Sharon M Weber
BACKGROUND: Poor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. STUDY DESIGN: The intervention includes in-person enrollment of patients...
May 18, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28529137/medicaid-participation-among-liver-transplant-candidates-after-the-affordable-care-act-medicaid-expansion
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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. However, it is difficult to accurately measure the length of the small intestine. Our aim 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
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