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Journal of the American College of Surgeons

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https://www.readbyqxmd.com/read/28414115/cost-analysis-of-a-surgical-consensus-guideline-in-breast-conserving-surgery
#1
Jennifer Yu, Leisha C Elmore, Amy E Cyr, Rebecca L Aft, William E Gillanders, Julie A Margenthaler
BACKGROUND: The SSO/ASTRO consensus statement was the first professional guideline in breast oncology to declare "no ink on tumor" as a negative margin in patients with stages I/II breast cancer undergoing breast conservation therapy (BCT). We sought to analyze the financial impact of this guideline at our institution using a historic cohort. STUDY DESIGN: We identified women undergoing re-excision following breast-conserving surgery for invasive breast cancer from 2010-2013 using a prospectively-maintained institutional database...
April 14, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28414117/global-surgery-lifeline-for-the-us-military-surgeon
#2
Dallas G Hansen
No abstract text is available yet for this article.
April 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28414116/the-largest-european-single-center-experience-300-laparoscopic-pancreatic-resections
#3
Safi Dokmak, Fadhel Samir Ftériche, Béatrice Aussilhou, Philippe Lévy, Philippe Ruszniewski, Jérome Cros, Marie Pierre Vullierme, Linda Khoy Ear, Jacques Belghiti, Alain Sauvanet
BACKGROUND: Although laparoscopic pancreatic resection (LPR) has become a routine, large single center series are still lacking. Our aim was to analyze the results of a large European single center series of LPR. STUDY DESIGN: Between January 2008 and September 2015, 300 LPR were performed and studied prospectively including 165 (55%) distal pancreatectomies, 68 (23%) pancreatoduodenectomies (PD), 30 (10%) enucleations, 35 (11%) central pancreatectomies and 2 (1%) total pancreatectomies...
April 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28414114/why-do-long-distance-travelers-have-improved-pancreatectomy-outcomes
#4
Manila Jindal, Chaoyi Zheng, Humair S Quadri, Chukwuemeka U Ihemelandu, Young K Hong, Andrew K Smith, Vikas Dudeja, Nawar M Shara, Lynt B Johnson, Waddah B Al-Refaie
BACKGROUND: Centralization of complex surgical care has led patients to travel longer distances. Emerging evidence suggested a negative association between increased travel distance and mortality after pancreatectomy. However, the reason behind this association remains largely unknown. We sought to unravel the relationships among travel distance, receiving pancreatectomy at high volume hospitals (HVH), delayed surgery, and operative outcomes. STUDY DESIGN: We identified 44,476 patients who underwent pancreatectomy for neoplasms between 2004 and 2013 at the reporting facility from the National Cancer Data Base...
April 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28412539/laparoscopic-reoperative-anti-reflux-surgery-is-more-cost-effective-than-open-approach
#5
Farzaneh Banki, Matthew Weaver, David Roife, Chandni Kaushik, Anshu Khanna, Kelly Ochoa, Charles C Miller
BACKGROUND: We previously reported the outcomes of laparoscopic and open reoperative antireflux surgery. The aim of this study was to compare costs. METHODS: Retrospective review. Financial and procedure coding data were obtained using a cost accounting system. There were 49 procedures in 46 patients: 36 females/10 males. There were 38 laparoscopic (including 4 conversions); and 11 open procedures (7 transabdominal repairs and 4 gastric preserving Roux-en-Y esophagojejunostomy)...
April 12, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28408311/validation-of-a-difficulty-scoring-system-for-laparoscopic-liver-resection-a-multicenter-analysis-by-the-endoscopic-liver-surgery-study-group-in-japan
#6
Shogo Tanaka, Shoji Kubo, Akishige Kanazawa, Yutaka Takeda, Fumitoshi Hirokawa, Hiroyuki Nitta, Takayoshi Nakajima, Takashi Kaizu, Hironori Kaneko, Go Wakabayashi
BACKGROUND: Laparoscopic liver resection (LLR) is widely used for hepatic disease treatment. Preoperative prediction of operative difficulty can be beneficial as a roadmap for surgeons advancing from simple to highly technical LLR. We performed a multicenter analysis to investigate a "difficulty scoring system" for predicting the difficulty of LLR. STUDY DESIGN: The proposed "difficulty scoring system" includes three difficulty levels based on five factors. The system was validated in a cohort of 2,199 patients who underwent LLR at 74 Japanese centers between 2010 and 2014; the difficulty level was rated as low (n = 965), intermediate (n = 891), and high (n = 343)...
April 10, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28400300/locoregional-therapy-and-recurrent-hepatocellular-carcinoma-after-liver-transplantation
#7
Min Xu, Majella Doyle, Babak Banan, Neeta Vachharajani, Xuanchuan Wang, Nael Saad, Katherine Fowler, Elizabeth M Brunt, Yiing Lin, William C Chapman
BACKGROUND: Neoadjuvant locoregional therapies (LRT) have been widely used to reduce tumor burden or downstage hepatocellular carcinoma (HCC) prior to orthotopic liver transplantation (OLT). We examined the impact of LRT response on HCC recurrence after OLT. STUDY DESIGN: We performed a retrospective study of 384 HCC patients treated by OLT. Tumor necrosis was determined by pathologic evaluation. The vascular and lymphatic vessels were localized by immunofluorescence (IF) staining in formalin-fixed, paraffin-embedded tissue; expressions of VEGFR-2 and VEGFR-3 were analyzed by Western Blot...
April 8, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28400299/strategies-for-identifying-and-closing-the-gender-salary-gap-in-surgery
#8
REVIEW
Hilary Sanfey, Marie Crandall, Elizabeth Shaughnessy, Sharon L Stein, Amalia Cochran, Sareh Parangi, Christine Laronga
No abstract text is available yet for this article.
April 8, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28400298/adverse-effect-of-post-discharge-care-fragmentation-on-outcomes-after-readmissions-after-liver-transplantation
#9
Anai N Kothari, Veronica M Loy, Sarah A Brownlee, Yoshiki Ezure, Colleen Schaidle-Blackburn, Scott J Cotler, Diego di Sabato, Paul C Kuo, Amy D Lu
BACKGROUND: Post-discharge surgical care fragmentation is defined as readmission to any hospital other than the hospital at which the surgery was performed. The objective of this study was to assess the impact of fragmented readmissions within the first year following orthotopic liver transplant (OLT). STUDY DESIGN: The Healthcare Cost and Utilization Project State Inpatient Databases (HCUP SID) for Florida and California from 2006-2011 were used to identify OLT patients...
April 8, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28392435/sex-specific-differences-in-colon-cancer-when-quality-measures-are-adhered-to-results-from-international-prospective-multicenter-clinical-trials
#10
Shrawan G Gaitonde, Aviram Nissan, Mladjan Protić, Alexander Stojadinovic, Zev A Wainberg, David C Chen, Anton J Bilchik
INTRODUCTION: There is no consensus on the relationship between patient sex and the location, stage and oncologic outcome of colon cancer (CC). We hypothesized a sex-specific difference in the biology and management of CC. STUDY DESIGN: Our cohort was drawn from a database of patients enrolled in international trials of nodal ultrastaging for non-metastatic CC. These trials required strict adherence to surgical and pathological quality measures. Postoperative follow-up included colonoscopy at 1 and 4 years and annual CT scans...
April 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28344051/massive-biliary-dilation-after-roux-en-y-gastric-bypass-is-it-ampullary-achalasia
#11
Jeffrey L Ponsky, Noble Jones, John H Rodriguez, Matthew D Kroh, Andrew T Strong
BACKGROUND: This series of patients with a history of Roux-en-Y gastric bypass (RYGB) and cholecystectomy presented with symptoms consistent with obstructive biliary disease and massive biliary dilation of ≥15 mm, suggesting a structural cause. Findings from laparoscopic-assisted transgastric (TG) ERCP were a normal-appearing ampulla without structural lesions or stones, suggesting a functional cause instead. STUDY DESIGN: Patients who underwent TGERCP from January 2008 to October 2016 and had a surgical history of RYGB and cholecystectomy were identified from an institutional database...
March 24, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28344050/liver-double-tightened-maneuver-how-i-do-it-optimal-outflow-control-during-liver-parenchymal-transection-of-the-right-and-left-hepatectomies
#12
Tullio Piardi, Mikael Chetboun, Sara Cavallari, Rami Rhaiem, Patrick Pessaux, Reza Kianmanesh, Daniele Sommacale
No abstract text is available yet for this article.
March 23, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28427885/prognostic-scoring-system-to-risk-stratify-parathyroid-carcinoma
#13
Angelica M Silva-Figueroa, Kenneth R Hess, Michelle D Williams, Callisia N Clarke, Ioannis Christakis, Paul H Graham, Elizabeth G Grubbs, Jeffrey E Lee, Naifa L Busaidy, Nancy D Perrier
BACKGROUND: Parathyroid carcinoma is a rare endocrine malignancy that lacks an established system for risk categorization. This study evaluated a prognostic scoring system for recurrence-free survival (RFS) of patients with parathyroid carcinoma. STUDY DESIGN: Patients diagnosed and confirmed to have parathyroid carcinoma and who were treated between 1980 and 2016 at The University of Texas MD Anderson Cancer Center were studied retrospectively. Univariate and multivariate Cox proportional hazards regression analyses of RFS were conducted...
March 15, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28315812/onset-of-coagulation-function-recovery-is-delayed-in-severely-injured-trauma-patients-with-venous-thromboembolism
#14
Belinda H McCully, Christopher R Connelly, Kelly A Fair, John B Holcomb, Erin E Fox, Charles E Wade, Eileen M Bulger, Martin A Schreiber
BACKGROUND: Altered coagulation function after trauma may contribute to venous thromboembolism (VTE) development. Severe trauma impairs coagulation function, but the trajectory for recovery is not known. We hypothesized that enhanced, early recovery of coagulation function increases VTE risk in severely-injured trauma patients. STUDY DESIGN: Secondary analysis was performed on data from The Pragmatic Randomized Optimal Platelet and Plasma Ratio (PROPPR) trial, excluding patients who died within 24 hours and/or were on pre-injury anticoagulants...
March 15, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28408176/using-the-nsqip-pancreatic-demonstration-project-to%C3%A2-derive-a-modified-fistula-risk-score-for-preoperative-risk-stratification-in-patients-undergoing-pancreaticoduodenectomy
#15
Olga Kantor, Mark S Talamonti, Henry A Pitt, Charles M Vollmer, Taylor S Riall, Bruce L Hall, Chi-Hsiung Wang, Marshall S Baker
BACKGROUND: The Fistula Risk Score (FRS) is a clinical tool developed from single-institutional data using primarily intraoperative factors to characterize the risk of clinically relevant pancreatic fistula (CR-POPF) after pancreaticoduodenectomy. We developed a modified FRS based on objective, nationally accrued data that is more readily determined before resection. STUDY DESIGN: The 2012 NSQIP Pancreatic Demonstration Project (PDP) was used to identify 1,731 pancreaticoduodenectomy resections over 14 months (2011 to 2012)...
March 9, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28389191/an-examination-of-american-college-of-surgeons-nsqip-surgical-risk-calculator-accuracy
#16
Mark E Cohen, Yaoming Liu, Clifford Y Ko, Bruce L Hall
BACKGROUND: The American College of Surgeons NSQIP offers a Surgical Risk Calculator (SRC) that provides detailed, patient-level, risk assessments for many adverse outcomes to surgeons, patients, and the general public. The SRC calculator was designed to help guide discussion and decisions by providing generally applicable (not hospital-specific) information about surgical risk using easily understood and broadly available preoperative variables. Although large, internal evaluations have shown that the SRC has good accuracy (model discrimination and calibration), external validations have been inconsistent and tend to favor a conclusion of inadequate performance...
March 8, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28279778/readmission-and-other-adverse-events-after-transsphenoidal-surgery-prevalence-timing-and-predictive-factors
#17
David J Cote, Hormuz H Dasenbrock, Ivo S Muskens, Marike Ld Broekman, Hasan A Zaidi, Ian F Dunn, Timothy R Smith, Edward R Laws
BACKGROUND: Transsphenoidal surgery is a common neurosurgical procedure for accessing the pituitary and anterior skull base, yet few multicenter analyses have evaluated outcomes after this procedure. STUDY DESIGN: Patients undergoing transsphenoidal surgery from 2006 to 2015 were extracted from the ACS NSQIP database. Logistic regression was used to identify predictors of thirty-day complications. RESULTS: Of 1240 patients included in this analysis; 6...
March 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28279777/sutureless-vs-sutured-gastroschisis-closure-a-prospective-randomized-controlled-trial
#18
Matias Bruzoni, Joshua D Jaramillo, Jonathan L Dunlap, Claire Abrajano, Shobha W Stack, Susan R Hintz, Tina Hernandez-Boussard, Sanjeev Dutta
BACKGROUND: Sutureless gastroschisis repair involves covering the abdominal wall defect with the umbilical cord or a synthetic dressing to allow closure by secondary intention. No randomized studies have described the outcomes of this technique. Our objective was to prospectively compare short-term outcomes of sutureless vs sutured closure in a randomized fashion. STUDY DESIGN: We recruited patients who presented with gastroschisis between 2009 and 2014 and were randomized into either sutureless or sutured treatment groups...
March 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28279776/outcomes-of-laparoscopic-vs-open-common-bile-duct-exploration-analysis-of-the-nsqip-database
#19
Hamzeh M Halawani, Hani Tamim, Farah Khalifeh, Aurélie Mailhac, Ali Taher, Jamal Hoballah, Faek R Jamali
BACKGROUND: Common bile duct exploration (CBDE) is one of the available options in the management of choledocholithiasis. We aim to analyze outcomes comparing the laparoscopic and open approach to CBDE using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. STUDY DESIGN: This is a retrospective cohort study of patients undergoing CBDE from year 2008 to 2013 using ACS NSQIP database. The cohort was split into 2 groups and compared based on the operative approach, laparoscopic versus open CBDE...
March 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28342652/effective-hospital-wide-education-in-hemorrhage-control
#20
James R Hegvik, Sarah K Spilman, Sherry D Olson, Carrie A Gilchrist, Richard A Sidwell
BACKGROUND: Uncontrolled hemorrhage is the leading cause of potentially preventable traumatic death. Bleeding victims must receive immediate medical attention to save lives, and the first opportunity to control bleeding after trauma often comes from bystanders. Educating the general public is important for improving outcomes for hemorrhaging victims, and it is imperative for all people, including those with no clinical training, to have the knowledge to respond until trained medical specialists arrive...
March 4, 2017: Journal of the American College of Surgeons
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