JAMA surgery最新文献

{"title":"Hospital Ownership and Surgical Outcomes in East, Central, and Southern Africa.","authors":"Robert K Parker, Yves Yankunze, Andrea S Parker, Eric O'Flynn, Niraj Bachheta, Abebe Bekele, Michael M Mwachiro","doi":"10.1001/jamasurg.2025.1430","DOIUrl":"10.1001/jamasurg.2025.1430","url":null,"abstract":"<p><strong>Importance: </strong>Surgical mortality remains a critical public health issue in resource-limited settings. Hospital ownership type may influence surgical outcomes, yet this relationship is not well understood in East, Central, and Southern Africa, where a diverse mix of public, private, and faith-based hospitals provides care.</p><p><strong>Objective: </strong>To determine whether hospital ownership type (public, private, or faith-based) is associated with differences in surgical mortality rates in East, Central, and Southern Africa.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study analyzed operative cases recorded by 214 general surgery trainees enrolled in surgical training programs at 85 public, private, and faith-based hospitals in East, Central, and Southern Africa from January 1, 2005, to December 31, 2020. Cases were documented in mandatory operative logbooks. Reported mortalities were analyzed using multilevel logistic regression to account for clustering by trainee while controlling for age category, emergency status, case complexity, specialty type, country Human Development Index, trainee postgraduate year, and self-reported autonomy. Data were analyzed in July 2024.</p><p><strong>Exposures: </strong>Hospital ownership type categorized as public, private, or faith-based.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was perioperative mortality, defined as in-hospital, all-cause mortality before discharge. Mortality rates were compared across hospital types.</p><p><strong>Results: </strong>Of the 106 106 operative cases analyzed, 48 474 (45.7%) were performed in public, 3507 (3.3%) in private, and 54 125 (51.0%) in faith-based hospitals. Patients' median (IQR) age was 34 (20-51) years, and 61.5% were male. The overall perioperative mortality rate was 1.6% (95% CI, 1.5%-1.6%). Among major cases (mortality, 1138 of 53 718 [2.1%; 95% CI, 2.0%-2.2%]), faith-based hospitals had 57% lower mortality (518 of 35 370 [1.5%; 95% CI, 1.3%-1.6%]) than public hospitals (589 of 17 223 [3.4%; 95% CI, 3.2%-3.7%]) and 47% lower mortality than private hospitals (31 of 1125 [2.8%; 95% CI, 1.9%-3.9%]). Mixed-effects logistic regression revealed that faith-based hospitals had lower odds of mortality compared with public hospitals (odds ratio, 0.67; 95% CI, 0.51-0.86; P = .002) and private hospitals (odds ratio, 0.57; 95% CI, 0.34-0.95; P = .03).</p><p><strong>Conclusions: </strong>In this study, faith-based hospitals in East, Central, and Southern Africa were associated with significantly lower surgical mortality rates compared with public and private hospitals. These findings suggest that practices and resources in faith-based hospitals contribute to improved surgical outcomes, warranting further investigation to inform health care policy and improve surgical care and outcomes in the region.</p>","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"795-803"},"PeriodicalIF":15.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Familiarity of the Surgeon-Anesthesiologist Dyad With Major Morbidity After Surgery.","authors":"Jasmine Hwang, Rachel R Kelz","doi":"10.1001/jamasurg.2025.1376","DOIUrl":"10.1001/jamasurg.2025.1376","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"781-782"},"PeriodicalIF":15.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Error in Limitations.","authors":"","doi":"10.1001/jamasurg.2025.1980","DOIUrl":"10.1001/jamasurg.2025.1980","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"826"},"PeriodicalIF":15.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemoradiotherapy and Local Excision vs Total Mesorectal Excision in T2-T3ab, N0, M0 Rectal Cancer: The TAUTEM Randomized Clinical Trial.","authors":"Xavier Serra-Aracil, Carles Pericay, Ariadna Cidoncha, Jesus Badia-Closa, Thomas Golda, Esther Kreisler, Pilar Hernández, Eduardo Targarona, Nerea Borda-Arrizabalaga, Angel Reina, Salvadora Delgado, Eloy Espín-Bassany, Aleidis Caro-Tarrago, Javier Gallego-Plazas, Marta Pascual, Carlos Álvarez-Laso, Hector Guadalajara-Labajo, Ana Otero, Sebastiano Biondo","doi":"10.1001/jamasurg.2025.1398","DOIUrl":"10.1001/jamasurg.2025.1398","url":null,"abstract":"<p><strong>Importance: </strong>According to international guidelines, the standard treatment for stage T2-T3ab, N0, M0 rectal cancer is total mesorectal excision (TME), but it is associated with high morbidity and quality of life disorders.</p><p><strong>Objective: </strong>To analyze locoregional recurrence (LR) after a follow-up of 2 years, applying a 1-sided noninferiority margin of 10%, and to assess distant recurrence (DR), overall survival (OS), and disease-free survival (DFS).</p><p><strong>Design, setting, and participants: </strong>This was a multicenter, prospective, open-label, noninferiority, phase 3 randomized clinical trial comparing TME (TME group) with chemoradiotherapy followed by local excision with transanal endoscopic microsurgery (CRT-TEM group). This study involved 17 hospitals in Spain. Eligibility criteria included patients with rectal adenocarcinoma located lower than 10 cm from the anal verge; stage T2-T3ab N0, M0; tumor size less than or equal to 4 cm in diameter; and American Society of Anesthesiologists stage III or less with no metastasis. Sample size was calculated with a 1-sided significance level of 2.5% and a power of 80%, assuming a nonrecurrence rate of 95% in each arm and a possible loss of 15%. Randomization was performed with a 1:1 allocation ratio. Data were analyzed from July 2010 to October 2021.</p><p><strong>Interventions: </strong>The 2 treatment groups were CRT-TEM and TME.</p><p><strong>Main outcomes and measures: </strong>The main study outcome was LR.</p><p><strong>Results: </strong>From July 2010 to October 2021, 173 patients (median [IQR] age, 67 [59-75] years; 116 male [67.1%]) were included (CRT-TEM, n = 86; TME, n = 87). In the 5-year modified intention-to-treat analysis, LR was 6.2% (5 of 81 patients) in the TME group and 7.4% (6 of 81 patients) in the CRT-TEM group (difference, -1.23%; 95% CI, 6.51% to -8.98%). DR was 17.3% (14 of 81 patients) in the TME group and 12.3% (10 of 81 patients) in the CRT-TEM group (difference, 4.94%; 95% CI, 15.85% to -5.98%). OS was 85.2% (69 of 81 patients) in the TME group and 82.7% (67 of 81 patients) in the CRT-TEM group (difference, 2.47%; 95% CI, 0.38%-1.78%). DFS in both groups was 88.9% (72 of 81), with a 95% CI of 9.68 to -9.68.</p><p><strong>Conclusions and relevance: </strong>Results of this randomized clinical trial reveal that CRT-TEM achieved noninferior results compared with standard TME treatment in terms of LR and similar results in terms of DR, OS, and DFS. CRT-TEM appears to be a suitable treatment option for patients with T2-T3ab, N0, M0 rectal cancer.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT01308190.</p>","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"783-793"},"PeriodicalIF":15.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-Gene Interactions and Clinical Outcomes After Vascular Surgery in the Million Veteran Program.","authors":"Sony Tuteja, William J O'Brien, Jeffrey P Ferraro, Scott M Damrauer, Kamal M F Itani, Benjamin F Voight, Craig C Teerlink, Julie A Lynch, Scott L DuVall, Timothy Strebel, Michael J Kim, Mark A Wilson, Thomas W Barrett","doi":"10.1001/jamasurg.2025.1503","DOIUrl":"10.1001/jamasurg.2025.1503","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Pharmacogenetics can improve medication-related outcomes by optimizing efficacy and minimizing adverse effects. It is unknown whether the presence of drug-gene interactions (DGIs) at the time of surgery results in adverse outcomes in the postoperative setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To determine the association of active DGIs on postsurgical outcomes following vascular surgery procedures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This was a retrospective cohort study of Veterans Affairs (VA) hospital patients participating in the Million Veteran Program who had a vascular procedure documented in the VA Surgical Quality Improvement Program (VASQIP) from January 1, 2011, to December 31, 2022. Data analysis was performed from June 1, 2023, to October 31, 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposure: &lt;/strong&gt;Receipt of drugs impacted by pharmacogenetic variants 30 days prior to and up to 7 days following the vascular surgery procedure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Clinical outcomes collected as part of VASQIP, including length of stay (LOS), 30-day readmission, composite of myocardial infarction, stroke, and myocardial injury after noncardiac surgery, and 30-day postoperative death.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 10 098 patients (mean [SD] age, 68.8 [8.3] years; 1581 [15.7%] Black [self-reported]; 9884 [97.9%] male), 5020 (49.7%) had a DGI. The most common DGIs included proton pump inhibitors with CYP2C19, statins with SLCO1B1, and clopidogrel with CYP2C19. Compared with 0 DGIs, the presence of 1, 2, or 3 or more DGIs was associated with a longer median (IQR) LOS: with 0 DGIs, 3 (1-6) days vs 1 DGI, 3 (1-7) days (adjusted incidence rate ratio [IRR], 1.12; 95% CI, 1.10-1.14; P &lt; .001); 2 DGIs, 3 (1-7) days (adjusted IRR, 1.22; 95% CI, 1.19-1.25; P &lt; .001); and 3 or more DGIs, 4 (2-8) days (adjusted IRR, 1.40; 95% CI, 1.35-1.44; P &lt; .001). The 30-day readmission rate, which was 17.4% among those with 0 DGIs, was not significantly different in those with 1 DGI (17.6%; adjusted odds ratio [aOR], 1.01; 95% CI, 0.90-1.14; P = .84) but was significantly higher in those with 2 DGIs (21.2%; aOR, 1.26; 95% CI, 1.08-1.47; P = .004) and 3 or more DGIs (25.1%; aOR, 1.61; 95% CI, 1.30-1.99; P &lt; .001). The risk of the composite outcome, which was 3.5% in those with 0 DGIs, was not significantly different in those with 1 DGI (4.1%; aOR, 1.15; 95% CI, 0.91-1.45; P = .24) but was significantly higher in those with 2 DGIs (5.7%; aOR, 1.62; 95% CI, 1.22-2.15; P = .001) and those with 3 or more DGIs (5.5%; aOR, 1.60; 95% CI, 1.04-2.36; P = .02).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;The findings suggest that patients with DGIs at the time of vascular surgery have increased risk of cardiovascular morbidity, increased readmission, and longer LOS. Further work is needed to determine which DGIs contribute to these outcomes and whether preoperative pharmacogenetic testing has the potential to","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"804-813"},"PeriodicalIF":15.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Familiarity of the Surgeon-Anesthesiologist Dyad and Major Morbidity After High-Risk Elective Surgery.","authors":"Julie Hallet, Angela Jerath, Pablo Perez d'Empaire, François Martin Carrier, Alexis F Turgeon, Daniel I McIsaac, Chris Idestrup, Gianni Lorello, Alana Flexman, Biniam Kidane, Wing C Chan, Anna Gombay, Natalie Coburn, Antoine Eskander, Rinku Sutradhar","doi":"10.1001/jamasurg.2025.1386","DOIUrl":"10.1001/jamasurg.2025.1386","url":null,"abstract":"<p><strong>Importance: </strong>The surgeon-anesthesiologist teamwork is a core component of performance in the operating room, which can influence patient outcomes.</p><p><strong>Objective: </strong>To examine the association between surgeon-anesthesiologist dyad familiarity (as dyad volume, the number of procedures done together) with 90-day postoperative major morbidity for high-risk elective surgery.</p><p><strong>Design, setting, and participants: </strong>This population-based retrospective cohort study used administrative health care data from Ontario, Canada. Participants included high-risk elective operations (cardiac, low- and high- risk gastrointestinal [GI], genitourinary, gynecology oncology, neurosurgery, orthopedic, spine, vascular, and head and neck) from 2009 through 2019. Data were analyzed from January 2009 to March 2020.</p><p><strong>Exposure: </strong>Dyad familiarity, as the annual volume of procedures done by the surgeon-anesthesiologist dyad in 4 years prior to index surgery.</p><p><strong>Main outcomes and measures: </strong>90-day major morbidity (any Clavien-Dindo grade 3 to 5). The association between exposure and outcome was examined using multivariable logistic regression, stratified by type of procedure.</p><p><strong>Results: </strong>Among 711 006 index procedures, the median dyad volume and rate of 90-day major morbidity varied by type of procedure. There was higher median volume and dyad consistency for cardiac, orthopedic, and lung surgery. For other procedures, the median dyad volume was low (3 or less procedures per dyad per year). An independent association was observed between dyad volume and 90-day major morbidity for high-risk GI surgery (odds ratio [OR], 0.92; 95% CI, 0.88-0.96), low-risk GI surgery (OR, 0.96; 95% CI, 0.95-0.98), gynecology oncology surgery (OR, 0.97; 95% CI, 0.94-0.99), and spine surgery (OR, 0.97; 95% CI, 0.96-0.99), after adjusting for hospital setting, hospital, surgeon and anesthesiologist volume, and patient age, sex, and comorbidity burden. The adjusted associations were not significant for other types of procedures.</p><p><strong>Conclusions and relevance: </strong>In this study, increasing familiarity of the surgeon-anesthesiologist dyad was associated with improved postoperative outcomes for patients undergoing low- and high-risk GI surgery, gynecology oncology surgery, and spine surgery. For each additional time that a unique surgeon-anesthesiologist dyad worked together, the odds of 90-day major morbidity decreased by 4% for low-risk GI surgery, 8% for high-risk GI surgery, 3% for gynecology oncology surgery, and 3% for spine surgery. Additional research is needed to determine the most effective care structures that harness the benefits of surgeon-anesthesiologist familiarity to potentially improve patient outcomes.</p>","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"772-781"},"PeriodicalIF":15.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Future of Oncology Is Now.","authors":"Syed A Ahmad,Greg C Wilson,Sameer H Patel","doi":"10.1001/jamasurg.2025.1978","DOIUrl":"https://doi.org/10.1001/jamasurg.2025.1978","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":"187 1","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shifting From Thoracic Epidurals to Nerve Blocks-Redefining Gold Standards.","authors":"Joseph D Phillips","doi":"10.1001/jamasurg.2025.1920","DOIUrl":"https://doi.org/10.1001/jamasurg.2025.1920","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":"13 1","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intercostal or Paravertebral Block vs Thoracic Epidural in Lung Surgery: A Randomized Noninferiority Trial.","authors":"Louisa N Spaans,Marcel G W Dijkgraaf,Denis Susa,Erik R de Loos,Jo M J Mourisse,R Arthur Bouwman,Ad F T M Verhagen,Frank J C van den Broek,,Patrick Meijer,Marieke Kuut,Nike Hanneman,Jelle Bousema,Aimée Franssen,Hes Brokx,Eino van Duyn,Jan-Willem Potters,Renee van den Broek,Thomas van Brakel,Herman Rijna,Annemieke Boom,Valentin Noyez,Jeroen M H Hendriks,Suresh K Yogeswaran,Chris Dickhoff,Martijn van Dorp","doi":"10.1001/jamasurg.2025.1899","DOIUrl":"https://doi.org/10.1001/jamasurg.2025.1899","url":null,"abstract":"ImportanceEffective pain control after thoracic surgery is crucial for enhanced recovery. While thoracic epidural analgesia (TEA) traditionally ensures optimal analgesia, its adverse effects conflict with the principles of enhanced recovery after thoracic surgery. High-quality randomized data regarding less invasive alternative locoregional techniques are lacking.ObjectiveTo evaluate the efficacy of continuous paravertebral block (PVB) and a single-shot intercostal nerve block (ICNB) as alternatives to TEA.Design, Setting, and ParticipantsThis randomized clinical trial compared PVB and ICNB vs TEA (1:1:1) in patients undergoing thoracoscopic anatomical lung resection at 11 hospitals in the Netherlands and Belgium, enrolled from March 5, 2021, to September 5, 2023. The study used a noninferiority design for pain and a superiority design for quality of recovery (QoR).InterventionsContinuous PVB and single-shot ICNB.Main Outcomes and MeasuresPrimary outcomes were pain, defined as mean proportion of pain scores 4 or greater during postoperative days (POD) 0 through 2 (noninferiority margin for the upper limit [UL] 1-sided 98.65% CI, 17.5%), and QoR, assessed with the QoR-15 questionnaire at POD 1 and 2. Secondary measures included opioid consumption, mobilization, complications, and hospitalization.ResultsA total of 450 patients were randomized, with 389 included in the intention-to-treat (ITT) analysis (mean [SD] age, 66 [9] years; 208 female patients [54%] and 181 male [46%]). Of these 389 patients, 131 received TEA, 134 received PVB, and 124 received ICNB. The mean proportions of pain scores 4 or greater were 20.7% (95% CI, 16.5%-24.9%) for TEA, 35.5% (95% CI, 30.1%-40.8%) for PVB, and 29.5% (95% CI, 24.6%-34.4%) for ICNB. While PVB was inferior to TEA regarding pain (ITT: UL, 22.4%; analysis per-protocol [PP]: UL, 23.1%), ICNB was noninferior to TEA (ITT: UL, 16.1%; PP: UL, 17.0%). The mean (SD) QoR-15 scores were similar across groups: 104.96 (20.47) for TEA, 106.06 (17.94; P = .641) for PVB (P = .64 for that comparison), and 106.85 (21.11) for ICNB (P = .47 for that comparison). Both ICNB and PVB significantly reduced opioid consumption and enhanced mobility compared with TEA, with no significant differences in complications. Hospitalization was shorter in the ICNB group.Conclusions and RelevanceAfter thoracoscopic anatomical lung resection, only ICNB provides noninferior pain relief compared with TEA. ICNB emerges as an alternative to TEA, although risks and benefits should be weighed for optimal personalized pain control.Trial RegistrationClinicalTrials.gov Identifier: NCT05491239.","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":"66 1","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anastomotic Leak Prevention.","authors":"Xiaoyao Shen, Xiang Xia, Zizhen Zhang","doi":"10.1001/jamasurg.2025.1914","DOIUrl":"https://doi.org/10.1001/jamasurg.2025.1914","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}