JAMA surgery最新文献

{"title":"Neoadjuvant Semaglutide, Bariatric Surgery Weight Loss, and Overall Outcomes.","authors":"Vasundhara Mathur, Katherine Wasden, Thomas H Shin, Pourya Medhati, Abdelrahman A Nimeri, Ali Tavakkoli, Eric G Sheu","doi":"10.1001/jamasurg.2025.0001","DOIUrl":"10.1001/jamasurg.2025.0001","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556923","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":"Travel to High-Volume Centers and Esophageal Cancer.","authors":"Kexun Li, Xin Yang, Yunchao Huang","doi":"10.1001/jamasurg.2025.0018","DOIUrl":"https://doi.org/10.1001/jamasurg.2025.0018","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556981","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":"Mixed Results With Oral Antibiotics for Fracture-Related Infections.","authors":"Kamal M F Itani, William G Henderson","doi":"10.1001/jamasurg.2024.6440","DOIUrl":"10.1001/jamasurg.2024.6440","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"284-285"},"PeriodicalIF":15.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005731","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":"Impact of IVF Restriction on Patients With Cancer and Surgeons.","authors":"Alexa C Glencer, Laura J Esserman","doi":"10.1001/jamasurg.2024.4741","DOIUrl":"10.1001/jamasurg.2024.4741","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"239-240"},"PeriodicalIF":15.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768966","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":"Silent Cost of Private Equity Hospitals.","authors":"Aaron R Dezube, Virginia R Litle","doi":"10.1001/jamasurg.2024.5983","DOIUrl":"10.1001/jamasurg.2024.5983","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"303"},"PeriodicalIF":15.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914601","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":"Delayed Mortality in Patients Receiving Postoperative High-Acuity Care.","authors":"Guy Ludbrook, Esrom E Leaman, Michael P W Grocott, Colin Royse, Jamie Sleigh, Sandy Clarke-Errey, L Bogdan Solomon","doi":"10.1001/jamasurg.2024.5289","DOIUrl":"10.1001/jamasurg.2024.5289","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"356-357"},"PeriodicalIF":15.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807014","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":"Injury to Internal Thoracic Artery to Left Anterior Descending Artery Grafts in Cardiac Reoperations.","authors":"Joshua E Insler, Richard A E Ramsingh, Jules J Bakhos, Penny L Houghtaling, Marijan Koprivanac, Lars G Svensson, Eugene H Blackstone, Faisal G Bakaeen","doi":"10.1001/jamasurg.2024.4952","DOIUrl":"10.1001/jamasurg.2024.4952","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"354-356"},"PeriodicalIF":15.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807017","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":"Anterior Gastropexy for Paraesophageal Hernia Repair: A Randomized Clinical Trial.","authors":"Clayton C Petro, Ryan C Ellis, Sara M Maskal, Sam J Zolin, Chao Tu, Adele Costanzo, Lucas R A Beffa, David M Krpata, Diya Alaedeen, Ajita S Prabhu, Benjamin T Miller, Kevin F Baier, Alisan Fathalizadeh, John Rodriguez, Michael J Rosen","doi":"10.1001/jamasurg.2024.5788","DOIUrl":"10.1001/jamasurg.2024.5788","url":null,"abstract":"<p><strong>Importance: </strong>Paraesophageal hernias can cause severe limitations in quality of life and life-threatening complications. Even though minimally invasive paraesophageal hernia repair (MIS-PEHR) is safe and effective, anatomic recurrence rates remain notoriously high. Retrospective data suggest that suturing the stomach to the anterior abdominal wall after repair-an anterior gastropexy-may reduce recurrence, but this adjunct is currently not the standard of care.</p><p><strong>Objective: </strong>To determine whether anterior gastropexy reduces 1-year recurrence after MIS-PEHR.</p><p><strong>Design, setting, and participants: </strong>This registry-based randomized clinical trial was conducted by 10 surgeons at 3 academic hospitals within the Cleveland Clinic Enterprise. Between June 26, 2019, and July 24, 2023, 348 patients were assessed for eligibility, and 240 patients were enrolled and randomized. Statistical analysis was performed from January to March 2024.</p><p><strong>Intervention: </strong>Enrolled patients were randomized to and received either an anterior gastropexy (n = 119) or no anterior gastropexy (n = 121).</p><p><strong>Main outcome: </strong>The primary outcome was recurrence as determined by reherniation of the stomach greater than 2 cm above the diaphragm on routine imaging at 1 year or reoperation. Secondary outcomes included quality of life as measured by the Gastroesophageal Reflux Health-Related Quality of Life survey, additional foregut symptom questionnaire, and patient satisfaction at 30 days and 1 year.</p><p><strong>Results: </strong>A total of 240 patients were randomized to either anterior gastropexy (n = 119; 104 [97%] women; median [IQR] age, 70 [64-75] years) or no anterior gastropexy (n = 121; 97 [80%] women; median [IQR] age, 68 [62-73] years) at the end of their MIS-PEHR. At 1 year, 188 patients (78%) had completed follow-up. By intention-to-treat analysis, 1-year recurrence was significantly lower in patients who received an anterior gastropexy (15% vs 36%; risk difference, 0.21 [95% CI, 0.09-0.33]), which remained significant after risk-adjusted regression analysis (hazard ratio, 0.38 [95% CI, 0.23-0.60]). Of 13 reoperations (5.4%) for recurrence in the first year, 3 (2.5%) were in the anterior gastropexy group and 10 (8.2%) were in the no-gastropexy group (P = .052). Two patients (1.7%) had their anterior gastropexy sutures removed for pain. There were no significant differences in quality-of-life outcomes at 30 days and 1 year between treatment groups.</p><p><strong>Conclusions and relevance: </strong>This randomized clinical trial found that the addition of an anterior gastropexy to MIS-PEHR is superior to no gastropexy in regard to reducing 1-year paraesophageal hernia recurrence. These results suggest that an anterior gastropexy should be routinely used in the context of minimally invasive paraesophageal hernia repair.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identif","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"247-255"},"PeriodicalIF":15.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877043","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":"Best Practices for Big Data Sources and Methods in Surgery.","authors":"Shipra Arya, Lesly A Dossett, Melina R Kibbe","doi":"10.1001/jamasurg.2024.6000","DOIUrl":"10.1001/jamasurg.2024.6000","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"245-246"},"PeriodicalIF":15.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949202","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":"Esophagectomy Trends and Postoperative Outcomes at Private Equity-Acquired Health Centers.","authors":"Jonathan E Williams, Sara L Schaefer, Ryan C Jacobs, Andrew M Ibrahim, David D Odell","doi":"10.1001/jamasurg.2024.5920","DOIUrl":"10.1001/jamasurg.2024.5920","url":null,"abstract":"<p><strong>Importance: </strong>Growing trends in private equity acquisition of acute care hospitals in the US have motivated investigations into quality of care delivered at these health centers. While some studies have explored comparative outcomes for high-acuity medical conditions, care trends and outcomes of complex surgical procedures, such as esophagectomy, at private equity-acquired hospitals is unknown.</p><p><strong>Objective: </strong>To compare structural characteristics and postoperative outcomes following esophagectomy between private equity-acquired and nonacquired health centers.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study included Medicare beneficiaries aged 65 to 99 years who underwent elective esophagectomy at US health centers between January 1, 2016, and December 31, 2020. Health centers were designated as private equity acquired using the Agency for Healthcare Research and Quality Compendium of US Health Systems. Data were analyzed between October 15, 2023, and March 30, 2024.</p><p><strong>Exposure: </strong>Patient cohorts were created based on whether they received care at private equity-acquired or nonacquired health centers.</p><p><strong>Main outcomes and measures: </strong>The main outcome was 30-day postoperative complications, mortality, failure to rescue, and readmission using summary statistics and multivariable logistic regression.</p><p><strong>Results: </strong>A total of 9462 patients (mean [SD] age, 72.9 [5.6] years; 6970 male [73.7%]) underwent esophagectomy during the study period, with 517 (5.5%) receiving care at private equity-acquired institutions. Annual procedure volume was lower at private equity-acquired hospitals vs nonacquired hospitals (median, 2 [IQR, 1-4] vs 7 [IQR, 3-15] procedures per year). Compared with patients treated at nonacquired hospitals, patients treated at private equity-acquired hospitals had significantly higher 30-day mortality (8.1% [95% CI, 5.8%-10.3%] vs 4.9% [95% CI, 4.5%-5.3%]; odds ratio [OR], 1.82 [95% CI, 1.25-2.64]; P = .002), any complications (36.6% [95% CI, 32.9%-40.3%] vs 30.1% [95% CI, 29.2%-30.9%]; OR, 1.46 [95% CI, 1.18-1.80]), serious complications (17.5% [95% CI, 14.5%-20.6%] vs 14.3% [95% CI, 13.7%-15.0%]; OR, 1.34 [95% CI, 1.03-1.77]; P = .03), and failure to rescue (5.9% [95% CI, 3.9%-7.9%] vs 3.4% [95% CI, 3.1%-3.8%]; OR, 1.86 [95% CI, 1.22-2.84]; P = .004).</p><p><strong>Conclusions and relevance: </strong>These findings suggest that patients who undergo esophagectomy at private equity-acquired hospitals may be at risk for worse outcomes. Further understanding of the drivers of these outcomes is needed to improve performance and inform policy pertaining to care allocation for select surgical conditions.</p>","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":"296-302"},"PeriodicalIF":15.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914593","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}