Journal of Surgical Research最新文献

{"title":"Cover 1: Update","authors":"","doi":"10.1016/S0022-4804(25)00195-7","DOIUrl":"10.1016/S0022-4804(25)00195-7","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Page OFC"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Journal of Surgical Research","authors":"","doi":"10.1016/S0022-4804(25)00198-2","DOIUrl":"10.1016/S0022-4804(25)00198-2","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Page iii"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASC 2026 Save the Date Journal Ad","authors":"","doi":"10.1016/S0022-4804(25)00202-1","DOIUrl":"10.1016/S0022-4804(25)00202-1","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Page ix"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AAS Fall Courses JSR Ad 2025","authors":"","doi":"10.1016/S0022-4804(25)00205-7","DOIUrl":"10.1016/S0022-4804(25)00205-7","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Page OBC"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct Carbon Dioxide Emissions in Robotic Lung Resection–Analysis of a Prospective Cohort","authors":"Ikennah L. Browne MD, MTM, MHA,&nbsp;Yogita S. Patel BSc,&nbsp;Waël C. Hanna MDCM, MBA","doi":"10.1016/j.jss.2025.03.001","DOIUrl":"10.1016/j.jss.2025.03.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Climate change is one of the most significant global health threats of the 21st century. Environmental concerns have led to increasing interest in reducing the carbon footprint of surgical procedures. However, there is a paucity of data evaluating direct carbon dioxide (CO2) emissions associated with robotic lung resection. This study aims to quantify direct CO2 emissions in robotic lung surgery.</div></div><div><h3>Materials and Methods</h3><div>Patients were identified from a prospectively maintained robotic thoracic database. Those undergoing either robotic segmentectomy or lobectomy for suspected or confirmed lung cancer from December 2017 to December 2022 were included. CO2 volume (liters; L) was used to calculate the weight (grams; g) of CO2 delivered into the chest cavity. Descriptive statistics were used to characterize CO2 utilization and linear regression was performed to identify factors associated with increased CO2 utilization.</div></div><div><h3>Results</h3><div>Of 528 patients identified, 421 had documented CO2 insufflation data and 90.97% (383/421) underwent either robotic segmentectomy or lobectomy. The mean weight of CO2 utilized was 756.52 (±409.86) g per patient and the weight of CO2 for the entire cohort was 0.29 metric tonnes. This is equivalent to a one-way flight from Toronto, Canada to Salt Lake City, USA. Segmentectomy, increased BMI, increased nodal harvest, and larger tumors were associated with reduced CO2 utilization.</div></div><div><h3>Conclusions</h3><div>Direct CO2 emissions in robotic lung resection may be lower than previously assumed. While strategies to reduce CO2 utilization ought to be pursued, future studies should be aimed at establishing the optimal approach to mitigating the environmental impact of robotic lung resection.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"309 ","pages":"Pages 19-24"},"PeriodicalIF":1.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aging Impairs the Capacity of Cardiac Functional Recovery Following Endotoxemia: Modulation of Myocardial Klotho Level for Remedy","authors":"Xueting Li MD, PhD ,&nbsp;Yufeng Zhai MS ,&nbsp;Qingzhou Yao PhD ,&nbsp;Erlinda The MD, PhD ,&nbsp;Lihua Ao BS ,&nbsp;David A. Fullerton MD ,&nbsp;Kai-Jiang Yu MD ,&nbsp;Xianzhong Meng MD, PhD","doi":"10.1016/j.jss.2025.02.042","DOIUrl":"10.1016/j.jss.2025.02.042","url":null,"abstract":"<div><h3>Introduction</h3><div>Endotoxemic/septic cardiac dysfunction occurs frequently in elderly patients undergoing major surgery and contributes to postsurgery morbidity and mortality. This study evaluated the effect of aging on cardiac functional recovery following endotoxemia and explored therapeutic approaches for promotion of the recovery.</div></div><div><h3>Methods</h3><div>A small dose of endotoxin (0.5 mg/kg, iv) was administered to young adult (3-4 mo) and old (18-22 mo) mice with or without subsequent treatment with recombinant interleukin-37 (IL-37, 50 μg/kg, iv) or recombinant Klotho (10 μg/kg, iv). Cardiac function was analyzed using a microcatheter at 24, 48, and 96 h following administration of endotoxin. Myocardial levels of Klotho, intercellular adhesion molecule-1, and IL-6 were determined by immunoblotting and Enzyme-linked immunosorbent assay.</div></div><div><h3>Results</h3><div>Compared to young adult endotoxemic mice, old endotoxemic mice had worse cardiac dysfunction accompanied by greater myocardial levels of intercellular adhesion molecule-1 and IL-6 at each time point and failed to fully recover cardiac function by 96 h. The exacerbated and prolonged myocardial inflammation and cardiac dysfunction in old endotoxemic mice were associated with lower myocardial Klotho level and its further reduction by endotoxemia. Interestingly, recombinant IL-37 up-regulated myocardial Klotho level in old mice with or without endotoxemia and treatment of old endotoxemic mice with IL-37 improved myocardial inflammation resolution and cardiac functional recovery. Similarly, recombinant Klotho suppressed myocardial inflammatory response and promoted inflammation resolution in old endotoxemic mice, leading to complete recovery of cardiac function by 96 h.</div></div><div><h3>Conclusions</h3><div>Myocardial Klotho insufficiency in old mice exacerbates myocardial inflammatory response, impairs inflammation resolution and hinders cardiac functional recovery. IL-37 is capable of up-regulating myocardial Klotho level to promote myocardial inflammation resolution and cardiac functional recovery in old endotoxemic mice.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"309 ","pages":"Pages 25-36"},"PeriodicalIF":1.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative Assessment and Description of Intraoperative Attending Surgeons' Leadership Skills","authors":"Egide Abahuje MBBS, PhD ,&nbsp;Lixuan Cong MPP ,&nbsp;My Nguyen ,&nbsp;Cassandra B. Iroz MS ,&nbsp;Kathryn Tesorero ,&nbsp;Jeffrey H. Barsuk MD, MS, SFHM ,&nbsp;Donald S. Likosky PhD ,&nbsp;Anne Stey MD, MS ,&nbsp;Julie K. Johnson MSPH, PhD ,&nbsp;Amy Halverson MD, MHPE, FACS ,&nbsp;Claudia Rosu MD, PhD","doi":"10.1016/j.jss.2025.02.031","DOIUrl":"10.1016/j.jss.2025.02.031","url":null,"abstract":"<div><h3>Introduction</h3><div>Leadership is one of the nontechnical skills that attending surgeons must apply in clinical settings. Effective leadership skills are fundamental for surgeons to lead the team and accomplish the goals of surgery. This study aimed to uncover how attending surgeons from a United States academic medical center apply leadership skills in the operating room (OR).</div></div><div><h3>Methods</h3><div>This qualitative study was conducted at an urban academic medical center from February to August 2022. Data were collected through nonparticipant observations of the attending surgeons operating with surgeons in training, and other surgical team members in the OR. Surgical teams were observed during the entire patient's time in the OR. Members of the study team took field notes to document the attending surgeons' behaviors related to their leadership skills. We used inductive and deductive thematic analysis using the Surgeons' Leadership Inventory framework. We used MAXQDA for data organization and retrieval.</div></div><div><h3>Results</h3><div>We conducted 179 observations involving 27 surgeons in training, operating with 45 attending surgeons from ten different general surgery subspecialties for a total of 351 hs. Our findings highlighted how leadership skills employed by attending surgeons spanned various domains outlined in the Surgeons Leadership Inventory framework. These skills encompassed ensuring resource availability, making timely decisions, delegating tasks proficiently, providing clear instructions, offering educational opportunities, attending to trainees' needs, sharing crucial information, and navigating challenging situations.</div></div><div><h3>Conclusions</h3><div>Attending surgeons applied leadership skills to orchestrate the activities of surgical team members and educate trainees in the OR. Future studies should investigate the effect of attending surgeons' leadership skills on patient's and trainee learning outcomes.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 315-325"},"PeriodicalIF":1.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Clinical and Angiographic Outcomes of Off-Pump Versus On-Pump Coronary Artery Bypass Grafting","authors":"Maciej Peksa MD ,&nbsp;Marcin Nawotka MD ,&nbsp;Lukasz Moskal MD ,&nbsp;Ahmed K. Awad MD ,&nbsp;Tomasz Stankowski MD, PhD ,&nbsp;Konrad Pieszko MD, PhD ,&nbsp;Tomasz Zemleduch MD, PhD ,&nbsp;Yuliia Onutska MD ,&nbsp;Grzegorz Adamiak MD ,&nbsp;Julia Zielska MD ,&nbsp;Marta Miklejewska MD ,&nbsp;Gianluca Torregrossa MD, MEBCTS ,&nbsp;Mario Gaudino MD, PhD ,&nbsp;Romuald Cichon MD, PhD ,&nbsp;Sleiman Sebastian Aboul-Hassan MD, PhD","doi":"10.1016/j.jss.2025.02.041","DOIUrl":"10.1016/j.jss.2025.02.041","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to compare long-term outcomes in patients undergoing off-pump coronary artery bypass grafting (OPCAB) <em>versus</em> on-pump coronary artery bypass grafting (ONCAB) in a single-center propensity-matched population.</div></div><div><h3>Methods</h3><div>Between January 2010 and June 2022, 2964 patients were analyzed and divided into two groups: 1671 (56.3%) patients receiving OPCAB and 1293 (43.7%) patients receiving ONCAB. Propensity score matching was performed resulting in 842 pairs.</div></div><div><h3>Results</h3><div>In the matched cohort, OPCAB was associated with a reduced incidence of early stroke (odds ratio: 0.40; 95% confidence interval [0.17-0.90], <em>P</em> = 0.02) as well as a reduced incidence of reoperation for bleeding and blood transfusion. The median follow-up time was 6.69 y (interquartile range: 3.47-9.83-y). OPCAB and ONCAB had comparable long-term mortality, myocardial infarction, repeat revascularization, and major adverse cardiac and cerebral events. However, OPCAB was associated with higher freedom from stroke at follow-up compared to ONCAB (hazard ratios stratified on matched pairs: 0.61; 95% confidence interval [0.39-0.95]; <em>P</em> = 0.015). A landmark analysis in the matched cohort was performed excluding the first 30 ds of follow-up to exclude the effect of early stroke. In the landmark analysis, OPCAB and ONCAB had comparable freedom from stroke at follow-up. Briefly, 821 patients with 2055 grafts were analyzed. The overall median time to angiogram was 3.68 y (interquartile range: 1.76-6.61). No difference was observed between OPCAB and ONCAB in the patency rates (Fitzgibbon A) of arterial grafts. However, the patency rate of saphenous vein graft was higher in the OPCAB group than in the ONCAB group (77.4% <em>versus</em> 71.7%, <em>P</em> = 0.04).</div></div><div><h3>Conclusions</h3><div>OPCAB was associated with lower rates of stroke, reoperation for bleeding, and blood product transfusion. Meanwhile, at long-term follow-up, OPCAB and ONCAB were associated with comparable outcomes, including all-cause mortality, myocardial infarction, repeat revascularization, major adverse cardiac and cerebral events, and stroke.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"309 ","pages":"Pages 8-18"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Getting Started in Leadership: Mindsets and Skillsets for Leading in Complex Systems","authors":"Joceline V. Vu MD ,&nbsp;Janet D. Pinkerton MHSA ,&nbsp;Callisia N. Clarke MD, MS ,&nbsp;Caprice Greenberg MD ,&nbsp;Justin B. Dimick MD, MPH ,&nbsp;Lesly A. Dossett MD, MPH","doi":"10.1016/j.jss.2025.02.039","DOIUrl":"10.1016/j.jss.2025.02.039","url":null,"abstract":"<div><div>As health-care systems grow increasingly complex, surgeons must adapt their leadership skills to different settings. At the 2024 Academic Surgical Congress Hot Topics session on leadership mindset, we discussed discrete strategies for tackling leadership challenges at multiple stages in a surgeon’s career. We review strategies for surgeons at any stage in their career, new-career surgeons, surgeons without defined leadership titles, surgeons in executive roles, and surgeons in mentorship positions.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 295-299"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Predictors of Hollow Viscus Injury in Patients With Abdominal Morel-Lavalleé Injury","authors":"Vinay Sharma BS ,&nbsp;Areg Grigorian MD ,&nbsp;Sigrid Burruss MD, FACS ,&nbsp;Lourdes Swentek MD ,&nbsp;John Scolaro MD ,&nbsp;Mallory Jebbia MD ,&nbsp;Catherine M. Kuza MD, FASA ,&nbsp;Jeffry Nahmias MD MHPE","doi":"10.1016/j.jss.2025.01.023","DOIUrl":"10.1016/j.jss.2025.01.023","url":null,"abstract":"<div><h3>Introduction</h3><div>Abdominal Morel-Lavalleé (ML) injuries, though rare, are associated with serious clinical implications, such as concomitant hollow viscus injury (HVI). However, research on the incidence of HVI in patients with abdominal ML injuries remains lacking. This study aimed to identify the incidence and predictors of HVI in patients with abdominal ML injury.</div></div><div><h3>Methods</h3><div>The 2017-2021 Trauma Quality Improvement Program database was queried for patients with abdominal ML injuries, ages 18 and older. Patients with abdominal ML + HVI were compared to patients with abdominal ML without HVI. A multivariable logistic regression analysis was performed to identify associated risk factors for HVI.</div></div><div><h3>Results</h3><div>Of 1439 patients with abdominal ML injuries, 532 (37.0%) suffered HVI. Compared to non-HVI patients, those with HVI were more often 30 years old or younger (44.0% vs 23.9%; <em>P</em> &lt; 0.001) and had higher rates of motor vehicle collision (MVC) (84.2% vs 40.1%; <em>P</em> &lt; 0.001). Abdominal ML + HVI patients had increased rates of spleen injuries (21.1% vs 6.1%; <em>P</em> &lt; 0.001) and liver injuries (17.3% vs 7.4%, <em>P</em> &lt; 0.001). The strongest independent associated risk factors for HVI in patients with abdominal ML injuries were age less than 30 years old (odds ratio [OR]: 1.94; confidence interval [CI]: 1.46-2.57; <em>P</em> &lt; 0.001), MVC mechanism (OR: 7.89; CI: 5.77-10.80; <em>P</em> &lt; 0.001), spleen injury (OR: 2.82; CI: 1.87-4.27; <em>P</em> &lt; 0.001), and liver injury (OR: 1.80; CI: 1.19-2.73; <em>P</em> = 0.01).</div></div><div><h3>Conclusions</h3><div>This national analysis demonstrates that 40% of patients with abdominal ML injury suffered HVI. Associated risk factors for HVI with abdominal ML injury included younger age, injuries to the spleen and liver, and an MVC mechanism of injury. These findings can help inform clinical decisions and improve prognostication for patients with abdominal ML injury.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"308 ","pages":"Pages 307-314"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}