Journal of Surgical Research最新文献

{"title":"Textbook Outcomes After Esophagectomy with Gastric Conduit for Cancer: A 2016-2021 National Surgical Quality Improvement Program Analysis","authors":"James J. Park BA ,&nbsp;Giles F. Whalen MD, FACS ,&nbsp;Isabel Cristina M. Emmerick PhD ,&nbsp;Karl F. Uy MD, FACS ,&nbsp;Mark W. Maxfield MD, FACS ,&nbsp;Allison Crawford MS ,&nbsp;Feiran Lou MD, MS, FACS","doi":"10.1016/j.jss.2025.12.036","DOIUrl":"10.1016/j.jss.2025.12.036","url":null,"abstract":"<div><h3>Introduction</h3><div>Textbook outcome (TO) is a composite measure designed to assess the overall short-term outcome of an operation. TO after esophagectomy with gastric conduit using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database has not yet been defined.</div></div><div><h3>Methods</h3><div>Records in the NSQIP Esophagectomy Procedure-Targeted database from 2016 to 2021 were analyzed. Patients who underwent elective esophagectomies with gastric conduit for resectable esophageal cancer were included. TO was defined as the absence of anastomotic leak, major complications, positive surgical margins, reintervention ≤30 d postsurgery, prolonged hospital stay (&gt; 21 d), postoperative mortality ≤ 30 d after surgery, and readmission ≤ 30 d after discharge.</div></div><div><h3>Results</h3><div>Of the 6813 patients in the 2016-2021 NSQIP database who underwent esophagectomy, 3733 met study criteria. A total of 2520 (68%) patients achieved TO. The presence of a major complication most frequently prevented the achievement of TO (19%, 692/3733), while the presence of postoperative mortality ≤ 30 d after surgery least frequently prevented achievement of TO (2.3%). The most common complications were organ/space Surgical Site Infection (10%, 372/3733) and unplanned intubation (10%, 366/3733). Of the 493 patients who failed to achieve TO due to one parameter, positive margins (4.7%, 175/3733) and major complications (3.2%, 120/3733) most frequently prevented the achievement of TO. In a multivariable analysis, node stage of 2 or 3 in the TNM staging system, chronic obstructive pulmonary disease, American Society of Anesthesiologists classification of 4, underweight body mass index, Asian race, prolonged operation time, increased preoperative white blood cell, and older age had statistically significant association with failure to achieve TO.</div></div><div><h3>Conclusions</h3><div>In an analysis of the NSQIP database, 68% of cases resulted in TO. Several factors were associated with failure to achieve TO. Further investigations are needed to test if modifying variables like preoperative weight can lead to improved outcomes.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"319 ","pages":"Pages 66-76"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137384","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":"Letter Regarding: Predicting Functional Outcomes in Adult Traumatic Brain Injuries Using the Base Deficit, International Normalized Ratio, and Glasgow Coma Scale Score","authors":"Amir Masoud Karimi MD,&nbsp;Ali Hosseini MD","doi":"10.1016/j.jss.2025.11.069","DOIUrl":"10.1016/j.jss.2025.11.069","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"319 ","pages":"Pages 213-214"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132101","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":"Optimizing Thyroid Cytopathology Reports Focused on a Patient-Centered Approach: Mixed Methods Study","authors":"Niranjna Swaminathan MD ,&nbsp;Prudence Wachira BS ,&nbsp;Alexandra Savage BS ,&nbsp;Christopher Wu MD ,&nbsp;K Kerrick Akinola MD ,&nbsp;Daniel Gomez Carrillo MD ,&nbsp;Christian Wells ,&nbsp;Raj Roy MBBS ,&nbsp;Chandler McLeod PhD, MS ,&nbsp;Brenessa Lindeman MD, MEHP ,&nbsp;Jessica Fazendin MD ,&nbsp;Herbert Chen MD ,&nbsp;Andrea Gillis MD, MSPH","doi":"10.1016/j.jss.2026.01.022","DOIUrl":"10.1016/j.jss.2026.01.022","url":null,"abstract":"<div><h3>Introduction</h3><div>Effective comprehension of pathology reports requires adequate health literacy and numeracy. Deficiencies in these skills may hinder communication between patients and providers. This study aimed to assess health literacy and numeracy levels in an endocrine surgery clinic to improve thyroid cytopathology reports from the patients’ perspective.</div></div><div><h3>Methods</h3><div>A prospective study was conducted over 2 mo at a single institution's endocrine surgery clinic. Pre- and post-procedure surveys assessed patient comprehension of thyroid fine-needle aspiration (FNA) cytopathology reports. The pre-procedure survey collected demographics and included 16 items: 12 assessing understanding of thyroid pathology terminology (Pathology Understanding Survey) and four evaluating health literacy and numeracy. The post-procedure survey, administered after patients reviewed their FNA cytopathology reports with the surgeon, included open-ended and multiple-choice questions addressing readability, terminology clarity, layout, and personalization. Qualitative data were thematically coded, and quantitative analyses used chi-square and <em>t</em>-tests.</div></div><div><h3>Results</h3><div>Out of 26 pre-procedure survey participants, most were White (58%), female (65%), and completed post-secondary education (64%). While 73% had high health literacy, 92% had limited numeracy. Higher scores on the cytopathology understanding survey were associated with higher numeracy (<em>P</em> = 0.025) but not prior exposure to thyroid cytopathology reports (<em>P</em> &gt; 0.05). Compared to White respondents, Black respondents had lower numeracy skills (<em>P</em> = 0.048) and older respondents had higher numeracy skills (<em>P</em> = 0.03). There were no demographics associated with higher health literacy (all <em>P</em> ≥ 0.05). Eleven patients completed the post-procedure survey; 82% viewed cytopathology reports favorably but suggested adding visual aids and a glossary. While preferring the existing text volume, patients favored personalized explanations tailored to their findings.</div></div><div><h3>Conclusions</h3><div>Endocrine surgery patients exhibit limited numeracy skills, whereas self-reported health literacy is high. Prior exposure to cytopathology reports was not associated with comprehension, but numeracy was. Patients preferred more personalized reports with visual enhancements, highlighting opportunities to improve cytopathology report design and patient understanding.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"319 ","pages":"Pages 178-184"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146191233","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":"Breast Conserving Therapy is a Safe Option for Women Under 40 Diagnosed With Breast Cancer","authors":"Arith Reyes MD ,&nbsp;Eunice Y. Lee MD, PhD ,&nbsp;Courtney Connelly MD ,&nbsp;Jonathan Wyrick MD ,&nbsp;Roshni Rao MD ,&nbsp;Luona Sun MD ,&nbsp;Bret Taback MD ,&nbsp;Stacy Ugras MD ,&nbsp;Lisa Wiechmann MD","doi":"10.1016/j.jss.2026.01.021","DOIUrl":"10.1016/j.jss.2026.01.021","url":null,"abstract":"<div><h3>Introduction</h3><div>The incidence of breast cancer in young, premenopausal women has increased over time. For women above the age of 40, it is well-established that mastectomy and breast conserving therapy (BCT)—defined as lumpectomy plus radiation— confer similar outcomes in survival, albeit with a higher rate of local recurrence with BCT. The outcomes of mastectomy <em>versus</em> BCT in young women, however, remain unclear. In this study, we evaluate survival and recurrence risk in women under the age of 40 who have undergone mastectomy <em>versus</em> BCT.</div></div><div><h3>Methods</h3><div>We performed a retrospective review of all women diagnosed with breast cancer at the age of 40 or younger between 1995 and 2020 at Columbia University Irving Medical Center. Overall survival and recurrence-free survival were compared for patients undergoing mastectomy and BCT. Data were obtained from an established tumor registry and chart review; multivariate analysis was performed.</div></div><div><h3>Results</h3><div>There were 414 women (average age 35 y) identified who were diagnosed with breast cancer at the age of 40 or younger. The median follow-up was 74 mo. In our cohort, 46% had a family history of breast cancer, 20% carried a <em>BRCA</em> gene pathogenic variant, 28% were nulliparous, and 12% presented with pregnancy-associated breast cancer. Distribution by subtype was: hormone receptor positive (HR+)/ human epidermal growth factor receptor negative (HER2-) in 59%, HER2+ in 21%, and HR-/HER2-/triple negative breast cancer in 20%. The stage at time of diagnosis was as follows: stage 0 (10%); stage 1 (24%); stage 2 (41%); stage 3 (14%), and stage 4 (11%). Neoadjuvant chemotherapy was administered to 42% of women per the standard of care, and 64% (<em>n</em> = 216) underwent mastectomy and 36% (<em>n</em> = 119) underwent BCT. Adjuvant radiation was administered to 68% of women (100% of BCT patients). The most common type of recurrence was distant metastasis (62%) compared with local and locoregional recurrence (38%). There was no statistically significant difference in 5-y overall survival (<em>P</em> = 0.24) and recurrence-free survival (<em>P</em> = 0.09) between BCT and mastectomy. On multivariate analysis , after controlling for age, stage, tumor subtype, and BRCA status, there was no difference in mortality (β = 0.018, <em>P</em> = 0.66) and recurrence (β = −0.069, <em>P</em> = 0.34) between patients who underwent BCT <em>versus</em> mastectomy at the last follow-up.</div></div><div><h3>Conclusions</h3><div>In our cohort with 5-y survival data, BCT is a safe option for women aged 40 y and under who are diagnosed with breast cancer. Despite no survival benefit, young women with breast cancer in our cohort underwent mastectomy more often than lumpectomy. Importantly, most recurrences were distant metastases, suggesting that local therapy choice is less relevant to outcome.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"319 ","pages":"Pages 152-159"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146191342","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 Risk Factors for Venous Thromboembolism in Hemodynamically Unstable Pelvic Fractures","authors":"Rachel A. Holstein MPH ,&nbsp;Courtney H. Meyer MD, MPH ,&nbsp;Olivia Herrmann BS ,&nbsp;Alejandro De Leon Castro MD ,&nbsp;James Walker MD ,&nbsp;Samuel R. Todd MD ,&nbsp;Randi N. Smith MD, MPH ,&nbsp;Jonathan Nguyen DO ,&nbsp;Jason D. Sciarretta MD","doi":"10.1016/j.jss.2026.01.008","DOIUrl":"10.1016/j.jss.2026.01.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Pelvic fractures can cause severe hemorrhage and instability in trauma patients. The association between pelvic fracture morphology, venous thromboembolism (VTE) risk, and clinical outcomes remains unclear. This study evaluates the incidence, risk factors, characteristics, and outcomes of VTE in hemodynamically unstable pelvic fractures.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included adult trauma patients with blunt pelvic ring disruptions and hemorrhagic shock (systolic blood pressure &lt;90 mmHg) admitted to an American College of Surgeons-verified Level I adult trauma center between January 1, 2022 and May 31, 2023. Demographic and clinical data were abstracted from the electronic medical record. The primary outcome was in-hospital VTE. Secondary outcomes included intensive care unit and hospital length of stay (LOS) and mortality.</div></div><div><h3>Results</h3><div>Of 133 patients, 32 (24.1%) developed VTE (4.5% deep vein thrombosis alone, 12.8% pulmonary embolism alone, 6.8% both). VTE was diagnosed a median of 7 d after admission. Nearly all patients received early chemoprophylaxis (median initiation hospital day 1), with no differences in timing by VTE status or fracture pattern (<em>P</em> &gt; 0.05). Fracture morphology was not independently associated with VTE. VTE was associated with longer intensive care unit LOS (11.5 <em>versus</em> 5.0 d, <em>P</em> &lt; 0.001) and hospital LOS (20.5 <em>versus</em> 17.0 d, <em>P</em> = 0.028), though mortality did not differ. In multivariable regression, no independent associations were found between VTE and age, sex, body mass index, or injury severity score.</div></div><div><h3>Conclusions</h3><div>VTE was common despite early chemoprophylaxis. Fracture morphology did not independently predict VTE. Early VTE timing underscores the need for vigilant surveillance and uninterrupted prophylaxis. Prospective studies are needed.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"319 ","pages":"Pages 47-57"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132147","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":"Risks of Failure in Advanced Trauma Life Support Courses","authors":"Zachary C. Newman MD ,&nbsp;David V. Deshpande BS ,&nbsp;Jim Doherty MD ,&nbsp;Sanja Nikolich MD ,&nbsp;Leah Carey Tatebe MD ,&nbsp;David A. Hampton MD, MEng ,&nbsp;Judith Brasic RN ,&nbsp;Timothy P. Plackett DO, MPH","doi":"10.1016/j.jss.2026.01.005","DOIUrl":"10.1016/j.jss.2026.01.005","url":null,"abstract":"<div><h3>Introduction</h3><div>The Advanced Trauma Life Support (ATLS) course is the common standard for care and disposition of trauma patients across both designated and nondesignated trauma centers. Evidence of individual student risk factors for ATLS course performance are minimal.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted using ATLS course data for hybrid student and refresher courses taught in 2022-2023 from a single American College of Surgeons Regional Committee on Trauma. Marginal performance was defined as a post-test score of &lt; 80% on the written examination or failing the practical test on the first attempt. Univariable analysis by predictor was completed using the <span><math><mrow><msup><mi>χ</mi><mn>2</mn></msup></mrow></math></span> test and Mann–Whitney <em>U</em> tests, as appropriate. Multivariable analysis was completed with logistic regression analysis.</div></div><div><h3>Results</h3><div>Among 996 students in the study, 191 (19%) were identified as having marginal ATLS course performance. Marginal performance was significantly more common in the student course (24%) than in the refresher course (9%). Marginal performers differed by medical degree and training status, medical specialty, and level of their home institution trauma center designation. In regression analysis, lower pretest score was associated with higher odds of marginal performance. As compared to advanced practice providers, an attending physician status was associated with lower odds of marginal performance.</div></div><div><h3>Conclusions</h3><div>Marginal performance varies by specialty, training level, and home institution trauma center designation. Future work is needed to identify and support at-risk students in both initial and refresher hybrid ATLS courses.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"319 ","pages":"Pages 18-23"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081860","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":"Implementation and Evaluation of a Protocol for the Management of Type C Tracheoesophageal Fistula","authors":"Sage A. Vincent MD ,&nbsp;Lori Silveira PhD, MS ,&nbsp;Samantha Bothwell MS ,&nbsp;Jonathan Roach MD ,&nbsp;Jose Diaz-Miron MD, MSCS ,&nbsp;Stephanie L. Bourque MD, MSCS ,&nbsp;Shannon N. Acker MD","doi":"10.1016/j.jss.2026.01.010","DOIUrl":"10.1016/j.jss.2026.01.010","url":null,"abstract":"<div><h3>Introduction</h3><div>A multidisciplinary protocol for the management of esophageal atresia/tracheoesophageal fistula (EA/TEF) was developed with stakeholders from pediatric surgery and neonatology. Introduced in July 2022, this study aims to assess protocol utilization and association with patient outcomes.</div></div><div><h3>Methods</h3><div>We performed a single-center, retrospective review of neonatal patients who underwent type C EA/TEF repair between 2010 and 2024. Utilization of protocol elements was assessed, as well as clinical outcomes. Preprotocol and postprotocol management and outcomes were compared using logistic regression. A prospective provider survey was administered to assess protocol sustainability and knowledge.</div></div><div><h3>Results</h3><div>There were 103 patients who underwent type C EA/TEF repair, 87 preprotocol and 16 postprotocol implementation. Thoracoscopic repair was more common postprotocol (68.8% <em>versus</em> 31.0%, <em>P</em> = 0.003). Patients were more likely to receive total parenteral nutrition until full enteral feeds were reached (odds ratio 75.6; 95% confidence interval 4.2, 1445; <em>P</em> = 0.003) and receive enteral feeds within 24 h of surgery when transanastomotic tube was in place (odds ratio 3.71; 95% confidence interval 1.04, 13.27; <em>P</em> = 0.043) postprotocol. There was no significant change in outcomes including anastomotic leak and stricture. Providers could correctly identify 2/3 of the EA/TEF protocol elements and 22% reported receiving education on its contents.</div></div><div><h3>Conclusions</h3><div>Implementation of an EA/TEF protocol was associated with a 75 times greater likelihood of patients receiving total parenteral nutrition until full feeds were reached and 3.7 times greater likelihood of starting enteral feeds within 24 h of surgery when transanastomotic tube was in place. There was a shift toward thoracoscopic repair of EA/TEF and no change in clinical outcomes including anastomotic leak and stricture. Implementation and knowledge of the protocol faced challenges and provider surveys identified avenues for improving education strategies.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"319 ","pages":"Pages 108-116"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165745","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":"Assessing the Association of Age and Preoperative Sodium Level on Colectomy Outcomes: An NSQIP Study","authors":"Amandeep S. Ahluwalia BS,&nbsp;Hari Ramesh MS,&nbsp;Zummar Asad MB, BCh, BAO,&nbsp;Alex I. Halpern MD,&nbsp;Matthew Ng MD,&nbsp;Susan Kartiko MD, PhD, FACS","doi":"10.1016/j.jss.2026.01.012","DOIUrl":"10.1016/j.jss.2026.01.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Preoperative abnormal sodium level is suggested to increase mortality risk in surgeries, including colectomy for colorectal cancer. However, it remains unclear which age groups are most affected by this electrolyte derangement. To bridge this gap and to better risk stratify patients preoperatively, we assessed the association of age on patients with abnormal sodium level undergoing colectomy for colorectal cancer.</div></div><div><h3>Materials and Methods</h3><div>We reviewed the American College of Surgeons National Safety Quality Improvement Program Procedure-Targeted Colectomy database from 2015-2020, identifying patients over the age of 18 who underwent colectomy for primary colon cancer. We dichotomized the group by age, either younger than or 65 y and older. We collected demographics, comorbidities, laboratory values, and operative variables. We performed descriptive statistics, univariate analysis, and multivariable logistic regression with interaction term analysis. Our primary outcome was the relationship between age and 30-d mortality among patients with abnormal sodium levels. We defined statistical significance using two-sided tests as <em>P</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>We identified 89,745 patients who underwent colectomy for primary colon cancer, 50,528 of those were aged 65 y and older. On multivariate analysis, we found that age ≥65 y is associated with an increased risk of mortality (odds ratio [OR], 2.574, <em>P</em> &lt; 0.01). We found sodium level to have a U-shaped relationship with increased risk of mortality for both hyponatremia and hypernatremia (hyponatremia OR, 1.38, <em>P</em> &lt; 0.01, hypernatremia OR, 1.878, <em>P</em> &lt; 0.01), controlling for demographics and comorbidities. On multivariate interaction analysis, sodium level did not pose a clinically significant higher mortality risk to patients' age (OR, 1.002, <em>P</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>Advanced age and abnormal sodium level are independently associated with 30-d mortality following colectomy for colon cancer. Furthermore, the association between abnormal sodium levels and mortality does not differ in a clinically meaningful way between younger and older patients. This finding reinforces that abnormal sodium level is associated with an increased mortality risk after colectomy for colon cancer and provides a potential target for further study.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"319 ","pages":"Pages 141-151"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146191639","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(26)00070-3","DOIUrl":"10.1016/S0022-4804(26)00070-3","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"319 ","pages":"Page iii"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147395679","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":"Reasons for Women Surgeon Attrition From the US Workforce","authors":"Elisa Bass BA ,&nbsp;Richard Butterfield MA ,&nbsp;Ruth Bush MD, JD, MPH ,&nbsp;Linda Harris MD ,&nbsp;Palma Shaw MD ,&nbsp;Kellie Brown MD ,&nbsp;Ellen Julian PhD ,&nbsp;Sarah McLaughlin MD ,&nbsp;Young Erben MD","doi":"10.1016/j.jss.2026.01.003","DOIUrl":"10.1016/j.jss.2026.01.003","url":null,"abstract":"<div><h3>Introduction</h3><div>With a projected shortage of over 30,000 surgeons by 2034, understanding and reducing nonretirement attrition is critical to maintaining a sustainable surgical workforce. Prior studies show higher attrition rates among women surgeons but have limited insight into the reasons behind these decisions. This study aims to identify the factors contributing to consideration of workforce attrition among women surgeons and to highlight modifiable elements that may support retention.</div></div><div><h3>Methods</h3><div>An anonymous online survey was distributed to the Association of Women Surgeons email list and women surgeons’ WhatsApp groups between October and December 2024. Respondents were asked whether they had considered leaving the surgical workforce for reasons unrelated to retirement and about factors contributing to both their consideration of leaving and their decision to remain. Responses were analyzed using descriptive statistics and chi-square tests.</div></div><div><h3>Results</h3><div>The response rate was 15%. Of 371 total female respondents, 242 (65%) reported having considered or currently considering leaving surgery. The top reasons cited were poor work-life balance (71%), overly demanding work (57%), and discrimination or mistreatment (50%), among whom 96% reported gender-based discrimination. Primary factors for staying included financial necessity (61%), good patient relationships (60%), and collegial support (54%). Among those who considered but decided not to leave, improved work-life balance (43%), increased compensation (26%), and improved workplace relationships (26%) were the most common influences.</div></div><div><h3>Conclusions</h3><div>Attrition among women surgeons stems from systemic challenges. Interventions targeting work-life balance, compensation, and workplace inclusion may meaningfully support retention and help sustain a diverse and effective surgical workforce.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"319 ","pages":"Pages 30-39"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119316","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}