Journal of Surgical Research最新文献

{"title":"Asian American Representation in Surgical Training in the United States","authors":"Christina L. Cui MD, MAS ,&nbsp;William Y. Luo MD, MAS ,&nbsp;Crystal Jing BS ,&nbsp;Tristen T. Chun MD, MS ,&nbsp;Suresh K. Agarwal MD ,&nbsp;Young Kim MD, MS","doi":"10.1016/j.jss.2025.09.002","DOIUrl":"10.1016/j.jss.2025.09.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Asians are considered an over-represented minority in medicine, making up 7% of the US national population but 17.1% of active physicians. However, representation trends are different across surgical specialties, and many surgical residency programs, most notably plastic surgery, otolaryngology, and orthopedic surgery, are less racially diverse than nonsurgical residency programs. Asian representation in surgical residency programs, in particular, has not been previously reported. The purpose of this study is to review demographic data among all surgical trainees to understand trends in Asian representation in surgical residency programs.</div></div><div><h3>Methods</h3><div>Annual Graduate Medical Education data reports were collected and retrospectively analyzed for demographic data on surgical trainees from 2013 to 2022. Sixteen surgical specialties were examined. All demographic data were self-reported. Linear regression analysis was used to examine annual trends in Asian representation over the study period.</div></div><div><h3>Results</h3><div>The study population included 1,296,204 resident physicians from 108,193 training programs over a 10-y study period. Of these, 350,417 (27.0%) individuals self-identified as Asian race. In fifteen out of sixteen surgical specialties, the proportion of Asian trainees was below the American Council on Graduate Medical Education (ACGME) average (<em>P</em> &lt; 0.05 each). Asian representation was lowest in orthopedic surgery (12.9 ± 0.4%), surgical critical care (13.1 ± 2.2%), and pediatric surgery (15.4% ± 2.6%) (<em>P</em> &lt; 0.0001 <em>versus</em> all programs). Only ophthalmology had a higher Asian representation (31.0 ± 1.9%, <em>P</em> &lt; 0.0001) compared with the aggregate trainee population. On linear regression analysis, Asian representation has declined among total ACGME-accredited programs at a rate of 0.2% annually (R² = 0.82, <em>P</em> &lt; 0.0001). Seven surgical specialties experienced an annual decline in Asian representation over the past decade, including cardiothoracic surgery (traditional), colorectal surgery, complex general surgical oncology, general surgery, ophthalmology, plastic surgery (traditional), and vascular surgery (traditional) (<em>P</em> &lt; 0.05 each). Similar trends in representation are reported among the current surgical workforce.</div></div><div><h3>Conclusions</h3><div>The percentage of Asians in almost all surgical residency training programs falls below the ACGME average, indicating low matriculation rates into surgical specialties. Trend analysis suggests that these disparities have only grown wider over the past decade. Future initiatives should focus on recruitment and mentorship of Asians surgeons, in order to best care for the large and growing Asian demographic in the United States.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"315 ","pages":"Pages 159-164"},"PeriodicalIF":1.7,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222100","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":"Response Regarding: Comparison of Risk Assessment Tools’ Prediction of Outcomes for Penetrating Trauma","authors":"Jeffrey Santos MD,&nbsp;Catherine M. Kuza MD,&nbsp;Areg Grigorian MD,&nbsp;Jeffry Nahmias MD, MHPE","doi":"10.1016/j.jss.2025.06.047","DOIUrl":"10.1016/j.jss.2025.06.047","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"314 ","pages":"Pages 720-721"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667902","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)00608-0","DOIUrl":"10.1016/S0022-4804(25)00608-0","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"314 ","pages":"Page IFC"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219608","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: Normothermic Machine Perfusion and Liver Transplant Waitlist Times: A Single-Center Matched Cohort Study","authors":"Parsa Torkaman MD,&nbsp;Nima Masoudi MD","doi":"10.1016/j.jss.2025.06.095","DOIUrl":"10.1016/j.jss.2025.06.095","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"314 ","pages":"Pages 731-732"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958565","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":"Nerve Blocks in Reduction Mammaplasty: A Systematic Review and Meta-Analysis of Pain Outcomes","authors":"Anya Y. Wang BA,&nbsp;Katherine G. Stark BS,&nbsp;Ethan Fung BS,&nbsp;Nicole Gladstein BS,&nbsp;Keisha E. Montalmant MD, MPH,&nbsp;Bernice Z. Yu DO,&nbsp;Peter W. Henderson MD, MBA, FACS","doi":"10.1016/j.jss.2025.09.020","DOIUrl":"10.1016/j.jss.2025.09.020","url":null,"abstract":"<div><h3>Introduction</h3><div>Postoperative pain can delay recovery following reduction mammaplasty (RM). While nerve blocks (NBs) are widely used in other surgeries, their efficacy in RM remains underexplored. This study evaluates the impact of perioperative NB on pain management and opioid use after RM.</div></div><div><h3>Methods</h3><div>A systematic review was performed per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pubmed, Embase, SCOPUS, and Cochrane databases were queried for studies on NB in RM. NB type and outcomes, including postoperative pain, opioid consumption, and rescue analgesia, were extracted. Meta-analysis was performed using a random-effects model and inverse-variance methods to calculate mean differences (MDs).</div></div><div><h3>Results</h3><div>Seven studies with 330 patients were included, of whom 53.6% (<em>n</em> = 177) received NB. Six studies used saline negative controls, and one compared drug compositions. NB significantly reduced postoperative pain at 1 h (MD −2.00, <em>P</em> &lt; 0.001), 4 h (MD −1.86, <em>P</em> &lt; 0.001), 6 h (MD −2.13, <em>P</em> = 0.005), and 12 h (MD −1.89, <em>P</em> &lt; 0.001), but not at 24 h (MD −0.78, <em>P</em> = 0.12). NB also reduced intraoperative (MD −8.51, <em>P</em> = 0.02) and 24-h postoperative opioid use (MD −7.55, <em>P</em> &lt; 0.001). The need for rescue analgesia was reduced by 96% following NB (odds ratio 0.04, <em>P</em> &lt; 0.001). No difference in pain reduction at 1 h was found between NB types (<em>P</em> = 0.81, I² = 0%).</div></div><div><h3>Conclusions</h3><div>NBs significantly reduce early postoperative pain and opioid use in RM, with no differences observed between NB types.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"315 ","pages":"Pages 128-138"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213136","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":"Equity of Access to Care in an Urban Trauma System.","authors":"Allan E Stolarski, Sophia M Smith, Michael Poulson, Daniel Holena, Sandro Galea, Danby Kang, Crisanto Torres, Noelle Saillant, Dane Scantling","doi":"10.1016/j.jss.2025.07.010","DOIUrl":"10.1016/j.jss.2025.07.010","url":null,"abstract":"<p><strong>Introduction: </strong>Every minute of prehospital transport-time (TT) is critical to survival. Our objective was to assess granular urban community-level access to trauma centers.</p><p><strong>Methods: </strong>We utilized 2020 Decennial Census data at the block group (BG) level. BG centroids were calculated and a network analysis of historic traffic data was used to determine the predicted TT to the nearest trauma center.</p><p><strong>Results: </strong>A total of 581 Boston BGs with 273,188 households and 675,647 individuals were identified. Five hundred sixty-six (97%) met inclusion criteria. Of households, 48,711 (17.8%) received cash/food assistance. Furthermore, 278 (49%) of BGs had a White non-Hispanic majority, 80 (14%) had a Black non-Hispanic majority and 27 (5%) had a Hispanic majority population. Household income quartiles ranged from $32,394 to $157,283 and White non-Hispanic majority BGs had more than double the median income of other BGs. Relative to the highest income BGs, TT increased as income decreased for the middle quartiles (β 1.7, 95% confidence interval [CI] 0.48 to 2.90, P < 0.01) and (β 2.6 95% CI 1.4 to 3.8, P < 0.01 respectively) but not in the lowest income quartile BGs. Public assistance was not associated with TT. An increased proportion of the population that was Black (β 0.10, 95% CI 0.07 to 0.11, P < 0.01) or Hispanic (β 0.04, 95% CI 0.01 to 0.07, P < 0.01) related to increased TT. Majority White communities had TTs nearly half that of majority Black communities (8.8 min vs. 15.6 min; P < 0.01).</p><p><strong>Conclusions: </strong>Communities with higher non-White populations have reduced access to trauma care while some available poverty metrics relate to TT (household income) and others do not.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"314 ","pages":"298-304"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817027","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":"Racial and Sex Disparities in US Kidney Transplant Clinical Trials: A Comparative Analysis With National Transplant Registry Data.","authors":"Inbar Hazan, Rahim Hirani, Shreeya Agrawal, Joanna Yao, Emily Zhang, Tammy Liu, Ryan Chan, Devon John, Mill Etienne","doi":"10.1016/j.jss.2025.07.036","DOIUrl":"10.1016/j.jss.2025.07.036","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease and kidney failure disproportionately affect racial and ethnic minorities in the United States, yet these populations remain underrepresented in clinical trials, especially in kidney transplantation research. The objective of this study was to analyze the representation of racial, ethnic, and sex groups in US-based kidney transplant clinical trials and assess whether participant demographics reflect the population receiving transplants, using national registry data.</p><p><strong>Methods: </strong>A total of 188 completed interventional trials related to kidney transplantation (1995-2022) were extracted from clinicaltrials.gov. Demographic data-including race, ethnicity, and sex-were compared against national data from the Organ Procurement and Transplantation Network. Chi-square tests and logistic regressions were performed to assess representation trends and predictors of demographic data reporting.</p><p><strong>Results: </strong>Only 58.51% of trials reported race or ethnicity (P < 0.01). White participants were consistently overrepresented across all time periods, while Black, Asian, multiracial, and Indigenous participants were underrepresented, despite elevated disease burdens (P < 0.0001). From 2011 to 2015 to 2016-2020, Black representation increased significantly (P < 0.001), though still fell short of parity. Multiracial and Asian participants remain markedly underrepresented. Trials with pharmaceutical sponsorship were significantly less likely to report racial or ethnic data (P = 0.008). Females were also underrepresented, comprising only 35.88% of trial participants (P < 0.0001).</p><p><strong>Conclusions: </strong>The persistent underrepresentation of minority groups and females in kidney transplant trials undermines the generalizability of findings and perpetuates inequities in care. Comprehensive and intersectional demographic reporting should be mandated, and recruitment strategies must prioritize inclusivity to ensure that clinical research equitably serves all affected populations.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"314 ","pages":"305-311"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817028","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":"Association of Transplant Rate Ratio, Waitlist Survival, and Post-Transplant Survival: Analysis of Scientific Registry of Transplant Recipients Metrics.","authors":"Faizaan Siddique, Sanath Patil, Nayeem Nasher, Daler Rahimov, Saaniya Farhan, Adam S Bodzin, John W Entwistle, Charles W Hoopes, Vakhtang Tchantchaleishvili","doi":"10.1016/j.jss.2025.07.012","DOIUrl":"10.1016/j.jss.2025.07.012","url":null,"abstract":"<p><strong>Introduction: </strong>We sought to elucidate the relationship between transplant rate ratio, waitlist survival, and 1-y post-transplant survival across liver, lung, and heart transplant programs.</p><p><strong>Methods: </strong>We extracted the Scientific Registry of Transplant Recipients (SRTR) tier rating data in July 2023 reflecting program performance over the past year in three metrics: transplant rate ratio, waitlist survival, and 1-y post-transplant survival. The five tiers ranged from one (lowest) to five (highest) in terms of performance within each metric. The rating metrics were compared across liver, heart, and lung transplant centers.</p><p><strong>Results: </strong>A higher transplant rate ratio rating was significantly associated with lower waitlist survival rating among lung transplant centers (r = -0.34, P < 0.01), with a nonsignificant trend observed among heart transplant centers (r = -0.16, P = 0.08). A higher transplant rate ratio rating was associated with higher 1-y post-transplant survival rating among heart transplant centers (r = 0.22, P < 0.05). Although no direct association was found between waitlist survival rating and post-transplant survival rating, the comparison of all three SRTR tier rating metrics simultaneously produced regression planes that were significant for heart and lung transplant centers (P < 0.01 and P = 0.02, respectively). A higher transplant rate ratio rating was significantly associated with lower waitlist survival rating and higher 1-y post-transplant survival rating for these centers, although liver transplant centers exhibited no relationship among these metrics.</p><p><strong>Conclusions: </strong>Heart and lung transplant centers with higher transplant rate were associated with lower waitlist survival and higher 1-y post-transplant survival, although the SRTR tier ratings were not significantly associated to each other among liver transplant centers.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"314 ","pages":"255-260"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804305","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":"Same-Day Discharge Sleeve Gastrectomy at a Military Treatment Facility: Protocol and Initial Outcomes.","authors":"Hannah Palmerton, Grace Pak, Bobby Zhang, Robert Shawhan, C Rees Porta","doi":"10.1016/j.jss.2025.07.013","DOIUrl":"10.1016/j.jss.2025.07.013","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The laparoscopic sleeve gastrectomy (LSG) has become the most common bariatric surgery. Due to its relative safety and low complication rate, it has been more commonly performed as an ambulatory surgery. \"Outpatient\" or discharge from postanesthesia care unit within 23 h has been well studied in the civilian sector and has been shown to result in reduced costs, hospital-acquired infections, and improved patient satisfaction. Although there are numerous benefits to outpatient LSG, the military health system has been slow to adopt this practice. This study represents the first and only series on same day (SD)-LSG within the military and demonstrates our protocol, experience, and initial outcomes at Madigan Army Medical Center.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Twenty-eight patients underwent SD-LSG between April 28, 2021, and May 22, 2023. Before initiation of the SD-LSG, a multidisciplinary protocol to include all phases of care (surgical clinic, operating room, and the postanesthesia care unit) was created. Data were prospectively collected. Exclusion criteria included patients with BMI &gt;50 kg/m&lt;sup&gt;2&lt;/sup&gt;, expected operative time &gt;2 h, nonambulatory, intermediate or high cardiac risk, severe obstructive sleep apnea, immunocompromised, or dialysis dependent. The primary outcomes included mortality, complications, and readmission rates. The secondary outcomes included patient satisfaction, operating room and postanesthesia care unit times, pIV patency rates, and percent excess body weight loss.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our patient demographics were similar to national demographics for all LSG in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program reported for the same period, with the exception of being slightly younger. During the study period in our institution, 76 LSG were performed in total, 46 of which were performed by participating surgeons and therefore included in the study. Of those included, 28 (61%) were same-day LSG, and 18 (39%) were inpatient LSG, as they did not qualify for the same-day protocol. Of the same-day group, none required unplanned postoperative admission. We had no mortality, reoperations, or readmissions. Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data for the same time frame showed 2.4% readmissions, 0.4% reoperations, and 0.1% mortality. We had one Clavien-Dindo class 2 complication of postoperative hematoma requiring transfusion (3.6%, n = 1/28), which is comparable to reported minor complication rates for LSG, ranging from 2.5% to 5.8% in the literature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;SD-LSG can be a safe and feasible practice in the military health system, helping to offload the inpatient census. Initiating this protocol requires careful patient selection, a multidisciplinary approach, and appropriate coordination with all phases of patient care. SD-LSG has comparable risks to inpatient LSG while reducing ","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"314 ","pages":"284-290"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812193","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: Ischemia-Modified Albumin as a Biomarker in Acute Appendicitis: Insightful but Incomplete?","authors":"Seshadri Reddy Varikasuvu, Satya Ranjan Patra, Saurabh Varshney","doi":"10.1016/j.jss.2025.07.066","DOIUrl":"10.1016/j.jss.2025.07.066","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":" ","pages":"739-741"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000825","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}