Journal of the American College of Surgeons最新文献

{"title":"Bridging Faith and Function: A Seamless Solution for Surgical Inclusivity.","authors":"Zaiba Shafik Dawood, Hasan B Alam","doi":"10.1097/XCS.0000000000001460","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001460","url":null,"abstract":"","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wireless Localization of Non-palpable Breast Cancer: An Ever-Moving Target.","authors":"Erin M Bayley","doi":"10.1097/XCS.0000000000001385","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001385","url":null,"abstract":"","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic vs Laparoscopic vs Open Ventral Hernia Repair: Insights from a Network Meta-Analysis of Randomized Clinical Trials.","authors":"Giulia Almiron da R Soares, Josélio Rodrigues de Oliveira Filho, Pedro Bicudo Bregion, Rafaela Hamada Juca, Lucas M Barbosa, Raquel Oliveira de S Silva, Deivyd Vieira Silva Cavalcante, Sergio Mazzola Poli de Figueiredo, Victor Kenzo Ivano","doi":"10.1097/XCS.0000000000001455","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001455","url":null,"abstract":"<p><strong>Background: </strong>Ventral hernia repair is one of the most frequently performed surgical procedures worldwide, yet there is no consensus on the safest and most effective approach. This network meta-analysis aimed to evaluate the optimal surgical technique for ventral hernia repair.</p><p><strong>Study design: </strong>We systematically searched PubMed, Embase, and Cochrane for randomized controlled trials (RCTs) comparing surgical interventions for ventral hernia repair. A frequentist network meta-analysis was conducted, pooling risk ratios (RR) for binary outcomes and mean differences (MD) for continuous outcomes with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>A total of 34 studies with 3,779 patients were included. No significant differences were observed in recurrence, seroma, or hematoma rates between groups. Laparoscopic IPOM plus significantly reduced hospital stays compared to open surgery (MD - 2.24 days; 95% CI -3.26 to -1.23) and wound infection risk (RR 0.29; 95% CI 0.21 to 0.41) compared to open surgery. The robotic approach was associated with increased operative time compared to both laparoscopic and open approaches (MD -49.08 minutes; 95% CI -87.77 to -10.39).</p><p><strong>Conclusion: </strong>Laparoscopic and robotic techniques demonstrated similar efficacy regarding recurrence, seroma, and hematoma rates. While open surgery remains a more cost-effective approach, it was associated with a higher risk of wound infections. Given these findings, the choice of surgical technique should be individualized based on patient-specific factors, surgeon expertise, and institutional resources to optimize both clinical and economic outcomes.</p>","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Straddling State Lines: The Hidden Burden of Cross-Border Trauma Care.","authors":"Cody L Mullens, John W Scott","doi":"10.1097/XCS.0000000000001457","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001457","url":null,"abstract":"","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of State Helmet Laws with Helmet Use and Injury Outcomes in Motorcycle Crashes.","authors":"Stephanie M Jensen, Ansley Ricker, Ronald F Sing, Sam Ross, Kyle W Cunningham, A Britton Christmas","doi":"10.1097/XCS.0000000000001400","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001400","url":null,"abstract":"<p><strong>Background: </strong>Helmet laws vary by state. North Carolina (NC) requires all motorcyclists to be helmeted, while South Carolina (SC) requires helmets only for drivers under 21 years of age. We examined helmet use data and outcomes among motorcycle crash (MCC) patients evaluated at a level I trauma center with a catchment area spanning the two states.Study Design: A retrospective cohort study was conducted of all adult MCC victims evaluated by the trauma department at an ACS-verified Level 1 Trauma Center between July 2012 and July 2022. Helmet usage was compared by state, and outcomes were compared by helmet status.</p><p><strong>Results: </strong>A total of 2,196 patients were evaluated following MCC; 86.3% were helmeted. Patients injured from NC were more likely to be helmeted as compared to SC (94 vs 52%, respectively, p<0.001). Helmeted patients had a lower Injury Severity Score (13.6 vs 16.0, p=0.001). Helmeted patients were more likely to be discharged from the ED (13 vs 10%) and were less likely to be admitted to the ICU (25% vs 39%, p<0.001). In-hospital mortality for helmeted patients was 4% vs 7% in unhelmeted patients (p=0.05).</p><p><strong>Conclusion: </strong>Patients from NC were more likely to be helmeted as compared to SC. Unhelmeted patients had more severe injuries, were more likely to be admitted and require ICU-level care.</p>","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardized Classification System for Pilonidal Disease and Recurrence Rate after Treatment.","authors":"Bill Chiu, Humza Thobani, Claire Abrajano, Faraz Khan, Elena Harnish, Kyla Dalusag","doi":"10.1097/XCS.0000000000001454","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001454","url":null,"abstract":"<p><strong>Background: </strong>Current classification systems for pilonidal disease do not objectively profile disease severity, limiting their clinical applicability. This study aimed to validate a novel pilonidal disease severity (PDS) staging system by testing its correlation with disease recurrence.</p><p><strong>Study design: </strong>This was a prospective cohort study set at a high-volume, specialized pilonidal care center. All patients presenting with pilonidal disease were included. The main effector under study was PDS stage assigned at initial presentation. Secondary effector variables were an open wound >1 cm on presentation (descriptor W) or prior surgical resection (descriptor R). The primary outcome was pilonidal disease recurrence at 1- and 2-year follow-up.</p><p><strong>Results: </strong>A total of 411 patients met criteria, with 212 and 206 patients completing 1- and 2-year follow-up respectively. Among patients who completed 1-year follow-up, recurrence occurred in 0.0%, 2.3%, 8.3% and 20.8% of patients with PDS stage 0, 1, 2, and 3 disease at initial presentation respectively (log-rank test, p=0.017). At 2-years, recurrence was noted in 0.0%, 4.8%, 12.7% and 27.5% of patients with PDS stage 0, 1, 2, and 3 disease respectively (log-rank test, p=0.010). The presence of an open wound at initial presentation and prior surgical resection were not associated with risk of recurrence (W, p=0.94; R, p=0.98).</p><p><strong>Conclusions: </strong>This study describes the first staging system for pilonidal disease which correlates with risk of recurrence. Upon further external validation, the PDS staging system may be utilized both clinically to tailor treatment regimens to risk of disease recurrence; and in research to standardize disease severity when comparing different therapeutic interventions.</p>","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuing the Conversation: Methodologies for Handling Multiple CPT Codes in NSQIP Benchmarking.","authors":"Mark E Cohen, Yaoming Liu, Bruce L Hall, Clifford Y Ko","doi":"10.1097/XCS.0000000000001452","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001452","url":null,"abstract":"","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Biomarkers of Acute Intestinal Ischemia: A Prospective Study Validating the Interest of GLP-1 and GLP-2.","authors":"Amar El Hamwi, Fanny Hamard, Charlotte Hinault-Boyer, Juliette Raffort, Fabien Lareyre, Jacques Grober, Damien Massalou","doi":"10.1097/XCS.0000000000001453","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001453","url":null,"abstract":"<p><strong>Background: </strong>Acute intestinal ischemia (AII) remains a major diagnostic challenge, associated with high morbidity and mortality. Current biomarkers lack sufficient sensitivity and specificity. Proglucagon-derived peptides constitute a family of hormones involved in the regulation of intestinal mucosal physiology. Alterations in circulating levels of these peptides may occur during intestinal ischemia, suggesting their potential as diagnostic biomarkers.</p><p><strong>Objective: </strong>The aim of our study was to assess whether circulating levels of proglucagon-derived peptides differ between patients with acute intestinal ischemia and a control group.</p><p><strong>Study design: </strong>This was a prospective, single-center study including patients diagnosed with acute intestinal ischemia (AII) and a control group of patients presenting with acute abdominal pain. Clinical and biochemical parameters, as well as management strategies, were recorded. Circulating levels of proglucagon-derived peptides were measured in serum.</p><p><strong>Results: </strong>A total of 23 patients were included in the ischemia group and 23 in the control group. Univariate analysis revealed statistically significant differences between groups : GLP-1 (glucagon-like peptide 1) levels were significantly higher in the ischemia group compared to controls (5.3 pmol/L vs. 2.3 pmol/L, p = 0.01), as were GLP-2 (glucagon-like peptide 2) levels (2.8 pmol/L vs. 0.9 pmol/L, p = 0.023)and venous lactate (3.3 mmol/L vs. 1.6 mmol/L, p = 0.034). Other biomarkers, including glicentin, intestinal fatty acid-binding protein (I-FABP), and citrulline, showed borderline or non-significant differences.</p><p><strong>Conclusion: </strong>Serum levels of GLP-1 and GLP-2 were significantly increased in patients with acute intestinal ischemia compared to controls. These findings suggest that GLP-1 and GLP-2 may serve as promising biomarkers for the early diagnosis of AII in the emergency setting.</p>","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Whole Blood Really Better?","authors":"Jennifer Freeman","doi":"10.1097/XCS.0000000000001451","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001451","url":null,"abstract":"","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician and Trainee Experiences with Hijab-Wear and Demonstration of a Surgical Hijab Prototype.","authors":"Raneem D Rajjoub, Alisha Kamboj, Andrew R Harrison, Ali Mokhtarzadeh","doi":"10.1097/XCS.0000000000001448","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001448","url":null,"abstract":"<p><strong>Background: </strong>Physician and trainee experiences with hijab-wear in the operating room and associated challenges impact wellness in the workplace.</p><p><strong>Study design: </strong>To evaluate physician and trainee experiences regarding hijab-wear and associated barriers in the operating room, and to devise a suitable alternative to current coverage options. A survey-based, cross-sectional analysis of female physicians and trainees who observe hijab in the operating room in the United States was performed using convenient-sampling methods. Inclusion criteria included Muslim females who wear hijab and are currently practicing in an operating room setting, a resident or fellow in a surgical specialty, or a medical student.</p><p><strong>Results: </strong>Seventy-five survey respondents, 45 physicians and 30 medical students, were included. A majority of physicians reported an academic clinical practice setting (66.7%) and hospital-based operating room setting (60.0%). Overall, 33.3% of physicians and 26.7% of medical students remove their hijab for the operating room. Bouffant caps were most frequently worn (62.2% of physicians, 53.3% of medical students) in place of or over their hijab. More than half of respondents are unsatisfied with their current amount of hair, neck, and arm coverage in the operating room. The majority of comments made regarding hijab-wear in the surgical setting pertained to the sterility of the hijab.</p><p><strong>Conclusions: </strong>This study highlights challenges faced by female physicians and medical students who observe hijab in the operating room. We introduce a novel, facility-laundered hijab for sterile areas in healthcare facilities to increase workplace satisfaction and inclusivity, while maintaining patient safety.</p>","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}