Journal of the American College of Surgeons最新文献_第5页

Invited Commentary: Seeing Beyond the Palpable Tumor: A Brighter Future for Image-Guided Precision Oncologic Operation in Children. 超越可触及的肿瘤：儿童影像引导精准肿瘤手术的光明未来。

IF 3.2 2区医学

Journal of the American College of Surgeons Pub Date : 2026-11-01 Epub Date: 2026-06-22 DOI: 10.1097/XCS.0000000000002076

Harold N Lovvorn

引用次数: 0

Self-Reported Flourishing Among US Surgeons: A National Physician Survey. 美国外科医生自我报告的繁荣：一项全国医师调查。

IF 3.2 2区医学

Journal of the American College of Surgeons Pub Date : 2026-11-01 Epub Date: 2026-06-04 DOI: 10.1097/XCS.0000000000002061

Kevin I Ig-Izevbekhai, Felix R De Bie, Kathryn Radulovacki, Hannah Johnston, Allan D Kirk, Julie A Freischlag, Tait Shanafelt, Jon C Tilburt, Ryan M Antiel

{"title":"Self-Reported Flourishing Among US Surgeons: A National Physician Survey.","authors":"Kevin I Ig-Izevbekhai, Felix R De Bie, Kathryn Radulovacki, Hannah Johnston, Allan D Kirk, Julie A Freischlag, Tait Shanafelt, Jon C Tilburt, Ryan M Antiel","doi":"10.1097/XCS.0000000000002061","DOIUrl":"10.1097/XCS.0000000000002061","url":null,"abstract":"Background: Although surgeon burnout is extensively documented, the medical community has limited corresponding data on what it might mean to thrive in the profession, as captured by robust measures of \"flourishing.\"Study design: We conducted a cross-sectional survey measuring flourishing in a sample of 1,000 practicing US surgeons from the AMA Masterfile between September and December 2025, including the Harvard Flourish Index and Secure Flourish Index. We used multivariable regression to assess personal and professional correlates of flourishing.Results: Of 959 eligible surgeons in our sample, 283 (30%) responded. The mean flourishing (Secure Flourish Index) score was 7.98 (±1.21) on a 0 to 10 scale (higher score = higher flourishing). Surgeons reported the highest flourishing in \"financial and material stability\" (8.57 ± 2.11) and \"meaning and purpose\" (8.50 ± 1.39), whereas \"close social relationships\" (7.41 ± 2.08) was the lowest-ranked domain. In multivariate linear regression, working fewer hours (adjusted β [each additional hour], -0.02; p < 0.001), having children (adjusted β, 0.43; p = 0.05), and viewing surgery as a calling (adjusted β, 0.28; p = 0.006) were associated with higher flourishing. A majority of surgeons (88%) view the profession as a calling.Conclusions: Practicing surgeons report high levels of flourishing, with scores surpassing several historical medical and nonmedical cohorts. Most surgeons reported comparatively high scores in meaning and purpose, concurrent with deficits in social connectivity. Burnout and well-being conversations in the surgical professions may benefit from a flourishing framework. Naming meaning and purpose exemplars while being able to identify key deficits, such as social connectivity, may be crucial for helping surgeons thrive.","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":"1130-1139"},"PeriodicalIF":3.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157072","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}

引用次数: 0

Invited Commentary: Is Distal Venous Resection Justified During Pancreaticoduodenectomy? 胰十二指肠切除术中远端静脉切除是否合理？

IF 3.2 2区医学

Journal of the American College of Surgeons Pub Date : 2026-11-01 Epub Date: 2026-06-08 DOI: 10.1097/XCS.0000000000002063

Megan A Satyadi, Ryan P Johnson, Syed A Ahmad

引用次数: 0

Timing of Emergency General Surgery After Acute Pulmonary Embolism. 急性肺栓塞后急诊普通手术时机选择

IF 3.2 2区医学

Journal of the American College of Surgeons Pub Date : 2026-10-27 DOI: 10.1097/XCS.0000000000002266

Deep Mehta, Saad Mallick, Preston Leung, Konmal Ali, Owen Lai, Jaden Rahmani, Syed Shaheer Ali, Troy Coaston, I Obi Emeruwa, Peyman Benharash

{"title":"Timing of Emergency General Surgery After Acute Pulmonary Embolism.","authors":"Deep Mehta, Saad Mallick, Preston Leung, Konmal Ali, Owen Lai, Jaden Rahmani, Syed Shaheer Ali, Troy Coaston, I Obi Emeruwa, Peyman Benharash","doi":"10.1097/XCS.0000000000002266","DOIUrl":"https://doi.org/10.1097/XCS.0000000000002266","url":null,"abstract":"Background: The optimal timing of emergency general surgery (EGS) after acute pulmonary embolism (PE) is uncertain, and elective noncardiac surgery guidelines provide limited guidance for this high-acuity population.Study design: Adults hospitalized with a principal diagnosis of acute PE who subsequently underwent EGS were identified in the 2016-2022 Nationwide Readmissions Database. Time from PE discharge to EGS was modeled using restricted cubic splines. Major adverse events (MAE), complications, readmission, and resource use were evaluated across operative risk and open/laparoscopic approach subgroups.Results: Among 1,309,175 acute PE hospitalizations, 3,785 (0.3%) underwent subsequent EGS within the calendar year of index hospitalization. Risk-adjusted analysis identified a 60-day inflection point for MAE; 52.4% underwent EGS within 60 days and were classified as Early, with remaining patients classified as Delayed. Compared with Early, Delayed EGS was associated with lower odds of MAE (adjusted odds ratio [OR] 0.45; 95% CI 0.37-0.55) and lower rates of thromboembolic, cardiac, and respiratory complications, readmission, and resource use. This association persisted across operative risk categories and surgical approaches.Conclusions: EGS performed at least 60 days after acute PE was associated with fewer adverse events and lower resource use. When clinically feasible, timing after PE may be an important consideration in planning EGS.","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149269413","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}

引用次数: 0

Optimal Timing of Emergency General Surgery Operation After Pulmonary Embolism: When Is It Too Soon? 肺栓塞后急诊普通外科手术的最佳时机：什么时候太早？

IF 3.2 2区医学

Journal of the American College of Surgeons Pub Date : 2026-10-27 DOI: 10.1097/XCS.0000000000002258

Martin Donald Zielinski

引用次数: 0

Often Wrong, Never in Doubt: Artificial Intelligence Will Not Be Doing Your Cholecystectomy Today. 经常错误，从不怀疑：人工智能今天不会做你的胆囊切除术。

IF 3.2 2区医学

Journal of the American College of Surgeons Pub Date : 2026-10-26 DOI: 10.1097/XCS.0000000000002263

Katharine E Caldwell

引用次数: 0

The Path for Our Elderly Patients. 老年病人的道路。

IF 3.2 2区医学

Journal of the American College of Surgeons Pub Date : 2026-10-26 DOI: 10.1097/XCS.0000000000002261

Michael E Zenilman

引用次数: 0

Multidisciplinary Readiness for Endovascular Hemorrhage Control. 血管内出血控制的多学科准备。

IF 3.2 2区医学

Journal of the American College of Surgeons Pub Date : 2026-10-26 DOI: 10.1097/XCS.0000000000002269

Robert Laverty

引用次数: 0

Planning for Calamity: Deep Uncertainty, Resilience, and the Next Catastrophe. 灾难计划：深度不确定性、恢复力和下一次灾难。

IF 3.2 2区医学

Journal of the American College of Surgeons Pub Date : 2026-10-21 DOI: 10.1097/XCS.0000000000002267

Philip S Barie, Divya Kewalramani, Mayur Narayan

{"title":"Planning for Calamity: Deep Uncertainty, Resilience, and the Next Catastrophe.","authors":"Philip S Barie, Divya Kewalramani, Mayur Narayan","doi":"10.1097/XCS.0000000000002267","DOIUrl":"https://doi.org/10.1097/XCS.0000000000002267","url":null,"abstract":"Healthcare disaster preparedness has advanced substantially during the past quarter century, yet catastrophes continue to expose vulnerabilities when events and system behavior differ from expectations. Experience from September 11, Hurricane Katrina, Superstorm Sandy, the Las Vegas mass shooting, and COVID-19 demonstrates that dissimilar catastrophes repeatedly stress many of the same interconnected components of healthcare delivery. Because the next catastrophe cannot be predicted reliably, preparedness must extend beyond anticipated events and prescribed responses to preserving essential function when assumptions fail. We distinguish capabilities-the resources, personnel, structures, processes, and services available to perform a function-from capacities that allow capabilities to remain usable or be reconfigured under changing conditions. We introduce ADSTARS (Absorptive, Distributive, Surge, Transformative, Adaptive, Reserve, and Sustainment capacities) as a synthesis of capacities supporting resilience. Planning for catastrophe should preserve not only what healthcare systems possess, but what they remain able to do when conventional arrangements fail.","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149238622","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}

引用次数: 0

In the Face of Shrinking Pediatric Services, Pediatric Surgical Transfers Come at Patient Expense. 面对萎缩的儿科服务，儿科手术转移是在病人的费用。

IF 3.2 2区医学

Journal of the American College of Surgeons Pub Date : 2026-10-21 DOI: 10.1097/XCS.0000000000002215

Liese Cc Pruitt, Peter C Minneci

引用次数: 0