Journal of the American College of Surgeons最新文献_第8页

Long-Term Survivorship After Gastrectomy or Endoscopic Resection for Gastric Cancer Using Nationwide Real-World Data. 胃切除术或内镜下胃癌切除术后的长期生存率：使用全国真实世界数据。

IF 3.8 2区医学

Journal of the American College of Surgeons Pub Date : 2025-06-10 DOI: 10.1097/XCS.0000000000001479

Hyeong-Taek Woo, So Hyun Kang, Ji Yoon Baek, Mira Yoo, Young Suk Park, Nayoung Kim, Dong Ho Lee, Hyung-Ho Kim, Aesun Shin, Yun-Suhk Suh

{"title":"Long-Term Survivorship After Gastrectomy or Endoscopic Resection for Gastric Cancer Using Nationwide Real-World Data.","authors":"Hyeong-Taek Woo, So Hyun Kang, Ji Yoon Baek, Mira Yoo, Young Suk Park, Nayoung Kim, Dong Ho Lee, Hyung-Ho Kim, Aesun Shin, Yun-Suhk Suh","doi":"10.1097/XCS.0000000000001479","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001479","url":null,"abstract":"Background: Nutritional deficiency and weight loss after gastrectomy are major challenges for gastric cancer survivorship, yet appropriate weight reduction may prevent chronic metabolic or cardiovascular diseases. This study evaluates long-term survivorship with chronic diseases in gastric cancer survivors who underwent gastrectomy vs endoscopic resection (ER) in the Korean population.Methods: Korean National Health Insurance data of gastric cancer patients treated by gastrectomy or ER between 2002 and 2020 were matched 2:1 by age, gender, Charlson Comorbidity Index, insurance premium quartiles, and year of treatment. The 15-year survivorship with major adverse cardiovascular events (MACE) and chronic diseases was compared.Results: A total of 74,367 gastric cancer survivors were matched (gastrectomy=49,578; ER=24,789). The gastrectomy group had lower incidence of hypertension (HR 0.53, P<0.001; 11,757 events), ischemic heart disease (HR 0.80, P<0.001; 4,740 events), heart failure (HR 0.77, P<0.001; 5,580 events), cerebrovascular diseases (HR 0.78, P<0.001; 6,013 events), and obesity-related cancers (HR 0.74, P<0.001; 1,500 events). They also showed lower risk of death from obesity-related cancers (HR 0.74, P<0.001) but higher risk of death by respiratory diseases (HR 1.37, P<0.001). MACE-3 and MACE-6 was lower in the gastrectomy group (HR 0.86, P<0.001). Average annual medical expenses for hypertension and diabetes within the first 10 years post-treatment were lower in the gastrectomy group ($90.3 ± 1.9 vs $118.4 ± 2.5, P<0.001).Conclusion: The gastrectomy group exhibited lower risk of MACE, reduced incidence and mortality of obesity-related cancers, and lower medical expenses for diabetes or hypertension compared with the ER group, despite higher risk of respiratory disease-related death.","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258230","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

Reassessing the Role of Physical Therapy in High-Acuity Transplant Patients. 重新评估物理治疗在高敏度移植患者中的作用。

IF 3.8 2区医学

Journal of the American College of Surgeons Pub Date : 2025-06-05 DOI: 10.1097/XCS.0000000000001411

Sofia Rozani

引用次数: 0

Healing Beyond the Wound: The Surgeon's Role in Building Healthier Communities Re Dechert 2025-405. 超越伤口的愈合：外科医生在建立更健康社区中的作用[j] Dechert 2025-405。

IF 3.8 2区医学

Journal of the American College of Surgeons Pub Date : 2025-06-05 DOI: 10.1097/XCS.0000000000001456

Paula Ferrada

引用次数: 0

Does Pelvic Angioembolization Increase Pelvic Ischemic Complication? A Multicenter American Association for the Surgery of Trauma Study. 盆腔血管栓塞会增加盆腔缺血并发症吗？美国创伤外科研究多中心协会。

IF 3.8 2区医学

Journal of the American College of Surgeons Pub Date : 2025-06-05 DOI: 10.1097/XCS.0000000000001477

Michael Artigue, Thomas Schroeppel, Brian Sheehan, Jeffry Nahmias, James Bradford, Laura Haines, Elizabeth Benjamin, Deepika Koganti, Stephany Kim, Jennifer Mooney

{"title":"Does Pelvic Angioembolization Increase Pelvic Ischemic Complication? A Multicenter American Association for the Surgery of Trauma Study.","authors":"Michael Artigue, Thomas Schroeppel, Brian Sheehan, Jeffry Nahmias, James Bradford, Laura Haines, Elizabeth Benjamin, Deepika Koganti, Stephany Kim, Jennifer Mooney","doi":"10.1097/XCS.0000000000001477","DOIUrl":"10.1097/XCS.0000000000001477","url":null,"abstract":"Background: Controversy exists if pelvic angioembolization (PAE) causes ischemic complications of the pelvis and if selective vs non-selective embolization influences the risk of these complications.Methods: We conducted a multicenter prospective observational study of adult blunt trauma patients with pelvic fractures who underwent angiography over 55 months. Patients who underwent angiography were divided into four groups: no embolization (No-Embo), selective embolization (Sel), unilateral nonselective embolization (Non-Sel) and bilateral Non-Sel embolization (B-Non-Sel). The primary outcome was ischemic complications; defined as gluteal skin/muscle necrosis, pelvic abscess, pelvic wound infection, pelvic wound breakdown, and osteomyelitis of the pelvis or femoral head.Results: Of the 460 patients undergoing angiography, pelvic ischemic complications occurred in 45 patients (9.8%). Of these 45 patients, 4 patients were in the No-Embo group (5.1%), 24 patients (10.0%) in the Sel group, 11 patients (15.1%) in the Non-Sel group, and 6 patients (8.8%) in the B-Non-Sel. There was no significant difference when comparing the groups on univariate analysis (p=0.23), multivariable analysis (Sel OR=2.16, p=0.3; Non-Sel OR=4.17, p=0.07; B-Non-Sel OR=1.00, p=0.99) nor when comparing each complication individually.Conclusion: The current study is the largest to date of blunt pelvic fracture patients undergoing angiography. Upon comparing those not embolized with those selectively and non-selectively embolized, we found no association between PAE and pelvic ischemic complications. The decision of when and where to embolize should be individualized to the injury encountered and the stability of the patient.","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225811","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

At No Added Expense: Normothermic Machine Perfusion Improves Access and Outcomes, Maintains Cost Neutrality in Liver Transplantation. 不增加费用：恒温机器灌注改善肝移植的可及性和结果，保持成本中性。

IF 3.8 2区医学

Journal of the American College of Surgeons Pub Date : 2025-06-05 DOI: 10.1097/XCS.0000000000001476

Steven A Wisel

引用次数: 0

Surgical Desirability of Outcomes Ranking: Implications of Racial and Economic Privilege on Days at Home after Major Operation. 手术结果排序的可取性：大手术后在家的种族和经济特权的含义。

IF 3.8 2区医学

Journal of the American College of Surgeons Pub Date : 2025-06-04 DOI: 10.1097/XCS.0000000000001475

Giovanni Catalano, Laura Alaimo, Selamawit Woldesenbet, Odysseas P Chatzipanagiotou, Abdullah Altaf, Zayed Rashid, Timothy M Pawlik

{"title":"Surgical Desirability of Outcomes Ranking: Implications of Racial and Economic Privilege on Days at Home after Major Operation.","authors":"Giovanni Catalano, Laura Alaimo, Selamawit Woldesenbet, Odysseas P Chatzipanagiotou, Abdullah Altaf, Zayed Rashid, Timothy M Pawlik","doi":"10.1097/XCS.0000000000001475","DOIUrl":"10.1097/XCS.0000000000001475","url":null,"abstract":"Background: Racial and economic privilege can impact postoperative outcomes. We sought to assess the association of socioeconomic privilege with surgical outcomes using a composite measure called Desirability of Outcome Ranking (DOOR) and days at home within 90 days (DAH-90).Methods: Medicare claims data were used to identify patients who underwent a range of complex surgical procedures between 2016 and 2021. Socioeconomic privilege was measured using the Index of Concentration of Extremes (ICE) and regression analyses were performed to evaluate its association with surgical outcomes and days at home.Results: Among 445,872 patients, 62.4% (n=278,032) achieved the most desirable outcome (i.e., DOOR=1). Living in areas with the highest privilege was associated with lower odds of achieving less desirable outcomes (OR 0.94, 95%CI 0.92-0.96; p<0.001) and increased days spent at home at the lower end of the distribution (0.10, 95%CI 0.02-0.19). A higher DOOR was associated with a reduction of 10 (95%CI -11.0 to -10.0), 2.8 (95%CI -2.8 to -2.7) and 1.2 (95%CI -1.2 to -1.1) days spent at home at the 25th, 50th, and 75th percentiles, respectively. The model based on DOOR demonstrated improved goodness of fit despite increased complexity compared with a model using Textbook Outcome (TO) to predict days at home.Conclusion: A higher DOOR was associated with lower DAH-90, whereas privileged patients had the highest probability of achieving the most desirable outcome and had increased DAH-90. A composite outcome ranking such as DOOR may provide more insight and improve detection of complex relationships between SDOH and surgical outcomes.","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216136","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

Future Perspective on Glucagon-like Peptide-1/2 as Potential Biomarkers of Acute Intestinal Ischemia. 胰高血糖素样肽-1/2作为急性肠缺血潜在生物标志物的研究前景

IF 3.8 2区医学

Journal of the American College of Surgeons Pub Date : 2025-06-03 DOI: 10.1097/XCS.0000000000001450

Gaëtan-Romain Joliat, Guillaume Passot

引用次数: 0

How to Best Serve Those That Need Us Most: Responding and Reacting to Operative Stress and Frailty. 如何最好地为那些最需要我们的人服务：对手术压力和虚弱的回应和反应。

IF 3.8 2区医学

Journal of the American College of Surgeons Pub Date : 2025-06-03 DOI: 10.1097/XCS.0000000000001415

Justin Linden, Julie Ann Freischlag

引用次数: 0

Sex-Based Outcomes After Pancreatic Resection: Do Women Fare Better? 胰腺切除术后基于性别的结局：女性是否更好？

IF 3.8 2区医学

Journal of the American College of Surgeons Pub Date : 2025-06-03 DOI: 10.1097/XCS.0000000000001459

Carl-Stephan Leonhardt, Ulla Klaiber

引用次数: 0

Sex Disparity and Procedure-Related Differences in Achieving an Ideal Outcome After Pancreatic Surgery: A National Observational Cohort Study. 胰腺手术后实现理想结果的性别差异和手术相关差异：一项全国观察性队列研究。

IF 3.8 2区医学

Journal of the American College of Surgeons Pub Date : 2025-06-03 DOI: 10.1097/XCS.0000000000001442

Marcus Tt Roalsø, Linn Såve Nymo, Dyre Kleive, Kim Waardal, Rachel Dille-Amdam, Kjetil Søreide

{"title":"Sex Disparity and Procedure-Related Differences in Achieving an Ideal Outcome After Pancreatic Surgery: A National Observational Cohort Study.","authors":"Marcus Tt Roalsø, Linn Såve Nymo, Dyre Kleive, Kim Waardal, Rachel Dille-Amdam, Kjetil Søreide","doi":"10.1097/XCS.0000000000001442","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001442","url":null,"abstract":"Introduction: An 'ideal outcome' represents a favorable postoperative journey defined by a composite endpoint. Gender-disparities and type of surgery may influence the chance to achieve an ideal outcome. We aimed to investigate factors associated with achieving an ideal outcome after pancreatectomy in a national cohort.Methods: A complete nationwide cohort of all pancreatoduodenectomies or left-sided pancreatectomies across a universal healthcare system. Uni- and multivariable logistic regression models were performed related to procedure- and sex-related outcomes.Results: Of 2057 patients, 1950 (95%) were included and 1,130 (57.9%) achieved an ideal outcome, with significant sex-disparities (62.3% vs. 54.1% for women and men, respectively, P<0.001). Women experienced fewer severe complications (22.6% vs. 30.1%, P<0.001), had fewer reoperations (5.5% vs. 10.1%, P<0.001), and lower 30-day mortality (0.8% vs. 1.9%, P=0.026) compared to men. Women also had lower rates of extended length of stay (22.1% vs. 26.1%, P=0.038) and lower 30-day readmission-rates (18.1% vs. 23.4%, P=0.004). Female sex was a strong predictor of achieving an ideal outcome (OR 1.39, 95% CI: 1.15-1.69, P<0.001), as was distal pancreatectomy compared to pancreatoduodenectomy (adjusted OR 2.09, 95% CI: 1.69-2.59, P<0.001). Sex-distribution of procedures (pancreatectomy vs. left-sided resections) was similar. Women were slightly older (24.0% vs. 20.3% >75 years, respectively; P=0.049) and lover rates of diabetes (12.8% vs. 21.2%, respectively; P<0.001).Conclusion: Women more often achieved an ideal outcome and had better outcomes across all domains. Observed sex-disparities in outcome warrant investigation into putative biological mechanisms that may underlie these observed clinical differences.","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208837","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