Journal of the American College of Surgeons最新文献

{"title":"NESS Commentary re JACS-2024-1308.","authors":"Olajumoke Megafu, Muriel Cleary","doi":"10.1097/XCS.0000000000001387","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001387","url":null,"abstract":"","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663827","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":"Natural History of Pancreatic Cyst with Diameter as the Solitary Risk Factor.","authors":"Ankur P Choubey, Remo Alessandris, Misha T Armstrong, Joanne Chou, Michael I D'Angelica, William R Jarnagin, Alice C Wei, Vineet S Rolston, Mark A Schattner, Kevin C Soares","doi":"10.1097/XCS.0000000000001389","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001389","url":null,"abstract":"<p><strong>Background: </strong>Multiple pancreatic cyst surveillance guidelines include cyst diameter ≥3cm as a worrisome feature prompting surgical referral.</p><p><strong>Methods: </strong>Single center retrospective review of patients with pancreatic cysts ≥3cm at diagnosis and no other worrisome features. Cyst progression was defined as the development of additional worrisome features, pancreatic cancer diagnosis, or pancreatectomy. Pseudocysts and biopsy proven malignancies or non-IPMN cysts at initial consultation were excluded.</p><p><strong>Results: </strong>Between 2010-2019, 89 patients met eligibility criteria with median age 70.9 (21-91), cyst size 3.5cm (3.10-9.7cm), and follow-up of 85.7 months (30.8-139.3). Cyst progression or resection occurred in 13 during follow-up There were no cases of pancreatic cancer or high-grade dysplasia on post-operative pathology. 12 patients (13%) died without evidence of progression. Cumulative incidence of progression from surveillance initiation was 3.4% [95%CI: 0.9%-8.8%] at 3 months, 5.6% [95%CI: 2.1%-11.9%] at 9 months, 9.0% [95%CI: 4.2%-16.2%] at 15 months, 11.2% [95%CI: 5.7%-18.8%] at 21 months, and 13.7% [95%CI: 7.5%-21.8%] at 57 months.</p><p><strong>Conclusion: </strong>Pancreatic cysts with diameter ≥3cm as the sole worrisome feature can be safely monitored with low rates of progression during surveillance, and no incidence of cancer or high-grade dysplasia in our cohort.</p>","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663826","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":"Early Results of Radiofrequency Ablation for Treating Molecular Negative Bethesda III Thyroid Nodules.","authors":"Katherine Jackson, Jillian McCabe, Stacey Stern, Ariela Edri, Melanie Goldfarb","doi":"10.1097/XCS.0000000000001388","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001388","url":null,"abstract":"<p><strong>Background: </strong>Radiofrequency ablation (RFA) has become an alternative option for management of symptomatic, large, or toxic benign (BII) thyroid nodules, but its role in treatment of thyroid nodules with Bethesda III (BIII) cytology is less described and controversial.</p><p><strong>Study design: </strong>Retrospective review of a prospectively maintained database of all thyroid RFA patients at a single institution. Patients were eligible for RFA if they had a symptomatic, large, or toxic thyroid nodule with benign cytology on two separate biopsies, including BIII cytology with negative molecular profiling. Volume reduction ratio (VRR) and symptom improvement at 1, 6, 12, and 24 months was compared between BII and BIII nodules.</p><p><strong>Results: </strong>Of 174 thyroid RFA patients, thirty-two patients had one or two BIII biopsies. Most patients were female (86.8%) with an average age of 58.6 years and a mean follow-up of 8.2 months (median 6, range 1-31). Both BII and BIII nodules were most frequently solid (BII 52.1%, BIII 78.1%) or predominantly solid (BII 43.7%, BIII 18.8%), (p>0.05). The average maximum nodule diameter was similar between groups (BII 4.1 cm, BIII 4.0 cm, p>0.05), as well as initial nodule volume (BII 20.2cc, BIII 15.8cc, p=NS). At 1-month, 6-month, 12-month, 18-month, and 24-month follow up, there was a mean VRR of 45.3%, 64.8%, 74.8%, 75.5%, and 77.8% for BII nodules vs. 46.4%, 69.0%, 81.6%, 72.3%, and 77.0% for BIII nodules (all p>0.05). All patients with at least 6 months of follow-up had symptom improvement.</p><p><strong>Conclusions: </strong>In our single institution study of RFA for patients with molecular negative BIII thyroid nodules, VRRs for BII and BIII nodules were similar at 12 months. RFA appears safe and effective for BIII nodules devoid of molecular alterations, though longer-term follow-up is needed.</p>","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657575","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":"Regional Medical Operations Coordinating Centers Promote Readiness for Daily Trauma Care and Mass Casualty Incidents.","authors":"John H Armstrong, Elizabeth Scherer, Warren Dorlac, Brian J Eastridge, Ronald Stewart, Jeffrey D Kerby, Eileen M Bulger","doi":"10.1097/XCS.0000000000001386","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001386","url":null,"abstract":"","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625143","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":"NESS Commentary re Ebadinejad JACS-2024-1301.","authors":"Gloria Chen, Joel T Adler","doi":"10.1097/XCS.0000000000001379","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001379","url":null,"abstract":"","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585921","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":"NESS Commentary re Shin 2024-1282.","authors":"Mohamed Elsheikh, Sarah Billmeier","doi":"10.1097/XCS.0000000000001378","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001378","url":null,"abstract":"","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586037","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":"First-in-Human Side-to-Side Duodeno-Ileal Bipartition for Weight Loss and Type 2 Diabetes with the Swallowable Biofragmentable Magnetic Anastomosis System.","authors":"Michel Gagner, David Abuladze, J N Buchwald, Levan Koiava, Lamees Almutlaq","doi":"10.1097/XCS.0000000000001384","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001384","url":null,"abstract":"<p><strong>Background: </strong>Anastomosis creation using a novel magnetic compression technique may provide an alternative minimally invasive approach to gastrointestinal surgery. The biofragmentable magnetic anastomosis system (BMAS) is endo-laparoscopically placed to effect magnetic duodeno-ileostomy (MagDI) bipartition for reduction of weight and type 2 diabetes (T2D). MagDI obviates major risks associated with enterotomy, stapling/suturing, and retained foreign materials.</p><p><strong>Study design: </strong>A first-in-human prospective investigation of feasibility, safety, and efficacy in adults with body mass index (BMI) ≥30.0 to ≤35.0 kg/m2. An initial BMAS magnet, swallowed by the patient or delivered under anesthesia by endoscopy, was guided laparoscopically to the distal ileum; a second magnet was endoscopically positioned in the post-pyloric duodenum; magnets were aligned to fuse over 7-21 days forming the duodeno-ileostomy. Primary endpoints: feasibility and severe adverse event (SAEs) incidence by Clavien-Dindo (CD) grade. Secondary endpoints: weight and T2D reduction.</p><p><strong>Results: </strong>Between 12-20-2022 and 5-21-2024, 15 patients (mean BMI 33.0±0.4 kg/m2), all with T2D (HbA1C 8.2±0.4%, glucose 187.9±15.5 mg/dL, on T2D medications) underwent MagDI. Mean operative time, 51.3±5.3 minutes. Feasibility at 90 days was confirmed in 100.0% with 0.0% leakage, bleeding, infection, stricture, mortality. 89.4% of AEs were mild; 3 CD-III SAEs were resolved. At 1 year, 100.0% of anastomoses were patent; BMI (n=8) 30.1±0.9; excess weight loss 38.8%; HbA1C 6.6±0.1%; glucose 142.8±9.5 mg/dL.</p><p><strong>Conclusions: </strong>The novel swallowable, biofragmentable magnetic anastomosis system was feasible, safe, and effective in achieving incisionless, suture/staple-free magnetic duodeno-ileostomy. The device and procedure provide a promising minimally invasive option for moderate, clinically meaningful weight loss and T2D mitigation.</p>","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585911","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":"NESS Commentary re Barth 2024-1227.","authors":"David McAneny","doi":"10.1097/XCS.0000000000001377","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001377","url":null,"abstract":"","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585915","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":"Evaluating the Need for Type and Screen Tests Before Thoracic Operation: Transfusing a Culture of Value-Based Care, Not Patients.","authors":"David B Nelson, Inderpal S Sarkaria","doi":"10.1097/XCS.0000000000001383","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001383","url":null,"abstract":"","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585992","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":"NESS Commentary re Hellman JACS-2024-1307.","authors":"Shawn J Rangel","doi":"10.1097/XCS.0000000000001380","DOIUrl":"https://doi.org/10.1097/XCS.0000000000001380","url":null,"abstract":"","PeriodicalId":17140,"journal":{"name":"Journal of the American College of Surgeons","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585927","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}