Surgery最新文献

{"title":"Response to: Timing of parathyroidectomy after kidney transplantation: A cost-effectiveness analysis.","authors":"Rongzhi Wang, Herbert Chen","doi":"10.1016/j.surg.2025.109570","DOIUrl":"10.1016/j.surg.2025.109570","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109570"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668536","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":"Fowl territory: A novel visual cue for staying in bounds during anatomic liver resection.","authors":"Jon M Harrison","doi":"10.1016/j.surg.2025.109667","DOIUrl":"10.1016/j.surg.2025.109667","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109667"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006556","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":"Comment on: \"Timing of parathyroidectomy after kidney transplantation: A cost-effectiveness analysis\".","authors":"Rihai Xiao, Ruohui Huang","doi":"10.1016/j.surg.2025.109521","DOIUrl":"10.1016/j.surg.2025.109521","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109521"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498009","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":"Invited Commentary: \"Patient-reported health-related social needs obtained at the bedside and outcomes after elective major surgery\".","authors":"Melissa Justo, Sona Mahrokhi, Robert Kropp, Peyman Benharash","doi":"10.1016/j.surg.2025.109734","DOIUrl":"10.1016/j.surg.2025.109734","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109734"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070540","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":"Letter to the editor: The utility of axial imaging among selected patients in the early postoperative period after pancreatectomy.","authors":"Hafsah Arif Kundi, Taha Nadeem, Abdullah Khan, Majid Baig","doi":"10.1016/j.surg.2025.109517","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109517","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"187 ","pages":"109517"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313679","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":"Patient-reported health-related social needs obtained at the bedside and outcomes after elective major surgery.","authors":"Kurt S Schultz, Miranda S Moore, Emily Y Park, Julianna M Mastrorilli, Eric B Schneider, Haddon J Pantel, Daniel J Boffa, Vikram B Reddy, Ira L Leeds","doi":"10.1016/j.surg.2025.109655","DOIUrl":"10.1016/j.surg.2025.109655","url":null,"abstract":"<p><strong>Background: </strong>Evidence supports an association between social determinants of health and surgical outcomes. Still, there is a gap in the literature on point-of-care, patient-level social needs data in the perioperative period. This study used a routine bedside screening tool to assess the independent association of patient-reported health-related social needs with surgical complications.</p><p><strong>Methods: </strong>This was a retrospective study of patients undergoing elective major thoracic or abdominal surgery across a statewide health care system. Upon admission for elective surgery, patients were screened for 4 core health-related social need domains on the basis of the Accountable Health Communities Health-Related Social Needs Screening Tool (January 2022 to June 2023). These data were linked with internal databases collected for the Society of Thoracic Surgeons General Thoracic Surgery Database and the National Surgical Quality Improvement Program. The primary outcome was any 30-day postoperative complication.</p><p><strong>Results: </strong>Of 1,172 patients screened, 356 underwent thoracic surgery, and 816 underwent abdominal surgery. In total, 6.1% (n = 72) reported at least 1 health-related social need. On adjusted analysis, patients with at least 1 health-related social need had 1.8 times the odds of any 30-day complication than patients without health-related social needs (odds ratio, 1.78; 95% confidence interval, 1.02-3.11; P = .043). Patients with at least 1 health-related social need domain had more extended hospital stays (median, days, 4.5 vs 4.0; P = .048) and were less likely to be discharged to a permanent residence (15.3% vs 5.5%, P < .001).</p><p><strong>Conclusion: </strong>This is the first study to evaluate the association of health-related social needs, obtained from the AHC health-related social need Screening Tool, with surgical outcomes, finding that patients who reported health-related social needs were more likely to experience complications after major surgery. Future studies should investigate the individual health-related social needs driving inequities in surgical care to inform the design of preoperative interventions.</p>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109655"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to the editor: \"Lung ultrasonography underdiagnoses clinically significant pneumothorax\".","authors":"Jarrett E Santorelli, Aaron Marshall, Louis Perkins, Laura Adams, Todd W Costantini","doi":"10.1016/j.surg.2025.109653","DOIUrl":"10.1016/j.surg.2025.109653","url":null,"abstract":"","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109653"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030557","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":"Slowly absorbable sutures do not increase the risk of reoperation for recurrence compared with nonabsorbable sutures in primary ventral hernia repair: A nationwide register-based cohort study.","authors":"Usamah Ahmed, Jacob Rosenberg, Jason Joe Baker","doi":"10.1016/j.surg.2025.109778","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109778","url":null,"abstract":"<p><strong>Background: </strong>Primary ventral hernias are common, and the choice of suture material may influence the risk of recurrence. This study investigated the risk of reoperation for recurrence following primary ventral hernia repair using slowly absorbable or fast-absorbable sutures compared with nonabsorbable sutures.</p><p><strong>Methods: </strong>This study used prospectively collected data from the Danish Ventral Hernia Database (2007-2024). Data were linked with the Danish National Patient Register and the Danish Civil Registration System to ensure complete follow-up. We included patients with primary ventral hernias (umbilical and epigastric) with a defect width ≤4 cm, stratified into suture-only and onlay mesh cohorts.</p><p><strong>Results: </strong>We included 31,189 patients, and suture-only repairs accounted for 68% (n = 21,202) of cases, while onlay mesh repairs accounted for 32% (n = 9,987). In the suture-only cohort, there was no difference in reoperation risk for slowly absorbable sutures (hazard ratio 1.02, 95% confidence interval 0.88-1.19, P = .768) or fast-absorbable sutures (1.16, 0.93-1.45, P = .184) compared with nonabsorbable sutures. Similarly, in the onlay mesh cohort, no difference was found for slowly absorbable (hazard ratio 1.19, 95% confidence interval 0.83-1.67, P = .355) or fast-absorbable sutures (0.80, 0.20-3.23, P = .754).</p><p><strong>Conclusion: </strong>Slowly absorbable sutures did not increase the risk of reoperation compared with nonabsorbable sutures, regardless of mesh use. Although no significant difference was found between nonabsorbable and fast-absorbable sutures, this should be interpreted with caution because of limited data. These findings suggest that slowly absorbable sutures are a safe option and may be preferred because of complications associated with nonabsorbable sutures.</p>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"188 ","pages":"109778"},"PeriodicalIF":2.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318678","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":"A risk-adjusted evaluation of the impact of neoadjuvant therapy on pancreatic fistula development after pancreatoduodenectomy.","authors":"Max Judish, Samuele Cannas, Fabio Casciani, Asmita Chopra, Neha Shetty, Rudy El Asmar, Giuseppe Malleo, Gabriella Lionetto, Niccolò Napoli, Emanuele F Kauffmann, Michael Ginesini, Ugo Boggi, Roberto Salvia, Amer H Zureikat, Charles M Vollmer","doi":"10.1016/j.surg.2025.109819","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109819","url":null,"abstract":"<p><strong>Background: </strong>Most patients undergoing pancreatoduodenectomy after neoadjuvant therapy for periampullary malignancies have pancreatic adenocarcinoma, a known protective factor against postoperative pancreatic fistula. Accordingly, the perceived lower postoperative rates of pancreatic fistula after neoadjuvant therapy might result from selection bias toward a lower-risk population. Accurate evaluation of neoadjuvant therapy effects requires adjustment for risk.</p><p><strong>Methods: </strong>Consecutive patients who underwent pancreatoduodenectomy from 2015 to 2022 for all periampullary malignancies were studied at 4 international specialty units. Risk adjustment used the original and alternative Fistula Risk Scores and multivariable analysis.</p><p><strong>Results: </strong>Of 2,240 patients, 80.5% had pancreatic adenocarcinoma; 19.5% had other periampullary malignancies. Neoadjuvant therapy was applied in 39.2%, and patients with pancreatic adenocarcinoma received neoadjuvant therapy more often than those with nonpancreatic ductal adenocarcinoma (47.6% vs. 4.3%, P < .001). Postoperative pancreatic fistula occurred in 289 patients (12.9%), more commonly after upfront resection (15.1%) versus neoadjuvant therapy (9.5%), P < .001. Rates of postoperative pancreatic fistula after neoadjuvant therapy (vs upfront resection) were significantly lower in the setting of pancreatic adenocarcinoma (9.1% vs 12.8%, P = .015), but not in nonpancreatic ductal adenocarcinoma malignancies (26.3% vs 20.3%, P = .73); this is despite patients with pancreatic ductal adenocarcinoma receiving neoadjuvant therapy having a significantly greater median Fistula Risk Score than those patients with pancreatic ductal adenocarcinoma receiving upfront resection (3 vs 2, P < .001). The protection of neoadjuvant therapy (vs upfront resection) was insignificant with blood loss >700 mL (12.8% vs 18.8%, P = .17). Concurrent radiotherapy did not decrease postoperative pancreatic fistula beyond chemotherapy alone (9.9% vs 8.9%, P = .77). Multivariable analysis confirmed a protective association between neoadjuvant therapy and postoperative pancreatic fistula (odds ratio, 0.51; 95% confidence interval, 0.36-0.70, P < .001) for pancreatic adenocarcinoma.</p><p><strong>Conclusion: </strong>In the setting of pancreatic adenocarcinoma, neoadjuvant therapy appears to reduce postoperative pancreatic fistula, with reductions significant only with low blood loss. Furthermore, neoadjuvant radiotherapy did not provide added mitigation in this series.</p>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109819"},"PeriodicalIF":2.7,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313766","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":"Intraoperative code status: Moving from misinformation to respect for patient autonomy.","authors":"Jacob Applegarth, Abram Brummett, Jacob Morton, Nathan M Novotny, Ngan Nguyen","doi":"10.1016/j.surg.2025.109822","DOIUrl":"https://doi.org/10.1016/j.surg.2025.109822","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative code status remains a complicated topic for patients and providers. Previous studies have demonstrated a lack of understanding of intraoperative do not resuscitate status. Few studies have used simulation-based education for surgical residents to navigate conversations with patients who request intraoperative do not resuscitate status. This project aims to implement a simulation-based curriculum for residents to navigate intraoperative do not resuscitate status while maintaining and fostering respect for patient autonomy.</p><p><strong>Methods: </strong>Anesthesiology and surgery residents were surveyed regarding clinical practice and policy surrounding intraoperative code status, which demonstrated a knowledge gap. To address this, a simulation-based curriculum was developed wherein surgery residents encounter a standardized patient who requests intraoperative do not resuscitate status. A posttraining survey assessed the effectiveness of this simulation.</p><p><strong>Results: </strong>Targeted needs assessment demonstrated 56.5% of surgery residents incorrectly believed do not resuscitate status must be rescinded for an elective operation and 52.1% believed this for an emergent operation. Results from posttraining survey responses demonstrated a statistically significant (P < .001, Figure 1) change in confidence discussing intraoperative do not resuscitate status and a statistically significant reduction in the misconception that a do not resuscitate order must be rescinded before surgery (P < .01, Figure 2).</p><p><strong>Conclusion: </strong>A simulation-based curriculum was created to meet the need for clear discussion of intraoperative do not resuscitate policy while emphasizing respect for patient autonomy. Posttraining survey demonstrated a significant increase in confidence and understanding when discussing intraoperative do not resuscitate status and ethics policy. Our future aims will assess curriculum impact on practice patterns and hospital outcomes via a 6-month follow-up survey.</p>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":" ","pages":"109822"},"PeriodicalIF":2.7,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313712","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}