The American Surgeon最新文献_第10页

Venous Thromboembolism in Children and Teenagers Admitted for Trauma: A 5-Year Nationwide Perspective. 因外伤入院的儿童和青少年静脉血栓栓塞症：5 年全国范围内的透视。

The American Surgeon Pub Date : 2024-04-02 DOI: 10.1177/00031348241241687

Jennifer Hernandez, Luis A. Quintero, Zaineb Shatawi, Lisa Ngo, Dino Romero, Rainya Heath, Anna Redden, Tamar Levene, Oliver B Lao, Joshua P Parreco

{"title":"Venous Thromboembolism in Children and Teenagers Admitted for Trauma: A 5-Year Nationwide Perspective.","authors":"Jennifer Hernandez, Luis A. Quintero, Zaineb Shatawi, Lisa Ngo, Dino Romero, Rainya Heath, Anna Redden, Tamar Levene, Oliver B Lao, Joshua P Parreco","doi":"10.1177/00031348241241687","DOIUrl":"https://doi.org/10.1177/00031348241241687","url":null,"abstract":"Venous thromboembolism (VTE) in pediatric trauma patients is under-investigated. The purpose of this study was to perform an evaluation of the risk factors for VTE after pediatric trauma, including readmissions across the United States. The Nationwide Readmissions Database for 2016-2020 was queried for all patients under the age of 18 years admitted for trauma. 276 670 patients were identified; 2063 (.8%) were diagnosed with VTE. Among those with VTE, 300 (15%) were identified during a readmission. Higher rates of VTE were seen in ages 15-17 years (n = 1,294, 1.3%, P < .001), penetrating injuries (n = 478, .9%, P < .001), and assault (n = 271, 2.7%, P < .001). The strongest risk factor for VTE was prolonged mechanical ventilation (OR 5.5 [4.9-6.3] P < .001). Our study found that a significant portion of post-traumatic VTE in children and teenagers occur during readmissions. A deeper understanding of the risk factors outlined here can guide enhanced clinical protocols, ensuring early detection and prevention of this complication.","PeriodicalId":325363,"journal":{"name":"The American Surgeon","volume":"28 4","pages":"31348241241687"},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140753193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ovarian Salvage With Prompt Surgical Intervention for Adnexal Torsion: Does Timing Matter? 附件扭转及时手术干预可挽救卵巢：时机重要吗？

The American Surgeon Pub Date : 2024-04-02 DOI: 10.1177/00031348241241678

Azalia Avila, Monique Motta, D. Schechter, S. Samuels, Ingry Jaramillo, J. Whitehouse, H. Neville, Tamar Levene

{"title":"Ovarian Salvage With Prompt Surgical Intervention for Adnexal Torsion: Does Timing Matter?","authors":"Azalia Avila, Monique Motta, D. Schechter, S. Samuels, Ingry Jaramillo, J. Whitehouse, H. Neville, Tamar Levene","doi":"10.1177/00031348241241678","DOIUrl":"https://doi.org/10.1177/00031348241241678","url":null,"abstract":"BACKGROUND\u0000Adnexal torsion requires treatment to limit ischemic injury and tissue loss. Optimal time to surgical intervention has not been established. We compared outcomes of ovarian loss amongst pediatric patients.\u0000\u0000\u0000METHODS\u0000We conducted a retrospective review of 88 patients with adnexal torsion from March 2014 through April 2021. Rates of ovarian loss were compared for patients who underwent surgery within and beyond 60 minutes from diagnosis.\u0000\u0000\u0000RESULTS\u0000Most patients underwent surgery more than 60 minutes from the time of diagnosis (83%; median time 116 minutes). Comparing patients with and without ovarian loss, there was no statistically significant difference in time to surgery from time of diagnosis (P = .618). Patients with ovarian loss had a longer duration of symptoms (24 vs 96 hours; P = .017).\u0000\u0000\u0000CONCLUSIONS\u0000While surgical repair of adnexal torsion may be urgent, this study suggests that duration of symptoms should be considered when assessing a patient's likelihood of ovarian loss.","PeriodicalId":325363,"journal":{"name":"The American Surgeon","volume":"149 ","pages":"31348241241678"},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140755245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What Happens After Discharge? A 2+ Year Follow-Up After Laparoscopic Subtotal Fenestrating and Reconstituting Cholecystectomy. 出院后发生了什么？腹腔镜胆囊切除术后两年多的随访。

The American Surgeon Pub Date : 2024-04-02 DOI: 10.1177/00031348241241617

Sunjay S. Kumar, Erin Briggs, Sami Tannouri, Talar Tatarian, M. Pucci, Renée M. Tholey, K. Chojnacki, Courtney Foley, F. Palazzo

{"title":"What Happens After Discharge? A 2+ Year Follow-Up After Laparoscopic Subtotal Fenestrating and Reconstituting Cholecystectomy.","authors":"Sunjay S. Kumar, Erin Briggs, Sami Tannouri, Talar Tatarian, M. Pucci, Renée M. Tholey, K. Chojnacki, Courtney Foley, F. Palazzo","doi":"10.1177/00031348241241617","DOIUrl":"https://doi.org/10.1177/00031348241241617","url":null,"abstract":"Laparoscopic subtotal cholecystectomy (LSC) is utilized to prevent complications in the difficult cholecystectomy. Medium-term outcomes are poorly studied for fenestrating and reconstituting operative techniques. A single-institution retrospective review was undertaken of all LSCs. A telephone survey was used to identify complications addressed at other institutions. We performed subgroup analyses by operative approach and of patients requiring postoperative endoscopic intervention (ERC). 28 patients met inclusion criteria. The median follow-up was 32.7 months. There were no bile duct injuries or reoperations. 21% of patients required a postoperative ERC and 50% were discharged home with a drain. Bile leaks were found to be more prevalent in the fenestrating LSC group (38% vs 0%, P = .003). The case series suggested more severe recurrent biliary disease in patients undergoing reconstituting LSC. Laparoscopic subtotal cholecystectomy appears to have satisfactory medium-term outcomes. The reconstituting LSC group trends toward more severe recurrent disease which warrants further investigation.","PeriodicalId":325363,"journal":{"name":"The American Surgeon","volume":"24 2","pages":"31348241241617"},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140752494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Effect of COVID-19 on Rib Fracture Patients in Michigan. COVID-19 对密歇根州肋骨骨折患者的影响。

The American Surgeon Pub Date : 2024-04-02 DOI: 10.1177/00031348241241634

Allie Eickholtz, Jeremy Mormol, Jesse K. Kelley, Madi Mangione, Steffen Pounders, Ryan Groseclose, M. Lypka, Charles Gibson, Alistair Chapman, Cathryn Chadwick, Laura Krech

引用次数: 0

Prognostic Value of Tumor Size in Colon Cancer—Smaller is Better? 肿瘤大小对结肠癌的预后价值:越小越好?

The American Surgeon Pub Date : 2023-06-26 DOI: 10.1177/00031348231180944

Yan Meng, Bingyan Wang, Hsinyi Lin, Fei Li, Siyi Lu, Junwei Wang, Hao Wang, Limei Guo, Xin Zhou, Wei Fu

{"title":"Prognostic Value of Tumor Size in Colon Cancer—Smaller is Better?","authors":"Yan Meng, Bingyan Wang, Hsinyi Lin, Fei Li, Siyi Lu, Junwei Wang, Hao Wang, Limei Guo, Xin Zhou, Wei Fu","doi":"10.1177/00031348231180944","DOIUrl":"https://doi.org/10.1177/00031348231180944","url":null,"abstract":"Background The prognostic value of tumor size in colon cancer remains controversial. This study aimed to reveal the correlation between tumor size and prognosis of colon cancer. Methods A total of 491 patients with colon cancer were included in this study. The correlation of tumor size with prognosis, mismatch repair status, and other clinicopathological characteristics as well as tumor microenvironment was analyzed. Results For stage IIA microsatellite stable (MSS) colon cancer, tumors sized <3.5 cm and ≥5 cm were associated with a poorer disease free survival (DFS) compared with tumors sized between 3.5 and 5 cm ( P = .002). Small tumor size (HR = 5.098, P = .001) and large tumor size (HR = 2.749, P = .029) were found to be independent prognostic factors for stage IIA MSS colon cancer. Moreover, high expression of transgelin (TAGLN), a marker of cancer-associated fibroblasts (CAFs), was found to be an independent prognostic factor for poorer DFS (HR = 9.651, P = .009), which was also associated with smaller tumor size ( P = .027). Conclusion Small (<3.5 cm) and large (≥5 cm) tumor sizes are associated with decreased DFS in stage IIA MSS colon cancer. Enrichment of TAGLN + CAFs is associated with decreased DFS and small tumor size.","PeriodicalId":325363,"journal":{"name":"The American Surgeon","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134933055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Racial Disparities in Colorectal Cancer Care for Black Patients: Barriers and Solutions. 黑人患者结肠直肠癌护理中的种族差异:障碍和解决方案。

IF 1

The American Surgeon Pub Date : 2022-12-01 Epub Date: 2022-06-26 DOI: 10.1177/00031348221111513

Naveen Balan, Beverley A Petrie, Kathryn T Chen

引用次数: 1

The Role of the Scarecrow in Surgery. 稻草人在外科手术中的作用。

IF 1

The American Surgeon Pub Date : 2022-12-01 DOI: 10.1177/00031348221101596

David S Shapiro

引用次数: 0

The State of the LGBTQ+ Community in Surgery. LGBTQ+群体在外科手术中的现状。

IF 1

The American Surgeon Pub Date : 2022-12-01 Epub Date: 2022-07-17 DOI: 10.1177/00031348221114039

Luigi Pascarella

引用次数: 2

Genital Gender Affirming Surgery. 生殖器性别确认手术。

IF 1

The American Surgeon Pub Date : 2022-12-01 Epub Date: 2022-06-28 DOI: 10.1177/00031348221109479

Virginia Y Li, Alysen Demzik, Liem Snyder, Adeyemi A Ogunleye, Annmarie Wang, Bradley D Figler

引用次数: 3

Prior Antibiotic Exposure Is Associated With Reoperation After Elective Non-colorectal Surgery. 既往抗生素暴露与择期非结直肠手术后再手术相关。

IF 1

The American Surgeon Pub Date : 2022-11-01 Epub Date: 2022-06-18 DOI: 10.1177/00031348221109812

Christopher A Guidry, Andrew J Medvecz, Raeanna C Adams, Bradley M Dennis, Shannon C Eastham, Oscar D Guillamondegui, Oliver L Gunter, Allan B Peetz, Callie M Thompson, Stephen P Gondek, Timothy C Nunez, Robert G Sawyer, Addison K May, Mayur B Patel

{"title":"Prior Antibiotic Exposure Is Associated With Reoperation After Elective Non-colorectal Surgery.","authors":"Christopher A Guidry, Andrew J Medvecz, Raeanna C Adams, Bradley M Dennis, Shannon C Eastham, Oscar D Guillamondegui, Oliver L Gunter, Allan B Peetz, Callie M Thompson, Stephen P Gondek, Timothy C Nunez, Robert G Sawyer, Addison K May, Mayur B Patel","doi":"10.1177/00031348221109812","DOIUrl":"https://doi.org/10.1177/00031348221109812","url":null,"abstract":"Background: Recent antibiotic exposure has previously been associated with poor outcomes following elective surgery. The purpose of this study is to evaluate the impact of prior recent antibiotic exposure in a multicenter cohort of Veterans Affairs patients undergoing elective non-colorectal surgery.Methods: This is a retrospective cohort study of the Veterans Affairs Surgical Quality Improvement Program, including elective, non-cardiovascular, non-colorectal surgery from 2013 to 2017. Outpatient antibiotic exposure within 90 days prior to surgery was identified from the Veterans Affairs outpatient pharmacy database and matched with each case. Primary outcomes included serious complication, any complication, any infection, or surgical site infection. Secondary outcomes included 30-day mortality, length of stay, and Clostridioides difficile infection.Results: Of 21,112 eligible patients, 2885 (13.7%) were exposed to antibiotics within 90 days prior to surgery with a duration of 7 (IQR: 5-10) days and prescribed 42 (IQR: 21-64) days prior to surgical intervention. Compared to non-exposed patients, exposed patients had higher unadjusted complication rates, increased length of stay, and rates of return to the operating. Exposure was independently associated with return to the operating room (OR: 1.39; 99% CI: 1.05-1.84).Conclusions: Among Veterans, recent antibiotic exposure within 90 days of elective surgery was associated with a 39% increase in the odds of return to the operating room. Further work is needed to evaluate the effects of antibiotic exposure and dysbiosis on surgical outcomes.","PeriodicalId":325363,"journal":{"name":"The American Surgeon","volume":" ","pages":"2752-2759"},"PeriodicalIF":1.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40057966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0