Annals of surgery open : perspectives of surgical history, education, and clinical approaches最新文献

{"title":"Utilizing Artificial Intelligence to Facilitate Qualitative Surgical Research.","authors":"Orly N Farber, Corey M Abramson, Amanda J Reich","doi":"10.1097/AS9.0000000000000577","DOIUrl":"10.1097/AS9.0000000000000577","url":null,"abstract":"","PeriodicalId":72231,"journal":{"name":"Annals of surgery open : perspectives of surgical history, education, and clinical approaches","volume":"6 2","pages":"e577"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Observational Study on Perioperative Dysgeusia and Trace Metal Elements in Patients Undergoing Pancreatoduodenectomy.","authors":"Fumihiro Terasaki, Katsuhisa Ohgi, Toshimi Inano, Teiichi Sugiura, Ryo Ashida, Yoshiyasu Kato, Mihoko Yamada, Shimpei Otsuka, Katsuhiko Uesaka","doi":"10.1097/AS9.0000000000000575","DOIUrl":"10.1097/AS9.0000000000000575","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the nature of perioperative dysgeusia and its associated factors in patients undergoing pancreatoduodenectomy (PD).</p><p><strong>Background: </strong>Perioperative dysgeusia is an unfavorable symptom associated with malnutrition.</p><p><strong>Methods: </strong>The Taste Alteration Survey and Trace Elements in patients undergoing PD (TASTE-PD) study was a single-center prospective observational study performed between April 2021 and September 2022. Dysgeusia was evaluated using a questionnaire administered to 100 patients undergoing PD during hospitalization. A blood examination was also performed for the detection of trace metal elements. Statistical analyses were performed between patients with and without preoperative dysgeusia and between those with and without postoperative dysgeusia.</p><p><strong>Results: </strong>Thirty-three (33%) patients experienced dysgeusia during hospitalization (11 with preoperative dysgeusia and 22 with postoperative dysgeusia). Preoperative albumin (3.7 vs 3.9 g/dL, <i>P</i> = 0.040) and hemoglobin levels (11.6 vs 12.4 g/dL, <i>P</i> = 0.029) were significantly lower in the patients with preoperative dysgeusia than in those without. Comparing patients with and without postoperative dysgeusia, those with dysgeusia were significantly older (73 vs 68 years, <i>P</i> = 0.007), and their serum iron levels referenced to the preoperative levels were significantly decreased on postoperative day 1 (20.5% vs 24.4%, <i>P</i> = 0.039), with insufficient recovery by postoperative day 14 (27.4% vs 44.0%, <i>P</i> = 0.020).</p><p><strong>Conclusions: </strong>One-third of the patients experienced dysgeusia. Hypoalbuminemia and anemia were associated with preoperative dysgeusia, and advanced age and insufficient iron recovery were associated with postoperative dysgeusia. Further studies will be conducted to evaluate the impact of iron supplementation for improving dysgeusia and postoperative nutritional status.</p>","PeriodicalId":72231,"journal":{"name":"Annals of surgery open : perspectives of surgical history, education, and clinical approaches","volume":"6 2","pages":"e575"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoadjuvant Chemotherapy Versus Adjuvant Chemotherapy for Very Low-Lying Clinical T3 Rectal Cancer: The NAIR Phase 2/3 Randomized Clinical Trial.","authors":"Yuichiro Tsukada, Norio Saito, Yuji Nishizawa, Riki Ohno, Fumihiko Fujita, Keiji Koda, Masayuki Ohue, Eiji Shinto, Akihiko Murata, Yoshikazu Koide, Koji Ikeda, Hideaki Bando, Motoko Suzuki, Toshihiro Misumi, Takayuki Yoshino, Masaaki Ito","doi":"10.1097/AS9.0000000000000579","DOIUrl":"10.1097/AS9.0000000000000579","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether neoadjuvant chemotherapy (NAC) followed by total mesorectal excision (TME) and adjuvant chemotherapy (AC) is superior to TME followed by AC for very low-lying clinical (c) T3 rectal cancer.</p><p><strong>Background: </strong>Preoperative radiation is widely used for preoperative treatment of cT3 rectal cancer; however, it worsens patient-reported outcomes (PROs). Preoperative treatment without radiation is expected to preserve PROs.</p><p><strong>Methods: </strong>Patients with cT3N-anyM0 rectal cancer located within 5 cm from the anal verge were randomly assigned (1:1) to the NAC group (3 months of NAC followed by TME and 3 months of AC) or AC group (TME followed by 6 months of AC). NAC and AC comprised mFOLFOX6 (oxaliplatin, l-folinic acid, and fluorouracil) or CAPOX (oxaliplatin and capecitabine). The primary endpoint was the 3-year recurrence-free survival (RFS). PROs were analyzed.</p><p><strong>Results: </strong>Between February 2013 and March 2019, 130 patients were randomly assigned to the NAC (n = 65) or AC (n = 65) groups; of these, 127 were evaluable (NAC, n = 65; AC, n = 62). At a median follow-up of 37.4 months, the 3-year RFS was 75.5% and 70.9% in NAC and AC groups, respectively [hazard ratio (HR) = 0.67, 60% confidence interval (CI) = 0.48-0.86, 95% CI = 0.34-1.32; <i>P</i> = 0.098 by log-rank test] and the primary endpoint was met. There was no significant intergroup difference in the local recurrence rate (LRR) or overall survival. Histologically, good responders to NAC showed a trend toward better RFS than poor responders. The study groups showed similar PROs.</p><p><strong>Conclusions: </strong>NAC for very low-lying cT3 rectal cancer improved RFS without worsening PROs although LRR remained high.</p><p><strong>Trial registration: </strong>UMIN Clinical Trials Registry: UMIN000009510/Japan Registry of Clinical Trials: jRCTs031180278.</p>","PeriodicalId":72231,"journal":{"name":"Annals of surgery open : perspectives of surgical history, education, and clinical approaches","volume":"6 2","pages":"e579"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustainability in Abdominal Wall Reconstruction: An Eco-Audit of the Abdominal Wall Reconstruction Pathway.","authors":"Zahra Ahmed, Alexander Zargaran, Andia Soltani, Sara Sousi, David Zargaran, Yazan Al-Ajam, Shadi Ghali, Afshin Mosahebi","doi":"10.1097/AS9.0000000000000576","DOIUrl":"10.1097/AS9.0000000000000576","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to perform process mapping and life cycle assessment of patients who underwent abdominal wall reconstruction to identify actionable carbon hotspots, decrease emissions, and increase sustainability.</p><p><strong>Background: </strong>Abdominal wall reconstruction is a procedure requiring input from multiple specialities and is often performed on complex multimorbid patients requiring a high level of care, the environmental impact of which has yet to be explored.</p><p><strong>Methods: </strong>A retrospective study was conducted on 30 patients who underwent abdominal wall reconstruction at a single center. Process mapping and life-cycle analyses were performed for surgical and inpatient stay, as well as preoperative and outpatient evaluation including facilities, consumables, medical gases, equipment, food and linen, and travel. Estimates for carbon dioxide emissions were generated for each stage, with variability considered, as well as potential areas for savings.</p><p><strong>Results: </strong>This study estimated the carbon footprint of a patient undergoing abdominal wall reconstruction surgery to be approximately 420.56 kgCO₂eq. Inpatient stay had the highest overall contribution to the carbon footprint (316.9 kgCO₂eq., 75.4% pathway emissions). From non-inpatient analysis, patient travel was the predominant source of carbon emissions (51.8 kgCO₂eq, 50.0%) followed by the production and transport of equipment and building electricity, gas, oil, and water usage.</p><p><strong>Conclusions: </strong>This is the first study to estimate the carbon footprint of a surgical pathway for complex patients, using abdominal wall reconstruction as an example. Strategies to combat the impact of carbon emissions and increase sustainability included greater implementation of enhanced recovery after surgery protocols to reduce inpatient stay, improved accuracy of waste segregation, and continued use of total intravenous anesthesia.</p>","PeriodicalId":72231,"journal":{"name":"Annals of surgery open : perspectives of surgical history, education, and clinical approaches","volume":"6 2","pages":"e576"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thank You, Dr. Keith Lillemoe, for Your Service to <i>Annals of Surgery</i> and <i>Annals of Surgery Open</i>.","authors":"Justin B Dimick, Luke M Funk","doi":"10.1097/AS9.0000000000000574","DOIUrl":"https://doi.org/10.1097/AS9.0000000000000574","url":null,"abstract":"","PeriodicalId":72231,"journal":{"name":"Annals of surgery open : perspectives of surgical history, education, and clinical approaches","volume":"6 2","pages":"e574"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Mechanism a Biological Variable?: A Secondary Analysis of the PROPPR Trial.","authors":"Emily W Baird, Daniel T Lammers, Russell L Griffin, Shannon W Stephens, Jan O Jansen, John B Holcomb","doi":"10.1097/AS9.0000000000000572","DOIUrl":"10.1097/AS9.0000000000000572","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The purpose of this study was to evaluate for differences in the baseline mortality rates of patients injured by different mechanisms, in the Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) trial, and compare their responses to 2 resuscitation paradigms. Our hypothesis was there are differences between the blunt and penetrating trauma patients, with regard to baseline and effect size.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Previous research including clinical trials and basic science research suggests differences in mortality among patients injured by blunt or penetrating mechanisms, although differences between these 2 mechanisms-both baseline and effect size-are rarely considered explicitly. The objective of this analysis was to compare mortality and other clinical outcomes of trauma patients stratified specifically by injury mechanism and resuscitation strategy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We performed a retrospective review of the PROPPR trial to assess for differences in mortality outcomes in patients with blunt or penetrating injuries who received a 1:1:1 or 1:1:2 resuscitation strategy. Our primary outcome was 24-hour mortality with additional endpoints at proximate (ie, 1 hour, 3 hours, and 6 hours) times post-arrival. A logistic regression model utilizing general estimating equations and adjusted for age, Injury Severity Score (ISS), and first documented pulse and Glasgow Coma Scale (GCS) score were used to assess the interaction of mortality outcomes by resuscitation type and injury mechanism. Secondary outcomes evaluated include acute kidney injury, ventilator-associated pneumonia, cardiac arrest, symptomatic and asymptomatic pulmonary embolism, deep vein thrombosis, acute respiratory distress syndrome, and stroke. Additional nonmortality outcomes of interest included total hospital and ventilator- and ICU-free days, time to hemostasis, time to exsanguination, and time to death.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The original trial enrolled 680 patients, 338 (49.7%) received 1:1:1 and 342 (50.3%) 1:1:2 resuscitation. 8 patients had combined blunt and penetrating injuries and were excluded from this analysis, leaving 672 patients with blunt (350, 52.1%) and penetrating (322, 47.9%) injuries. Compared to penetrating injuries, patients with blunt injuries were older, more likely to be white, had a higher rate of air transfers, longer transport time and longer time to hemostasis, lower GCS Score, and higher ISS and R time on thromboelastography (&lt;i&gt;P&lt;/i&gt; &lt; 0.001). Overall mortality between blunt and penetrating injuries was similar at 1 hour (2.6% vs 4.0%, &lt;i&gt;P&lt;/i&gt; = 0.286) and 3 hours (7.4% and 8.1%, &lt;i&gt;P&lt;/i&gt; = 0.754). However, mortality in both groups steadily increased overtime, and more markedly at 24 hours for patients with blunt compared to penetrating injuries (16.9% and 11.8%, &lt;i&gt;P&lt;/i&gt; = 0.063). When comparing resuscitation strategies, receipt of a 1:1:1 resuscitation significantly decre","PeriodicalId":72231,"journal":{"name":"Annals of surgery open : perspectives of surgical history, education, and clinical approaches","volume":"6 2","pages":"e572"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgeon Sex and Postoperative Resource Utilization: A Population-Based Cohort Study.","authors":"Kiyan Heybati, Raj Satkunasivam, Khatereh Aminoltejari, Hannah S Thomas, Arghavan Salles, Natalie Coburn, Frances C Wright, Lesley Gotlib Conn, Amy N Luckenbaugh, Sanjana Ranganathan, Carlos Riveros, Jason Sutherland, Colin McCartney, Kathleen Armstrong, Barbara Bass, Allan S Detsky, Angela Jerath, Christopher J D Wallis","doi":"10.1097/AS9.0000000000000569","DOIUrl":"10.1097/AS9.0000000000000569","url":null,"abstract":"<p><strong>Objectives: </strong>To determine associations between physician sex and use of postoperative healthcare resources among patients undergoing common surgeries in Ontario, Canada.</p><p><strong>Background: </strong>Prior studies have shown that patients of female physicians experience better outcomes and have lower healthcare costs compared with patients of male physicians. Understanding differences in resource utilization may offer insights into the care pathways and practice patterns contributing to these differences.</p><p><strong>Methods: </strong>We conducted a population-based, retrospective cohort study of adults (≥18 years of age) undergoing 1 of 25 common surgeries, between January 1, 2007, and December 31, 2019, in Ontario, Canada. The primary outcome was the utilization of one of the following: intensive care unit admission, other medical interventions (eg, tracheostomy, new dialysis starts, and home oxygen), and discharge care needs (eg inpatient rehab, long-term care, and home care use) within 30 days. The data were summarized using descriptive statistics and adjusted using multivariable generalized estimating equations.</p><p><strong>Results: </strong>This population-based study included 1,100,193 patients (61.8% female). Patients treated by male surgeons had higher use of postoperative resources versus those with female surgeons within 30 days (adjusted rate 33.1; 95% confidence interval [CI]: 28.0-39.2 versus 31.2; 95% CI: 25.8-37.7), 90 days, and 1 year. Consistent with these findings, following adjustment for patient, surgeon, procedural, and hospital characteristics, patients treated by male surgeons were significantly more likely to utilize postoperative resources within 30 days (adjusted odds ratio: 1.14; 95% CI: 1.03-1.27; <i>P</i> = 0.010) and at other time points. This difference was primarily driven by the higher use of home care among patients with a male versus female surgeon at all time points (30 days: adjusted odds ratio, 1.13; 95% CI: 1.05-1.21; <i>P</i> = 0.002).</p><p><strong>Conclusions: </strong>Patients with male surgeons had higher postoperative resource utilization when compared with those treated by female surgeons, which was almost entirely driven by the higher use of home care. Further mixed-methods investigation is needed to better understand other potentially relevant factors including surgical outcomes, individual patient preferences, and surgical team decision-making.</p>","PeriodicalId":72231,"journal":{"name":"Annals of surgery open : perspectives of surgical history, education, and clinical approaches","volume":"6 2","pages":"e569"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Federated Learning for Predicting Major Postoperative Complications.","authors":"Yuanfang Ren, Yonggi Park, Benjamin Shickel, Ziyuan Guan, Ayush Patel, Yingbo Ma, Zhenhong Hu, Jeremy A Balch, Tyler J Loftus, Parisa Rashidi, Tezcan Ozrazgat-Baslanti, Azra Bihorac","doi":"10.1097/AS9.0000000000000573","DOIUrl":"10.1097/AS9.0000000000000573","url":null,"abstract":"<p><strong>Objective: </strong>To develop a robust model to accurately predict the risk of postoperative complications using clinical data from multiple institutions while ensuring data privacy.</p><p><strong>Background: </strong>Building accurate, artificial intelligence models to predict postoperative complications relies on accessibility of large-scale and diverse datasets, often restricted by privacy concerns.</p><p><strong>Methods: </strong>This retrospective cohort study includes adult patients admitted to University of Florida Health (UFH) hospitals in Gainesville (GNV) (n = 79,850) and Jacksonville (JAX) (n = 28,636) for all inpatient major surgical procedures. We developed federated learning models to predict 9 major postoperative complications and compared them with both local models trained on a single site and central models trained on a pooled dataset from 2 hospitals.</p><p><strong>Results: </strong>Our best-federated learning models using preoperative features achieved the area under the receiver operating characteristics curve values with 95% confidence interval (CI) ranging from 0.80 (95% CI, 0.79-0.80) for wound complications to 0.90 (95% CI, 0.90-0.91) for prolonged intensive care unit (ICU) stay at UFH GNV. At UFH JAX, these values ranged from 0.71 (95% CI, 0.70-0.72) for wound complications to 0.90 (95% CI, 0.88-0.92) for in-hospital mortality. Federated learning models achieved comparable discrimination to central models for all outcomes, except prolonged ICU stay, where the performance of the federated learning model was slightly better at UFH GNV and slightly worse at UFH JAX. Our federated learning models obtained comparable performance to the best local models.</p><p><strong>Conclusions: </strong>We show federated learning to be a useful tool to train robust postoperative outcome prediction models from large-scale data across 2 hospitals.</p>","PeriodicalId":72231,"journal":{"name":"Annals of surgery open : perspectives of surgical history, education, and clinical approaches","volume":"6 2","pages":"e573"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Lower Staple Heights in Robotic Sleeve Gastrectomy: National Trends and Impact on Outcomes.","authors":"Kay S Hung, Shih-Hao Lee, Dan E Azagury, Brian Ruhle, James K Wall, Lee White, Feibi Zheng, Micaela M Esquivel","doi":"10.1097/AS9.0000000000000570","DOIUrl":"10.1097/AS9.0000000000000570","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to characterize SureForm stapler usage trends in robotic sleeve gastrectomy (RSG) and compare associated outcomes, accounting for staple height used.</p><p><strong>Background: </strong>The proportion of sleeve gastrectomy cases done robotically is increasing, but uncertainty remains about optimal stapler choice, reload height and reinforcement, and the impact of these choices on perioperative outcomes.</p><p><strong>Methods: </strong>Elective laparoscopic and robotic SG performed from January 1, 2019, to February 28, 2023, were identified in the PINC AI Healthcare Database. Patients who underwent RSG were included. RSG with no stapler type/height information was excluded. The incidences of complications such as bleeding, leak, and sepsis in the perioperative period were evaluated using International Classification of Diseases/Current Procedure Terminology codes. Hospital resource utilization data such as length of stay, operative time, intensive care unit utilization, and readmission were also analyzed. Propensity score matching (PSM) analysis was used to compare outcomes.</p><p><strong>Results: </strong>A total of 35,795 RSG were analyzed with 23,904 documenting use of SureForm stapler. Use of at least one SureForm white reload increased from 19.2% to 52.7% in the study period; use of 3 or more white reloads per case increased from 6% to 71%. PSM analysis compared 5795 RSG with any white reload versus 5795 RSG with non-white reloads, showing equivalent complication rates, marginally shorter length of stay, and longer operative time with white reloads.</p><p><strong>Conclusions: </strong>There is a trend toward downsizing to white stapler reloads in RSG without significant changes in perioperative outcomes and minor differences in hospital resource utilization. These findings suggest that white stapler reload use is safe in RSG.</p>","PeriodicalId":72231,"journal":{"name":"Annals of surgery open : perspectives of surgical history, education, and clinical approaches","volume":"6 2","pages":"e570"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 on Opioid Prescribing, Consumption, Pain, and Outcomes after Surgery.","authors":"Dorna Kheirabadi, Vidhya Gunaseelan, Yenling Lai, Chad M Brummett, Jennifer F Waljee, Michael J Englesbe, Mark C Bicket","doi":"10.1097/AS9.0000000000000571","DOIUrl":"10.1097/AS9.0000000000000571","url":null,"abstract":"<p><strong>Objective: </strong>The aim is to compare opioid prescription, consumption, and patient-reported and clinical outcomes after surgical discharge pre- versus post-COVID-19 pandemic.</p><p><strong>Background: </strong>Numerous studies have demonstrated negative health outcomes after pandemic onset. However, the impact on postoperative opioid use, pain, and relevant outcomes is unclear.</p><p><strong>Methods: </strong>Using interrupted time series analysis, we examined opioid-naive adults undergoing a variety of surgical procedures across 69 hospitals in a statewide quality collaborative, adjusting for demographic and clinical factors. We compared postsurgical outcomes in the prepandemic period (June 1, 2018-February 29, 2020) and the postpandemic period (June 1, 2020-December 31, 2021). Primary outcomes included 30-day opioid prescriptions and patient-reported consumption; secondary outcomes included patient-reported pain, quality of life, satisfaction, and surgical regret; and the composite outcome included 30-day complications, readmissions, and emergency department visits.</p><p><strong>Results: </strong>The primary analysis included 18,031 patients in the prepandemic group and 19,973 in the postpandemic group. Adjusted analyses showed no significant impact of the pandemic on opioid prescribing (level change in any prescription: -0.012 [95% confidence interval (CI): -0.073 to 0.048]; number of pills prescribed: 0.863 [95% CI: -0.277 to 2.003]) or opioid consumption (level change in amount consumed: 0.614 [95% CI: -11.748 to 12.977]). No differences appeared in patient-reported outcomes or composite outcomes of 30-day complications, readmissions, and emergency room visits (<i>P</i> for all level change >0.05).</p><p><strong>Conclusions: </strong>The absence of significant changes in opioid prescribing or consumption, clinical outcomes, and patient-reported outcomes suggest that certain quality improvement outcomes may have been resilient to disruptions caused by the COVID-19 pandemic.</p>","PeriodicalId":72231,"journal":{"name":"Annals of surgery open : perspectives of surgical history, education, and clinical approaches","volume":"6 2","pages":"e571"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}