American journal of surgery最新文献

{"title":"From the Editor - in - Chief.","authors":"Herbert Chen","doi":"10.1016/j.amjsurg.2025.116627","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116627","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116627"},"PeriodicalIF":2.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rise of women in pediatric surgery training: Have we reached equity?","authors":"Lisa Marie Jackson, James Petrancosta, Nina Kosciuszek, Sophia Liu, Tawny Kim, Erin E Perrone, Claudia N Emami, Kristen A Calabro, Kenneth W Gow","doi":"10.1016/j.amjsurg.2025.116624","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116624","url":null,"abstract":"<p><strong>Background: </strong>Women have long been underrepresented in surgical fields, including pediatric general surgery (PGS), one of the most competitive subspecialties. This study examined trends in gender representation in PGS.</p><p><strong>Methods: </strong>We identified all PGS graduates from U.S. and Canadian programs between 1919 and 2025 using validated sources. Gender was determined, and male-to-female ratios were analyzed by year. National leadership roles were reviewed for their representation of females. Chi-square tests were used to assess statistical significance (p ​< ​0.05).</p><p><strong>Results: </strong>Seventy-nine programs produced 2235 graduates: 1675 (75 ​%) men and 560 (25 ​%) women. Female representation increased steadily, with gender parity emerging around 2020. Although women entered leadership roles in PGS earlier than in General Surgery, they still lag behind men in overall leadership representation.</p><p><strong>Conclusions: </strong>PGS has made significant progress toward gender equity in training, with recent parity among graduates. However, leadership remains an area for continued improvement to ensure equitable representation at all levels.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116624"},"PeriodicalIF":2.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145204927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A call to action to formally incorporate SDOH training in surgery residency curricula.","authors":"Lamario Williams, Toluwani Akinpelu, Ariana Naaseh, Cameron Comrie, Alizeh Abbas","doi":"10.1016/j.amjsurg.2025.116625","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116625","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116625"},"PeriodicalIF":2.7,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"More than just stuck in the middle: papillary thyroid cancer of the isthmus may present with aggressive features and nodal metasasis","authors":"Michael S. Lui ,&nbsp;Patrick T. Hangge ,&nbsp;Olivia DeLozier ,&nbsp;Kepal N. Patel ,&nbsp;Fang Zhou ,&nbsp;Tina WF. Yen ,&nbsp;Douglas B. Evans ,&nbsp;Tracy S. Wang ,&nbsp;Sophie Dream","doi":"10.1016/j.amjsurg.2025.116621","DOIUrl":"10.1016/j.amjsurg.2025.116621","url":null,"abstract":"<div><h3>Introduction</h3><div>Differentiated thyroid cancer is the most common endocrine malignancy and has an excellent 5-year survival rate after appropriate management. Current management guidelines state that thyroid lobectomy is adequate resection for papillary thyroid cancer (PTC) without preoperative evidence of high-risk features. However, the extent of surgery for PTC in the thyroid isthmus remains controversial, given the unclear lymphatic drainage and retrospective studies suggesting higher rates of lymphatic metastasis. The aim of this study was to examine the surgical management and outcomes of patients with isthmus PTC.</div></div><div><h3>Methods</h3><div>A retrospective review was performed at two high-volume centers of 138 patients who underwent thyroidectomy between 2013 and 2021 with isthmus PTC on final pathology. Preoperative tumor characteristics, surgical pathology, and postoperative outcomes were compared.</div></div><div><h3>Results</h3><div>There were 138 patients treated for isthmus PTC. Total thyroidectomy (TT) was most frequently performed (70.0 ​%), followed by lobectomy (TL, 17.1 ​%) and isthmusectomy (TI, 12.9 ​%). Among the 106 patients with Bethesda V/VI nodules, most underwent TT (75.5 ​%), followed by TL (13.2 ​%), and TI (11.3 ​%). Patients with Bethesda III/IV nodules most frequently had TI (44.4 ​%) or TL (44.4 ​%), then followed by TT (11.1 ​%). Patients who underwent TT more frequently had suspicious lymph nodes on preoperative imaging (n ​= ​30, n ​= ​1, n ​= ​0, p ​&lt; ​0.001) and/or multiple nodules than TL and TI respectively (73.5 ​%, 70.8 ​%, 16.7 ​%, p ​&lt; ​0.001). Of TT patients, 48 had central neck dissections (29 prophylactic and 19 therapeutic) and 20 had both therapeutic CND and lateral neck dissections. TT patients had larger median tumor size (1.5 ​cm; TL 1.1 ​cm; TI 1.0 ​cm; p ​= ​0.008). PTC variants were identified in 26.1 ​% of patients. Completion thyroidectomy was performed in 4 patients (TL, n ​= ​2; TI, n ​= ​2, p ​= ​0.41). Of 99 patients with lymph nodes sampled, 62 patients had metastatic lymph nodes (TT 58.2 ​%; TL, 16.7 ​%; TI: 11.1 ​%; p ​= ​0.02). At the last follow-up, 10 patients had persistent/recurrent disease (TT: 8, TI: 2, TL: 0). At one year, among patients who did not undergo TT, 10 patients required thyroid hormone replacement (TL: 56 ​%; TI: 10 ​%; p ​= ​0.018).</div></div><div><h3>Conclusion</h3><div>Isthmus PTC may present with high-risk pathologic variants and positive nodes in 2 out of 3 patients. TI may be an appropriate management strategy in small, low-risk tumors, with similar reoperation rates as TL and lower rates of needing thyroid hormone replacement.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116621"},"PeriodicalIF":2.7,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Well-differentiated grade 1 and 2 nonfunctioning pancreatic neuroendocrine tumor: Consideration of additional factors to aid treatment decision-making","authors":"Omid Salehi ,&nbsp;Ponnandai Somasundar ,&nbsp;N Joseph Espat ,&nbsp;Abdul Saied Calvino ,&nbsp;Mohammad Ali ,&nbsp;Sasha Lightfoot ,&nbsp;Steve Kwon","doi":"10.1016/j.amjsurg.2025.116622","DOIUrl":"10.1016/j.amjsurg.2025.116622","url":null,"abstract":"<div><h3>Background</h3><div>Guidelines for 1–2 ​cm well-differentiated non-functional pancreatic neuroendocrine tumors (NF-PNET) are broad; observation (OB), enucleation (EN), and pancreatic resection (PR) all viable. The objective is analyzing factors impacting survival between approaches.</div></div><div><h3>Methods</h3><div>Retrospective analysis of NCDB for 1–2 ​cm well-differentiated grade 1/2 NF-PNET stratified by approach. Factors predicting survival analyzed using Cox regression.</div></div><div><h3>Results</h3><div>4023 patients included; 1030 OB, 321 ​EN, and 2672 ​PR. EN was associated with improved survival (HR 0.20, 95 %CI 0.08–0.53) and was dependent on negative margins (margin negative: HR 0.12, 95 %CI 0.05–0.34). Positive margins for EN were high (29.7 ​% EN vs. 3.4 ​% PR, p ​&lt; ​0.01). Factors influencing margins for EN were pancreatic tail location (OR 0.36, 95 %CI 0.13–0.98) and lymphovascular invasion (OR 5.28, 95 %CI 1.42–19.53). Among PRs, only distal pancreatectomy conferred improved survival (HR 0.53, 95 %CI 0.30–0.92).</div></div><div><h3>Conclusion</h3><div>Optimal treatment for 1–2 ​cm well-differentiated NF-PNET should incorporate factors influencing positive margins for EN and resection type for PR.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116622"},"PeriodicalIF":2.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145117720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmasking gender disparities in industry payments to U.S. surgeons: Royalty and consulting fees across surgical subspecialties","authors":"Sofia Wagemaker Viana ,&nbsp;Brenda Feres ,&nbsp;Gabriele Eckerdt Lech ,&nbsp;Yasmin Biscola Da Cruz ,&nbsp;Mariana Ferrari ,&nbsp;Mecker G. Möller","doi":"10.1016/j.amjsurg.2025.116612","DOIUrl":"10.1016/j.amjsurg.2025.116612","url":null,"abstract":"<div><h3>Introduction</h3><div>Research demonstrates persistent gender-based pay disparities among U.S. surgeons.</div></div><div><h3>Methods</h3><div>We analyzed 2023 OpenPaymentsData.CMS.gov consulting and royalty (C/R) payments by pharmaceutical and medical device companies to surgeons, comparing gender differences across subspecialties.</div></div><div><h3>Results</h3><div>Of 5505 ​C/R payments totaling $23.9 million, $16.9 million were consulting fees with male surgeons (n ​= ​1,056, 87 ​%) receiving a total of $15,322,355 with a significantly higher mean consulting fee across subspecialties ($14,637 ​± ​$33,314) vs female (n ​= ​164; 13 ​%) ($9728 ​± ​$16,749.44, p ​= ​0.009). Median consulting fees for males ($4800.00, IQR $11,403) vs females ($4650.00, IQR $8778), (p ​= ​0.0005) Only one female received royalties vs 37 males ($298,836 vs. $6.66 million).</div></div><div><h3>Conclusion</h3><div>Our findings reveal persistent and multifaceted gender disparities in both representation and industry remuneration across surgical subspecialties. Addressing these inequities is crucial to fostering transparency and equity in compensation within the healthcare industry.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116612"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health policy advocacy: Navigating personal, professional, and organizational politics.","authors":"Amy E Liepert, Christina Colosimo","doi":"10.1016/j.amjsurg.2025.116617","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116617","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116617"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Clinical Anatomy\" - An advanced anatomical construct for optimizing patient care.","authors":"Nirusha Lachman, Kevin N Christensen, Samuel J Asirvatham, George C Velmahos","doi":"10.1016/j.amjsurg.2025.116620","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116620","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116620"},"PeriodicalIF":2.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antecedent traumatic injuries independently predict higher 90-day mortality for patients admitted to the ICU with surgical sepsis.","authors":"Courtney M Collins, Anahita Jalilvand, Whitney Kellett, Holly Baselice, Jon Wisler","doi":"10.1016/j.amjsurg.2025.116618","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116618","url":null,"abstract":"<p><strong>Introduction: </strong>Sepsis and trauma are leading causes of mortality. We hypothesize that antecedent trauma contributes to worse outcomes.</p><p><strong>Methods: </strong>A single-institution retrospective study of patients admitted to the SICU between September 2013-January 2019 who met Sepsis III criteria. 1401 patients were included, 7.8 ​% (n ​= ​106) had preceding trauma. Cox regression was used to model in-hospital death and 90-day mortality. Kaplan-Meier 90- Day Survival Curve was calculated based on trauma status.</p><p><strong>Results: </strong>Antecedent trauma was associated with in-hospital mortality (p ​= ​0.03). Trauma, transfer status, age, Charlson comorbidity index, admission lactate and SOFA score were all independent predictors of in-hospital and 90-day mortality (p ​< ​0.005). 90-day survival curve showed a trend towards decreasing survival for the trauma cohort (p ​= ​0.02).</p><p><strong>Conclusion: </strong>Our findings indicate antecedent trauma may have significant impact on patient outcomes. Further investigation is necessary to explore the underlying mechanisms linking trauma and sepsis.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"116618"},"PeriodicalIF":2.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"My thoughts: On surgical personalities, stereotypes, and leadership.","authors":"Bipul Mainali, Ramsha Akhund, Connie C Shao, Grace E Kennedy, Herbert Chen, Jessica M Fazendin","doi":"10.1016/j.amjsurg.2025.116614","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116614","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116614"},"PeriodicalIF":2.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}