American journal of surgery最新文献

Time is money: The return on investment of research in surgical training 时间就是金钱：外科培训研究的投资回报

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-10 DOI: 10.1016/j.amjsurg.2024.116011

引用次数: 0

Variation in PTH levels and kinetics after parathyroidectomy 甲状旁腺切除术后 PTH 水平和动力学的变化

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-10 DOI: 10.1016/j.amjsurg.2024.116010

引用次数: 0

The impact of externalized pancreatic stents in our practice: A comparison of outcomes after pancreaticoduodenectomy in two time periods 外置胰腺支架对我们工作的影响：两个时期胰十二指肠切除术后疗效的比较

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-06 DOI: 10.1016/j.amjsurg.2024.116004

{"title":"The impact of externalized pancreatic stents in our practice: A comparison of outcomes after pancreaticoduodenectomy in two time periods","authors":"","doi":"10.1016/j.amjsurg.2024.116004","DOIUrl":"10.1016/j.amjsurg.2024.116004","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative pancreatic fistula is a severe complication of pancreaticoduodenectomy. Using an externalized pancreatic stent is a potential mitigation strategy not previously studied in Latin America.</div></div><div><h3>Methods</h3><div>Pancreaticoduodenectomies performed in a single center between 2006 and 2019 were retrospectively analyzed. Clinical variables were collected with a 90-day follow-up according to stent intervention: externalized stent (ES), internal stent (IS), or no stent. Before and after ES implementation (2016) periods were also compared.</div></div><div><h3>Results</h3><div>Out of 237 patients, 77 (32.5 %) had an ES, 24 (10.1 %) an IS, and 136 (57.4 %) none. No difference was found in the overall incidence of POPF. The use of an ES was associated with less type C POPF, despite having an increased risk for fistula development. PD performed after 2016 were also associated with a reduced incidence of type C POPF, surgical reintervention requirement, POPF-associated mortality, and intrahospital stay.</div></div><div><h3>Conclusions</h3><div>The use of an ES is a low-cost intervention that can mitigate POPF severity in high-risk patients.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441535","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}

引用次数: 0

The association of genetic testing timing and mutation type on breast cancer management in patients with breast cancer-related mutations. 基因检测时间和突变类型对乳腺癌相关突变患者乳腺癌治疗的影响。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-05 DOI: 10.1016/j.amjsurg.2024.116005

Ebunoluwa J Olunuga, Samantha M Thomas, Koumani W Ntowe, Juliet C Dalton, Ton Wang, Akiko Chiba, Jennifer K Plichta

{"title":"The association of genetic testing timing and mutation type on breast cancer management in patients with breast cancer-related mutations.","authors":"Ebunoluwa J Olunuga, Samantha M Thomas, Koumani W Ntowe, Juliet C Dalton, Ton Wang, Akiko Chiba, Jennifer K Plichta","doi":"10.1016/j.amjsurg.2024.116005","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.116005","url":null,"abstract":"<p><strong>Background: </strong>We aim to characterize breast management for patients with genetic mutations and concurrent breast cancer (BC) or prior BC treatment.</p><p><strong>Methods: </strong>Adults with a BC-related mutation and prior/concurrent BC diagnosis were identified. Groups were stratified by mutation type [BRCA1/2, high penetrance mutation (HPM), moderate penetrance mutation (MPM)] and timing of genetic testing (concurrent with BC versus after BC treatment). Outcomes were compared.</p><p><strong>Results: </strong>Among 338 patients included, 63 % had BRCA1/2 mutations, 9 % HPM, and 28 % MPM. Approximately 38 % had testing concurrent with a BC diagnosis and 62 % after BC treatment. Patients with concurrent testing favored bilateral mastectomy (57 %) versus 26 % lumpectomy, and 16 % unilateral mastectomy, which varied by mutation type. Patients previously treated preferred surveillance (92 % vs. 8 % additional surgery), regardless of mutation type.</p><p><strong>Conclusion: </strong>The timing of a significant BC-related genetic test result and mutation type may be associated with management decisions among patients with breast cancer.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142405916","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}

引用次数: 0

Scholarly impact of student authorship in urology research. 泌尿学研究中学生作者的学术影响。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-05 DOI: 10.1016/j.amjsurg.2024.116006

Maya T Zhou, Olivia T Zhou, Julia Pakey, Joanna Wang, Muhammad M Qureshi, Ariel E Hirsch, Shaun E L Wason

{"title":"Scholarly impact of student authorship in urology research.","authors":"Maya T Zhou, Olivia T Zhou, Julia Pakey, Joanna Wang, Muhammad M Qureshi, Ariel E Hirsch, Shaun E L Wason","doi":"10.1016/j.amjsurg.2024.116006","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.116006","url":null,"abstract":"<p><strong>Background: </strong>H-index is an indicator of research productivity considered in faculty promotion. We examine trends in female authorship and effect of student authorship on H-index of principal investigators (PI).</p><p><strong>Methods: </strong>Author gender, degree, designation as student, PI, or other, were recorded from Journal of Endourology from 2011 to 2020. PI Scopus H-index was recorded. PIs were classified into having student authors (SA) or not (nSA). Analysis conducted with IBM SPSS.</p><p><strong>Results: </strong>Of 819 total articles, 26 % had SA. Articles with SAs increased from 22.2 % in 2011 to 31.1 % in 2020 (p for trend<0.01). There was an increasing trend in female authorship overall (R<sup>2</sup> = 0.84). PIs with SA had a significantly higher mean H-index than those without, across all years (SA = 30.91, nSA = 27.45, p = 0.025).</p><p><strong>Conclusions: </strong>Student authorship is increasing and positively benefits PI H-index. Female authorship is increasing overall within urology. Encouraging mentorship and student research can enhance and support female student interest in urology.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142405915","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}

引用次数: 0

Development and dissemination of a series of surgical skills and procedures video tutorials using a novel, low-cost, and sustainable simulation kit (GlobalSurgBox). 利用新颖、低成本和可持续的模拟工具包（GlobalSurgBox），开发和传播一系列外科技能和程序视频教程。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-04 DOI: 10.1016/j.amjsurg.2024.116002

Mayte Bryce-Alberti, Rachel E Wittenberg, Michael J Kirsch, Daniel Bollinger, Kiana Winslow, Matthew T Hey, Raisa Rauf, Barnabas Alayande, Geoffrey A Anderson, Yihan Lin

{"title":"Development and dissemination of a series of surgical skills and procedures video tutorials using a novel, low-cost, and sustainable simulation kit (GlobalSurgBox).","authors":"Mayte Bryce-Alberti, Rachel E Wittenberg, Michael J Kirsch, Daniel Bollinger, Kiana Winslow, Matthew T Hey, Raisa Rauf, Barnabas Alayande, Geoffrey A Anderson, Yihan Lin","doi":"10.1016/j.amjsurg.2024.116002","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.116002","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical simulation and video-based learning are limited in lower-resource settings. We sought to develop and assess a series of surgical tutorials using a low-cost simulator.</p><p><strong>Methods: </strong>We created 8 surgical skills and procedures videos using low-cost equipment. We assessed video quality using the DISCERN scale and the Global Quality Scale (GQS).</p><p><strong>Results: </strong>Videos ranged from surgical techniques to complex procedures. We uploaded these to Youtube and included them in the curriculum of a medical school in Rwanda. Excluding the cost of the kit (25 USD), production costs ranged from 2 to 5 USD. All videos scored a mean DISCERN of 2.44 ± 1.05 and GQS of 3.06 ± 0.90. Generally, these lacked points on providing additional sources of information and addressing areas of uncertainty.</p><p><strong>Conclusions: </strong>This study addresses the demand for accessible surgical education resources. Using low-cost, standardized materials ensures consistency, democratization of training, and feasibility.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387352","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}

引用次数: 0

Practice variations, trends, and outcomes of drain use in thyroidectomy: A NSQIP study. 甲状腺切除术中引流管使用的实践差异、趋势和结果：一项 NSQIP 研究。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-04 DOI: 10.1016/j.amjsurg.2024.115998

Kelvin Memeh, Sara Abou Azar, Oluwasegun Afolaranmi, Tanaz M Vaghaiwalla

{"title":"Practice variations, trends, and outcomes of drain use in thyroidectomy: A NSQIP study.","authors":"Kelvin Memeh, Sara Abou Azar, Oluwasegun Afolaranmi, Tanaz M Vaghaiwalla","doi":"10.1016/j.amjsurg.2024.115998","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.115998","url":null,"abstract":"<p><strong>Background: </strong>The benefit of drains remains unclear and variable among thyroid surgeons. This study examines the utility and trend in drain use after thyroidectomy.</p><p><strong>Method: </strong>This is a retrospective cross-sectional study utilizing a pooled sample of thyroidectomy patients from the 2016-2019 NSQIP. The impact of drain use on outcomes of interest (rate of postoperative neck hematoma (PNH)-primary outcome, and length-of-stay (LOS)-secondary outcome), as well as year-over-year and practice variations were evaluated using inverse-probability-weighted-regression adjustment and multivariable logistic regression analyses.</p><p><strong>Results: </strong>Of 24,370 patients, 6673(27.4 %) received drains. The average LOS and PNH rates were 27.3 h and 1.87 %, respectively. Drain use increased year-over-year for concomitant neck dissections (OR = 1.08,p = 0.002). Year-over-year odds of drain use trended down across specialties (OR = 0.96,p = 0.005); however, ENT used drains more frequently than General Surgeons (RR = 3.06, 95%CI = 2.91-3.22). Drains were associated with longer LOS (mean-difference = 9.6hrs, 95%CI 8.51-10.62) with no effect on PNH rates (RR = 0.96,p < 0.05).</p><p><strong>Conclusion: </strong>Drain use is decreasing, but practice variations across specialties persist. Post-thyroidectomy drain use was associated with longer LOS with no effect on PNHR.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387353","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}

引用次数: 0

Caudate lobe and posterosuperior segment hepatectomy using the robotic approach. Outcome analysis of liver resection in difficult locations 使用机器人方法进行尾状叶和后上段肝切除术。疑难部位肝切除术的结果分析。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-04 DOI: 10.1016/j.amjsurg.2024.115996

{"title":"Caudate lobe and posterosuperior segment hepatectomy using the robotic approach. Outcome analysis of liver resection in difficult locations","authors":"","doi":"10.1016/j.amjsurg.2024.115996","DOIUrl":"10.1016/j.amjsurg.2024.115996","url":null,"abstract":"<div><h3>Background</h3><div>Caudate and posterosuperior hepatectomy are technically challenging resections, especially in a minimally invasive approach. We aimed to analyze the outcomes of isolated caudate resection (ICR), en-bloc caudate resection with right/left hepatic lobectomy (ECR), and posterosuperior segment resection (PSR) using our institutional database.</div></div><div><h3>Methods</h3><div>Following IRB approval, we prospectively followed 500 consecutive patients between 2013 and 2023 who underwent robotic hepatectomy. Posterosuperior segments include segment 4 A, 7, and 8. The data are presented as median (mean ± standard deviation).</div></div><div><h3>Results</h3><div>Of the 500 patients included in this study, 19 (4 %) underwent ICR, 65 (13 %) underwent ECR, and 131 (26 %) patients underwent PSR. ECR was associated with significantly longer operative time, increased EBL, and longer LOS when compared with those of ICR and PSR. The patients who underwent ICR had the shortest operation duration, lowest EBL, and shortest LOS compared to ECR and PSR.</div></div><div><h3>Conclusions</h3><div>Robotic resection of liver tumors located in difficult segments is safe and feasible with excellent clinical and oncological outcomes. With appropriate expertise, a minimally invasive approach to those operations should not be avoided.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142405917","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}

引用次数: 0

The impact of routine cholangiography for asymptomatic patients after cholecystostomy insertion for acute cholecystitis 对急性胆囊炎胆囊造口术后无症状患者进行常规胆管造影的影响。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-04 DOI: 10.1016/j.amjsurg.2024.116000

{"title":"The impact of routine cholangiography for asymptomatic patients after cholecystostomy insertion for acute cholecystitis","authors":"","doi":"10.1016/j.amjsurg.2024.116000","DOIUrl":"10.1016/j.amjsurg.2024.116000","url":null,"abstract":"<div><h3>Background</h3><div>We aim to investigate the impact of routine cholangiography on asymptomatic patients with percutaneous cholecystostomy (PCC) for acute cholecystitis (AC).</div></div><div><h3>Methods</h3><div>The study included all patients treated with PCC for AC from 2017 to 2020 at a single academic center. Patients who underwent routine cholangiography within 30 days post-discharge while asymptomatic were compared to patients who were only followed clinically.</div></div><div><h3>Results</h3><div>The groups (cholangiography group, n = 44, and control group, n = 145) were similar in terms of age, comorbidities, and clinical presentation. The readmission rate for biliary disease in the cholangiography group was nearly half that of the control group (22.7 % vs. 40.7 %, p = 0.05) over an average follow-up of 10.4 months. The time to drain removal, cholecystectomy rate, and time to operation were comparable between the groups (42 vs. 40 days, p = 0.47, 52.3 % vs 53.1 %, p = NS and 69 vs. 82 days, p = 0.17, respectively).</div></div><div><h3>Conclusions</h3><div>Routine cholangiography can help reduce biliary disease readmissions among asymptomatic patients with PCC for AC without delaying further treatment.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387355","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}

引用次数: 0

Practice variation in venous thromboembolism prophylaxis in adolescent trauma patients: A comparative analysis of pediatric, adult, and mixed trauma centers 青少年创伤患者静脉血栓栓塞预防措施的实践差异：儿科、成人和混合创伤中心的比较分析。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-09-27 DOI: 10.1016/j.amjsurg.2024.115994

{"title":"Practice variation in venous thromboembolism prophylaxis in adolescent trauma patients: A comparative analysis of pediatric, adult, and mixed trauma centers","authors":"","doi":"10.1016/j.amjsurg.2024.115994","DOIUrl":"10.1016/j.amjsurg.2024.115994","url":null,"abstract":"<div><h3>Introduction</h3><div>Adolescent trauma patients are at increased risk of venous thromboembolism (VTE). It is unclear whether VTE prophylaxis practice patterns differ across trauma center types.</div></div><div><h3>Methods</h3><div>The ACS-TQP database was queried for patients aged 12-17 admitted to a pediatric, adult, or mixed level I/II trauma center. VTE prophylaxis was compared between center types. Preplanned subgroup analyses were performed to evaluate guideline adherence.</div></div><div><h3>Results</h3><div>Of 101,010 patients included, 35 % were treated at a pediatric trauma center (PTC), 43 % at a mixed trauma center (MTC), and 22 % at an adult trauma center (ATC). VTE prophylaxis was more common at ATCs and MTCs compared to PTCs (51.0 % vs 24.9 % vs 5.0 %,p < 0.001). This trend persisted in subgroup analyses of patients aged 16–17 (63.8 % vs 40.5 % vs 6.4 %,p < 0.001) and with injury severity score greater than 25 (83.8 % vs 74.0 % vs 35.1 %,p < 0.001).</div></div><div><h3>Conclusion</h3><div>VTE prophylaxis is administered more frequently to adolescent trauma patients treated at ATCs and MTCs compared to PTCs despite published guidelines. Prospective studies are needed to assess the clinical utility of VTE prophylaxis in the adolescent trauma population.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142374891","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}

引用次数: 0