American journal of surgery最新文献

The association of race and ethnicity with risk-reducing mastectomies in patients with non-BRCA mutations 非brca突变患者的种族和民族与降低风险的乳房切除术的关系

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-06-18 DOI: 10.1016/j.amjsurg.2025.116485

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

{"title":"The association of race and ethnicity with risk-reducing mastectomies in patients with non-BRCA mutations","authors":"Koumani W. Ntowe , Samantha M. Thomas , Juliet C. Dalton , Ebunoluwa Olunuga , Ton Wang , Akiko Chiba , Jennifer K. Plichta","doi":"10.1016/j.amjsurg.2025.116485","DOIUrl":"10.1016/j.amjsurg.2025.116485","url":null,"abstract":"<div><h3>Introduction</h3><div>We compared rates of risk reducing mastectomies (RRM) in patients with breast cancer (BC)-related pathogenic variants.</div></div><div><h3>Methods</h3><div>Female patients ages ≥18 with a BC-related pathogenic variant, without a concurrent or prior BC diagnosis, were identified from a single academic center's database. Patients were stratified by BRCA mutations, high penetrance mutations (HPM), and moderate penetrance mutations (MPM). Race and ethnicity were classified as non-Hispanic White (NHW), non-Hispanic Black (NHB), non-Hispanic other (NHO), and Hispanic.</div></div><div><h3>Results</h3><div>Our study included 528 patients, which included 79.2 % (n = 418) NHW, 7.0 % (n = 37) NHB, 3.6 % (n = 19) NHO, and 3.4 % (n = 18) Hispanic patients. Overall, 16.5 % of patients underwent RRM: 18.4 % of NHW, 10.8 % of NHB, 5.6 % of Hispanic (p = 0.45). For NHB and Hispanic patients, no individuals with HPMs (NHB 0/6, Hispanic 0/5) or MPMs (NHB 0/11, Hispanic 0/4) underwent RRM.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that race and ethnicity may be associated with the decision to undergo RRM.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"247 ","pages":"Article 116485"},"PeriodicalIF":2.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144331153","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

Identifying resource needs of patients with breast cancer by examining alignment of Reddit post content with BREAST-Q domains 通过检查Reddit帖子内容与breast - q域的一致性来确定乳腺癌患者的资源需求

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-06-17 DOI: 10.1016/j.amjsurg.2025.116486

Jessie G. Jiang , Trisha Agarwal , Madeline G. Higgins , Micaela K. Roy , Monica Adams , Sarah E. Leslie , Erin Baurle , Kristin E. Rojas , Sarah E. Tevis

{"title":"Identifying resource needs of patients with breast cancer by examining alignment of Reddit post content with BREAST-Q domains","authors":"Jessie G. Jiang , Trisha Agarwal , Madeline G. Higgins , Micaela K. Roy , Monica Adams , Sarah E. Leslie , Erin Baurle , Kristin E. Rojas , Sarah E. Tevis","doi":"10.1016/j.amjsurg.2025.116486","DOIUrl":"10.1016/j.amjsurg.2025.116486","url":null,"abstract":"<div><h3>Background</h3><div>Reddit is a popular online forum for breast cancer survivors, but its content is largely unstudied. We compared topics discussed on the r/breastcancer subreddit to BREAST-Q, a validated breast surgery patient-reported outcome measure. We hypothesized that Reddit discussions would align with, yet transcend, BREAST-Q domains (BQDs).</div></div><div><h3>Methods</h3><div>The top 1000 original posts (OP) on r/breastcancer were extracted using R studio. Content analysis and thematic coding (TC) were performed independently by five trained coders. Deductive TC was conducted using the BQDs as a framework for themes. Inductive TC was conducted to establish other emerging themes.</div></div><div><h3>Results</h3><div>Of the 1000 OPs analyzed, 828 included topics covered by BQDs. All BQDs were represented, including “Psychosocial Well-Being” (57 %), “Physical Well-Being” (18 %), “Satisfaction with Care” (11 %), “Satisfaction with Outcome” (8.0 %), “Satisfaction with Breasts” (3.4 %), and “Sexual Well-Being” (2.5 %).</div></div><div><h3>Conclusions</h3><div>Breast cancer survivors would benefit from more resources targeting psychosocial and physical well-being.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"247 ","pages":"Article 116486"},"PeriodicalIF":2.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144364889","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

Thyroid-stimulating immunoglobulin is not associated with aggressive clinicopathologic features in concomitant Graves’ disease and papillary thyroid cancer 促甲状腺免疫球蛋白与伴发Graves病和甲状腺乳头状癌的侵袭性临床病理特征无关

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-06-17 DOI: 10.1016/j.amjsurg.2025.116487

Brendan M. Finnerty , Teagan Marshall , Chandler A. Annesi , Rasa Zarnegar , Thomas J. Fahey III , Kristin Long , Frederick Thurston Drake , Toni Beninato

{"title":"Thyroid-stimulating immunoglobulin is not associated with aggressive clinicopathologic features in concomitant Graves’ disease and papillary thyroid cancer","authors":"Brendan M. Finnerty , Teagan Marshall , Chandler A. Annesi , Rasa Zarnegar , Thomas J. Fahey III , Kristin Long , Frederick Thurston Drake , Toni Beninato","doi":"10.1016/j.amjsurg.2025.116487","DOIUrl":"10.1016/j.amjsurg.2025.116487","url":null,"abstract":"<div><h3>Background</h3><div>Graves’ disease has been associated with increased tumor aggressiveness in differentiated thyroid carcinoma, however, its correlation with thyroid stimulating immunoglobulin (TSI) remains unclear.</div></div><div><h3>Methods</h3><div>A tri-institutional retrospective review of 96 thyroidectomy patients with Graves’ disease and papillary thyroid carcinoma (PTC) was performed (2002–2020). Clinicopathologic features and recurrence were compared based on TSI level.</div></div><div><h3>Results</h3><div>ATA risk stratification distribution was low (72.9 %), intermediate (14.6 %), and high (12.5 %). Recurrence rate was 11.5 % with median follow-up of 3.2 years. TSI was not associated with high-risk clinicopathologic features at its 50 % and 75 % quartiles. There was no difference in median TSI between patients with recurrence versus no recurrence [212 (IQR 98–361) vs. 327 (IQR 152–461), p = 0.148]. TSI was not associated with recurrence on univariable Cox regression, even when excluding microcarcinomas.</div></div><div><h3>Conclusions</h3><div>In this majority low-risk PTC cohort with concomitant Graves’ disease, TSI level is not associated with aggressive clinicopathologic features or recurrence.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"247 ","pages":"Article 116487"},"PeriodicalIF":2.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144331152","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

'Curiouser and curiouser' - an invited commentary regarding FDG-avid thyroid nodules. “越来越奇怪”——关于fdg狂热的甲状腺结节的特邀评论。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-06-14 DOI: 10.1016/j.amjsurg.2025.116470

Edwina C Moore

引用次数: 0

Corrigendum to "In-hospital and post-discharge outcomes with autologous versus prosthetic repair of traumatic abdominal vascular injuries: a 10-year review of the PROOVIT registry" [Am J Surg 248, October (2025), 116413]. “外伤性腹腔血管损伤自体修复与假体修复的住院和出院后疗效：回顾性分析”[J].中华外科杂志，2008(10):116413。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-06-12 DOI: 10.1016/j.amjsurg.2025.116465

Negar Nekooei, Danielle Brabender, Stephen Park, Christine Bent, Anaar Siletz, Kazuhide Matsushima, Morgan Schellenberg, Kenji Inaba, Joseph Dubose, Matthew J Martin

引用次数: 0

Isolated common bile duct dilation on pre-operative ultrasound is not a predictor of choledocholithiasis on intraoperative cholangiogram 术前超声检查孤立的胆总管扩张不能作为术中胆管造影检查胆总管结石的预测指标

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-06-11 DOI: 10.1016/j.amjsurg.2025.116478

Benjamin Ramser , Kassandra Samuel , Fredric M. Pieracci , Alexander Morton , Daniel D. Yeh

{"title":"Isolated common bile duct dilation on pre-operative ultrasound is not a predictor of choledocholithiasis on intraoperative cholangiogram","authors":"Benjamin Ramser , Kassandra Samuel , Fredric M. Pieracci , Alexander Morton , Daniel D. Yeh","doi":"10.1016/j.amjsurg.2025.116478","DOIUrl":"10.1016/j.amjsurg.2025.116478","url":null,"abstract":"<div><h3>Background</h3><div>Common bile duct (CBD) dilation is typically an indication for intraoperative cholangiogram (IOC). We hypothesized that isolated CBD dilation on pre-operative ultrasound (US) is not predictive of choledocholithiasis (CD) on IOC.</div></div><div><h3>Methods</h3><div>A retrospective study comparing patients with dilated versus normal CBD diameter on pre-operative US. CBD dilation on pre-operative ultrasound was defined as ≥ 0.6 cm, with 1 mm added per decade of life above 60-years-old. Demographics, laboratory values, CBD diameter, cholecystitis grades, and clinical outcomes were collected.</div></div><div><h3>Results</h3><div>341 patients underwent LC with IOC during the study period, of which 46 patients had isolated CBD dilation. CBD dilation via ultrasound had a sensitivity of 80.00 %, specificity of 25.49 %, positive predictive value of 17.39 %, and negative predictive value of 86.67 %. There was no difference in demographics, cholecystitis severity, complication or readmission rates.</div></div><div><h3>Conclusion</h3><div>Isolated CBD dilation does not present an increased risk of CD compared to normal CBD diameter.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116478"},"PeriodicalIF":2.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322341","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

Trends in Axillary Staging for Breast Cancer in the Elderly: Outcomes of Choosing Wisely at a High-Usage Institution 老年乳腺癌腋窝分期趋势：在高使用率机构中明智选择的结果

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-06-11 DOI: 10.1016/j.amjsurg.2025.116477

Lena K. Egbert MD , Heidi Kosiorek MS , Patricia Cronin MD , Julie Billar MD , Richard Bold MD, MBA , Barbara Pockaj MD

{"title":"Trends in Axillary Staging for Breast Cancer in the Elderly: Outcomes of Choosing Wisely at a High-Usage Institution","authors":"Lena K. Egbert MD , Heidi Kosiorek MS , Patricia Cronin MD , Julie Billar MD , Richard Bold MD, MBA , Barbara Pockaj MD","doi":"10.1016/j.amjsurg.2025.116477","DOIUrl":"10.1016/j.amjsurg.2025.116477","url":null,"abstract":"<div><h3>Background</h3><div>In 2016, a Choosing Wisely guideline was published recommending omission of sentinel lymph node biopsy (SLNB) in low-risk elderly females with breast cancer. Our study evaluated trends and factors associated with omission of axillary surgery.</div></div><div><h3>Methods</h3><div>Patients ≥70 years old undergoing surgery for an initial diagnosis of invasive breast cancer from 2014 to 2022 at our institution were retrospectively reviewed. A sub-group of pT1, cN0, ER+/HER2-patients was analyzed.</div></div><div><h3>Results</h3><div>A total of 218 pT1, cN0, ER+/HER2-patients were identified. In these patients, the percentage of SLNB performed decreased from 73 % in 2014 to 30 % in 2022 (p < 0.0001). Older age (OR 0.82, 95 % CI 0.73–0.91) and smaller preoperative tumor size (OR 3.63, 95 % CI 1.62–8.14) were associated with SLNB omission. There were no differences in loco-regional recurrence-free survival (p = 0.57) and disease-free survival (p = 0.66) with SLNB omission.</div></div><div><h3>Conclusions</h3><div>With increasing omission of axillary staging, there was no adverse impact on recurrence-free survival.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116477"},"PeriodicalIF":2.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322342","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

Prophylactic ureteral stent placement by general surgeons is safe and Feasible: Implementation of a training and credentialing program for non-urologic surgeons 普通外科医生预防性输尿管支架置入是安全可行的：对非泌尿外科医生的培训和认证计划的实施

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-06-11 DOI: 10.1016/j.amjsurg.2025.116474

Kadee-Kalia Tamashiro , Charles Joseph Wilkins , Angela Maron , Amy M. Kwok , Yeng Vue , Jessica Gallegos , Cynthia Tom , Devon Livingston-Rosanoff , Pamela Emeny , David Disbrow

{"title":"Prophylactic ureteral stent placement by general surgeons is safe and Feasible: Implementation of a training and credentialing program for non-urologic surgeons","authors":"Kadee-Kalia Tamashiro , Charles Joseph Wilkins , Angela Maron , Amy M. Kwok , Yeng Vue , Jessica Gallegos , Cynthia Tom , Devon Livingston-Rosanoff , Pamela Emeny , David Disbrow","doi":"10.1016/j.amjsurg.2025.116474","DOIUrl":"10.1016/j.amjsurg.2025.116474","url":null,"abstract":"<div><h3>Background</h3><div>Prophylactic ureteral stenting has been used to aid with intraoperative identification of ureters and immediate injury recognition during pelvic surgery. This study aims to establish the safety and ability of non-urological surgeons to perform cystoscopy and prophylactic ureteral stent placement.</div></div><div><h3>Methods</h3><div>A retrospective review of patients who underwent cystoscopy and prophylactic ureteral stent placement performed by the primary operating surgeon was conducted.</div></div><div><h3>Results</h3><div>748 cases were included. The overall complication rate was 9.4 % and successful ureter cannulation rate was 97.7 %. Complications included hematuria ≥3 days (0.9 %), AKI (4.4 %), urinary retention (3.3 %), UTI (2.7 %), urethral injury (0.4 %), and ureteral injury (0.5 %). There was no significant difference in complications between surgical services (p = 0.193), surgical approach (p = 0.648), use of unilateral indwelling stent (p = 0.768), bilateral indwelling stents (p = 0.801), or ICG injection alone (p = 0.596).</div></div><div><h3>Conclusions</h3><div>Cystoscopy with prophylactic ureteral stent placement can be safely performed by non-urologic surgeons.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116474"},"PeriodicalIF":2.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307992","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

Don’t ignore the patient with a “fragility fracture”! Risk factors for bleeding from stable pelvic fractures 不要忽视“脆性骨折”患者！稳定性骨盆骨折出血的危险因素

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-06-11 DOI: 10.1016/j.amjsurg.2025.116479

Walter L. Biffl , Ali Sepahdari , Matthew Castelo , Jeffrey Smith , Dunya Bayat , Katrina DeLeon

{"title":"Don’t ignore the patient with a “fragility fracture”! Risk factors for bleeding from stable pelvic fractures","authors":"Walter L. Biffl , Ali Sepahdari , Matthew Castelo , Jeffrey Smith , Dunya Bayat , Katrina DeLeon","doi":"10.1016/j.amjsurg.2025.116479","DOIUrl":"10.1016/j.amjsurg.2025.116479","url":null,"abstract":"<div><h3>Background</h3><div>Stable pelvic fractures are common in elderly patients. Significant bleeding (SigBleed)- requiring transfusion or angioembolization- is reported in 9–15 %. Bleeding risk factors are poorly defined. We hypothesized that SigBleed is related to antithrombotic therapy and sarcopenia.</div></div><div><h3>Methods</h3><div>Level I trauma center retrospective review (2015–2021). Primary outcome was SigBleed. Sarcopenia measured by psoas:lumbar vertebral body index (PLVI).</div></div><div><h3>Results</h3><div>141 patients (70% female; mean age 80; 52% on antithrombotics) had mean Injury Severity Score (ISS) 8.8, mean PLVI 0.50. 24% had adverse hematoma characteristics. 22% had SigBleed: 28 (20%) received transfusion and 15 (11%) angioembolization. Adverse hematoma characteristics and ISS were independent predictors of SigBleed; PLVI (OR 0.01 [0.00002, 0.88], p = 0.065) and antithrombotics were not significant.</div></div><div><h3>Conclusions</h3><div>Older patients with stable pelvic fractures have a relatively high rate of clinically-important bleeding. Awareness of the issue and identification of risk factors is important. The relationship between sarcopenia and bleeding requires further study.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116479"},"PeriodicalIF":2.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279501","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

Just a general surgeon. 只是个普通外科医生。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-06-11 DOI: 10.1016/j.amjsurg.2025.116469

Thomas J Schroeppel

引用次数: 0