American journal of surgery最新文献

{"title":"Drunk Platelets: Ethanol intoxication is associated with platelet inhibition in male Trauma patients.","authors":"Brittany M Stansbury, Rigel P Hall, Andrea Carolina Vazquez-Loreto, Robert A Easter, Trevor M Low, Jody L Handschug, Kristina M Kupanoff, Dih-Dih Huang, Michael D Jones, Brian R Czarkowski, Hahn Soe-Lin, Jordan A Weinberg, James N Bogert","doi":"10.1016/j.amjsurg.2025.116550","DOIUrl":"10.1016/j.amjsurg.2025.116550","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"249 ","pages":"116550"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811556","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":"Changing the culture from the bottom Up: Results of a resident-led ergonomics quality improvement initiative.","authors":"Sean Perez, Myat Wai, Bryanna Chavez, Sabrina Chriqui, Jennifer Berumen","doi":"10.1016/j.amjsurg.2025.116551","DOIUrl":"10.1016/j.amjsurg.2025.116551","url":null,"abstract":"<p><strong>Background: </strong>Poor ergonomic habits in residency contribute to musculoskeletal (MSK) disorders later in a surgeon's career. Despite growing awareness, formal ergonomics training is limited. This study implemented a resident-led ergonomics curriculum to assess its impact on resident habits.</p><p><strong>Methods: </strong>A 1-h educational session covering MSK disorders, microbreaks, and ergonomics best practices was delivered to general surgery residents. The session included active demonstrations, pre- and post-lecture knowledge assessments, and surveys on ergonomic practices. Follow-up assessments were conducted at 4 months and 1 year.</p><p><strong>Results: </strong>Among 26 attendees, knowledge scores improved by 16.8 ​% (p ​= ​0.001). At 4-month follow-up 26.7 ​% adopted microbreaks and 46.7 ​% implemented ergonomic exercises into their regular routine. At 1 year, adoption of practices remained similar, with time constraints and faculty disapproval as common barriers.</p><p><strong>Conclusion: </strong>The curriculum improved ergonomics awareness and practices, but more robust adoption of ergonomic techniques and microbreaks remains limited largely due to hierarchical barriers and time constraints.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"249 ","pages":"116551"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803212","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":"Implementation of a quality improvement initiative reduced adult inpatient gastrostomy tube dislodgements.","authors":"Anna J Kobzeva-Herzog, Maia R Nofal, Jacob Bodde, Sophia M Smith, Pamela Rosenkranz, David Guez, David McAneny, Jeffrey J Siracuse, Aaron Richman","doi":"10.1016/j.amjsurg.2025.116522","DOIUrl":"10.1016/j.amjsurg.2025.116522","url":null,"abstract":"<p><strong>Background: </strong>We examined the success of a quality improvement initiative intended to prevent acute inpatient gastrostomy tube (g-tube) dislodgements.</p><p><strong>Study design: </strong>This was a retrospective cohort study of adult inpatients ≥18-years-old who underwent new g-tube placement at our institution (September 2021-August 2023). A new nursing order and revised nursing education, which specified standardized g-tube care, was implemented in September 2022. The incidence of g-tube dislodgments was compared between the pre-intervention and post-intervention cohorts.</p><p><strong>Results: </strong>There were 555 ​g-tube placements, of which 236 occurred post-intervention. At one year after implementation, the compliance rate was 71.2 ​%. Patients with the new order had fewer dislodgements compared to those who did not have the order (8.3 ​% vs 29.4 ​%, P ​< ​0.001). Multivariable analysis demonstrated use of the order was associated with a decreased risk of dislodgement (OR 0.51, CI 0.28-0.99, P ​= ​0.046).</p><p><strong>Conclusions: </strong>Multidisciplinary initiatives can reduce the likelihood of complications and improve patient outcomes.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"249 ","pages":"116522"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811557","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":"Effectiveness of calcium channel blockers in traumatic brain injury patients requiring operative intervention","authors":"Tianrun Pan ,&nbsp;Melissa Blatt ,&nbsp;Tania Zielonka ,&nbsp;Yen-Hong Kuo ,&nbsp;Jamshed Zuberi ,&nbsp;Stephanie Bonne","doi":"10.1016/j.amjsurg.2025.116661","DOIUrl":"10.1016/j.amjsurg.2025.116661","url":null,"abstract":"<div><h3>Introduction</h3><div>In patients with traumatic brain injury (TBI), calcium channel blockers (CCBs) may be used in the early phase to manage hypertension. However, these medications may exacerbate secondary brain injury via hypotension and cerebral vasodilation, blunting Cushing's reflex. We hypothesized that preoperative CCB use does not improve outcomes.</div></div><div><h3>Method</h3><div>A retrospective study (2017–2023) at a Level 1 Trauma Center includes adults undergoing craniotomy or craniectomy within 6 ​h of arrival. Patients were grouped by CCB exposure. Outcomes included mortality, Glasgow Outcome Scale (GOS), ICU days, hospital length of stay, and discharge location.</div></div><div><h3>Result</h3><div>Of 105 patients, 33 received CCBs. Groups were similar in injury severity and initial GCS. Preoperative CCB was linked to significantly higher mortality (46.9 ​% vs. 23.3 ​%, p ​= ​0.029) without significant GOS differences (p ​= ​0.135). Other outcomes showed no significant differences.</div></div><div><h3>Conclusion</h3><div>Preoperative CCB use in TBI patients may be associated with higher mortality without improving outcomes.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116661"},"PeriodicalIF":2.7,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328103","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":"Advancements in neurosurgical techniques for managing sports-related traumatic brain injuries.","authors":"Barbara Buccilli, Yasser F Almealawi, Kimiya Shahabi, Dimitrie-Ionuț Atasiei, Khaled Elsousi, Marium Khan, Sarah Alshamery, Albert Alan, Martin Weinand","doi":"10.1016/j.amjsurg.2025.116664","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116664","url":null,"abstract":"<p><strong>Background: </strong>Sports-related Traumatic Brain Injury (TBI) is a public health concern, often requiringneurosurgical intervention. Outcomes vary widely across sports, yet remain underreported.</p><p><strong>Methods: </strong>We conducted a PRISMA-guided systematic review and meta-analysis of sports-related TBI in athletes, focusing on injury mechanisms, neurosurgical interventions, and clinical outcomes, including return-to-play. PubMed, Embase, and MEDLINE were searched; studies reporting injury mechanisms, neuroimaging or hemorrhage types, neurosurgical procedures, and outcomes were included. Two reviewers independently screened and extracted data, and proportions were pooled using random-effects models.</p><p><strong>Results: </strong>A total of 42,112 patients were included (62.0 ​% male; mean age 20.1 years). Skiing/snowboarding, football, and cycling were the leading sports associated with TBI. Across all sports, the mean GCS was 13.5, and average return to practice occurred at 5.4 months. Helmet use was confirmed in only 17 ​% of patients and 8.8 ​% of cyclists. Among cyclists, 27 ​% had ICH at presentation, with subdural hematoma being the most common type (32.1 ​%). Mechanisms of injury varied by sport, with falls dominating in cycling, horse riding, skiing, and skateboarding. Meta-analysis showed concussions were the most common injury (pooled proportion 0.11), followed by contusions (0.05). Hemorrhages included SDH (0.17), EDH (0.05), and SAH (0.04). Skull fractures occurred in 18 ​% of cases. Neurosurgical intervention was required in 21 ​% of patients, most commonly craniotomy (7 ​%). Mortality was low (<3 ​%), and favorable outcomes were frequent (93 ​%). Return to play was high overall (96 ​%) but only 23 ​% within 1 month. Helmet use was low overall (17 ​%) and varied substantially across different sports and study settings.</p><p><strong>Conclusions: </strong>Outcomes and surgical needs vary by sport. Targeted prevention and individualized carestrategies are essential.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"116664"},"PeriodicalIF":2.7,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342736","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":"Treatment patterns of anal melanoma in the era of immunotherapy","authors":"Hannah E. Sofield ,&nbsp;Sara H. Buchner ,&nbsp;Rachel J. Nation ,&nbsp;T.N. Hess ,&nbsp;Gena V. Topper ,&nbsp;Matthew C. Moccia ,&nbsp;John Epoh Dibato ,&nbsp;Michael E. Kwiatt ,&nbsp;Steven J. McClane ,&nbsp;Danica N. Giugliano ,&nbsp;Francis R. Spitz ,&nbsp;Young K. Hong ,&nbsp;Madeline B. Torres","doi":"10.1016/j.amjsurg.2025.116658","DOIUrl":"10.1016/j.amjsurg.2025.116658","url":null,"abstract":"<div><h3>Background</h3><div>Anal melanoma (AM) is a rare and aggressive cancer with poor survival and absence of standard treatment guidelines.</div></div><div><h3>Methods</h3><div>This study analyzed 762 cases of AM from the National Cancer Database during 2004–2021. The primary objectives were to evaluate treatment patterns and survival outcomes before and after the FDA approval of immunotherapy (IT) in 2011.</div></div><div><h3>Results</h3><div>The use of IT increased significantly after 2011 in patients with stage IV AM (14 ​%–58 ​%). Abdominoperineal resection (APR) rates declined post-IT (49 ​%–31 ​%, p ​&lt; ​0.0001), in both community and academic centers. For patients treated with IT, median overall survival for stage III rose from 20.3 to 27.2 months (p ​= ​0.0057) and nearly doubled for stage IV (6.7–13.3 months, p ​&lt; ​0.0001). No survival benefit was observed in earlier stages (p ​= ​0.5712).</div></div><div><h3>Conclusions</h3><div>IT use in advanced AM is increasing, correlating with longer survival and reduced APR rates in later stage patients.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116658"},"PeriodicalIF":2.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318104","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":"Integrating artificial intelligence into scientific writing: a narrative review for clinical and surgical researchers","authors":"Suleyman Utku Celik","doi":"10.1016/j.amjsurg.2025.116657","DOIUrl":"10.1016/j.amjsurg.2025.116657","url":null,"abstract":"<div><div>Artificial intelligence (AI), particularly large language models, is reshaping academic and clinical research by supporting key stages of the scientific writing process, including idea generation, literature review, drafting, and revision. Tools such as ChatGPT enhance efficiency, clarity, and accessibility while assisting with hypothesis development, evidence synthesis, data analysis, and figure generation. This narrative review examines the benefits, challenges, and ethical considerations of AI-assisted scientific writing, with emphasis on medical and surgical research. While AI tools streamline manuscript preparation when effectively prompted, they also pose risks such as hallucinations, biased outputs, plagiarism, and reduced critical engagement. Concerns have emerged regarding overreliance and diminished scholarly autonomy. Editorial policies increasingly require transparency and human oversight. To ensure responsible use, structured training for researchers and reviewers is essential. AI should be seen as an augmentative tool that complements—not replaces—human expertise, offering opportunities to broaden access to publishing and promote equitable participation in scientific discourse.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116657"},"PeriodicalIF":2.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312186","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":"Selective visualization of the recurrent laryngeal nerve during parathyroidectomy","authors":"Marina E. Robson Chase,&nbsp;Mackenzie Donoho,&nbsp;Oliver J. Fackelmayer,&nbsp;William B. Inabnet III,&nbsp;Cortney Y. Lee,&nbsp;David A. Sloan","doi":"10.1016/j.amjsurg.2025.116659","DOIUrl":"10.1016/j.amjsurg.2025.116659","url":null,"abstract":"<div><h3>Introduction</h3><div>Direct visualization of the recurrent laryngeal nerve (RLN) is considered the gold standard for avoiding nerve injury during parathyroidectomy. We hypothesize that with routine intraoperative nerve monitoring (IONM), RLN visualization is not mandatory for safe parathyroidectomy.</div></div><div><h3>Methods</h3><div>Following institutional review board approval, adult patients undergoing parathyroidectomy using IONM during a two-year period were reviewed. The RLN was only visualized if exposed during parathyroid gland dissection. Outcomes included the rate of nerve visualization and rates of RLN injury.</div></div><div><h3>Results</h3><div>240 of 479 (50.1 ​%) nerves at risk were visualized. There was loss of signal in three cases where the RLN was visually identified and none in non-visualized cases. The rates of temporary and permanent RLN injury were 0.99 ​% and 0 ​%, respectively.</div></div><div><h3>Conclusion</h3><div>Routine IONM provides reassurance of nerve integrity in cases where the RLN is not visualized and an acceptably low rate of RLN injury is achieved with selective visualization.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116659"},"PeriodicalIF":2.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318107","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":"Evaluating the economic impact of bariatric surgery: A multi-year comparative analysis.","authors":"Kate V Lauer, Dawda Jawara, Lily N Stalter, Bret M Hanlon, Matthew R Lemahieu, Luke M Funk","doi":"10.1016/j.amjsurg.2025.116665","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116665","url":null,"abstract":"<p><strong>Introduction: </strong>Bariatric surgery results in significant weight loss and improvement of obesity-related comorbidities, but data regarding its cost impact are mixed. We compared healthcare costs for bariatric surgery patients and non-operative controls through four years after surgery.</p><p><strong>Methods: </strong>Patients who underwent bariatric surgery in 2018-2019 were matched 1:5 with controls who met criteria for bariatric surgery but were medically managed. Post-operative costs were compared by year after surgery and healthcare setting.</p><p><strong>Results: </strong>Bariatric surgery patients (n ​= ​37) had higher mean total costs years 1-4 after surgery compared to non-operative controls (n ​= ​185) [$26,805(SD $47,039) vs. $14,547($30,170); p ​< ​0.001]. The largest differences occurred in the outpatient setting [$16,935($19,807) vs. $8972($14,690); p ​< ​0.0001] and during the first year after surgery [$12,616($36,422) vs. $3355($9367); p ​< ​0.0001].</p><p><strong>Conclusions: </strong>Bariatric surgery patients had higher post-operative costs through four years after surgery compared to non-operative controls, primarily due to higher costs within the first year after surgery and increased outpatient costs.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116665"},"PeriodicalIF":2.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318077","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":"Bridging surgical education gaps in times of conflict: Experience with virtual and remote platforms for enhancing surgical workforce.","authors":"Kala T Pham, Youmna A Sherif, Melany C Hughes, Sudha Jayaraman, Rachel W Davis, Host","doi":"10.1016/j.amjsurg.2025.116656","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116656","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116656"},"PeriodicalIF":2.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318042","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}