American journal of surgery最新文献_第10页

Changing the surgical pipeline: A commentary on early engagement strategies 改变手术管道：早期介入策略的评论。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-07-10 DOI: 10.1016/j.amjsurg.2025.116514

Alejandro Chara MD, Christina Edwards Bailey MD

引用次数: 0

Does one session suffice? Evaluation of single-session ethanol ablation for thyroid cysts of varying sizes 一个疗程够吗？单次乙醇消融治疗不同大小甲状腺囊肿的疗效评价

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-07-10 DOI: 10.1016/j.amjsurg.2025.116519

Wei-Shin Yu , Pin-Hsien Lai , Hsiang-Lin Lee , Yu-Hsun Wang , Chun-Lang Su , Yu-Shen Lee , Kai-Lun Cheng

引用次数: 0

Structured muscle-strengthening exercise program and intraoperative targeted stretch micro-breaks: A work in cohesion to improve surgeon ergonomics during open thyroidectomy and modified radical mastectomy 有组织的肌肉强化锻炼计划和术中有针对性的拉伸微断裂：一项改善开放性甲状腺切除术和改良根治性乳房切除术中外科医生工效学的工作

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-07-10 DOI: 10.1016/j.amjsurg.2025.116517

Hari K. Rathee , Jidin Joy , Abhijith K. Anil , Suhani , Mohit Joshi , Brijesh kumar , Hemanga K. Bhattacharjee , Maroof A. Khan , Yashdeep Gupta , Ashok K. Jaryal , Rajinder Parshad

{"title":"Structured muscle-strengthening exercise program and intraoperative targeted stretch micro-breaks: A work in cohesion to improve surgeon ergonomics during open thyroidectomy and modified radical mastectomy","authors":"Hari K. Rathee , Jidin Joy , Abhijith K. Anil , Suhani , Mohit Joshi , Brijesh kumar , Hemanga K. Bhattacharjee , Maroof A. Khan , Yashdeep Gupta , Ashok K. Jaryal , Rajinder Parshad","doi":"10.1016/j.amjsurg.2025.116517","DOIUrl":"10.1016/j.amjsurg.2025.116517","url":null,"abstract":"<div><h3>Background</h3><div>Work-related musculoskeletal disorders (WMSDs) are an emerging occupational health concern for surgeons. We studied the effect of structured exercise training, and intraoperative Targeted Stretch Micro-Breaks on surgeons’ workload during open thyroidectomy and modified radical mastectomy (MRM).</div></div><div><h3>Methods</h3><div>Experienced surgeons performed thyroidectomies and MRM before and after a structured self-administered muscle-strengthening exercise program and Targeted Stretch Micro-Breaks. Workload was assessed using EMG, body part discomfort, and SURG-TLX questionnaires. To observe the median change in pre intervention muscle data to post intervention muscle data, Wilcoxon Sign rank test was used.</div></div><div><h3>Results</h3><div>Four surgeons performed 5 MRM and three thyroidectomy pre and post intervention. EMG analysis for MRM showed reduced muscle fatigue and postural muscle strain post-intervention. Thyroidectomy data indicated decreased trapezius activity, suggesting reduced neck strain. Body part discomfort questionnaire assessment showed improvement but SURG TLX didn't show any change post intervention.</div></div><div><h3>Conclusions</h3><div>Self-administered structured muscle-strengthening exercises and TSMB improved muscle efficiency and reduced muscle strain, although subjective workload remained unchanged.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"247 ","pages":"Article 116517"},"PeriodicalIF":2.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633302","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

A pilot study on the impact of da Vinci 5's force feedback on clinical outcomes: Does it lead to less tissue trauma in colorectal surgery? 一项关于达芬奇5的力反馈对临床结果影响的初步研究：它能减少结直肠手术中的组织创伤吗？

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-07-10 DOI: 10.1016/j.amjsurg.2025.116518

Grace C. Chang , Upinder Sidhu , Debra Lai , Gabriela Vargas , Sai Shah , Laila Rashidi

{"title":"A pilot study on the impact of da Vinci 5's force feedback on clinical outcomes: Does it lead to less tissue trauma in colorectal surgery?","authors":"Grace C. Chang , Upinder Sidhu , Debra Lai , Gabriela Vargas , Sai Shah , Laila Rashidi","doi":"10.1016/j.amjsurg.2025.116518","DOIUrl":"10.1016/j.amjsurg.2025.116518","url":null,"abstract":"<div><h3>Background</h3><div>The Da Vinci 5 (DV5) platform's force feedback (FFB) may enhance tactile cues for surgeons. We compare DV5 FFB levels and surgical outcomes in colorectal surgery, focusing on complex versus non-complex cases.</div></div><div><h3>Methods</h3><div>A retrospective analysis of colectomies performed with the DV5 between April and July 2024 was conducted. Primary outcomes included time to bowel function and length of stay (LOS). Secondary outcomes included case complexity, complications, operative time, console time, and readmission rates.</div></div><div><h3>Results</h3><div>Among 68 surgeries, the mean time to bowel function was 0.8 days, with no significant differences by force feedback (p = 0.12). LOS averaged 1.4 days across feedback levels (p = 0.12). Lower force was applied to tissue as FFB setting was higher. Force on tissue was higher in complex cases (2.40 vs. 1.83 N, p = 0.007). A trend toward lower force was observed with high feedback settings (1.54 vs. 1.85 N, p = 0.0646). Operative and console times were significantly longer in complex cases (p = 0.0002 and p = 0.0003, respectively). Complications and readmission rates were similar across complexity levels.</div></div><div><h3>Conclusion</h3><div>Preliminary data suggest that FFB does decrease the total amount of force applied without significantly affecting primary outcomes like bowel function and LOS. As expected, operative and console times increase with case complexity. Enhanced FFB may reduce time in non-complex cases and decrease force applied to tissue but has a more pronounced impact in complex surgeries. Further research is needed to clarify its role in clinical outcomes.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"248 ","pages":"Article 116518"},"PeriodicalIF":2.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144758942","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

Giving back to the Community: Outcomes from a free hernia repair program 回馈社区：免费疝气修复计划的结果

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-07-09 DOI: 10.1016/j.amjsurg.2025.116513

Zachary M. Bauman, Sophie Bouldoukian, Sophie Cemaj, Keely L. Buesing, Bennett J. Berning, Samuel Cemaj, Emily Cantrell

{"title":"Giving back to the Community: Outcomes from a free hernia repair program","authors":"Zachary M. Bauman, Sophie Bouldoukian, Sophie Cemaj, Keely L. Buesing, Bennett J. Berning, Samuel Cemaj, Emily Cantrell","doi":"10.1016/j.amjsurg.2025.116513","DOIUrl":"10.1016/j.amjsurg.2025.116513","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to assess quality of life (QoL) for patients involved in a free hernia repair program (FHRP), hypothesizing improvements in these patients’ QoL.</div></div><div><h3>Methods</h3><div>Single-center, retrospective survey study of underserved patients who underwent inguinal/umbilical hernia repair through our FHRP from 2016 to 2024. Basic demographics obtained. Survey questions included: New bulge since surgery; Still experiencing pain at the hernia site; Return to work since surgery; Surgery-related complications; Satisfaction with the free hernia repair program. Descriptive statistics were utilized.</div></div><div><h3>Results</h3><div>Ninety-one patients underwent hernia repair. 59(64.8 %) patients participated in the survey. Majority of patients were Hispanic/Latinx. 5.1 % reported a bulge post-operatively without true hernia recurrence. 45.8 % reported ongoing pain, but tolerable. 86.4 % returned to work, but 100 % were back to full activities of daily living. Zero reported post-operative complications and 98.3 % were satisfied with the FHRP experience.</div></div><div><h3>Conclusion</h3><div>Our FHRP greatly improves quality of life for hernia patients.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116513"},"PeriodicalIF":2.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632827","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

From the editor – in – chief 总编辑的信。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-07-09 DOI: 10.1016/j.amjsurg.2025.116515

Herbert Chen (Editor-in-Chief)

引用次数: 0

Who is performing routine screening endoscopy in Kansas rural communities 谁在堪萨斯州的农村社区进行常规的内窥镜检查

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-07-08 DOI: 10.1016/j.amjsurg.2025.116511

Todd T. Savolt, Jared Reyes, Siman Antar, Kyle Vincent

{"title":"Who is performing routine screening endoscopy in Kansas rural communities","authors":"Todd T. Savolt, Jared Reyes, Siman Antar, Kyle Vincent","doi":"10.1016/j.amjsurg.2025.116511","DOIUrl":"10.1016/j.amjsurg.2025.116511","url":null,"abstract":"<div><h3>Background</h3><div>General surgeons perform a majority of endoscopic procedures in rural areas. This study examined which providers are performing endoscopies in Kansas communities and how prepared those providers felt to perform those procedures after their residency.</div></div><div><h3>Methods</h3><div>Family medicine physicians (FMP) and general surgeons in rural Kansas were surveyed if they provide endoscopic procedures in their communities and how prepared they felt to provide those services after residency.</div></div><div><h3>Results</h3><div>76.2 % of FMP performed less than 50 endoscopic procedures a year, while 68 % of general surgeons performed more than 200 endoscopic procedures a year. 88 % and 76 % of general surgeons felt comfortable performing screening colonoscopies and EGD respectively compared to 25 % of FMP.</div></div><div><h3>Conclusions</h3><div>General surgeons appear to perform the majority of endoscopic procedures in rural areas. General surgeons reported they felt prepared and comfortable performing screening endoscopies. However, general surgeons felt less prepared and comfortable in performing advanced endoscopic procedures.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116511"},"PeriodicalIF":2.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680434","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

Timing of trauma deaths due to uncontrolled bleeding have not changed in three decades: A multicenter study of patients in hemorrhagic shock 三十年来，由于不受控制的出血导致的创伤死亡时间没有改变：一项对失血性休克患者的多中心研究

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-07-08 DOI: 10.1016/j.amjsurg.2025.116510

Isabella M. Bernhardt , Ernest E. Moore , Angela Sauaia , Bryan A. Cotton , Jeremy W. Cannon , Martin A. Schreiber , Nicholas Namias , Joseph P. Minei , Stephen R. Wisniewski , Francis X. Guyette , Jason L. Sperry , the Shock, Whole Blood, and Assessment of Traumatic Brain Injury (SWAT) Study Group

{"title":"Timing of trauma deaths due to uncontrolled bleeding have not changed in three decades: A multicenter study of patients in hemorrhagic shock","authors":"Isabella M. Bernhardt , Ernest E. Moore , Angela Sauaia , Bryan A. Cotton , Jeremy W. Cannon , Martin A. Schreiber , Nicholas Namias , Joseph P. Minei , Stephen R. Wisniewski , Francis X. Guyette , Jason L. Sperry , the Shock, Whole Blood, and Assessment of Traumatic Brain Injury (SWAT) Study Group","doi":"10.1016/j.amjsurg.2025.116510","DOIUrl":"10.1016/j.amjsurg.2025.116510","url":null,"abstract":"<div><h3>Introduction</h3><div>Hemorrhage is the major cause of early, preventable trauma deaths. We provide a contemporary(2018–2021) description of deaths of patients at risk for lethal traumatic hemorrhage admitted to seven trauma centers equipped with the most advanced hemostatic therapies.</div></div><div><h3>Methods</h3><div>This is a secondary analysis of non-survivors of the multicenter SWAT study, which enrolled patients at high-risk for life-threatening hemorrhage(age>15yrs, required blood + surgical/embolization hemorrhage control procedures<1 h; penetrating head injury and >5min CPR were excluded. Causes of death(COD) were prospectively adjudicated by the SWAT team of trauma surgeons.</div></div><div><h3>Results</h3><div>Of 1051 patients, 176(16.7 %) died(74 % < 24 h,56 %<6 h,35 %<3 h). Bleeding was the main COD, occurring mostly <3 h. Over one third of these patients had a TRISS estimated survival probability>50 %. TBI was the COD in 10 % of the deaths(TRISS = 8 %), mostly 12–48 h. The third COD was organ failure, in 9 %(TRISS = 25 %), often >48 h.</div></div><div><h3>Conclusion</h3><div>Uncontrolled bleeding in patients with high probability of survival remains a challenge to reduce preventable trauma deaths.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116510"},"PeriodicalIF":2.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144685665","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

Pre-injury statin therapy is associated with lower VTE after traumatic brain injury 损伤前他汀类药物治疗与创伤性脑损伤后较低的静脉血栓栓塞有关

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-07-07 DOI: 10.1016/j.amjsurg.2025.116509

Kelly E. Sanders , Gabrielle E. Hatton , Ashna S. Karpe , Mabel P. Luciano , Devi A. Bavishi , Keith W. Burczak , Jan Michael Van Gent , Ava Mokhtari , Bryan A. Cotton , Michelle K. McNutt , Thaddeus J. Puzio

{"title":"Pre-injury statin therapy is associated with lower VTE after traumatic brain injury","authors":"Kelly E. Sanders , Gabrielle E. Hatton , Ashna S. Karpe , Mabel P. Luciano , Devi A. Bavishi , Keith W. Burczak , Jan Michael Van Gent , Ava Mokhtari , Bryan A. Cotton , Michelle K. McNutt , Thaddeus J. Puzio","doi":"10.1016/j.amjsurg.2025.116509","DOIUrl":"10.1016/j.amjsurg.2025.116509","url":null,"abstract":"<div><h3>Background</h3><div>Hemorrhage progression is a potentially devastating complication after TBI, mandating delay to VTE prophylaxis in high-risk patients. Statins have endothelial stabilizing effects associated with decreased VTE in other populations.</div></div><div><h3>Objective</h3><div>To explore whether prehospital statin exposure is associated with decreased incidence of VTE in TBI.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included adult trauma patients and excluded bleeding disorder, disseminated cancer, pregnancy, and deaths <24 h. TBI progression, VTE incidence, VTE prophylaxis type/timing were assessed, grouped by prehospital statin exposure. Univariate and multivariable analyses were performed.</div></div><div><h3>Results</h3><div>148/1188 patients used statins. Statin users were older (71.5 vs 41 years, p < 0.001) with lower injury severity score (22 vs 27, p < 0.001) and higher incidence of pre-existing comorbidities. Time to DVT prophylaxis was shorter (35.2 vs 38.8 h, p = 0.005) and plasma transfusion within 4 h of admission was lower for statin users (0 vs 1 unit, p = 0.039). Statin use was associated with less progression of TBI (24.3 % vs 37 %, Fisher's exact test p < 0.001) and lower incidence of DVT (1.4 % vs 2.2 %, p < 0.001. After controlling for known covariates, statin users had a lower odds of developing VTE (OR = 0.24, 95 % CI 0.06–0.99; p = 0.048).</div></div><div><h3>Conclusions</h3><div>Statin exposure was associated with decreased incidence of VTE after TBI.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116509"},"PeriodicalIF":2.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605597","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

Commentary on "disordered eating behaviours, self-compassion, and psychological distress in Canadian general surgery residents". 评论“加拿大普通外科住院医生的饮食失调、自我同情和心理困扰”。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-07-07 DOI: 10.1016/j.amjsurg.2025.116507

Laszlo Kiraly

引用次数: 0