American journal of surgery最新文献_第10页

Application of hepatic artery interventional therapies in the conversion treatment of unresectable hepatocellular carcinoma: A systematic review and meta-analysis 肝动脉介入治疗在不可切除肝癌转化治疗中的应用：一项系统回顾和荟萃分析

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-02-01 Epub Date: 2025-11-13 DOI: 10.1016/j.amjsurg.2025.116712

Yongchao Zeng, Zhiqiang Wang, Shixun Lin, Yihe Yan

{"title":"Application of hepatic artery interventional therapies in the conversion treatment of unresectable hepatocellular carcinoma: A systematic review and meta-analysis","authors":"Yongchao Zeng, Zhiqiang Wang, Shixun Lin, Yihe Yan","doi":"10.1016/j.amjsurg.2025.116712","DOIUrl":"10.1016/j.amjsurg.2025.116712","url":null,"abstract":"<div><h3>Background</h3><div>The conversion therapy aims to transform initially unresectable hepatocellular carcinoma (uHCC) into a resectable state through systemic or locoregional treatment (LRT). However, there is no clear optimal conversion therapy strategy at present.</div></div><div><h3>Methods</h3><div>A systematic search was performed across PubMed, Web of Science, Cochrane Library, Embase to identify relevant studies. The primary endpoint was the conversion to surgery rate (CSR), with objective response rate (ORR), overall survival (OS), and progression-free survival (PFS) analyzed as secondary endpoints.</div></div><div><h3>Results</h3><div>A total of 44 studies were included, comprising data from 5065 patients. The pooled CSR in each treatment group was as follows: 6 % in the conventional transcatheter arterial chemoembolization (cTACE) group, 9 % in the hepatic arterial infusion chemotherapy (HAIC) group, 20 % in the drug-eluting beads transarterial chemoembolization (DEB-TACE) group, 25 % in the transarterial radioembolization (TARE) group, 42 % in the combination of TACE and HAIC (TACE-HAIC) group. Among dual therapies, the pooled CSR was 13 % in the TACE combined with tyrosine kinase inhibitor (TKI) group, 15 % in the HAIC plus TKI group, 8 % in the TACE-HAIC plus TKI group. For triple therapies, the pooled CSR was 29 % in the TACE combined with TKI and immune checkpoint inhibitor (ICI) group, 29 % in the TACE-HAIC plus TKI and ICI group, 33 % in the HAIC plus TKI and ICI group, and 41 % in the DEB-TACE-HAIC plus TKI and ICI group.</div></div><div><h3>Conclusions</h3><div>Triple therapies yield significantly higher CSR than dual therapies, both surpassing single transarterial approaches. The DEB-TACE-HAIC + TKI + ICI regimen demonstrated the highest CSR. HAIC-based strategies outperformed cTACE-based approaches.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"252 ","pages":"Article 116712"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145555194","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}

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It's the patient's decision, for better or for worse 这是病人的决定，是好是坏。

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-02-01 Epub Date: 2025-10-23 DOI: 10.1016/j.amjsurg.2025.116677

Ambria S. Moten MD, MS

引用次数: 0

Intestinal discontinuity may be associated with worse outcomes in damage control laparotomy for trauma: An American association for the surgery of trauma prospective multicenter observational study 美国创伤外科协会的一项前瞻性多中心观察性研究表明，创伤控制性剖腹手术中肠不连续性可能与较差的预后相关

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-02-01 Epub Date: 2025-12-11 DOI: 10.1016/j.amjsurg.2025.116777

Elizabeth R. Benjamin , Demetrios Demetriades , Camilla Cremonini , Anaar Siletz , Subarna Biswas , Jennifer Mooney , Joe DuBose , Nori Bradley , David J. Skaurpa , Lucyna Krzywon , Paula Ferrada , Pak S. Leung , John D. Berne , Jason Young , Thomas M. Scalea

{"title":"Intestinal discontinuity may be associated with worse outcomes in damage control laparotomy for trauma: An American association for the surgery of trauma prospective multicenter observational study","authors":"Elizabeth R. Benjamin , Demetrios Demetriades , Camilla Cremonini , Anaar Siletz , Subarna Biswas , Jennifer Mooney , Joe DuBose , Nori Bradley , David J. Skaurpa , Lucyna Krzywon , Paula Ferrada , Pak S. Leung , John D. Berne , Jason Young , Thomas M. Scalea","doi":"10.1016/j.amjsurg.2025.116777","DOIUrl":"10.1016/j.amjsurg.2025.116777","url":null,"abstract":"<div><h3>Introduction</h3><div>In damage control laparotomy (DCL) for trauma, intestinal injuries are often left in discontinuity. This study compared outcomes in patients with intestinal discontinuity versus immediate anastomosis.</div></div><div><h3>Methods</h3><div>Prospective multicenter, AAST study, included patients requiring DCL with intestinal resection. Patients were categorized into bowel Discontinuity and Continuity groups.</div><div>Data collection included clinical characteristics, injury severity, peritoneal contamination, intraoperative blood products, crystalloids and vasopressors, operative time, takeback operative findings, fascia closure and postoperative complications. Outcomes included mortality, bowel ischemia, postoperative complications, fascia closure, and hospital stay.</div></div><div><h3>Results</h3><div>246 patients from 16 centers. Using propensity score matching, 132 patients in the Discontinuity group were well-matched with 66 in the Continuity group. Discontinuity was associated with significantly higher mortality and septic complications. Fascia closure was more likely to be achieved in the Continuity group at the 2nd takeback operation.</div></div><div><h3>Conclusions</h3><div>Intestinal discontinuity in DCL is associated with increased mortality and septic complications.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"252 ","pages":"Article 116777"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145786935","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}

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Reconsidering the timeline: Delayed cosyntropin stimulation testing in adrenalectomy patients receiving perioperative steroids 重新考虑时间：肾上腺切除术患者接受围手术期类固醇的延迟共syntropin刺激试验。

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-02-01 Epub Date: 2025-08-28 DOI: 10.1016/j.amjsurg.2025.116596

Alexa Lisevick Kumar , George A. Taylor , Tracy S. Wang , Sophie Y. Dream

引用次数: 0

Rethinking transfusion timing: Evaluating preoperative transfusion morbidity using a national pediatric database 重新思考输血时机：使用国家儿科数据库评估术前输血发病率

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-02-01 Epub Date: 2025-11-19 DOI: 10.1016/j.amjsurg.2025.116731

Matthew T. Parrish , Katie Bews , Stephanie F. Polites , Elizabeth B. Habermann

{"title":"Rethinking transfusion timing: Evaluating preoperative transfusion morbidity using a national pediatric database","authors":"Matthew T. Parrish , Katie Bews , Stephanie F. Polites , Elizabeth B. Habermann","doi":"10.1016/j.amjsurg.2025.116731","DOIUrl":"10.1016/j.amjsurg.2025.116731","url":null,"abstract":"<div><h3>Background</h3><div>Transfusion within 72 h after surgery (BT) is associated with increased postoperative morbidity in pediatric patients, but the impact of preoperative transfusion (PBT), given within 48 h before surgery, is unclear. We hypothesize that PBT is associated with lower morbidity than BT.</div></div><div><h3>Methods</h3><div>Pediatric (<18-years-old) general surgery patients who received PBT or BT were identified from the 2012–2022 NSQIP-P files, excluding those with preoperative hematocrit <21 %. PBT and BT patients were propensity-score matched with rates of postoperative infection (PI) and surgical site infections (SSI) compared using logistic regression.</div></div><div><h3>Results</h3><div>Among 15,401 patients, 4559 (30 %) received PBT and 10,842 (70 %) received BT. After matching, 3439 PBT patients were compared to 3439 BT patients. PBT was associated with fewer PI (8 % vs 10 %; OR = 0.75, 95 % CI 0.64–0.89) and SSI (5 % vs 8 %, OR = 0.72, 95 % CI 0.59–0.87).</div></div><div><h3>Conclusions</h3><div>PBT was associated with lower odds of postoperative infections compared to BT in matched pediatric general surgery patients.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"252 ","pages":"Article 116731"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616361","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

Assessing the performance of the updated 2021 Field Triage Guidelines with the Need For Trauma Intervention (NFTI) metric 评估更新的2021年现场分诊指南与创伤干预需求（NFTI）指标的绩效。

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-02-01 Epub Date: 2025-11-21 DOI: 10.1016/j.amjsurg.2025.116729

Tyler J. Johnston , Dina M. Filiberto , Peter B. DePhillips , Chandler E. Morel , Peter E. Fischer , Andy J. Kerwin , Emily K. Lenart , Saskya E. Byerly

{"title":"Assessing the performance of the updated 2021 Field Triage Guidelines with the Need For Trauma Intervention (NFTI) metric","authors":"Tyler J. Johnston , Dina M. Filiberto , Peter B. DePhillips , Chandler E. Morel , Peter E. Fischer , Andy J. Kerwin , Emily K. Lenart , Saskya E. Byerly","doi":"10.1016/j.amjsurg.2025.116729","DOIUrl":"10.1016/j.amjsurg.2025.116729","url":null,"abstract":"<div><h3>Background</h3><div>Pre-hospital triage is critical for resource-allocation and patient-outcomes. This study aimed to assess the sensitivity (SN) of updated 2021 Field Triage Guidelines (FTGs) and trauma center activation criteria (TAC) related to Need for Trauma Intervention (NFTI).</div></div><div><h3>Methods</h3><div>Data were collected to identify FTGs Red Criteria (RC) and Yellow Criteria (YC) and NFTI: pRBC within 4 h, operating room within 90 min, interventional radiology, ICU length-of-stay ≥3 days, mechanical ventilation within 3 days, or death within 60 h. SN was analyzed for RC and TAC. Lastly, logistic regressions assessed covariates associated with under-triage (UT).</div></div><div><h3>Results</h3><div>319 patients were included. SN of RC and TAC were 79 % and 77 %, respectively. Regression analysis showed UT by RC and TAC was associated with blunt mechanism.</div></div><div><h3>Conclusions</h3><div>FTGs did not meet ACS goals of ≤5 % UT and ≤35 % OT with blunt mechanism being associated with UT.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"252 ","pages":"Article 116729"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145659833","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

Assessing the utility of surveillance imaging in high-grade liver injury patients 评估监测成像在高级别肝损伤患者中的应用。

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-02-01 Epub Date: 2025-12-01 DOI: 10.1016/j.amjsurg.2025.116757

Pooja Podugu , Amisha Paul , Ari Zlota , Priyash Hafiz , Tien Nguyen , Annabel Yang , Nikhil Madugula , Caleb Curry , Hope Carrane , Vanessa P. Ho , Justin Dvorak

{"title":"Assessing the utility of surveillance imaging in high-grade liver injury patients","authors":"Pooja Podugu , Amisha Paul , Ari Zlota , Priyash Hafiz , Tien Nguyen , Annabel Yang , Nikhil Madugula , Caleb Curry , Hope Carrane , Vanessa P. Ho , Justin Dvorak","doi":"10.1016/j.amjsurg.2025.116757","DOIUrl":"10.1016/j.amjsurg.2025.116757","url":null,"abstract":"<div><h3>Introduction</h3><div>The utility of surveillance imaging (SI) after high-grade liver injury is unclear. We studied SI's detection rate and its association with unplanned interventions, emergency department (ED) visits, and mortality.</div></div><div><h3>Methods</h3><div>Adult patients with American Association for the Surgery of Trauma (AAST) grade III-V liver injury (2018–2024) were categorized by follow-up imaging: surveillance imaging (SI, no clinical change), clinically-prompted imaging (CI), or none. Outcomes included unplanned intervention, liver-related ED visits, and mortality.</div></div><div><h3>Results</h3><div>Among 252 patients, SI prompted intervention in 10 % of cases versus 31 % for CI. Unplanned interventions were more frequent after CI than SI (37 % vs. 18 %; p = 0.018). ED visits were marginally lower after SI versus CI (30 % vs. 43 %; p = 0.10). Mortality did not differ across groups.</div></div><div><h3>Conclusions</h3><div>SI identified complications in select patients and was associated with fewer unplanned interventions, marginally fewer ED visits, and no mortality difference compared to CI.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"252 ","pages":"Article 116757"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699714","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

Society of Black Academic Surgeons (SBAS) diversity, equity and inclusion series: A review of surgical disparities in the vulnerable communities of the USA - The black community (Part I) 黑人学术外科医生协会（SBAS）多样性、公平和包容系列：美国弱势社区手术差异的回顾-黑人社区（第一部分）。

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-02-01 Epub Date: 2025-08-14 DOI: 10.1016/j.amjsurg.2025.116578

Paris D. Butler , Erin King-Mullins , Bridget A. Oppong , Steven D. Wexner , Martin S. Karpeh , Luz María Rodríguez

引用次数: 0

Duodenal diverticulectomy: A novel surgical technique 十二指肠憩室切除术：一种新的手术技术。

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-02-01 Epub Date: 2025-08-16 DOI: 10.1016/j.amjsurg.2025.116582

Savannah R. Smith MD , Juan M. Sarmiento MD, FACS

引用次数: 0

Clinical impact of percutaneous transhepatic gallbladder drainage followed by laparoscopic cholecystectomy in patients with moderate to severe acute cholecystitis: A propensity score-matched case-control study 中重度急性胆囊炎患者经皮经肝胆囊引流后腹腔镜胆囊切除术的临床影响：一项倾向评分匹配的病例对照研究

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-02-01 Epub Date: 2025-11-19 DOI: 10.1016/j.amjsurg.2025.116737

Kyong Joo Lee , Jang Han Jung , Se Woo Park , Da Hae Park , Hye Won Cha , Dong Hee Koh , Jin Lee , Jung Min Lee , Jung Woo Lee , Eunae Cho

{"title":"Clinical impact of percutaneous transhepatic gallbladder drainage followed by laparoscopic cholecystectomy in patients with moderate to severe acute cholecystitis: A propensity score-matched case-control study","authors":"Kyong Joo Lee , Jang Han Jung , Se Woo Park , Da Hae Park , Hye Won Cha , Dong Hee Koh , Jin Lee , Jung Min Lee , Jung Woo Lee , Eunae Cho","doi":"10.1016/j.amjsurg.2025.116737","DOIUrl":"10.1016/j.amjsurg.2025.116737","url":null,"abstract":"<div><div>Percutaneous transhepatic gallbladder drainage (PTGBD) is frequently performed for moderate to severe acute cholecystitis (AC) when early laparoscopic cholecystectomy (LC) is not feasible. While PTGBD relieves symptoms, its impact on surgical outcomes is uncertain. We retrospectively analyzed 505 patients with grade II or III AC undergoing LC (2012–2022). After propensity score matching, 122 received PTGBD and 122 underwent direct LC. PTGBD was associated with longer time to surgery (10.1 vs. 3.6 days), higher ICU admission (44.3 % vs. 22.1 %), and prolonged hospital stay (18.2 vs. 11.3 days), without reducing postoperative complications. Importantly, delayed hospital presentation (>4 days from symptom onset) independently increased postoperative complications (OR:3.01, 95 % CI:1.16–7.81, P = 0.023). Early LC yielded shorter hospital and ICU stays compared with delayed surgery. These findings indicate that PTGBD may extend hospitalization and ICU use without improving outcomes, underscoring the importance of timely admission and early LC in moderate to severe AC.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"252 ","pages":"Article 116737"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616362","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