American journal of surgery最新文献

{"title":"Built-in Bias: The role of surgical locker rooms in sustaining gender inequity in the United States.","authors":"Insa Mannstadt, Omar Taha, Matthew Weintraub, Sally J Kuehn, Victoria A Scala, Christen M Russo","doi":"10.1016/j.amjsurg.2025.116425","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116425","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116425"},"PeriodicalIF":2.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132112","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":"High usability, low adoption: The struggle of a perioperative patient decision aid for extended thromboprophylaxis after major abdominal cancer surgery","authors":"Victoria Ivankovic ,&nbsp;Abdelrahman Noureldin ,&nbsp;Celine Dainhi ,&nbsp;Mary Farnand ,&nbsp;Rebecca C. Auer ,&nbsp;Sameer Apte ,&nbsp;Lev Bubis ,&nbsp;Pamela Hebbard ,&nbsp;Justin Rivard ,&nbsp;Marc Carrier ,&nbsp;Megan Delisle","doi":"10.1016/j.amjsurg.2025.116415","DOIUrl":"10.1016/j.amjsurg.2025.116415","url":null,"abstract":"<div><h3>Background</h3><div>Clinical guidelines recommend 30-day extended venous thromboembolism (VTE) prophylaxis after major abdominal cancer surgery, though equipoise exists among experts. We developed a patient decision aid (PtDA) to support patient decision-making and evaluated its perioperative usability.</div></div><div><h3>Methods</h3><div>Patients undergoing major abdominal cancer surgery and discharging healthcare professionals at two academic centers were recruited. Usability was assessed using the Post Study System Usability Questionnaire (PSSUQ) for patients and the Pragmatic Assessment Tool (pCAT) for clinicians. PtDA revisions occurred iteratively every three participants.</div></div><div><h3>Results</h3><div>Of 108 eligible patients, 79 (73%) enrolled, and 20 (25%) completed the PtDA. Among them, 65% used it to decide on extended VTE prophylaxis. The median PSSUQ score was 2 (IQR 2–3.75). Fifteen clinicians completed the pCAT, reporting more facilitators than barriers to its implementation.</div></div><div><h3>Conclusion</h3><div>The PtDA was highly useable, but low completion rates suggest systemic barriers that require further study to improve implementation.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"248 ","pages":"Article 116415"},"PeriodicalIF":2.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139127","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":"Fostering scientific excellence through diversity, equity, and inclusion in academic surgery editorial peer review.","authors":"Patricia Martinez Quinones, Sophie Dream, M Libby Weaver, Pauline Park, Caitlin W Hicks, Lisa K Cannada","doi":"10.1016/j.amjsurg.2025.116423","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116423","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116423"},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132114","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":"Quality of life and decision satisfaction after re-excision in breast cancer surgery.","authors":"Leah J Beight, Jaime Pardo, Stephanie K Serres, Rene Flores, Evelyn Inga, Prabh R Pannu, Hiral Thakkar, Laura Martin Manfroi, Jessica Means, Tarbia Hamid, Samir Mitri, Ted A James","doi":"10.1016/j.amjsurg.2025.116401","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116401","url":null,"abstract":"<p><strong>Introduction: </strong>The literature reports positive margin rates after breast conserving surgery (BCS) as high as 20-60 ​%, often necessitating re-excision, which may negatively influence patients. This study evaluates how re-excision affects quality-of-life and decision satisfaction.</p><p><strong>Methods: </strong>Patients who underwent re-excision following BCS from January 2013 to December 2015 ​at a single institution were surveyed on physical, social, and emotional wellbeing, as well as satisfaction with their initial surgical decision. Descriptive statistics and the Wilcoxon Rank Sum Test were used for analysis.</p><p><strong>Results: </strong>Among 106 patients, 51 (48.1 ​%) completed the survey. Quality of life declined in all categories following re-excision, with a significant reduction in emotional wellbeing (p ​= ​0.006). Decision satisfaction to undergo partial mastectomy decreased from 76.5 ​% to 47.1 ​%, while dissatisfaction rose from 2 ​% to 11.8 ​%.</p><p><strong>Conclusion: </strong>Re-excision was associated with decreased emotional wellbeing and increased decision dissatisfaction with breast conservation. These findings emphasize the need to optimize preoperative counseling and margin control during the primary surgery to enhance patient experience.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116401"},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085528","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":"Original scientific paper in-hospital and post-discharge outcomes with autologous versus prosthetic repair of traumatic abdominal vascular injuries: a 10-year review of the PROOVIT registry","authors":"Negar Nekooei ,&nbsp;Danielle Brabender ,&nbsp;Stephen Park ,&nbsp;Christine Bent ,&nbsp;Anaar Siletz ,&nbsp;Kazuhide Matsushima ,&nbsp;Morgan Schellenberg ,&nbsp;Kenji Inaba ,&nbsp;Joseph Dubose ,&nbsp;Matthew Martin","doi":"10.1016/j.amjsurg.2025.116413","DOIUrl":"10.1016/j.amjsurg.2025.116413","url":null,"abstract":"<div><h3>Purpose</h3><div>Abdominal vascular injury (AVI) often coincides with bowel injury and abdominal contamination. Prosthetic materials may be necessary for vascular reconstruction, but outcomes are poorly understood. We examined outcomes in patients undergoing autologous vs. prosthetic open repair of AVI using a national database.</div></div><div><h3>Methods</h3><div>This retrospective cohort study (2013–2023) utilized the PROOVIT registry. Patients with abdominal aorta, inferior vena cava, iliac artery/vein, renal vein, or portal vein injuries who underwent open repair and survived ≥72 ​h were included. Univariate and multivariate analyses assessed the association between repair type and in-hospital vascular complications, including re-intervention, amputation, and bowel resection, as well as re-intervention outcomes specifically. Post-discharge data was also reviewed.</div></div><div><h3>Results</h3><div>A total of 142 patients met inclusion criteria, with 124 (87.3%) undergoing autologous repair, primarily as primary repairs with only 5 autologous vein grafts, and 18 (12.7%) undergoing prosthetic repair, including synthetic grafts and bovine pericardial patches, predominantly for arterial injuries (iliac artery, abdominal aorta). In univariate analysis, no significant differences were observed in in-hospital vascular complications, re-intervention, and infection. In adjusted analysis, prosthetic repairs showed a higher risk of in-hospital vascular complications (aOR 5.253, p ​= ​0.017), but comparable risk of re-interventions (aOR 3.046, p ​= ​0.138). Follow-up data (N ​= ​36) revealed 2 complications (5.6%): one infection (autologous) and one thrombosis (prosthetic). Notably, no prosthetic repair required revision due to infection, either in-hospital or during extended follow-up.</div></div><div><h3>Conclusions</h3><div>Prosthetic repairs may be associated with higher overall complication rates compared to autologous repairs. However, despite the increased complexity of prosthetic repairs and adjustment for injury severity, the autologous cohort did not demonstrate a clear advantage in terms of re-intervention rates. Future studies with more homogeneous cohorts are needed to further confirm or refute the impact of different graft materials on patient outcomes.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"248 ","pages":"Article 116413"},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107236","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":"Association of traumatic brain injury with management and outcomes of patients with blunt thoracic aortic injury.","authors":"Victor Andujo, Benjamin Chou, Eni Nako, Samantha Durbin, Gregory L Moneta, Cherrie Z Abraham, Siran Abtin, Scott Mcloud, Martin A Schreiber, Julie Doberne","doi":"10.1016/j.amjsurg.2025.116404","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116404","url":null,"abstract":"<p><strong>Background: </strong>30% of patients with blunt thoracic aortic injury (BTAI) can have concomitant traumatic brain injury (TBI), with mortality nearing 20%. Conflicting blood pressure goals may influence decision and timing of thoracic endovascular aortic repair (TEVAR). This study analyzed management and outcomes in patients with concomitant TBI/BTAI.</p><p><strong>Methods: </strong>Patients with concomitant TBI/BTAI and BTAI were identified in our trauma registry. Descriptive statistics and logistic regression compared management and outcomes.</p><p><strong>Results: </strong>Twenty patients had concomitant TBI/BTAI. 46 patients had BTAI alone. 9(13%) patients with concomitant TBI/BTAI and 30(45%) patients with BTAI alone underwent TEVAR. There was no difference in overall mortality (OR 0.29, 0.05-1.55 CI, p ​= ​0.12), aortic-related mortality (x2 3.51, p ​= ​0.06), incidence of TEVAR (x2 1.59, p ​= ​0.10) or timing to TEVAR (t ​= ​-1.6056, p ​= ​0.06) between patients with concomitant TBI/BTAI and BTAI alone.</p><p><strong>Conclusion: </strong>There was no difference in outcomes or interventions in patients with TBI/BTA vs BTAI alone in this small, hypothesis-generating single institutional trial.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116404"},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141144","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":"Emeritus Editorial Board","authors":"","doi":"10.1016/S0002-9610(25)00202-8","DOIUrl":"10.1016/S0002-9610(25)00202-8","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"244 ","pages":"Article 116380"},"PeriodicalIF":2.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947251","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":"Expectations.","authors":"Walter L Biffl","doi":"10.1016/j.amjsurg.2025.116402","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116402","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116402"},"PeriodicalIF":2.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132113","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":"Postoperative outcomes in super- and super-super obese patients undergoing emergency abdominal surgery","authors":"Helene M. Sterbling ,&nbsp;Brynley R. Dean ,&nbsp;Laura Madarász ,&nbsp;Courtney L. Culbreath ,&nbsp;Lolita Ramsey ,&nbsp;Jonathan M. Dort ,&nbsp;Hani M. Seoudi ,&nbsp;Erik J. Teicher","doi":"10.1016/j.amjsurg.2025.116412","DOIUrl":"10.1016/j.amjsurg.2025.116412","url":null,"abstract":"<div><div>With a rising prevalence of Class III obesity (BMI ≥40), it is crucial to identify the perioperative risks associated with super-obesity (BMI 50–59.9) and super-super-obesity (BMI ≥60) in patients undergoing emergency general surgery procedures. The American College of Surgeons National Surgery Quality Improvement Program (NSQIP) database was queried for emergency abdominal surgeries between January 1, 2015 and December 31, 2019. 19,205 patients aged ≥18 years with a BMI ≥40 were included and stratified into morbidly obese, super-obese, and super-super-obese categories.</div><div>The 30-day mortality rate in the super-super-obese group (7.2%) was significantly higher than the morbidly obese (4.1%) and super-obese (5.4%) groups. Compared to morbidly obese patients, super-obese and super-super-obese patients had significantly higher odds for septic shock and reoperation. Super-super-obese patients additionally had significantly higher odds for readmission.</div><div>These findings suggest that super- and super-super-obese patients warrant tailored perioperative management and separate risk considerations.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"246 ","pages":"Article 116412"},"PeriodicalIF":2.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144084121","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":"Demystifying the surgery clerkship: Tips for excelling inside and outside the operating room.","authors":"Jennifer E Geller, Ariana Naaseh, Nicole M Mott","doi":"10.1016/j.amjsurg.2025.116414","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116414","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116414"},"PeriodicalIF":2.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109112","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}