American journal of surgery最新文献

{"title":"Inclusive excellence in surgery: From recognition to transformation","authors":"Shaidy Moronta , Jessica Liu McMullin","doi":"10.1016/j.amjsurg.2025.116363","DOIUrl":"10.1016/j.amjsurg.2025.116363","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"246 ","pages":"Article 116363"},"PeriodicalIF":2.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092682","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":"Pancreatic neuroendocrine tumors: Do we need more nuanced staging?","authors":"Eunise Chen , J. Bart Rose","doi":"10.1016/j.amjsurg.2025.116383","DOIUrl":"10.1016/j.amjsurg.2025.116383","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"246 ","pages":"Article 116383"},"PeriodicalIF":2.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075474","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":"ErgoEd: a pre-post trial investigating the effect of ergonomic education on laparoscopic surgeons' ergonomic risk scores.","authors":"Frances Dixon, Parveen Vitish-Sharma, Achal Khanna, Barrie D Keeler","doi":"10.1016/j.amjsurg.2025.116398","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116398","url":null,"abstract":"<p><p>This pre-post trial investigates whether ergonomic education using the STEPS model (Screen, Table, Equipment, Posture, Stance) can improve laparoscopic surgeons' ergonomic risk. Intraoperative photographs taken at 1-min intervals were used to calculate risk through the objective Rapid Entire Body Assessment (REBA) scale. Surgeons were reobserved immediately after an educational video, then again 4-6 weeks later. Cognitive strain (modified NASA-TLX), subjective outcomes, and knowledge retention were also assessed. Ten surgeons were recruited from colorectal, general, and gynaecology. There was no difference in REBA between baseline (REBA ​= ​5.0) and early reobservation (REBA ​= ​4.5) [0 ​= ​0.058], but between baseline and late reobservation (REBA ​= ​4.5) there was a significant reduction [p ​= ​0.028]. The overall scores for each day remained in the \"medium risk\" category. Knowledge retention was good (90 ​% correct answers). All found the education worthwhile and subsequently made changes to their practice. Ergonomic education is desired and deemed very important by surgeons, and reduces both their ergonomic risk and subjective experience of pain, but laparoscopic surgery remains ergonomically \"medium risk\" overall. Further solutions must be found to reduce risk.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116398"},"PeriodicalIF":2.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085523","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":"Gender and racial diversity in leadership roles within academic surgery internationally: a retrospective cross-sectional study pre-COVID-19.","authors":"Téa C Sue, Isabella F Churchill, Caroline Mallity, Rebecca Lau, Daniel A Peters, Jacinthe Lampron, Philippe Phan, Alexandra Stratton, Eugene K Wai, Eve C Tsai","doi":"10.1016/j.amjsurg.2025.116394","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116394","url":null,"abstract":"<p><strong>Objective: </strong>Journal editorial and society executive boards have widespread impacts, however, the associated leadership diversity remains underexplored. Our study evaluated such diversity across four surgical specialties before the influences of COVID-19.</p><p><strong>Methods: </strong>This retrospective, cross-sectional study obtained perceived gender and race of identified leaders from publicly available websites. Leadership of the top three journals and journal-affiliated societies based on the 2021 Journal Citation Reports journal impact factor was evaluated for subspecialties within neurosurgery, orthopaedic, general, and plastic surgery.</p><p><strong>Results: </strong>Leadership diversity within 58 journals and 55 societies were reviewed. Orthopedics had a significantly lower proportion of females (p ​< ​0.05) and intersectional minorities (p ​< ​0.05). Higher journal impact factor and a greater proportion of intersectional minorities were significantly related (p ​= ​0.0009).</p><p><strong>Conclusion: </strong>We assessed leadership diversity amongst both journal editorial and society executive boards and identified differences with respect to proportions of females, minorities and intersectional minorities across specialties.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116394"},"PeriodicalIF":2.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075472","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":"FDG-avid thyroid nodules are at a significantly increased risk of malignancy.","authors":"Brodie D Laurie, Elizabeth Thomas, Hieu Nguyen, Simon Ryan, David Leong","doi":"10.1016/j.amjsurg.2025.116400","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116400","url":null,"abstract":"<p><strong>Background: </strong>FDG-avid thyroid incidentalomas pose a diagnostic challenge due to their potential for malignancy. This study evaluated the malignancy rates in FDG-avid thyroid nodules, stratified by fine needle aspiration (FNA) cytology results.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on patients with FDG-avid thyroid incidentalomas who underwent surgical resection between 2012 and 2023. The primary outcome was malignancy rates stratified by pre-operative cytology results. Logistic regression was used to assess the utility of patient age, gender and nodule size for predicting malignancy in FDG-avid thyroid incidentaloma.</p><p><strong>Results: </strong>Of 258 patients included, malignancy rates stratified by cytology were: Bethesda I (15.4 ​%), Bethesda II(11.1 ​%), Bethesda III(29.1 ​%), Bethesda IV(34 ​%), Bethesda V (83.3 ​%), and Bethesda VI (98.3 ​%). The overall malignancy rate was 48.1 ​%, predominantly papillary thyroid carcinoma. No significant differences in malignancy were observed concerning age, gender, or nodule size.</p><p><strong>Conclusion: </strong>FDG-avid thyroid nodules exhibit a significantly higher risk of malignancy, particularly in Bethesda categories III to VI.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116400"},"PeriodicalIF":2.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155562","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":"Sustainability within Surgery: Historical and Contemporary Perspectives The 2024 North Pacific Surgical Association Historian's Lecture.","authors":"Laura Collier, John Mayberry","doi":"10.1016/j.amjsurg.2025.116403","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116403","url":null,"abstract":"<p><p>Hospitals in Europe and North America, responding to surgeons' pleas for an antiseptic space to perform surgery, began to build thoughtfully designed operating rooms in the late nineteenth century. The energy consumption and waste production of early and middle twentieth century operating rooms was sustainable compared to those of the late twentieth century and early twenty-first century. The adoption of technological advances that use more energy, e.g. laparoscopy and robotic surgery, and the diminishment of the applicability of local or regional anesthesia to many common procedures diminished the sustainability of surgery. In addition, waste production dramatically increased with the growth of the global supply chain and its provision of inexpensive disposable instruments and accouterments. Surgeons can help reverse this unsustainable trend by requesting reusable instruments and accouterments and by using local or regional anesthesia whenever safely possible.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116403"},"PeriodicalIF":2.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092683","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":"Range, and why we need to save general surgery","authors":"","doi":"10.1016/j.amjsurg.2025.116368","DOIUrl":"10.1016/j.amjsurg.2025.116368","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116368"},"PeriodicalIF":2.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068739","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":"Analyzing racial and ethnic disparities among geriatric patients undergoing elective versus emergent colorectal procedures: A National Surgical Quality Improvement Program (NSQIP) analysis.","authors":"Spencer T Johnson, Venu Bangla, Adriano Cuadros, Alexandra Z Agathis, Jeanne Wu, Celia M Divino","doi":"10.1016/j.amjsurg.2025.116397","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116397","url":null,"abstract":"<p><strong>Objective: </strong>Non-elective colorectal surgeries are associated with an increased risk of complications compared to elective procedures, which is accentuated amongst geriatric patients. This study examines racial/ethnic disparities in rates of elective versus non-elective colorectal procedures among geriatric patients.</p><p><strong>Methods: </strong>This retrospective cohort study included data from patients aged ≥65 registered in the National Surgical Quality Improvement Program database. Using multivariate logistic regression, we examined associations between race/ethnicity and elective versus non-elective surgical status.</p><p><strong>Results: </strong>Among 79,497 patients included, 24,544 (30.9 ​%) received non-elective colorectal surgery. 81.1 ​% of patients were White, 8.93 ​% were Black, 5.3 ​% were Hispanic, 4.1 ​% were Asian, and 0.6 ​% were NAPI. Multivariate analysis revealed higher odds ratios for receiving non-elective surgery amongst Black and Hispanic patients (Black ​= ​1.38, 95 ​% CI 1.30-1.47, p ​< ​0.01; Hispanic ​= ​1.54, 95 ​% CI 1.43-1.67, p ​< ​0.01).</p><p><strong>Conclusions: </strong>Black and Hispanic geriatric patients were more likely to receive non-elective procedures.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116397"},"PeriodicalIF":2.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085620","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":"Comparative value of frailty versus ECOG performance in preoperative risk assessment for elderly patients with gastric cancer","authors":"Chi-Lin Hsieh ,&nbsp;Chi-Chen Lan ,&nbsp;Keng-Hao Liu ,&nbsp;Jun-Te Hsu ,&nbsp;Chun-Yi Tsai ,&nbsp;Ta-Sen Yeh ,&nbsp;Yu-Shin Hung ,&nbsp;Wen-Chi Chou","doi":"10.1016/j.amjsurg.2025.116396","DOIUrl":"10.1016/j.amjsurg.2025.116396","url":null,"abstract":"<div><h3>Background</h3><div>Radical gastrectomy with D2 lymphadenectomy reduces the postoperative recurrence in gastric cancer, but increases risk of complications, especially among elderly patients. This study aimed to assess the predictive value of frailty in determining postoperative complication risks in patients aged ≥80 years undergoing D2 gastrectomy.</div></div><div><h3>Methods</h3><div>This prospective observational study enrolled 78 patients aged ≥80 years who underwent gastrectomy with D2 lymphadenectomy for gastric cancer between January 2020 and December 2021 ​at a medical center in Taiwan. Frailty was evaluated using the Comprehensive Geriatric Assessment (CGA) within one week before surgery. Outcomes: Length of hospital stay (LOS), intensive care unit (ICU) stays, postoperative complications, and survival were analyzed and compared with the Eastern Cooperative Oncology Group (ECOG) performance status.</div></div><div><h3>Results</h3><div>Among the 78 patients, ECOG performance scores were 0, 1, 2, and 3 in 47 ​%, 40 ​%, 12 ​%, and 1 ​% of patients, respectively; 19 patients (24 ​%) were classified as fit and 59 (76 ​%) as frail based on CGA. Frail patients had a significantly longer median LOS (20 days vs. 12 days, p ​= ​0.001), a higher ICU admission rate (46 ​% vs. 16 ​%, p ​= ​0.027), a higher incidence of any surgical complication (85 ​% vs. 47 ​%, p ​= ​0.001), and an increased rate of major surgical complications (Accordion grade 2 or higher) (24 ​% vs. 0 ​%, p ​= ​0.012) compared to fit patients. Although ECOG performance was associated with major complication rates, it did not significantly predict LOS, ICU admissions, or overall complication rates. Survival did not differ significantly between the frail and ECOG performance groups.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that frailty is commonly observed in Taiwanese octogenarian patients and is a valuable predictor of postgastrectomy outcomes.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"246 ","pages":"Article 116396"},"PeriodicalIF":2.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936939","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":"Tumor molecular signatures: bridging the bench and the operating room","authors":"Iakovos N. Nomikos ,&nbsp;Christos Kosmas ,&nbsp;Vasiliki Gkretsi","doi":"10.1016/j.amjsurg.2025.116393","DOIUrl":"10.1016/j.amjsurg.2025.116393","url":null,"abstract":"<div><div>Contemporary diagnostic and therapeutic strategies for many solid tumors rely on understanding the Mismatch Repair (MMR) system, a fundamental DNA repair mechanism responsible for correcting errors introduced during DNA replication. Pathology reports written for tumors excised in surgery, often indicate the expression status of MMR proteins. This is of significant clinical value, as loss of MMR protein expression is associated with the accumulation of DNA replication errors.</div><div>The MMR system recognizes and replaces mismatched nucleotides, particularly in microsatellite regions. These are short, repetitive non-coding DNA sequences prone to replication errors. When MMR proteins are inactivated by genetic or epigenetic alterations, MMR deficiency (dMMR) occurs, preventing repair and leading to microsatellite instability (MSI). MSI is a hallmark of Lynch syndrome, which is commonly associated with colorectal cancer (CRC) and endometrial cancer.</div><div>This work highlights the clinical utility of MMR protein and MSI status as molecular signatures and discusses diagnostic, prognostic, and therapeutic implications. Understanding these molecular changes supports clinicians in making informed therapeutic decisions and may improve patient outcomes by providing personalized treatments to fit individual tumor profiles.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"246 ","pages":"Article 116393"},"PeriodicalIF":2.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068059","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}