American journal of surgery最新文献

{"title":"Development and dissemination of a series of surgical skills and procedures video tutorials using a novel, low-cost, and sustainable simulation kit (GlobalSurgBox).","authors":"Mayte Bryce-Alberti, Rachel E Wittenberg, Michael J Kirsch, Daniel Bollinger, Kiana Winslow, Matthew T Hey, Raisa Rauf, Barnabas Alayande, Geoffrey A Anderson, Yihan Lin","doi":"10.1016/j.amjsurg.2024.116002","DOIUrl":"10.1016/j.amjsurg.2024.116002","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical simulation and video-based learning are limited in lower-resource settings. We sought to develop and assess a series of surgical tutorials using a low-cost simulator.</p><p><strong>Methods: </strong>We created 8 surgical skills and procedures videos using low-cost equipment. We assessed video quality using the DISCERN scale and the Global Quality Scale (GQS).</p><p><strong>Results: </strong>Videos ranged from surgical techniques to complex procedures. We uploaded these to Youtube and included them in the curriculum of a medical school in Rwanda. Excluding the cost of the kit (25 USD), production costs ranged from 2 to 5 USD. All videos scored a mean DISCERN of 2.44 ​± ​1.05 and GQS of 3.06 ​± ​0.90. Generally, these lacked points on providing additional sources of information and addressing areas of uncertainty.</p><p><strong>Conclusions: </strong>This study addresses the demand for accessible surgical education resources. Using low-cost, standardized materials ensures consistency, democratization of training, and feasibility.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116002"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387352","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":"Preoperative cognitive performance and its association with postoperative complications in vascular surgery patients: A prospective study.","authors":"Dagmar Goodijk, Louise B D Banning, Charlotte A Te Velde-Keyzer, Barbara C van Munster, Stephan J L Bakker, Barbara L van Leeuwen, Clark J Zeebregts, Robert A Pol","doi":"10.1016/j.amjsurg.2024.115784","DOIUrl":"10.1016/j.amjsurg.2024.115784","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment affects nearly half of vascular surgery patients, but its association with postoperative outcomes remains poorly understood. This study explores the link between preoperative cognitive performance and postoperative complications, including postoperative delirium, in vascular surgery patients.</p><p><strong>Methods: </strong>A prospective cohort study was conducted on vascular surgery patients aged ≥65. Preoperative cognitive performance was assessed using the Montreal Cognitive Assessment, and postoperative complications were evaluated using the Comprehensive Complication Index. The association was analyzed through multivariable logistic regression.</p><p><strong>Results: </strong>Among 110 patients (18.2 ​% female, mean age 73.8 ​± ​5.7 years), cognitive impairment was evident in 48.2 ​%. Of the participants, 29 (26.3 ​%) experienced postoperative complications, among which 11 (10 ​%) experienced postoperative delirium. The adjusted odds ratio for the association between cognitive performance and postoperative complications was 1.19 (95 ​% CI 1.02-1.38; p ​= ​0.02).</p><p><strong>Conclusion: </strong>Worse preoperative cognitive performance correlated with increased odds of postoperative complications and postoperative delirium in vascular surgery patients.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"115784"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141185689","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":"The association of genetic testing timing and mutation type on breast cancer management in patients with breast cancer-related mutations.","authors":"Ebunoluwa J Olunuga, Samantha M Thomas, Koumani W Ntowe, Juliet C Dalton, Ton Wang, Akiko Chiba, Jennifer K Plichta","doi":"10.1016/j.amjsurg.2024.116005","DOIUrl":"10.1016/j.amjsurg.2024.116005","url":null,"abstract":"<p><strong>Background: </strong>We aim to characterize breast management for patients with genetic mutations and concurrent breast cancer (BC) or prior BC treatment.</p><p><strong>Methods: </strong>Adults with a BC-related mutation and prior/concurrent BC diagnosis were identified. Groups were stratified by mutation type [BRCA1/2, high penetrance mutation (HPM), moderate penetrance mutation (MPM)] and timing of genetic testing (concurrent with BC versus after BC treatment). Outcomes were compared.</p><p><strong>Results: </strong>Among 338 patients included, 63 ​% had BRCA1/2 mutations, 9 ​% HPM, and 28 ​% MPM. Approximately 38 ​% had testing concurrent with a BC diagnosis and 62 ​% after BC treatment. Patients with concurrent testing favored bilateral mastectomy (57 ​%) versus 26 ​% lumpectomy, and 16 ​% unilateral mastectomy, which varied by mutation type. Patients previously treated preferred surveillance (92 ​% vs. 8 ​% additional surgery), regardless of mutation type.</p><p><strong>Conclusion: </strong>The timing of a significant BC-related genetic test result and mutation type may be associated with management decisions among patients with breast cancer.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116005"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11649441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142405916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice variations, trends, and outcomes of drain use in thyroidectomy: A NSQIP study.","authors":"Kelvin Memeh, Sara Abou Azar, Oluwasegun Afolaranmi, Tanaz M Vaghaiwalla","doi":"10.1016/j.amjsurg.2024.115998","DOIUrl":"10.1016/j.amjsurg.2024.115998","url":null,"abstract":"<p><strong>Background: </strong>The benefit of drains remains unclear and variable among thyroid surgeons. This study examines the utility and trend in drain use after thyroidectomy.</p><p><strong>Method: </strong>This is a retrospective cross-sectional study utilizing a pooled sample of thyroidectomy patients from the 2016-2019 NSQIP. The impact of drain use on outcomes of interest (rate of postoperative neck hematoma (PNH)-primary outcome, and length-of-stay (LOS)-secondary outcome), as well as year-over-year and practice variations were evaluated using inverse-probability-weighted-regression adjustment and multivariable logistic regression analyses.</p><p><strong>Results: </strong>Of 24,370 patients, 6673(27.4 ​%) received drains. The average LOS and PNH rates were 27.3 ​h and 1.87 %, respectively. Drain use increased year-over-year for concomitant neck dissections (OR ​= ​1.08,p ​= ​0.002). Year-over-year odds of drain use trended down across specialties (OR ​= ​0.96,p ​= ​0.005); however, ENT used drains more frequently than General Surgeons (RR ​= ​3.06, 95%CI ​= ​2.91-3.22). Drains were associated with longer LOS (mean-difference ​= ​9.6hrs, 95%CI 8.51-10.62) with no effect on PNH rates (RR ​= ​0.96,p ​< ​0.05).</p><p><strong>Conclusion: </strong>Drain use is decreasing, but practice variations across specialties persist. Post-thyroidectomy drain use was associated with longer LOS with no effect on PNHR.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"115998"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387353","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":"From the Editor - In - Chief: Association of Women Surgeons.","authors":"Herbert Chen","doi":"10.1016/j.amjsurg.2024.116102","DOIUrl":"10.1016/j.amjsurg.2024.116102","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116102"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692677","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":"Subsequent percutaneous breast biopsies after initial atypia diagnosis: The patient burden of long-term follow up.","authors":"Juliet C Dalton, Samantha M Thomas, Akiko Chiba, Ton Wang, E Shelley Hwang, Jennifer K Plichta","doi":"10.1016/j.amjsurg.2024.115993","DOIUrl":"10.1016/j.amjsurg.2024.115993","url":null,"abstract":"<p><strong>Background: </strong>Breast atypia increases overall breast cancer risk, potentially necessitating future interventions. This study examines the frequency and outcomes of additional percutaneous biopsies after an atypia diagnosis.</p><p><strong>Methods: </strong>Adult patients with breast atypia (atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ) at a single institution were reviewed for subsequent core needle biopsies (CNBs) and corresponding malignant outcomes.</p><p><strong>Results: </strong>Among 432 patients, median age at diagnosis was 54.8 ​y. Seventy-one (71/432, 16.4 ​%) patients developed a breast malignancy. During a median follow-up of 7.4 ​y, 113 patients underwent 149 additional CNBs. Twenty-six patients (26/113, 23.0 ​%) had >2 additional CNBs. Approximately half (79/149, 53.0 ​%) of all additional CNBs occurred within 5 years after breast atypia diagnosis.</p><p><strong>Conclusion: </strong>A considerable number of patients with breast atypia undergo additional percutaneous biopsies, especially within 5 years post-atypia diagnosis. Our study highlights the significant burden of surveillance and the need for tailored follow-up strategies.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"115993"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379023","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":"Assessing general surgery residents outside of the operating room: Our experience with entrustable professional activities in the pre-operative and post-operative settings.","authors":"Nancy Ly, Faith Ocoko, Rebecca M Minter, Sarah Jung","doi":"10.1016/j.amjsurg.2024.115849","DOIUrl":"10.1016/j.amjsurg.2024.115849","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"115849"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141764881","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":"Analysis of the incidence and outcomes of breast cancer in women with schizophrenia.","authors":"Jennifer Den, Nicole Nelson, V Suzanne Klimberg","doi":"10.1016/j.amjsurg.2024.116050","DOIUrl":"10.1016/j.amjsurg.2024.116050","url":null,"abstract":"<p><strong>Objective: </strong>Breast cancer (BC) is the leading cause of female cancer death in the world and the second leading cause of female cancer death in the U.S, Mortality from breast cancer is even higher in individuals with schizophrenia. The aim of our project was to evaluate the incidence of breast cancer in women with schizophrenia and to compare outcomes between breast cancer patients who were or were not on antipsychotics prior to diagnosis.</p><p><strong>Methods: </strong>This retrospective study used data from the TriNetX database. Women ≥18 years old diagnosed with schizophrenia were identified. The incidence of primary BC diagnosis between January 2011 and December 2023 was evaluated and stratified by ethnicity. We then conducted a retrospective cohort study to compare outcomes of women ≥18 years who did or did not use antipsychotics one year before BC diagnosis. Patients' propensity score was matched based on age, obesity, tobacco use, socioeconomic status, cancer stage, chemoradiation, axillary lymph node dissection (ALND), sentinel lymph node biopsy (SLNB), and hormone therapy use. Outcomes of interest were 5-year overall survival, recurrence, chemotherapy need, and lymphedema.</p><p><strong>Results: </strong>1,398,475 women ≥18 years old with schizophrenia were identified. Breast cancer incidence in these patients was 0.53 ​% in 2011 and 0.53 ​% in 2022, with a peak in 2017 (1.29 ​%). Non-Hispanic patients were diagnosed with BC approximately 1.3 times more than Hispanic patients. The outcomes study included 183,062 matched patients, with 91,531 per cohort. 5-year survival with the Kaplan-Meier analysis was significantly greater in women not on antipsychotics (72 ​%) compared to those on antipsychotics (60 ​%), log-rank test p-value <0.0001. The risk of local recurrence (13.4 ​% versus 22.6 ​%, p-value <0.0001), chemotherapy need (41.2 ​% versus 48.4 ​%, p-value <0.0001), and lymphedema (7.7 ​% versus 11.5 ​%, p-value <0.0001) were also significantly lower in women who did not take antipsychotics.</p><p><strong>Conclusion: </strong>Breast cancer incidence in patients with schizophrenia identified through TriNetX has not experienced a significant uptrend or downtrend over the past decade. Non-Hispanic patients with schizophrenia have a higher incidence of BC than Hispanic patients. Matched breast cancer patients on antipsychotics at least one year prior to diagnosis had higher mortality, recurrence, chemotherapy need, and risk of lymphedema.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116050"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638558","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":"Not so sweet victory: Diabetes associated with increased unplanned healthcare utilization following ostomy creation.","authors":"Tabitha E Norton, Pasithorn A Suwanabol, Samantha L Savitch","doi":"10.1016/j.amjsurg.2024.115889","DOIUrl":"10.1016/j.amjsurg.2024.115889","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"115889"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035026","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":"The cost of waiting: Index vs. delayed cholecystectomy for acute cholangitis.","authors":"Reed I Ayabe, Oliver S Eng","doi":"10.1016/j.amjsurg.2024.115937","DOIUrl":"10.1016/j.amjsurg.2024.115937","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"115937"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103617","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}