American journal of surgery最新文献_第7页

Investigating racial/ethnic disparities in opioid use among patients undergoing gastrointestinal cancer surgery 调查胃肠癌手术患者阿片类药物使用的种族差异。

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-03-01 Epub Date: 2025-12-26 DOI: 10.1016/j.amjsurg.2025.116799

Shahzaib Zindani , Zayed Rashid , Selamawit Woldesenbet , Mujtaba Khalil , Timothy M. Pawlik

{"title":"Investigating racial/ethnic disparities in opioid use among patients undergoing gastrointestinal cancer surgery","authors":"Shahzaib Zindani , Zayed Rashid , Selamawit Woldesenbet , Mujtaba Khalil , Timothy M. Pawlik","doi":"10.1016/j.amjsurg.2025.116799","DOIUrl":"10.1016/j.amjsurg.2025.116799","url":null,"abstract":"<div><h3>Introduction</h3><div>We sought to investigate racial/ethnic disparities in opioid prescribing patterns among patients undergoing gastrointestinal (GI) cancer surgery.</div></div><div><h3>Methods</h3><div>Patients who underwent surgery for GI cancer (2016–2023) were identified using the EPIC Cosmos database. Multivariate analyses were conducted to assess differences in opioid prescription patterns postoperatively.</div></div><div><h3>Results</h3><div>168,220 individuals underwent GI cancer surgery (esophagus: 2.5 %; stomach: 4.1 %, pancreas: 9.7 %; hepatobiliary: 6.4 %; colorectal: 77.3 %); 52.9 % were male, 86.0 % were White with median age of 72 years (IQR: 62–80). Black patients were younger (68 years [IQR: 60–76] vs. 72 years [IQR: 63–81]) and had a lower Charlson Comorbidity Index score (>2) (66.2 % vs. 68.5 %) compared with White patients (both p < 0.001). On multivariable analysis, Black patients had similar odds of receiving opioids as White patients (OR: 1.01, 95 % CI: 0.95–1.08).</div></div><div><h3>Conclusion</h3><div>No race-based differences were noted in the use of opioid prescriptions, duration of prescriptions, or mode of opioid administration following GI surgery.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116799"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916607","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

Neighborhood deprivation is associated with longer hospital stay for common pediatric surgical procedures independent of complication rates 邻里剥夺与常见儿科外科手术住院时间延长有关，与并发症发生率无关

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-03-01 Epub Date: 2025-12-09 DOI: 10.1016/j.amjsurg.2025.116773

Phillip J. Hsu , Katherine Khosrovaneh , Nick Kunnath , Cody L. Mullens , Andrew M. Ibrahim , Samir K. Gadepalli

{"title":"Neighborhood deprivation is associated with longer hospital stay for common pediatric surgical procedures independent of complication rates","authors":"Phillip J. Hsu , Katherine Khosrovaneh , Nick Kunnath , Cody L. Mullens , Andrew M. Ibrahim , Samir K. Gadepalli","doi":"10.1016/j.amjsurg.2025.116773","DOIUrl":"10.1016/j.amjsurg.2025.116773","url":null,"abstract":"<div><h3>Background</h3><div>Neighborhood deprivation begets care delays and complications after children's surgery in single center studies. We aimed to better understand these associations through generalizable data.</div></div><div><h3>Methods</h3><div>We identified children undergoing six common operations using State Inpatient Databases, defining neighborhood deprivation using Child Opportunity Index. Risk-adjusted length of stay (LOS) and complication rates were compared using multivariable regression.</div></div><div><h3>Results</h3><div>Among 102,399 children, neighborhood deprivation was associated with race, public insurance, and transfer. On risk-adjusted analysis, children with greater neighborhood deprivation had longer LOS for appendectomy (4.36 vs 4.21 days), skin graft (10.80 vs 8.55 days), and skin excision/debridement (10.45 vs 9.51 days). Risk-adjusted complication rates were not different, and LOS differences persisted in children without complications.</div></div><div><h3>Conclusions</h3><div>Children from deprived neighborhoods stay longer post-operatively, despite similar complication rates. Factors beyond clinical care are thus associated with utilization, and should inform how payment models and quality metrics account for these non-clinical factors.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116773"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145882037","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

Current urgent and emergent management of acute sigmoid diverticulitis … has the LADIES trial impacted change in surgical management at a single institution? 目前急性乙状结肠憩室炎的紧急和紧急治疗…LADIES试验是否影响了单一机构手术治疗的改变？

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-03-01 Epub Date: 2025-12-24 DOI: 10.1016/j.amjsurg.2025.116797

Nicholas Stevens, Raisa Gao-Gibbons, Clayton Wyland, Kayla Flewelling, Theresa McGoff, Austin Brubaker, Laurence E. McCahill

{"title":"Current urgent and emergent management of acute sigmoid diverticulitis … has the LADIES trial impacted change in surgical management at a single institution?","authors":"Nicholas Stevens, Raisa Gao-Gibbons, Clayton Wyland, Kayla Flewelling, Theresa McGoff, Austin Brubaker, Laurence E. McCahill","doi":"10.1016/j.amjsurg.2025.116797","DOIUrl":"10.1016/j.amjsurg.2025.116797","url":null,"abstract":"<div><h3>Introduction</h3><div>For perforated sigmoid diverticulitis, the “gold standard” has traditionally been the Hartmann's Procedure (HP). The LADIES trial published in 2019 suggested that primary anastomosis (PA) is safe. Our study aims to evaluate whether the LADIES trial has influenced the surgical management of perforated diverticulitis at our institution.</div></div><div><h3>Methods</h3><div>Retrospective cohort study of patients undergoing urgent or emergent colectomy for perforated diverticulitis, divided into Group 1 (2013–2019) and Group 2 (post LADIES Trial, 2020–2024). Inclusion criteria was similar to the LADIES trial and included patients 85 years or younger, not immunocompromised, and without preoperative vasopressor requirements.</div></div><div><h3>Results</h3><div>There were 88 patients total, 41 patients in Group 1 and 47 in Group 2. No significant difference was noted in procedure performed, though there was an upwards trend for performing PA (19.5 % vs 36.2 %, p = 0.084) and creation of protective ileostomy (7.3 % vs 19.2 %, p = 0.129) in Group2.</div></div><div><h3>Conclusion</h3><div>After publication in 2019, our institution demonstrated limited adoption of the LADIES trial for surgical management of perforated diverticulitis. Further study is required to better delineate surgeon continued reluctance for PA in this setting.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116797"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145882038","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 new era of surgical intelligence: Analyzing disruption in general surgery from 2015 to 2021 外科智能新时代：分析2015 - 2021年普外科的颠覆性。

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-03-01 Epub Date: 2025-10-01 DOI: 10.1016/j.amjsurg.2025.116648

Adan Z. Becerra PhD , Christopher T. Aquina MD, MPH , Steven D. Schwaitzberg MD, FACS, MAMSE , Katia Noyes PhD, MPH

引用次数: 0

Bridging surgical education gaps in times of conflict: Experience with virtual and remote platforms for enhancing surgical workforce 弥合冲突时期的外科教育差距：增强外科劳动力的虚拟和远程平台的经验。

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-03-01 Epub Date: 2025-10-10 DOI: 10.1016/j.amjsurg.2025.116656

Kala T. Pham BS , Youmna A. Sherif MD , Melany C. Hughes MD , Sudha Jayaraman MD, MSc, FACS , Rachel W. Davis MD , Dr. Host MD

引用次数: 0

From the Editor – in – Chief 来自总编辑。

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-03-01 Epub Date: 2026-01-17 DOI: 10.1016/j.amjsurg.2026.116830

Herbert Chen (Editor-in-Chief)

引用次数: 0

The Hues of Limb Loss 肢体丧失的色彩。

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-03-01 Epub Date: 2025-10-29 DOI: 10.1016/j.amjsurg.2025.116678

引用次数: 0

Outcomes of non-obstructed gastric volvulus: Repair during the index hospitalization vs early elective setting 非梗阻性胃扭转的结局：指数住院期间的修复与早期选择设置。

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-03-01 Epub Date: 2025-11-27 DOI: 10.1016/j.amjsurg.2025.116758

A. Laykova , D. Scheeres , G. Zambito , A. Banks-Venegoni

{"title":"Outcomes of non-obstructed gastric volvulus: Repair during the index hospitalization vs early elective setting","authors":"A. Laykova , D. Scheeres , G. Zambito , A. Banks-Venegoni","doi":"10.1016/j.amjsurg.2025.116758","DOIUrl":"10.1016/j.amjsurg.2025.116758","url":null,"abstract":"<div><h3>Introduction</h3><div>There is a current gap in literature regarding the appropriate timing of non-emergent repair for a resolved obstructing gastric volvulus. This study aims to evaluate outcomes related to hiatal hernia repair (HHR) during the index hospitalization versus early outpatient repair, with the assumption that outpatient repair will result in better outcomes.</div></div><div><h3>Methods</h3><div>This study included HHR data from 2017 to 2022. The primary outcome assessed overall morbidity using the Clavien-Dindo classification among various secondary outcomes.</div></div><div><h3>Results</h3><div>A total of 25 patients were included. There was no difference in morbidity between groups (p = 0.66). In the outpatient group, 3 patients re-volvulized prior to repair and the LOS post repair was statistically longer in the inpatient group (2.5 days vs 1 day, p = 0.0172).</div></div><div><h3>Conclusion</h3><div>Our findings demonstrate that definitive HHR following resolved obstructing gastric volvulus can be safely performed during the index hospitalization, without increase in morbidity, which may be preferred for this patient population.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116758"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780076","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

Risk factors for lymph node metastasis in p/ypT1-2 rectal cancer p/ypT1-2直肠癌淋巴结转移的危险因素

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-03-01 Epub Date: 2025-12-17 DOI: 10.1016/j.amjsurg.2025.116782

Young Hae Choi, Jung Wook Huh, Woo Yong Lee, Seong Hyeon Yun, Hee Cheol Kim, Yong Beom Cho, Yoonah Park, Jung Kyong Shin

{"title":"Risk factors for lymph node metastasis in p/ypT1-2 rectal cancer","authors":"Young Hae Choi, Jung Wook Huh, Woo Yong Lee, Seong Hyeon Yun, Hee Cheol Kim, Yong Beom Cho, Yoonah Park, Jung Kyong Shin","doi":"10.1016/j.amjsurg.2025.116782","DOIUrl":"10.1016/j.amjsurg.2025.116782","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to identify and compare risk factors for lymph node metastasis in rectal cancer patients with and without neoadjuvant chemoradiotherapy.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 1354 patients who underwent curative surgery, categorized into a Non-CRT group (pT1–2, n = 921) and a CRT group (ypT1–2, n = 433).</div></div><div><h3>Results</h3><div>Lymph node metastasis occurred in 20.4 % of Non-CRT and 17.6 % of CRT patients. Independent predictors were lymphatic invasion (p < 0.001), tumor budding (p < 0.001), and pT2 stage (p = 0.002) in Non-CRT, and lymphatic invasion (p = 0.001) and venous invasion (p < 0.001) in CRT. Venous invasion showed a markedly stronger association in the CRT group (OR 12.102). Lymph node metastasis rates increased up to 64.3 % and 87.5 % with all risk factors, respectively.</div></div><div><h3>Conclusion</h3><div>Risk factors for lymph node metastasis differed by CRT status, with venous invasion emerging as the key determinant in the CRT group.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116782"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145817404","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

Misunderstandings in robotic surgical instruction: An exploratory discourse analysis 机器人手术指导中的误解：探索性语篇分析

IF 2.7 3区医学

American journal of surgery Pub Date : 2026-03-01 Epub Date: 2025-12-18 DOI: 10.1016/j.amjsurg.2025.116783

Riley Brian , Alyssa Murillo , Ivori White , Laura Sterponi , Hueylan Chern , Daniel Oh , Patricia S. O'Sullivan

{"title":"Misunderstandings in robotic surgical instruction: An exploratory discourse analysis","authors":"Riley Brian , Alyssa Murillo , Ivori White , Laura Sterponi , Hueylan Chern , Daniel Oh , Patricia S. O'Sullivan","doi":"10.1016/j.amjsurg.2025.116783","DOIUrl":"10.1016/j.amjsurg.2025.116783","url":null,"abstract":"<div><h3>Introduction</h3><div>When communication breaks down, misunderstandings ensue and may result in a communication process called repair. We aimed to characterize misunderstandings in robotic surgical instruction by appraising repairs.</div></div><div><h3>Methods</h3><div>We recorded learners and instructors working through simulated robotic surgical procedures. Using tools from discourse analysis, we categorized different aspects of repair: the trouble source (cause of confusion), initiation of repair (marker of the trouble source as confusing), repair proper (attempted resolution of confusion), and response to repair (signal of repair proper as adequate or inadequate).</div></div><div><h3>Results</h3><div>We reviewed 2596 min of video and audio data from 33 simulated cases. Using transcripts, we defined categories of trouble source, initiation of repair, repair proper, and response to repair.</div></div><div><h3>Conclusions</h3><div>Our findings suggest methods by which instructors can avoid common trouble sources to reduce reasons for misunderstanding and through which both learners and instructors can more effectively address misunderstandings when they do occur.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116783"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145838746","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