American journal of surgery最新文献_第7页

Is it really just the Milestones? 真的只有里程碑吗？

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-25 DOI: 10.1016/j.amjsurg.2025.116583

John Potts

引用次数: 0

Reducing hypocalcemia in patients undergoing thyroidectomy for Graves’ disease with a parathyroid hormone based protocol 基于甲状旁腺激素方案的Graves病甲状腺切除术患者降低低钙血症

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-23 DOI: 10.1016/j.amjsurg.2025.116570

C. Corbin Frye , Zhixing Song , Ashba Allahwasaya , Kerrick Akinola , Sanjana Balachandra , Raj Roy , Andrea Gillis , Jessica Fazendin , Brenessa Lindeman , Herbert Chen

{"title":"Reducing hypocalcemia in patients undergoing thyroidectomy for Graves’ disease with a parathyroid hormone based protocol","authors":"C. Corbin Frye , Zhixing Song , Ashba Allahwasaya , Kerrick Akinola , Sanjana Balachandra , Raj Roy , Andrea Gillis , Jessica Fazendin , Brenessa Lindeman , Herbert Chen","doi":"10.1016/j.amjsurg.2025.116570","DOIUrl":"10.1016/j.amjsurg.2025.116570","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with Graves' disease have a high risk of post-thyroidectomy hypocalcemia. Our aim was to evaluate the postoperative outcomes of hypoparathyroidism and hypocalcemia in Graves' disease.</div></div><div><h3>Methods</h3><div>A prospectively maintained, single institution database was retrospectively reviewed to identify patients with Graves' Disease who had undergone total or completion thyroidectomy. The primary outcomes of interest were postoperative hypoparathyroidism and hypocalcemia and secondary outcomes included surgical complication rates. Outcomes were further stratified based on post-anesthesia care unit (PACU) measurement of parathyroid hormone (PTH) levels and preoperative thyrotoxic status.</div></div><div><h3>Results</h3><div>Of the 245 Graves' thyroidectomy patients identified, nearly a third of patients (32.0 %) were thyrotoxic preoperatively. In the PACU, 26.5 % of patients had a PTH <10 pg/mL, although 62.9 % of these patients had normal PTH levels two-weeks postoperatively. Postoperative hypoparathyroidism was associated with White race and hypocalcemia two-weeks post-operatively. Thyrotoxic patients were more likely to have persistent hypocalcemia.</div></div><div><h3>Conclusion</h3><div>In this large series of Graves' patients undergoing thyroidectomy, in which a substantial proportion of patients had uncontrolled disease, a quarter of patients had hypoparathyroidism immediately after surgery, although this self-resolved for more than half of patients.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"249 ","pages":"Article 116570"},"PeriodicalIF":2.7,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079550","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

Frailty impacts outcomes for all older adult age groups in emergency laparotomy 在急诊剖腹手术中，虚弱会影响所有老年成人群体的预后

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-21 DOI: 10.1016/j.amjsurg.2025.116571

Jefferson A. Proaño-Zamudio, Yasmin Arda, Teresia M. Perkins, Ikemsinachi C. Nzenwa, Dias Argandykov, Wardah Rafaqat, Charudutt N. Paranjape, George C. Velmahos, Haytham M.A. Kaafarani, John O. Hwabejire

{"title":"Frailty impacts outcomes for all older adult age groups in emergency laparotomy","authors":"Jefferson A. Proaño-Zamudio, Yasmin Arda, Teresia M. Perkins, Ikemsinachi C. Nzenwa, Dias Argandykov, Wardah Rafaqat, Charudutt N. Paranjape, George C. Velmahos, Haytham M.A. Kaafarani, John O. Hwabejire","doi":"10.1016/j.amjsurg.2025.116571","DOIUrl":"10.1016/j.amjsurg.2025.116571","url":null,"abstract":"<div><h3>Background</h3><div>The quantitative effect of frailty on post-operative complications in older adults undergoing surgical emergencies is not well understood.</div></div><div><h3>Methods</h3><div>The 2013-2019ACS-NSQIP database was used to identify emergency laparotomy patients≥65 years. Frailty was measured using the modified-frailty-index-5 factors (mFI-5). We examined 30-day mortality, discharge to home, post-operative complications and unplanned readmissions. Multivariable logistic regression examined the association between frailty and outcomes.</div></div><div><h3>Results</h3><div>52,356 patients were included. The median age was 76(70–82) years. Most patients (68 %) had an mFI-5 score between 0.2 and 0.5. Higher frailty index was associated with higher mortality and shorter length of survival (log-rank p < 0.001). On multivariable analysis, a higher frailty index was associated with increased mortality, pneumonia, urinary tract infection, respiratory failure, acute kidney injury, and readmission in a linear fashion.</div></div><div><h3>Conclusion</h3><div>Increasing levels of frailty not only increase the risk of adverse post-operative outcomes, but also increase the risk of further functional loss and deterioration after discharge.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"249 ","pages":"Article 116571"},"PeriodicalIF":2.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913721","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

Bridging the gender gap: Female representation in urology residency and fellowship matches 弥合性别差距：泌尿外科住院医师和研究员匹配中的女性代表。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-21 DOI: 10.1016/j.amjsurg.2025.116586

Lillian Royston BS , Anne Roberts BS , Ching Man Carmen Tong DO

引用次数: 0

If you build it, they will come - Implementation of a prehospital whole blood program 如果你建好了，他们就会来——院前全血计划的实施

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-21 DOI: 10.1016/j.amjsurg.2025.116587

R.B. Fransman , C.H. Meyer , J. Nguyen , S.R. Todd , E.R. Benjamin , L de leon Castro , S. Collins , L. Pack , A. Schwartz , B. Spaeth , M. Thorton , M.S. McCain , J. Sikora , L. Kumar

{"title":"If you build it, they will come - Implementation of a prehospital whole blood program","authors":"R.B. Fransman , C.H. Meyer , J. Nguyen , S.R. Todd , E.R. Benjamin , L de leon Castro , S. Collins , L. Pack , A. Schwartz , B. Spaeth , M. Thorton , M.S. McCain , J. Sikora , L. Kumar","doi":"10.1016/j.amjsurg.2025.116587","DOIUrl":"10.1016/j.amjsurg.2025.116587","url":null,"abstract":"<div><h3>Introduction</h3><div>We sought to develop, implement and evaluate an urban prehospital whole blood (PH-WB) program.</div></div><div><h3>Methods</h3><div>Using retrospective heat map data, Quick Response Vehicles (QRVs) carrying PH-WB were strategically placed throughout the city and dispatched using dynamic deployment. Patient inclusion criteria were age ≥15 years, traumatic mechanism, and SBP ≤90 mmHg. Prospective data were collected between 3/21-6/21/2025.</div></div><div><h3>Results</h3><div>375 patients were transfused 588 units of PH-WB, with 55 % receiving >1 unit. With transfusion, the average SBP increased by 28 mmHg and pulse decreased by 19 bpm from field to ED arrival. The overall survival at 24-h and 30-days was 83 % and 80.8 %, respectively.</div></div><div><h3>Conclusion</h3><div>This study demonstrates the successful implementation of large-scale PH-WB program utilizing creative strategies to cover a large catchment zone with limited resources. Preliminary results document safe delivery of PH-WB, minimal variation in pre-hospital scene times, 0 % expiration rate of whole-blood in the field and high compliance with protocols.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116587"},"PeriodicalIF":2.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004056","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

Intercostal nerve block is superior than erector spinae plane block after uniportal video-assisted thoracoscopic surgery: randomized controlled trial 肋间神经阻滞优于单门电视胸腔镜手术后竖脊面阻滞：随机对照试验

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-21 DOI: 10.1016/j.amjsurg.2025.116575

Shuo-Ying Dai , Yen-Chin Liu , Ting-Wei Kang , Chao-Chun Chang , Ying-Yuan Chen , Wei-Li Huang , Yi-Ting Yen , Wu-Wei Lai , Yau-Lin Tseng , I-Chen Chien

{"title":"Intercostal nerve block is superior than erector spinae plane block after uniportal video-assisted thoracoscopic surgery: randomized controlled trial","authors":"Shuo-Ying Dai , Yen-Chin Liu , Ting-Wei Kang , Chao-Chun Chang , Ying-Yuan Chen , Wei-Li Huang , Yi-Ting Yen , Wu-Wei Lai , Yau-Lin Tseng , I-Chen Chien","doi":"10.1016/j.amjsurg.2025.116575","DOIUrl":"10.1016/j.amjsurg.2025.116575","url":null,"abstract":"<div><div>In this double-blinded, randomized controlled trial, sixty patients undergoing elective uniportal video-assisted thoracoscopic surgery (VATS) lobectomy were randomly assigned to receive thoracoscopic intercostal nerve block (ICNB, n = 30) or ultrasound-guided erector spinae plane block (ESPB, n = 30).</div><div>No block-related adverse events occurred. The ICNB group showed significantly lower resting and coughing visual analog scale scores, than the ESPB group, 4 (4.0 and 5.0 versus 5.0 and 6.0, p = 0.006 and 0.012) and 8 (3.0 and 4.0 versus 5.0 and 6.0, p = 0.003 and 0.017) hours postoperatively. The ESPB group consumed morphine significantly earlier (1.5 versus 10 h, p = 0.002), and had a higher 24-h cumulative consumption (11 versus 7 mg, <em>p</em> = 0.103). No differences were observed in postoperative nausea, vomiting, complications, drainage duration, or hospital stay.</div><div>ICNB demonstrated superior early analgesic efficacy, whereas ICNB and ESPB depicted safety and facilitated rapid recovery following uniportal VATS lobectomy.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"249 ","pages":"Article 116575"},"PeriodicalIF":2.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996349","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

Delays in Crime Victim Compensation in Illinois affect the most vulnerable. 伊利诺伊州的犯罪受害者赔偿延迟影响了最弱势群体。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-20 DOI: 10.1016/j.amjsurg.2025.116579

Joy Ayemoba, Clarice Robinson, Rachel Nordgren, Myles Francis, Carla Galvan, Leon Sawh, Fatima Bouftas, Ezra Moos, Diane N Haddad, Marion C Henry, Carmelle V Romain, Kylie Callier, Phillip M Dowzicky, Tanya L Zakrison, Franklin Cosey-Gay, Charlotte Kvasnovsky

{"title":"Delays in Crime Victim Compensation in Illinois affect the most vulnerable.","authors":"Joy Ayemoba, Clarice Robinson, Rachel Nordgren, Myles Francis, Carla Galvan, Leon Sawh, Fatima Bouftas, Ezra Moos, Diane N Haddad, Marion C Henry, Carmelle V Romain, Kylie Callier, Phillip M Dowzicky, Tanya L Zakrison, Franklin Cosey-Gay, Charlotte Kvasnovsky","doi":"10.1016/j.amjsurg.2025.116579","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116579","url":null,"abstract":"<p><strong>Introduction: </strong>Crime victim compensation (CVC) was developed to help individuals and families with expenses following violent injury. Administrative obstacles and potential biases may contribute to disparities in CVC. We explored rates of successful claims, award amounts and time to disbursement in Illinois.</p><p><strong>Methods: </strong>We completed a freedom of information act request for CVC data from the Office of the Illinois Attorney General from January 2012 to July 2024. Results were stratified by race, mechanism of victimization and denial characteristics.</p><p><strong>Results: </strong>We identified 42,477 claimants for CVC in Illinois during our study period. Of these claims 16,935 (39.9 %) were awarded. Black applicants composed the largest portion of denied claims (N = 9,055, 37.7 %) and comprised almost half of all claims denied based on 'victim misconduct' (N = 1,924, 42.5 %). Mean time to case closure ranged from 345 to 405 days following homicide.</p><p><strong>Conclusion: </strong>Focused advocacy is needed to support survivors in pursuit of this program.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116579"},"PeriodicalIF":2.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939438","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

From the Editor – in – Chief 来自总编辑。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-18 DOI: 10.1016/j.amjsurg.2025.116581

Herbert Chen (Editor-in-Chief)

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 : 2025-08-16 DOI: 10.1016/j.amjsurg.2025.116582

Savannah R Smith, Juan M Sarmiento

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 : 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

{"title":"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).","authors":"Paris D Butler, Erin King-Mullins, Bridget A Oppong, Steven D Wexner, Martin S Karpeh, Luz María Rodríguez","doi":"10.1016/j.amjsurg.2025.116578","DOIUrl":"10.1016/j.amjsurg.2025.116578","url":null,"abstract":"<p><strong>Background: </strong>Surgical health care disparities remain pervasive in the US, with historically marginalized communities disproportionately suffering from numerous health disorders and experiencing excess mortality compared to the majority community. The African American/Black community remains one of those historically challenged communities and efforts to help mitigate these health care disparities are ongoing.</p><p><strong>Methods: </strong>To aid in this issue, The Society of Black Academic Surgeons (SBAS) convened a series of presentations and a panel discussion by leaders from SBAS to better articulate disease specific health care disparities in the Black community. This program was part of a monthly diversity, equity, and inclusion series produced by the Advances in Surgery Channel in alliance with the American College of Surgeons. Dr. Erin King-Mullins addresses the current state of colorectal cancer in the Black population. Dr. Bridget Oppong speaks about disparities and equity in breast cancer care in the Black community, and Dr. Paris Butler provides insight into racial disparities in post mastectomy breast cancer reconstruction.</p><p><strong>Results: </strong>Exhaustively, SBAS members candidly provide evidence-based data describing disease specific health care disparities that disproportionately impact the Black community. Of equal import, these experts also provide strategies to mitigate disparities both locally and nationally, if properly resourced.</p><p><strong>Conclusions: </strong>Providing equitable surgical health care for historically vulnerable communities remains an unsolved challenge in the US. Amplifying these disparities and implementing strategies to alleviate them are necessary. Organized surgery's efforts in partnership with the community will be essential to addressing these longstanding issues.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116578"},"PeriodicalIF":2.7,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939513","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