American journal of surgery最新文献_第8页

Analysis of ERAS protocol adherence and postoperative outcomes after major colorectal surgery in a community hospital 一家社区医院结直肠大手术后ERAS方案遵守情况和术后效果分析。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-16 DOI: 10.1016/j.amjsurg.2024.116022

Ashlyn B. White, Steven D. Scarcliff, Tyler J. Stoneman, Dylan S. Schindele, Blake A. Lyon, Charlton T. Nguyen, Sarah E. Thompson, Amy E. Hudson

{"title":"Analysis of ERAS protocol adherence and postoperative outcomes after major colorectal surgery in a community hospital","authors":"Ashlyn B. White, Steven D. Scarcliff, Tyler J. Stoneman, Dylan S. Schindele, Blake A. Lyon, Charlton T. Nguyen, Sarah E. Thompson, Amy E. Hudson","doi":"10.1016/j.amjsurg.2024.116022","DOIUrl":"10.1016/j.amjsurg.2024.116022","url":null,"abstract":"<div><div>Despite widespread adoption, the efficacy of Enhanced Recovery After Surgery (ERAS) protocols in community hospital settings remains understudied. This retrospective analysis conducted at a high-volume community hospital aimed to evaluate adherence to ERAS protocols and analyze postoperative outcomes following colorectal surgery. A total of 278 adult patients undergoing elective colorectal surgery between January 2022 and January 2024 were included. Data analysis revealed time to first mobilization proved to be satisfactory in accordance with ERAS hospital guidelines (mean 1.0 ± 0.05 days, range 0.1–13.8 days), and furthermore demonstrated a strong positive correlation with both time to first bowel function (r = 0.69, p < 0.0001) and length of stay (r = 0.25, p < 0.0001). Time to urinary catheter removal occurred slightly after guideline-directed removal (mean 1.1 ± 0.05 days, range 0.5–12.9 days), however did exhibit a significant positive correlation with length of stay (r = 0.33, p < 0.0001). 10.9 % of patients experienced a postoperative complication, while the average length of stay across all procedures was 3.1 ± 0.17 days (range 0.9–23.3 days), and the overall 30-day readmission rate stood at 10.43 %. This study underscores the need for ongoing evaluation and refinement of ERAS protocols in community hospital settings to enhance surgical care and patient satisfaction.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"239 ","pages":"Article 116022"},"PeriodicalIF":2.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456231","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

Unveiling the disparities within: Why we need to disaggregate data for Asian women with breast cancer. 揭示内部差异：为什么我们需要对亚洲女性乳腺癌患者的数据进行分类？

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-16 DOI: 10.1016/j.amjsurg.2024.116013

Angelena Crown, Amanda L Kong

引用次数: 0

National trends and costs of same day discharge in patients undergoing elective minimally invasive colectomy 接受择期微创结肠切除术的患者当天出院的全国趋势和费用。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-16 DOI: 10.1016/j.amjsurg.2024.116021

Wardah Rafaqat , Mahin Janjua , Omar Mahmud , Bradford James , Baryalay Khan , Hanjo Lee , Aimal Khan

{"title":"National trends and costs of same day discharge in patients undergoing elective minimally invasive colectomy","authors":"Wardah Rafaqat , Mahin Janjua , Omar Mahmud , Bradford James , Baryalay Khan , Hanjo Lee , Aimal Khan","doi":"10.1016/j.amjsurg.2024.116021","DOIUrl":"10.1016/j.amjsurg.2024.116021","url":null,"abstract":"<div><h3>Background</h3><div>Enhanced Recovery Pathways (ERPs) have enabled safe same day discharge (SDD) of select patients after elective minimally invasive colectomy. We aimed to analyse the financial impact of SDD in these cases.</div></div><div><h3>Methods</h3><div>We queried the Nationwide Readmission Database (2016–2019) and included patients with a hospital length of stay ≤2 days after minimally invasive elective colectomy. Propensity score matched pairs of patients discharged on the day of the operation and those discharged on post operative day 1 or 2 were compared. Our primary outcome was the combined cost of hospitalization and readmission.</div></div><div><h3>Results</h3><div>SDD patients had lower comorbidity (33 % vs 21 %) and illness severity (79 % vs 63 %), more Medicare insurance (44 % vs 38 %), and more benign neoplasms (52 % vs 17 %). Most SDD patients underwent right colectomy (89 %). Across 647 matched pairs, total cost was significantly lower in SDD patients ($8000 vs. $12,900; p < 0.001) due to cheaper index hospitalizations. No difference in readmission rates or costs emerged.</div></div><div><h3>Conclusion</h3><div>SDD reduced costs of index hospitalization and may be cost-effective in a select cohort of healthier patients.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"239 ","pages":"Article 116021"},"PeriodicalIF":2.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456233","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

Cognitive conservation in surgery: More than efficiency, efficiency, efficiency. 手术中的认知保护：不仅仅是效率、效率、效率。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-15 DOI: 10.1016/j.amjsurg.2024.116024

Mina Sarofim

引用次数: 0

Histologic parameters driving completion thyroidectomy for papillary thyroid carcinoma in a high-volume institution: A retrospective observational study 在一家高容量医疗机构中，甲状腺乳头状癌组织学参数是完成甲状腺切除术的驱动力：一项回顾性观察研究。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-15 DOI: 10.1016/j.amjsurg.2024.116016

Leonardo Rossi , Andrea De Palma , Carlo Enrico Ambrosini , Lorenzo Fregoli , Antonio Matrone , Rossella Elisei , Gabriele Materazzi

{"title":"Histologic parameters driving completion thyroidectomy for papillary thyroid carcinoma in a high-volume institution: A retrospective observational study","authors":"Leonardo Rossi , Andrea De Palma , Carlo Enrico Ambrosini , Lorenzo Fregoli , Antonio Matrone , Rossella Elisei , Gabriele Materazzi","doi":"10.1016/j.amjsurg.2024.116016","DOIUrl":"10.1016/j.amjsurg.2024.116016","url":null,"abstract":"<div><h3>Background</h3><div>When the histological examination indicates papillary thyroid carcinoma (PTC), there is no unanimity on the need to proceed with completion thyroidectomy (CT). This study aims to assess the histologic parameters that influenced the decision to perform CT.</div></div><div><h3>Materials and methods</h3><div>This study included PTC patients who underwent thyroid lobectomy between 2019 and 2022. Group A included patients who underwent thyroid lobectomy without further treatments, whereas Group B included those who underwent CT based on histological findings. Differences in terms of histologic parameters were analyzed.</div></div><div><h3>Results</h3><div>Group A included 291 patients (68.3 %), whereas Group B 135 patients (31.7 %). Multivariate analysis identified associations between CT and tumor size (p < 0.001), aggressive variant (p = 0.009), and vascular invasion (p < 0.001). ROC curve analysis established a tumor size cut-off of 21 mm for CT. At ROC curve analysis, the cut-off number of aggressive factors required for CT was 2.</div></div><div><h3>Conclusion</h3><div>A thorough comprehensive assessment encompassing all pathological characteristics might be necessary in case of PTC with aggressive histologic features after thyroid lobectomy.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"239 ","pages":"Article 116016"},"PeriodicalIF":2.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493099","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}

引用次数: 0

Assessing students' perception of gender as a barrier in Orthopedic residency matching: A pilot survey study 评估学生对性别是骨科住院医师配对障碍的看法：一项试点调查研究。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-12 DOI: 10.1016/j.amjsurg.2024.116015

Reem Sarsour , Monica Guirgus , Mina Balen , Katie Kyan , Van Le , Bradley Carlson , Rina Jain

{"title":"Assessing students' perception of gender as a barrier in Orthopedic residency matching: A pilot survey study","authors":"Reem Sarsour , Monica Guirgus , Mina Balen , Katie Kyan , Van Le , Bradley Carlson , Rina Jain","doi":"10.1016/j.amjsurg.2024.116015","DOIUrl":"10.1016/j.amjsurg.2024.116015","url":null,"abstract":"<div><h3>Background</h3><div>Gender disparity in orthopedic residency programs is evident. Limited research investigates if gender attitudes deter women from applying to orthopedic surgery residency programs.</div></div><div><h3>Methods</h3><div>A questionnaire was distributed to a single medical school which explored medical students' perceptions regarding their gender's influence on matching into orthopedic surgery residency, alongside motivators and barriers for applying. Descriptive statistics and chi-square tests analyzed potential association and trends using SPSS computation with alpha set at 0.05.</div></div><div><h3>Results</h3><div>202 medical students completed the questionnaire. Women respondents were found to be 10.6 times more likely to report their own gender as a barrier to matching to orthopedic surgery residency compared to men.</div></div><div><h3>Conclusion</h3><div>A significant proportion of women perceive their gender as a barrier to matching. Dismantling gender stereotypes may increase consideration of women medical students of orthopedic surgery as a career option.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"239 ","pages":"Article 116015"},"PeriodicalIF":2.7,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543178","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

Time is money: The return on investment of research in surgical training 时间就是金钱：外科培训研究的投资回报

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-10 DOI: 10.1016/j.amjsurg.2024.116011

Terry P. Gao, Rebecca L. Green, Kristen M. HoSang, Eric S. Kopelson, Lindsay E. Kuo

{"title":"Time is money: The return on investment of research in surgical training","authors":"Terry P. Gao, Rebecca L. Green, Kristen M. HoSang, Eric S. Kopelson, Lindsay E. Kuo","doi":"10.1016/j.amjsurg.2024.116011","DOIUrl":"10.1016/j.amjsurg.2024.116011","url":null,"abstract":"<div><h3>Introduction</h3><div>Future income potential can impact surgical trainees’ career choices, particularly when deciding to subspecialize, which often requires additional training and research time. This study quantifies the effects of added time on career value for eight surgical subspecialties.</div></div><div><h3>Methods</h3><div>The Net present value(NPV) was calculated for eight subspecialties and general surgery over a 35-year career, factoring in salary, educational debt, tax, inflation, and practice setting. NPV for each was compared over a number of research years (0, 1, 2) using data from the MGMA, AAMC, and US government records.</div></div><div><h3>Results</h3><div>After a 35-year career, six subspecialties in private practice increased career NPV(>$14,000) with 0 research years. One additional research year yielded negative career values for transplant, trauma, and vascular; with two, only cardiovascular and pediatric retained a positive NPV. In academia, 1–2 research years resulted in negative NPV for all but cardiovascular and thoracic surgery.</div></div><div><h3>Conclusions</h3><div>The financial return of additional training years is highly variable.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"239 ","pages":"Article 116011"},"PeriodicalIF":2.7,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441534","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

Women in surgical innovation: A guide to breaking down barriers and developing solutions from bench to bedside (Part I). 外科创新中的女性：从工作台到床边打破障碍和制定解决方案指南（第一部分）。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-10 DOI: 10.1016/j.amjsurg.2024.116012

Tandis Soltani, Asanthi Ratnasekera, Mecker G Möller, Pauline K Park, Rachel M Russo

引用次数: 0

AJS virtual research mentor: Tips on writing an abstract for a conference. AJS 虚拟研究导师：撰写会议摘要的技巧。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-10 DOI: 10.1016/j.amjsurg.2024.116009

Nicole M Mott, Madhushree Zope, Ian S Reynolds, Yanick Tadé, Guillermo Polcano Serra, Jane J Long, Wendelyn M Oslock

引用次数: 0

Variation in PTH levels and kinetics after parathyroidectomy 甲状旁腺切除术后 PTH 水平和动力学的变化

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-10-10 DOI: 10.1016/j.amjsurg.2024.116010

Claire E. Graves MD, Michael J. Campbell MD

引用次数: 0