American journal of surgery最新文献

{"title":"Appendectomy, acute appendicitis, and gastrointestinal diseases: A Mendelian randomization study","authors":"Yi Zhao ,&nbsp;Xuecheng Bai ,&nbsp;Yi Ding ,&nbsp;Cheng Cui ,&nbsp;Dongning Zheng ,&nbsp;Benjian Gao ,&nbsp;Yongfa Liu ,&nbsp;Shuai Hu ,&nbsp;Yaling Li ,&nbsp;Xiaoli Yang ,&nbsp;Bo Li","doi":"10.1016/j.amjsurg.2024.116107","DOIUrl":"10.1016/j.amjsurg.2024.116107","url":null,"abstract":"<div><h3>Background</h3><div>Appendectomy is the standard treatment for acute appendicitis. However, the effects of appendectomy and acute appendicitis on gastrointestinal diseases are not fully understood.</div></div><div><h3>Methods</h3><div>Genetic variants associated with appendectomy and acute appendicitis at a genome-wide significance level (<em>P</em> ​&lt; ​5.0E−08) were selected as instrumental variables. Two-sample univariate and multivariate Mendelian randomization (MR) analyses were performed to examine the independent effects of appendectomy and acute appendicitis on related gastrointestinal diseases.</div></div><div><h3>Results</h3><div>Appendectomy was linked to an increased risk of colon cancer (odds ratio [OR], 1.54; 95 ​% confidence interval [CI], 1.15–2.07; <em>P</em> ​= ​0.004; FDR-corrected <em>P</em> ​= ​0.016) and a decreased risk of primary sclerosing cholangitis (OR, 0.57; 95 ​% CI, 0.38–0.84; <em>P</em> ​= ​0.004; FDR-corrected <em>P</em> ​= ​0.016). Acute appendicitis was associated with a higher risk of cholelithiasis (OR, 1.16; 95 ​% CI, 1.06–1.27; <em>P</em> ​= ​0.002; FDR-corrected <em>P</em> ​= ​0.016).</div></div><div><h3>Conclusion</h3><div>This study suggested that appendectomy and acute appendicitis might affect the risk of several gastrointestinal diseases in European populations.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"240 ","pages":"Article 116107"},"PeriodicalIF":2.7,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748527","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":"Who takes the lead? Defining leadership among prospective surgical trainees.","authors":"Eleanor A Fallon","doi":"10.1016/j.amjsurg.2024.116109","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.116109","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116109"},"PeriodicalIF":2.7,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811733","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":"Are general surgery programs offering the wellness opportunities that residents need?","authors":"Nicole Rademacher, Wendelyn M Oslock, Abigail Luman, Herbert Chen","doi":"10.1016/j.amjsurg.2024.116108","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.116108","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116108"},"PeriodicalIF":2.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765486","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":"Timing of tracheostomy in geriatric patients with isolated severe traumatic brain injury: A nationwide analysis","authors":"Omar I. Morales Rosario ,&nbsp;Emanuele Lagazzi ,&nbsp;Vahe S. Panossian ,&nbsp;Josip Plascevic ,&nbsp;Yasmin Arda ,&nbsp;May Abiad ,&nbsp;Ikemsinachi Nzenwa ,&nbsp;George C. Velmahos ,&nbsp;John O. Hwabejire","doi":"10.1016/j.amjsurg.2024.116100","DOIUrl":"10.1016/j.amjsurg.2024.116100","url":null,"abstract":"<div><h3>Background</h3><div>The impact of tracheostomy timing on outcomes is unclear in geriatric patients with traumatic brain injury (TBI).</div></div><div><h3>Methods</h3><div>Patients aged≥65 with isolated severe TBI who underwent tracheostomy were identified in the ACS-TQIP 2017–2020 database. Patients were grouped by early (&lt;10 days) vs. late (≥10 days) tracheostomy. Propensity score matching accounted for confounders. Outcomes included mortality, hospital (H-LOS) and ICU length of stay (ICU-LOS), ventilator days, and complications.</div></div><div><h3>Results</h3><div>Among 1385 patients, 637 (46.0 ​%) had an early tracheostomy. Following propensity score matching, early tracheostomy was associated with shorter H-LOS (18 vs. 25 days, p ​&lt; ​0.001), ICU-LOS (14 vs. 20 days, p ​&lt; ​0.001), and fewer ventilator days (12 vs. 17 days, p ​&lt; ​0.001). Furthermore, the incidence of deep vein thrombosis was lower in the early tracheostomy group (6.7 ​% vs. 11.3 ​%, p ​= ​0.024), but mortality rates were similar (11.1 ​% vs. 9.5 ​%, p ​= ​0.48).</div></div><div><h3>Conclusion</h3><div>Early tracheostomy in geriatric patients with isolated severe TBI is associated with reduced LOS, ventilator days, and complications, suggesting potential benefits of earlier intervention.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"240 ","pages":"Article 116100"},"PeriodicalIF":2.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723094","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":"Table of Contents (5pgs)","authors":"","doi":"10.1016/j.amjsurg.2024.116038","DOIUrl":"10.1016/j.amjsurg.2024.116038","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"238 ","pages":"Article 116038"},"PeriodicalIF":2.7,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699083","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":"Evaluating the effect of hyperbaric oxygen therapy to treat mastectomy skin flap ischemia in breast reconstruction: A single-institution retrospective analysis.","authors":"Ava Daniel, Victoria Haney, Meghan Tveit, Isabella Lipkin, Sean M Lee, Kara Couch, Sean J Wallace, Christine B Teal, Bharat Ranganath","doi":"10.1016/j.amjsurg.2024.116110","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.116110","url":null,"abstract":"<p><strong>Background: </strong>Mastectomy skin flap ischemia is a well-known postoperative complication following mastectomy and breast reconstruction. Hyperbaric oxygen therapy (HBOT) has shown promising results for reducing the adverse effects associated with mastectomy skin flap ischemia and associated necrosis; however, there is paucity of literature regarding the indications for HBOT following breast cancer surgery. This study aimed to assess HBOT efficacy in treating and mitigating complications from postoperative tissue ischemia. Secondarily, it explored how patient-related factors may impact the success of HBOT.</p><p><strong>Methods: </strong>A retrospective analysis was conducted from January 2018 to October 2023. The study analyzed 23 patients at a single institution who were treated with HBOT for diagnosed skin flap ischemia following mastectomy and immediate breast reconstruction. Patient demographics, preoperative, and operative details were collected, as well as postoperative outcomes. The authors deemed HBOT a \"success\" if there were no major complications and a \"failure\" if there was ≥1 major complication reported within 6 months following the last HBOT treatment. Logistic regression modeled the odds of HBOT success as a function of patient characteristics.</p><p><strong>Results: </strong>HBO was deemed a success in 15/23 patients (65 ​%) and a failure in 8/23 (35 ​%). Of the successes, 11 received immediate post-operative HBOT. Average age at surgery was 49 years, average BMI was 24, and average number of HBOT treatments was 11. Logistic regression analysis revealed that preceding minor complications and age both trended towards significance regarding their impact on HBO outcome. Odds of success decreased by 92 ​% in the presence of minor complications (OR ​= ​0.08; p ​< ​0.09) and increased by 15 ​% with every 1-year increase in age (OR ​= ​1.16; p ​< ​0.07) CONCLUSIONS: In this retrospective analysis, HBOT was successful in treating postoperative mastectomy skin flap ischemia and preventing major complications in the majority of patients. Notably, age at time of surgery and presence of minor complications were the only variables found to potentially impact the success of HBOT. Future studies on a larger scale are needed to better evaluate HBOT's therapeutic utility in mastectomy flap necrosis.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116110"},"PeriodicalIF":2.7,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749470","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":"Emeritus Editorial Board","authors":"","doi":"10.1016/j.amjsurg.2024.116037","DOIUrl":"10.1016/j.amjsurg.2024.116037","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"238 ","pages":"Article 116037"},"PeriodicalIF":2.7,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699086","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 comparative effectiveness of pelvic floor muscle training and hypopressive breathing techniques for pelvic organ prolapse: A systematic review and pooled analysis of randomized controlled trials.","authors":"Jessica R Mitchell, Hanna E Brancaccio, Morgan Blusewicz Spt, David F Lo, Brandon Goodwin, Danielle Carey","doi":"10.1016/j.amjsurg.2024.116111","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.116111","url":null,"abstract":"<p><strong>Background: </strong>Pelvic floor (PF) disorder affects 25 ​% of females, often progressing to Pelvic Organ Prolapse (POP). PF muscle training (PFMT) and hypopressive breathing (HB) are conservative techniques used to repair pelvic muscles. This study analyzes the comparative efficacy of PFMT and HB for POP.</p><p><strong>Methods: </strong>A systematic review was conducted and seven records were included in the pooled analysis, which compared PF outcomes between HB and PFMT.</p><p><strong>Results: </strong>PFMT (d ​= ​2.14 and d ​= ​1.07) demonstrated a larger effect size compared to HB (d ​= ​1.24 and d ​= ​0.78) for sEMG contractility and the Modified Oxford Scale, respectively. The Pelvic Floor Disability Index (PFDI-20) found a lower effect size of PFMT (d ​= ​0.558) compared to HB (d ​= ​0.961).</p><p><strong>Conclusions: </strong>PFMT was found to improve PF strength (Oxford) more than HB, while HB had a greater effect on quality of life (PFDI-20). Results were insignificant for contractility.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116111"},"PeriodicalIF":2.7,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142737984","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 role of combining interim and final analysis by using endoscopic and radiologic methods in total neoadjuvant treatment","authors":"Kamil Erozkan ,&nbsp;David Liska ,&nbsp;Ayda Oktem ,&nbsp;Ali Alipouriani ,&nbsp;Lukas Schabl ,&nbsp;Michael A. Valente ,&nbsp;Jacob A. Miller ,&nbsp;Andrei S. Purysko ,&nbsp;Scott R. Steele ,&nbsp;Emre Gorgun","doi":"10.1016/j.amjsurg.2024.116104","DOIUrl":"10.1016/j.amjsurg.2024.116104","url":null,"abstract":"<div><h3>Background</h3><div>We aim to compare the relative performance of flexible sigmoidoscopy (FS), rectal magnetic resonance imaging (MRI), and their combinations during interim (i) and final (f) analysis to evaluate concordance with complete response (CR) following total neoadjuvant treatment (TNT) in rectal cancer.</div></div><div><h3>Method</h3><div>Patients who opted TNT and underwent restaging with FS and MRI between 2015 and 2022 were evaluated. Concordance between the assessment methods and CR was analyzed using the weighted-κ test.</div></div><div><h3>Results</h3><div>A cohort comprising 208 patients revealed CR rate of 42.3 ​%. When evaluating individual methods, fFS alone demonstrated the most heightened sensitivity (68.2 ​%) for CR detection, with a moderate level of concordance (κ ​= ​0.46). Only the combinations of iFS-fFS and fFS-fMRI reached a comparable level of concordance to that achievable by fFS alone.</div></div><div><h3>Conclusion</h3><div>Among the available diagnostic tools, the combination of final MRI and FS still appears to offer the highest concordance with CR, with relatively higher sensitivity. Additionally, interim MRI may not add significant clinical value and could be omitted.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"241 ","pages":"Article 116104"},"PeriodicalIF":2.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692678","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":"Is there an association between inflammatory biomarkers and organ space surgical site infection after emergency laparotomy in massively transfused trauma patients?","authors":"Stephanie Martinez Ugarte ,&nbsp;Mokunfayo O. Fajemisin ,&nbsp;Chelsea J. Guy-Frank ,&nbsp;James M. Klugh ,&nbsp;Xu Zhang ,&nbsp;Erin E. Fox ,&nbsp;Charles E. Wade ,&nbsp;Kimberly A. Mankiewicz ,&nbsp;Lillian S. Kao","doi":"10.1016/j.amjsurg.2024.116106","DOIUrl":"10.1016/j.amjsurg.2024.116106","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between inflammatory biomarkers (IB) and organ space surgical site infections (OS-SSIs) after emergency laparotomy (EL) is poorly understood.</div></div><div><h3>Methods</h3><div>Retrospective, single-center analysis of patients in the Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR) trial who underwent EL and survived 48 ​h after admission was performed. IB levels of IL-6, IL-8, G-CSF, MCP-1, neutrophil to lymphocyte ratio, and platelet to lymphocyte ratio were analyzed. IB and OS-SSIs association was evaluated using the Wilcoxon rank sum test.</div></div><div><h3>Results</h3><div>Of 74 eligible patients, 80 ​% were male, 69 ​% sustained blunt trauma, the injury severity score was 31 (24–41), and 22 ​% developed OS-SSIs. Levels of IL-6 (12, 24 ​h), IL-8 (2, 12, 24, 72 ​h), and MCP-1 (24 ​h) were higher in OS-SSI patients (<em>P</em> ​&lt; ​0.05).</div></div><div><h3>Conclusions</h3><div>IL-6, IL-8, and MCP-1 levels were associated with OS-SSIs in PROPPR patients who underwent EL. The IB may help to predict high-risk patients for OS-SSIs.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"244 ","pages":"Article 116106"},"PeriodicalIF":2.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748380","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}