American journal of surgery最新文献

{"title":"Colorectal cancer care equity in underserved communities: Innovative solutions for screening, outreach & capacity in rural Washington","authors":"Lauren Duffy,&nbsp;Marley Anderson,&nbsp;Evelyn Rowe,&nbsp;Michelle Yan,&nbsp;Aliya Abdelhak,&nbsp;Juliana Garcia,&nbsp;Clemma Muller,&nbsp;Anjali Kumar","doi":"10.1016/j.amjsurg.2025.116246","DOIUrl":"10.1016/j.amjsurg.2025.116246","url":null,"abstract":"<div><h3>Background</h3><div>Colorectal cancer (CRC) mortality hotspots in rural Washington, notably Yakima and Richland, identified an 8-year earlier median age of death in non-white patients. Post-pandemic data from WA State Department of Health and MultiCare's electronic health records revealed a 40 ​% decrease in CRC screenings.</div></div><div><h3>Methods</h3><div>During a 2023 CRC prevention summit, barriers and solutions were discussed focusing on rural Hispanic laborers as this population is often seen at partner locations, Yakima Valley Farm Workers Clinic (YVFWC).</div></div><div><h3>Results</h3><div><em>Community outreach</em><strong>—</strong>Our team established a presence at Yakima's largest health fair, Fiesta de Salud. We also provided screening resources at Richland's farmers' markets. <em>Planned events</em> <strong>--</strong> We will network with local community leaders and health providers to actualize screening (stool-based testing, hands-on endoscopy training).</div></div><div><h3>Conclusion</h3><div>Persistent CRC mortality disparities in Washington State underscores the need for targeted interventions. Partnering with organizations and engaging in community outreach aims to increase screening rates and enhance education.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"243 ","pages":"Article 116246"},"PeriodicalIF":2.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453819","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":"Trends in use of outpatient minimally-invasive adrenalectomy: A population-based analysis","authors":"J. Walker Rosenthal ,&nbsp;Caitlin B. Finn ,&nbsp;Jasmine Hwang ,&nbsp;James E. Sharpe ,&nbsp;Shane T. Williams ,&nbsp;Lauren N. Krumeich ,&nbsp;Doug L. Fraker ,&nbsp;Heather Wachtel ,&nbsp;Rachel R. Kelz","doi":"10.1016/j.amjsurg.2025.116247","DOIUrl":"10.1016/j.amjsurg.2025.116247","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine temporal trends and outcomes of outpatient adrenalectomy in a population-based sample.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study using the Healthcare Cost and Utilization Project's State Inpatient and State Ambulatory Surgery Databases, 2016–2020. Patients undergoing minimally invasive adrenalectomy were identified using billing codes. The primary exposure was admission status defined by length of stay. Outcomes included temporal trend in admission type, readmission rates and costs.</div></div><div><h3>Results</h3><div>Among 4431 adrenalectomies, 51.3 ​% were performed in the outpatient setting. The majority were observed overnight with only 100 patients (2.3 ​%) discharged same-day. Outpatient adrenalectomy increased annually from 44.1 ​% in 2016 to 59.2 ​% in 2020 (p ​&lt; ​0.01). Median costs were similar with a risk-adjusted marginal difference of $179 (same-day: $9565 vs overnight $9491; p ​= ​0.81). Odds of readmission were similar between same-day and overnight stays (OR 0.18; p ​= ​0.10).</div></div><div><h3>Conclusion</h3><div>Given similar costs and readmission rates, case selection and surgeon expertise should continue to guide decision-making on same-day adrenalectomy.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"243 ","pages":"Article 116247"},"PeriodicalIF":2.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453818","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":"“Sucking the trouble” out of troubleshooting wound vacs: Video based curriculum development and implementation in a live tissue model","authors":"M.K. Lonneman,&nbsp;L. Pumiglia,&nbsp;B. Zhang,&nbsp;A.A. Edinger,&nbsp;J. Dejong,&nbsp;O.O. Akinmoladun,&nbsp;J.C. Van Eaton,&nbsp;A. Kelly,&nbsp;K. Dolezal,&nbsp;A. Enzerink,&nbsp;J.J. Glaser,&nbsp;J.R. Bingham,&nbsp;J. Oliver","doi":"10.1016/j.amjsurg.2025.116244","DOIUrl":"10.1016/j.amjsurg.2025.116244","url":null,"abstract":"<div><div>We hypothesized that non-surgeon, Negative Pressure Wound Therapy (NPWT) naïve participants would better identify device functions and troubleshoot failures after being exposed to a video curriculum (VC) compared to similar participants exposed to clinical practice guidelines (CPGs). VC and critical action step development was followed by randomization of 115 non-surgical, NPWT naïve participants into either the CPG or VC study groups. Participants individually identified components of the NPWT system and then worked as a team to troubleshoot three scenarios on an in vivo porcine model. VC participants better identified all NPWT components and functions (p ​&lt; ​0.001), demonstrated correct cannister attachment (p ​&lt; ​0.001) and performed a seal check (p ​&lt; ​0.001). VC teams performed more critical action steps in the leak (p ​= ​0.011) and obstruction (p ​= ​0.001) scenarios. In post-event surveys, participants were more likely to find the VC easy to use and informative and were likely to recommend the videos to a colleague (p ​= ​0.008, p ​= ​0.019, p ​= ​0.02). VC participants demonstrated improved competency in individual NPWT component identification and team-based troubleshooting of NPWT failures. This VC represents an effective alternative to existing CPGs.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"243 ","pages":"Article 116244"},"PeriodicalIF":2.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143421051","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":"Continuous intraoperative AI monitoring of surgical technical skills using computer vision.","authors":"Recai Yilmaz, Rolando F Del Maestro, Daniel Donoho","doi":"10.1016/j.amjsurg.2025.116248","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116248","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116248"},"PeriodicalIF":2.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424910","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.2025.116219","DOIUrl":"10.1016/j.amjsurg.2025.116219","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"241 ","pages":"Article 116219"},"PeriodicalIF":2.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143376533","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":"How economic policies which drive competition amongst hospitals impacts quality of care: The case of the English NHS (A systematic review)","authors":"Diego Najera Saltos,&nbsp;Søren Rud Kristensen","doi":"10.1016/j.amjsurg.2025.116237","DOIUrl":"10.1016/j.amjsurg.2025.116237","url":null,"abstract":"<div><h3>Background</h3><div>England's National Health Service (NHS) has undergone significant reforms, including the internal market in the 1990s and the 2006 patient choice reform. This systematic review examines how economic policies driving hospital competition impact the quality of care, particularly surgical outcomes, using access and effectiveness as indicators.</div></div><div><h3>Methods</h3><div>This systematic review followed PRISMA guidelines. Studies were identified from four databases (Embase, Global Health, HMIC, and Medline) with inclusion criteria focusing on competition's effect on surgical care within the NHS.</div></div><div><h3>Results</h3><div>From 308 studies screened, 12 met the inclusion criteria. Competition generally improves surgical quality, though variations exist across quality measures.</div></div><div><h3>Conclusion</h3><div>Competition in the NHS has improved surgical outcomes, especially in high-volume procedures. These findings are relevant to US surgical practice, where similar competition may drive efficiency and quality. However, policies must address risks of patient selection biases and regional disparities to ensure equitable improvements across surgical specialities.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"244 ","pages":"Article 116237"},"PeriodicalIF":2.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419840","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":"Table of Contents (4 pgs)","authors":"","doi":"10.1016/S0002-9610(25)00036-4","DOIUrl":"10.1016/S0002-9610(25)00036-4","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"241 ","pages":"Article 116214"},"PeriodicalIF":2.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143376534","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":"Metabolic and bariatric surgery versus glucagon-like peptide-1 receptor agonist therapy: A comparison of cardiovascular outcomes in patients with obesity","authors":"Soban Maan ,&nbsp;Amir H. Sohail ,&nbsp;Samia Aziz Sulaiman ,&nbsp;Linta Mansoor ,&nbsp;Ethan M. Cohen ,&nbsp;Ayowumi A. Adekolu ,&nbsp;Salim Abunnaja ,&nbsp;Nova Szoka ,&nbsp;Lawrence E. Tabone ,&nbsp;Shyam Thakkar ,&nbsp;Shailendra Singh","doi":"10.1016/j.amjsurg.2025.116242","DOIUrl":"10.1016/j.amjsurg.2025.116242","url":null,"abstract":"<div><h3>Background</h3><div>This study compared cardiovascular outcomes associated with metabolic and bariatric surgery (MBS) and glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy in individuals with obesity.</div></div><div><h3>Methods</h3><div>The TriNetX network was used to compare cardiovascular risk in adult patients with BMI ≥35 who underwent MBS with those who received GLP-1 RA therapy for ≥2 years. Primary outcome was cardiovascular disease (CVD), a composite of incident heart failure (HF), coronary artery disease (CAD), and cerebrovascular disease. Patient follow-up lasted up to 10 years.</div></div><div><h3>Results</h3><div>MBS was associated with lower hazard of the primary composite outcome of CVD (HR, 0.54, 95 ​% CI, 0.49–0.60), and the secondary outcomes of incident HF (HR, 0.45, 95 ​% CI, 0.39–0.52), CAD (HR, 0.54, 95 ​% CI, 0.45–0.66), and cerebrovascular disease (HR, 0.64, 95 ​% CI, 0.53–0.77).</div></div><div><h3>Conclusions</h3><div>A lower risk of adverse cardiovascular outcomes was noted after MBS compared with GLP-1 RA therapy in patients with obesity.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"242 ","pages":"Article 116242"},"PeriodicalIF":2.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419135","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":"Hyperthermic intraperitoneal chemotherapy (HIPEC) for gastric cancer with peritoneal metastasis - Joint analysis of European GASTRODATA and American national cancer database","authors":"Zuzanna Pelc ,&nbsp;Katarzyna Sędłak ,&nbsp;Yutaka Endo ,&nbsp;Johanna Van Sandick ,&nbsp;Suzanne Gisbertz ,&nbsp;Manuel Pera ,&nbsp;Gian Luca Baiocchi ,&nbsp;Paolo Morgagni ,&nbsp;Massimo Framarini ,&nbsp;Arnulf Hoelscher ,&nbsp;Stefan Moenig ,&nbsp;Piotr Kołodziejczyk ,&nbsp;Ines Gockel ,&nbsp;Guillaume Piessen ,&nbsp;Clarisse Eveno ,&nbsp;Paulo Matos Da Costa ,&nbsp;Andrew Davies ,&nbsp;Cara Baker ,&nbsp;William Allum ,&nbsp;Uberto Fumagalli Romario ,&nbsp;Karol Rawicz-Pruszyński","doi":"10.1016/j.amjsurg.2025.116235","DOIUrl":"10.1016/j.amjsurg.2025.116235","url":null,"abstract":"<div><h3>Introduction</h3><div>Palliative chemotherapy is the current standard among advanced gastric cancer (GC) patients with peritoneal metastasis (PM), while the role of gastrectomy with cytoreductive surgery and HIPEC remains unclear. The current study aimed to assess treatment outcomes among GC patients with PM undergoing gastrectomy and hyperthermic intraperitoneal chemotherapy (HIPEC) using multinational cancer registries.</div></div><div><h3>Methods</h3><div>The analysis (2012–2022) included stage IV GC patients with PM undergoing gastrectomy and HIPEC from the European GASTRODATA Registry (EU cohort) and the American National Cancer Database (NCDB, U.S. cohort). The study outcomes were textbook oncological outcome (TOO) assessment and overall survival (OS).</div></div><div><h3>Results</h3><div>Among 193 patients, 49.7 ​% were from the EU cohort and 50.3 ​% from the U.S. cohort. EU cohort had significantly higher rates of pT4 tumors (EU: 50 ​% vs U.S.: 40.2 ​%), metastatic lymph nodes (EU: 68.8 ​% vs U.S.: 54.6 ​%), and ≥16 lymph nodes evaluated (EU: 91.7 ​% vs U.S.: 68 ​%). Postoperatively, the EU cohort had longer hospital stay (EU: 53.1 ​% vs 22.2 ​%, p ​&lt; ​0.001), with no significant differences in 30-day readmission (EU: 14.6 ​% vs U.S: 7.2 ​%, p ​= ​0.11) and 90-day mortality (EU: 4.2 ​% vs U.S.: 9.3 ​%, p ​= ​0.25). TOO rates were 30.2 ​% and 32 ​% for EU and U.S. cohorts, respectively. Within the U.S. cohort, TOO achievement was associated with improved 1- (86.7 ​% vs. 57.4 ​%), 3- (55.8 ​% vs. 29.7 ​%), and 5-year OS (50.2 ​% vs. 29.7 ​%) (p ​= ​0.0025) survival compared with non-TOO.</div></div><div><h3>Conclusions</h3><div>Among patients with GC and PM undergoing gastrectomy and HIPEC, achievement of TOO was associated with decreased risk of postoperative complications (EU cohort) and improved long-term survival (U.S. cohort).</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"242 ","pages":"Article 116235"},"PeriodicalIF":2.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419276","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":"Tumor infiltrating lymphocytes in primary melanoma are associated with a better prognosis.","authors":"Steven L Morrison, Gang Han, Faith Elenwa, Stanley P Leong, Mohammed Kashani-Sabet, Barbara Pockaj, Heidi E Kosiorek, Richard L White, Jonathan S Zager, Jane L Messina, Vernon Sondak, Cristina O'Donoghue, John Harrison Howard, Schlomo Schneebaum, Roger Olofsson Bagge, Jukes P Namm, Carlos Garberoglio, Eli Avisar, Graham Fowler, Dale Han, John Vetto","doi":"10.1016/j.amjsurg.2025.116243","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116243","url":null,"abstract":"<p><strong>Background: </strong>The relationship between tumor infiltrating lymphocytes (TIL) and survival in melanoma is poorly understood. We present a large multicenter study assessing the association between TIL and survival.</p><p><strong>Methods: </strong>The Sentinel Lymph Node Working Group database was queried from 1993 to 2024 for cases with known TIL and survival data. TIL was analyzed dichotomously and stratified as non-brisk, brisk, and absent. Clinicopathologic factors were correlated with melanoma-specific survival (MSS), overall survival (OS), and recurrence-free survival (RFS).</p><p><strong>Results: </strong>Among 4957 patients, TIL was present in 3980 (80.2 ​%) of patients. TIL was prognostic of MSS (p ​= ​0.0033), OS (p ​= ​0.0053), and RFS (p ​= ​0.0011). In the stratified analysis, brisk TIL was more strongly associated with MSS, OS, and RFS than non-brisk TIL (all p ​< ​0.04). Among patients with a positive sentinel lymph node, TIL was prognostic of MSS, OS, and RFS (all p ​< ​0.03).</p><p><strong>Conclusions: </strong>TIL is strongly predictive of survival in melanoma and may be useful in risk stratification when deciding whether risks of adjuvant therapy outweigh benefits for certain patients.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116243"},"PeriodicalIF":2.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466771","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}