American journal of surgery最新文献_第9页

Decision analysis of left renal vein stenting and renal autotransplantation for Nutcracker syndrome 左肾静脉支架置入术与自体肾移植治疗胡桃夹子综合征的决策分析

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-10 DOI: 10.1016/j.amjsurg.2025.116567

Armaun D. Rouhi , Marissa Di Napoli , Hanya Yang , Thomas Pshak , Maria Baimas-George , Rose Castle , Trevor L. Nydam , Rashikh A. Choudhury

{"title":"Decision analysis of left renal vein stenting and renal autotransplantation for Nutcracker syndrome","authors":"Armaun D. Rouhi , Marissa Di Napoli , Hanya Yang , Thomas Pshak , Maria Baimas-George , Rose Castle , Trevor L. Nydam , Rashikh A. Choudhury","doi":"10.1016/j.amjsurg.2025.116567","DOIUrl":"10.1016/j.amjsurg.2025.116567","url":null,"abstract":"<div><h3>Introduction</h3><div>Management strategies for Nutcracker syndrome (NCS) differ across vascular and transplant surgery, with options such as left renal vein stenting and renal autotransplantation offering potential long-term pain relief.</div></div><div><h3>Methods</h3><div>A decision-analytic Markov state transition model was generated to simulate NCS management strategies over a two-year time horizon: Stent First, Autotransplantation, Stent Only, and No Intervention.</div></div><div><h3>Results</h3><div>Autotransplantation achieved the highest rate of pain resolution at 77.0 % followed by Stent First at 64.9 % after two years. Stent Only and No Intervention demonstrated the lowest rates of pain resolution at 51.8 % and 0 %, respectively. The estimated cumulative morphine milligram equivalents (MMEs) over the simulated two-year period were approximately 5037 MMEs for Autotransplantation, 7684 MMEs for Stent First, 10,556 MMEs for Stent Only, and 21,900 MMEs for No Intervention.</div></div><div><h3>Conclusion</h3><div>Renal autotransplantation was associated with higher rates of pain resolution and lower opioid usage over a simulated two-year period.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"249 ","pages":"Article 116567"},"PeriodicalIF":2.7,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860492","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

Effectiveness of treatment modalities for signet ring cell adenocarcinoma of the appendix 阑尾印戒细胞腺癌治疗方式的有效性

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-09 DOI: 10.1016/j.amjsurg.2025.116549

Hoe Yan Hor , Melody Pi Yin Tu , Arshia Pessaran , Po Hong Tan , Richard Max Miller , Emily R. Thompson , Travis E. Grotz , Emmanuel M. Gabriel , Sanjay P. Bagaria , Zhi Ven Fong , Nabil Wasif

{"title":"Effectiveness of treatment modalities for signet ring cell adenocarcinoma of the appendix","authors":"Hoe Yan Hor , Melody Pi Yin Tu , Arshia Pessaran , Po Hong Tan , Richard Max Miller , Emily R. Thompson , Travis E. Grotz , Emmanuel M. Gabriel , Sanjay P. Bagaria , Zhi Ven Fong , Nabil Wasif","doi":"10.1016/j.amjsurg.2025.116549","DOIUrl":"10.1016/j.amjsurg.2025.116549","url":null,"abstract":"<div><h3>Background</h3><div>Signet Ring Cell Adenocarcinoma (SRCA) of the appendix is a rare tumor with a poor prognosis and limited information to help guide treatment.</div></div><div><h3>Methods</h3><div>We reviewed patients diagnosed with SRCA between 1998 and 2024 at all Mayo Clinic sites.</div></div><div><h3>Results</h3><div>Among 84 patients, the most common presentation was non-specific abdominal pain (31 %). The majority of tumors were high grade (81 %), and most patients had metastatic disease (69 %). The best overall survival at 5 years was 25 % with complete cytoreduction, which was not significantly improved with the addition of systemic therapy. The addition of HIPEC to cytoreduction surgery showed a clinically significant but not a statistically significant improvement in 5-year survival (20 % vs 5 %, p = 0.059).</div></div><div><h3>Conclusions</h3><div>Cytoreductive surgery with HIPEC showed the best survival outcomes for SRCA, with no demonstrated efficacy for systemic chemotherapy. Overall outcomes remain poor and new treatment modalities are needed.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"249 ","pages":"Article 116549"},"PeriodicalIF":2.7,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931754","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 meta-analysis of the timing of endovascular repair for blunt thoracic aortic injury: Safety and efficacy of early vs. delayed treatment 钝性胸主动脉损伤血管内修复时机的荟萃分析：早期与延迟治疗的安全性和有效性

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-08 DOI: 10.1016/j.amjsurg.2025.116564

Meng Liu , Lina Yu , Dezhi Yu , Qiuming Liu , Huilan Wei , Mingke Yu , Zhiyuan Wang , Rong Wang

{"title":"A meta-analysis of the timing of endovascular repair for blunt thoracic aortic injury: Safety and efficacy of early vs. delayed treatment","authors":"Meng Liu , Lina Yu , Dezhi Yu , Qiuming Liu , Huilan Wei , Mingke Yu , Zhiyuan Wang , Rong Wang","doi":"10.1016/j.amjsurg.2025.116564","DOIUrl":"10.1016/j.amjsurg.2025.116564","url":null,"abstract":"<div><h3>Background</h3><div>Blunt thoracic aortic injury (BTAI) carries a high risk of mortality. Thoracic endovascular aortic repair (TEVAR) is a standard treatment. However, the optimal timing of TEVAR remains debated.</div></div><div><h3>Methods</h3><div>Embase, Web of Science, PubMed, Cochrane, and Chinese databases were searched for studies comparing emergency (≤24h, n = 4233) and delayed (>24h, n = 1457) TEVAR. Meta-analyses were conducted using Stata 15.0. Subgroup and sensitivity analyses were performed.</div></div><div><h3>Results</h3><div>Among 5690 patients (13 studies), emergency TEVAR (n = 4233) showed higher in-hospital mortality (OR = 1.99, 95 %CI 1.53 to 2.58) but shorter hospital stays (SMD = −0.30, 95 %CI -0.54 to −0.07) compared to delayed group (n = 1457). Stroke risk was comparable (OR = 0.89, 95 % CI 0.51 to 1.53). Emergency TEVAR reduced ICU and ventilation durations (P < 0.05).</div></div><div><h3>Conclusion</h3><div>Delayed TEVAR reduces mortality risk, while emergency TEVAR shortens hospitalization without increasing the risk of stroke. Tailored protocols are necessary for patients from different regions. Given insignificant results in the Chinese population, improving multi-center collaboration and guidelines is essential by enhancing resource allocation.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"249 ","pages":"Article 116564"},"PeriodicalIF":2.7,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863525","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

First, heal thy team - the ergonomics imperative when the OR hurts and burns out. 首先，治愈你的团队——当手术室受伤和精疲力竭时，人体工程学是必不可少的。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-08 DOI: 10.1016/j.amjsurg.2025.116563

Julie Hallet, Fahad Alam

引用次数: 0

Exploring relationships of senior medical students' performance with entrustable professional activities assessed by oral examinations. 探讨高年级医学生的表现与委托性专业活动的关系。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-08 DOI: 10.1016/j.amjsurg.2025.116538

Chaise Zozaya, Tamir E Bresler, Philip Bohlmann, Sean Morton, Anjali S Kumar

{"title":"Exploring relationships of senior medical students' performance with entrustable professional activities assessed by oral examinations.","authors":"Chaise Zozaya, Tamir E Bresler, Philip Bohlmann, Sean Morton, Anjali S Kumar","doi":"10.1016/j.amjsurg.2025.116538","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116538","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates the link between senior medical students' performance on oral exams and overall competency, expanding on previous research.</p><p><strong>Methods: </strong>We analyzed the performance of students in surgery rotations with required oral exams, focusing on Core Entrustable Professional Activities for entering Residency (CEPAR) domains. Oral exam scores were compared with end-of-rotation grades to identify correlations.</p><p><strong>Results: </strong>From 2020 to 2024, 158 enrollments in 11 surgical courses by 89 students were analyzed. Of these, 47 % were from required sub-internships. Faculty volunteers contributed ∼150 h. In AY2023, 24 oral exams were conducted. Oral exam scores showed a weak correlation with clinical performance (r = 0.232, P = 0.275) and a moderate correlation with final grades (r = 0.37, P = 0.074). Clinical performance was strongly correlated with final grades (r = 0.86, P < 0.05).</p><p><strong>Conclusion: </strong>The analysis revealed weak-to-moderate correlations between senior medical students' performance on surgery oral examinations and their overall competency, suggesting the oral exam offers additive, rather than redundant, assessment information. This tool may aid in assessing readiness for residency and tailoring educational interventions.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116538"},"PeriodicalIF":2.7,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939481","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

Nomogram-based prediction of postoperative seroma in elderly patients undergoing ambulatory hernia repair 基于nomogram预测老年门诊疝修补术后血清肿的研究

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-07 DOI: 10.1016/j.amjsurg.2025.116565

Yabin Zhu , Yunxiang Li , Hailin Xing , Hong Xie , Zhiguo Yuan , Dong Xiang , Lin Jiang

{"title":"Nomogram-based prediction of postoperative seroma in elderly patients undergoing ambulatory hernia repair","authors":"Yabin Zhu , Yunxiang Li , Hailin Xing , Hong Xie , Zhiguo Yuan , Dong Xiang , Lin Jiang","doi":"10.1016/j.amjsurg.2025.116565","DOIUrl":"10.1016/j.amjsurg.2025.116565","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to explore potential risk factors associated with the occurrence of postoperative seroma in elderly patients after ambulatory hernia surgery and to construct a prediction model.</div></div><div><h3>Methods</h3><div>This study consecutively included elderly patients who underwent ambulatory Lichtenstein tension-free hernioplasty for inguinal hernia from 2021 to 2024. The receiver operating characteristic (ROC) curves were used to assess the predictive and optimal cut-off points of continuous variables. Multivariate regression analysis was used to identify independent risk factors. Based on the identified factors, a nomogram model was further constructed and evaluated using R.</div></div><div><h3>Results</h3><div>A total of 340 patients were enrolled in this study, and 35 cases (10.3 %) developed seroma within three months post-surgery. Body mass index (BMI) ≥ 24.0 (OR: 2.65, 95 %CI: 1.15–6.14, P = 0.023), taking anticoagulant drug (OR: 3.04, 95 %CI: 1.31–7.03, P = 0.009),systemic immune-inflammation index (SII) ≥ 892.5 (OR: 8.34, 95 %CI: 3.44–20.21, P < 0.001), and prognostic nutritional index (PNI) < 50.4 (OR: 5.54, 95 %CI: 1.87–16.41, P = 0.002) were four independent risk factors for seroma by the logistic regression analysis. The AUC of the nomogram based on these four indicators was 0.848, with a sensitivity of 0.751 and a specificity of 0.829. The external validation from another center indicated that the nomogram model acts well with an AUC of 0.903.</div></div><div><h3>Conclusions</h3><div>The nomogram model based on BMI, anticoagulant drug use, SII, and PNI possesses well predictive capabilities for postoperative seroma after ambulatory hernia surgery.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"249 ","pages":"Article 116565"},"PeriodicalIF":2.7,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863616","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

Enhancing the European hernia society classification: The importance of including abdominal wall component loss for optimized surgical planning in complex ventral hernia repair. 加强欧洲疝学会分类：包括腹壁成分损失对优化腹壁疝修补手术计划的重要性。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-07 DOI: 10.1016/j.amjsurg.2025.116566

Luis Felipe Cabrera Vargas, William Mauricio Basto Borbon, Manuela Jaramillo Vasquez, Maria Diaz Sanchez, Nicolas Forero Ramirez

引用次数: 0

Is there a discrepancy in general surgery recertification rates between genders? An analysis of data from the American board of surgery. 普通外科再认证率在性别之间是否存在差异？对美国外科委员会数据的分析。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-08-07 DOI: 10.1016/j.amjsurg.2025.116552

Erika Paola Brigmon, Vika M Guloyan, Mustafa Khan, Susannah Nicholson, Elizabeth Scherer, Daniel L Dent

{"title":"Is there a discrepancy in general surgery recertification rates between genders? An analysis of data from the American board of surgery.","authors":"Erika Paola Brigmon, Vika M Guloyan, Mustafa Khan, Susannah Nicholson, Elizabeth Scherer, Daniel L Dent","doi":"10.1016/j.amjsurg.2025.116552","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116552","url":null,"abstract":"<p><strong>Introduction: </strong>The American Board of Surgery (ABS) recertification process is required to maintain certification. We hypothesized that the percentage of women becoming certified in General Surgery (GS) has increased over the past 40 years and that they stay in the workforce for a shorter period of time than their male counterparts.</p><p><strong>Methods: </strong>This is a retrospective study using deidentified ABS data. Descriptive statistics and Chi-square were used to compare male and female recertification rates. Significance was set at a p-value less than 0.05.</p><p><strong>Results: </strong>The percentage of women obtaining initial certification had a statistically significant increase over time. Female surgeons that achieved initial certification between 1998 and 2007 were seen to achieve first recertification at a higher rate. Despite that, maintaining recertification over subsequent decades lags behind that of male surgeons, specifically at the second recertification - 20-year time point.</p><p><strong>Conclusion: </strong>Overall, these data align with studies showing that female physicians exit the workforce at higher rates. This discrepancy in long-term recertification represents an opportunity to improve our clinical work environments so that all surgeons can thrive and have long, productive careers.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116552"},"PeriodicalIF":2.7,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939390","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

Effect of implicit bias in the operating room and beyond 内隐偏见在手术室内外的影响。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-07-31 DOI: 10.1016/j.amjsurg.2025.116533

Veronica Jones MD, FACS

引用次数: 0

Cholecystectomy patient characteristics on Acute Care Surgery versus general surgery services. 胆囊切除术患者在急诊外科与普通外科服务中的特点。

IF 2.7 3区医学

American journal of surgery Pub Date : 2025-07-30 DOI: 10.1016/j.amjsurg.2025.116548

Tynan H Friend, Madeline Goosman, Adam Aluisio, Brent Emigh, Benjamin Hall, Stephanie Lueckel, Daithi S Heffernan, Andrew Stephen

引用次数: 0