American Surgeon最新文献

An Investigation of Surgical Feeding Access in Patients With Remote Bariatric Surgery History. 有远程减肥手术史患者手术喂养通路的调查。

IF 0.9 4区医学

American Surgeon Pub Date : 2026-06-01 Epub Date: 2025-12-23 DOI: 10.1177/00031348251409255

Renee Rumsey, Corbin Lemon, Alison Smith, Michael Cook

{"title":"An Investigation of Surgical Feeding Access in Patients With Remote Bariatric Surgery History.","authors":"Renee Rumsey, Corbin Lemon, Alison Smith, Michael Cook","doi":"10.1177/00031348251409255","DOIUrl":"10.1177/00031348251409255","url":null,"abstract":"BackgroundPatients with a history of bariatric surgery present a challenge in obtaining surgical feeding access due to altered gastrointestinal anatomy after these procedures. The aim of this study was to evaluate provider practice patterns for feeding tube access in bariatric patients.MethodsPatients with a history of either Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy who required surgical feeding access remote from their bariatric surgery were identified retrospectively at a single institution. Data on the nature of these procedures and their associated complications were obtained. A literature review was conducted on tube placement procedures after bariatric and foregut surgery and 11 publications were included.ResultsGastrostomy tubes (GTs) (n = 26/42, 61.9%) were placed most frequently, followed by jejunostomy tubes (JTs) (n = 13/42, 31.0%), and gastrojejunostomy tubes (n = 3/42, 7.1%). Most feeding tubes were placed in patients with a history of a RYGB (n = 29/38, 76.3%). General surgeons performed most of these procedures (n = 37/42, 88.1%). Feeding tube-associated complications were reported in most cases (n = 22/42, 52.4%). Two patients receiving JTs after sleeve gastrectomy developed aspiration pneumonia (n = 2/42, 4.8%).DiscussionThis study highlights the need for further research on surgical feeding access in patients with a history of bariatric surgery. Larger, prospective studies may help to define guidelines for feeding tube access in bariatric patients.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1833-1838"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Instant Answers, Enduring Responsibility: Teaching Judgment in the Age of Artificial Intelligence. 即时回答，持久责任：人工智能时代的教学判断。

IF 0.9 4区医学

American Surgeon Pub Date : 2026-06-01 Epub Date: 2026-02-11 DOI: 10.1177/00031348261422742

Don K Nakayama

{"title":"Instant Answers, Enduring Responsibility: Teaching Judgment in the Age of Artificial Intelligence.","authors":"Don K Nakayama","doi":"10.1177/00031348261422742","DOIUrl":"10.1177/00031348261422742","url":null,"abstract":"Artificial intelligence (AI) has become embedded in medical practice and education. In today's digital world, medical learners use AI tools to arrive at plausible diagnoses with speed and accuracy that can equal those of experienced clinicians. This shift challenges a long-standing assumption in medical education that clinical error primarily reflects gaps in factual knowledge. Digital information and AI now make facts immediately accessible. Errors arise when AI is misapplied, when users accept outputs with unwarranted confidence, and when clinicians fail at the therapeutic judgment required to act. Two brief outpatient encounters involving a third-year medical student illustrate the gap between technology-assisted diagnosis and the human decision to act. In both cases, the student used AI and digital resources to reframe the clinical problem in a useful way. The responsibility to verify the diagnosis, assess risk, and accept the consequences of action remained with the attending physician. AI collapses the distance between presentation and diagnosis. It leaves untouched the distance between knowledge and responsibility an intersection that defines medical professionalism and now focuses explicit attention in medical education.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1625-1626"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146163383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

C¹¹ Choline-PET/CT as a Localization Standard for Reoperative Primary Hyperparathyroidism. C11胆碱- pet /CT作为再手术原发性甲状旁腺功能亢进的定位标准

IF 0.9 4区医学

American Surgeon Pub Date : 2026-06-01 Epub Date: 2026-01-05 DOI: 10.1177/00031348251413528

Peter Hopmann, Sarah Lund, Trenton Foster, Benzon Dy, Travis McKenzie, Geoffrey B Johnson, Robert A Wermers, Melanie Lyden

{"title":"C11 Choline-PET/CT as a Localization Standard for Reoperative Primary Hyperparathyroidism.","authors":"Peter Hopmann, Sarah Lund, Trenton Foster, Benzon Dy, Travis McKenzie, Geoffrey B Johnson, Robert A Wermers, Melanie Lyden","doi":"10.1177/00031348251413528","DOIUrl":"10.1177/00031348251413528","url":null,"abstract":"IntroductionPrevious studies have demonstrated that C11 choline positron emission tomography/computed tomography (Choline-PET/CT) can localize abnormal parathyroid glands in the reoperative setting. This study assesses a large volume of patients with primary hyperparathyroidism (1HPT) who underwent Choline-PET/CT to confirm its utility in the setting of negative or equivocal conventional imaging.MethodsAll patients who underwent Choline-PET/CT for evaluation of 1HPT from July 2017 to July 2024 at a single institution were reviewed. Inclusion criteria were patients who underwent parathyroidectomy and had lab testing to assess for cure (defined as >50% drop from baseline PTH and into normal range, or resolution of hypercalcemia at follow-up). Sensitivity, positive predictive value (PPV), false negative rate (FNR), and accuracy were compared to conventional imaging (neck ultrasound, parathyroid scan, and parathyroid four-dimensional CT (4D-CT)). Subgroup analysis was conducted comparing sensitivity of modalities among index operations and separately in reoperations.Results84 patients were included for analysis. 61 failed to localize on at least one conventional modality, and 15 failed to localize on all conventional studies. 67 patients (80%) achieved cure, of which 53 were reoperations. Choline-PET/CT outperformed conventional modalities across sensitivity, PPV, FNR, and accuracy. Choline-PET/CT also outperformed conventional modalities when comparing sensitivity in both subgroups.ConclusionC11 choline-PET/CT is a valuable imaging modality in the reoperative setting and demonstrates utility for index operations. It provides localization when other modalities fail and allows for a high surgical cure rate. Further investigation into its utility as a primary imaging modality is warranted.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1806-1812"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145905309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Predictive Value of Magee Equation 3 for Tumor and Axillary Response to Neoadjuvant Chemotherapy in HR-Positive, HER2-Negative Breast Cancer. Magee方程3对hr阳性、her2阴性乳腺癌肿瘤和腋窝对新辅助化疗反应的预测价值

IF 0.9 4区医学

American Surgeon Pub Date : 2026-06-01 Epub Date: 2026-01-08 DOI: 10.1177/00031348261416096

Mustafa Onur Beştaş, Erkan Güler, Ahmet Dağ, Recep Okan Üstün, Sami Benli, Mustafa Berkeşoğlu

{"title":"Predictive Value of Magee Equation 3 for Tumor and Axillary Response to Neoadjuvant Chemotherapy in HR-Positive, HER2-Negative Breast Cancer.","authors":"Mustafa Onur Beştaş, Erkan Güler, Ahmet Dağ, Recep Okan Üstün, Sami Benli, Mustafa Berkeşoğlu","doi":"10.1177/00031348261416096","DOIUrl":"10.1177/00031348261416096","url":null,"abstract":"BackgroundHormone receptor-positive (HR+), HER2-negative breast cancer demonstrates limited chemosensitivity, making patient selection for neoadjuvant chemotherapy (NACT) a challenge. The Magee Equation 3 (ME3), derived from routine immunohistochemistry, provides a cost-effective surrogate for genomic assays. This study aimed to evaluate the predictive value of ME3 for both primary tumor and axillary response to NACT in HR+/HER2- breast cancer.MethodsWe retrospectively analyzed 116 patients with HR+/HER2- breast cancer who received NACT between 2018 and 2023. Magee Equation 3 scores, calculated from ER, PR, HER2, and Ki-67 data, were stratified into low (<18), intermediate (18-31), and high (>31) categories. Pathological complete response (pCR) and axillary response were assessed using Residual Cancer Burden criteria. Receiver operating characteristic (ROC) analyses determined optimal ME3 cut-offs.ResultsOverall, 16.4% of patients achieved tumor pCR, and 59.5% achieved axillary response. No patients with ME3 <18 achieved pCR, compared with 7.4% in the intermediate and 46.9% in the high category (P < .001). Axillary response rates were 13.3%, 63.0%, and 96.9% across the low, intermediate, and high groups, respectively (P < .001). Receiver operating characteristic analysis identified ME3 >31.2 as the optimal cut-off for tumor pCR (AUC 0.863, sensitivity 78.9%, and specificity 87.6) and >22.5 for axillary response (AUC 0.887, sensitivity 78.3%, and specificity 85.1).DiscussionMagee Equation 3 is a strong predictor of both tumor and axillary response following NACT in HR+/HER2- breast cancer. By offering a practical and inexpensive alternative to genomic assays, ME3 may support treatment decision-making, particularly for axillary management, and has the potential to expand clinical utility in settings where genomic testing is limited.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1799-1805"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Application of Secondary Intention Healing in Repairing Facial Defects: A Practical Review for General Surgeons. 二次意向愈合在面部缺损修复中的应用：普通外科医生的实践回顾。

IF 0.9 4区医学

American Surgeon Pub Date : 2026-06-01 Epub Date: 2025-12-26 DOI: 10.1177/00031348251413539

Shenzhen Gao, ZengYang Feng, Liying Tu, He Chen, Jinde Lin, Weicheng Gao

引用次数: 0

Short-Term Outcomes of Robotic-Assisted Sigmoidectomy Using the Senhance Digital Laparoscopy System: A Comparison With Laparoscopic Surgery Using Propensity Score Matching. 使用增强数字腹腔镜系统的机器人辅助乙状结肠切除术的短期疗效：与使用倾向评分匹配的腹腔镜手术的比较。

IF 0.9 4区医学

American Surgeon Pub Date : 2026-06-01 Epub Date: 2026-01-11 DOI: 10.1177/00031348261415617

Sohei Akuta, Yasumitsu Hirano, Yasuhiro Ishiyama, Yamato Misuzu, Takatsugu Fujii, Chikashi Hiranuma, Yusuke Kinugasa

{"title":"Short-Term Outcomes of Robotic-Assisted Sigmoidectomy Using the Senhance Digital Laparoscopy System: A Comparison With Laparoscopic Surgery Using Propensity Score Matching.","authors":"Sohei Akuta, Yasumitsu Hirano, Yasuhiro Ishiyama, Yamato Misuzu, Takatsugu Fujii, Chikashi Hiranuma, Yusuke Kinugasa","doi":"10.1177/00031348261415617","DOIUrl":"10.1177/00031348261415617","url":null,"abstract":"BackgroundColorectal cancer is a common and deadly form of cancer. Sigmoid colon cancer is the most prevalent type of colon cancer. Robotic-assisted surgical systems, like the Senhance Digital Laparoscopy System, have attracted considerable attention in recent years. The purpose of this study was to confirm the non-inferiority of Senhance-assisted surgery regarding its short-term safety compared with conventional laparoscopic surgery for sigmoid colon cancer.MethodsThis retrospective single-center study analyzed data from patients undergoing a sigmoidectomy between March 2020 and 2025. Propensity score matching was employed to create comparable groups. Patient characteristics, short-term surgical outcomes, and pathological data were assessed. Postoperative complications were graded using the Clavien-Dindo system.ResultsPrior to propensity score matching, there were differences in cancer stage between groups. After matching, two groups comprising 45 patients each were comparable across various factors. The operative time was significantly longer in the Senhance-assisted group compared with the conventional laparoscopic surgery group (236 min vs 204 min, P = .001), underscoring the importance of optimizing surgical techniques. Postoperative Numerical Rating Scale pain scores were significantly lower in the Senhance-assisted group on day 1 (3 [1-5] vs 4 [2-6], P = .03) and day 3 (2 [0-4] vs 3 [2-5], P = .02). However, no there were no significant differences in blood loss, complications, or pathological characteristics between the groups.ConclusionsThis study demonstrated that Senhance-assisted sigmoidectomy was non-inferior to conventional laparoscopic surgery in terms of short-term safety outcomes.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1721-1729"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

High-Fidelity Simulated Teaching Cases Improve Resident Confidence Performing Laparoscopic Cholecystectomy Procedures. 高保真模拟教学案例提高住院医师施行腹腔镜胆囊切除术的信心。

IF 0.9 4区医学

American Surgeon Pub Date : 2026-06-01 Epub Date: 2026-01-09 DOI: 10.1177/00031348261416095

Alexandra Z Agathis, Sarah Cao, Lee S Schmidt, Jeanne Z Wu, Celia M Divino

{"title":"High-Fidelity Simulated Teaching Cases Improve Resident Confidence Performing Laparoscopic Cholecystectomy Procedures.","authors":"Alexandra Z Agathis, Sarah Cao, Lee S Schmidt, Jeanne Z Wu, Celia M Divino","doi":"10.1177/00031348261416095","DOIUrl":"10.1177/00031348261416095","url":null,"abstract":"IntroductionTo assess if performing a high-fidelity simulated laparoscopic cholecystectomy in a teaching case format improves junior residents' operative confidence or senior residents' comfort in coaching.MethodsThis is a prospective observational study including categorical general surgery residents across all postgraduate levels (1-5) from a program based in New York, NY. Randomly paired junior and senior residents performed a laparoscopic cholecystectomy teaching case on a high-fidelity laparoscopic simulator. Residents answered pre- and post-simulation survey questions regarding operative experience, laparoscopic surgery comfort, biliary anatomy knowledge, confidence coaching, and impressions of the exercise.ResultsThe study included n = 30 residents. Juniors reported significant improvements in confidence obtaining a critical view with and without anatomic variants, placing trocars, and detecting their instruments on-screen (P < .05). Seniors experienced non-statistically significant improvements in coaching confidence (P > .05). On a scale of 1-5, seniors felt these exercises should be completed by both seniors (3.47, SD 1.20) and juniors (3.67, SD 0.94) before their first teaching cholecystectomy. There were no significant associations found between survey responses and simulator performance metrics (instrument path length or number of collisions) on regression analysis. In free responses, junior residents emphasized the benefits of having a senior mentor with real-life operative experience to provide nuanced guidance and tailored real-time feedback.DiscussionThese findings suggest that junior residents' technical comfort improved after performing a simulated teaching laparoscopic cholecystectomy. By implementing coached simulation in early training, residents will enter the operating room with enhanced confidence to become more autonomous.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1752-1758"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Serous Cystadenocarcinoma of the Pancreas: A Systematic Review of Presentation, Management, and Outcomes. 胰腺浆液性囊腺癌：表现、治疗和结果的系统回顾。

IF 0.9 4区医学

American Surgeon Pub Date : 2026-06-01 Epub Date: 2026-01-20 DOI: 10.1177/00031348261419750

Spencer Wilhelm, Ryan T Davis, Michael Tolkacz, Diane Studzinski, Rose Callahan, Alexander M DeMare

{"title":"Serous Cystadenocarcinoma of the Pancreas: A Systematic Review of Presentation, Management, and Outcomes.","authors":"Spencer Wilhelm, Ryan T Davis, Michael Tolkacz, Diane Studzinski, Rose Callahan, Alexander M DeMare","doi":"10.1177/00031348261419750","DOIUrl":"10.1177/00031348261419750","url":null,"abstract":"IntroductionSerous cystadenocarcinoma (SCAc) of the pancreas is the rare malignant counterpart of serous cystadenoma, with fewer than 40 reported cases. Its clinical behavior and optimal management remain poorly defined. This systematic review summarizes the presentation, diagnosis, treatment, and outcomes of pancreatic SCAc.MethodsA systematic search of PubMed, Scopus, Web of Science, and Embase was performed from inception through December 2025. Thirty-six studies describing 38 histologically confirmed cases met inclusion criteria. Data on demographics, tumor characteristics, imaging, management, and outcomes were extracted and summarized descriptively.ResultsMedian age at diagnosis was 66.5 years (IQR 55.8-71.0), and 71% of patients were female. Abdominal pain and incidental imaging findings were the most common presentations. Tumors were typically large and located in the pancreatic body or tail. Local invasion occurred in 74% of cases. Distant metastases were present in 68% (26 of 38), most commonly to the liver. All patients underwent surgical resection. Chemotherapy use was rare. Recurrence was reported in 26% of cases, with a median disease-free interval of roughly 50 months. Disease-related mortality was infrequently reported.ConclusionsDespite frequent invasion and metastasis, SCAc often demonstrates an indolent course, and long-term survival is common after resection. Surgical management remains central to treatment. Given its rarity and diagnostic limitations, individualized management and prolonged surveillance are warranted.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1773-1779"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146008635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Unintentional Firearm-Related Injury and Death at a Level 1 Trauma Center Located in a Rural State. 位于乡村州的一级创伤中心的非故意枪支相关伤害和死亡。

IF 0.9 4区医学

American Surgeon Pub Date : 2026-06-01 Epub Date: 2026-01-14 DOI: 10.1177/00031348251412262

Nada Jibbe, Kelly Lightwine, Hayrettin Okut, Elizabeth Ablah, James M Haan

引用次数: 0

Cranial Access in Preperitoneal Pretransversalis eTEP (PeTEP) for Primary Midline Hernias: Technical Description of a Novel Approach. 腹膜前前横肌eTEP （PeTEP）治疗原发性中线疝：一种新入路的技术描述。

IF 0.9 4区医学

American Surgeon Pub Date : 2026-06-01 Epub Date: 2026-02-19 DOI: 10.1177/00031348261419754

Juan Ramón Gómez-López, Jeancarlos Trujillo-Díaz, Pilar Concejo-Cutoli, Ana Benítez Riesco, Francesco Schenone, Rosaura Bennazar Nin, Juan Carlos Martín-Del Olmo

{"title":"Cranial Access in Preperitoneal Pretransversalis eTEP (PeTEP) for Primary Midline Hernias: Technical Description of a Novel Approach.","authors":"Juan Ramón Gómez-López, Jeancarlos Trujillo-Díaz, Pilar Concejo-Cutoli, Ana Benítez Riesco, Francesco Schenone, Rosaura Bennazar Nin, Juan Carlos Martín-Del Olmo","doi":"10.1177/00031348261419754","DOIUrl":"10.1177/00031348261419754","url":null,"abstract":"Minimally invasive abdominal wall surgery continues to evolve, and the cranial approach to the PeTEP (preperitoneal/pretransversalis enhanced-view totally extraperitoneal) technique represents a meaningful addition to our armamentarium. In this report, we present a 62-year-old obese male (BMI 34.3) with a combined umbilical and epigastric hernia (EHS M2-M3 W1) managed using the cranial PeTEP approach. The procedure is detailed step-by-step to highlight technical nuances. The operation was completed without complications in 150 minutes, and the patient was discharged within 24 hours with no postoperative pain. Follow-up at 1 week, 1 month, 3 months and 6 months showed no adverse events or recurrence. Based on this experience, the cranial PeTEP approach appears to be a safe, effective, and reproducible option for primary midline hernia repair in appropriately selected patients, enabling wide preperitoneal mesh placement without entering the retromuscular space. Larger studies with longer follow-up are warranted to further validate these findings.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1697-1700"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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