American Surgeon最新文献_第2页

The Competitive Edge: Improving American Board of Surgery In-Training Examination Scores Through a Team-Based Competition. 竞争优势：通过团队竞赛提高美国外科培训委员会考试成绩。

IF 1 4区医学

American Surgeon Pub Date : 2025-06-01 Epub Date: 2025-02-04 DOI: 10.1177/00031348251318381

Sean E Masters, Kathryn K Howard, Darci C Foote, Joshua Halka, Diane Studzinski, Rose Callahan, Felicia A Ivascu, Begum Akay

{"title":"The Competitive Edge: Improving American Board of Surgery In-Training Examination Scores Through a Team-Based Competition.","authors":"Sean E Masters, Kathryn K Howard, Darci C Foote, Joshua Halka, Diane Studzinski, Rose Callahan, Felicia A Ivascu, Begum Akay","doi":"10.1177/00031348251318381","DOIUrl":"10.1177/00031348251318381","url":null,"abstract":"BackgroundThe American Board of Surgery (ABS) In-Training Examination (ABSITE) scores are predictive of passing the ABS qualifying exam and have become a marker of residency education success. A competitive team-based approach to encourage self-studying and didactic participation is a novel method of ABSITE preparation. We aimed to determine if this method significantly improves residents' percentile performances on the ABSITE.MethodsRetrospective review of ABSITE percentile scores were compared before and after implementation of a purchased online question bank (TrueLearn LLC, Mooresville, NC), a team-based competition, and a virtual format of the team-based competition.ResultsThe median ABSITE percentile at the program level increased from 40.0 (IQR 21.0-67.0) in 2011 to 77.0 by 2022 (IQR 60.0-91.0) (P < 0.0001). After implementation of the team-based competition, ABSITE median percentile rose significantly from 67.0 (IQR 31.5-85.5) to 84.5 (IQR 60.8-91.0) (P = 0.026). This did not change significantly after a transition to a virtual format of the team-based competition in 2021 (P = 0.146) and 2022 (P = 0.335). There was no significant relationship between the number of TrueLearn questions taken and ABSITE scores specifically before and after implementation of the team-based competition (AUC = 0.0002, Spearman's r (67) 0.064, P = 0.605). Furthermore, the team-based competition was well received by residents and was believed to be beneficial to their studying.DiscussionThe team-based competition is easy to implement and improves ABSITE performance through means other than encouraging residents to take more practice questions. The team-based competition is well-received by residents and may prove beneficial to board examination preparation and pass rates.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"933-939"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187984","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

Near-Hanging Injuries: Perspective for the Trauma and Emergency Surgeon. 近悬吊伤：创伤和急诊外科医生的视角。

IF 1 4区医学

American Surgeon Pub Date : 2025-06-01 Epub Date: 2025-04-03 DOI: 10.1177/00031348251329500

Patrizio Petrone, Carlos J García-Sánchez, Shahidul Islam, John McNelis, Corrado P Marini

{"title":"Near-Hanging Injuries: Perspective for the Trauma and Emergency Surgeon.","authors":"Patrizio Petrone, Carlos J García-Sánchez, Shahidul Islam, John McNelis, Corrado P Marini","doi":"10.1177/00031348251329500","DOIUrl":"10.1177/00031348251329500","url":null,"abstract":"Introduction: Near-hanging injuries are a significant cause of morbidity and mortality worldwide. These injuries result in complex clinical presentations due to the combination of mechanical asphyxia and potential neck and cervical spine trauma. The primary objectives of this narrative review include assessing the incidence, sex distribution, pathophysiology, prognostic indicators, neurologic outcomes, and treatment strategies.Methods: Review performed using Medline in English from 1946 to 2023. Excluded: articles of accidental, sex-related, auto-asphyxiation, cancer-related, and pediatric near-hanging, review articles, and case reports.Results: 53 articles were first reviewed; 30 articles encompassing 4712 patients had complete demographic and neck injuries data. Sixteen articles reported the presence and absence of ligature markings in 1778 patients. Ligature markings were present in 1103 (73.5%). Median Age: 33 (29-38) 75.7% male distribution. Suicide attempt: 97.3%. Neck vascular injuries, aerodigestive, and neck bony injuries occurred in 83 (1.8%), 123 (2.6%), and 125 (2.7%), respectively. Cardiac arrest: 1195 (25.3%) and GCS<9-2125 (45%) were the major contributors to the mortality: 26.9%. Glasgow Outcome Score>3 or by a Cerebral Performance Category score of 1-2 was documented in 35.2% of patients. Hyperbaric oxygen treatment, hypothermia treatment, and targeted temperature management did not appear to be useful from the standpoint of survival in patients who suffered a cardiac arrest.Conclusions: Near-hanging as an attempt to suicide is more frequent in young male patients. The incidence of associated neck injuries is low; mortality is likely to occur in patients with cardiac arrest with an associated neurologic injury. There is insufficient evidence to support the use of hyperbaric oxygen treatment, hypothermia treatment, and targeted temperature management in patients who have suffered a cardiac arrest and severe neurologic injury after near-hanging.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1025-1035"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771139","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

Factors Predicting Incidentally Found Appendiceal Tumors Following Appendectomy: Propensity Score Matching Analysis. 预测阑尾切除术后意外发现阑尾肿瘤的因素：倾向评分匹配分析。

IF 1 4区医学

American Surgeon Pub Date : 2025-06-01 Epub Date: 2025-02-21 DOI: 10.1177/00031348251323706

Sadettin Er, Abidin Göktaş Goktas, Sabri Özden Ozden, Merve Akın Akin, Tezcan Akın Akin, Hüseyin Fahri Martlı Martli, Arzu Hazal Aydın Aydin, Birkan Birben, Fatih Acehan

{"title":"Factors Predicting Incidentally Found Appendiceal Tumors Following Appendectomy: Propensity Score Matching Analysis.","authors":"Sadettin Er, Abidin Göktaş Goktas, Sabri Özden Ozden, Merve Akın Akin, Tezcan Akın Akin, Hüseyin Fahri Martlı Martli, Arzu Hazal Aydın Aydin, Birkan Birben, Fatih Acehan","doi":"10.1177/00031348251323706","DOIUrl":"10.1177/00031348251323706","url":null,"abstract":"PurposeThe factors that predict coincidental appendiceal neoplasms in patients who underwent appendectomy due to appendicitis were investigated.Methods5829 patients diagnosed with appendicitis and underwent appendectomy in the department of surgery were examined. Among these patients, patients with appendiceal neoplasia and benign pathology were selected by propensity score matching analysis in a ratio of 1:4. As a result of analysis, 74 and 274 patients were grouped as appendiceal neoplasia and benign pathology, respectively.ResultsThe mean age of the 348 appendiceal neoplasia and benign pathology groups included in the study was 45.6 and 46.4, respectively. Appendiceal diameter, contrast enhancement in the appendix wall, and neutrophil count were independent parameters for appendiceal neoplasia pathology. The AUC value of the combination of appendix diameter, lack of enhancement in the appendix wall, and neutrophil count in distinguishing appendiceal neoplasia pathology was 0.787.ConclusionAppendix diameter, lack of wall enhancement, and neutrophil count are the three predictive indicators useful in helping clinicians suspect appendiceal neoplasms.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"946-953"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476201","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

Galen's Surgical Legacy: Treating the Children in Ancient Rome. 盖伦的外科遗产：古罗马儿童的治疗。

IF 1 4区医学

American Surgeon Pub Date : 2025-06-01 Epub Date: 2025-03-18 DOI: 10.1177/00031348251329486

Michele Augusto Riva, Francesco Petrella, Maria Emilia Paladino

引用次数: 0

The State of Surgical Care Access in America: Current Challenges, Disparities, and Emerging Solutions. 美国外科护理准入状况：当前的挑战、差距和新兴解决方案。

IF 1 4区医学

American Surgeon Pub Date : 2025-06-01 Epub Date: 2025-04-09 DOI: 10.1177/00031348251331283

S M Johnson, K Miller-Hammond

引用次数: 0

Letter re: Pathological Examination in Pilonidal Sinus Surgery: Evaluating Necessity and Cost-Effectiveness: A 10-Year Retrospective Analysis. 关于：乳头状窦手术中的病理学检查：评估必要性和成本效益：10 年回顾性分析。

IF 1 4区医学

American Surgeon Pub Date : 2025-06-01 Epub Date: 2025-02-11 DOI: 10.1177/00031348251318401

İlyas Kudaş, Fatih Başak, Yahya Kemal Çalışkan, Aylin Acar, Hüsna Tosun

引用次数: 0

Is Pneumatosis and Portal Venous Air an Indication for Surgical Intervention: A Systematic Review. 肺气肿和门静脉空气是手术干预的指征吗：一项系统综述。

IF 1 4区医学

American Surgeon Pub Date : 2025-06-01 Epub Date: 2025-02-05 DOI: 10.1177/00031348251318378

N Pina, D Winston, T Kasprzycki, M Gul Muhammad, M Ingram, R Joyner, G Kowdley

{"title":"Is Pneumatosis and Portal Venous Air an Indication for Surgical Intervention: A Systematic Review.","authors":"N Pina, D Winston, T Kasprzycki, M Gul Muhammad, M Ingram, R Joyner, G Kowdley","doi":"10.1177/00031348251318378","DOIUrl":"10.1177/00031348251318378","url":null,"abstract":"Pneumatosis and portal venous gas are radiological findings that have been historically associated with 70% mortality, and usually trigger surgical intervention. This is due to their association with acute mesenteric ischemia. As cross-sectional imaging usage has increased in recent years, these findings have also been observed in patients with indolent symptoms, the true mortality among patients with pneumatosis or portal venous gas is now theorized to be significantly lower than previously stated. This systematic review was designed to assess the mortality rate among patients with pneumatosis and portal venous gas on initial imaging. We systematically searched Embase, Web of Science, PubMed, and Scopus. Eleven articles were included for final analysis. Ten articles assessed mortality, and included a total of 308 patients, with an overall mortality rate of 31%. Eight articles reported on both ischemia and mortality (n = 233). Of the patients with confirmed ischemia (n = 74), a mortality rate of 69% (n = 51) was noted. Of those without ischemia (n = 159), a mortality rate of 14% (n = 22) was seen. Four studies reported pneumatosis and ischemia (n = 45), in which 64% (n = 29) had ischemia. Four articles reported on portal venous air and ischemia (n = 78). Ischemia was confirmed in 44% of these patients (n = 34). Given an overall mortality of 31% vs prior estimates of 70% for patients with these findings, the decision for surgery on patients with these imaging findings should be made utilizing the overall clinical picture of the patient.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"940-945"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254031","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

Risk Factors and Timing of Fasciotomy for Isolated Pediatric Lower Extremity Trauma. 孤立性儿童下肢创伤筋膜切开术的危险因素和时机。

IF 1 4区医学

American Surgeon Pub Date : 2025-06-01 Epub Date: 2025-04-01 DOI: 10.1177/00031348251331292

Mennatalla Hegazi, Jeffry Nahmias, Michael Lekawa, Matthew Dolich, Allen Kong, Cristobal Barrios, Areg Grigorian

{"title":"Risk Factors and Timing of Fasciotomy for Isolated Pediatric Lower Extremity Trauma.","authors":"Mennatalla Hegazi, Jeffry Nahmias, Michael Lekawa, Matthew Dolich, Allen Kong, Cristobal Barrios, Areg Grigorian","doi":"10.1177/00031348251331292","DOIUrl":"10.1177/00031348251331292","url":null,"abstract":"BackgroundPrevious single-center reports have demonstrated a longer time from traumatic leg injury to fasciotomy in pediatric trauma patients (PTPs) with compartment syndrome. We hypothesized most fasciotomies in isolated pediatric lower extremity trauma (LET) are delayed (>6 hours from admission) and sought to investigate risk factors for pediatric fasciotomy.MethodsThe 2017-2020 TQIP database was queried for PTPs <17 years old with isolated injury to the leg. The primary outcome was fasciotomy. A multivariable logistic regression analysis was performed to identify associated risk factors for fasciotomy.ResultsFrom 97,217 PTPs, 358 (0.4%) underwent a fasciotomy, with a majority being delayed (60.3%); the median time to fasciotomy was 9.6 hours. Patients undergoing fasciotomy were older (median age 14 vs 12 years, P < 0.001), had a higher rate of severe LET (4.9% vs 1.2%, P < 0.001), and had tibial fracture (70.7% vs 27.6%, P < 0.001). They also had increased rates of in-hospital complications (14.2% vs 0.6%, P < 0.001), limb loss (1.1% vs <0.1%, P < 0.001), and longer median length of stay (LOS) (5 vs 2 days, P < 0.001). The most injured vessel in those undergoing fasciotomy was the popliteal artery (9.9%). Independent risk factors associated with fasciotomy included injuries to the popliteal vein (OR 30.72, CI 11.06-85.29, P < 0.001), femoral vein (OR 18.19, CI 6.40-51.69, P < 0.001), and popliteal artery (OR 13.74, CI 8.45-22.34, P < 0.001) and tibial fracture (OR 7.46, CI 5.57-10.00, P < 0.001).DiscussionMost fasciotomies were delayed for PTPs with isolated lower extremity injury. Popliteal vein injury increases the risk for fasciotomy 30-fold. Patients undergoing fasciotomy tend to have more complications and longer LOS.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"998-1005"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750711","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

Letter re: BMI is Inadequate in Proposing an Immunological Effect of Excess Adipose Tissue. 信re: BMI不足以提出多余脂肪组织的免疫效应。

IF 1 4区医学

American Surgeon Pub Date : 2025-06-01 Epub Date: 2025-02-19 DOI: 10.1177/00031348251314155

Sol Lee, Davin Agustines

引用次数: 0

Effects of Planned Stoma Before Neoadjuvant Chemoradiation in Patients With Endoscopically Obstructing Colorectal Cancer. 内镜下梗阻结直肠癌患者新辅助放化疗前计划造口的影响。

IF 1 4区医学

American Surgeon Pub Date : 2025-06-01 Epub Date: 2025-03-20 DOI: 10.1177/00031348251329482

Zhan-Xiang Hai, Jun-Nan Zhao, Xu-Rui Liu, Shu-Pei Qu, Quan Lv, Chun-Yi Wang

{"title":"Effects of Planned Stoma Before Neoadjuvant Chemoradiation in Patients With Endoscopically Obstructing Colorectal Cancer.","authors":"Zhan-Xiang Hai, Jun-Nan Zhao, Xu-Rui Liu, Shu-Pei Qu, Quan Lv, Chun-Yi Wang","doi":"10.1177/00031348251329482","DOIUrl":"10.1177/00031348251329482","url":null,"abstract":"PurposeIn order to investigate whether colorectal cancer (CRC) patients with endoscopic obstruction benefited from a planned stoma before neoadjuvant chemoradiation (nCRT).MethodsPatients who were diagnosed with CRC with endoscopic obstruction at a single clinical center from January 2017 to April 2022 were retrospectively collected. Baseline characteristics and short-term and long-term outcomes were compared between the stoma group and the no stoma group. Statistical analysis was performed using SPSS (version 22.0) software.ResultsA total of 51 CRC patients with endoscopic obstruction were included in this study. Eleven (21.6%) patients received a planned stoma before nCRT, and 40 (78.4%) patients were treated with immediate nCRT. The mean time from diagnosis to nCRT was 30.6 days for the stoma group and 11.9 days for the no stoma group. There was a significant delay in the initiation of nCRT in the stoma group (P < 0.05). In terms of complications, there was a statistical difference between the stoma group and the no stoma group (P < 0.05). Planned stoma before nCRT did not affect survival for patients with endoscopically obstructing CRC (P > 0.05).ConclusionA planned stoma caused delay in nCRT; the no stoma group was more likely to develop perforation or obstruction of the tumor during nCRT. A comprehensive assessment might be needed to determine whether a planned stoma was necessary in CRC patients with endoscopic obstruction.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"978-983"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668613","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