American Surgeon最新文献

{"title":"The Evolution of Reconstructive Microsurgery in Warfare.","authors":"Amy MiHyun Jang, Zachariah L Lee","doi":"10.1177/00031348261496609","DOIUrl":"https://doi.org/10.1177/00031348261496609","url":null,"abstract":"<p><p>War has been a powerful accelerant of innovation in reconstructive surgery. From the storytelling of Greek heroes of war to modern warfare, each conflict expanded on what was surgically possible. The World Wars introduced pedicled flaps and advancements in burn care and skin grafting. The Korean and Vietnam Wars established arterial and venous repair, halving amputation rates and priming the microsurgical revolution by Jacobson, Suarez, Malt, McKhann, and Buncke. Post-9/11 conflicts drove damage control reconstruction, negative pressure wound therapy, and clinical translation of vascularized composite allotransplantation. The war in Ukraine has catalyzed innovation, including the use of bioengineered vascular conduits, and modern interest in AI-assisted technology highlights the potential for surgical triage in resource-scarce environment. This reflection offers a historically grounded framework for understanding contemporary microsurgery in relation to war and anticipating where the current technological revolution will lead.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348261496609"},"PeriodicalIF":1.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147172","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}

{"title":"Medieval Islamicate Surgery and the Evolution of Ascites Management: Early Principles of Patient Selection, Controlled Drainage, and Postoperative Care.","authors":"Narges Tajik, Mohammad H Ayati, Fuat Ince, Azadeh Zarei, Arman Zargaran","doi":"10.1177/00031348261494199","DOIUrl":"https://doi.org/10.1177/00031348261494199","url":null,"abstract":"<p><p>Ascites management is currently guided by well-established surgical principles, including careful patient selection, controlled fluid removal, and prevention of circulatory dysfunction during paracentesis. Although framed in modern physiological terms, these principles have conceptual roots in earlier medical traditions. This study re-examines the surgical management of ascites within the medieval Islamicate medical tradition, encompassing medical cultures and scholarly practices that developed in societies shaped by Islamic civilization, rather than referring solely to religious doctrines or institutions. The study focuses on operative reasoning rather than historical description. Primary sources, including Avicenna's <i>Canon of Medicine</i>, Rhazes' <i>Al-Hawi</i>, Haly Abbas' <i>Kamil al-Sina'ah</i>, and Albucasis' <i>Al-Tasrif</i>, were analyzed thematically to identify underlying surgical principles. These findings were contextualized in relation to earlier Greco-Roman writings, particularly those of Paul of Aegina, and compared with contemporary clinical concepts in ascites management. The analysis demonstrates that medieval Islamicate physicians developed a coherent framework for ascites intervention based on 4 core principles: (1) strict patient selection prior to surgery, (2) gradual and controlled fluid evacuation, (3) recognition of physiological tolerance and operative risk, and (4) structured postoperative care. Despite differences in theoretical background, these principles closely parallel modern concepts in large-volume paracentesis, including prevention of paracentesis-induced circulatory dysfunction and risk stratification before intervention. Rather than constituting isolated historical techniques, these writings reflect an early form of physiology-guided surgical judgment. This reframing highlights the continuity of operative principles across medical history and underscores the relevance of classical Islamic medical literature to contemporary surgical decision-making.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348261494199"},"PeriodicalIF":1.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134587","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}

{"title":"The Neoadjuvant Window: Serial Assessment of Sarcopenia During Treatment for Pancreatic Cancer.","authors":"Dillon C Cheung, Anagha J Deshpande, Nabil Wasif, Richard J Butterfield, Panagiotis Korfiatis, Jason R Klug, Kumar Sandrasegaran, Zhi Ven Fong, Chee-Chee H Stucky","doi":"10.1177/00031348261495994","DOIUrl":"https://doi.org/10.1177/00031348261495994","url":null,"abstract":"<p><p>BackgroundSarcopenia is associated with worse outcomes in pancreatic cancer patients, but longitudinal body composition changes during neoadjuvant therapy remain poorly understood.MethodsA retrospective review identified patients who underwent pancreatectomy, either upfront or after neoadjuvant therapy, for pancreatic adenocarcinoma between 2011 and 2021. Skeletal muscle area, index, and mean attenuation were calculated from CT images throughout the treatment course to assess sarcopenia. Multivariable generalized linear and logistic regression models were used to assess associations between sarcopenia, neoadjuvant therapy, and postoperative outcomes.ResultsA total of 72 patients were included: 32 who underwent neoadjuvant therapy and 40 who underwent upfront surgery. Forty-one (57%) patients had sarcopenia at diagnosis (65% upfront surgery vs 47% neoadjuvant, <i>P</i> = 0.154). Post-neoadjuvant therapy, 15.6% developed and 18.8% resolved sarcopenia. Median skeletal muscle mean attenuation increased by 2.4 HU after neoadjuvant therapy (<i>P</i> = 0.02). Patients receiving neoadjuvant therapy were more likely to undergo nutrition consultation prior to surgery (61% vs 7%, <i>P</i> = 0.003). Neoadjuvant therapy was also associated with higher postoperative albumin levels (β = 0.244; 95% CI 0.041-0.446). Baseline sarcopenia diagnosed by skeletal muscle area was associated with increased postoperative complications (OR 13.696; 95% CI 2.537-73.921), while neoadjuvant therapy did not significantly impact complications (OR 0.384; 95% CI 0.12-1.226).ConclusionsPatients who completed neoadjuvant therapy and underwent resection did not have increased rates of sarcopenia and were more likely to receive preoperative nutrition consultation and have higher postoperative albumin levels. The neoadjuvant period may represent an opportunity for sarcopenia assessment, nutritional optimization, and multimodal prehabilitation prior to pancreatectomy.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348261495994"},"PeriodicalIF":1.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134616","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}

{"title":"Ultrasound-Guided Intrasac Thrombin Injection for Iatrogenic Femoral Artery Pseudoaneurysm: A Systematic Review.","authors":"Musheng Rao, Bin Peng, Lanting Deng","doi":"10.1177/00031348261494202","DOIUrl":"https://doi.org/10.1177/00031348261494202","url":null,"abstract":"<p><p>ObjectiveTo systematically evaluate the efficacy and safety of ultrasound-guided thrombin injection (UGTI) for the treatment of femoral pseudoaneurysms, analyze the technical factors influencing treatment success, and provide evidence-based guidance for clinical practice.MethodsA systematic search of the PubMed database was conducted to identify clinical studies on UGTI for femoral pseudoaneurysms. Original studies with clearly defined efficacy outcome measures were included. Key data, including technical success rates and complication rates, were extracted. Technical details of the procedure (eg, thrombin concentration, injection dose, and neck management strategies) were summarized and analyzed.ResultsMultiple relevant studies were included. The technical success rate of UGTI for femoral pseudoaneurysms exceeded 90%. The commonly used thrombin concentration ranged from 100 to 1000 U/mL, with a single total injection dose typically between 150 and 750 U (equivalent to an injection volume of 1-5 mL). The overall complication rate was approximately 2%, with distal thromboembolism being the most frequent. For wide-necked or anatomically complex pseudoaneurysms, balloon-assisted UGTI further enhanced treatment safety by effectively preventing limb ischemia resulting from thrombin extravasation. Compared to traditional treatment methods, UGTI demonstrated significant advantages in terms of procedure time, patient comfort, and therapeutic stability.ConclusionUGTI for the treatment of femoral pseudoaneurysms offers the benefits of being a simple, rapid, minimally invasive procedure with definitive efficacy and a low recurrence rate. It has become the first-line treatment option, replacing traditional compression therapy and surgery. Strict adherence to indications, precise ultrasound guidance, and individualized thrombin dosing are crucial for successful treatment. For complex cases, balloon-assisted techniques serve as an important adjunctive strategy.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348261494202"},"PeriodicalIF":1.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126394","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}

{"title":"Veno-Venous ECMO after Penetrating Trauma: A Viable Option With Individualized Anticoagulation.","authors":"Talia R Arcieri, Ana M Reyes, Akshat Sanan, Avery M Hebert, Joyce I Kaufman, Louis R Pizano, Nicholas Namias, Mauricio Pipkin, Kenneth G Proctor, Brandon M Parker","doi":"10.1177/00031348261496001","DOIUrl":"https://doi.org/10.1177/00031348261496001","url":null,"abstract":"<p><p>BackgroundThe incidence, clinical characteristics, complications, and outcomes for extracorporeal membrane oxygenation (ECMO) in penetrating trauma cases are mostly unknown. The purpose of this study was to evaluate the concept that ECMO could be a safe and effective therapy after severe penetrating injury at a single high-volume center.MethodsWe conducted a retrospective case series of all penetrating trauma patients supported with ECMO at a single Level I trauma center between January 2022 and June 2025. Data collected included demographics, injury patterns, ECMO indications and cannulation details, anticoagulation management, operative interventions performed on ECMO, bleeding and thrombotic complications, and clinical outcomes.ResultsEight patients were supported with veno-venous ECMO, all male, with a median age of 36 years and a median Injury Severity Score of 20. Injury mechanisms included six gunshot wounds and two stab wounds, with a median PaO2/FiO2 ratio of 71 at ECMO consultation. Anticoagulation was individualized, with initiation delayed a median of 4 days after cannulation, and one patient received no anticoagulation throughout their ECMO course. Four patients underwent major operative procedures while on ECMO. Three patients had manageable bleeding complications, and three had thrombotic complications not associated with anticoagulation interruption. Overall survival to hospital discharge was 75% (6/8 patients).DiscussionThis case series demonstrates basic proof of concept that ECMO can be safely implemented in carefully selected penetrating trauma patients. Individualized anticoagulation strategies and concurrent operative management were feasible with manageable complications. Further multicenter studies are needed to define optimal patient selection and anticoagulation practices.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348261496001"},"PeriodicalIF":1.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134703","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}

{"title":"Distinguishing Reversible Physiologic Acuity From Behavioral Risk in Liver Transplantation for Acute Alcoholic Hepatitis.","authors":"Piyush Gupta, Brian Nguyen, David Walls, Shekhar Gogna, Alexander Kroemer, Pejman Radkani, Maryam Dadashzadeh, Thomas M Fishbein, Dimitrios Moris, Yuri S Genyk","doi":"10.1177/00031348261495993","DOIUrl":"https://doi.org/10.1177/00031348261495993","url":null,"abstract":"<p><p>Liver transplantation for acute alcohol-associated hepatitis (AAH) remains contested because severe pre-transplant illness is read as a marker of poor prognosis. We asked whether physiologic acuity at transplantation predicts early outcome and which severity measure carries prognostic information. We studied 492 consecutive adult single-organ liver transplant recipients at one center (2018-2023), 32 transplanted for AAH. One-year survival was estimated by Kaplan-Meier methods with censoring at last follow-up and modeled by Cox regression adjusted for age, laboratory MELD, intensive care, and Karnofsky status. Biopsy-proven rejection and candidacy scores were taken from institutional records. Acute alcohol-associated hepatitis recipients were younger (40 vs 55 years), had higher MELD (37 vs 24), poorer Karnofsky status (30% vs 50%), and were more often hospitalized (91% vs 37%; all <i>P</i> < .001). One-year survival was 96.9% (95% CI, 79.8-99.6) vs 91.1% (95% CI, 87.9-93.4); this rests on 1 death among AAH recipients and is not evidence of equivalence. Karnofsky status was the only independent predictor of death (HR per 10 points, 0.75; 95% CI, 0.57-0.98); AAH, MELD, age, and intensive care were not. Physiologic acuity did not forecast early death, and functional capacity rather than the severity score carried the prognostic signal. These data support decoupling MELD and level of care from candidacy; they do not measure alcohol relapse, which is a later cumulative outcome and the substantive unresolved concern in this population.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348261495993"},"PeriodicalIF":1.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134615","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}

{"title":"Why Do Prehabilitation Studies Differ? Patient Selection and Program Design in Colorectal Cancer Surgery.","authors":"Yuezhi Dong, Guocan Si, Shuming Zhuang, Jiakai Jiang, Wenling Wang, Die Wu","doi":"10.1177/00031348261494136","DOIUrl":"https://doi.org/10.1177/00031348261494136","url":null,"abstract":"<p><p>BackgroundPrehabilitation (PH) aims to optimize postoperative outcomes in patients with colorectal cancer (CRC), yet randomized trials have shown variable benefits. This meta-analysis investigated factors contributing to heterogeneous effects, including patient age, intervention duration, and program composition. The objectives were to evaluate the efficacy of PH on postoperative recovery and outcomes and identify factors influencing its effects.MethodsRandomized controlled trials (RCTs) were searched in PubMed, Embase, Web of Science, and Cochrane Library from database inception to Sep. 2024. Postoperative recovery included functional outcomes (eg, 6-minute walk test [6MWT] and grip strength), while postoperative outcomes included complications, readmission, and mortality. Data were pooled using random-effects models, with sensitivity and subgroup analyses performed.ResultsSixteen RCTs were included. PH improved 6MWT performance (SMD 0.23, 95% CI 0.11-0.35) and reduced 30-day complications (RR 0.77, 95% CI 0.62-0.95). No significant effects were observed on other recovery indicators or outcomes, including length of stay, readmission, reoperation, and mortality. Subgroup analysis suggested greater benefits from multimodal PH in patients aged <70 years.ConclusionPH may improve functional recovery and reduce 30-day complications after CRC surgery, but its effects vary according to patient characteristics and intervention strategies. Although multimodal programs and younger patients may derive greater benefits, these findings are hypothesis-generating and require validation. Further high-quality RCTs are needed to establish optimal PH strategies for specific patient populations.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348261494136"},"PeriodicalIF":1.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134710","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}

{"title":"Choosing Value: Antivenom Selection in the Modern Trauma System.","authors":"Jack H Bowdle, Morgan Butler, Justin Pritchett, Drew Hungerford, Sarah A King, Amanda L McKinney, Robert E Heidel, Lou M Smith, Catherine L McKnight","doi":"10.1177/00031348261492221","DOIUrl":"https://doi.org/10.1177/00031348261492221","url":null,"abstract":"<p><p>BackgroundVenomous snakebites require timely antivenom administration to prevent progression of local and systemic toxicity. In the United States, two FDA-approved crotalid antivenoms, CroFab® and ANAVIP®, are available, both associated with substantial cost. Real-world data comparing antivenom utilization and institutional cost between these agents remain limited.MethodsWe performed an IRB-approved retrospective review of consecutive patients treated with antivenom for venomous snakebite and admitted to a Level I trauma center between March 2017 and August 2023. Demographics, snakebite characteristics, Snakebite Severity Score (SSS), clinical outcomes, complications, hospital length of stay (LOS), and antivenom-associated costs were abstracted.ResultsFifty-four patients were admitted for venomous snakebite and received antivenom; 48 received a single antivenom formulation. CroFab® was administered to 36 patients (75%) and ANAVIP® to 12 patients (25%). There were no significant differences between groups in demographic characteristics or injury severity. Clinical outcomes, including improvement after initial antivenom administration, need for additional dosing, antivenom-related complications, and hospital LOS, were comparable between groups. Median hospital cost was significantly lower in the ANAVIP® group compared with CroFab® ($9665.30 [IQR $9665.30-$9670.00] vs $16,470.57 [IQR $11,775.04-$27,184.72], <i>P</i> = 0.003).DiscussionIn this single-center trauma cohort, ANAVIP® and CroFab® demonstrated comparable clinical effectiveness for the treatment of crotalid snakebites. Use of ANAVIP® was associated with a substantial reduction in hospital cost without detectable compromise in clinical outcomes. These findings support consideration of ANAVIP® as a cost-conscious antivenom strategy in trauma systems.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348261492221"},"PeriodicalIF":1.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134577","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}

{"title":"From Benchmarking to Intervention: Using SECOND Trial Data to Improve Residency Culture.","authors":"Omar Zayed, Rebecca Tuttle, Randy Woods, Priti P Parikh","doi":"10.1177/00031348261495999","DOIUrl":"https://doi.org/10.1177/00031348261495999","url":null,"abstract":"<p><p>Burnout and mistreatment remain persistent challenges in surgical residency, with wide-ranging consequences for both resident well-being and patient care. Much of the existing literature describes the prevalence and causes of resident burnout, but fewer studies provide practical insight into how programs can effectively address it. In 2019, our program enrolled in the Surgical Education Culture Optimization through Targeted Interventions based on National Comparative Data (SECOND) Trial, a national benchmarking initiative that measures resident wellness, work environment, and mistreatment relative to institutions nationwide. Initial SECOND Trial benchmarking demonstrated lowest-quartile (Q4) performance in burnout, emotional exhaustion, suicidal thoughts, and work-life integration, with outlier-level mistreatment across multiple domains relative to national peers. These findings prompted targeted organizational interventions led by residents with sustained faculty partnership. Interventions were centered around three domains: (1) structural and culture-focused initiatives through an inclusive excellence committee that promoted belonging, education on healthcare disparities, and anonymous reporting of mistreatment; (2) wellness initiatives including retreats, family-inclusive social events, protected wellness days, and peer mentorship; and (3) mentorship and professional development through faculty workshops, invited speakers, and resident and faculty recognition programs. By 2024, SECOND Trial benchmarking demonstrated improvement to mid-quartile (Q2) performance in burnout-related domains, including burnout, emotional exhaustion, work-life integration, and suicidal thoughts. Mistreatment measures no longer met outlier criteria, although gender disparities persisted. Our experience provides real-world evidence that structured, organizational interventions can produce measurable improvement in resident well-being and residency culture, while highlighting the continued need to address persistent disparities in surgical training.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348261495999"},"PeriodicalIF":1.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126275","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}

{"title":"The Cost of Recurrence: Long-Term Outcomes After Recurrent Ventral Hernia Repair.","authors":"Amy L Gin Gossett, Andew J Cole, Austin T Coale, Colston A Edgerton, William W Hope","doi":"10.1177/00031348261492210","DOIUrl":"https://doi.org/10.1177/00031348261492210","url":null,"abstract":"<p><p>Most hernia recurrence literature records follow-up periods from one to five years and focus on hernia recurrence. More recent data suggest many ventral hernia repairs have long-term consequences related not only to hernia recurrence but also reoperation and mesh-related complications. The purpose of this project was to evaluate long-term outcomes of ventral hernia repair and compare outcomes between non-recurrent and recurrent hernias repairs. An IRB approved retrospective review of consecutive patients undergoing ventral hernia repair from August 2008 to July 2014 from a prospectively collected database was performed to allow for long-term follow-up. Demographic and surgical characteristics were recorded as well as short-term outcomes. Long-term outcomes including recurrences, mesh-related complications, and hernia reoperation were obtained by retrospective chart review. Recurrence was defined as documentation of a hernia by physical exam or CT imaging. A total of 200 patients were included. The median follow-up was 4322 [2959, 4787] days. Mesh-related complications occurred in 9%, recurrence 21%, and reoperation 19%. In comparing non-recurrent to recurrent hernia repairs, recurrent hernia repairs had a higher rate of mesh complications mesh complications (2.0% vs 16.0% (<i>P</i> < 0.001)), hernia recurrence (16.0% vs 42.0% (<i>P</i> < 0.001)), and reoperation rate (9.0% vs 29.0% (<i>P</i> < 0.001)) Long-term outcomes associated with ventral hernia repair are less than ideal with a high rate of recurrence, reoperation, and mesh-related complications. Recurrent hernia repair was shown to have worse long-term outcomes compared to primary hernias and represent a high clinical burden to surgeon and patient.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348261492210"},"PeriodicalIF":1.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126386","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}