Annals of surgery最新文献

{"title":"Where You Train Matters: Surgeon-Scientists Disproportionately Trained at Highly Funded Institutions.","authors":"Mackenzie M Mayhew,Nidhi Kuchimanchi,Justin Lee,Elizabeth J Olecki,Jacob Sellers,Craig L Slingluff,Allan Tsung,Russell G Witt","doi":"10.1097/sla.0000000000006880","DOIUrl":"https://doi.org/10.1097/sla.0000000000006880","url":null,"abstract":"OBJECTIVETo assess the distribution of National Institutes of Health (NIH)-funded surgeon-scientists by residency training institution and to examine whether training at institutions with higher NIH funding is associated with greater individual NIH funding.SUMMARY BACKGROUND DATASurgeon-scientists face challenges securing NIH funding, with surgical research funding lagging behind other fields. Training in resource-rich environments may enhance research engagement and funding success.METHODSBlue Ridge Institute for Medical Research (BRIMR) rankings were used to identify NIH-funded principal investigators (NIH-PIs) among surgeons in Departments of Surgery from 2013-2023. Residency program NIH-funding quartiles, and top-ten programs, were determined by averaging institutional funding from BRIMR spreadsheets. Chi-square or Fisher's exact tests, nonparametric tests, Z-tests, and linear regression were performed.RESULTSAmong 559 NIH-funded surgeon-scientists, 394 (70.5%) trained at first-quartile institutions, representing 75-82% of NIH-PIs annually and receiving 79-85% of total funding each year. Total annual funding was significantly higher among first-quartile trained NIH-PIs ($117.9 vs. $24.8 million; P <0.0001), though median funding per NIH-PI did not differ ($354,544 vs. $328,179; P =0.358). In subgroup analysis, top-ten trained NIH-PIs had higher median funding per PI ($379,407 vs. $322,666; P =0.013) and experienced faster annual growth in funding per PI ($61,920/year vs. $38,666/year, P =0.009) even when adjusted for current affiliated institution funding quartile. Additionally, top-ten trained PIs exhibited greater scientific influence measured by the NIH iCite tool's weighted relative citation ratio (119 vs. 100; P =0.034).CONCLUSIONSurgeon-scientists who trained at first-quartile institutions represent the majority of NIH-funded investigators, highlighting the potential influence of training in well-funded environments.","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":"147 1","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outpatient Stoma Closure in 130 Patients. Insights From the GRECCAR Multicentric Study.","authors":"Boris Cleret de Langavant,Antoine Camerlo,Quentin Denost,Laura Beyer-Berjot,Maxime Collard,Yann Parc,Benoit Gignoux,Jérémie H Lefevre","doi":"10.1097/sla.0000000000006875","DOIUrl":"https://doi.org/10.1097/sla.0000000000006875","url":null,"abstract":"OBJECTIVEevaluate feasibility and outcomes of outpatient stoma closure.BACKGROUNDStoma closure is a routine procedure still associated with prolonged hospital stays, despite a low complication rate. We hypothesized that it could be performed in an outpatient setting.METHODSThis retrospective observational study analyzed prospectively collected data on outpatient stoma closures across 5 centers (5/2019-10/2024) was conducted. Inclusion required a caregiver on surgery day and no associated procedures. Follow-up consisted of phone consultations, a 24/7 emergency contact line, and routine outpatient appointment.RESULTS130 patients (57% male, median age=60 y, ASA score 1-2=94%) were included. 122 loop ileostomies (94%), 5 loop colostomies (4%) and 3 ileocolostomies(3%) were closed. Stoma had been performed mainly after anterior resection (81%) or ileal pouch-anal anastomosis (9%). The median interval before stoma closure was 70 days [7-2310]. Median operative time was 48 minutes [20-247]. Anastomosis was mainly stapled (55.4%). Wounds were closed either directly (56%) or with a purse-string technique (44%). Same-day discharge was possible for 90% of patients. Main reasons for admission were postoperative pain (n=5) and logistical issues (n=4). Median length of hospital stay was 10 hours.[4-16] 21 patients (16%) were readmitted after a median time of 6 days [1-14] (ileus=9, parietal abscess=5). Severe morbidity (Dindo III) was 3%. Direct wound closure was a risk factor of wound infection (P=0.009). Steroid therapy was a risk factor of morbidity and readmission (P<0.001).CONCLUSIONSOutpatient stoma closure is a safe and effective approach with low complication and readmission rates when using appropriate protocols.","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":"5 1","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144778133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylactic Regenerative Peripheral Nerve Interface Surgery in Pediatric Lower Limb Amputation Patients.","authors":"Ahneesh J Mohanty, Paul S Cederna, Stephen W P Kemp, Theodore A Kung","doi":"10.1097/SLA.0000000000006327","DOIUrl":"10.1097/SLA.0000000000006327","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the prophylactic effect of regenerative peripheral nerve interface (RPNI) surgery on pediatric postamputation pain.</p><p><strong>Background: </strong>Chronic postamputation pain is a debilitating and refractory sequela of limb amputation affecting up to 83% of pediatric patients with limb loss, resulting in disability and decreased quality of life. We postulate that prophylactic RPNI surgery performed during amputation may decrease the incidence of symptomatic neuroma and development of phantom limb pain, as well as limit analgesic use among pediatric patients with limb loss.</p><p><strong>Methods: </strong>Retrospective chart review was performed on pediatric patients between the ages of 8 and 21 years who underwent major lower limb amputation with and without RPNI surgery. Documented neuroma and phantom limb pain scores, as well as analgesic use, were recorded. Narcotic use was converted to milligrams morphine equivalents per day, whereas overall analgesic use was converted to Medication Quantification Scale version III scores. Analysis was performed using Stata.</p><p><strong>Results: </strong>Forty-four pediatric patients were identified; 25 RPNI patients and 19 controls. Of control patients, 79% developed chronic postamputation pain versus 21% of RPNI patients ( P < 0.001). Among the patients who developed postamputation pain, 20% of controls developed clinical neuroma pain, compared with 0% of RPNI patients ( P < 0.001). In addition, RPNI patients demonstrated a significant decrease in pain score ( P = 0.007) and narcotic usage ( P < 0.01) compared with controls. Overall analgesic use did not vary significantly between groups.</p><p><strong>Conclusions: </strong>Prophylactic RPNI surgery shows promise for pediatric patients undergoing major lower limb amputation by preventing both symptomatic neuromas and possibly the development of phantom limb pain.</p>","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":" ","pages":"346-351"},"PeriodicalIF":7.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140875661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes from 871,441 Consecutive Surgical Procedures Without Overlap or with Maximally Permissible Nonconcurrent Overlap.","authors":"Austin J Borja, Ritesh Karsalia, Ryan S Gallagher, Krista Strouz, Jianbo Na, Scott D McClintock, Ronald P DeMatteo, Neil R Malhotra","doi":"10.1097/SLA.0000000000006340","DOIUrl":"10.1097/SLA.0000000000006340","url":null,"abstract":"<p><strong>Objective: </strong>To isolate the impact of subsumed surgery (a shorter procedure completed entirely during overlapping noncritical portions of a longer antecedent procedure) on patient outcomes.</p><p><strong>Summary background data: </strong>The American College of Surgeons recently recommended the elimination of \"concurrent surgery\" with overlap during a procedure's critical portions. Guidelines for nonconcurrent overlap have been established, but the safety of subsumed surgery remains to be examined.</p><p><strong>Methods: </strong>All consecutive procedures from 2013 to 2021 within a multihospital academic medical center were included (n=871,441). Simple logistic regression was performed to compare postoperative events between patients undergoing non-overlaping surgery (n=533,032) and completely subsumed surgery (n=11,319). Thereafter, coarsened exact matching was used to match patients with non-overlaping and subsumed surgery 1:1 on CPT code, 18 demographic features, baseline health characteristics, and procedural variables (n=7,146). Exact-matched cases were subsequently limited to pairs performed by the same surgeon (n=5,028). Primary outcomes included 30-day readmission, ED visits, and reoperations.</p><p><strong>Results: </strong>Univariate analysis suggested that subsumed surgery had a higher 30-day risk of readmission (OR 1.55, P <0.0001), ED evaluation (OR 1.19, P <0.0001), and reoperation (OR 1.98, P <0.0001). When comparison was limited to the exact same procedure and patients were matched on demographics and health characteristics, there were no outcome differences between patients with subsumed surgery and non-overlapping surgery, even when limiting analyses to the same surgeon.</p><p><strong>Conclusions: </strong>Similar surgeries for similar patients result in similar outcomes whether they are performed completely subsumed or without overlap. Individual surgeons performing a specific procedure have no outcome differences with subsumed and non-overlapping cases.</p>","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":" ","pages":"258-266"},"PeriodicalIF":7.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140896949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blumgart Anastomosis Versus Invaginating Pancreato-gastrostomy For Reconstruction After Pancreatoduodenectomy: A Randomized Controlled Trial.","authors":"Dimitri Dorcaratto,Marina Garcés-Albir,Sara Palomares-Casasús,Santiago Sánchez-Cabús,Gonzalo Suárez-Artacho,Rosa Jorba-Martín,Gerardo Blanco-Fernández,Esteban Cugat-Andorra,Fabio Ausania,Constantino Fondevila-Campo,José Manuel Ramia-Ángel,Juan Manuel Sánchez-Hidalgo,Alejandro Serrablo-Requejo,Elena Martín-Pérez,Ángela De la Hoz-Rodríguez,Elena Muñoz-Forner,Isabel Mora-Oliver,Manuel Rodríguez-Blanco,Carmen Cepeda-Franco,Robert Memba,Diego López-Guerra,María Isabel García-Domingo,Filippo Landi,Patricia Sánchez-Velázquez,Nuria Losa-Boñar,Gonzalo Rodríguez-Laiz,Sandra Paterna,Mario Serradilla-Martín,Benedetto Ielpo,Ángel García-Romera,Javier Padillo-Ruiz,Luis Sabater-Ortí","doi":"10.1097/sla.0000000000006873","DOIUrl":"https://doi.org/10.1097/sla.0000000000006873","url":null,"abstract":"OBJECTIVETo compare postoperative pancreatic fistula (POPF) rates between Blumgart anastomosis (BA) and invaginating pancreato-gastrostomy (PG) after pancreatoduodenectomy (PD).SUMMARY BACKGROUND DATAPOPF rates after PD are still high. The only modifiable factor available to improve POPF is the anastomotic technique. BA and PG anastomoses have been previously shown to be feasible and safe, but they have never been compared in a randomized trial.METHODSA multicenter, randomized, controlled trial was conducted in 13 University Hospitals. Eligible patients were those presenting a pancreatic or periampullary neoplasm undergoing PD. Assignment to each group (BA or PG) was randomized by blocks and stratified by centers. The primary endpoint was the rate of POPF with special assessment of clinically relevant (B-C) POPF; secondary endpoints were postoperative complications, factors related to POPF and quality of life (QoL).RESULTSTwo hundred and sixteen patients were randomized. POPF and B-C POPF were 44%-28% in BA group and 34%- 23% in PG group (P=0.39 and P=0.74, respectively). Overall complications, severe complications and mortality rates were 76%, 24%, 3.7% respectively, in the BA group, and 73%, 32%, 5.9%, in the PG group, with no significant differences. Soft pancreatic consistency, small preoperative CT Wirsung diameter, patient age, and 1st postoperative drain amylase concentration were independently associated with B-C POPF. QoL functional scales favoured the PG anastomosis at 9-months.CONCLUSIONSBA and PG showed no differences in POPF and postoperative outcomes; B-C POPF can be predicted based on several pre-intra and early postoperative parameters; QoL favoured PG anastomosis at 9 months.","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":"27 1","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overlapping Surgery Verbiage in Informed Consent Documents.","authors":"Margaret B Mitchell, George Lin, Kavita Prasad, Daniel R S Habib, Alexander Langerman","doi":"10.1097/SLA.0000000000006324","DOIUrl":"10.1097/SLA.0000000000006324","url":null,"abstract":"<p><strong>Objective: </strong>To assess informed consent documents from U.S. institutions for verbiage regarding overlapping surgery.</p><p><strong>Background: </strong>Overlapping surgery remains a controversial practice. Recent guidance from the Senate Finance Committee and American College of Surgeons emphasizes transparency with patients regarding this practice through the informed consent process, but it remains unclear how many institutions adopted their recommendations.</p><p><strong>Methods: </strong>Informed consent documents were collected from a national sample of 104 institutions and assessed for verbiage regarding overlapping surgery and/or attending absence during a surgical case. The verbiage of these forms was further analyzed for inclusion of key terms (e.g., \"overlapping surgery,\" \"critical portions\"), as well as transparency regarding surgeon absence.</p><p><strong>Results: </strong>Thirty (29%) forms included verbiage regarding overlapping surgery and/or surgeon absence during a case. Most of these 30 utilized the terms \"overlapping surgery\" or \"critical portions\" (18 [60%] and 25 [83%], respectively), although only 3 (10%) explicitly stated that portions of the procedure that may be performed in the absence of the attending surgeon. Six forms (20%) specifically stated who may perform the procedure without the attending present, and 3 forms (10%) had patients acknowledge this section of the consent form with an additional signature or initial. Only 2 of the forms (7%) fulfilled all of the criteria set forth by the Senate Finance Committee.</p><p><strong>Conclusions: </strong>Detailed information regarding overlapping surgery is infrequently included in hospitals' procedure informed consent documents. Forms that include this information rarely provide explicit statements of attending presence and trainee participation, raising concerns regarding surgeon-patient transparency.</p>","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":" ","pages":"254-257"},"PeriodicalIF":7.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Alternative to \"Checkmark Credentialing\" for Effective Physician Benchmarking and Professional Improvement.","authors":"Thoralf M Sundt, John B Herman, Michael Jellinek","doi":"10.1097/SLA.0000000000006725","DOIUrl":"10.1097/SLA.0000000000006725","url":null,"abstract":"","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":" ","pages":"199-201"},"PeriodicalIF":7.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appendectomy and Long-term Colorectal Cancer Incidence, Overall and by Tumor Fusobacterium nucleatum Status.","authors":"Hidetaka Kawamura, Tomotaka Ugai, Yasutoshi Takashima, Kazuo Okadome, Takashi Shimizu, Kosuke Mima, Naohiko Akimoto, Koichiro Haruki, Kota Arima, Melissa Zhao, Juha P Väyrynen, Kana Wu, Xuehong Zhang, Kimmie Ng, Jonathan A Nowak, Jeffrey A Meyerhardt, Edward L Giovannucci, Marios Giannakis, Andrew T Chan, Curtis Huttenhower, Wendy S Garrett, Mingyang Song, Shuji Ogino","doi":"10.1097/SLA.0000000000006315","DOIUrl":"10.1097/SLA.0000000000006315","url":null,"abstract":"<p><strong>Objective: </strong>To test hypotheses that appendectomy history might lower long-term colorectal cancer risk and that the risk reduction might be strong for tumors enriched with Fusobacterium nucleatum , bacterial species implicated in colorectal carcinogenesis.</p><p><strong>Background: </strong>The absence of the appendix, an immune system organ and a possible reservoir of certain pathogenic microbes, may affect the intestinal microbiome, thereby altering long-term colorectal cancer risk.</p><p><strong>Methods: </strong>Utilizing databases of prospective cohort studies, namely the Nurses' Health Study and the Health Professionals Follow-up Study, we examined the association of appendectomy history with colorectal cancer incidence overall and subclassified by the amount of tumor tissue Fusobacterium nucleatum​​ ( Fusobacterium animalis ). We used an inverse probability weighted multivariable-adjusted duplication-method Cox proportional hazards regression model.</p><p><strong>Results: </strong>During the follow-up of 139,406 participants (2,894,060 person-years), we documented 2811 incident colorectal cancer cases, of which 1065 cases provided tissue Fusobacterium nucleatum analysis data. The multivariable-adjusted hazard ratio of appendectomy for overall colorectal cancer incidence was 0.92 (95% CI, 0.84-1.01). Appendectomy was associated with lower Fusobacterium nucleatum -positive cancer incidence (multivariable-adjusted hazard ratio, 0.53; 95% CI, 0.33-0.85; P =0.0079), but not Fusobacterium nucleatum -negative cancer incidence (multivariable-adjusted hazard ratio, 0.98; 95% CI, 0.83-1.14), suggesting a differential association by Fusobacterium nucleatum status ( Pheterogeneity =0.015). This differential association appeared to persist in various participant/patient strata including tumor location and microsatellite instability status.</p><p><strong>Conclusions: </strong>Appendectomy likely lowers the future long-term incidence of Fusobacterium nucleatum -positive (but not Fusobacterium nucleatum -negative) colorectal cancer. Our findings do not support the existing hypothesis that appendectomy may increase colorectal cancer risk.</p>","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":" ","pages":"319-327"},"PeriodicalIF":7.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140846905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Method for Continuous Surgeon Improvement in Rectal Cancer: Risk-adjusted Cumulative Sum.","authors":"Davide Ferrari, Tommaso Violante, Amit Merchea, Eric Dozois, Robert A Vierkant, David W Larson","doi":"10.1097/SLA.0000000000006330","DOIUrl":"10.1097/SLA.0000000000006330","url":null,"abstract":"<p><strong>Objective: </strong>To develop and analyze a risk-adjusted cumulative sum (RA-CUSUM) chart as a potential method to monitor individual surgeon performance in robotic total mesorectal excision (TME) for rectal cancer.</p><p><strong>Background: </strong>Currently, surgeons lack real-time tools to monitor and enhance their performance beyond residency completion. While national quality programs exist, granular, individual-level data are crucial for continuous improvement. Previous studies suggest cumulative sum charts hold promise in identifying performance trends and outliers.</p><p><strong>Methods: </strong>This retrospective study analyzed data from 640 robotic TME cases performed by 12 surgeons at 2 institutions. RA-CUSUM charts were generated for 3 outcomes: (1) complications, (2) operative time, and (3) length of stay.</p><p><strong>Results: </strong>The overall RA-CUSUM curves for operative time and complications showed an initial learning phase, followed by a plateau or downward slope, indicating proficiency or improvement. However, individual surgeon curves revealed significant heterogeneity. Three surgeons consistently excelled in operative time, while 5 minimized complications most effectively. Potential quality improvement could be implemented to drive performance toward positive outliers. No differences were found in unadjusted outcomes, including conversion, number of lymph nodes harvested, and positive circumferential margins.</p><p><strong>Conclusions: </strong>The RA-CUSUM chart is a promising method for identifying individual surgeon performance in robotic TME. It could help surgeons, teams, and leaders identify improvement areas and benchmark themselves against positive outliers. Further studies are needed to explore the potential of RA-CUSUM for implementing interventions to improve surgical quality.</p>","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":" ","pages":"304-310"},"PeriodicalIF":7.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Women Surgeons Have It All? If Not Now, When?","authors":"Heather A Lillemoe, Rebecca A Snyder","doi":"10.1097/SLA.0000000000006768","DOIUrl":"10.1097/SLA.0000000000006768","url":null,"abstract":"","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":" ","pages":"184-185"},"PeriodicalIF":7.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}