Should surgeons reconsider the role of intraoperative sentinel lymph node evaluation for premenopausal breast cancer patients in the era of RxPONDER?
Tremendous improvements in the role of personalized breast cancer care have resulted in paradigms shifts to treatment algorithms, particularly regarding the role of systemic chemotherapy in patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer. The landmark TAILORx data demonstrated the utility and efficacy of the 21-gene recurrence score assay (Oncotype DX, Genomic Health) in women with HR-positive, HER2-negative, node-negative breast cancer as it demonstrated a statistically and clinically significant benefit to the receipt of adjuvant chemoendocrine therapy ...
Source: American Journal of Surgery - February 17, 2024 Category: Surgery Authors: Chandler S. Cortina, Amanda L. Kong Tags: My Thoughts / My Surgical Practice Source Type: research
Collating evidence to support the validation of a simulated laparotomy incision and closure-training model
In this study, we assessed the use of a simulated laparotomy incision and closure-training model by collating validity evidence to determine its utility as well as pre and post-test interval data. (Source: American Journal of Surgery)
Source: American Journal of Surgery - February 16, 2024 Category: Surgery Authors: Adam F. Roche, Dara Kavanagh, Niamh McCawley, J.M. O'Riordan, Caitriona Cahir, Conor Toale, Dara O'Keeffe, Tim Lawler, Claire M. Condron Tags: Original Research Article Source Type: research
Can screen-time help? An analysis of usage of patient engagement technology following colorectal surgery
Patient engagement technologies (PETs) guide patients through the perioperative period. We aimed to investigate the levels of patient engagement with PETs through the peri-operative period and its impact on clinical outcomes. (Source: American Journal of Surgery)
Source: American Journal of Surgery - February 16, 2024 Category: Surgery Authors: Ahmer Irfan, Burke Smith, Lauren Wood, Robert H. Hollis, Eric Wallace, Michael Rubyan, Sushanth Reddy, Daniel I. Chu Tags: Original Research Article Source Type: research
“Do No harm” - How Medicare Advantage policies are harming cancer patients
Medicare Advantage began in 2003 as a rebranding of the then-named Medicare Part C. It has since expanded to include most Medicare-eligible patients and is projected to capture 60% of these patients by 2028.1 Its programs promote great benefits and high-value care at low premiums across the board, but recently, numerous organizations have scrutinized these claims. Medicare Advantage operates under the “benchmark-bid” scheme, in which the plan “bids” its estimated cost of care per patient against an average Traditional Medicare patient. (Source: American Journal of Surgery)
Source: American Journal of Surgery - February 16, 2024 Category: Surgery Authors: James Waters, Young Hong Tags: My Thoughts / My Surgical Practice Source Type: research
Intraoperative hypotension and postoperative acute kidney injury: A systematic review
There is no consensus regarding safe intraoperative blood pressure thresholds that protect against postoperative acute kidney injury (AKI). This review aims to examine the existing literature to delineate safe intraoperative hypotension (IOH) parameters to prevent postoperative AKI. (Source: American Journal of Surgery)
Source: American Journal of Surgery - February 15, 2024 Category: Surgery Authors: Yordan Penev, Matthew M. Ruppert, Ahmet Bilgili, Youliei Li, Raiya Habib, Abdul-Vehab Dozic, Coulter Small, Esra Adiyeke, Tezcan Ozrazgat-Baslanti, Tyler J. Loftus, Chris Giordano, Azra Bihorac Tags: Review Article Source Type: research
Outcomes and quality of life of frail patients following elective ventral hernia repair: Retrospective review of a national hernia collaborative
This study compares postoperative quality of life (QOL) and complications between frail and non-frail patients undergoing elective VHR. We hypothesized that frail patients would have higher complication rates and smaller gains in quality of life compared to non-frail patients. (Source: American Journal of Surgery)
Source: American Journal of Surgery - February 14, 2024 Category: Surgery Authors: Alison Whalen, Sahana Holla, Savannah Renshaw, Molly Olson, Kavya Sreevalsan, Benjamin K. Poulose, Courtney E. Collins Tags: Original Research Article Source Type: research
A stakeholder model for prioritization and distribution of elective surgery for population health
The COVID-19 pandemic strained healthcare delivery across the United States and created barriers to elective surgical care due to lack of capacity and temporary legal mandates.1 Elective surgery is often perceived as discretionary, though surgical disease carries major consequences for function, mobility, and quality of life. Referring to these procedures as “elective” can be a misnomer, as this reflects urgency rather than clinical necessity and potential health benefits. For example, an individual may pursue a knee replacement to begin an exercise regimen to lose weight and optimize comorbid conditions. (Source: Amer...
Source: American Journal of Surgery - February 13, 2024 Category: Surgery Authors: Victor Agbafe, Jennifer F. Waljee, Nicholas L. Berlin Tags: My Thoughts / My Surgical Practice Source Type: research
Determinants of long-term physical and mental health outcomes after intensive care admission for trauma survivors
Collectively, studies from medical and surgical intensive care units (ICU) suggest that long-term outcomes are poor for patients who have spent significant time in an ICU. We sought to identify determinants of post-intensive care physical and mental health outcomes 6 –12 months after injury. (Source: American Journal of Surgery)
Source: American Journal of Surgery - February 13, 2024 Category: Surgery Authors: Juan P. Herrera-Escobar, Taylor Lamarre, Jordan Rosen, Saba Ilkhani, Ashley N. Haynes, Kaman Hau, Kendall Jenkins, Jack Ruske, Joyce Y. Wang, Jessica Serventi-Gleeson, Sabrina E. Sanchez, Haytham MA. Kaafarani, George Velmahos, Ali Salim, Nomi C. Levy-Car Tags: Original Research Article Source Type: research
We don't really know our residents as well as we think. Trait characteristic recognition by faculty in autonomy needs more attention. But does it matter?
Autonomy in the operating room is considered by the general surgery resident to be essential in their evolution from trainee to surgeon and has been considered the essential cornerstone to residency training in general surgery.1 Operative autonomy in residency program is decreasing in frequency.2 Barriers around resident autonomy in practice and operatively are number one in institutional factors cited by program stakeholders affecting burnout and wellness.3 What is this entity of Autonomy? Specifically in the operating room, how does this work? (Source: American Journal of Surgery)
Source: American Journal of Surgery - February 13, 2024 Category: Surgery Authors: James N. Lau Tags: Invited Commentary Source Type: research
The incidence and risk factors of marginal ulcers in the short and medium term in symptomatic post-pancreaticoduodenectomy patients –––– single-center experience
Marginal ulcer (MU) is one of the postoperative complications of pancreaticoduodenectomy (PD), which needs particular attention in postoperative treatments. (Source: American Journal of Surgery)
Source: American Journal of Surgery - February 12, 2024 Category: Surgery Authors: Shaoqin Fan, Guosheng Chen, Kai Zhang, Li Zhao, Hao Yuan, Junli Wu, Wentao Gao, Jishu Wei, Chunhua Xi, Feng Guo, Jianmin Chen, Zipeng Lu, Kuirong Jiang, Yi Miao, Bin Xiao Tags: Original Research Article Source Type: research
My thoughts: The rise of social media as a reporting source for firearm violence
The United States (US) continues to grapple with the firearm violence epidemic, a crisis exacerbated during the COVID-19 pandemic.1 Historically, firearm violence reporting has been dominated by traditional media channels like television and newspapers. However, with the rapid growth of social media, news has shifted toward platforms such as Twitter (now known as X), Facebook, Instagram, or Tik Tok, with 61% of Americans using these as their regular news source.2 Twitter particularly has become a source of real-time information, increasingly utilized by first responders and bystanders in mass shootings. (Source: American Journal of Surgery)
Source: American Journal of Surgery - February 12, 2024 Category: Surgery Authors: Shaelyn Choi, Jason Liang, Megan R. Donnelly, Mallory Jebbia, Catherine M. Kuza, Lourdes Swentek, Areg Grigorian, Jeffry Nahmias Tags: My Thoughts / My Surgical Practice Source Type: research
Traumatic lower extremity amputation as a risk factor for venous thromboembolism
This study aimed to evaluate whether lower extremity (LE) amputation among civilian casualties is a risk factor for venous thromboembolism. (Source: American Journal of Surgery)
Source: American Journal of Surgery - February 12, 2024 Category: Surgery Authors: Dias Argandykov, Emanuele Lagazzi, Jefferson A. Proa ño-Zamudio, Wardah Rafaqat, May Abiad, Michael DeWane, Charudutt N. Paranjape, Haytham M.A. Kaafarani, George C. Velmahos, John O. Hwabejire Tags: Original Research Article Source Type: research
Are we measuring what matters most? ACP completion among patients undergoing gastrostomy tube placement
An alleged benefit of Advance Care Planning (ACP) is the facilitation of goal-concurrent care for patients facing serious and life-limiting illness. In this edition of The American Journal of Surgery, Williams et al. retrospectively examine the prevalence of advanced care planning (ACP) documentation among a diverse cohort of 877 patients undergoing endoscopic, fluoroscopic, laparoscopic, or open surgical gastrostomy tube (GT) procedures at an academic, tertiary-care safety-net hospital.1 The authors report that only 10.6% of included patients had accessible ACP documents available within the electronic medical record (EMR...
Source: American Journal of Surgery - February 10, 2024 Category: Surgery Authors: R. Ekaireb, K.E. Kopecky Tags: Invited Commentary Source Type: research
Some thoughts on surgery for primary hyperparathyroidism
Parathyroid surgery is an endless exercise of intelligence, enjoyment and … frustration. Even well-trained endocrine surgeons acknowledge that although straightforward parathyroidectomy (PTX) is the rule in, let's say, 90% of the cases, the remaining 10% can be a real challenge, not only from a technical point of view but also from the diagnostic, localization, genetics and postoperative aspects. I am pleased and honored to have been invited to write this introduction editorial and provide the reader with personal insights regarding some of the issues addressed in this comprehensive volume of the AJS on controversies and...
Source: American Journal of Surgery - February 10, 2024 Category: Surgery Authors: Antonio Sitges-Serra Tags: My Thoughts / My Surgical Practice Source Type: research
Patient reported outcomes of emergency general surgery procedures
Emergency general surgery (EGS) involves care of a patient's often previously unknown disease in the setting of an unplanned interaction with the healthcare system. This leads to challenges collecting and interpreting patient reported outcome measures (PROMs). (Source: American Journal of Surgery)
Source: American Journal of Surgery - February 10, 2024 Category: Surgery Authors: Pawan J. Mathew, Yasmin M. Ali, Rick O'Connor, Rachel Levinson, Ahmed Khan, Kevin M. Schuster Tags: Original Research Article Source Type: research
