Response to the Comment on “Meta-analysis of Effect of Volume (Hospital and Operator) on Carotid Revascularization Outcomes”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Response to the Comment on “The Prevalence of Lymph Node Metastases in Patients With T1 Esophageal Adenocarcinoma A Retrospective Review of Esophagectomy Specimens”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Comment on “Long Term Outcome of Surgery Versus Conservative Management for Recurrent and Ongoing Complaints After an Episode of Diverticulitis. 5-year Follow-up Results of a Multicenter Randomized Control Trial (DIRECT-trial)”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Response to the Comment on “Preoperative Ultrasound Assessment of Regional Lymph Nodes in Melanoma Patients Does Not Provide Reliable Staging: Results From a Large Multicenter Trial”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Comment on “Preoperative Ultrasound Assessment of Regional Lymph Nodes in Melanoma Patients Does Not Provide Reliable Nodal Staging: Results From a Large Multicenter Trial”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Response to the Comment on “Effect of Microvascular Invasion Risk on Early Recurrence of Hepatocellular Carcinoma After Surgery and Radiofrequency Ablation”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Comment on “Effect of Microvascular Invasion Risk on Early Recurrence of Hepatocellular Carcinoma After Surgery and Radiofrequency Ablation”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Comment on “Survival Following Liver Transplantation for Patients With Nonresectable Liver-only Colorectal Metastases”: What if Those Lesions are Gone?
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Commentary on: Intraoperative Celiac Plexus Block With Preperitoneal Infusion Reduces Opioid Usage in Major Hepato-pancreato-biliary Surgery: A Pilot Study
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Intraoperative Celiac Plexus Block With Preperitoneal Infusion Reduces Opioid Usage in Major Hepato-pancreato-biliary Surgery: A Pilot Study
Conclusions: CPB can be considered as part of a multimodal approach for postoperative pain management in open hepato-pancreato-biliary surgeries. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Surgeons and Machines Can Learn From Operative Video: Will the System Let Them?
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

A Computer Vision Platform to Automatically Locate Critical Events in Surgical Videos: Documenting Safety in Laparoscopic Cholecystectomy
Conclusions: Deep learning models for workflow analysis can be used to reliably locate critical events in surgical videos and document CVS in LC. Further studies are needed to assess the clinical impact of surgical data science solutions for safer laparoscopic cholecystectomy. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

What a Reduction in Disparities Can Look Like…and What it Signifies
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: DISPARITIES, DIVERSITY AND SOCIAL JUSTICE Source Type: research

Disparities in Surgical Readmissions and Use of Observation Status in Hip and Knee Replacements: A Retrospective Cohort Study
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: DISPARITIES, DIVERSITY AND SOCIAL JUSTICE Source Type: research

What's in a System? The Uncertain Meaning of Health System Affiliation in Surgery
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Preoperative Cognitive Evaluations: An Opportunity to Protect the Vulnerable Brain
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

A Call for Caution in Overinterpreting Exceptional Outcomes After Radical Surgery for Pancreatic Cancer: Let the Data Speak
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Perioperative Symptoms: A New Frontier for Surgical Palliative Care
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Readmission After Lobectomy for Lung Cancer: Not All Complications Contribute Equally
Conclusions: Complications are the main driver of readmission after lobectomy for lung cancer. The highest risk was related to postoperative events requiring a procedure or medical therapy necessitating inpatient care. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Impact of Trainee Participation on Inguinal Hernia Repair Outcome: A Study Based on the Swedish Hernia Register
Objective: The aim of this study was to investigate whether differences in postoperative outcome exist between open inguinal hernia repairs performed by surgical trainees and those performed by specialist surgeons. Summary of Background Data: Inguinal hernia repair is the prototype educational surgical procedure. The impact of trainee participation on postoperative outcome is still controversial and despite earlier studies no reliable hernia-specific data exist. Methods: The study cohort was based on the Swedish Hernia Register and consisted of 61,161 cases of male patients aged 18 years and older with op...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): Zone I Balloon Occlusion Time Affects Spinal Cord Injury in the Nonhuman Primate Model
Conclusions: REBOA limits mortality in the primate model of severe hemorrhagic shock. However, unopposed balloon inflation in the distal thoracic aorta for 60 minutes results in high rates of spinal cord ischemia, an effect mitigated by limiting balloon inflation to 30 minutes. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Prior Resection of the Primary Tumor Prolongs Survival After Peptide Receptor Radionuclide Therapy of Advanced Neuroendocrine Neoplasms
Objective: The aim of the study was to compare impact on survival after resection of primary tumors (PTs) after peptide receptor radionuclide therapy (PRRT). Background: PRRT is a highly effective therapeutic option to treat locally advanced or metastatic neuroendocrine neoplasms (NENs). Methods: We retrospectively analyzed the data of 889 patients with advanced NEN (G1-G3, stage IV) treated with at least 1 cycle of PRRT. In 486 of 889 patients (55%, group 1), PT had been removed before PRRT. Group 2 constituted 403 patients (45%) with no prior PT resection. Progression-free survival (PFS) and overall sur...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Left-sided Portal Hypertension After Pancreaticoduodenectomy With Resection of the Portal Vein/Superior Mesenteric Vein Confluence in Patients With Pancreatic Cancer: A Project Study by the Japanese Society of Hepato-Biliary-Pancreatic Surgery
Objective: The aim of this study was to evaluate how often left-sided portal hypertension (LPH) develops and how LPH affects the long-term outcomes of patients with pancreatic cancer treated with pancreaticoduodenectomy (PD) and resection of the portal vein (PV)/superior mesenteric vein (SMV) confluence. Summary Background Data: Little is known about LPH after PD with resection of the PV/SMV confluence. Methods: Overall, 536 patients who underwent PD with PV/SMV resection were enrolled. Among them, we mainly compared the SVp group [n=285; the splenic vein (SV) was preserved] and the SVr group (n = 227; th...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

New Nodal Staging for Primary Pancreatic Neuroendocrine Tumors: A Multi-institutional and National Data Analysis
Objective: To determine the prognostic role of metastatic lymph node (LN) number and the minimal number of LNs for optimal staging of patients with pancreatic neuroendocrine tumors (pNETs). Background: Prognosis relative to number of LN metastasis (LNM), and minimal number of LNs needed to evaluate for accurate staging, have been poorly defined for pNETs. Methods: Number of LNM and total number of LN evaluated (TNLE) were assessed relative to recurrence-free survival (RFS) and overall survival (OS) in a multi-institutional database. External validation was performed using Surveillance, Epidemiology and En...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Procedure-specific Training for Robot-assisted Distal Pancreatectomy
Objective: To train practicing surgeons in robot-assisted distal pancreatectomy (RADP) and assess the impact on 5 domains of healthcare quality. Background: RADP may reduce the treatment burden compared with open distal pancreatectomy (ODP), but studies on institutional training and implementation programs are scarce. Methods: A retrospective, single-center, cohort study evaluating surgical performance during a procedure-specific training program for RADP (January 2006 to September 2017). Baseline and unadjusted outcomes were compared “before training” (ODP only; June 2012). Exclusion criteria...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Intraoperative Increase of Portal Venous Pressure is an Immediate Predictor of Posthepatectomy Liver Failure After Major Hepatectomy: A Prospective Study
Objectives: The aim of this study was to assess intraoperative changes of hepatic macrohemodynamics and their association with ascites and posthepatectomy liver failure (PHLF) after major hepatectomy. Summary of Background Data: Large-scale ascites and PHLF remain clinical challenges after major hepatectomy. No study has concomitantly evaluated arterial and venous liver macrohemodynamics in patients undergoing liver resection. Methods: Portal venous pressure (PVP), portal venous flow (PVF), and hepatic arterial flow (HAF) were measured intraoperatively pre- and postresection in 67 consecutive patients wit...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Circulating MicroRNAs in Small-bowel Neuroendocrine Tumors: A Potential Tool for Diagnosis and Assessment of Effectiveness of Surgical Resection
Conclusions: Our study represents the largest global profiling of serum miRNAs in SBNET patients, and the first to evaluate ongoing serum miRNA expression changes after surgical resection. Serum miR-125b-5p and miR-362–5p have potential to be used to detect RSD/RCD. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Mental Skills in Surgery: Lessons Learned From Virtuosos, Olympians, and Navy Seals
Conclusions: Establishing a taxonomy for mental skills in surgery may help in the development of robust mental skills training programs to promote optimal surgeon wellness and performance. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Surgical Repair of Congenital Diaphragmatic Hernia After Extracorporeal Membrane Oxygenation Cannulation: Early Repair Improves Survival
Objective: To determine the optimal timing of congenital diaphragmatic hernia (CDH) repair after extracorporeal membrane oxygenation (ECMO) cannulation Summary Background Data: The timing of CDH repair after ECMO cannulation remains a controversial topic due to studies with low power or strong selection bias. Methods: This is a 2-aim retrospective cohort study based on the CDH Study Group registry for the period of 2007–2017. Aim 1—Compare On versus After ECMO repair. Aim 2—Compare Early versus Late repair on ECMO. In order to minimize selection bias and account for non-repairs, subjects...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Long-term Reintervention After Endovascular Abdominal Aortic Aneurysm Repair
Conclusions: All patients retain a high likelihood of reintervention after EVR, but clinical factors at the time of repair can predict those at highest risk. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Risk of Lymphedema Following Contemporary Treatment for Breast Cancer: An Analysis of 7617 Consecutive Patients From a Multidisciplinary Perspective
Objective: The aim of this study was to identify the comprehensive risk factors for lymphedema, thereby enabling a more informed multidisciplinary treatment decision-making. Summary Background Data: Lymphedema is a serious long-term complication in breast cancer patients post-surgery; however, the influence of multimodal therapy on its occurrence remains unclear. Methods: We retrospectively collected treatment-related data from 5549 breast cancer patients who underwent surgery between 2007 and 2015 at our institution. Individual radiotherapy plans were reviewed for regional nodal irradiation (RNI) field d...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Recurrence in Patients Achieving Pathological Complete Response After Neoadjuvant Treatment for Advanced Pancreatic Cancer
Conclusions: A pCR following neoadjuvant therapy in patients with advanced PDAC is associated with remarkable survival, although recurrence occurs in about half of patients. Nevertheless, patients with pCR and recurrence respond well to treatment and survival remains encouraging. Advanced molecular characterization and longitudinal liquid biopsy may offer additional assistance with understanding tumor biologic behavior after achieving a pCR. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

A Predictive Model for Nodal Metastases in Patients With Appendiceal Cancers
Conclusions: The risk for nodal metastases in patients with appendiceal cancers can be quantified with reasonable accuracy using a predictive model incorporating patient age, sex, tumor histology, T-stage, and grade. This can help inform clinical decision making regarding the need for a right hemicolectomy following appendectomy. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Management of Pneumoperitoneum: Role and Limits of Nonoperative Treatment
Conclusions: Operative intervention is associated with reduced mortality in patients with pneumoperitoneum and peritonitis. In the absence of peritonitis, operative treatment is associated with increased morbidity and nonhome discharge. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Patients Undergoing Ileoanal Pouch Surgery Experience a Constellation of Symptoms and Consequences Representing a Unique Syndrome: A Report From the Patient-Reported Outcomes After Pouch Surgery (PROPS) Delphi Consensus Study
Conclusions: This study is the first to identify key functional outcomes after pouch surgery with direct input from a large panel of ileoanal pouch patients. The inclusion of patients in all stages of the consensus process allowed for a true patient-centered approach in defining the core domains that should be focused on in future studies of pouch function. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Long-term Comparison of Robotic and Laparoscopic Gastrectomy for Gastric Cancer: A Propensity Score-weighted Analysis of 2084 Consecutive Patients
Conclusions: After balancing covariates, RG demonstrated reliable surgical outcomes from the beginning. Long-term survival after RG and LG for GC was similar. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Mapping of Lymph Node Metastasis From Esophagogastric Junction Tumors: A Prospective Nationwide Multicenter Study
Conclusion: The study accurately identified the distribution of lymph node metastases from EGJ tumors and the optimal extent of subsequent lymph node dissection. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

System Factors Affecting Patient Safety in the OR: An Analysis of Safety Threats and Resiliency
Conclusions: Through a detailed human factors analysis of elective laparoscopic general surgery cases, this study provided a quantitative analysis of the existing safety threats and resilience supports in a modern endoscopic operating room. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Variation in Intraoperative and Postoperative Utilization for 3 Common General Surgery Procedures
Conclusions: Surgeons are significant drivers of variation in surgical supply costs and procedure time, but much less so for postoperative LOS. Intraoperative and postoperative utilization profiles can be generated for individual surgeons and may be an important tool for reducing surgical costs. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Consensus Guidelines for the Use of Fluorescence Imaging in Hepatobiliary Surgery
Conclusions: The Shanghai consensus recommendations offer practical tips and techniques to augment the safety and technical feasibility of ICG fluorescence-guided hepatobiliary surgery, including laparoscopic cholecystectomy, liver segmentectomy, and liver transplantation. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: REVIEW PAPERS Source Type: research

Intraoperative Red Blood Cell Transfusion Decision-making: A Systematic Review of Guidelines
The objective of this work was to carry out a systematic review of clinical practice guidelines (CPGs) pertaining to intraoperative red blood cell (RBC) transfusions, in terms of indications, decision-making, and supporting evidence base. Summary of Background Data: RBC transfusions are common during surgery and there is evidence of wide variability in practice. Methods: Major electronic databases (MEDLINE, EMBASE, and CINAHL), guideline clearinghouses and Google Scholar were systematically searched from inception to January 2019 for CPGs pertaining to indications for intraoperative RBC transfusion. Eligible ...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: REVIEW PAPERS Source Type: research

Outcomes of Laparoscopic Redo Fundoplication in Patients With Failed Antireflux Surgery: A Systematic Review and Meta-analysis
Conclusions: LRF is a feasible and safe procedure that provides symptom relief and improved QoL to the vast majority of patients. Although heterogeneously assessed, recurrence rates seem to be low. LRF should be considered a valuable treatment modality for patients with failed antireflux surgery. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: META-ANALYSES Source Type: research

The Impact of Prehabilitation on Patient Outcomes in Hepatobiliary, Colorectal, and Upper Gastrointestinal Cancer Surgery: A PRISMA-Accordant Meta-analysis
Objective: To determine the impact of prehabilitation on hospital length of stay, functional capacity, complications, and mortality after surgery in patients with hepatobiliary, colorectal, and upper gastrointestinal cancer. Background: “Prehabilitation” encompasses exercise, nutrition, and psychosocial interventions to optimize health before surgery. The benefits of prehabilitation are ill-defined. Methods: Medline, Embase and Cochrane Databases were searched systematically for the terms “prehabilitation AND exercise,” “perioperative care AND cancer surgery,” and &ldqu...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: META-ANALYSES Source Type: research

Intermittent Pneumatic Compression in Addition to Standard Prophylaxis of Postoperative Venous Thromboembolism in Extremely High-risk Patients (IPC SUPER): A Randomized Controlled Trial
Conclusions: Among patients with a Caprini score of ≥11 who received standard prophylaxis for VTE, adjunctive IPC resulted in a significantly lower incidence of asymptomatic venous thrombosis. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Feasibility and Safety of Laparoscopic Complete Mesocolic Excision (CME) for Right-sided Colon Cancer: Short-term Outcomes. A Randomized Clinical Study
Objective: The aim of this prospective clinical study is to compare short-term outcome of laparoscopic right hemicolectomy using the Complete Mesocolic Excision (CME group) with patients who underwent conventional right-sided colonic resection (NCME group). Summary Background Data: Although CME with central vascular ligation in laparoscopic right hemicolectomy is associated with a significant decrease in local recurrence rates and improvements in cancer-related 5-year survival, there may be additional risks associated with this technique because of increased surgical complications. As a result, there is controve...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

International Delphi Expert Consensus on Safe Return to Surgical and Endoscopic Practice: From the Coronavirus Global Surgical Collaborative
Conclusions: The Delphi process resulted in 99 recommendations. These consensus statements provide expert guidance, based on scientific methodology, for the safe resumption of surgical activities during the COVID-19 pandemic. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: COVID-19 Source Type: research

Short-term Effects of Canceled Elective Procedures Due to COVID-19: Evidence From the Veterans Affairs Healthcare System
Conclusions: The pause in elective surgical cases was not associated with short-term adverse outcomes in VA hospitals, suggesting appropriate surgical case triage and management. Further study will be essential to determine if the delayed cases were associated with longer-term effects. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: COVID-19 Source Type: research

Analysis of COVID-19 Patients With Acute Respiratory Distress Syndrome Managed With Extracorporeal Membrane Oxygenation at US Academic Centers
Conclusions: In this large US study of patients with COVID-19 and ARDS managed with ECMO, the in-hospital mortality is high but much lower than initial reports. Future research is needed to evaluate which patients with COVID-19 and ARDS would benefit from ECMO. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: COVID-19 Source Type: research

How Hospitals Can Save Lives and Themselves: Lessons on Patient Flow From the COVID-19 Pandemic
This article lays out a tested strategy that surgical and hospital leaders can use to overcome clinical and financial strain, emphasizing the experience at 2 leading North American medical centers. By classifying the time and resource needs of surgical patients and smoothing the flow of surgical admissions over all days of the week, hospitals can dramatically improve hospital efficiency, the quality of care and timely access to care for emergent and urgent surgeries. Through and beyond the time of COVID, smoothing the flow of surgical patients is a key means to restore hospital vitality and improve the care of all patients...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

The Left Hepatic Bile Duct Is Not Longer?!
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research