In the Next Issue
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: In the Next Issue - Online Only Source Type: research

The “T” now Matters: The Eighth Edition of the Union for International Cancer Control Classification of Pancreatic Adenocarcinoma
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Letters and Responses Source Type: research

Response to: “Sweet Versus Ivor-Lewis Is It Time To Draw a Conclusion?”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Letters and Responses Source Type: research

Sweet Versus Ivor-Lewis: Is It Time To Draw a Conclusion?
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Letters and Responses Source Type: research

Response to: “Aspirin Therapy on Blood Transfusion in Noncardiac Surgery Evidence From Quality Effect Model”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Letters and Responses Source Type: research

Aspirin Therapy on Blood Transfusion in Noncardiac Surgery: Evidence From Quality Effect Model
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Letters and Responses Source Type: research

Response to: “Carotid Endarterectomy Versus Stenting to Treat Carotid Stenosis There is More to Than Meets the Eye”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Letters and Responses Source Type: research

Carotid Endarterectomy Versus Carotid Stenting to Treat Carotid Stenosis: There Is More to Than Meets the Eye
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Letters and Responses Source Type: research

Response to: “Follow-up of the STOMAMESH Cohort”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Letters and Responses Source Type: research

Follow-up of the STOMAMESH Cohort
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Letters and Responses Source Type: research

Response to: “Prophylactic Mesh for the Prevention of Parastomal Hernias Need for a Deep Dive”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Letters and Responses Source Type: research

Prophylactic Mesh for the Prevention of Parastomal Hernias: Need for a Deep Dive
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Letters and Responses Source Type: research

Overlapping Surgery in Pediatric Surgical Care: Is It a Safe and Cost-effective Practice?
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Letter-Brief Clinical Reports Source Type: research

Assessing the Safety of Overlapping Surgery at a Children's Hospital
Conclusions: The safety of overlapping and nonoverlapping surgical procedures did not differ at this children's center. These findings may not extrapolate to other centers. LOS or intraoperative measures may be more appropriate than mortality for safety evaluations due to low event rates for mortality. (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Letter-Brief Clinical Reports Source Type: research

How Do Thresholds of Principle and Preference Influence Surgeon Assessments of Learner Performance?
Conclusions: The findings of the present study provide the first empirical evidence to suggest that surgeons’ attitudes toward their own procedural variations may be an important influence on the subjectivity of intraoperative assessment in surgical education. Assessment based on intraoperative entrustment may harness such subjectivity for the purpose of implementing competency-based surgical education. (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Original Articles Source Type: research

Intraoperative Use of Vasopressors Does Not Increase the Risk of Free Flap Compromise and Failure in Cancer Patients
Conclusions: Intraoperative use of phenylephrine, ephedrine, or calcium chloride as an intravenous bolus does not increase flap compromise and failure rates in cancer patients. (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Original Articles Source Type: research

Male Fertility After Inguinal Hernia Mesh Repair: A National Register Study
Conclusions: Patients who underwent inguinal hernia repair using Lichtenstein technique or laparoscopic approach did not father fewer children than expected. Thus, inguinal hernia repair using Lichtenstein or laparoscopic approach did not impair male fertility. (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Original Articles Source Type: research

Long-term Outcomes of Carotid Endarterectomy Versus Stenting in a Multicenter Population-based Canadian Study
Objective: To compare the long-term outcomes of patients treated with carotid endarterectomy and carotid-artery stenting. Background: Evidence for the long-term safety and efficacy of carotid-artery stenting compared with endarterectomy is accumulating from randomized trials. However, comparative data on the long-term outcomes of carotid revascularization strategies in real world practice are lacking. Methods: We conducted a population-based, multicenter, observational cohort study using validated linked databases from Ontario, Canada. We identified all individuals treated with carotid endarterectomy and stenting (...
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Original Articles Source Type: research

Myocardial Injury After Noncardiac Surgery (MINS) in Vascular Surgical Patients: A Prospective Observational Cohort Study
The objectives of the present study were to determine (i) if MINS is prognostically important in vascular surgical patients, (ii) the clinical characteristics of vascular surgery patients with and without MINS, (iii) the 30-day outcomes for vascular surgery patients with and without MINS, and (iv) the proportion of MINS that probably would have gone undetected without routine troponin monitoring. Results: The incidence of MINS in the vascular surgery patients was 19.1% (95% confidence interval (CI), 15.7%–22.6%). 30-day all-cause mortality in the vascular cohort was 12.5% (95% CI 7.3%–20.6%) in patients with...
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Original Articles Source Type: research

Novel Synthetic, Host-defense Peptide Protects Against Organ Injury/Dysfunction in a Rat Model of Severe Hemorrhagic Shock
Conclusions: Trauma-associated HS results in release of LL-37. The synthetic host-defense/antimicrobial peptide Pep19-4LF attenuates the organ injury/dysfunction associated with HS. (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Original Articles Source Type: research

Multi-institutional Validation Study of Pancreatic Cyst Fluid Protein Analysis for Prediction of High-risk Intraductal Papillary Mucinous Neoplasms of the Pancreas
Objective: Preliminary work by our group suggested that proteins within the pancreatic cyst fluid (CF) may discriminate degree of IPMN dysplasia. We sought to externally validate these markers and determine whether their inclusion in a preoperative clinical nomogram could increase diagnostic accuracy. Summary Background Data: IPMN is the most common radiographically identifiable precursor to pancreatic cancer; however, the timing and frequency of its malignant progression are unknown, and there are currently no reliable preoperative tests that can determine the grade of dysplasia in IPMN. Methods: Clinical and radi...
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Original Articles Source Type: research

Liver Inflammation Relates to Decreased Canalicular Bile Transporter Expression in Pediatric Onset Intestinal Failure
Conclusions: In pediatric onset IF, current PN delivery synergistically with intestinal compromise promote liver inflammation, which associates with progression of biochemical and histologic liver injury, while reducing expression of canalicular bile transporters. (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Original Articles Source Type: research

Use of Elderly Donors in Liver Transplantation: A Paired-match Analysis at a Single Center
Objective: To evaluate the use of elderly donors in liver transplantation (LT) and identify risk factors associated with a worse outcome. Summary Background Data: Use of livers from very old donors could expand the donor pool but is not universally implemented. Methods: This is a retrospective, single-center medical record review. From January 2001 to December 2014, 1354 LTs were performed. After exclusion of donors (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Original Articles Source Type: research

Open versus Laparoscopic Surgery for Advanced Low Rectal Cancer: A Large, Multicenter, Propensity Score Matched Cohort Study in Japan
Background: Laparoscopic surgery for rectal cancer is widely performed all over the world and several randomized controlled trials have been reported. However, the usefulness of laparoscopic surgery compared with open surgery has not been demonstrated sufficiently, especially for the low rectal area. Objective: The aim of this study was to investigate the hypothesis that laparoscopic primary tumor resection is safe and effective when compared with the open approach for locally advanced low rectal cancer. Patients and Methods: Data from patients with clinical stage II to III low rectal cancer below the peritoneal re...
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Original Articles Source Type: research

Higher Surgical Morbidity for Ulcerative Colitis Patients in the Era of Biologics
Objective: To investigate differences in surgical approach and postoperative outcomes for patients with ulcerative colitis (UC) before and after the introduction of biologic therapy. Background: Biologic use has dramatically increased since Food and Drug Administration approval of infliximab. Studies conflict as to the effect of these agents on surgical outcomes with some demonstrating worse surgical outcomes whereas others have found no difference. Methods: We used an administrative, all-payer, all-age group database located in New York State. Patients were included if they had a diagnosis of UC and underwent surg...
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Original Articles Source Type: research

Hospital Minimally Invasive Surgery Utilization for Gastrointestinal Cancer
Objective: The aim of the study was to evaluate the impact of receiving care at high minimally invasive surgery (MIS)-utilizing hospitals Background: MIS techniques are used across surgical specialties. The extent of MIS utilization for gastrointestinal (GI) cancer resection and impact of receiving care at high utilizing hospitals is unclear. Methods: This is a retrospective cohort study of 137,581 surgically resected esophageal, gastric, pancreatic, hepatobiliary, colon, and rectal cancer patients within the National Cancer Data Base (2010–2013). Disease-specific, hospital-level, reliability-adjusted MIS uti...
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Original Articles Source Type: research

Cytoreductive Surgery for Metastatic Gastrointestinal Stromal Tumors Treated With Tyrosine Kinase Inhibitors: A 2-institutional Analysis
Objective: To refine treatment recommendations for patients with metastatic gastrointestinal stromal tumors (GISTs) treated with tyrosine kinase inhibitors (TKIs) and surgery. Background: Early reports suggested that patients with metastatic GIST responding to TKIs treated with surgery may have favorable outcomes. However, identification of prognostic factors was limited by small cohorts. Methods: Progression-free survival (PFS) and overall survival (OS) from time of surgery and from start of initial TKI was determined. Multivariate analysis was conducted on all patients undergoing GIST metastasectomy between 2001 ...
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Original Articles Source Type: research

Recurrence Risk Stratification After Preoperative Chemoradiation of Esophageal Adenocarcinoma
Objective: To discern recurrence risk stratification and investigate its influence on postoperative surveillance in patients with esophageal adenocarcinoma (EAC) after neoadjuvant chemoradiotherapy (CRT). Background: Reports documenting recurrence risk stratification in EAC after neoadjuvant CRT are scarce. Methods: Between 1998 and 2014, 601 patients with EAC who underwent neoadjuvant CRT followed by esophagectomy were included for analysis. The pattern, site, timing, and frequency of the first recurrence and potential prognostic factors for developing recurrences were analyzed. This cohort was used as the trainin...
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Original Articles Source Type: research

Improving Benchmarks for Global Surgery: Nationwide Enumeration of Operations Performed in Ghana
Conclusion: The operation rate was short of the Lancet Commission benchmark, indicating large unmet need, although most operations were in the essential procedure category. Future global surgery benchmarking should consider both total numbers and priority levels. Most surgical care was delivered at district-level hospitals, many without fully trained surgeons. Benchmarking to improve surgical care needs to address both access deficiencies and hospital and provider level. (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Original Articles Source Type: research

Do Surgeons React?: A Retrospective Analysis of Surgeons’ Response to Harassment of a Colleague During Simulated Operating Theatre Scenarios
Conclusion: It is apparent that trainees are more aware of instances of harassment, and were more likely to intervene during the simulated scenario. However, a large proportion of harassment was unchallenged. The hierarchical nature of surgical education and the surgical workforce in general needs to enable a culture in which the responsibility to intervene is allowed and respected. Simulation-based education programs could be developed to train in the recognition and intervention of discrimination, bullying, harassment and sexual harassment. (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Original Articles Source Type: research

Probability of Opioid Prescription Refilling After Surgery: Does Initial Prescription Dose Matter?
Conclusions: The probability of refilling prescription opioids after surgery was not correlated with initial prescription strength, suggesting surgeons could prescribe smaller prescriptions without influencing refill requests. Future research that examines the interplay between pain, substance abuse, and mental health could inform strategies to tailor opioid prescribing for patients. (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Original Articles Source Type: research

Achievements and Challenges in Facial Transplantation
The first facial transplantation in 2005 ushered in a new era in reconstructive surgery, offering new possibilities for the repair of severe disfigurements previously limited by conventional techniques. Advances in allograft design, computerized preoperative planning, surgical technique, and postoperative revisions have helped push the boundaries in this new frontier of vascularized composite allotransplantation. Over the past 12 years, 40 of these procedures have been performed across the world, offering the field the opportunity to reflect on current outcomes. Successes achieved in the brief history of facial transplanta...
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Review Paper Source Type: research

Robotic Versus Video-assisted Lobectomy/Segmentectomy for Lung Cancer: A Meta-analysis
Objective: To compare the safety/efficacy of the robotic-assisted lobectomy/segmentectomy (RAL/S) with the video-assisted lobectomy/segmentectomy (VAL/S) for radical lung cancer resection. Background: It remains uncertain whether the newly developed RAL/S is comparable with the VAL/S. Methods: A comprehensive search of online databases was performed. Perioperative outcomes were synthesized. Cumulative meta-analysis was performed to evaluate the temporal trend of pooled outcomes. Specific subgroups (propensity score matching studies, pure lobectomy studies) were examined. Results: Analysis of 14 studies including a...
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Meta-Analyses Source Type: research

The Safety and Efficacy of Laparoscopic Common Bile Duct Exploration Combined with Cholecystectomy for the Management of Cholecysto-choledocholithiasis: An Up-to-date Meta-analysis
Conclusion: The updated meta-analysis first confirms that LCBDE+LC is superior to pre-EST+LC both in perioperative safety and short- and long-term postoperative efficacy, which should be considered as optimal treatment choice for cholecysto-choledocholithiasis. (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Meta-Analyses Source Type: research

Higher Recurrence Rate After Endoscopic Totally Extraperitoneal (TEP) Inguinal Hernia Repair With Ultrapro Lightweight Mesh: 5-Year Results of a Randomized Controlled Trial (TULP-trial)
Conclusions: The overall recurrence rate 5 years after TEP repair was low. Ultrapro lightweight meshes showed higher recurrence rates than heavyweight meshes and are not recommended for endoscopic TEP inguinal hernia repair. (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Randomized Controlled Trials Source Type: research

Medial Open Transversus Abdominis Plane (MOTAP) Catheters Reduce Opioid Requirements and Improve Pain Control Following Open Liver Resection: A Multicenter, Blinded, Randomized Controlled Trial
Conclusion: MOTAP catheter analgesia reduces opioid requirements, pain, and length of hospital stay compared with IV PCA following open liver resection with subcostal incisions. (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Randomized Controlled Trials Source Type: research

Randomized Trial of Division Versus Nondivision of Short Gastric Vessels During Nissen Fundoplication: 20-Year Outcomes
Conclusions: Although laparoscopic Nissen fundoplication has durable efficacy for heartburn symptom control at up to 20 years follow-up, division of short-gastric vessels failed to confer any reduction in side effects, and was associated with persistent epigastric bloat symptoms at late follow-up in this trial. (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Randomized Controlled Trials Source Type: research

The Whiteboard Technique: Personalized Communication to Improve Operating Room Teamwork
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Surgical Perspective Source Type: research

Preoperative Chemoradiation for Borderline Resectable Pancreatic Cancer: The New Standard?
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Features Source Type: research

Oncological Benefits of Neoadjuvant Chemoradiation With Gemcitabine Versus Upfront Surgery in Patients With Borderline Resectable Pancreatic Cancer: A Prospective, Randomized, Open-label, Multicenter Phase 2/3 Trial
Conclusion: This is the first prospective randomized controlled trial on the oncological benefits of neoadjuvant treatment in BRPC. Compared to upfront surgery, neoadjuvant chemoradiation provides oncological benefits in patients with BRPC. (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Features Source Type: research

Invited Commentary on: Gender Differences in Utilization of Duty-hour Regulations, Aspects of Burnout, and Psychological Well-being Among General Surgery Residents in the U.S
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Features Source Type: research

Gender Differences in Utilization of Duty-hour Regulations, Aspects of Burnout, and Psychological Well-being Among General Surgery Residents in the United States
Objective: The aim of the study was to (1) assess differences in how male and female general surgery residents utilize duty-hour regulations and experience aspects of burnout and psychological well-being, and (2) to explore reasons why these differing experiences exist. Background: There may be differences in how women and men enter, experience, and leave residency programs. Methods: A total of 7395 residents completed a survey (response rate = 99%). Logistic regression models were developed to examine the association between gender and resident outcomes. Semistructured interviews were conducted with 42 faculty and...
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Features Source Type: research

Overadjustment Bias as a Threat in the Drive for Gender Equity
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Features Source Type: research

Sex Differences in Faculty Rank Among Academic Surgeons in the United States in 2014
Conclusion: Among surgical faculty at US medical schools in 2014, women were less likely than men to be full professors after adjustment for multiple factors known to impact faculty rank. (Source: Annals of Surgery)
Source: Annals of Surgery - July 11, 2018 Category: Surgery Tags: Features Source Type: research

In the Next Issue
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 12, 2018 Category: Surgery Tags: In the Next Issue - Online Only Source Type: research

Response to: “Letter to the Editor for ‘Low Versus Standard Urine Output Targets in Patients Undergoing Major Abdominal Surgery’”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 12, 2018 Category: Surgery Tags: Letters and Responses Source Type: research

Letter to the Editor for “Low Versus Standard Urine Output Targets in Patients Undergoing Major Abdominal Surgery”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 12, 2018 Category: Surgery Tags: Letters and Responses Source Type: research

Response to: “Reducing the Burden of Catastrophic Health Expenditures in the United States”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 12, 2018 Category: Surgery Tags: Letters and Responses Source Type: research

Reducing the Burden of Catastrophic Health Expenditures in the United States
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 12, 2018 Category: Surgery Tags: Letters and Responses Source Type: research

Response: “Prophylactic Negative Pressure Dressing Use in Closed Laparotomy Wounds Following Abdominal Operations What We Really Know?”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 12, 2018 Category: Surgery Tags: Letters and Responses Source Type: research