In the Next Issue
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: IN THE NEXT ISSUE - ONLINE ONLY Source Type: research

Technology for Technology's Sake No Longer
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: BRIEF CLINICAL REPORTS (WITH COMMENTARY) Source Type: research

Patient-specific 3D Printing: A Novel Technique for Complex Pediatric Renal Transplantation
Conclusions: We report the new and safe integration of patient-specific 3D printing into complex pediatric renal transplantation. This technique enhances surgical planning and can inform operative feasibility in those cases which would otherwise be uncertain. (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: BRIEF CLINICAL REPORTS (WITH COMMENTARY) Source Type: research

Gender and Specialty Influences on Personal and Professional Life Among Trainees
This study aimed to determine the impact of surgical training on lifestyle and parenthood, and to assess for gender-based workplace issues. Background: The effects of a surgical career on lifestyle are difficult to quantify and may vary between male and female doctors. A gender gap is present in the highest tiers of the profession, and reasons why women do not attain senior positions are complex but likely relate to factors beyond merit alone. Methods: An anonymous Web-based survey was distributed to Irish surgical and nonsurgical trainees. They were asked questions regarding family planning, pregnancy outcomes, pare...
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

How Many Observations are Needed to Assess a Surgical Trainee's State of Operative Competency?
Conclusion: The number of observations needed to achieve reproducible assessments of operative competency far exceeds current certification requirements, yet remains an important and achievable goal. Attention should also be paid to the mix of cases and raters in order to assure fair judgments about operative competency and fair comparisons of trainees. (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

The Survival Benefit of a Novel Trauma Workflow that Includes Immediate Whole-body Computed Tomography, Surgery, and Interventional Radiology, All in One Trauma Resuscitation Room: A Retrospective Historical Control Study
Objective: The aim of this study was to evaluate the impact of a novel trauma workflow, using an interventional radiology (IVR)–computed tomography (CT) system in severe trauma. Background: In August 2011, we installed an IVR-CT system in our trauma resuscitation room. We named it the Hybrid emergency room (ER), as it enabled us to perform all examinations and treatments required for trauma in a single place. Methods: This retrospective historical control study conducted in Japan included consecutive severe (injury severity score ≥16) blunt trauma patients. Patients were divided into 2 groups: Conventional...
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Nationwide Procedural Trends for Renal Trauma Management
Objective: To characterize national trends in procedural management of renal trauma. Background: Management of renal trauma has evolved to favor a more conservative approach. For patients requiring intervention, there is a paucity of information to characterize the nature of procedural therapy administered. Methods: A retrospective cross-sectional analysis was performed using data contained within the National Trauma Data Bank. The National Trauma Data Bank is a voluntary data repository managed by the American College of Surgeons, containing data regarding trauma admissions at 747 level I to V trauma centers throu...
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Management of Reducible Ventral Hernias: Clinical Outcomes and Cost-effectiveness of Repair at Diagnosis Versus Watchful Waiting
Conclusions: Ventral hernia repair at diagnosis is very cost-effective. The choice between open and laparoscopic repair depends on surgical costs and postoperative quality of life. In patients with high risk of perioperative mortality or recurrence, watchful waiting is preferred. (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Lichtenstein Versus Total Extraperitoneal Patch Plasty Versus Transabdominal Patch Plasty Technique for Primary Unilateral Inguinal Hernia Repair: A Registry-based, Propensity Score-matched Comparison of 57,906 Patients
Objective: Outcome comparison of the Lichtenstein, total extraperitoneal patch plasty (TEP), and transabdominal patch plasty (TAPP) techniques for primary unilateral inguinal hernia repair. Background: For comparison of these techniques the number of cases included in meta-analyses of randomized controlled trials is limited. There is therefore an urgent need for more comparative data. Methods: In total, 57,906 patients with a primary unilateral inguinal hernia and 1-year follow up from the Herniamed Registry were selected between September 1, 2009 and February 1, 2015. Using propensity score matching, 12,564 matche...
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Outcomes of a Multicenter Training Program in Laparoscopic Pancreatoduodenectomy (LAELAPS-2)
Conclusions: This LPD training program was feasible and ensured acceptable outcomes during the learning curve in all centers. Future studies should determine whether such a training program is applicable in other settings and assess the added value of LPD. (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Identification of an Optimal Cut-off for Drain Fluid Amylase on Postoperative Day 1 for Predicting Clinically Relevant Fistula After Distal Pancreatectomy: A Multi-institutional Analysis and External Validation
Objective: The aim of this study was to investigate the relationship between drain fluid amylase value on the first postoperative day (DFA1) and clinically relevant fistula (CR-POPF) after distal pancreatectomy (DP), and to identify the cut-off of DFA1 that optimizes CR-POPF prediction. Background: DFA1 is a well-recognized predictor of CR-POPF after pancreatoduodenectomy, but its role in DP is largely unexplored. Methods: DFA1 levels were correlated with CR-POPF in 2 independent multi-institutional sets of DP patients: developmental (n = 338; years 2012 to 2017) and validation cohort (n = 166; years 2006 to 2016)....
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

The Liver Tunnel: Intention-to-treat Validation of a New Type of Hepatectomy
Conclusions: This study shows that LT is technically feasible and safe. Further studies are needed for standardizing its use. (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Impact of Surgical Treatment for Recurrence After 2-Stage Hepatectomy for Colorectal Liver Metastases, on Patient Outcome
Conclusions: Repeat surgery for recurrence after TSH may be crucial for the long-term survival in patients with extensive bilobar CRLM. Intensive oncosurgical surveillance is essential to avoid missing the chance for repeat surgery after TSH. (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Surgical and Survival Outcomes Following Pelvic Exenteration for Locally Advanced Primary Rectal Cancer: Results From an International Collaboration
Objective: The aim of the study was to analyze data from an international collaboration, and ascertain prognostic indicators that inform clinical decision-making and practices regarding the role of pelvic exenteration for locally advanced primary rectal cancer (LARC). Background: With improved national screening programs fewer patients present with LARC. Despite this, select cohorts of patients require pelvic exenteration. To date, the majority of outcome data are from single-center series. Methods: Anonymized data from 14 countries on patients who had pelvic exenteration for LARC between 2004 and 2014 were accumul...
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Functional Results and Quality of Life Following Magnetic Anal Sphincter Augmentation in Severely Incontinent Patients
Conclusions: Satisfaction, functional, and quality of life outcomes improve significantly following magnetic anal sphincter augmentation. (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Transcatheter Arterial Embolization Compared With Surgery for Uncontrolled Peptic Ulcer Bleeding: A Population-based Cohort Study
Objective: To compare key outcomes after transcatheter arterial embolization (TAE) with conventional surgery for peptic ulcer bleeding when endoscopic intervention fails to achieve hemostasis. Background: Mortality in peptic ulcer bleeding remains high, especially in patients who require surgical treatment. Methods: A population-based cohort study in Stockholm, Sweden, in 2000 to 2014, assessing the main outcome all-cause mortality and the secondary outcomes re-bleeding, re-intervention, length of hospitalization, and complications, was conducted. Data were taken from well-maintained registries and medical records....
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Safety of Revision Sleeve Gastrectomy Compared to Roux-Y Gastric Bypass After Failed Gastric Banding: Analysis of the MBSAQIP
Objective: The aim of this study was to assess the safety of revisional surgery to laparoscopic sleeve gastrectomy (LSG) compared to laparoscopic Roux-Y gastric bypass (LRYGB) after failed laparoscopic adjustable gastric banding (LAGB). Background: The number of reoperations after failed gastric banding rapidly increased in the United States during the last several years. A common approach is band removal with conversion to another weight loss procedure such as gastric bypass or sleeve gastrectomy in a single procedure. The safety profile of those procedures remains controversial. Methods: Preoperative characterist...
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Benchmarking Complications Associated with Esophagectomy
Conclusion: Standardized methods provide contemporary international benchmarks for reporting outcomes after esophagectomy. (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Causal Analysis of World Health Organization's Surgical Safety Checklist Implementation Quality and Impact on Care Processes and Patient Outcomes: Secondary Analysis From a Large Stepped Wedge Cluster Randomized Controlled Trial in Norway
Objective: We hypothesize that high-quality implementation of the World Health Organization's Surgical Safety Checklist (SSC) will lead to improved care processes and subsequently reduction of peri- and postoperative complications. Background: Implementation of the SSC was associated with robust reduction in morbidity and length of in-hospital stay in a stepped wedge cluster randomized controlled trial conducted in 2 Norwegian hospitals. Further investigation of precisely how the SSC improves care processes and subsequently patient outcomes is needed to understand the causal mechanisms of improvement. Methods: Care...
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Surgeons’ Perceptions Toward Providing Care for Diverse Patients: The Need for Cultural Dexterity Training
Conclusions: Surgeons identified the need to provide better cross-cultural care and proposed tenets for training. Based on these findings, we suggest the development and dissemination of a cultural dexterity training program that will provide surgeons with specific knowledge and skills to care for patients from diverse sociocultural backgrounds. (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Characteristics of Effective Mentorship for Academic Surgeons: A Grounded Theory Model
Conclusions: This study identified a need for multiple mentors across time and disciplines, and identified 3 key characteristics of effective mentoring relationships in academic surgery. Future work in this area should generate an operational definition of mentorship that supports quantitative evaluation of mentor and mentoring panel performance. (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Prognostic Value of Lymph Node Yield on Overall Survival in Esophageal Cancer Patients: A Systematic Review and Meta-analysis
Objective: This meta-analysis determines whether increased lymph node yield improves survival in patients with esophageal cancer undergoing esophagectomy with or without neoadjuvant therapy. Background: Esophagectomy involves resection of the esophagus and surrounding lymph nodes, which are commonly the first stations of cancer spread. The extent of lymphadenectomy during esophagectomy remains controversial, with several studies publishing conflicting results, especially in the era of neoadjuvant therapy. Methods: An electronic literature search was undertaken using Embase, Medline, and the Cochrane library databas...
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: META-ANALYSES Source Type: research

Preperitoneal or Subcutaneous Wound Catheters as Alternative for Epidural Analgesia in Abdominal Surgery: A Systematic Review and Meta-analysis
Conclusion: Continuous wound infiltration with preperitoneal wound catheters is an effective pain modality in abdominal surgery. Pain control is as effective as epidural analgesia, but could be favored based upon recovery parameters and patient satisfaction. (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: META-ANALYSES Source Type: research

Modified Blumgart Mattress Suture Versus Conventional Interrupted Suture in Pancreaticojejunostomy During Pancreaticoduodenectomy: Randomized Controlled Trial
Conclusions: Mattress suture of pancreatic parenchyma and the jejunal seromuscular layer during PJ (modified Blumgart technique) did not reduce clinically relevant POPF compared with interrupted suture. (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Perfect Registration Leads to Imperfect Performance: A Randomized Trial of Multimodal Intraoperative Image Guidance
Conclusion: Side-by-side unregistered image guidance (IG) improved safety and surgical efficiency in a simulated setting when compared with AR or NG. IG provides a more tangible opportunity for integrating image guidance into existing surgical workflow as well as delivering the safety and efficiency benefits desired. (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Burnout in Surgery Viewed Through the Lens of Psychological Safety
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: SURGICAL PERSPECTIVE Source Type: research

Ethical Issues Across the IDEAL Stages of Surgical Innovation
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: FEATURES Source Type: research

A Comparison of the Learning Curves of Laparoscopic Liver Surgeons in Differing Stages of the IDEAL Paradigm of Surgical Innovation: Standing on the Shoulders of Pioneers
Conclusions: With specific training, “early adapting” laparoscopic liver surgeons are able to overcome the learning curve for minor and major liver resections faster than the “pioneers” who were self-taught in LLS. The findings of this study are applicable to all surgical specialties and highlight the importance of specific training in the safe expansion of novel surgical practice. (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: FEATURES Source Type: research

No Surgical Innovation Without Evaluation: Evolution and Further Development of the IDEAL Framework and Recommendations
Conclusions: The intention of this article is to widen the practical use of IDEAL by clarifying the rationale for and practical details of the Recommendations. Additional research based on the experience of implementing these Recommendations is needed to further improve them. (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: FEATURES Source Type: research

Surgical Research in Patients: Ideal Time for an IDEAL Checklist
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: FEATURES Source Type: research

Leadership in American Surgery: Women are Rising to the Top
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: FEATURES Source Type: research

Leadership in American Surgery: Women are Rising to the Top
Conclusions: Great progress has been made in the advancement of women into leadership positions in surgery. To continue this trend and increase the number of under-represented minority women in surgery will require attention to recruitment, mentorship, and sponsorship. (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: FEATURES Source Type: research

Achieving High-value Surgical Care Through Accountable Care Organizations: Are the Risks Worth the Rewards?
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: FEATURES Source Type: research

Early Impact of Medicare Accountable Care Organizations on Inpatient Surgical Spending
Conclusion: Although Medicare ACOs have had success reducing spending for medical care, they have not had similar success with surgical spending. Given that surgical care accounts for 30% of total health care costs, ACOs and policymakers must pay greater attention to reducing surgical expenditures. (Source: Annals of Surgery)
Source: Annals of Surgery - January 9, 2019 Category: Surgery Tags: FEATURES Source Type: research

Response to “ALPPS Versus Conventional Two-stage Hepatectomy in Patients With Advanced Colorectal Liver Metastases”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 19, 2018 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

ALPPS Versus Conventional Two-stage Hepatectomy in Patients With Advanced Colorectal Liver Metastases
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 19, 2018 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

MySurgeryRisk and Machine Learning: A Promising Start to Real-time Clinical Decision Support
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 19, 2018 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Response: Feedback Given to Surgeons Is a Useful Tool for Quality Improvement: Demystifying the “Sensitizing Surgeons to Their Outcome Has No Measurable Short-term Benefit”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 19, 2018 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Feedback Given to Surgeons Is a Useful Tool for Quality Improvement: Demystifying the “Sensitizing Surgeons to Their Outcome Has No Measurable Short-term Benefit”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 19, 2018 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Post Hoc Power: A Surgeon's First Assistant in Interpreting “Negative” Studies
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 19, 2018 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Post Hoc Power Calculation: Observing the Expected
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 19, 2018 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Letter to Editor: A Proposal to Mitigate the Consequences of Type 2 Error in Surgical Science
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 19, 2018 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Don’t Calculate Post-hoc Power Using Observed Estimate of Effect Size
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 19, 2018 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Response to: Managing the High-risk Pancreatic Anastomosis
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 19, 2018 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Prevention of Clinically-relevant Postoperative Pancreatic Fistula After Pancreticoduodenectomy
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 19, 2018 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Response “Surgeon Age in Relation to Prognosis After Esophageal Cancer Resection”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 19, 2018 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Surgeon Age in Relation to Prognosis After Esophageal Cancer Resection
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 19, 2018 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Transplantation Versus Resection for Hilar Cholangiocarcinoma: An Argument for Shifting Treatment Paradigms for Resectable Disease
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 19, 2018 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Reply to: “Decoding Tumor Biology of Colorectal Liver Metastases With Radiogenomics: A Novel Insight Into Surgical Approach Selection”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 19, 2018 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Decoding Tumor Biology of Colorectal Liver Metastases With Radiogenomics: A Novel Insight Into Surgical Approach Selection
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - December 19, 2018 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research