Clinical Judgment and Experience Remain Critical Factors in the Safety of Minimally Invasive Adrenalectomy: Commentary on “Outpatient Adrenalectomy: A Framework for Assessment and Institutional Protocol”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Outpatient Adrenalectomy: A Framework for Assessment and Institutional Protocol
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Commentary on Balci et al “RAPID in Cirrhosis: Watch Out for Blood Flow!”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Left Lobe Living Donor Liver Transplantation Using Rapid Procedure in a Cirrhotic Patient With Portal Vein Thrombosis
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Invited Commentary: “Robotic Airway Resection Under Spontaneous Ventilation”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Nonintubated Robotic-assisted Thoracic Surgery for Tracheal/Airway Resection and Reconstruction: Technique Description and Preliminary Results
Conclusion: This is the first report on RATS use in tracheal/airway surgery, in combination with nonintubation spontaneous ventilation. In selected patients, this novel combined approach is feasible and safe. A patient can potentially benefit from the combined advantages of both techniques. More cases and longer-term data are required to establish its role in tracheal/airway surgery. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

A Prospective Audit of 805 Consecutive Patients With Penetrating Abdominal Trauma: Evolving Beyond Injury Mechanism Dictating Management
Background: Global trends of penetrating abdominal trauma (PAT) have seen a shift toward a selectively conservative management strategy. However, its widespread adoption for gunshot injuries has been sluggish. The purpose of this study is to compare the injury mechanisms of gunshot (GSW) and stab wounds (SW) to the abdomen in presentation, management, and outcomes. Methods: Prospective cohort study, set in Cape Town, South Africa, over 2 years. All patients presenting to the center with PAT during this time were included. Presentation, management, and outcomes were compared by injury mechanism, with a focus on t...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Prospective Observational Evaluation of the ER-REBOA Catheter at 6 U.S. Trauma Centers
Conclusion: REBOA can be used in blunt and penetrating trauma patients, including those in arrest. Balloon inflation uniformly improved hemodynamics and was associated with a 59% rate of return of spontaneous circulation for patients in arrest. Use of the ER-REBOA catheter is technically safe with a low procedural complication rate. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Outcomes and Health Care Utilization After Early Hospital Dismissal in Kidney Transplantation: An Analysis of 1001 Consecutive Cases
Objective: To understand whether reduced lengths of stay after kidney transplantation were associated with excess health care utilization in the first 90 days or long-term graft and patient survival outcomes. Background: Reducing length of stay after kidney transplant has an unknown effect on post-transplant health care utilization. We studied this association in a cohort of 1001 consecutive kidney transplants. Methods: We retrospectively reviewed 2011–2015 data from a prospectively-maintained kidney transplant database from a single center. Results: A total of 1001 patients underwent kidney ...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Intestinal Oxygenation and Survival After Surgery for Necrotizing Enterocolitis: An Observational Cohort Study
Objective: To assess whether regional intestinal oxygen saturation (rintSO2) and regional cerebral oxygen saturation (rcSO2) measurements aid in estimating survival of preterm infants after surgery for NEC. Summary of Background Data: Predicting survival after surgery for NEC is difficult yet of the utmost importance for counseling parents. Methods: We retrospectively studied prospectively collected data of preterm infants with surgical NEC who had available rintSO2 and rcSO2 values measured via near-infrared spectroscopy 0–24 hours preoperatively. We calculated mean rintSO2 and rcSO2 for 60&ndash...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Recent Modifications of the Nuss Procedure: The Pursuit of Safety During the Minimally Invasive Repair of Pectus Excavatum
Conclusions: A standardized Nuss procedure was performed by multiple surgeons in 1034 patients with good overall safety and results in primary repairs. Vacuum bell treatment is useful. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

The Risk of Incarceration During Nonoperative Management of Incisional Hernias: A Population-based Analysis of 30,998 Patients
Conclusions: Incarceration is an uncommon complication of NOM but is associated with a significant risk of death. Tailored decision making for elective repair and considering the aforementioned risk factors for incarceration provides an initial step toward mitigating the excess morbidity and mortality of an incarceration event. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Clinical Presentation, Treatment, and Outcome of Parathyroid Carcinoma: Results of the NEKAR Retrospective International Multicenter Study
Objective: In this retrospective cohort study, we describe the clinical presentation and workup of parathyroid carcinoma (PC) and determine its clinical prognostic parameters. Primary outcome was recurrence free survival. Summary Background Data: PC is an orphan malignancy for which diagnostic workup and treatment is not established. Methods: Eighty-three patients were diagnosed with PC between 1986 and 2018. Disease-specific and recurrence-free survivals were estimated with the Kaplan-Meier method. Risk factors for recurrence were identified by binary logistic regression with adjustment for age and sex. ...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Associations Between Physician Prescribing Behavior and Persistent Postoperative Opioid Use Among Cancer Patients Undergoing Curative-intent Surgery: A Population-based Cohort Study
This study aimed to evaluate the association between prescribers’ opioid prescribing history and persistent postoperative opioid use in cancer patients undergoing curative-intent surgery. Background: Study has shown that patients may be over-prescribed analgesics after surgery. However, whether and how the prescriber's opioid prescribing behavior impacts persistent opioid use is unclear. Methods: All adults with a diagnosis of solid cancers who underwent surgery during the study period (2009–2015) in Alberta, Canada and were opioid-naïve were included. The key exposure was the historical opio...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

The Fistula Risk Score Catalog: Toward Precision Medicine for Pancreatic Fistula After Pancreatoduodenectomy
This study aims to present a full spectrum of individual patient presentations of pancreatic fistula risk, and to define the utility of mitigation strategies amongst some of the most prevalent, and vulnerable scenarios surgeons encounter. Background: The FRS has been utilized to identify technical strategies associated with reduced CR-POPF incidence across various risk strata. However, risk-stratification using the FRS has never been investigated with greater granularity. By deriving all possible combinations of FRS elements, individualized risk assessment could be utilized for precision medicine purposes. Method...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Molecular Patterns in Acute Pancreatitis Reflect Generalizable Endotypes of the Host Response to Systemic Injury in Humans
Conclusions: Our results show that molecular endotypes exist in AP and reflect biological patterns that are also present in ARDS, suggesting that generalizable patterns exist in diverse presentations of critical illness. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Expression Patterns and Prognostic Value of DNA Damage Repair Proteins in Resected Pancreatic Neuroendocrine Neoplasms
This study aimed to examine the expression profiles and prognostic value of multiple DDR proteins in resected PanNENs. Background: DDR proteins play important roles in various cancers, including pancreatic ductal adenocarcinoma. However, the expression patterns and prognostic value of DDR proteins in PanNENs remain unclear. Methods: This retrospective analysis included PanNEN patients who underwent resection at the Fudan University Shanghai Cancer Center from 2012 to 2018. Immunohistochemical staining was performed for 12 DDR proteins in tissue microarrays. The associations of DDR protein expression and clini...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Outcomes of Robotic Living Donor Right Hepatectomy From 52 Consecutive Cases: Comparison With Open and Laparoscopy-assisted Donor Hepatectomy
Objective: To investigate the feasibility and safety of RLDRH Summary of Background Data: Data for minimally invasive living-donor right hepatectomy, especially RLDRH, from a relatively large donor cohort that have not been reported yet. Methods: From March 2016 to March 2019, 52 liver donors underwent RLDRH. The clinical and perioperative outcomes of RLDRH were compared with those of CODRH (n = 62) and LADRH (n = 118). Donor satisfaction with cosmetic results was compared between RLDRH and LADRH using a body image questionnaire. Results: Although RLDRH was associated with longer operative time (mi...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Perioperative Complications After Proctectomy for Rectal Cancer: Does Neoadjuvant Regimen Matter?
Objective: Investigate the association between neoadjuvant treatment strategy and perioperative complications in patients undergoing proctectomy for nonmetastatic rectal cancer. Summary of Background Data: Neoadjuvant SC-TNT is an alternative to neoadjuvant CRT for rectal cancer. Some have argued that short-course radiation and extended radiation-to-surgery intervals increase operative difficulty and complication risk. However, the association between SC-TNT and surgical complications has not been previously investigated. Methods: This single-center retrospective cohort study included patients undergoing ...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Oncological Outcomes After Anastomotic Leakage After Surgery for Colon or Rectal Cancer: Increased Risk of Local Recurrence
Conclusion: Short-term morbidity, mortality, and long-term oncological outcomes are negatively influenced by the occurrence of anastomotic leakage after rectal cancer surgery. For colon cancer, no significant effect was observed; however, due to low power, no conclusions on the influence of anastomotic leakage on outcomes after colon surgery could be reached. Clinical awareness of increased risk of local recurrence after anastomotic leakage throughout the follow-up is mandatory. Trial Registration: Registered with ClinicalTrials.gov, number NCT00387842 and NCT00297791. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Validation of the Adapted Clavien-Dindo in Trauma (ACDiT) Classifications in Medical and Surgical Management of Acute Diverticulitis
Objectives: To validate the adapted Clavien-Dindo in trauma (ACDiT) tool as a novel outcome measure for patients with acute diverticulitis managed both operatively and nonoperatively. Background: Complications following diverticulitis are difficult to classify because no traditional tools address patients managed both operatively and nonoperatively. The ACDiT grading system—graded from 0 to 5b—is applied in this manner but has not yet been validated for this patient group. Methods: We performed a 5-year observational study of patients with acute diverticulitis at a safety-net hospital. Baselin...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Risk Factors for Suicide After Bariatric Surgery in a Population-based Nationwide Study in Five Nordic Countries
Conclusions: Although the risk of suicide is low, psychiatric disorders, male sex, and gastric bypass procedure seem to increase the risk of suicide after bariatric surgery, indicating a role for tailored preoperative psychiatric evaluation and postoperative surveillance. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

A 4-tier Protocolized Radiological Classification System for Leaks Following Sleeve Gastrectomy
Objectives: To develop and validate a classification of sleeve gastrectomy leaks able to reliably predict outcomes, from protocolized computed tomography (CT) findings and readily available variables. Summary of Background Data: Leaks post sleeve gastrectomy remain morbid and resource-consuming. Incidence, treatments, and outcomes are variable, representing heterogeneity of the problem. A predictive tool available at presentation would aid management and predict outcomes. Methods: From a prospective database (2009–2018) we reviewed patients with staple line leaks. A Delphi process was undertaken on ...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Lasting Symptoms After Esophageal Resection (LASER): European Multicenter Cross-sectional Study
Conclusion: Two-thirds of patients experience significant symptoms more than 1 year after surgery. The 3 key symptoms associated with poor HRQOL identified in this study should be further validated, and could be used in clinical practice to identify patients who require increased support. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Rates of Anastomotic Complications and Their Management Following Esophagectomy: Results of the Oesophago-Gastric Anastomosis Audit (OGAA)
This study aimed to characterize rates and management of anastomotic leak (AL) and conduit necrosis (CN) after esophagectomy in an international cohort. Background: Outcomes in patients with anastomotic complications of esophagectomy are currently uncertain. Optimum strategies to manage AL/CN are unknown, and have not been assessed in an international cohort. Methods: This prospective multicenter cohort study included patients undergoing esophagectomy for esophageal cancer between April 2018 and December 2018 (with 90 days of follow-up). The primary outcomes were AL and CN, as defined by the Esophageal Compli...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Hospital Costs Following Surgical Complications: A Value-driven Outcomes Analysis of Cost Savings Due to Complication Prevention
Objective: Surgical complications have substantial impact on healthcare costs. We propose an analysis of the financial impact of postoperative complications. Summary of Background Data: Both complications and preoperative patient risk have been shown to increase costs following surgery. The extent of cost increase due to specific complications has not been well described. Methods: A single institution's American College of Surgeons National Surgical Quality Improvement Program data was queried from 2012 to 2018 and merged with institutional cost data for each encounter. A mixed effects multivariable gener...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Increased Intraoperative Faculty Entrustment and Resident Entrustability Does Not Compromise Patient Outcomes After General Surgery Procedures
Conclusions: OpTrust, an educational intervention to increase faculty entrustment and resident entrustability, does not compromise postoperative patient outcomes. Integrating faculty and resident development to further enhance entrustment and entrustability through OpTrust may help facilitate increased resident autonomy within the safety net of surgical training without negatively impacting clinical outcomes. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Comparing Clinician Consensus Recommendations to Patient-reported Opioid Use Across Multiple Hospital Systems
Conclusions: Although consensus recommendations were an important first step to address opioid prescribing, our data suggests that following these recommendations would result in 47%–56% of pills prescribed remaining unused. Future multi-institutional efforts should be directed toward refining and personalizing prescribing recommendations. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Measuring and Improving Emotional Intelligence in Surgery: A Systematic Review
Conclusions: The literature entailing the intersection between EI and surgery is diverse but still limited. Generally, EI has been demonstrated to be beneficial in terms of overall well-being and job satisfaction while also protecting against burnout. EI skills may provide a promising modifiable target to achieve desirable outcomes for both the surgeon and the patient. Future studies may emphasize the relevance of EI in the context of surgical teamwork. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: REVIEW PAPERS Source Type: research

Use of Feedback Data to Reduce Surgical Site Infections and Optimize Antibiotic Use in Surgery: A Systematic Scoping Review
Conclusions: Our findings highlight the need to provide feedback to all levels of perioperative care providers involved in patient care. Future research in this area should report implementation parameters in more detail. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: REVIEW PAPERS Source Type: research

Facilitating Success of the Early Stage Surgeon Scientist Trainee: Growing the Surgeon Scientist Pipeline
Conclusions: This guidance enhances awareness of essential education, communication, infrastructure, resources, and advocacy by surgery leaders and other stakeholders to promote quality research training in residency and to re-invigorate the surgeon scientist pipeline. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: REVIEW PAPERS Source Type: research

Outcomes of Saphenous Vein Intervention in the Management of Superficial Venous Incompetence: A Systematic Review and Network Meta-analysis
Conclusions: Although CAE offered the lowest risk of initial procedural failure, HLS resulted in lower rates of long-term recurrence without considerably increasing morbidity when compared with other endovenous options. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: META-ANALYSES Source Type: research

Efficacy and Safety of Migraine Surgery: A Systematic Review and Meta-analysis of Outcomes and Complication Rates
The objectives of this study are to assess the efficacy and safety of peripheral nerve surgery for migraine headaches and to bibliometrically analyze all anatomical studies relevant to migraine surgery. Summary Background Data: Migraines rank as the second leading cause of disability worldwide. Despite the availability of conservative management options, individuals suffer from refractive migraines which are associated with poor quality of life. Migraine surgery, defined as the peripheral nerve decompression/trigger site deactivation, is a relatively novel treatment strategy for refractory migraines. Methods: ...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: META-ANALYSES Source Type: research

Early Drain Removal is Safe in Patients With Low or Intermediate Risk of Pancreatic Fistula After Pancreaticoduodenectomy: A Multicenter, Randomized Controlled Trial
Conclusions: Nearly half of the patients undergoing PD met the inclusion criteria, predicting low incidence of grade B/C POPF and major complications. EDR was safe in these patients but did not significantly decrease major complications. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Effects of Community-based Exercise Prehabilitation for Patients Scheduled for Colorectal Surgery With High Risk for Postoperative Complications: Results of a Randomized Clinical Trial
Objective: To assess the effects of a 3-week community-based exercise program on 30-day postoperative complications in high-risk patients scheduled for elective colorectal resection for (pre)malignancy. Summary Background Data: Patients with a low preoperative aerobic fitness undergoing colorectal surgery have an increased risk of postoperative complications. It remains, however, to be demonstrated whether prehabilitation in these patients reduces postoperative complications. Methods: This 2-center, prospective, single-blinded randomized clinical trial was carried out in 2 large teaching hospitals in the ...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

NPWT Resource Use Compared With Conventional Wound Treatment in Subcutaneous Abdominal Wounds With Healing Impairment After Surgery: SAWHI Randomized Clinical Trial Results
Objective: To compare resource utilization of NPWT and CWT for SAWHI after surgery Summary of Background Data: NPWT is widely used in the management of complex wounds but high-level evidence of its resource use remains sparse. Methods: The multicenter, multinational, randomized clinical SAWHI study enrolled a total of 539 consecutive, compliant adult patients with SAWHI after surgery without fascial dehiscence between August 2, 2011, and January 31, 2018. Patients were randomly assigned to NPWT and CWT stratified by study site and wound size using a centralized web-based tool. Evaluation of direct resourc...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

New Persistent Opioid Use After Surgery: A Risk Factor for Opioid Use Disorder?
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Surgery and Population Health: Closing the Gap Between Margin and Mission
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Using Social Science Theory Can Change How the Patient Experience Is Viewed in Surgical Care
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Looking Beyond Perioperative Morbidity and Mortality as Measures of Surgical Quality
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Extending Trauma Quality Improvement Beyond Trauma Centers: Hospital Variation in Outcomes Among Nontrauma Hospitals
Conclusions: Wide variation in trauma outcomes exists across nontrauma hospitals. Efforts to improve trauma quality should include engagement of nontrauma hospitals to reduce variation in outcomes of injured patients treated at those facilities. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

The Beirut Port Explosion Injuries and Lessons Learned: Results of the Beirut Blast Assessment for Surgical Services (BASS) Multicenter Study
Objective: This multicenter study aims to describe the injury patterns, emergency management and outcomes of the blast victims, recognize the gaps in hospital disaster preparedness, and identify lessons to be learned. Summary Background Data: On August 4th, 2020, the city of Beirut, Lebanon suffered the largest urban explosion since Hiroshima and Nagasaki, resulting in hundreds of deaths and thousands of injuries. Methods: All injured patients admitted to four of the largest Beirut hospitals within 72 hours of the blast, including those who died on arrival or in the emergency department (ED), were inclu...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

A Combination of Biochemical and Pathological Parameters Improves Prediction of Postresection Survival After Preoperative Chemotherapy in Pancreatic Cancer: The PANAMA-score
Objective: To build a prognostic score for patients with primary chemotherapy undergoing surgery for pancreatic cancer based on pathological parameters and preoperative Carbohydrate antigen 19-9 (CA19-9) levels. Background: Prognostic stratification after primary chemotherapy for pancreatic cancer is challenging and prediction models, such as the AJCC staging system, lack validation in the setting of preoperative chemotherapy. Methods: Patients with primary chemotherapy resected at the Massachusetts General Hospital between 2007 and 2017 were analyzed. Tumor characteristics independently associated with o...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Combined Vascular Resection for Locally Advanced Perihilar Cholangiocarcinoma
Objective: To evaluate the efficacy and safety of combined vascular resection (VR) in advanced perihilar cholangiocarcinoma (PHC). Summary of Background Data: Hepatectomy combined with portal vein resection (PVR) and/or hepatic artery resection (HAR) is technically demanding but an option only for tumor eradication against PHC involving the hilar hepatic inflow vessels; however, its efficacy and safety have not been well evaluated. Methods: Patients diagnosed with PHC during 2001–2018 were included. Patients who underwent resection were divided according to combined VR. Patients undergoing VR were s...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Genomic Stratification of Resectable Colorectal Liver Metastasis Patients and Implications for Adjuvant Therapy and Survival
Conclusions: Genomic alterations in RAS/RAF, SMAD4, and EGFR may be useful to guide treatment selection in resectable CRLM patients and warrant external validation and integration in future clinical trial design. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

National Variation in Elective Colon Resection for Diverticular Disease
Conclusion: We observed pronounced variation (excess of 3-fold) in standardized colon resection ratios for recurrent diverticulitis. Surgeon density and hospital level factors were strongly associated with this variation and may be the main drivers of colonic resection for diverticular disease. Further investigation and stronger national guidelines are needed to optimize patient selection for colectomy. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Relationship Between Health Care Spending and Clinical Outcomes in Bariatric Surgery: Implications for Medicare Bundled Payments
Objective: To evaluate sources of 90-day episode spending variation in Medicare patients undergoing bariatric surgery and whether spending variation was related to quality of care. Summary of Background Data: Medicare's bundled payments for care improvement-advanced program includes the first large-scale episodic bundling program for bariatric surgery. This voluntary program will pay bariatric programs a bonus if 90-day spending after surgery falls below a predetermined target. It is unclear what share of bariatric episode spending may be due to unnecessary variation and thus modifiable through care improvement....
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

The Impact of Adjuvant Therapy on Survival After Esophagectomy for Node-negative Esophageal Adenocarcinoma
Conclusion: In this analysis, adjuvant chemotherapy with or without radiation was not associated with a significant survival benefit in completely resected, pathologically node-negative distal esophageal adenocarcinoma, independent of presence of high risk characteristics. The risks and benefits of adjuvant therapy should be weighed before offering it to patients with completely resected pT2-4aN0M0 esophageal adenocarcinoma. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Geographic Variation in the Utilization of and Mortality After Emergency General Surgery Operations in the Northeastern and Southeastern United States
Objective: To define geographic variations in emergency general surgery (EGS) care, we sought to determine how much variability exists in the rates of EGS operations and subsequent mortality in the Northeastern and Southeastern United States (US). Summary Background Data: While some geographic variations in healthcare are normal, unwarranted variations raise questions about the quality, appropriateness, and cost-effectiveness of care in different areas. Methods: Patients ≥18 years who underwent 1 of 10 common EGS operations were identified using the State Inpatient Databases (2011–2012) for 6 sta...
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Aligning Patient Acuity With Resource Intensity After Major Surgery: A Scoping Review
Conclusion: To optimize value, postoperative resource intensity decisions should align with precise, data-driven patient acuity assessments augmented by models that accurately represent complex, non-linear relationships among risk factors. (Source: Annals of Surgery)
Source: Annals of Surgery - January 11, 2022 Category: Surgery Tags: REVIEW PAPERS Source Type: research