Adjuvant Chemotherapy Versus Observation Following Resection for Patients With Nonmetastatic Poorly Differentiated Colorectal Neuroendocrine Carcinomas
Objective: The aim of this study was to determine whether adjuvant chemotherapy (AC) provides a survival benefit in patients with nonmetastatic poorly differentiated colorectal neuroendocrine carcinomas (CRNECs) following resection. Background: There is little evidence to support the association between use of AC and improved overall survival (OS) in patients with CRNECs. Methods: Patients with resected non-metastatic CRNECs were identified in the National Cancer Database (2004–2014). Inverse probability of treatment weighting (IPTW) method was used to reduce the selection bias. IPTW-adjusted Kaplan...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Urethral Injury and Other Urologic Injuries During Transanal Total Mesorectal Excision: An International Collaborative Study
Conclusions: Urologic injuries result in substantial morbidity. Our survey indicated that those occurring in surgeons’ early experience might best be reduced by implementation of structured taTME training and proctoring, whereas those occurring later relate to case complexity and may be avoided by more stringent case selection. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Preoperative Sedative-hypnotic Medication Use and Adverse Postoperative Outcomes
Conclusions: Preoperative benzodiazepines and Z-drug use is common and associated with increased odds of adverse outcomes after surgery, particularly when coprescribed with opioids. Counseling on appropriate benzodiazepine and Z-drug use in advance of elective surgery may potentially increase the safety of surgical care. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Association of Surgical Resident Wellness With Medical Errors and Patient Outcomes
Conclusions: Although surgical residents with poor wellness were more likely to self-report a harmful medical error, there was not a higher rate of objectively reported outcomes for surgical patients treated at hospitals with higher rates of burnout or poor psychiatric well-being. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Comparing Nipple-sparing Mastectomy to Secondary Nipple Reconstruction: A Multi-institutional Study
Conclusions: Despite reports of superior aesthetics for NSM over simple mastectomy with nipple reconstruction in immediate IBBR, we found no significant differences at 2 years after reconstruction in patient satisfaction, quality-of-life, or complication rates. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Neoadjuvant Cytoreductive Treatment With BRAF/MEK Inhibition of Prior Unresectable Regionally Advanced Melanoma to Allow Complete Surgical Resection, REDUCTOR: A Prospective, Single-arm, Open-label Phase II Trial
Conclusions: This prospective, single-arm, open-label phase II trial, shows neoadjuvant dabrafenib plus trametinib as a potent cytoreductive treatment, allowing radical resection of metastases in 17/21 (81%) patients with prior unresectable locally advanced melanoma. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Long-term Survival of 10,116 Korean Live Liver Donors
Objective: To evaluate the long-term mortality of Korean live liver donors using data from a national donor registry by comparing it with the mortality of the general population. Summary of Background Data: Although live liver donors generally have a healthy status, their long-term mortality has not been properly addressed in a large donor registry. Methods: Data of 10,116 live liver donors were drawn from a mandated national registry of Korean live liver donors between 2000 and 2015. Matched controls were selected from the Korean National Health Insurance System-National Sample Cohort (NHIS-NSC). Median ...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Outcomes Following an Index Emergency Admission With Cholecystitis: A National Cohort Study
The objective of this study was to evaluate the differences between patients who undergo cholecystectomy following index admission for cholecystitis, and those who are managed nonoperatively. Summary Background Data: Index emergency cholecystectomy following acute cholecystitis is widely recommended by national guidelines, but its effect on clinical outcomes remains uncertain. Methods: Data collected routinely from the Hospital Episode Statistics database (all admissions to National Health Service organizations in England and Wales) were extracted between April 1, 2002 and March 31, 2015. Analyses were limite...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Local Recurrence After Transanal Total Mesorectal Excision for Rectal Cancer: A Multicenter Cohort Study
Conclusions and Relevance: This study shows good loco regional control after TaTME in selected cases from tertiary referral centers and does not indicate an inherent oncological risk of the surgical technique. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

New Ileostomy Formation and Subsequent Community-onset Acute and Chronic Kidney Disease: A Population-based Cohort Study
Conclusions: Ileostomy formation is strongly associated with subsequent kidney disease. Vigilance for this complication and new strategies for prevention and treatment are necessary. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Clinical and Genetic Factors Impact Time to Surgical Recurrence After Ileocolectomy for Crohn's Disease
Conclusions: Ileocolonic distribution of disease and the rs2066844 SNP in NOD2 are associated with shorter time to recurrent ileocolectomy. The initiation of postoperative biologics in naïve patients was associated with a reduced incidence of recurrence over time. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Prediction of Suicide and Nonfatal Self-harm After Bariatric Surgery: A Risk Score Based on Sociodemographic Factors, Lifestyle Behavior, and Mental Health: A Nonrandomized Controlled Trial
Conclusions: Our findings suggest that male sex, psychiatric disorder history, and sleep difficulties are important predictors for nonfatal self-harm and suicide in postbariatric patients. High-risk patients who undergo surgery might require regular postoperative psychosocial monitoring to reduce the risk for future self-harm behaviors. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

True Short Esophagus in Gastroesophageal Reflux Disease: Old Controversies With New Perspectives
Objective: To explore the true short esophagus (TSE) frequency and long-term results of patients undergoing gastroesophageal reflux disease (GERD) or hiatus hernia (HH) surgery. Background: The existence and treatment of TSE during GERD/HH surgery is controversial. Satisfactory long-term results have been achieved with and without surgical techniques dedicated to TSE. Methods: In 311 consecutive patients undergoing minimally invasive surgery for GERD/HH, the distance between the endoscopically-localized gastroesophageal junction (GEJ) and the apex of the diaphragmatic hiatus after maximal thoracic esophag...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Comparing Perioperative Mortality and Morbidity of Minimally Invasive Esophagectomy Versus Open Esophagectomy for Esophageal Cancer: A Nationwide Retrospective Analysis
Objective: We compared the surgical outcomes of minimally invasive esophagectomy (MIE) and open esophagectomy (OE) for esophageal cancer. Summary Background Data: MIE has become a widespread procedure. However, the definitive advantages of MIE over OE at a nationwide level have not been established. Methods: We analyzed patients who underwent esophagectomy for clinical stage 0 to III esophageal cancer from April 2014 to March 2017 using a Japanese inpatient database. We performed propensity score matching to compare in-hospital mortality and morbidities between MIE and OE, accounting for clustering of pat...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Coaching as a Mechanism to Challenge Surgical Professional Identities
Conclusions: Participation in a coaching program challenged how surgeons thought of themselves in relationship to social and peer expectations. Our results indicate that surgeons do feel peer and social pressures related to identity but are much more complex and nuanced than has been previously discussed. The safe space of intentional coaching allowed participants to practice vulnerability without the pressures of sometimes caustic professional norms. Participants in this study viewed coaching as the way to improve the culture of surgery. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Simulated Volume-Based Regionalization of Complex Procedures: Impact on Spatial Access to Care
This study simulates the regionalization of pancreatectomies to assess its impact on spatial access in terms of patient driving times. Background: Although policies to regionalize complex procedures to high-volume centers may improve outcomes, the impact on patient access is unknown. Methods: Patients who underwent pancreatectomies from 2005 to 2014 were identified from California's statewide database. Round-trip driving times between patients’ home ZIP code and hospital addresses were calculated via Google Maps. Regionalization was simulated by eliminating hospitals performing (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

A Quantitative Analysis of Surgical Smoke Exposure as an Occupational Hazard
Objective: We hypothesized that OR airborne PM was different in quantity and mutagenic potential than office air and cigarette smoke. Summary of Background Data: Exposure to surgical smoke has been equated to cigarette smoking and thought to be hazardous to health care workers despite limited data. Methods: PM was measured during 15 operations in ORs with 24.8 ± 2.0 air changes/h, and in controls (cigarettes, office air with 1.9–2.9 air changes/h). Mutagenic potential was assessed by gamma Histone 2A family member X staining of DNA damage in small airway epithelial cells co-cultured with ...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Prevention of Firearm Violence Through Specific Types of Community-based Programming: An Eastern Association for the Surgery of Trauma Evidence-based Review
Conclusions: Gun violence may be mitigated by community-based efforts, such as gun buybacks or violence prevention programs. These programs come with caveats, notably community cultural relevance and proper support and funding from local leadership. Level of Evidence: Review, Decision, level III. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: REVIEW PAPERS Source Type: research

Postoperative Work and Activity Restrictions After Abdominal Surgery: A Systematic Review
Conclusions: This systematic review identified gaps in our understanding of what is best for patients recovering from abdominal surgery. Randomized controlled trials are crucial in safely optimizing the recovery period. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: REVIEW PAPERS Source Type: research

A Systematic Review and Meta-analysis on the Impact of Proficiency-based Progression Simulation Training on Performance Outcomes
Objective: To analyze all published prospective, randomized, and blinded clinical studies on the proficiency-based progression (PBP) training using objective performance metrics. Background: The benefit of PBP methodology to learning clinical skills in comparison to conventional training is not settled. Methods: Search of PubMed, Cochrane library's Central, EMBASE, MEDLINE, and Scopus databases, from inception to 1st March 2020. Two independent reviewers extracted the data. The Medical Education Research Study Quality Instrument (MERSQI) was used to assess the methodological quality of included studies. R...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: META-ANALYSES Source Type: research

Types, Safety, and Efficacy of Limb Distalization for Inadequate Weight Loss After Roux-en-Y Gastric Bypass: A Systematic Review and Meta-analysis With a Call for Standardized Terminology
Conclusions: LD has an encouraging rate of resolution of comorbidities. A judicious patient selection is essential for better weight loss after LD. Type I LD with total alimentary limb length ≥350 cm was associated with less risk of malnutrition. PEM is a life-threatening complication that may require revisional surgery years after LD. Future studies on LD, adopting standardized surgical practice and terminology, will allow a more conclusive assessment of the outcome of the procedure. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: META-ANALYSES Source Type: research

Art Heals: Randomized Controlled Study Investigating the Effect of a Dedicated In-house Art Gallery on the Recovery of Patients After Major Oncologic Surgery
Introduction: We sought to investigate the effect of exposure to a dedicated art gallery during the perioperative period on the recovery of patients undergoing major oncologic procedures. Methods: Eighty patients were randomized into 2 arms; standard of care versus exposure to art. All patients completed a survey assessing their baseline art knowledge, and 4 poststudy validated questionnaires assessing their pain (Pain Rating Scale), hope (Herth Hope Index), anxiety (State-Trait Anxiety Inventory for Adults), and mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale). A linear model adjusted for baseline sc...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Immediate Oral Refeeding in Patients With Mild and Moderate Acute Pancreatitis: A Multicenter, Randomized Controlled Trial (PADI trial)
Objective: To establish the optimal time to start oral refeeding in mild and moderate acute pancreatitis (AP) to reduce hospital length-of-stay (LOS) and complications. Summary Background Data: Oral diet is essential in mild and moderate AP. The greatest benefits are obtained if refeeding starts early; however, the definition of “early” remains controversial. Methods: This multicenter, randomized, controlled trial (NCT03829085) included patients with a diagnosis of mild or moderate AP admitted consecutively to 4 hospitals from 2017 to 2019. Patients were randomized into 2 treatment groups: imm...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

A Randomized Phase II Trial of Adjuvant Hepatic Arterial Infusion and Systemic Therapy With or Without Panitumumab After Hepatic Resection of KRAS Wild-type Colorectal Cancer
Conclusions: The addition of Pmab to HAI FUDR + SYS FOLFIRI showed promising activity without increased biliary toxicity and should be further investigated in a larger trial. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

A Randomized Clinical Trial Evaluating the Efficacy and Quality of Life of Antibiotic-only Treatment of Acute Uncomplicated Appendicitis: Results of the COMMA Trial
Objective: Evaluate the efficacy and quality of life associated with conservative treatment of acute uncomplicated appendicitis. Summary background data: Conservative management with antibiotics only has emerged as a potential treatment option for acute uncomplicated appendicitis. However the reported failure rates are highly variable and there is a paucity of data in relation to quality of life. Methods: Symptomatic patients with radiological evidence of acute, uncomplicated appendicitis were randomized to either intravenous antibiotics only or undergo appendectomy. Results: One hundred eighty-six...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Tracheostomy for COVID-19 Respiratory Failure: Multidisciplinary, Multicenter Data on Timing, Technique, and Outcomes
Conclusion: Early, percutaneous tracheostomy was associated with improved outcomes compared to surgical tracheostomy in a multi-institutional series of ventilated patients with COVID-19. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: COVID-19 Source Type: research

Black Medical Student Considerations in the Era of Virtual Interviews
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Commentary on “Hotel Room #1438”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Hotel Room #1438
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Board Certification – A Remnant of Days Past or Reflection of a Commitment to Lifelong Learning and Professionalism?
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: FEATURES Source Type: research

Is Initial Board Certification Associated With Better Early Career Surgical Outcomes?
Conclusion: Patients undergoing partial colectomy by an early career general surgeon have decreased odds of severe complications and death when their surgeon is board certified. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: FEATURES Source Type: research

Gentrification in America – The Potential Deadly Consequences
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: FEATURES Source Type: research

Firearm Violence, Access to Care, and Gentrification: A Moving Target for American Trauma Systems
Objective: We aimed to determine whether gentrification predicts the movement of shooting victims over time and if this process has decreased access to care. Background: Trauma centers remain fixed in space, but the populations they serve do not. Nationally, gentrification has displaced disadvantaged communities most at risk for violent injury, potentially decreasing access to care. This process has not been studied, but an increase of only 1 mile from a trauma center increases shooting mortality up to 22%. Methods: We performed a cross-sectional study utilizing Philadelphia Police Department (PPD) and Pe...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: FEATURES Source Type: research

Implementation of Enhanced Recovery Pathways in the Real World: Change is Hard
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: FEATURES Source Type: research

Clinical and Economic Outcomes of Enhanced Recovery Dissemination in Michigan Hospitals
Objective: To evaluate real-world effects of enhanced recovery protocol (ERP) dissemination on clinical and economic outcomes after colectomy. Summary Background Data: Hospitals aiming to accelerate discharge and reduce spending after surgery are increasingly adopting perioperative ERPs. Despite their efficacy in specialty institutions, most studies have lacked adequate control groups and diverse hospital settings and have considered only in-hospital costs. There remain concerns that accelerated discharge might incur unintended consequences. Methods: Retrospective, population-based cohort including patien...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: FEATURES Source Type: research

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